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PubMed1997

Practice parameters for the assessment and treatment of children and adolescents with schizophrenia. American Academy of Child and Adolescent Psychiatry.

These practice parameters review the literature on children and adolescents with schizophrenia. Because this literature is sparse, information is also drawn from research with adults. Clinical features in youth with schizophrenia include predominance in males, high rate of premorbid abnormalities, increased family history of schizophrenia, and often poor outcome. Diagnostic issues include the overlap, and therefore potential for misdiagnosis, between the first presenting symptoms of schizophrenia and those of psychotic mood disorders, developmental disorders, organic conditions, and other nonpsychotic emotional/behavioral disorders. Treatment should include using antipsychotic medications in conjunction with psychoeducational, psychotherapeutic, and social and educational support programs. These parameters were previously published in J. Am. Acad. Child Adolesc. Psychiatry, 1994, 33:616-635.

Adolescent↗
PubMed1998

Summary of the practice parameters for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. American Academy of Child and Adolescent Psychiatry.

This summary provides an overview of the assessment, differential diagnosis, and treatment recommendations contained in the Practice Parameters for the Assessment and Treatment of Children and Adolescents With Obsessive-Compulsive Disorder. OCD is a disorder of heterogeneous origin characterized by intrusive thoughts or compulsive urges or behaviors that are distressing, time-consuming, or functionally impairing. In children and adolescents, the disorder often is accompanied by a wide range of comorbidity. Two modalities have been systematically assessed and empirically shown to ameliorate the core symptoms of OCD: cognitive-behavioral therapy (primarily exposure/response prevention) and serotonin reuptake inhibitor medication. Additional individual and family psychotherapeutic, pharmacological, and educational interventions often are necessary.

Adolescent↗
PubMed1999

Summary of the Practice Parameters for the Assessment and Treatment of Children, Adolescents, and Adults with Autism and other Pervasive Developmental Disorders. American Academy of Child and Adolescent Psychiatry.

This summary provides an overview of the assessment and treatment recommendations contained in the Practice Parameters for the Assessment and Treatment of Children, Adolescents, and Adults With Autism and Other Pervasive Developmental Disorders. The parameters were written to aid clinicians in the assessment and treatment of children and adolescents with autism and other pervasive developmental disorders. Autism and the related pervasive developmental disorders are characterized by patterns of delay and deviance in the development of social, communicative, and cognitive skills, which arise in the first years of life. Although frequently associated with mental retardation, these conditions are distinctive in terms of their course and treatment. These conditions have a wide range of syndrome expression, and their management presents particular challenges for clinicians. Individuals with these conditions can present for clinical care at any point in development. The multiple developmental and behavioral problems associated with these conditions often require the care of multiple providers; coordination of services and advocacy for individuals and their families is important. Early, sustained intervention is indicated, as is the use of various treatment modalities (e.g., pharmacotherapy, special education, speech/communication therapy, and behavior modification.

Adolescent↗
PubMed2005

An adolescent scuba diver with 2 episodes of diving-related injuries requiring hyperbaric oxygen recompression therapy: a case report with medical considerations for child and adolescent scuba divers.

Worldwide, more than 1000 scuba (self-contained underwater breathing apparatus) diving injuries per year requiring hyperbaric recompression are documented. Approximately 80 to 90 fatalities per year are reported in North America. On average, there were 16 diving injuries requiring hyperbaric recompression therapy in scuba divers aged 19 years and younger in North America between 1988 and 2002. The youngest injured diver was 11 years old, and the youngest fatality was 14 years old during this time period. In the year 2000, certifying recreational scuba diving organizations lowered the minimum age to 8 from age 12 years for participation in the sport. We report a case of a highly trained adolescent scuba diver who, despite having advanced diving certifications, had 2 separate episodes of diving-related injuries requiring hyperbaric recompression therapy. A discussion of medical considerations in the care of the child and adolescent scuba diver is included.

Adolescent↗
PubMed2005

Prevalence of skin diseases among male adolescent and post-adolescent boarding school students in Turkey.

Skin disease is a common problem in boarding schools and may account for significant morbidity. To document the prevalence and patterns of skin diseases among male adolescent and post-adolescent boarding school residents, a cross-sectional epidemiologic survey was performed. A total of 682 students were examined for evidence of any skin disease, and subjects with skin disease(s) were also asked to fill in a questionnaire. Of the study population, 378 (55.42%) had at least one skin disease. The most prevalent diseases were tinea pedis (32.5%), acne vulgaris (28.6%), onychomycosis (8.06%), androgenetic alopecia (5.6%), common warts (5.3%), unguium incarnatus (4.1%), irritant hand dermatitis (3.6%), foot callosities (3.6%), and pitted keratolysis (2.6%). Of those with skin problem(s), 245 (65%) were not aware of their disease(s) and 45% of the remaining 133 subjects who were aware of their disease(s) had not sought medical help. We concluded that skin diseases, especially foot problems, are very common among male boarding school students. In additional to monitoring the epidemiology of skin diseases, intermittent medical education programs for both health-care workers and residents living in these communities would be useful for enhancing knowledge of available and effective treatments and implementing appropriate preventive measures.

