BACKGROUND Depression has gradually become a common psychological disorder among children and adolescents.Depression in children and adolescents affects their physical and mental development.Psychotherapy is considere...BACKGROUND Depression has gradually become a common psychological disorder among children and adolescents.Depression in children and adolescents affects their physical and mental development.Psychotherapy is considered to be one of the main treatment options for depressed children and adolescents.However,our understanding of the global performance and progress of psychological interventions for depression in children and adolescents(PIDCA)research is limited.AIM To identify collaborative research networks in this field and explore the current research status and hotspots through bibliometrics.METHODS Articles and reviews related to PIDCA from January 2010 to April 2023 were identified from the Web of Science Core Collection database.The Charticulator website,CiteSpace and VOSviewer software were used to visualize the trends in publications and citations,the collaborative research networks(countries,institutions,and authors),and the current research status and hotspots.RESULTS Until April 16,2023,1482 publications were identified.The number of documents published each year and citations had increased rapidly in this field.The United States had the highest productivity in this field.The most prolific institution was the University of London.Pim Cuijpers was the most prolific author.In the context of research related to PIDCA,both reference co-citation analysis and keywords co-occurrence analysis identified 10 research hotspots,including thirdwave cognitive behavior therapy,short-term psychoanalytic psychotherapy,cognitive behavioral analysis system of psychotherapy,family element in psychotherapy,modular treatment,mobile-health,emotion-regulation-based transdiagnostic intervention program,dementia risk in later life,predictors of the efficacy of psychological intervention,and risks of psychological intervention.CONCLUSION This bibliometric study provides a comprehensive overview of PIDCA from 2010 to present.Psychological intervention characterized as psychological-process-focused,short,family-involved,modular,internet-based,emotionregulation-based,and personalized may benefit more young people.展开更多
Objective:Factors influencing school adaptation of school-aged children include both executive function(EF)and parent–child interaction.This study aims to investigate the developmental trajectory of mother–child int...Objective:Factors influencing school adaptation of school-aged children include both executive function(EF)and parent–child interaction.This study aims to investigate the developmental trajectory of mother–child interaction longitudinally using latent growth model analysis.Methods:A longitudinal descriptive survey study was conducted.The par ticipants comprised of 1,614 mothers and school-aged children,who participated in the Panel Study on Korean Children(6 th–8 th panel surveys).A model was designed and analyzed using latent growth modeling to estimate the pattern of change over time.Results:In the group where the maternal depression was within the normal range,only the path by which the change rate of mother–child interaction affected school adaptation of children was statistically nonsignificant(t=1.007,p=0.314).In the group where maternal depression was mild or higher,only the paths by which the initial value of mother–child interaction affected EF difficulty(t=-2.75,p=0.032)and EF difficulty affected school adaptation(t=-7.876,p<0.001)were statistically significant.Conclusions:This study confirms the research models developed by dividing mother–child interaction into two groups according to depression levels(i.e.,normal range and mild or higher-level depression).The findings provide a basis for construction of individualized interventions.展开更多
Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines stil...Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.展开更多
The concept of Multidisciplinary approach is not new to Medical Science. It is an evolving concept that is widely appreciated and adopted in most of the disciplines of medicine. It’s rational and applicable in the ma...The concept of Multidisciplinary approach is not new to Medical Science. It is an evolving concept that is widely appreciated and adopted in most of the disciplines of medicine. It’s rational and applicable in the management of Child and Adolescent Depression,which needs to be revisited focusing on the interplay of various contextual factors that are entwined and tend to affect the course of the illness. The limitations of any one mental health professional in envisioning all possible dimensions of Child and Adolescent Depression make this approach all the more important wherein Psychiatrists, Clinical Psychologists, Psychiatric Social Workers collaborate with each other and other allied professionals in the treatment and management of the disorder. India, being a heavily populated country, where multidisciplinary management approach is in a phase of expansion and is practiced in many leading institutes to meet the quality needs of patients. This article focuses on the Indian scene of multidisciplinary management approach in child and adolescent depression.展开更多
This study aimed to elaborate on theoretical model of the perceptions, feelings, and meanings of early stress for people with depression. To perform a qualitative study based on the Symbolic Interactionism and Grounde...This study aimed to elaborate on theoretical model of the perceptions, feelings, and meanings of early stress for people with depression. To perform a qualitative study based on the Symbolic Interactionism and Grounded Theory, we interviewed 12 patients diagnosed with depression. It was structured a model based on “walking between traumatic childhood and the adult life with depression,” integrating eight inter-articulated categories that represent the perceptions, feelings, and meanings of the experiences of the depressed individual with a history of early stress. The theoretical model constructed meanings and conditions that affect the individual from a traumatic childhood to depression in adulthood.展开更多
