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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Content-free cueing and 'Remembering Goals' Training : the rehabilitation of prospective memory deficits in a paediatric population

Mahan, Steven January 2015 (has links)
Background: It is often considered that, following paediatric acquired brain injury (pABI) and epilepsy, higher-level cognitive deficits, such as prospective memory (PM), are impaired and may only become apparent over time when these abilities are expected to develop and mature in a typically developing child. Interventions supporting PM have the potential to increase independence and enhance social participation. Despite research indicating PM difficulties in children and adolescents with pABI and epilepsy, and also in children with PM difficulties with unknown aetiology, currently, there is a limited evidence-base for interventions, although previous research has attempted to address this following pABI (Rous, 2011). Objective: The objective of this empirical paper was to build upon the work of Rous (2011) and optimise the effectiveness of brief metacognitive 'Remembering Goals' Training (RGT) and external content-free cueing (in the form of 'STOP' text messages) on PM task performance and the achievement of real-life goals. Method: The research employed a single-case series design with a randomised, alternating treatment (Barlow & Hayes, 1979). Eight participants (aged 10-15 years) completed the study. Three participants had an ABI, two participants had epilepsy, and three participants experienced PM difficulties with unknown aetiology. The PM task required participants to send three text messages at set times and to complete three real-life goals each working day for a four-week period. After a baseline period, participants completed brief RGT via Skype twice during the study (once following baseline, and again half way through the study). The brief RGT facilitated metacognitive skills and participants learnt to associate texts reading 'STOP' with mentally reviewing their goals and tasks for that day. Six 'STOP' text messages (cues) were sent at random times on half of the days of the intervention. The number and accuracy of texts messages, and the achievement of real-life goals, were compared across cued and un-cued days to evaluate the efficacy of the intervention for each participant. Results: Five participants demonstrated improved PM text message performance and seven participants demonstrated improved performance in real-life goals. Most of the participants reported positive gains in self-reported PM abilities, and most parents of children with acquired neurological conditions reported reduced levels of family stress and burden following the intervention. Conclusions: This research offers some evidence in support of the efficacy of content-free cueing and RGT for facilitating PM abilities. The majority of participants engaged in more frequent and accurate PM tasks and, most importantly, achieved more of their real-life goals as a result of the intervention.
12

Nature, Severity And Origins Of Fears Among Children And Adolescents With Respect To Age, Gender And Socioeconomic Status

Serim, Begum 01 September 2010 (has links) (PDF)
The present study aimed to investigate the fears of female and male children and adolescents between the ages of 8 and 18 from different socioeconomic levels. Additionally, the origins of children&rsquo / s and adolescents&rsquo / fears were examined. To reach the aims, the study was divided into two stages. In the first stage adaptation study of Fear Survey Schedule for Children-AM (Burnham, 1995) into Turkish was conducted. Two different samples were utilized in stage one. First sample was comprised of 355 participants (173 females and 182 males) with a mean age of 12.66 (SD=3.05). Second sample was comprised of 1315 participants (642 females and 673 males) with a mean age of 13.15 (SD=3.18). Second stage of the study was the main study. Second sample of the first stage including 1315 participants was utilized in stage two. Beside Fear Survey Schedule for Children, assessing the origins of children&rsquo / s and adolescents&rsquo / fears were utilized in the present study. Results of the study pointed that female children from low socioeconomic status at age 8 were the most fearful group among all children and adolescents. Also, for all fear factors female children and especially from low socioeconomic status reported higher level of fear than male preadolescents and adolescents. In general, it can be said that being female, from low socioeconomic status and young especially at age 8 is related to more intense fears. Among all children and adolescents, fears of children at age 8, 9 and 10 were significantly different than fears of preadolescents and adolescents at various ages, but they were not significantly different than each other. Fears of preadolescents at age 11, 12 and 13 were significantly different than preadolescents at least 2 years older than themselves. Overall most commonly endorsed fears were &ldquo / someone in my family dying&rdquo / , &ldquo / going to Hell&rdquo / , &ldquo / death of a closed person (grandparent, best friend etc.)&rdquo / , &ldquo / abuse&rdquo / , &ldquo / God&rdquo / , &ldquo / AIDS&rdquo / , &ldquo / someone in my family having an accident&rdquo / , &ldquo / my parents separating or getting divorced&rdquo / and &ldquo / terrorist attacks&rdquo / . Findings related to the origins of children&rsquo / s and adolescents&rsquo / fears indicated that 64.8% of all children learnt fear by modeling, 51.8% of all children learnt fear by negative information transmission and 35.8% all of children fear by experiences (conditioning). Negative information transmission intensified 45.7% of all children and adolescents, modeling intensified 49% of all children and adolescents and experience (conditioning) intensified 44.8% of all children and adolescents.
13

