As part of our series on managing neurological and psychiatric conditions in children and adolesc... more As part of our series on managing neurological and psychiatric conditions in children and adolescents, Dr Julia Gledhill and Dr Matthew Hodes discuss depression.
BACKGROUND Children and young people's mental health is a growing public health concern, whic... more BACKGROUND Children and young people's mental health is a growing public health concern, which is further exacerbated by the COVID-19 pandemic. Mobile health apps, particularly those using passive smartphone sensor data, present an opportunity to address this issue and support mental well-being. OBJECTIVE This study aimed to develop and evaluate a mobile mental health platform for children and young people, Mindcraft, which integrates passive sensor data monitoring with active self-reported updates through an engaging user interface to monitor their well-being. METHODS A user-centered design approach was used to develop Mindcraft, incorporating feedback from potential users. User acceptance testing was conducted with a group of 8 young people aged 15-17 years, followed by a pilot test with 39 secondary school students aged 14-18 years, which was conducted for a 2-week period. RESULTS Mindcraft showed encouraging user engagement and retention. Users reported that they found the app to be a friendly tool helping them to increase their emotional awareness and gain a better understanding of themselves. Over 90% of users (36/39, 92.5%) answered all active data questions on the days they used the app. Passive data collection facilitated the gathering of a broader range of well-being metrics over time, with minimal user intervention. CONCLUSIONS The Mindcraft app has shown promising results in monitoring mental health symptoms and promoting user engagement among children and young people during its development and initial testing. The app's user-centered design, the focus on privacy and transparency, and a combination of active and passive data collection strategies have all contributed to its efficacy and receptiveness among the target demographic. By continuing to refine and expand the app, the Mindcraft platform has the potential to contribute meaningfully to the field of mental health care for young people.
ABSTRACT Summer-born children perform less well academically and are more likely to receive SEN p... more ABSTRACT Summer-born children perform less well academically and are more likely to receive SEN provision than those born in the spring or autumn. School studies using small samples suggest that summer-born children with learning difficulties perform no less well on age-standardised tests. This article examines the relation between season of birth, SEN, specific learning difficulties and performance on age-standardised measures of IQ, reading and spelling, using data from a large population-based cross-sectional community survey of British children. There were more summer-born children with SEN compared with autumn and spring-born, but no significant differences in IQ, reading ability, spelling ability or specific learning difficulties between seasons. The excess of summer-born children with special needs does not mirror age-adjusted attainment. Teachers' expectations may not allow fully for age variation within the school year.
Aims and methodNon-attendance at psychiatric outpatient appointments has a substantial financial ... more Aims and methodNon-attendance at psychiatric outpatient appointments has a substantial financial cost, and may also have clinical significance. To prevent non-attendance and formulate effective responses, its determinants need to be understood. Patient dissatisfaction with services has been suggested as a reason for non-attendance, we therefore investigated the role of patient satisfaction in attendance at psychiatric out-patients appointments. All patients booked for adult psychiatric out-patient follow-up appointments in a three-month period were studied using a brief, self-report questionnaire.ResultsSixty-three per cent (340/538) of offenders and 54% (118/219) of non-attenders responded. Responders expressed high levels of satisfaction with their treatment (92% offenders, 91% non-attenders) and with the service (96% attenders 92% non-attenders). Despite adequate statistical power, there were no statistically significant differences in satisfaction between the two groups.Clinical...
The consensus statement by the Royal College of Psychiatrists recommended that patients on high d... more The consensus statement by the Royal College of Psychiatrists recommended that patients on high dose antipsychotic medication receive regular electro-cardiographic monitoring to identify prolongation of the QT interval. A survey of trainee psychiatrists in three hospitals investigated the accuracy with which trainees could identify this abnormality and found only 20% could do so.
Journal of the American Academy of Child & Adolescent Psychiatry, 2007
To assess psychiatric status after meningococcal disease. Cohort study of 66 children (34 boys, 3... more To assess psychiatric status after meningococcal disease. Cohort study of 66 children (34 boys, 32 girls) ages 4 to 17 years admitted to pediatric hospitals with meningococcal disease. The main outcome measure was psychiatric disorder (1-year period and point prevalence on the Schedule for Affective Disorders and Schizophrenia for School-Age Children interview for children 6 years or older; point prevalence in younger children on the Behavior Screening Questionnaire). During the course of the year after discharge from hospital, psychiatric disorders were identified in 23 of 40 (57%) children ages 6 years or older. The most common primary disorders were depressive, oppositional defiant, and anxiety disorders. At the time of 12-month follow-up, psychiatric disorders were present in 13 of 40 (32%) of those ages 6 or older and in 7 of 26 (26%) under 6 years old. Two children had a diagnosis of posttraumatic stress disorder. Logistic regression analysis showed that global meningococcal illness severity score, clinical shock on admission, and impairing premorbid emotional and behavioral problems in the child were independent predictors of psychiatric disorder at 12-month follow-up. Psychiatric disorders are common in the year after meningococcal disease. Especially at risk are children who are severely medically ill and those with more impairing premorbid emotional and behavioral problems.
