A study of the Board Certification Examination in Child and Adolescent Psychiatry.

In 1977, training directors of 55 child psychiatry training programs agreed to provide the Committee on Certification in Child Psychiatry of the American Board of Psychiatry and Neurology, Inc. with confidential data about the clinical performance of each of their graduates in 1978, 1979, and 1980. Information about 267 graduates from 37 programs was received. Almost all programs were university affiliated and located in medical centers. By 1986, 112 of these graduates had taken the child aboard examination. Training director ratings were found to be statistically correlated to a significant degree with actual pass or fail results on the written and on the overall examination.

Trends in the delivery of mental health services for children and adolescents.

Current systems for delivery of mental health services to children and adolescents are woefully inefficient, inadequate, and fragmented. The author briefly reviews specific deficits and then discusses eight aspects of an integrated program that will provide easy access to appropriate mental health care for all children who need it with a minimum of stress on their families.

[The risk factors for hepatitis B virus infection in hospital personnel]. / Factores de riesgo para infección por virus de hepatitis B en personal hospitalario.

Viral hepatitis is one of the leading causes of disease around the world. In Latin America is a severe public health problem. We conducted a case-control study in the Cayetano Heredia Hospital, Lima, Perú, seeking for risk factors for hepatitis B infection. We found 0.41% of frequency of HBsAg and 8.13% of anti-HBs in the 492 persons screened. Contact with blood was confirmed as a risk factor for hepatitis B infection; disposable needle-wash was also identified as a major risk factor. The personnel of the Sterilization Room is also in high risk for the infection. The nurse-aid personnel was also identified as a high-risk group. We suggest that the needle wash is a risk factor very easy to remove, and also stopping the rotation of the auxiliary personnel could reduce the incidence of the infection in the personnel at risk.

[Risk factors for hepatitis B virus infection among hospital staff]. / Factores de riesgo para infección por virus de hepatitis B en personal hospitalario.

Viral Hepatitis is one of the leading causes of disease around the world. In Latin America is a severe public health problem. We conducted a case-control study in the Cayetano Heredia Hospital, Lima-Perú, seeking for risk factors for Hepatitis B infection. We found 0.41% of frequency of HBsAg and 8.13% of anti-HBs in the 492 persons screened. Contact with blood was confirmed as a risk factor for Hepatitis B infection; disposable needle-wash was also identified as a major risk factor. The personnel of the Sterilization Room is also in high risk for the infection. The nurse-aid personnel was also identified as a high risk group. We suggest that the needle wash is a risk factor very easy to remove, and also stopping the rotation of the auxiliary personnel could reduce the incidence of the infection in the personnel at risk.

Opportunities for prevention in the practice of psychiatry.

There are opportunities for prevention in the practice of general psychiatry that are often overlooked by the psychiatrist. The author discusses three groups that lend themselves to preventive efforts--the hospitalized mentally ill parent, children of depressed parents, and children of divorce. He also enumerates aspects of intervention that may result in opportunities for prevention. The application of research findings to individual situations may often result in change and improve the practice of psychiatry.

Child psychiatry education in early child development: description of a training program.

Career training in child psychiatry, though provided from a developmental perspective, often lacks opportunity for directly observing normally developing infants. This paper describes a training program in which child psychiatry fellows, in collaboration with residents in pediatrics, follow a young couple and their first child from the third trimester of pregnancy through infancy and early childhood. Case illustrations and discussion of approximately 10 years' experience demonstrate how the program can enhance understanding of normal child development, development of the nuclear family, liaison between child psychiatrist and pediatrician and early detection of psychopathology in infants.

Research directions in child psychiatry.

Current research in child psychiatry emphasizes the understanding of biological mechanisms of behavior and its aberrations but neglects the transactional relationships in interpersonal phenomena. This situation may led to an unwarranted enthusiasm for biological forms of treatment. The author calls attention to the importance of biopsychosocial elements of behavior in the understanding of growth and development. He discusses research directions to incorporate all elements of the behavioral sciences in the study of child behavior.

Recertification and child psychiatry.

Recertification raises a number of issues for the subspecialty of child psychiatry. The author discusses double jeopardy (i.e., examination in both the main and subspecialty areas), the use of multiple methodologies for achieving certification, and the problems of attaining evaluation and validity of the recertification process.

Childhood depression: interpersonal interactions and depressive phenomena.

The author discusses the impact of parental disability, particularly parental depression, on children. Depression in children, which takes different forms according to the child's developmental level, may mirror or be a response to similar affect in a parent. Clinicians need to take note of the relationship between child and caretaker and of the various manifestations of childhood depression in order to avoid underdiagnosing this disorder.

Psychopathology and mental retardation: a statistical study of 100 mentally retarded children treated at a psychiatric clinic: II. hyperactivity.

The authors studied 100 mentally retarded children referred to a psychiatric clinic and found that 39 were hyperactive. However, there was no significant relationship between hyperactivity and mental retardation (with or without psychosis) or brain damage. Comparison with a group of nonretarded children revealed no significant difference regarding hyperactivity, thus suggesting that the disorder is not an inevitable concomitant of mental retardation.