scholarly journals The Implementation, Diagnostic Yield and Clinical Outcome of Genetic Testing on an Inpatient Child and Adolescent Psychiatry Service

2019 ◽  
Author(s):  
Aaron D. Besterman ◽  
Joshua Sadik ◽  
Michael J. Enenbach ◽  
Fabiola Quintero-Rivera ◽  
Mark DeAntonio ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Adolescent Psychiatry ◽  
Diagnostic Yield ◽  
Child And Adolescent Psychiatry ◽  
Underrepresented Minorities ◽  
Clinical Services ◽  
Genetics Education ◽  
Access To Genetic Services ◽  
Improve Access

AbstractObjectiveDiagnostic genetic testing is recommended for children with neurodevelopmental disorders (NDDs). However, many children with NDDs do not receive genetic testing. One approach to improve access to genetic services for these patients is to offer testing on the inpatient child and adolescent psychiatry (CAP) service.MethodsWe implemented systematic genetic testing on an inpatient CAP service by providing medical genetics education to CAP fellows. We compared the genetic testing rates pre- and post-education. We compared the diagnostic yield to previously published studies and the demographics of our cohort to inpatients who received genetic testing on other clinical services. We assessed rates of outpatient genetics follow-up post-discharge.ResultsThe genetic testing rate on the inpatient CAP service was 1.6% (2/125) before the educational intervention and 10.7% (21/197) afterwards (OR = 0.13, 95% CI = 0.015- 0.58, p = 0.0015). Diagnostic yield for patients on the inpatient service was 4.3% (1/23), lower than previously reported. However, 34.8% (8/23) of patients had variants of unknown significance (VUSs). 39.1% (9/23) of children who received genetic testing while inpatients were underrepresented minorities, compared to 7.7% (1/13) of patients who received genetic testing on other clinical services (OR = 7.35, CI = 0.81-365.00, p = 0.057). 43.5% of patients were lost to outpatient genetics follow-up.ConclusionMedical genetics education for fellows on an inpatient CAP service can improve genetic testing rates. Genetic testing for inpatients may primarily identify VUSs instead of well-known NDD risk variants. Genetic testing on the inpatient CAP service may improve access to genetic services for underrepresented minorities, but assuring outpatient follow-up can be challenging.

scholarly journals Service innovations: second opinions in child and adolescent psychiatry

2003 ◽  
Vol 27 (1) ◽  
pp. 22-24
Author(s):  
Greg Richardson ◽  
David Cottrell
Keyword(s):  
Mental Health ◽  
Young People ◽  
Adolescent Psychiatry ◽  
Best Practice ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Clinical Implications ◽  
Academic Unit ◽  
Diagnosis And Management

AIMS AND METHODSTo devise a protocol, reflecting best practice, for obtaining second opinions in child and adolescent psychiatry through discussion with consultants in child and adolescent psychiatry within the Yorkshire region at their quarterly meetings.ResultsThe major pressure for second opinions falls upon the Academic Unit of Child and Adolescent Mental Health and on the in-patient units. Other consultants who are considered to have specialist expertise in certain areas may also receive referrals for second opinions. Both consultants requesting and offering second opinions considered a protocol for obtaining them would be helpful to their practice.Clinical ImplicationsAn agreed protocol between consultants in child and adolescent psychiatry within a region ensures that young people with complex problems have access to second opinions on their diagnosis and management by consultants who can be recommended to referrers by other consultants. The network of consultants ensures such opinions are not requested excessively and that ‘rogue’ opinions without therapeutic follow-up are avoided.

Initial Treatment of Bipolar I Disorder in Children and Adolescents

2018 ◽  
Author(s):  
Stephanie Ng ◽  
Andres Martin
Keyword(s):  
Children And Adolescents ◽  
Adolescent Psychiatry ◽  
Initial Treatment ◽  
Clinical Case ◽  
Child And Adolescent Psychiatry ◽  
Divalproex Sodium ◽  
Bipolar I Disorder ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in child and adolescent psychiatry. In medication-naïve children and adolescents with bipolar I disorder who have had a recent manic or mixed phase episode, should risperidone, lithium, or divalproex sodium be used for initial treatment? Also, for partial responders or nonresponders to the first medication, which agent should be added on or switched to? Starting with these questions, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

scholarly journals A substance misuse clinic for adolescents

1994 ◽  
Vol 18 (7) ◽  
pp. 401-402 ◽  
Author(s):  
Richard Blennerhassett ◽  
Eilish Gilvarry ◽  
Peter Tayler
Keyword(s):  
Adolescent Psychiatry ◽  
Substance Misuse ◽  
Joint Venture ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Clinical Services ◽  
Adolescent Substance ◽  
Voluntary Organisation ◽  
Newcastle Upon Tyne