ERASMA is an extensive survey which was conducted on more than 1800 depressed patients, who under... more ERASMA is an extensive survey which was conducted on more than 1800 depressed patients, who underwent hospital treatment between January and June 1993. It was a naturalistic survey which aimed to explore real performances of antidepressants prescribed within the context of everyday hospital use. Design Protocol Inclusion criteria: • man or woman > 18 years old • major depressive episode according to DSM-III-R • MADRS : Score ~ 25. major depress ion. of moderate to severe intensity • patient whose condition requires hospitalisation for at least 12 days and oral antidepressant treatment • ant idepressant prescription details and any concomitant treatments are left to the discretion of the practitioner Evaluation criteria from Day 0 to Day 60: MADRS scale/COVI scale/CGI scale Overall improvement/Clinical index of assessment/Adverse events Patient self-assessment visual scale Results: MAORS scale: percentage of patients with a 50% improvement in score : it can be seen that nearly half of them achieved this level on 012. 80% on 030 and 88% on 060. At the end point. 74% of patients had improved by 50%. which is consistent with the efficacy rates usually observed with antidepressants. Apart from prov iding a substantial amount of information concerning current practice in the treatment of depression in hospitals. the survey supports many others so far carr ied out which have not demonstrate any differences in the time to onset of therapeutic effects, just at global efficacy level. between the various therapeutic classes of antidepressants currently on the market. However. a very clear synergy appears between drug treatment and hospital care. which is crucial for the depressed patient. since any delay in the provision of effective care can lead to an exacerbation or chronicity of the symptomatology. or even to suicide. Conclusion: For any furture survey of this type. it would be a good idea to attempts to make a better assessment of the importance of these non-pharmacological factors which most definitely lie in the relational dimension of care. It should therefore be possible to take into account, at least in part. the importance of relational and psychological factors. which are often. if not always. not taken into account in conventional therapeutic studies.
As part of our series on managing neurological and psychiatric conditions in children and adolesc... more As part of our series on managing neurological and psychiatric conditions in children and adolescents, Dr Julia Gledhill and Dr Matthew Hodes discuss depression.
BACKGROUND Children and young people's mental health is a growing public health concern, whic... more BACKGROUND Children and young people's mental health is a growing public health concern, which is further exacerbated by the COVID-19 pandemic. Mobile health apps, particularly those using passive smartphone sensor data, present an opportunity to address this issue and support mental well-being. OBJECTIVE This study aimed to develop and evaluate a mobile mental health platform for children and young people, Mindcraft, which integrates passive sensor data monitoring with active self-reported updates through an engaging user interface to monitor their well-being. METHODS A user-centered design approach was used to develop Mindcraft, incorporating feedback from potential users. User acceptance testing was conducted with a group of 8 young people aged 15-17 years, followed by a pilot test with 39 secondary school students aged 14-18 years, which was conducted for a 2-week period. RESULTS Mindcraft showed encouraging user engagement and retention. Users reported that they found the app to be a friendly tool helping them to increase their emotional awareness and gain a better understanding of themselves. Over 90% of users (36/39, 92.5%) answered all active data questions on the days they used the app. Passive data collection facilitated the gathering of a broader range of well-being metrics over time, with minimal user intervention. CONCLUSIONS The Mindcraft app has shown promising results in monitoring mental health symptoms and promoting user engagement among children and young people during its development and initial testing. The app's user-centered design, the focus on privacy and transparency, and a combination of active and passive data collection strategies have all contributed to its efficacy and receptiveness among the target demographic. By continuing to refine and expand the app, the Mindcraft platform has the potential to contribute meaningfully to the field of mental health care for young people.
ABSTRACT Summer-born children perform less well academically and are more likely to receive SEN p... more ABSTRACT Summer-born children perform less well academically and are more likely to receive SEN provision than those born in the spring or autumn. School studies using small samples suggest that summer-born children with learning difficulties perform no less well on age-standardised tests. This article examines the relation between season of birth, SEN, specific learning difficulties and performance on age-standardised measures of IQ, reading and spelling, using data from a large population-based cross-sectional community survey of British children. There were more summer-born children with SEN compared with autumn and spring-born, but no significant differences in IQ, reading ability, spelling ability or specific learning difficulties between seasons. The excess of summer-born children with special needs does not mirror age-adjusted attainment. Teachers' expectations may not allow fully for age variation within the school year.
