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Michael Schulte-Markwort

Publications and source records attributed to Michael Schulte-Markwort.

10 recordsLinked to original sources
PubMed2006

Posttraumatic syndromes in children and adolescents after road traffic accidents--a prospective cohort study.

BACKGROUND: The impact of road traffic accidents (RTAs) on the physical health of children is well recognized, but their psychological consequences have only recently become a topic of research. While other traumatic experiences in childhood are well studied, this kind of trauma has been poorly investigated to date. SAMPLING AND METHODS: A prospective cohort study was conducted of 8- to 18-year-old children and adolescents who were involved in RTAs in a large urban area during a 6-month period. The children and adolescents were interviewed within 1 week after the accident and, again, 3 months later. In total, 72 children and adolescents took part in the study. Symptoms of posttraumatic stress, depression and anxiety were assessed by a structured clinical interview and standardized questionnaires. RESULTS: One week after the accident, 11% of the children met the diagnostic criteria for posttraumatic stress disorder (PTSD) according to ICD-10 and a further 13% met the criteria for 'subsyndromal PTSD'. Complex syndromes consisting of subsyndromal posttraumatic stress, (separation) anxiety and depression were common among those children. Isolated cases of anxiety and depression symptoms were also observed but rarely reached an impairing level. Three months after the accident, 25% of the children reported persistence of the PTSD symptoms (measured by the Impact of Event Scale - Revised). The strongest predictor of the extent of posttraumatic stress after 3 months was proven to be the initial level of PTSD symptoms. This predictor alone accounted for 38% of its variance. CONCLUSIONS: Our results provide evidence that even after 'everyday' RTAs, psychological consequences are common. Special attention should be paid to the common occurrence of subsyndromal psychological disturbances and more complex syndromes. The results further indicate the limitations of the PTSD concept in the assessment of posttraumatic disturbances in childhood and adolescence.

Accidents, Traffic↗
PubMed2006

Eating Pattern Inventory for Children: a new self-rating questionnaire for preadolescents.

A questionnaire on psychological dimensions of eating behavior in children is presented. Existing questionnaires for children specifically focus on symptoms of eating disorders only, whereas for adults, questionnaires assessing general psychological dimensions of eating behavior are also available. The development of the Eating Pattern Inventory for Children (EPI-C) was based on a sample of 373 fourth-grade students. Factor and item analysis led to a psychometrically sound 20-item questionnaire with the dimensions dietary restraint, external eating, parental pressure to eat, and emotional eating. These factors explain 62% of the total item variance. Subscale scores and emerging eating patterns were associated with children's body weight suggesting initial evidence of its validity. The EPI-C is proposed for research on eating behavior in clinical and non-clinical preadolescent samples.

Body Mass Index↗
PubMed2006

[Life situation and health status of children and adolescents].

In the last decades an increasing number of characteristics of the child's life circumstances have been identified as risk factors for mental health problems. Up to now, the natural distribution of these factors in the population has not been systematically investigated. In the Hamburg Health Survey N=1950 children and adolescents between 4 and 18 years of age and their families representative for Germany have been examined. The questionnaire used asks for sociodemographic variables, pregnancy and birth, kindergarten and school attendance, psychosocial burden and utilization of health services. Complications in pregnancy, birth or in the first year of life arise in every fifth child. Severe childhood illnesses, serious accidents, hospital stays for longer than 14 days or early changes of caregivers have 14% of those investigated. Every tenth child has problems in the kindergarten (mostly separation anxiety), every fourth child has problems in school (especially problems in concentration or performance) and 8% suffer from stressful life events (mostly changed family relations). Mental or physical illness and disabilities are found in 8.5% of all families. Although the majority of all children and adolescents live in healthy life circumstances, risk factors are not as rare as to be neglected. Especially the frequency of problems in kindergarten and school as well as stressful life events indicate that preventive interventions are necessary.

Adolescent↗
PubMed2005

Emotional and behavioral problems of children and adolescents in Germany--an epidemiological screening.

BACKGROUND: Previous studies that were carried out to investigate the prevalence of mental health problems among children and adolescents in Germany are based on regional samples, limited age ranges or used ambiguous case definitions. METHOD: In the Hamburg Health Survey, data on emotional and behavioral problems were collected by a parent and a child questionnaire on the basis of a nationwide representative sample of 1950 families with children and adolescents between the ages of 4 and 18. Besides study-specific items, the Child Behavior Checklist and the Youth Self-Report were used. The symptom and total prevalence rates of clinically significant cases as well as dimensional descriptive statistics and coefficients of agreement between parent- and self-report were calculated. RESULTS: The results indicate that children and adolescents in Germany suffer from a variety of emotional and behavioral problems which require differentiated interpretations depending on their symptom, age and sex. In accordance with the respective case definition, between 10 % and 18% of the children and adolescents were considered to have a clinically relevant score requiring counseling, diagnostics or treatment. The agreement between parent- and self-report scores in the middle range using dimensional statistics and in the lower range for the case definitions. CONCLUSION: The results are discussed in comparison with German and international studies carried out so far. An increase of mental health problems over the past decades cannot be deduced from the data. Procedures which allow the standardization of future investigations are recommended and possibilities to improve current mental health care utilization are discussed.

