Adolescent Psychiatry - Volume 11, Issue 1, 2021

Background: COVID-19 is one of the most challenging and devastating public health emergencies we have experienced in our lifetimes. There is a growing concern that the pandemic and its imposed public health restrictions may be harming a generation of young people. This article concerns child and adolescent psychiatry as there is already a mismatch between resources and demand. Method: This paper will outline the day to day working challenges encountered by the SPMHS adolescent service, staff, and patients in the initial months of the COVID-19 crisis and some of the strategies implemented to deal with these. Discussion: In St. Patrick’s University Hospital in Ireland, significant challenges in the adolescent service were encountered in the initial months of the COVID-19 crisis. These included the cessation of face-to-face patient interactions, therapeutic leave and visiting restrictions, school closure, social restrictions, difficulties in organizing medical appointments and investigations, family stress and increased workload for staff. Strategies including telepsychiatry have enabled the delivery of an efficient and accessible adolescent service during this crisis. Conclusion: Future research is required to analyse how best we can support children and adolescents during COVID-19, particularly those with existing mental illness is crucial.

Background: Today’s teenagers face several challenges that result in poor mental health, depression and anxiety. Several studies in the past decade have explored meditation as adjunctive therapy for mental illness however, the long-term residual benefits of meditation have rarely been studied. Objective: The aim of the study was to investigate the benefits of a four day meditation retreat on cognitive abilities, mental and emotional well-being of teenagers. Methods: 303 teenagers participated in this study. Cognitive abilities of the students were measured using the Six letter cancellation test (SLCT). Mental and emotional well-being was measured using World Health Organization Well-being index (WHO-5) and Strength and Difficulties questionnaire (SDQ), respectively. Data analysis was performed using paired sample t-test and repeated measure ANOVA. Results: Teenagers demonstrated a 33% increase in average accuracy for SLCT post intervention. WHO-5 mental well-being index scores also increased significantly (p <0.001). The participants experienced a significant reduction in emotional problems and hyperactivity as measured by SDQ. The benefits of the retreat continued to persist, when measured after 40 days of the intervention. Conclusion: A well-structured meditation retreat has significant and long-term benefits on teenagers’ mental well-being, emotional stability and cognitive capacity.

Background: Bullying others among school-aged youth is a worldwide phenomenon that has a variety of adverse outcomes, depression being one of them. Objective: The objective of the current study was to examine whether perceived parenting styles moderated the relationship between bullying others and depression among adolescents. It was hypothesized that perceived authoritarian parenting would increase the association between bullying others and depression than nonauthoritarian parents. Methods: The sample included 116 adolescents aged 12-17, with a mean age of 13.87. The percentage of male participants was 47.41%. We used self-report questionnaires, which measured the different variables in the study (bullying, perceptions of parenting styles, and depression). Results: A positive correlation between bullying others and depressive symptoms was found. Bullying others and perceived authoritarian parenting style were also correlated, and a positive correlation was found between perceived authoritarian parenting style and depressive symptoms. The moderation effect of perceived parenting style on the association between bullying others and depressive symptoms was found significant. Among adolescents perceiving their parents as authoritarian, the association between bullying others and depressive symptoms was found to be stronger. In contrast, among adolescents perceiving their parents as non-authoritarian, the association was low. Conclusion: Results of this study have important clinical implications by understanding the parenting component in the association between bullying others and depression. Our results suggest that the psychological outcomes for bullies may depend, among other things, on their perception of parents' parenting style.

Background: Quality of family functioning and levels of parental Expressed Emotion (criticism, hostility, or emotional overinvolvement) are prospectively associated with the course and outcome of a range of childhood psychiatric disorders. Aims: This study examined family functioning, expressed emotion and quality of life, in a clinical sample of 40 adolescents presenting with schizophrenia spectrum or affective psychotic disorders. Methods: Expressed Emotion was measured using the Family Questionnaire, family functioning using the Family Assessment Device and Quality of life using the KIDSCREEN 27. Results: Parents scored high on both parts of the Family Questionnaire, the Critical Comments and Emotional Over-involvement. Higher Expressed Emotion was associated with more emotional difficulties of both parents, especially depressive features. Economic difficulties of the family were found to be negatively associated with the adolescents’ psychological wellbeing. Conclusions: Overall, the study points out the need for appropriate family interventions, which will assist the caregivers in developing communication and problem-solving strategies and will contribute to the reduction of high levels of hostile or critical expressed emotion and emotional over-involvement within the family.

Background and Goals: Suicide attempts occur mostly during adolescence and are much more frequent in females than in males, although males tend to commit suicide more often than females. This study aims to examine the association between female gender, gender conflict, depression, stress and suicide attempts in adolescent girls. Methods: Participants included 86 adolescent girls aged 12-21 (μ=15.7, SD=3.07) with depression (n=29), attempted suicide (n=15) or both (n=42), admitted consecutively to a tertiary medical center and 93 healthy controls from the community. Depression, suicidal ideation and behavior, gender identity and conflict, personality factors, and stress were compared between the study group and controls and each of the three study-subgroups and controls. Results: A difference was found in the perception gap of own femininity versus others' expectations of the subject’s femininity, between the suicide attempters both with and without depression and the controls. Personality factors were also found to be related to depression and suicide attempts. Suicide attempters with depression showed more harm avoidance than those without depression. Novelty seeking was significantly higher in non-depressed suicide attempters than in controls but not when compared to suicide attempters with depression. Conclusion: It seems that suicide attempts and depression may not only be related to female gender identity. Conflicting gender expectations may result in increased stress, raising the risk for suicide attempts, particularly in girls with high harm avoidance.

Objective: The aim for this study was to explore the proportion of patients with a Substance Use Disorder (SUD), their proportion of overall admissions, and their psychosocial histories at a regional child and adolescent inpatient psychiatric unit. Methods: A retrospective chart review was conducted on all admissions of patients with a SUD. Abstracted patient data included demographic information, diagnoses, psychosocial histories, living situation at the time of admission, legal involvement and charges, whether an alternate level of care was needed, and discharge plans. Results: From September 2018 to February 2020, of the 540 patients admitted, 126 (23.3%) had a SUD recorded in their charts and accounted for 34.6% of the total number of admissions. Their mean age was 15.85 (SD 1.10; range 13 to 18) years, and most were identified as female (n=81; 64%), which is consistent with the number of female patients admitted during the study period (n=366 female of 540 admitted; X²=0.56, p= 0.45). Common psychiatric diagnoses included mood, trauma, and stressor-related and anxiety disorders. Most patients (124; 98.4%) had a history of psychosocial adversity, 90 (71.4%) patients had a parent with a mental illness or a SUD, 55 (44%) reported being bullied, 54 (43%) reported being sexually assaulted and several (n=41;33%) had experienced precarious living situations. Conclusion: Adolescent inpatients with a SUD were also managing a complex array of clinical and psychosocial challenges. Upon discharge from the hospital, some patients were placed on waitlists, and many patients were referred to specialized treatment far from home, highlighting the need for additional, comprehensive programs for SUD and the constellation of psychosocial problems associated with these disorders.