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Biomedical subjects

L Scahill

Publications and source records attributed to L Scahill.

At least 73 records · Page 4Linked to original sources
PubMed1989

Adopted children in psychotherapy.

Research shows that a larger than expected proportion of children in psychiatric treatment are adopted. When these children present with more pressing symptomatology, it is often difficult to determine how and when to address the adoption issue. This report provides a brief analysis of adoption from the perspective of attachment theory and family of origin theory. Case examples illustrate typical themes and dilemmas that arise in therapy. The authors conclude the report with an analysis of factors to consider in clinical decision-making and guidelines for intervention.

Adolescent↗
PubMedDate not supplied

Videotape tic counts in the assessment of Tourette's syndrome: stability, reliability, and validity.

OBJECTIVE: We examined the short- and long-term temporal stability of tic counts to estimate the minimum length of videotape needed for a reliable index of overall tic activity and determined the interrater reliability and validity of tic counts based on prolonged videotape segments (> 10 minutes). METHOD: Motor and phonic tic counts and clinician ratings were performed on 43 patients with Tourette's syndrome (TS), aged 7 to 50 years. Short-term stability was estimated by determining the mean interval-to-interval correlation of sequential equal-length segments from 30-minute videotape recordings of 20 subjects. Long-term stability was determined by correlating tic counts at 1-week (N = 14) and 2-week intervals (N = 11). In addition, tic counts were correlated with the most widely used clinical ratings of TS. RESULTS: The short-term stability data indicated that estimates of motor and phonic tic frequencies should be based on videotape counts of at least 5 minutes' duration. Tic counts also were highly reliable and were significantly correlated with clinical ratings with the Yale Global Tic Severity Scale and the Clinical Global Impression Scale for Tourette Syndrome. CONCLUSIONS: Standardized videotape tic counts can provide highly reliable, stable measures of tic frequencies that are moderately correlated with selected global ratings of tic severity.

Adolescent↗
PubMedDate not supplied

Developmental history collection on a child psychiatric inpatient service.

This retrospective study was the first step of a larger project aimed at constructing a data collection tool to be used by child psychiatric nurses on an acute psychiatric inpatient service. A sample of 41 records was reviewed by a single reviewer using explicit criteria to determine the quality of data currently being gathered. The sample was randomly selected from 180 records of children admitted to an acute child psychiatric inpatient service in a major teaching institution. Of the 41 records reviewed, 14 had little or no information concerning the child's developmental course, and in about 50% of the charts similar information was recorded by different team members. It was noted that this service is fairly new, and no assessment tool that reflects a consensus of the multidisciplinary team is currently in use. Without a systematic method of gathering data upon admission, data collection will continue to be inconsistent and incomplete.

Adolescent↗
PubMedDate not supplied

A method of screening for communication disorders in child psychiatric inpatients.

Research indicates that children with speech and language disorders probably are at greater risk for developing emotional and behavior problems. A retrospective review of referral patterns on a child psychiatric inpatient service suggested that some children with speech and language disorders were either being missed or referred late in their hospital stay. A four-part procedure was developed to screen children for speech or language problems at admission to a child psychiatric inpatient service. A pilot study of the new method showed promise as a screening procedure (estimated sensitivity = 81%; estimated specificity = 90%). The four-part screening method, referral guidelines and clinical implications are presented.

Child↗
PubMedDate not supplied

Genetic epidemiology in child psychiatric nursing. Tourette's Syndrome as a model.

Recent discoveries in the field of molecular biology and increased attention to genetic epidemiology have stimulated renewed interest in the genetics of psychiatric disorders. Tourette's syndrome, a neuropsychiatric disorder characterized by motor and phonic tics, is used as a model to describe the research strategies employed in the genetic epidemiology of child psychiatric disorders. The relevance of genetic research findings to child psychiatric nursing is also discussed.

Genetics, Population↗
PubMedDate not supplied

Inpatient treatment of obsessive compulsive disorder in childhood: a case study.