The number of deaths caused by child abuse is increasing, which is one of social concerns. The mental health of mothers might be related to child abuse. The aim of this study was to examine and compare the mental stat...The number of deaths caused by child abuse is increasing, which is one of social concerns. The mental health of mothers might be related to child abuse. The aim of this study was to examine and compare the mental state of mothers in both the antepartum and postpartum period assessed by the Edinburgh Postnatal Depression Scale (EPDS) and Mother-Infant-Bonding-Scale (MIBS), and compare the results. Participants (n = 134) were recruited twice in antepartum medical checkups (20 to 36 weeks of gestation) and postpartum medical checkups (1 month after birth). Information on characteristics of participants was collected from medical records in both periods. Family function and ante-postpartum mental health were assessed by Family APGAR, EPDS, and MIBS. Antepartum depressive state was related to postpartum depressive state (p = 0.015), antepartum bonding was related to bonding in postpartum bonding (p = 0.0001), and antepartum bonding disorder was related to postpartum depressive state (relative risk = 11.7). Worries about costs and poor of family function were related to the mental health of mothers in both the antepartum and postpartum periods. Antepartum depressive state is an indicator of postpartum depression. We suggested that health professionals conduct an evaluation of mother’s mental health and related factors in the antepartum period. The present findings emphasize the importance of antepartum mental health as a predictor of postpartum depression and bonding disorder.展开更多
This paper employs archival documents to research how the Gold Coast colonial government worked with European women medical doctors at preventive health to sustain infant and child welfare clinics.After the First Worl...This paper employs archival documents to research how the Gold Coast colonial government worked with European women medical doctors at preventive health to sustain infant and child welfare clinics.After the First World War,the objective of the colonial government and medical officers was to prevent child mortality and child morbidity.European women medical doctors working with the government and in private practice at infant and child welfare clinics cared for African pregnant women,mothers,and children not older than three years old.European women medical doctors at infant and child welfare clinics educated the community.In 1932,the Great Depression peaked and Percy Selwyn-Clarke in the health service needed to increase funds and staff.Selwyn-Clarke established the Gold Coast Local Branch of the British Red Cross Society to work at the infant and child welfare clinics.展开更多
AIM: To review evidence supporting pharmacological treatments for treatment-resistant depression(TRD) and to discuss them according to personal clinical experience.METHODS: Original studies, clinical trials, systemati...AIM: To review evidence supporting pharmacological treatments for treatment-resistant depression(TRD) and to discuss them according to personal clinical experience.METHODS: Original studies, clinical trials, systematic reviews, and meta-analyses addressing pharmacological treatment for TRD in adult patients published from 1990 to 2013 were identified by data base queries(Pub Med, Google Scholar e Quertle Searches) using terms: "treatment resistant depression", "treatment refractory depression", "partial response depression", "non responder depression", "optimization strategy", "switching strategy", "combination strategy", "augmentation strategy", selective serotonin reuptake inhibitors antidepressants(SSRI), tricyclic antidepressants(TCA), serotonin norepinephrine reuptake inhibitors antidepressants, mirtazapine, mianserine, bupropione, monoamine oxidase inhibitor antidepressant(MAOI), lithium, thyroid hormones, second generation antipsychotics(SGA), dopamine agonists, lamotrigine, psychostimulants, dextromethorphan, dextrorphan, ketamine, omega-3 fatty acids, S-adenosil-L-metionine, methylfolat, pindolol, sex steroids, glucocorticoid agents. Other citations of interest were further identified from references reported in the accessed articles. Selected publications were grouped by treatment strategy:(1) switching from an ineffective antidepressant(AD) to a new AD from a similar or different class;(2) combining the current AD regimen with a second AD from a different class; and(3) augmenting the current AD regimen with a second agent not thought to be an antidepressant itself.RESULTS: Switching from a TCA to another TCA provides only a modest advantage(response rate 9%-27%), while switching from a SSRI to another SSRI is more advantageous(response rate up to 75%). Evidence supports the usefulness of switching from SSRI to venlafaxine(5 positive trials out 6), TCA(2 positive trials out 3), and MAOI(2 positive trials out 2) but not from SSRI to bupropione, duloxetine and mirtazapine. Three reviews demonstrated that the benefits of intraand cross-class switch do not significantly differ. Data on combination strategy are controversial regarding TCA-SSRI combination(positive results in old studies, negative in more recent study) and bupropion-SSRI combination(three open series studies but not three controlled trails support the useful of this combination) and positive regard mirtazapine(or its analogue mianserine) combination with ADs of different classes. As regards the augmentation strategy, available evidences supported the efficacy of TCA augmentation with lithium salts and thyroid hormone(T3), but are conflicting regard the SSRI augmentation with these two drugs(1 positive trial out of 4 for lithium and 3 out of 5 for thyroid hormone). Double-blind controlled studies showed the efficacy of AD augmentation with aripiprazole(5 positive trials out 5), quetiapine(3 positive trials out 3) and, at less extent, of fluoxetine augmentation with olanzapine(3 positive trials out 6), so these drugs received the FDA indication for the acute treatment of TRD. Results on AD augmentation with risperidone are conflicting(2 short term positive trials, 1 short-term and 1 long-term negative trials). Case series and open-label trials showed that AD augmentation with pramipexole or ropinirole, two dopamine agonists, could be an effective treatment for TRD(response rate to pramipexole 48%-74%, to ropinirole 40%-44%) although one recent double-blind placebo-controlled study does