Insecure attachment and psychopathology in children and adolescents : a meta-analysis

Goldstein, Caroline January 2012 (has links)
Since Bowlby (1958, cited in Bowlby, 1969) originally introduced the theory of attachment it has been written about extensively and a vast amount of research has contributed to the development of the theory. In more recent years research has focused on the possible link between attachment and psychopathology. The major aim of the present meta-analysis was to contribute to this research effort by establishing the magnitude of the effect size for the relationship between attachment security and internalizing psychopathology; and attachment security and externalizing psychopathology, in children and adolescents. Four separate meta-analyses were conducted investigating internalizing and externalizing problems in cross-sectional and prospective studies. A comprehensive literature search was conducted to identify relevant studies for inclusion in the analysis. Identified studies were assessed for eligibility according to stringent inclusion and exclusion criteria. A total of 23 studies contributing 45 effect size correlations, involving 3793 different participants were considered eligible for inclusion. Relevant information was extracted and coded from the studies before the analyses were conducted. For cross-sectional studies the mean effect size correlation for attachment security and internalizing psychopathology was r = -0.24 (k = 14; p <0.01; 95% CI = -0.31, -0.17). For attachment security and externalizing psychopathology the mean effect size was r = -0.28 (k = 16; p <0.01; 95% CI = -0.34, -0.21). In terms of prospective studies the mean effect size correlation for attachment security and internalizing psychopathology was r = -0.17 (k = 8; p = 0.01; 95% CI = -0.28, -0.04); and for externalizing psychopathology it was r = -0.09 (k = 7; p = 0.02; 95% CI = -0.16, -0.01). When attachment security and psychopathology were measured concurrently, there was evidence of a negative association for both internalizing and externalizing psychopathology. Although the magnitude of effect was smaller for prospective studies evidence was also found for the predictive validity of a lower level of attachment security in the development of both internalizing and externalizing psychopathology. Theoretical explanations for these findings are presented and the research and clinical implications are discussed in terms of the limitations of the study.
14

Beliefs about emotions and mindfulness : impact on the relationship between stressors and somatic symptoms in a school population

Purcell, Ann-Marie January 2013 (has links)
Background: Mindfulness based interventions are becoming increasingly popular for use with children and adolescents, particularly within the school context. Objectives: The aim of the systematic review was to examine the effectiveness of school-based mindfulness interventions with particular reference to mental health and wellbeing. The main study aimed to determine if beliefs about emotions and mindfulness moderated the relationship between stressors and somatic symptoms in an adolescent population. Method: The literature was systematically searched for mindfulness interventions carried out with children and adolescents within the school context. A cross-sectional survey was carried out in a rural sample of 489 high school students to examine specific a priori anticipated relationships amongst beliefs about emotions, mindfulness, stressors, and somatic symptoms. Results: Six studies met the criteria for inclusion. The study demonstrated that school-based mindfulness interventions produce some evidence of effective outcomes for mental health and wellbeing in children and adolescents. Factors associated with improvements included that the intervention was delivered by an experienced mindfulness trainer, and that home practice formed part of the intervention. Somatic symptoms were significantly correlated with beliefs about emotions and were significantly inversely correlated with dispositional mindfulness. Lower levels of mindfulness were associated with stronger beliefs about the unacceptability of expressing or experiencing negative emotions. Beliefs about emotions and mindfulness did not significantly moderate the relationship between somatic symptoms and stressors within an adolescent population. Conclusion: Further research is necessary to determine if mindfulness as a construct or an intervention is effective in enhancing adolescents’ resilience to stressors by improving mental health and wellbeing.
15

