Analysis of longitudinal patterns of child maltreatment reports in the United States.

Background: Child maltreatment is a continuous and prevalent issue, and victims of maltreatment often suffer adverse effects well into adulthood. Since child maltreatment rates tend to be clustered geographically and temporally, intervention programs are best implemented at a local level, targeting local risk factors for sustained and effective reduction over time.

Objective: Quantifying geographic variation in child maltreatment rate trajectories can help states identify local risk factors to guide program development and resource allocation.

Reporting of Child Maltreatment During the COVID-19 Pandemic in a Southern State in the United States.

Objectives: COVID-19-related stay-at-home orders (SAHOs) created an immediate physical barrier between children and professionals such as pediatricians and teachers, who are often first to identify and report signs of child maltreatment. Our objective was to determine how the SAHO in a southern state was associated with reports of child maltreatment and whether this association was modified by sociodemographic characteristics.

Methods: We linked data on reports of child maltreatment from a southern state in the United States from October 1, 2018, through September 30, 2020, to data from the US Census Bureau to obtain data on county-level socioeconomic characteristics.

Psychopharmaceutical Prescription Monitoring for Children in the Child Welfare System.

Objective: Children in the child welfare system are more likely to receive psychotropic medication prescriptions than children in the general population. The authors used prescription- and administrative-level data to quantify variability in prescribing practices among prescribers for the child welfare population in a southern U.S.

Incidence and neighborhood-level determinants of child welfare involvement.

Background: Child maltreatment is a global public health issue that has been linked with multiple negative health and life outcomes.

Objective: This study evaluates the association between children placed in out-of-home care and neighborhood-level factors using eight years of administrative data.

Participants And Setting: Between 2011-2018, 33,890 unique instances of child welfare involvement were captured in a department of child and family services database in a southern state in the United States.

A population-based examination of maltreatment referrals and substantiation for children with autism spectrum disorder.

Children with disabilities experience elevated rates of maltreatment, but little is known about the interaction of children with autism spectrum disorder with child protection systems. A population-based dataset of 24,306 children born in 2008 in Tennessee, which included 387 children with autism spectrum disorder identified through the Autism and Developmental Disabilities Monitoring network, was linked with state child protection records. Rates of maltreatment referrals, screening for further action, and substantiated maltreatment were examined for children with versus without autism spectrum disorder.

A systematic review of screening tools in non-young children and adults for autism spectrum disorder.

Background: Existing reviews of screening tools for Autism Spectrum Disorder (ASD) focus on young children, and not all screening tools have been examined against validated diagnostic procedures.

Aims: To examine the validity of screening tools for ASD in non-young children and adults to provide clinical recommendations about the use of these tools in a variety of clinical settings.

Methods And Procedures: Electronic databases, including MEDLINE, EMBASE, PsychINFO, Cochrane Library and CINAHL, were searched through March 2017.

AHRQ series on complex intervention systematic reviews-paper 3: adapting frameworks to develop protocols.

Background: Once a proposed topic has been identified for a systematic review and has undergone a question formulation stage, a protocol must be developed that specifies the scope and research questions in detail and outlines the methodology for conducting the systematic review.

Rationale: Framework modifications are often needed to accommodate increased complexity. We describe and give examples of adaptations and alternatives to traditional analytic frameworks.

Psychosocial Interventions for Child Disruptive Behaviors: A Meta-analysis.

Background: Disruptive behavior disorders are among the most common child and adolescent psychiatric disorders and associated with significant impairment.

Objective: Systematically review studies of psychosocial interventions for children with disruptive behavior disorders.

Methods: We searched Medline (via PubMed), Embase, and PsycINFO.

Treatment of ankyloglossia for reasons other than breastfeeding: a systematic review.

Background And Objective: Children with ankyloglossia, an abnormally short, thickened, or tight lingual frenulum, may have restricted tongue mobility and sequelae, such as speech and feeding difficulties and social concerns. We systematically reviewed literature on feeding, speech, and social outcomes of treatments for infants and children with ankyloglossia.

Methods: Medline, PsycINFO, Cumulative Index of Nursing and Allied Health Literature, and Embase were searched.

Implementing clinical outcomes assessment in everyday school mental health practice.

Evidence-based assessment (EBA) has been shown to improve clinical outcomes, but this practice is frequently not implemented in school mental health practice. This article reviews potential barriers to implementation and offers practical strategies for addressing these challenges. Several valid and reliable tools for assessment are reviewed, and information is provided on clinical use.

Evidence-based interventions for adolescents with disruptive behaviors in school-based settings.

Disruptive behaviors in the school setting can threaten the maintenance of optimal learning environments in schools. Challenging behaviors, such as defiance, hostility, and aggression, often define disruptive classroom behaviors. This article presents a clinical review of existing literature on interventions for adolescent disruptive behavior problems in school-based settings and in outpatient mental health settings and makes recommendations around working with adolescents with disruptive behaviors in school-based settings.