Aims and methodNon-attendance at psychiatric outpatient appointments has a substantial financial ... more Aims and methodNon-attendance at psychiatric outpatient appointments has a substantial financial cost, and may also have clinical significance. To prevent non-attendance and formulate effective responses, its determinants need to be understood. Patient dissatisfaction with services has been suggested as a reason for non-attendance, we therefore investigated the role of patient satisfaction in attendance at psychiatric out-patients appointments. All patients booked for adult psychiatric out-patient follow-up appointments in a three-month period were studied using a brief, self-report questionnaire.ResultsSixty-three per cent (340/538) of offenders and 54% (118/219) of non-attenders responded. Responders expressed high levels of satisfaction with their treatment (92% offenders, 91% non-attenders) and with the service (96% attenders 92% non-attenders). Despite adequate statistical power, there were no statistically significant differences in satisfaction between the two groups.Clinical...
The consensus statement by the Royal College of Psychiatrists recommended that patients on high d... more The consensus statement by the Royal College of Psychiatrists recommended that patients on high dose antipsychotic medication receive regular electro-cardiographic monitoring to identify prolongation of the QT interval. A survey of trainee psychiatrists in three hospitals investigated the accuracy with which trainees could identify this abnormality and found only 20% could do so.
Journal of the American Academy of Child & Adolescent Psychiatry, 2007
To assess psychiatric status after meningococcal disease. Cohort study of 66 children (34 boys, 3... more To assess psychiatric status after meningococcal disease. Cohort study of 66 children (34 boys, 32 girls) ages 4 to 17 years admitted to pediatric hospitals with meningococcal disease. The main outcome measure was psychiatric disorder (1-year period and point prevalence on the Schedule for Affective Disorders and Schizophrenia for School-Age Children interview for children 6 years or older; point prevalence in younger children on the Behavior Screening Questionnaire). During the course of the year after discharge from hospital, psychiatric disorders were identified in 23 of 40 (57%) children ages 6 years or older. The most common primary disorders were depressive, oppositional defiant, and anxiety disorders. At the time of 12-month follow-up, psychiatric disorders were present in 13 of 40 (32%) of those ages 6 or older and in 7 of 26 (26%) under 6 years old. Two children had a diagnosis of posttraumatic stress disorder. Logistic regression analysis showed that global meningococcal illness severity score, clinical shock on admission, and impairing premorbid emotional and behavioral problems in the child were independent predictors of psychiatric disorder at 12-month follow-up. Psychiatric disorders are common in the year after meningococcal disease. Especially at risk are children who are severely medically ill and those with more impairing premorbid emotional and behavioral problems.
ERASMA is an extensive survey which was conducted on more than 1800 depressed patients, who under... more ERASMA is an extensive survey which was conducted on more than 1800 depressed patients, who underwent hospital treatment between January and June 1993. It was a naturalistic survey which aimed to explore real performances of antidepressants prescribed within the context of everyday hospital use. Design Protocol Inclusion criteria: • man or woman > 18 years old • major depressive episode according to DSM-III-R • MADRS : Score ~ 25. major depress ion. of moderate to severe intensity • patient whose condition requires hospitalisation for at least 12 days and oral antidepressant treatment • ant idepressant prescription details and any concomitant treatments are left to the discretion of the practitioner Evaluation criteria from Day 0 to Day 60: MADRS scale/COVI scale/CGI scale Overall improvement/Clinical index of assessment/Adverse events Patient self-assessment visual scale Results: MAORS scale: percentage of patients with a 50% improvement in score : it can be seen that nearly half of them achieved this level on 012. 80% on 030 and 88% on 060. At the end point. 74% of patients had improved by 50%. which is consistent with the efficacy rates usually observed with antidepressants. Apart from prov iding a substantial amount of information concerning current practice in the treatment of depression in hospitals. the survey supports many others so far carr ied out which have not demonstrate any differences in the time to onset of therapeutic effects, just at global efficacy level. between the various therapeutic classes of antidepressants currently on the market. However. a very clear synergy appears between drug treatment and hospital care. which is crucial for the depressed patient. since any delay in the provision of effective care can lead to an exacerbation or chronicity of the symptomatology. or even to suicide. Conclusion: For any furture survey of this type. it would be a good idea to attempts to make a better assessment of the importance of these non-pharmacological factors which most definitely lie in the relational dimension of care. It should therefore be possible to take into account, at least in part. the importance of relational and psychological factors. which are often. if not always. not taken into account in conventional therapeutic studies.
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