not support the superiority of pramipexole over placebo. Evidences do not justify the use of psychostimulants, omega-3 fatty acids, S-adenosil-Lmetionine, methylfolate, pindolol, lamotrigine, and sex hormone as AD augmentation for TRD. Combining the available evidences with our experience we suggest treating non-responders to one SSRI bupropion or mirtazapine trial by switching to venlafaxine, and nonresponders to one venlafaxine trial by switching to a TCA or, if TCA are not tolerated, combining mirtazapine with SSRI or venlafaxine. In non-responders to two or more ADs(including at least one TCA if tolerated) current AD regimen could be augmented with lithium salts(mainly in patients with bipolar depression or suicidality), SGAs(mostly aripiprazole) or DA-agonists(mostly pramipexole). In patients with severe TRD, i.e., non-responders to combination and augmentation strategies as well as to electroconvulsive therapy if workable, we suggest to try a combination plus augmentation strategy.CONCLUSION: Our study identifies alternative effective treatment strategies for TRD. Further studies are needed to compare the efficacy of different strategies in more homogeneous subpopulations.展开更多
BACKGROUND The prevalence of depression in patients with chronic obstructive pulmonary disease(COPD)ranges from 10%to 42%,but the diagnosis of depression in patients with COPD is often unrecognized and untreated.Unrec...BACKGROUND The prevalence of depression in patients with chronic obstructive pulmonary disease(COPD)ranges from 10%to 42%,but the diagnosis of depression in patients with COPD is often unrecognized and untreated.Unrecognized depression has major implications for compliance with medical treatment,prolonged lengths of stay,increased frequency of hospital admissions,and increased consultations with primary care physicians.Many studies have attempted to identify risk factors for progression,prognosis and response to therapy in patients with depression.However,few studies have examined the risk factors for depression in patients with COPD,and some results remain controversial.AIM To identify the potential risk factors to define patients with COPD who are at“high risk”of depression.METHODS The clinical data of 293 patients with COPD were reviewed from January 2017 to December 2018.The correlations between demographics,clinical characteristics and depression were analyzed.The risk factors for depression in patients with COPD were identified by multivariate logistic regression analysis.The cutoff value,sensitivity and specificity of the independent correlation factors were calculated with a receiver operating characteristic curve.RESULTS Of the 293 patients included,65(22.18%)individuals were identified to have depression.Significant differences were detected between patients with and without depression in terms of body mass index(BMI),forced expiratory volume in 1 s(FEV1),and COPD assessment test(CAT)score(all P<0.05).Low BMI,low FEV1,and high CAT were independent risk factors for depression in patients with COPD and the cutoff values of BMI,FEV1,and CAT scores were 21.373 kg/m2,0.855 L and 12.5,respectively.CONCLUSION Low BMI,low FEV1,and high CAT score were identified as independent risk factors for depression in patients with COPD.展开更多
Birth of preterm infants is a stressful event for their parents, particularly for mothers. The mothers of preterm infants often feel hard to relate their infants because they have separated since their first days afte...Birth of preterm infants is a stressful event for their parents, particularly for mothers. The mothers of preterm infants often feel hard to relate their infants because they have separated since their first days after delivery. Long term separation and less attractive, less responsive appearance of preterm infants also make it difficult to build mother-child relationships. In addition, the mothers of preterm infants are likely to have mood disorders such as depression, anxiety, and stress-related disorders. The mothers’ psychiatric illnesses affect the psychosocial development of preterm infants and are often regarded as a risk factor for child abuse and maltreatment in later life. Child abuse and maltreatment are also prevalent among preterm infants than the full term infants. Intervention from the early period of preterm birth is an important issue for both preterm infants and their mothers. Medical and co-medical professionals should pay attention to developmental outcome of preterm as well as psychosocial conditions of their mothers for the improvement of their mental health.展开更多
Objective To observe the clinical effect of thumbtack needles combined with pediatric Tuina(Chinese therapeutic massage)for constipation in children caused by liver depression and Qi stagnation.Methods A total of 60 c...Objective To observe the clinical effect of thumbtack needles combined with pediatric Tuina(Chinese therapeutic massage)for constipation in children caused by liver depression and Qi stagnation.Methods A total of 60 children with constipation caused by liver depression and Qi stagnation were randomly divided into a combined group and a Tuina group,with 30 cases in each group.The cases in the Tuina group were treated with pediatric Tuina,while those in the combined group were treated with additional thumbtack needle therapy.We observed the clinical efficacy and the change in the number of spontaneous bowel movements per week before and after treatment.Results After treatment,the cure rate and the total effective rate in the combined group were higher than in the Tuina group,showing statistical significance(P<0.05).Compared with the same group before treatment,the number of spontaneous bowel movements per week in both groups increased after treatment(P<0.05).With the progression of treatment,the number of spontaneous bowel movements per week increased in both groups,and the number in the combined group was more than that in the Tuina group,showing statistical significance(P<0.01).Conclusion Thumbtack needles combined with pediatric Tuina is more effective than pediatric Tuina alone in the treatment of constipation in children caused by liver depression and Qi stagnation.展开更多