Study of growth and bone mineral density and factors affecting them in children and adolescents with thalassaemia major and sickle cell disease

Soliman, Ashraf January 1998 (has links)
Thalassaemia and sickle cell disease (SCD) are the most widely distributed blood genetic disorders that occur at a high frequency in some populations including the Mediterranean region, parts of the Middle East, South East Asia and the Indian subcontinent. It is estimated that thalassaemia major affects 100,000 newborn every year world-wide. The high incidence of these chronic haemolytic diseases in developing countries poses a high load on the national economy because of the expensive treatment protocols and the considerably high morbidity rates of these patients. Repeated blood transfusion to keep haemoglobin above an acceptable level requires well-equipped blood banks with expensive facilities to screen, store and manipulate blood and blood products. Iron chelation therapy is an essential part of treatment to avoid or delay the deleterious effects of iron overload on different organs including the liver, heart, pancreas and endocrine glands. This inquires injecting deferoxamine subcutaneously for 12 hours daily with a special pump. Both deferoxamine and pumps are expensive and therefore not accessible for all patients. In developing countries, the majority of transfusion-dependent patients with chronic haemolytic anaemia (thalassaemia and SCD) suffer from the consequences of sub-optimal treatment. The mortality rate is still high and usually patients die before the age of 30 years. They also suffer from chronic multi-organ damage including cardiac failure, liver cirrhosis, insulin-dependent diabetes mellitus, growth and pubertal failure and many skeletal abnormalities and fractures. In developed countries the introduction of high transfusion regimes and efficient chelation therapy improved survival rates and prevented cardiac and hepatic damage. However, a majority of thalassaemic patients still have significant growth and pubertal abnormalities, bone disease and multiple endocrine disorders. In Egypt the incidence of thalassaemia major ranges between 0.1 - 0.2% which gives very high patient load on the medical services. In our University of Alexandria Children's Hospital, Alexandria, Egypt. The Haematology clinic has an average of 150 thalassaemic children registered. The same problem is encountered by me in the Royal Hospital, Muscat, Oman, with high prevalence of SCD and thalassaemia and suboptimal treatment. Because of the restricted economic resources, both hospitals adopt a low transfusion therapy (to keep haemoglobin above 9 g/dl) with IM chelation 3 times per week. With this form of sub-optimal treatment we observed that a large number of our thalassaemic children have severe growth and pubertal failure/delay, beside other hepatic, cardiac and skeletal abnormalities. In fact they constitute 40% of patients attending our Endocrinology clinic. This stimulated me to perform an extensive study to survey growth and pubertal development in theses patients (study-1) and investigate the different factors that might affect their growth and pubertal development (studies 4 through 10) a \veU as bone mass density (studies > 1,12). The frequent involvement of the liver in these patients led us to study some hepatic functions and the prevalence of transfusion-associated hepatitis B surface antigenaemia and hepatitis-C virus antibody scropositivity in relation to their linear growth (studies 2,3). We studied the nutritional intake of these patients, their intestinal absorption of D-Xylosc and 48-h stool fat content in relation to their body mass index, subcutaneous 'at thickness and mid-arm circumference (studies 4,5,9). Their defective linear growth urged us to investigate their growth hormone (GH) secretion (spontaneous nocturnal as well as after provocation) and insulin-like growth factor-I (IGF-I) and IGK-binding protein-3 (IGKBl'3) concentrations. Our findings demonstrated high prevalence of defective GH secretion in these children that necessitated imaging of their hypothalamic pituitary area. Imaging studies revealed original data about structural abnormalities in the anterior pituitary gland, different degrees of pituitary atrophy and empty sella and infiltration the gland as well as the mid-brain by hacniosidrin in thalassaemic children, the mechanism of these findings was explained (studies 4-6,10). Because of their slow growth, the presence of abnormal GH/IGF-I/BP3 axis, and structural abnormalities of the pituitary gland, the next step dealt with the response of IGF-I to exogenous GH and the clinical response of their linear growth to GH therapy for a year or more (studies 4,9). Based on the fact that these patients have high prevalence of bone pains and osteoporosis during late childhood and have high risk of spontaneous fracture thereafter, we measured their bone mass density to investigate the relation between the former and the degree of iron load, growth parameters, and different anabolic hormone concentrations in these patients (studies 11,12).
16

