Over the past 20 years, child and adolescent community mental health has evolved conceptually, clinically, and scientifically towards the community-based systems of care model. This model asserts important values and principles, including the centrality of the child and family in the care process, the integration of the efforts of disparate agencies and interveners into a contextual approach, and the importance of serving children with serious disturbances in their homes and communities. The article reviews the evolution of the community-based systems of care model, its evidence-base, its application in practice, and the challenges it faces in today's human services environment.

The consequences of childhood bereavement are two-fold, in the pain he/ she suffers at the time of the death, and in future psychiatric disorders which can follow unresolved mourning. The bereaved child needs a familiar and responsible adult outside the family to help him/her cope with his/her grief, because parents are sometimes emotionally absent from him/her due to their own grief or they seek to "protect" the child from the pain of the loss. This study presents a programme given to 164 primary school teachers from nine schools in Cape Town to educate them in how to help the bereaved child in the classroom situation, so that they can fill the role of an outside responsible adult in the life of the bereaved child. 78 bereavements occurred in the nine schools in the year of the study. It was found that the teachers responded positively to the training programme and that they perceived it to be helpful in dealing with a bereaved child.

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This master’s thesis examines the motives behind the establishment of the child and adolescent psychiatry in Sweden as a public health institution during the 1940’s and 1950’s. Children’s welfare was an ongoing question during this period of time and a political matter often discussed. The political perspective used in the thesis has managed to illuminate results of a more political nature in relation to previous research which has been focusing more on the medical reasons behind the institution’s development. The results from my analysis show that the development of the child and adolescent psychiatry can be explained through Kathleen Thelen’s models of explanations including an utilitarian-funcionalistic explanation and a cultural-sociological one, explaining that an institution develops both due to more specific problems with the goal to benefit as many as possible. An institution also develops due to a cultural surrounding where it exists commonly known believes about which solutions are the most moral, legitimate or even the only ways to act. My results show that the establishment was founded on a basis of the Swedish welfare society where certain political goals demanded certain political solutions, the establishment of the Swedish child and adolescent psychiatry being one of the solutions. A range ofmotivesthathasbeenuncovered inthestudycanallberelatedtofeaturesoftheSwedish welfare state, such as universalism, social order, centralisation, state control and state tending. In this political landscape the institution child and adolescent psychiatry became a tool for investing in the future, aiming at sustaining certain achievements and to reach certain goals.

Introduction: Maternal antenatal depression is associated with increased risk of adverse offspring outcomes, which manifest in approximately 20% of infants. However, the mechanisms by which risk is transferred from mother to infant, and the factors determining susceptibility to antenatal mood disturbance, remain poorly understood. Objectives: The primary objectives of this thesis are to investigate whether: (i) Antenatal depression is associated with alterations of the maternal and infant Hypothalamic-Pituitary-Adrenal (HPA) axis. (ii) The infant serotonin transporter genotype (5-HTTLPR) confers susceptibility to antenatal mood disturbance. Methods: This thesis is an analysis of two different cohorts. First, 103 pregnant women were recruited in Oxford, UK. Participants’ self-reported antenatal mood, and salivary cortisol was assessed in response to a stressor and diurnally. 88 participants were visited two months post-birth. Mothers reported postnatal mood and infant temperament. Infant cortisol responses to inoculation were assessed, as was infant DNA methylation. Analysis of this cohort addresses the first objective of this thesis. Next, data from the ALSPAC cohort was analysed to address the second objective. Maternal-reported antenatal mood and infant behaviour up to 7 years was available, as was 5-HTTLPR genotype data for over 4,000 infants. Results: Antenatal depression was not associated with increased maternal cortisol during pregnancy. Neither antenatal depression nor cortisol was associated with infant cortisol reactivity or temperament. Antenatal depression predicted increased NR3C1 DNA methylation in males, and decreased BDNF DNA methylation in male and female infants. Infant 5-HTTLPR genotype did not moderate associations between antenatal mood disturbance and behavioural difficulties. Conclusions: This thesis does not support the theory that antenatal depression exerts influence on infant development via increased activity of the maternal and infant HPA axis; however, changes in infant DNA methylation may be a mediating mechanism. Further, susceptibility to antenatal mood may be more complex than previously thought.