Research has indicated that child maltreatment is associated with an increased likelihood of mental disorders and suicidal ideation and attempts that continues into adulthood. The purpose of this paper is to provide a...Research has indicated that child maltreatment is associated with an increased likelihood of mental disorders and suicidal ideation and attempts that continues into adulthood. The purpose of this paper is to provide a synopsis of the recent published research from 2006 to 2010 on the association between child maltreatment and Axis I mental disorders and suicidal ideation and attempts. The databases MEDLINE and PsycINFO were searched for relevant and high quality citations up to October 2010. The results indicated that all types of child maltreatment examined are linked to reduced mental health. A general noted trend in the literature is that earlier age of onset of child maltreatment is associated with poorer mental health outcomes. Sex differences do exist with some disorders being more likely among males (e.g., anti-social behaviour) and other more likely among females (e.g., depression, PTSD, substance use disorders) following child maltreatment.展开更多
The 13 th Five-Year Plan(2016─2020), with the balanced development of population being the core element, is crucial for China. The superimposed effect of an aging population and low birthrate leading to a reduction i...The 13 th Five-Year Plan(2016─2020), with the balanced development of population being the core element, is crucial for China. The superimposed effect of an aging population and low birthrate leading to a reduction in the labor supply would have a fundamental influence on the long term balanced development of China's population, implying that China's population policy must be adjusted. This paper argues that a gradual relaxation of the family-planning policy adjustments accords with the original intention of the population policy design and development direction. The universal second-child policy is the logical results of the adjustment and improvement of China's family-planning policy, and is designed to bring about positive effects on future demographic and economic development, particularly in sustaining the long term balanced development of China's population, easing the marriage squeeze, extending the demographic dividend, and delaying the population aging process. China needs to develop and improve support and governance systems for fully implementing the universal second-child policy, realizing the policy transition from rewarding one-child families to population security and the modern transition of governance systems and capacity to a universal second-child policy.展开更多
China’s family planning policy is back in the spotlight.Guangdong, the country’s most populous province according to the latest population census,has officially applied to the Central Government for permission for i...China’s family planning policy is back in the spotlight.Guangdong, the country’s most populous province according to the latest population census,has officially applied to the Central Government for permission for it lifting family planning restrictions.If the application is approved,couples in which either the husband or wife is an only child will be allowed to have a second child,according to Zhang Feng, family planning chief in Guangdong.展开更多
Background: To describe the mental health status of 78 child and adolescent survivors of post-war landmine explosions.Methods: Child and adolescent survivors of landmine explosions who were younger than 18 years old a...Background: To describe the mental health status of 78 child and adolescent survivors of post-war landmine explosions.Methods: Child and adolescent survivors of landmine explosions who were younger than 18 years old at the time of the study were identified and enrolled in this study. The mental health status of the participants was assessed by general health assessment and psychiatric examinations. Psychiatric assessment and diagnosis were undertaken using the Diagnostic and Statistical Manual for mental disorders(DSM-IV) criteria. A psychiatrist visited and interviewed each survivor and identified psychiatric disorders.Results: Seventy-eight child and adolescent survivors with a mean age of 16.11±2 years old were identified and agreed to participate in the study. The mean age of the victims at the time of injury was 8.2±3.12 years old(range 2–15). Thirty-seven(47.4%) of the adolescent survivors suffered from at least one psychiatric disorder. Twenty-nine survivors(37.1%) were newly diagnosed and needed to start medication and psychiatric treatment. The most common findings were anxiety disorders(34.6%), including posttraumatic stress disorder(PTSD) in 20(25.6%), and generalized anxiety disorder(GAD) in 7(9%) subjects. Mild-Moderate depression was found in 5(6.4%) subjects. No personality disorders were observed, and two patients suffered from mental retardation. The study results revealed a significant association between age of casualty, duration of injury and limb amputation, and types of psychological disorders.Conclusion: Child and adolescent survivors of landmine explosions had a high prevalence of psychiatric disorders.展开更多
Objective: To investigate the relationships between depressive mood, bonding failure, and abusive parenting. Method: We distributed questionnaires to 1198 mothers attending a three-month postnatal health check-up in r...Objective: To investigate the relationships between depressive mood, bonding failure, and abusive parenting. Method: We distributed questionnaires to 1198 mothers attending a three-month postnatal health check-up in rural areas in Japan. The questionnaires assessed these three variables along with demographics. We evaluated the causal relationships by comparing different structural equation models to the data. Results: Although all the models fit the data well, the best Akaike Information Criterion was obtained from a model where both depressive mood and bonding failure predict abusive parenting, but depressive mood and bonding failure do not predict each other directly. The determinant coefficient of child abuse in the final model was 0.13. Discussion: We found depressive mood and bonding failure during postpartum period impacted negatively on mother’s parenting behaviour. Because only 13% of the variance of abusive parenting was explainable by this model, further study should be needed to identify other risk factors of child abuse. Similarly, midwives and public health nurse in community should pay attention to not only depression but also bonding failure to prevent child abuse.展开更多