Adolescent↗
PubMed2005

Subjective distress related to side effects and subjective well-being in first admitted adolescents with early-onset psychosis treated with atypical antipsychotics.

OBJECTIVE: Side effects (SE) of antipsychotics are considered a major source of subjective discomfort. The aim of this pilot study was to evaluate the subjective distress-related to different SE and its association with subjective well-being in a sample of adolescents treated with atypical antipsychotics. METHODS: Subjects enrolled were first hospitalized adolescent inpatients with diagnoses of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) schizophrenia, schizophreniform, or schizoaffective disorder. Subjects' Clinical Global Impression-Severity (CGI-S) and subjective well-being (SWN-K, BfS) were evaluated at baseline, week 2, and week 6. Side effects (UKU) and subjective distress under SE (Subjective Distress Scale, SDS) were evaluated at weeks 2 and 6. RESULTS: Twenty adolescents were included. Almost all subjects suffered from at least one distressing SE at both follow-up time points. The mean number of distressing SE decreased from weeks 2 to 6. The most prevalent distressing SE were psychic SE and weight gain. There was an association between distress related to psychic and neurological SE and negative subjective wellbeing (r = 0.60-0.70). Subjective distress with these SE, especially neurological SE at both time points and sedation-increased sleep at week 6, did not correspond to clinician's severity ratings. CONCLUSIONS: Clinicians may overlook distress by only judging the severity of SE objectively in the treatment with atypical antipsychotics, leading to negative subjective well-being and a high rate of nonadherence to treatment. Therefore, it is recommended to discuss the severity of, and distress with, SE independently with patients. Future studies should focus on distress related to neurological SE, sedation, and weight gain.

Adolescent↗
PubMed2004

[Prevalence of emotional and behavioral disorders in children and adolescents in Germany -- a systematic literature review].

OBJECTIVE: Methods and results from empirical research carried out so far on the prevalence of psychopathology in children and adolescents in Germany are presented. METHODS: The relevant studies (n = 29) identified by systematic literature search are presented and compared in table form on the basis of important epidemiological key factors, and a descriptive analysis is provided. RESULTS: The prevalence of emotional and behavioral disorders is 17.2 +/- 5.07 % (M +/- SD). Determination of the prevalence rates is influenced by the study methods used. The results presented here do not indicate an increase or decrease in the prevalence of psychopathology in childhood and adolescence over the past decades. CONCLUSIONS: The results are discussed with respect to study quality, also in an international context, and recommendations are made for standardization of future studies.

Adolescent↗
PubMed2004

Huntington disease: a case study of early onset presenting as depression.

Huntington disease is a dominantly inherited, neurodegenerative disease characterized by choreiform movement disturbances and dementia, usually with adult onset. The rare juvenile-onset Huntington disease differs from the adult phenotype. A case presenting twice, at age 10 with all the signs of a major depression and age 14 with mutism and rigidity, is reported. Meanwhile, the father developed the adult variant of Huntington disease. The boy's diagnosis was confirmed by molecular genetic analysis and magnetic resonance imaging. It is important to be aware of hereditary conditions such as Huntington disease and to provide family counseling before genetic testing and after the diagnosis is confirmed.

Adolescent↗
PubMed2004

["Operationalised psychodynamic diagnostics in childhood and adolescence" (OPD-CA) in practice].

"Operationalised psychodynamic diagnostics in childhood and adolescence" (OPD-CA) has been completed in its first version after years of development. In a first interview with a 13-year-old boy, the diagnostic instruments of OPD-CA are presented by means of examples. The text passages of the transcribed first interview are evaluated in four sections by representatives of the respective working groups regarding the axes--relationships, conflict, structure and preconditions for treatment--and the diagnostic conclusions resulting from this are presented, thus providing a direct insight into the specific psychodynamic diagnostics of OPD-CA.

Adolescent↗
PubMed2003

[Planning and implementation of evaluation studies in child and adolescent psychiatry].

An introduction into planning and implementing evaluation studies in child and adolescent psychiatry is presented. After the presentation of theoretical aspects of evaluation studies, the necessity of these studies is elucidated. Further, a conceptualisation of the dimensions of a treatment programme and some criteria for the selection of outcome criteria are offered. In addition to symptomatology, other criteria such as family functioning and quality of life are proposed in this context. Furthermore, it is recommended to ascertain data already at the time of the patient's registration. The influence of drop-out rate on the study result makes it necessary to closely consider any missing data. These and other problems lead to the conclusion that a sophisticated and complex evaluation methodology is required to assess the performance of a child and adolescent treatment programme validly. Finally, the design of the Hamburg evaluation study is presented, which is suitable for the implementation of some of the mentioned aspects.

Adolescent↗