Childhood trauma and its psychosocial sequelae : a thesis portfolio

Lemaigre, Charlotte January 2017 (has links)
Background: It is widely understood that survivors of childhood trauma (emotional abuse, physical abuse, sexual abuse and emotional, physical neglect) have poorer mental health outcomes than their non-abused counterparts; one of which is an increased risk of suicidality. The disclosure of childhood abuse is key to safeguarding against further victimization and promoting better psychosocial outcomes for survivors in the long-term. Aims: The aims of this thesis portfolio are twofold. Firstly, to review the published literature investigating the barriers and facilitators to disclosing sexual abuse as perceived by children and adolescents (Chapter 1). Secondly, to research the relationship between childhood trauma and suicidality in a cohort of socio-economically deprived men living in Scotland (Chapter 3). The bridging chapter (Chapter 2) discusses the main themes that connect chapters one and three, notably the possible negative impact of childhood trauma on adult psychosocial functioning. Method: An exploratory systematic review and meta-synthesis of the literature was carried out. Strict eligibility criteria were predefined and a comprehensive search strategy identified a total of thirteen studies for review. For the empirical study, a total of 86 adult men with past and/or present suicidality participated in a quantitative cohort study and completed measures on childhood trauma, emotion regulation, interpersonal difficulties and suicidal behaviour. Multiple mediation analysis was used to analyse the data and to answer the study’s research questions. Results: The exploratory review highlighted that existing research into child and adolescent disclosures of sexual abuse is still in its infancy and that robust, longitudinal studies with more sophisticated methodologies are required to replicate findings. The collective body of literature identified that limited support, perceived negative consequences and feelings of self-blame, shame and guilt serve as significant barriers to disclosure whilst being asked or prompted through the provision of developmentally appropriate information facilitates young people to tell. The empirical study found that emotion regulation and interpersonal difficulties mediate the relationship between childhood trauma and suicidality in a sample of adult men. Conclusion: Several important clinical implications were identified in both parts of the thesis portfolio. Firstly, the systematic review identified the need for family members, friends and frontline professionals to explicitly ask children about the possibility of sexual abuse. It was also considered imperative that recipients are supported in responding to disclosures in positive and supportive ways so as to reduce young peoples’ feelings of responsibility, self-blame, shame and guilt. The empirical study concluded that dysfunctional emotion regulation and interpersonal difficulties are implicated in the overall collateral and compounding psychosocial sequelae of childhood trauma. The provision of psychological interventions for men with past and/or present suicidality should support individuals to develop healthy social problem-solving and emotion regulation skills. Providing effective, trauma-informed interventions for these individuals will move their treatment beyond simple risk management and focus, instead, on instilling recovery and resilience.
17

Análise bioecológica de um serviço de atendimento às crianças e adolescentes vítimas de violência, abuso e exploração sexual