This paper stands for the results of the applied linguistic research from the University of Southampton (UK) which was designed and carried on by the master students in language oral corpus. The theoretical guide is b...This paper stands for the results of the applied linguistic research from the University of Southampton (UK) which was designed and carried on by the master students in language oral corpus. The theoretical guide is based on the second language research and the CHILDES system.展开更多
To analyze the impact of the“two-child policy”on the population size and structure,first of all,the birth rate,the ratio of men and women,and the ratio of urban and rural population are used as indicators.Before and...To analyze the impact of the“two-child policy”on the population size and structure,first of all,the birth rate,the ratio of men and women,and the ratio of urban and rural population are used as indicators.Before and after the dispersion,then establish a PDE model,and compare it with the population predicted by the gray forecast to analyze the mitigation of the ageing of the second child policy;continue to analyze the impact of changes in the population structure on the national economy,and select the male and female ratio and the labor population The urban-rural population ratio is used as an index to establish a multiple regression equation for analysis,and a related regression equation is obtained.Finally,the future marriage problem is analyzed,considering only the difference in the number of men and women entering the marriageable period at the same time.The difference in the number of marriageable populations is analyzed through the difference in the number of men and women born at birth,focusing on a dynamic perspective.展开更多
文摘BACKGROUND Depression has gradually become a common psychological disorder among children and adolescents.Depression in children and adolescents affects their physical and mental development.Psychotherapy is considered to be one of the main treatment options for depressed children and adolescents.However,our understanding of the global performance and progress of psychological interventions for depression in children and adolescents(PIDCA)research is limited.AIM To identify collaborative research networks in this field and explore the current research status and hotspots through bibliometrics.METHODS Articles and reviews related to PIDCA from January 2010 to April 2023 were identified from the Web of Science Core Collection database.The Charticulator website,CiteSpace and VOSviewer software were used to visualize the trends in publications and citations,the collaborative research networks(countries,institutions,and authors),and the current research status and hotspots.RESULTS Until April 16,2023,1482 publications were identified.The number of documents published each year and citations had increased rapidly in this field.The United States had the highest productivity in this field.The most prolific institution was the University of London.Pim Cuijpers was the most prolific author.In the context of research related to PIDCA,both reference co-citation analysis and keywords co-occurrence analysis identified 10 research hotspots,including thirdwave cognitive behavior therapy,short-term psychoanalytic psychotherapy,cognitive behavioral analysis system of psychotherapy,family element in psychotherapy,modular treatment,mobile-health,emotion-regulation-based transdiagnostic intervention program,dementia risk in later life,predictors of the efficacy of psychological intervention,and risks of psychological intervention.CONCLUSION This bibliometric study provides a comprehensive overview of PIDCA from 2010 to present.Psychological intervention characterized as psychological-process-focused,short,family-involved,modular,internet-based,emotionregulation-based,and personalized may benefit more young people.
文摘Objective:Factors influencing school adaptation of school-aged children include both executive function(EF)and parent–child interaction.This study aims to investigate the developmental trajectory of mother–child interaction longitudinally using latent growth model analysis.Methods:A longitudinal descriptive survey study was conducted.The par ticipants comprised of 1,614 mothers and school-aged children,who participated in the Panel Study on Korean Children(6 th–8 th panel surveys).A model was designed and analyzed using latent growth modeling to estimate the pattern of change over time.Results:In the group where the maternal depression was within the normal range,only the path by which the change rate of mother–child interaction affected school adaptation of children was statistically nonsignificant(t=1.007,p=0.314).In the group where maternal depression was mild or higher,only the paths by which the initial value of mother–child interaction affected EF difficulty(t=-2.75,p=0.032)and EF difficulty affected school adaptation(t=-7.876,p<0.001)were statistically significant.Conclusions:This study confirms the research models developed by dividing mother–child interaction into two groups according to depression levels(i.e.,normal range and mild or higher-level depression).The findings provide a basis for construction of individualized interventions.
文摘Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.
文摘The concept of Multidisciplinary approach is not new to Medical Science. It is an evolving concept that is widely appreciated and adopted in most of the disciplines of medicine. It’s rational and applicable in the management of Child and Adolescent Depression,which needs to be revisited focusing on the interplay of various contextual factors that are entwined and tend to affect the course of the illness. The limitations of any one mental health professional in envisioning all possible dimensions of Child and Adolescent Depression make this approach all the more important wherein Psychiatrists, Clinical Psychologists, Psychiatric Social Workers collaborate with each other and other allied professionals in the treatment and management of the disorder. India, being a heavily populated country, where multidisciplinary management approach is in a phase of expansion and is practiced in many leading institutes to meet the quality needs of patients. This article focuses on the Indian scene of multidisciplinary management approach in child and adolescent depression.