Adolescent↗
PubMed1997

Psychosocial functioning in adolescent psychiatric patients: a prospective study on changes in psychosocial functioning among severely and moderately impaired adolescent out-patients.

Changes in psychosocial functioning during out-patient treatment among 73 adolescent male and 100 female subjects, aged 12 to 19 years, were studied. The mean number of total treatment sessions was 15 sessions among the severely impaired and 14 sessions among the moderately impaired patients. The level of psychosocial functioning improved among the severely impaired (Global Assessment Scale (GAS) at treatment entry 3.9 vs. 4.7 at the last session, 95% CI, -1.085 to -0.577) and the moderately impaired patients (GAS 5.5 vs. 6.0, 95% CI, -0.682 to -0.355). The improvement was highly dependent on the psychiatric diagnosis. The level of psychosocial impairment improved in about two-thirds of subjects with adjustment and non-comorbid mood disorders, in about one-third of those with non-comorbid personality disorders, and in about a quarter of those with disruptive disorders. Careful diagnostic evaluation and assessment of psychosocial functioning are essential elements in the development of adolescent psychiatric services.

Adjustment Disorders↗
PubMed2000

Prevalence of abnormal urinary albumin excretion in adolescents and children with insulin dependent diabetes: the MIDAC study. Microalbinuria in Diabetic Adolescents and Children (MIDAC) research group.

OBJECTIVE: To examine the prevalence of microalbuminuria, defined as an albumin to creatinine ratio (UAC) equal to or greater than 2 mg/mmol in at least two of three early morning urine samples, in adolescents and children with insulin dependent diabetes mellitus. DESIGN: Centrally coordinated, cross sectional, multicentre study in paediatric diabetes outpatient clinics in the United Kingdom and Republic of Ireland. METHODS: Blood and urine samples collected between July 1997 and July 1998 were analysed at a central reference laboratory for HbA(1C) using high performance liquid chromatography, and for urinary albumin and creatinine concentrations from which the UAC was derived (mg/mmol). Clinical data were collected locally and coordinated centrally. SUBJECTS: Patients, aged between 10 and 20 years, with insulin dependent diabetes mellitus for more than a year, attending diabetes outpatient clinics. RESULTS: A total of 1007 patients, comprising 69% of the eligible population of 1451, provided three early morning urine samples. Ninety eight (9.7%) had microalbuminuria using the currently accepted screening cut off of UAC >/= 2 mg/mmol in at least two of three early morning urine samples. Significantly more girls than boys and significantly more pubertal and postpubertal patients had abnormal albumin excretion. Microalbuminuria was not associated with raised blood pressure. CONCLUSIONS: A prevalence of 9.7% for abnormal UAC was found in a cohort of 1007 children and adolescents aged 10-20 years. Thus a tenth of this national sample of young people were identified as being at particular risk of microvascular and later macrovascular disease.

Adolescent↗
PubMed2006

Country material distribution and adolescents' perceived health: multilevel study of adolescents in 27 countries.

OBJECTIVE: To assess the impact of country material distribution on adolescents' perceptions of health. DESIGN: Cross sectional multilevel study. SETTING: Data were collected from the school based health behaviour in school aged children: WHO cross national study 1997/98, which includes students from 27 European and North American countries. PARTICIPANTS: 12 0381 students in year 6, 8, and 10 who were attending school classes on the day of data collection. MAIN RESULT: Adolescents in countries with a high dispersion of family affluence were more likely to have self rated poor health even after controlling for individual family level of affluence and family social resources. CONCLUSION: There are substantial inequalities in subjective health across European and North American countries related to the distribution of family material resources in these countries.

Adolescent↗
PubMedDate not supplied

Asthma in adolescents: a randomized, controlled trial of an asthma program for adolescents and young adults with severe asthma.