Obsessive compulsive disorder (OCD) is now recognized as a relatively common disorder that often has its onset in childhood. Both behavior modification and newly available serotonin reuptake inhibitors have shown to be beneficial in reducing the primary symptoms of OCD in adults, but behavior therapy has not been well-studied in children. This paper presents a case of a 13-year-old boy admitted to a child psychiatric inpatient service with severe OCD, psychotic features, and a history of Tourette's syndrome. The integration of standard behavior therapy techniques on a child inpatient service and barriers to implementing these techniques are discussed.

Adolescent↗
PubMedDate not supplied

Clomipramine and obsessive-compulsive disorder.

Clomipramine is a tricyclic antidepressant that was the first effective agent in the treatment of OCD. Its capacity to block serotonin reuptake appears to be essential to reducing the primary symptoms of OCD. Like other tricyclic agents, CMI has an array of possible side effects including gastrointestinal, autonomic, hepatic, and cardiac problems that need to be considered in the clinical management of children and adolescents treated with CMI. Evaluation of clinical response begins with the identification of target symptoms and monitoring the change in these target symptoms over time. This effort can be aided by the use of clinical rating instruments such as the Children's Yale-Brown Obsessive Compulsive Scales and, to a limited degree, drug plasma levels. Although many OCD patients manifest a positive response to CMI, some patients do not. This variation suggests that other neurochemical systems may be implicated in OCD.

Adolescent↗
PubMedDate not supplied

Selection and use of clinical rating instruments in child psychiatric nursing.

TOPIC: The selection of appropriate clinical rating instruments and integration of their findings in child psychiatric nursing practice may not be clear. PURPOSE: To offer guidance concerning the selection and application of clinical rating instruments SOURCES: A review of recent literature of commonly used parent and teacher checklists, clinician-rated instruments, structured diagnostic interviews, and child self-reports. CONCLUSION: Clinical rating scales have an important place in clinical practice and research in child and adolescent psychiatric settings. Selecting an appropriate instrument depends on the purpose, developmental level of the child, and expertise of the clinician--and requires careful consideration.

Adolescent↗
PubMedDate not supplied

Contemporary approaches to pharmacotherapy in Tourette's syndrome and obsessive-compulsive disorder.

TOPIC: Contemporary approaches used in the pharmacological treatment of children and adolescents with Tourette's syndrome or obsessive-compulsive disorder. BACKGROUND: Tourette's syndrome (TS) and obsessive-compulsive disorder (OCD) now are recognized as more common than previously believed. Moreover, there is accumulating evidence that these two disorders may share common neurobiological underpinnings. Nonetheless, pharmacologic approaches to treatment may be quite different. SOURCES: Using recently published information, this paper reviews current treatment for TS and OCD. CONCLUSION: There have been major advances in the understanding of the pathophysiology of OCD and TS. These advances provides guidance for the treatment of children and adolescents with these disorders. However, additional research is needed to refine current treatment approaches.

Adolescent↗
PubMedDate not supplied

Nursing education and clinical practice on child and adolescent psychiatric inpatient services: survey results.

OBJECTIVE: To evaluate the educational preparation of staff nurses working on child and adolescent psychiatric inpatient services. METHODS: A 40-item questionnaire was sent to 169 staff nurses in nine institutions. One hundred seventeen questionnaires (69.2%) were suitable for analyses. RESULTS: Respondents ranged in age from 22 to 52 years (mean = 34.7, +/- 7.43 years) and 87.2% (n = 102) were women. Seventy-one percent (n = 83) of the respondents agreed that basic nursing education inadequately prepared them for work on child and adolescent psychiatric inpatient services. Deficiencies were cited in psychopharmacology, child psychiatric diagnosis, child psychopathology, and milieu treatment. There were few differences across educational type. CONCLUSION: Recent advances in psychiatric epidemiology, psychopharmacology, and neuroscience merit greater attention in undergraduate nursing education. Child psychiatric institutions and professional nursing organizations have a role to play in continuing education.

Adolescent↗