文摘This study aimed to elaborate on theoretical model of the perceptions, feelings, and meanings of early stress for people with depression. To perform a qualitative study based on the Symbolic Interactionism and Grounded Theory, we interviewed 12 patients diagnosed with depression. It was structured a model based on “walking between traumatic childhood and the adult life with depression,” integrating eight inter-articulated categories that represent the perceptions, feelings, and meanings of the experiences of the depressed individual with a history of early stress. The theoretical model constructed meanings and conditions that affect the individual from a traumatic childhood to depression in adulthood.
文摘The number of deaths caused by child abuse is increasing, which is one of social concerns. The mental health of mothers might be related to child abuse. The aim of this study was to examine and compare the mental state of mothers in both the antepartum and postpartum period assessed by the Edinburgh Postnatal Depression Scale (EPDS) and Mother-Infant-Bonding-Scale (MIBS), and compare the results. Participants (n = 134) were recruited twice in antepartum medical checkups (20 to 36 weeks of gestation) and postpartum medical checkups (1 month after birth). Information on characteristics of participants was collected from medical records in both periods. Family function and ante-postpartum mental health were assessed by Family APGAR, EPDS, and MIBS. Antepartum depressive state was related to postpartum depressive state (p = 0.015), antepartum bonding was related to bonding in postpartum bonding (p = 0.0001), and antepartum bonding disorder was related to postpartum depressive state (relative risk = 11.7). Worries about costs and poor of family function were related to the mental health of mothers in both the antepartum and postpartum periods. Antepartum depressive state is an indicator of postpartum depression. We suggested that health professionals conduct an evaluation of mother’s mental health and related factors in the antepartum period. The present findings emphasize the importance of antepartum mental health as a predictor of postpartum depression and bonding disorder.
文摘This paper employs archival documents to research how the Gold Coast colonial government worked with European women medical doctors at preventive health to sustain infant and child welfare clinics.After the First World War,the objective of the colonial government and medical officers was to prevent child mortality and child morbidity.European women medical doctors working with the government and in private practice at infant and child welfare clinics cared for African pregnant women,mothers,and children not older than three years old.European women medical doctors at infant and child welfare clinics educated the community.In 1932,the Great Depression peaked and Percy Selwyn-Clarke in the health service needed to increase funds and staff.Selwyn-Clarke established the Gold Coast Local Branch of the British Red Cross Society to work at the infant and child welfare clinics.
文摘AIM: To review evidence supporting pharmacological treatments for treatment-resistant depression(TRD) and to discuss them according to personal clinical experience.METHODS: Original studies, clinical trials, systematic reviews, and meta-analyses addressing pharmacological treatment for TRD in adult patients published from 1990 to 2013 were identified by data base queries(Pub Med, Google Scholar e Quertle Searches) using terms: "treatment resistant depression", "treatment refractory depression", "partial response depression", "non responder depression", "optimization strategy", "switching strategy", "combination strategy", "augmentation strategy", selective serotonin reuptake inhibitors antidepressants(SSRI), tricyclic antidepressants(TCA), serotonin norepinephrine reuptake inhibitors antidepressants, mirtazapine, mianserine, bupropione, monoamine oxidase inhibitor antidepressant(MAOI), lithium, thyroid hormones, second generation antipsychotics(SGA), dopamine agonists, lamotrigine, psychostimulants, dextromethorphan, dextrorphan, ketamine, omega-3 fatty acids, S-adenosil-L-metionine, methylfolat, pindolol, sex steroids, glucocorticoid agents. Other citations of interest were further identified from references reported in the accessed articles. Selected publications were grouped by treatment strategy:(1) switching from an ineffective antidepressant(AD) to a new AD from a similar or different class;(2) combining the current AD regimen with a second AD from a different class; and(3) augmenting the current AD regimen with a second agent not thought to be an antidepressant itself.RESULTS: Switching from a TCA to another TCA provides only a modest advantage(response rate 9%-27%), while switching from a SSRI to another SSRI is more advantageous(response rate up to 75%). Evidence supports the usefulness of switching from SSRI to venlafaxine(5 positive trials out 6), TCA(2 positive trials out 3), and MAOI(2 positive trials out 2) but not from SSRI to bupropione, duloxetine and mirtazapine. Three reviews demonstrated that the benefits of intraand cross-class switch do not significantly differ. Data on combination strategy are controversial regarding TCA-SSRI combination(positive results in old studies, negative in more recent study) and bupropion-SSRI combination(three open series studies but not three controlled trails support the useful of this combination) and positive regard mirtazapine(or its analogue mianserine) combination with ADs of different classes. As regards the augmentation strategy, available evidences supported the efficacy of TCA augmentation with lithium salts and thyroid hormone(T3), but are conflicting regard the SSRI augmentation with these two drugs(1 positive trial out of 4 for lithium and 3 out of 5 for thyroid hormone). Double-blind controlled studies showed the efficacy of AD augmentation with aripiprazole(5 positive trials out 5), quetiapine(3 positive trials out 3) and, at less extent, of fluoxetine augmentation with olanzapine(3 positive trials out 6), so these drugs received the FDA indication for the acute treatment of TRD. Results on AD augmentation with risperidone are conflicting(2 short term positive trials, 1 short-term and 1 long-term negative trials). Case series and open-label trials showed that AD augmentation with pramipexole or ropinirole, two dopamine agonists, could be an effective treatment for TRD(response rate to pramipexole 48%-74%, to ropinirole 40%-44%) although one recent double-blind placebo-controlled study does not support the superiority of pramipexole over placebo. Evidences do not justify the use of psychostimulants, omega-3 fatty acids, S-adenosil-Lmetionine, methylfolate, pindolol, lamotrigine, and sex hormone as AD augmentation for TRD. Combining the available evidences with our experience we suggest treating non-responders to one SSRI bupropion or mirtazapine trial by switching to venlafaxine, and nonresponders to one venlafaxine trial by switching to a TCA or, if TCA are not tolerated, combining mirtazapine with SSRI or venlafaxine. In non-responders to two or more ADs(including at least one TCA if tolerated) current AD regimen could be augmented with lithium salts(mainly in patients with bipolar depression or suicidality), SGAs(mostly aripiprazole) or DA-agonists(mostly pramipexole). In patients with severe TRD, i.e., non-responders to combination and augmentation strategies as well as to electroconvulsive therapy if workable, we suggest to try a combination plus augmentation strategy.CONCLUSION: Our study identifies alternative effective treatment strategies for TRD. Further studies are needed to compare the efficacy of different strategies in more homogeneous subpopulations.