A research report submitted to the Faculty of Health Sciences , University of the Witwatersrand in partial fulfillment of the requirements for the degree of the Masters of Science in Medicine in Psychiatry, Johannesburg, 2014 / In the past ten years, there has been an increased awareness about the diagnosis and treatment of psychiatric disorders in childhood. As a consequence, there has been a concomitant increase in the prescription of psychiatric medication for children. Off-label and concomitant medication are particular issues of concern in child psychiatry. In South Africa, there is limited data on paediatric prescribing trends. It is important to know the demographic trends and clinical reasons for medication use in order to assess, plan, improve and budget for children’s mental health care services. The results of this study will give insights into the current prescribing patterns at Tara’s Outpatient Child Clinic (TOCC)

Concerned that depression might be a common malady among youth who are placed in treatment centers for delinquents, we undertook an exploratory study to determine the validity of this premise. The authors of this study have all worked with youth who, for various reasons, have been placed in residential treatment centers. The authors have observed that symptoms of depression seem to be more prevalent in these youth than in non-institutionalized adolescents, and that these symptoms are often perceived as individual pathology rather than emotional responses common to institutionalized youth. We thus began questioning if these were common emotional responses, and if they were common in males and females in a number of treatment centers. We were interested in knowing if the youth do in fact become more, depressed after being admitted to a treatment center, and if they do, at what point in their stay at the center this occurs.

Although mental disorders are common among children all over the world, information on the extent and types of child psychiatric disorders in Ethiopia is extremely limited. A study was conducted in an urban setting of Ethiopia to look at the prevalence of child psychiatric disorders and their correlates. A two-phase survey was performed. In the first phase, parents of 5000 children in Addis Ababa, the capital city of Ethiopia, were interviewed using the Reporting Questionnaire for Children (RQC). In the second phase, parents of all screen-positive children (n=864) and parents of 1537 screen-negative children were interviewed using the revised parent version of the Diagnostic Interview for Children and Adolescents (DICA-R), a semi-structured diagnostic instrument that is based on the third revised edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-III-R). This thesis discusses the results of that study in comparison with other child mental health studies in Ethiopia and elsewhere. At the recommended cut-off score of 1, the sensitivity, specificity, predictive values and likelihood ratios of the RQC to DICA-R diagnoses were acceptable. The RQC had high accuracy with a misclassification rate of 17%. The weighted prevalence for any DSM-III-R diagnosis was 17%. The most prevalent condition was enuresis (12.1%) followed by simple phobia (5.5%). The prevalence rates of all other identified conditions were below 1%. Children's age, severe economic problems, and single parenthood were found to be risk factors for any DSM-III-R diagnosis in children. Male sex, younger age, and lower achieved educational grade of the child were all independently associated with childhood enuresis. The odds of having enuresis were significantly higher for children in families with extreme poverty and in children from single-parent homes. The risk of having enuresis was significantly higher in children who had anxiety disorders (AD) and disruptive behaviour disorders (DBD). Sex was significantly associated with disruptive behaviour disorders while grade level, age, family size, ethnicity, poverty, and single parenthood were not. Anxiety disorders were significantly associated with sex, ethnicity, and extreme poverty but not with the other socio-demographic variables. The absence of mood disorders and somatoform disorders, of which symptoms are often encountered in both children and adults at clinical settings and the low prevalence rates of most identified conditions, were probably related to the lack of awareness or alternative explanations at the community level regarding the understanding of behaviour changes. Campaigns of public mental health education with the aim of providing scientific information to society are highly recommended. While Ethiopia works towards mainstreaming mental health into its health care system, training health care workers in applying simple screening tools like the RQC is recommended.

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Thesis (Ph. D.)--University of Wisconsin--Madison, 1965. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 109-118).