Albuquerque, Beatriz de Mello January 2010 (has links)
Dissertação(mestrado)- Universidade Federal do Rio Grande, Pós-Graduação em Educação Ambiental, Instituto de Educação, 2010. / Submitted by Luize Santos (lui_rg@hotmail.com) on 2012-07-02T00:49:52Z No. of bitstreams: 1 Beatriz Mello de Albuquerque.pdf: 847870 bytes, checksum: 400ae2845d00718a2949b58e05341a13 (MD5) / Approved for entry into archive by Bruna Vieira(bruninha_vieira@ibest.com.br) on 2012-07-03T22:35:54Z (GMT) No. of bitstreams: 1 Beatriz Mello de Albuquerque.pdf: 847870 bytes, checksum: 400ae2845d00718a2949b58e05341a13 (MD5) / Made available in DSpace on 2012-07-03T22:35:54Z (GMT). No. of bitstreams: 1 Beatriz Mello de Albuquerque.pdf: 847870 bytes, checksum: 400ae2845d00718a2949b58e05341a13 (MD5) Previous issue date: 2010 / O Serviço de Enfrentamento à Violência, ao Abuso e à Exploração Sexual de Crianças e Adolescentes, oferece um conjunto de procedimentos técnicos especializados para o atendimento e proteção imediata das vítimas destas modalidades de violência, bem como de seus familiares. Este estudo buscou realizar uma análise das práticas sociais e relacionais da equipe de agentes sociais para com os usuários do Serviço de atendimento na cidade de Rio Grande/RS e investigou as relações/interações das famílias vitimizadas com os profissionais. A pesquisa é de cunho qualitativo, na linha de pesquisa da Educação Ambiental não formal. Teve como base a Inserção Ecológica, metodologia que requer a imersão do pesquisador no ambiente investigado e está referendada na teoria bioecológica de desenvolvimento humano. Foram entrevistados individualmente dois técnicos responsáveis pelo Serviço, a saber: um psicólogo, um assistente social; e duas famílias usuárias do mesmo Serviço, indicadas como participantes pelos técnicos. Os procedimentos de entrevista foram padronizados e utilizados para técnicos e familiares. Todas as entrevistas foram gravadas, transcritas na íntegra e analisadas qualitativamente seguindo os passos da grounded-theory. Os resultados apontaram que tanto os técnicos como os usuários do Serviço se sentem satisfeitos com os atendimentos e acreditam na sua eficácia. Pode-se observar uma relação deste fato com a diversidade de metodologias de abordagem desenvolvidas e o trabalho comprometido dos profissionais, tanto nos grupos psicoterapêuticos, como nos grupos de cuidadores. Os profissionais consideram que o número de casos de reincidência após a alta do atendimento é baixo. As crianças e adolescentes revelaram que gostam de ir aos atendimentos e as cuidadoras referendaram esta apreciação, afirmando que estes aprendem a lidar com o “problema” sem julgamentos pelo fato ocorrido. Todos revelaram que saem das reuniões com sentimentos de calma e tranquilidade. Pode-se concluir que, no município pesquisado, o Serviço está atingindo seus objetivos enquanto política pública nacional, pois as famílias referiram a real interrupção da situação de violência. Isso colabora para minimizar os danos psicológicos dos envolvidos e facilita a superação do sofrimento causado na família. Em conclusão, pode-se constatar que são três os fatores cruciais para a obtenção de resultados satisfatórios no tratamento às vítimas de violência sexual: a vinculação e a confiança das famílias no tratamento, a troca de experiências entre os cuidadores envolvidos nestas situações e as crenças otimistas dos profissionais do Serviço responsável nas possibilidades de superação dos usuários. / The Service for Combating Violence, Abuse and Sexual Exploitation of Children, offers a set of procedures for specialized support and immediate protection of victims of these forms of violence attending also the families. This study aimed to do an analysis of the social professional´s team relational practices towards the service users in the city of Rio Grande / RS. It also aimed to investigated the relationships / interactions of families victimized with those professionals. The research is qualitative, in-line with the non-formal studies of Environmental Education. The Project was based on the Ecological Engagement methodology which requires the researcher's immersion in the investigated environment and it is referenced by the bioecological theory of human development. Two professionals were individually interviewed: one psychologist and one social worker, plus two families who use the same service. The families were indicated by the social agents. The interview procedures were standardized and used for the professionals and families. All interviews were taped, transcribed and qualitatively analyzed by following the steps of the grounded-theory. The results showed that both the agents and service users feel satisfied with the care received and also believe in its effectiveness. It is possible to observe a relationship between this fact with the diversity of methodological approaches developed in addiction to the committed work of the professionals, both in the psychotherapy groups, or in the caregiver groups. The professionals consider that the number of cases of relapse after discharge from the service is low. Children and adolescents showed that they like to go to the Service and their caregivers endorsed this assessment, claiming that they learn to deal with the "problem" without feeling judged by the fact that happened to them. All participants meetings showed that they come out of the meetings with feelings of calm and tranquility. It can be concluded that the studied Service in this city is achieving its goals as a National Public Policy as the families reported the real cessation of the situation of violence. This helps to minimize the psychological damage of all participants and facilitates the overcoming of suffering caused in the whole family. In conclusion, there are three crucial factors to achieve satisfactory results in treating victims of sexual violence: the binding and confidence of families in the offered treatment, the exchange of experiences among care takers involved in these situations and the optimistic beliefs on the procedures of the Service by the professionals as well the same beliefs in the service users´ possibilities of overcoming the suffering.
18