基金Supported by Horizontal Projects of National Key Research and Development Plan Projects,No.1210053010.
文摘BACKGROUND The prevalence of depression in patients with chronic obstructive pulmonary disease(COPD)ranges from 10%to 42%,but the diagnosis of depression in patients with COPD is often unrecognized and untreated.Unrecognized depression has major implications for compliance with medical treatment,prolonged lengths of stay,increased frequency of hospital admissions,and increased consultations with primary care physicians.Many studies have attempted to identify risk factors for progression,prognosis and response to therapy in patients with depression.However,few studies have examined the risk factors for depression in patients with COPD,and some results remain controversial.AIM To identify the potential risk factors to define patients with COPD who are at“high risk”of depression.METHODS The clinical data of 293 patients with COPD were reviewed from January 2017 to December 2018.The correlations between demographics,clinical characteristics and depression were analyzed.The risk factors for depression in patients with COPD were identified by multivariate logistic regression analysis.The cutoff value,sensitivity and specificity of the independent correlation factors were calculated with a receiver operating characteristic curve.RESULTS Of the 293 patients included,65(22.18%)individuals were identified to have depression.Significant differences were detected between patients with and without depression in terms of body mass index(BMI),forced expiratory volume in 1 s(FEV1),and COPD assessment test(CAT)score(all P<0.05).Low BMI,low FEV1,and high CAT were independent risk factors for depression in patients with COPD and the cutoff values of BMI,FEV1,and CAT scores were 21.373 kg/m2,0.855 L and 12.5,respectively.CONCLUSION Low BMI,low FEV1,and high CAT score were identified as independent risk factors for depression in patients with COPD.
文摘Birth of preterm infants is a stressful event for their parents, particularly for mothers. The mothers of preterm infants often feel hard to relate their infants because they have separated since their first days after delivery. Long term separation and less attractive, less responsive appearance of preterm infants also make it difficult to build mother-child relationships. In addition, the mothers of preterm infants are likely to have mood disorders such as depression, anxiety, and stress-related disorders. The mothers’ psychiatric illnesses affect the psychosocial development of preterm infants and are often regarded as a risk factor for child abuse and maltreatment in later life. Child abuse and maltreatment are also prevalent among preterm infants than the full term infants. Intervention from the early period of preterm birth is an important issue for both preterm infants and their mothers. Medical and co-medical professionals should pay attention to developmental outcome of preterm as well as psychosocial conditions of their mothers for the improvement of their mental health.
文摘Objective To observe the clinical effect of thumbtack needles combined with pediatric Tuina(Chinese therapeutic massage)for constipation in children caused by liver depression and Qi stagnation.Methods A total of 60 children with constipation caused by liver depression and Qi stagnation were randomly divided into a combined group and a Tuina group,with 30 cases in each group.The cases in the Tuina group were treated with pediatric Tuina,while those in the combined group were treated with additional thumbtack needle therapy.We observed the clinical efficacy and the change in the number of spontaneous bowel movements per week before and after treatment.Results After treatment,the cure rate and the total effective rate in the combined group were higher than in the Tuina group,showing statistical significance(P<0.05).Compared with the same group before treatment,the number of spontaneous bowel movements per week in both groups increased after treatment(P<0.05).With the progression of treatment,the number of spontaneous bowel movements per week increased in both groups,and the number in the combined group was more than that in the Tuina group,showing statistical significance(P<0.01).Conclusion Thumbtack needles combined with pediatric Tuina is more effective than pediatric Tuina alone in the treatment of constipation in children caused by liver depression and Qi stagnation.