BACKGROUND: Asthma is common and is often poorly controlled in adolescent subjects. OBJECTIVE: To determine the impact of an age-specific asthma program on asthma control, particularly on exacerbations of asthma requiring emergency department treatment, and on the quality of life of adolescents with asthma. METHODS: The present randomized, controlled trial included patients who were 15 to 20 years of age and had visited emergency departments for management of their asthma. The interventional group attended an age-specific asthma program that included assessment, education and management by a team of asthma educators, respiratory therapists and respiratory physicians. In the control group, spirometry was performed, and the patients continued to receive usual care from their regular physicians. The outcomes were assessed by a questionnaire six months after entry into the study. RESULTS: Ninety-three subjects entered the study and were randomly assigned to the intervention or control group. Of these, only 62 patients were available for review after six months. Subjects in both the control and the intervention groups showed a marked improvement in their level of asthma control, reflected primarily by a 73% reduction in the rate of emergency department attendance for asthma. Other indexes of disease control, including disease-specific quality of life, as assessed by questionnaires, were improved. There was, however, no discernible difference between the subjects in the two groups, with the exception of an improvement in favour of the intervention group in the symptom (actual difference 0.7, P=0.048) and emotional (actual difference 0.8, P=0.028) domains of the asthma quality of life questionnaire. The overall quality of life score favoured the intervention group by a clinically relevant difference of 0.6, but this difference did not reach statistical significance (P=0.06). CONCLUSIONS: Although all subjects demonstrated a significant improvement in asthma control and quality of life, the improvement attributable to this intervention was limited to two domains in disease-specific quality of life.

Adolescent↗
PubMed2003

[Child and adolescent gynecology. Introduction to the focal topic 'Child and adolescent gynecology'].

Valuable knowledge from the subspecialty of child and adolescent gynecology is of considerable importance for the clinically active pediatrician and gynecologist. Focal topics such as sexual violence to children and young adults, undesired pregnancies and pregnancy termination should not only be made known in the media, but also to specialists, so that successful prevention and treatment can be carried out. Furthermore, endocrinological problems and genital malformations in adolescence should be detectable and treatable.

Adolescent↗
PubMed1982

A prospective study of delinquency in 110 adolescent boys with attention deficit disorder and 88 normal adolescent boys.

The authors studied official arrests from childhood through adolescence in two groups of boys; one group (N = 110) was diagnosed in childhood as suffering from attention deficit disorder (ADD), and the second group (N = 88) consisted of normal control adolescents. Rates of single and multiple serious offenses and of institutionalization for delinquency were significantly higher in the ADD subjects. These findings suggest a strong relationship between childhood ADD and later arrests for delinquent behavior.

Adolescent↗
PubMed1983

Reexamining the concept of adolescence: differences between adolescent boys and girls in the context of their families.

As part of a larger study on family functioning, the authors administered a questionnaire on individual attitudes toward family values to 158 Japanese-American and Caucasian families. Differences between the generations on questions of authority and responsibility were predictable; few differences were found between ethnic groups. However, differences were striking between adolescent boys and girls, regardless of ethnicity: Girls valued family affiliation, closeness, and emotional expression significantly more highly than did boys. The authors emphasize the need for families to value girls' needs for closeness and emotional expression as highly as boys' needs for independence and self-differentiation. They suggest that the concept of separation-individuation as the major goal of adolescence be reexamined.

Adolescent↗
PubMed1985

Dose and plasma levels of nortriptyline and chlorpromazine in delusionally depressed adolescents and of nortriptyline in nondelusionally depressed adolescents.

Eight adolescents with major depressive disorder were treated with nortriptyline and six adolescents with delusional depression were treated with combined nortriptyline and chlorpromazine. Dose and plasma levels of nortriptyline for the two groups were compared. The delusional group receiving combined drug treatment needed significantly less nortriptyline than did the nondelusional group receiving only nortriptyline to obtain similar mean steady state plasma levels of the drug. The mean plasma chlorpromazine levels were quite low.

Adolescent↗
PubMed2005

Psychiatric symptoms of adolescents with physical complaints admitted to an adolescence unit.

SUMMARY: The aim of this study was to evaluate the psychiatric symptoms among adolescents who were seen in the outpatient clinic for their physical complaints. Two hundred and ninety adolescent outpatients (154 males and 136 females) between 13 and 17 years of age (mean 14.3+/-1.2) are included in this study. Patients with known psychiatric disorders, mental retardation, organic brain diseases, or chronic organic problems were excluded. The Brief Symptom Inventory, which measures the psychiatric symptoms under the categories of anxiety, depression, negative self, somatization, and hostility, was given to all subjects. Symptoms of urinary and cardiovascular systems were related to hostility. Patients with obesity, hirsutism, problems of external genitalia, enuresis nocturna, abdominal pain, chest pain, and lack of weight gain showed psychiatric symptoms at pathological levels. Hostility symptom was found to be high in all groups.

