pdf/owards-a-holistic-approach-to-support-learners-at-risk-of-2fezhy43f6.pdf

owards a holistic approach to support learners at risk of interrupted development: Midst- and post-COVID-19 interventions

COVID-19 and Psychiatric Disorders in Minors: Changes in Inpatient Treatment According to Hospital Statistics Abstract: Increased rates of psychiatric disorders and psychiatric emergencies in children and adolescents stemming from the COVID-19 pandemic have been reported, with more children and adolescents suffering from internalizing disorders. This study analyzes whether the increased rates led to increased rates of inpatient treatment in child and adolescent psychiatric and pediatric hospitals in Germany as well as a change in diagnoses of the treated patients. We analyzed routine hospital data ("InEK" data, § 21 KHG data files) from a prepandemic (2019) and a pandemic (2021) half-year regarding changes in the number of cases, diagnoses, and length of stay (LoS) in child and adolescent psychiatry and pediatrics. We also investigated the development of psychiatric emergencies in minors. We found an increase in internalizing problems (depression, anorexia nervosa, trauma-related disorders) and a decrease in externalizing problems among the admitted psychiatric inpatients. Further, we observed a halving of cases treated for alcohol intoxication. However, we discovered no change for the frequency of psychiatric emergency treatments nationwide. A more detailed analysis revealed that, in areas with a low number of child and adolescent psychiatry inpatient beds, emergency care was prioritized and LoS decreased, whereas in areas with a fair bed-to-inhabitant ratio among minors, there was a trend toward increased LoS, also in pediatric departments. We recommend continued monitoring of inpatient care after the pandemic, with special attention paid to underprivileged children and adolescents such as those with externalizing problems.

[COVID-19 and Psychiatric Disorders in Minors: Changes in Inpatient Treatment According to Hospital Statistics].

Psychotherapy delivered via videoconferencing (teletherapy) was a well-accepted treatment option for children and adolescents during the early phases of the COVID-19 pandemic. Information on the long-term satisfaction with teletherapy in routine clinical practice is missing.Caregivers (parents) and psychotherapists of n = 228 patients (4-20 years) treated in a university outpatient clinic completed a follow-up survey on satisfaction with videoconference-delivered cognitive-behavioral treatment (CBT). The follow-up survey (T2) was conducted about 1 year after initial assessment of treatment satisfaction in 2020 (T1).At follow up, therapists reported that 79% of families had received teletherapy as part of a blended treatment approach including in-person and videoconference delivery of CBT. Wilcoxon tests revealed that satisfaction with teletherapy was stable over time. In addition, parent ratings of the impact of teletherapy on treatment satisfaction and the therapeutic relationship did not change over time. Therapists' ratings of the impact of teletherapy on the therapeutic relationship with the caregiver were more negative at T2 compared to T1. Satisfaction with teletherapy was higher for patients with less pandemic-related stress, less externalizing behavior problems, and older age (all r < .35).The high level of satisfaction with teletherapy for children and adolescents treated in routine clinical practice reported in 2020 was maintained after social distancing regulations were eased in 2021. Teletherapy provided as part of a blended treatment approach is a well-accepted method of treatment delivery for youths with mental health problems. The study was registered in the German Clinical Trials Register (DRKS00028639). 

Satisfaction with videoconference-delivered CBT provided as part of a blended treatment approach for children and adolescents with mental disorders and their families during the COVID-19 pandemic: A follow-up survey among caregivers and therapists

Introduction Psychotherapy delivered via videoconferencing (teletherapy) was a well-accepted treatment option for children and adolescents during the early phases of the COVID-19 pandemic. Information on the long-term satisfaction with teletherapy in routine clinical practice is missing. Methods Caregivers (parents) and psychotherapists of n  =  228 patients (4–20 years) treated in a university outpatient clinic completed a follow-up survey on satisfaction with videoconference-delivered cognitive-behavioral treatment (CBT). The follow-up survey (T2) was conducted about 1 year after initial assessment of treatment satisfaction in 2020 (T1). Results At follow up, therapists reported that 79% of families had received teletherapy as part of a blended treatment approach including in-person and videoconference delivery of CBT. Wilcoxon tests revealed that satisfaction with teletherapy was stable over time. In addition, parent ratings of the impact of teletherapy on treatment satisfaction and the therapeutic relationship did not change over time. Therapists’ ratings of the impact of teletherapy on the therapeutic relationship with the caregiver were more negative at T2 compared to T1. Satisfaction with teletherapy was higher for patients with less pandemic-related stress, less externalizing behavior problems, and older age (all r < .35). Conclusion The high level of satisfaction with teletherapy for children and adolescents treated in routine clinical practice reported in 2020 was maintained after social distancing regulations were eased in 2021. Teletherapy provided as part of a blended treatment approach is a well-accepted method of treatment delivery for youths with mental health problems. The study was registered in the German Clinical Trials Register (DRKS00028639).

