ABSTRACT
BACKGROUND: Child and adolescent psychiatric disorders are prevalent, their care in Austria is still in progress. METHODS: We investigated whether the child and adolescent psychiatric care made progress dsince the establishment of the medical special discipline. RESULTS: There remains massive heterogeneity between the Austrian provinces. The "Mangelfachregelung" in ist current version is insufficient in order to consolidate our medical special discipline and to guarantee full carewithin the next years. CONCLUSION: Hints are given how the situation of care in our discipline can be strengthened.
Subject(s)
Adolescent Psychiatry , Mental Disorders , Adolescent , Austria , Child , Humans , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Mental Disorders/therapy , Psychotherapy , Surveys and QuestionnairesABSTRACT
Nonsuicidal self-injury in connection with the axes Structure and Relationship of the OPD-KJ-2 (Operationalized Psychodynamic Diagnostics in Childhood and Adolescence) Abstract. This study investigates nonsuicidal self-injury (NSSV) in relation to psychological structure as well as inter- and intrapersonal relationships. The Structure and Relationship axes of the OPD-CA-2 (Operationalized Psychodynamic Diagnosis in Childhood and Adolescence) were used to record relationship dynamics and structural aspects; the MOUSI was applied for nonsuicidal self-injury. The sample included 40 adolescent psychiatric patients, most of whom were in inpatient care. A total of 20 adolescents with and 20 without NSSV were compared with regard to the Structure and Relationship axes. The two samples showed no differences on the Structure axis, whereas differences were found on the Relationship axis. Adolescents with NSSV, for example, were more likely to gently influence others and to react in interactive settings more openly toward their counterpart than adolescents without NSSV. In their relationship to themselves, the adolescents with NSSV were more often assessed as tormented and reproachful. Results indicate that the Relationship axis of the OPD-CA-2 can provide helpful information, so that this should be considered in psychotherapeutic measures for NSSV patients.
Subject(s)
Psychology, Adolescent , Psychology, Child , Self-Injurious Behavior/diagnosis , Self-Injurious Behavior/psychology , Adolescent , Child , Hospitalization , Humans , Psychoanalytic Therapy , Self-Injurious Behavior/therapyABSTRACT
OBJECTIVES: The purpose of this study was to compare results of patients', parents', and caregivers' (nursing staff and educators) (self-)assessments of quality of life, treatment outcomes, and satisfaction with inpatient treatment in a child and adolescent psychiatric hospital. In addition, the investigation included a comparison between admission and discharge of the three investigated groups. METHODS: The study considered adolescents at the Department of Child and Adolescent Psychiatry and Psychotherapy, Hinterbruehl, along with their parents and caregivers. Following questionnaires at admission and discharge were used: the Youth Self-Report (YSR) or Child Behavior Checklist (CBCL/4-18), Inventory for Assessing Quality of Life in Children and Adolescents (ILK), and Questionnaires of the Evaluation of Treatment (FBB). RESULTS: Adolescents (58 patients, aged 14-18 years, standard deviationâ¯= 1.06) with different psychiatric diagnoses consecutively admitted for a diagnostic or therapeutic stay were included. The quality of life score was significantly different between patients' and parents' rating at discharge. The results of the treatment satisfaction revealed no significant correlations between patients', parents', and caregivers' ratings. A reduction in the psychopathology between admission and discharge was measured in all groups of raters. In addition, an increase in quality of life between admission and discharge was observed in patients, parents, and caregivers. Treatment satisfaction was moderate in all groups of raters. CONCLUSION: The views of patients' treatment measured by patients themselves, parents, and caregivers during a psychiatric ward stay are different and more or less unrelated. This indicates that each group applies different criteria when assessing treatment satisfaction.
Subject(s)
Caregivers/psychology , Inpatients/psychology , Mental Disorders/psychology , Parents/psychology , Patient Admission , Patient Discharge , Patient Satisfaction/statistics & numerical data , Quality of Life , Adolescent , Female , Humans , Male , Surveys and QuestionnairesABSTRACT
According to underlying law (Krankenanstaltengesetz) the internal structure of Departments of Child and Adolescent Psychiatry (CAP) represents a matrix structure, defining formal roles and tasks of the personel. In contrast, external cooperation is defined in several different laws. Furthermore, patients and their systems are exhibiting a high tensional potential. These different influences can cause more or less severe enmeshments. Thus, during the treatment of this patients it is necessary to take into account the possibility of these enmeshments. It should be answered by special forms of care of the relationship between professionals and families. These special forms of relational care can be delivered by clear organizational structures and must undergo reflective processes on a regular basis. The planning and delivery of those structures is clearly seen as a central responsibility of the management of a CAP-Department.