Atopic diseases in children and adolescents are associated with behavioural difficulties

Keller, Wiebke 12 July 2022 (has links)
Background: Atopic diseases and behavioural difficulties in children have both been on the rise in recent decades. This study seeks to assess associations between atopic diseases and behavioural difficulties, examining the differences considering child age and how behavioural difficulties were reported (via self-report or parent-report). Methods: Data on behavioural difficulties, assessed through the Strengths And Difficulties Questionnaire (SDQ), and on atopic diseases, assessed through the participant’s medical history, were available for 2701 study participants aged 3 to 18 years. Associations between atopic diseases and behavioural difficulties were evaluated using linear regression analyses. We split the study sample into two groups. I: 3-to 10-year-olds/parent-reported SDQ (n=1764), II: 11- to 18-year-olds/parent-reported SDQ (n=937) and self-reported SDQ (n=915). All analyses were adjusted for age, gender, and socioeconomic status. Results: In younger children, atopic dermatitis was strongly associated with higher total difficulties scores, more emotional problems and conduct problems, and more symptoms of hyperactivity/inattention. Parents reported higher total difficulties scores, more emotional problems, and more peer-relationship problems for adolescents with bronchial asthma and other allergies, whereas the adolescents themselves reported more peer relationship problems. Conclusion: In younger children, atopic dermatitis is associated with internalizing and externalizing problems. In adolescents, bronchial asthma and other allergies are associated with a greater level of internalizing problems only. The findings further suggest that parents of adolescents are more likely to perceive associations between atopic diseases and behavioural difficulties than the adolescents themselves.
19

Subjective impact of COVID-19 pandemic on youth with tic and OCD spectrum disorders

Nguyen, Stephanie T. 06 March 2024 (has links)
This study aimed to characterize and assess the subjective impact of the COVID- 19 pandemic on symptom severity and psychosocial experiences of youth with chronic tic disorders (CTD), obsessive-compulsive disorder (OCD), and co-occurring tic and OCD (Tics+OCD) through the use of Likert scales and validated measures. Children and adolescents aged 6 to 18 and their parents were asked to complete an online survey from July 2020 to April 2021. Overall, youth in the study reported negative pandemic-related impact on several domains, particularly after-school activities, relationships with friends, and family and community gatherings. Though limited by the small sample size of the group, youth with OCD appeared to report more negative impact compared to the other diagnostic subgroups. The median screen use for youth in this study was 3-8 hours a day; youth who reported >8 hours of screen time per day on weekends trended towards a 13x greater odds of depression compared to those with <8 hours per day although not statistically significant. If future public health emergencies were to ensue, supports aimed at helping these particularly vulnerable youth navigate the impact of those restrictions would be welcome and important to their mental health and general well-being.
20

Psychische Störungen in deutschen pädiatrischen Praxen vor und während der COVID-19-Pandemie: Dissertation zur Erlangung des akademischen Grades Dr. med. an der Medizinischen Fakultät der Universität Leipzig