Clinical aspects of adaptation in old age

Abstract Analyzing COVID-19-related stress in children with affective dysregulation (AD) seems especially interesting, as these children typically show heightened reactivity to potential stressors and an increased use of maladaptive emotion regulation strategies. Children in out-of-home care often show similar characteristics to those with AD. Since COVID-19 has led to interruptions in psychotherapy for children with mental health problems and to potentially reduced resources to implement treatment strategies in daily life in families or in out-of-home care, these children might show a particularly strong increase in stress levels. In this study, 512 families of children without AD and 269 families of children with AD reported on COVID-19-related stress. The sample comprised screened community, clinical, and out-of-home care samples. Sociodemographic factors, characteristics of child and caregiver before the pandemic, and perceived change in external conditions due to the pandemic were examined as potential risk or protective factors. Interestingly, only small differences emerged between families of children with and without AD or between subsamples: families of children with AD and families in out-of-home care were affected slightly more, but in few domains. Improvements and deteriorations in treatment-related effects balanced each other out. Overall, the most stable and strongest risk factor for COVID-19-related stress was perceived negative change in external conditions—particularly family conditions and leisure options. Additionally, caregiver characteristics emerged as risk factors across most models. Actions to support families during the pandemic should, therefore, facilitate external conditions and focus on caregiver characteristic to reduce familial COVID-19-related stress. Trial registration: German Clinical Trials Register (DRKS), ADOPT Online: DRKS00014963 registered 27 June 2018, ADOPT Treatment: DRKS00013317 registered 27 September 2018, ADOPT Institution: DRKS00014581 registered 04 July 2018. 

/pdf/impact-of-the-covid-19-pandemic-on-children-with-and-without-2ioldc2o.pdf

Impact of the COVID-19 pandemic on children with and without affective dysregulation and their families

A clinico-epidemiologic prevalence survey was conducted in the sub-mountainous area of Northern Bohemia, which is distinguished by the highest proportion of aged people in Bohemian countries. It involved 6057 persons of the 70-79 age group, 1718 persons of the 80-89 age group and 139 persons of the 90+ group, plus control subjects in various other groups. In this study an attempt was made to find an effective measure of the presumed risk factors of pathologic aging in persons of the 70-105 age group. The data were analyzed by the method of coincidence of two parameters of binomial decomposition on the computer Odra. The quantity dependence of the signs was determined, and an index of the compound-risk factor of pathologic aging was calculated. When the numerical value of the index is lower than 56.9 +/- 4.36 for a group of males or 50.3 +/- 3.55 for a group of females, the probability is that a given person in those groups will survive to an advanced age. The total risk is higher for the male sex. Of considerable importance are the genetic burden, external environmental causes, harmful habits, certain "civilization" diseases, and other factors such as disturbed social contacts and defective nutrition.

Some Risk Factors in Pathologic Aging

In a prevalence epidemiologic study conducted in a characteristic submontane area in North Bohemia, the genealogic incidence of myocardial infarction, sudden brain vascular episodes, and malignant tumors was studied in a representative sample of persons aged 70 to 105 years. The incidence was then compared with that in two other samples: 1) men under age 40 with a history of transmural myocardial infarction, and 2) both men and women aged 40–60 who had had a stroke. The statistical evaluation was performed according to accepted international criteria (WHO). A significantly lower genealogic incidence of myocardial infarction and sudden brain vascular episodes was found in the geriatric subjects (70–105 years old) who had symptoms of so-called physiologic aging, as compared with the incidence in the younger subjects who had symptoms of so-called pathologic aging. The difference was less clear-cut with respect to the genealogic incidence of malignant tumors.

Relative Genealogic Incidence of Certain “Civilization Diseases” in a Geriatric Population versus Pregeriatric Groups

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Impact of the COVID-19 pandemic on children with and without affective dysregulation and their families

Some Risk Factors in Pathologic Aging

Relative Genealogic Incidence of Certain “Civilization Diseases” in a Geriatric Population versus Pregeriatric Groups