Subject(s)
Adolescent Psychiatry/organization & administration , Child Psychiatry/organization & administration , Interdisciplinary Communication , Intersectoral Collaboration , Professional-Family Relations , Psychiatric Department, Hospital/organization & administration , Systems Theory , Adolescent , Austria , Child , Delivery of Health Care/organization & administration , Group Processes , Humans , Interinstitutional Relations , NegotiatingABSTRACT
Anniversaries are turningpoints for reflexions of the past and planing for the future. In conclusion of all papers in this actual issue one can say tha CAP has reached a respected place in the medical landscape. Also internationally, the work of Austrian child and adolescent psychiatrist is recognised and respected. CAP is cooperating as an respected discipline with adjacent specialties as pediatrics and psychiatry as well as with external partners as Kinder- und Jugendhilfe (social child welfare).Anyway, the actual situation shows several deficits concerning patient care on all levels of the health system as well as in education and training of sufficient numbers of child and adolescent psychiatrists.
Subject(s)
Adolescent Psychiatry/organization & administration , Adolescent Psychiatry/trends , Child Psychiatry/organization & administration , Child Psychiatry/trends , Adolescent , Austria , Child , Forecasting , HumansABSTRACT
BACKGROUND: The aim of this study was to compare the Operationalized Psychodynamic Diagnostics (OPD-CA) for children and adolescents with the modified version (OPD-CA-2) focusing on the mainly unchanged treatment conditions and the redesigned structure axis. METHODS: The patient sample consisted 371 inpatient children and adolescents with psychiatric disorders from 3 to 18 years. OPD-CA and OPD-CA-2 diagnostics were routinely performed by OPD-experienced raters. Statistical calculation included Cronbach's alpha (internal consistency) and confirmatory factor analysis. RESULTS: The OPD-CA-2 structure axis showed very good internal consistency (reliability) compared to the OPD-CA. We found satisfactorily good values for the treatment conditions with slightly higher average scores in the OPD-CA-2. Confirmatory factor analysis resulted in two models where the items on the OPD-CA-2 structure axis were stronger correlated than those of the OPD-CA. CONCLUSION: The OPD-CA-2 is a reliable and valid instrument for assessing treatment conditions and psychic structure in children and adolescents. The reorganization of the structure axis and the treatment conditions in the OPD-CA-2 resulted in a measurable improvement.
Subject(s)
Mental Disorders/diagnosis , Mental Disorders/therapy , Projective Techniques/statistics & numerical data , Psychometrics/statistics & numerical data , Adolescent , Austria , Child , Female , Humans , Infant , Male , Mental Disorders/psychology , Patient Admission , Psychoanalytic Theory , Reproducibility of ResultsABSTRACT
OBJECTIVE: This paper presents the advantages of making comprehensive diagnoses with OPD-KJ in a child and adolescent psychiatric sample. METHOD: In addition to the MAS and the ICD-10 diagnoses, three axes of the OPD-KJ, the conflict and structural axis as well the axis of treatment conditions, were assessed, in 61 inpatient child and adolescent psychiatric patients in Austria. RESULTS: There are significant gender differences in the importance of internalized, developmentally inhibitive conflicts. However, the structural level was low to moderate in all patients. Structural capacities such as dealing with negative emotions, self and object differentiation, and contact could be maintained only with substantial help from outside. Older patients were more motivated to obtain treatment and show more insight. Of importance were also links between the conflict axis and the treatment conditions. Patients who have been classified as control vs. submissive showed less treatment motivation, reduced motivation to change, and more gains than did patients with other conflicts. CONCLUSION: The study shows that, beyond the axis of treatment conditions, a comprehensive OPD-KJ diagnosis that gathered information from the assessment of the conflict and structural axis as well can provide useful information for treatment planning.