Weber, Kerstin 06 December 2023 (has links)
Die vorliegende Arbeit befasst sich mit Folgen der COVID-19-Pandemie und der damit verbundenen Infektionsschutzmaßnahmen auf die psychische Gesundheit von Kindern und Jugendlichen. Im Mittelpunkt der Untersuchung stehen dabei Kinder und Jugendliche zwischen 2 und 17 Jahren, die in Praxen von Fachärztinnen und Fachärzten für Kinder- und Jugendmedizin behandelt wurden. Ziel einer ersten Studie war es zu klären, ob und in welchem Umfang die Gruppe dieser jungen Patientinnen und Patienten in den pädiatrischen Praxen gegenüber einem präpandemischen Vergleichszeitraum häufiger unter Störungen mit ängstlicher oder depressiver Symptomatik litten. Als Vergleichszeitraum wurde hier April 2020 bis Dezember 2020 versus April 2019 bis Dezember 2019 gewählt. Der erste Ergebnisparameter war die Anzahl der Kinder und Jugendlichen mit den Diagnosen Depression (ICD-10: F32, F33) und Angststörung (ICD-10: F41) pro Praxis. Der zweite Ergebnisparameter der Studie war die Veränderung der Prävalenz von Depressions- und Angststörungsdiagnosen im Zeitraum April 2020-Dezember 2020 gegenüber April 2019-Dezember 2019 (Studie 1). In einer zweiten Studie wurden alle psychischen Störungen des Kapitels F des ICD-10 untersucht. Hier war ein längerer Vergleichszeitraum von 2018 bis 2021 möglich. 2018 und 2019 waren präpandemische Jahre und 2020 und 2021 wurden als pandemische Jahre eingestuft. Im Zentrum stand hier die Gesamtzahl der Patienten mit psychischen Störungen und die Anzahl von Patienten mit diesen Störungsbildern in den einzelnen Praxen (Studie 2). Die Ergebnisse der ersten Studie zeigten, dass die Anzahl der Kinder und Jugendlichen mit Depressions- und Angstdiagnosen pro Praxis im Zeitraum April 2020 bis Dezember 2020 im Vergleich zum gleichen Zeitraum 2019 zugenommen hatte (Angst: +9%, Depression: +12%). Der Anstieg war bei Mädchen deutlich größer als bei Jungen (Angst: +13% vs. +5%; Depression +19% vs. +1%). Die Prävalenz der Angststörung stieg von 0,31% auf 0,59% (p<0,001), die der Depression von 0,23% auf 0,47% (p<0,001). Die größten Anstiege wurden bei Mädchen beobachtet (Angst von 0,35% auf 0,72% (+106%, p<0,001), Depression von 0,28% auf 0,72% (+132%, p<0,001) (Studie 1). In der Folgestudie zeigten die Ergebnisse, dass in den Pandemiejahren 2020 und 2021 im Vergleich zu den beiden Vorjahren signifikant mehr psychische Störungen diagnostiziert (chi2 p<0,001) wurden. Ein Anstieg von 2018 zu 2021 wurde besonders bei affektiven Störungen deutlich. Allerdings war die Zunahme der Anzahl dieser Patienten in der einzelnen Praxis mit einer durchschnittlichen Zunahme von 7 Patienten pro Praxis im Jahr sehr gering und war vermutlich für die einzelne Ärztin oder den einzelnen Arzt kaum wahrnehmbar (Studie 2). Während in der ersten Studie für einen kürzeren Zeitraum von 9 Monaten gezeigt wurde, dass die Zahl der pädiatrischen Diagnosen von Depressionen und Angststörungen im Pandemiejahr 2020 im Vergleich zum Vorjahr zugenommen hatte, konnte in der zweiten Studie für einen Zweijahreszeitraum belegt werden, dass die Summe aller psychischen Störungen des Kapitels F der ICD 10 zugenommen hatte. Beide Studienergebnisse weisen auf die Chance hin, dass wenige standardisierte Fragen zur psychischen Gesundheit z. B. in die pädiatrischen Vorsorgeuntersuchungen implementiert werden können, um ungedeckte Bedarfssituationen im Hinblick auf die psychische Gesundheit besser wahrzunehmen.:1. Einleitung 1 1.1. Hintergrund 1 1.2. Fragestellungen 2 1.3. Methoden 3 2. Publikationen 5 2.1. Zunahme von Depressions- und Angststörungsdiagnosen während der Covid-19-Pandemie bei Kindern und Jugendlichen 5 2.2. Psychische Störungen in deutschen pädiatrischen Praxen vor und während der COVID-19-Pandemie 14 3. Diskussion 19 4. Schlussfolgerungen, Implikationen für Forschung und Praxis 23 5. Zusammenfassung der Arbeit 25 5.1. Zusammenfassung 25 5.2. Studienziele 25 5.3. Ergebnisse 26 5.4. Schlussfolgerung 27 5.5. Implikationen für die weitere Forschung 27 6. Literaturverzeichnis 28 7. Anlagen 34 7.1. Darstellung des eigenen Beitrages 34 7.2. Selbstständigkeitserklärung 38 7.3. Lebenslauf 39 7.4. Wissenschaftliche Veröffentlichungen 40 7.5. Danksagung 42

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