Adolescent↗
PubMed2001

Confirmatory factor analysis of the Kaufman Adolescent and Adult Intelligence Test with young adolescents.

This study examined the factor structure of the Kaufman Adolescent and Adult Intelligence Test (KAIT) in 375 11- to 14-year-olds (normative sample) and 60 sixth- and eighth-graders (cross-validation sample). Previous exploratory and confirmatory factor analyses of the KAIT have included optional subtests, which are often not administered in practice, and have not tested oblique versus orthogonal two-factor models. In this study, three factor models were tested via confirmatory factor analysis for the six core subtests of the KAIT: a one-factor general intelligence (g) model, an orthogonal fluid intelligence (Gf)-crystallized intelligence (Gc) model, and an oblique Gf-Gc model. The orthogonal Gf-Gc model fit poorly in both samples. The g model fit only the cross-validation sample. The oblique Gf-Gc model fit both samples and fit significantly better than the g model in both samples. Additional tests of factor structure, path coefficients, and covariance between Gf and Gc indicated that the data from both samples fit even the most restrictive oblique Gf-Gc model tested. KAIT users can be confident that the Fluid and Crystallized IQs from the KAIT are adequate representations of a robust and interpretable factor structure when only the core subtests are administered to young adolescents.

Adolescent↗
PubMed1976

Volunteer adolescents in adolescent group therapy. Effects on patients and volunteers.

The effects on patients, volunteers and staff of using volunteer adolescents in adolescent group therapy are examined. From 40 candidates eight volunteers were selected and oriented to the group process. Four volunteers and four patients were placed in each of two groups, and eight patients were placed in the third group. Patients and volunteers were aware of their identities in the first group session. Attendance in the groups with volunteers was better than in the group without. The volunteers themselves gained new knowledge and skills, and their presence was even helpful to the group leaders.

Adolescent↗
PubMed1999

Factor-based prototypes of the Millon Adolescent Clinical Inventory in adolescents referred for residential treatment.

Although well received by the clinical community, there have been few published reports on the use of the Millon Adolescent Clinical Inventory (MACI). There have been no published studies describing use of the MACI with a residential treatment population. In addition, there have been no published reports investigating the factor structure of the MACI. A principal components factor analysis was performed for all MACI scales and sex for 251 adolescents referred to a residential treatment facility. Five factors were found accounting for 77.4% of the variance. Factor-based prototypes were generated from these results: Factor 1 defines a prototype for Defiant Externalizers, Factor 2 for Intrapunitive Ambivalent Types, Factor 3 for Inadequate Avoidants, Factor 4 for Self-Deprecating Depressives, and Factor 5 for Reactive Abused Types. Prototype descriptions and clinical vignettes are included for each of the 5 factor-based prototypes. These results are consistent with our clinical experience with this population. Prototype analysis may offer a powerful way of enhancing the utility of the MACI in clinical settings.

Adolescent↗
PubMedDate not supplied

Neighborhood social composition and injury risks among pre-adolescent and adolescent boys and girls. A study in Stockholm metropolitan.

The study investigates the extent to which social and socioeconomic characteristics of a population within a particular living area influence injury risks among young people. The study group comprised pre-adolescent and adolescent boys and girls aged 10-19 living in the Stockholm metropolitan area in Sweden over the three-year period 2000--2002 (about 185,000 subjects each year). Area comparisons were made at parish level (96 parishes) based on three compositional indexes derived from a factor analysis of sixteen population attributes. Thereafter, each factor was transformed into an additive index and divided into three levels. Diagnosis-specific injury risks were then measured by index, considering injury causes with documented social differences (five for boys and three for girls). Injuries resulting in at least one night of hospitalization during the period 2000--2002 were considered. Three main dimensions with regard to the social fabric of the Stockholm metropolitan area were identified: socioeconomic precariousness and ethnic concentration (Factor 1), educational and financial assets (Factor 2), and concentration of well-off citizens of Nordic origin (Factor 3). Lower levels of socioeconomic precariousness and ethnic concentration showed a protective effect on boys in the cases of traffic and sports-related injuries, but an aggravating one in the cases of falls on the same level and violence-related injuries. Level of educational and financial assets did not impact on falls on the same level among boys, but increased the risk of such injuries among girls. Increased risks of traffic-related injuries among boys and of falls on the same level among both boys and girls were found in areas with lower concentrations of well-off citizens of Nordic origin. It is concluded that social and socioeconomic composition of the population in a living area impacts on injury risks of various kinds in a rather specific manner--in magnitude and in kind. The mechanisms via which contextual aspects operate during youth are likely to vary according to type (cause) of injury and gender.

Accident Prevention↗