文摘Research has indicated that child maltreatment is associated with an increased likelihood of mental disorders and suicidal ideation and attempts that continues into adulthood. The purpose of this paper is to provide a synopsis of the recent published research from 2006 to 2010 on the association between child maltreatment and Axis I mental disorders and suicidal ideation and attempts. The databases MEDLINE and PsycINFO were searched for relevant and high quality citations up to October 2010. The results indicated that all types of child maltreatment examined are linked to reduced mental health. A general noted trend in the literature is that earlier age of onset of child maltreatment is associated with poorer mental health outcomes. Sex differences do exist with some disorders being more likely among males (e.g., anti-social behaviour) and other more likely among females (e.g., depression, PTSD, substance use disorders) following child maltreatment.
文摘The 13 th Five-Year Plan(2016─2020), with the balanced development of population being the core element, is crucial for China. The superimposed effect of an aging population and low birthrate leading to a reduction in the labor supply would have a fundamental influence on the long term balanced development of China's population, implying that China's population policy must be adjusted. This paper argues that a gradual relaxation of the family-planning policy adjustments accords with the original intention of the population policy design and development direction. The universal second-child policy is the logical results of the adjustment and improvement of China's family-planning policy, and is designed to bring about positive effects on future demographic and economic development, particularly in sustaining the long term balanced development of China's population, easing the marriage squeeze, extending the demographic dividend, and delaying the population aging process. China needs to develop and improve support and governance systems for fully implementing the universal second-child policy, realizing the policy transition from rewarding one-child families to population security and the modern transition of governance systems and capacity to a universal second-child policy.
文摘China’s family planning policy is back in the spotlight.Guangdong, the country’s most populous province according to the latest population census,has officially applied to the Central Government for permission for it lifting family planning restrictions.If the application is approved,couples in which either the husband or wife is an only child will be allowed to have a second child,according to Zhang Feng, family planning chief in Guangdong.
基金Foundation of Martyr and Veterans Af airsJanbazan Medical and Engineering Research Center (JMERC)the International Committee of the Red Cross
文摘Background: To describe the mental health status of 78 child and adolescent survivors of post-war landmine explosions.Methods: Child and adolescent survivors of landmine explosions who were younger than 18 years old at the time of the study were identified and enrolled in this study. The mental health status of the participants was assessed by general health assessment and psychiatric examinations. Psychiatric assessment and diagnosis were undertaken using the Diagnostic and Statistical Manual for mental disorders(DSM-IV) criteria. A psychiatrist visited and interviewed each survivor and identified psychiatric disorders.Results: Seventy-eight child and adolescent survivors with a mean age of 16.11±2 years old were identified and agreed to participate in the study. The mean age of the victims at the time of injury was 8.2±3.12 years old(range 2–15). Thirty-seven(47.4%) of the adolescent survivors suffered from at least one psychiatric disorder. Twenty-nine survivors(37.1%) were newly diagnosed and needed to start medication and psychiatric treatment. The most common findings were anxiety disorders(34.6%), including posttraumatic stress disorder(PTSD) in 20(25.6%), and generalized anxiety disorder(GAD) in 7(9%) subjects. Mild-Moderate depression was found in 5(6.4%) subjects. No personality disorders were observed, and two patients suffered from mental retardation. The study results revealed a significant association between age of casualty, duration of injury and limb amputation, and types of psychological disorders.Conclusion: Child and adolescent survivors of landmine explosions had a high prevalence of psychiatric disorders.
文摘Objective: To investigate the relationships between depressive mood, bonding failure, and abusive parenting. Method: We distributed questionnaires to 1198 mothers attending a three-month postnatal health check-up in rural areas in Japan. The questionnaires assessed these three variables along with demographics. We evaluated the causal relationships by comparing different structural equation models to the data. Results: Although all the models fit the data well, the best Akaike Information Criterion was obtained from a model where both depressive mood and bonding failure predict abusive parenting, but depressive mood and bonding failure do not predict each other directly. The determinant coefficient of child abuse in the final model was 0.13. Discussion: We found depressive mood and bonding failure during postpartum period impacted negatively on mother’s parenting behaviour. Because only 13% of the variance of abusive parenting was explainable by this model, further study should be needed to identify other risk factors of child abuse. Similarly, midwives and public health nurse in community should pay attention to not only depression but also bonding failure to prevent child abuse.
文摘This paper stands for the results of the applied linguistic research from the University of Southampton (UK) which was designed and carried on by the master students in language oral corpus. The theoretical guide is based on the second language research and the CHILDES system.
文摘To analyze the impact of the“two-child policy”on the population size and structure,first of all,the birth rate,the ratio of men and women,and the ratio of urban and rural population are used as indicators.Before and after the dispersion,then establish a PDE model,and compare it with the population predicted by the gray forecast to analyze the mitigation of the ageing of the second child policy;continue to analyze the impact of changes in the population structure on the national economy,and select the male and female ratio and the labor population The urban-rural population ratio is used as an index to establish a multiple regression equation for analysis,and a related regression equation is obtained.Finally,the future marriage problem is analyzed,considering only the difference in the number of men and women entering the marriageable period at the same time.The difference in the number of marriageable populations is analyzed through the difference in the number of men and women born at birth,focusing on a dynamic perspective.