We describe the operation of a substance misuse clinic for adolescents as a Joint venture between a voluntary organisation ‘Streetwise’ and the Adult Substance Misuse Services and Child and Adolescent Psychiatry Services in Newcastle upon Tyne. A number of issues are discussed relevant to improving clinical services for adolescent substance misusers.

Predictors of Suicidal Events

2018 ◽  
Author(s):  
Michael Maksimowski ◽  
Zheala Qayyum
Keyword(s):  
Study Design ◽  
Adolescent Psychiatry ◽  
Psychiatric Illness ◽  
Clinical Case ◽  
Suicide Attempts ◽  
Child And Adolescent Psychiatry ◽  
History Of ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in child and adolescent psychiatry. Youths with a history of psychiatric illness are known to be at greater risk of suicide. What are the predictors of suicidal events and attempts in adolescents with a history of suicide attempts and depression? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. Several characteristics were identified that correlated with subsequent suicidal events. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Cost-effectiveness of intensive home treatment enhanced by inpatient treatment elements in child and adolescent psychiatry in Germany: A randomised trial

2015 ◽  
Vol 30 (5) ◽  
pp. 583-589 ◽  
Author(s):  
I. Boege ◽  
N. Corpus ◽  
R. Schepker ◽  
R. Kilian ◽  
J.M. Fegert
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Costs ◽  
Adolescent Psychiatry ◽  
Inpatient Treatment ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Care Costs

AbstractBackgroundAdmission rate to child and adolescent mental health inpatient units in Germany is high (54 467 admissions in 2013), resources for providing necessary beds are scarce. Alternative pathways to care are needed. Objective of this study was to assess the cost-effectiveness of inpatient treatment versus Hot-BITs-treatment (Hometreatment brings inpatient-treatment outside), a new supported discharge service offering an early discharge followed by 12 weeks of intensive support.MethodsOf 164 consecutively recruited children and adolescents, living within families and being in need of inpatient mental health care, 100 patients consented to participate and were randomised via a computer-list into intervention (n = 54) and control groups (n = 46). Follow-up data were available for 76 patients. Primary outcome was cost-effectiveness. Effectiveness was gathered by therapist-ratings on the Children's Global Assessment Scale (CGAS) at baseline (T1), treatment completion (T2) and an 8-month-follow-up (T3). Cost of service use (health care costs and non–health care costs) was calculated on an intention-to-treat basis at T2 and T3.ResultsSignificant treatment effects were observed for both groups between T1/T2 and T1/T3 (P < 0.001). The Hot-BITs treatment, however, was associated with significantly lower costs at T2 (difference: −6900.47€, P = 0.013) and T3 (difference: −8584.10€, P = 0.007). Bootstrap cost-effectiveness ratio indicated that Hot-BITs was less costly and tended to be more effective at T2 and T3.ConclusionsHot-BITs may be a feasible cost-effective alternative to long inpatient stays in child and adolescent psychiatry. Further rigorous evaluations of the model are required. (Registration number: ISRCTN02672532, part 1, Current Controlled Trials Ltd, URL: http://www.controlled-trials.com).

scholarly journals The Feasibility and Outcomes of Genetic Testing for Autism and Neurodevelopmental Disorders on an Inpatient Child and Adolescent Psychiatry Service

2020 ◽  
Vol 13 (9) ◽  
pp. 1450-1464 ◽  
Author(s):  
Aaron D. Besterman ◽  
Joshua Sadik ◽  
Michael J. Enenbach ◽  
Fabiola Quintero‐Rivera ◽  
Mark DeAntonio ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Adolescent Psychiatry ◽  
Neurodevelopmental Disorders ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry
Sign in / Sign up

Export Citation Format

Share Document