Treatment of bipolar disorders during pregnancy: maternal and fetal safety and challenges.

Treating pregnant women with bipolar disorder is among the most challenging clinical endeavors. Patients and clinicians are faced with difficult choices at every turn, and no approach is without risk. Stopping effective pharmacotherapy during pregnancy exposes the patient and her baby to potential harms related to bipolar relapses and residual mood symptom-related dysfunction.

Transition care for children with special health care needs.

Background: Approximately 750,000 children in the United States with special health care needs will transition from pediatric to adult care annually. Fewer than half receive adequate transition care.

Methods: We had conversations with key informants representing clinicians who provide transition care, pediatric and adult providers of services for individuals with special health care needs, policy experts, and researchers; searched online sources for information about currently available programs and resources; and conducted a literature search to identify research on the effectiveness of transition programs.

Treatment of nonpsychotic major depression during pregnancy: patient safety and challenges.

In pregnant women with major depression, the overarching goal of treatment is to achieve or maintain maternal euthymia, thus limiting both maternal and fetal exposure to the harmful effects of untreated or incompletely treated depression. However, the absence of uniformly effective therapies with guaranteed obstetric and fetal safety makes the treatment of major depression during pregnancy among the most formidable of clinical challenges. Clinicians and patients are still faced with conflicting data and expert opinion regarding the reproductive safety of antidepressants in pregnancy, as well as large gaps in our understanding of the effectiveness of most antidepressants and nonpharmacological alternatives for treating antenatal depression.

Applying principles from safety science to improve child protection.

Child Protective Services Agencies (CPSAs) share many characteristics with other organizations operating in high-risk, high-profile industries. Over the past 50 years, industries as diverse as aviation, nuclear power, and healthcare have applied principles from safety science to improve practice. The current paper describes the rationale, characteristics, and challenges of applying concepts from the safety culture literature to CPSAs.

The effect of regulatory advisories on maternal antidepressant prescribing, 1995-2007: an interrupted time series study of 228,876 pregnancies.

The purpose of this study was to assess whether antidepressant prescribing during pregnancy decreased following release of U.S. and Canadian public health advisory warnings about the risk of perinatal complications with antidepressants.

Increasing pregnancy-related use of prescribed opioid analgesics.

Purpose: To quantify the prevalence of prescribed opioid analgesics among pregnant women enrolled in Tennessee Medicaid from 1995 to 2009.

Methods: Retrospective cohort study of 277,555 pregnancies identified from birth and fetal death certificates, and linked to previously validated, computerized pharmacy records. Poisson regression was used to estimate trends over time, rate ratios, and 95% confidence intervals (CI).

Increasing use of atypical antipsychotics and anticonvulsants during pregnancy.

Purpose: To quantify maternal use of atypical antipsychotics, typical antipsychotics, anticonvulsants, and lithium during pregnancy.

Methods: Tennessee birth and death records were linked to Tennessee Medicaid data to conduct a retrospective cohort study of 296,817 women enrolled in Tennessee Medicaid throughout pregnancy who had a live birth or fetal death from 1985 to 2005.

Results: During the study time period, the adjusted rate of use of any study medication during pregnancy increased from nearly 14 to 31 per 1000 pregnancies (β = 0.

Trends in the use of antiepileptic drugs among pregnant women in the US, 2001-2007: a medication exposure in pregnancy risk evaluation program study.

Background: Little is known about the extent of antiepileptic drug (AED) use in pregnancy, particularly for newer agents. Our objective was to assess whether AED use has increased among pregnant women in the US, 2001-2007.

Methods:   We analysed data from the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP) database, 1 January 2001 to 31 December 2007.

Changes to the financial responsibility for juvenile court ordered psychiatric evaluations reduce inpatient services utilization: an interrupted time series study.

Background: The purpose of the current study was to evaluate the impact of a July 2008 Tennessee Court of Appeals opinion that shifted financial responsibility for juvenile court ordered psychiatric evaluations from the State to the County.

Methods: We used de-identified administrative data from the Tennessee Department of Mental Health and mid-year population estimates from the U.S.

Positive predictive value of automated database records for diabetic ketoacidosis (DKA) in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid Study.

Background: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of treatment with some atypical antipsychotic drugs in children and youth. Because drug-associated DKA is rare, large automated health outcomes databases may be a valuable data source for conducting pharmacoepidemiologic studies of DKA associated with exposure to individual antipsychotic drugs. However, no validated computer case definition of DKA exists.

A randomized open comparison of long-acting injectable risperidone and treatment as usual for prevention of relapse, rehospitalization, and urgent care referral in community-treated patients with rapid cycling bipolar disorder.

Objective: To compare adjunctive long-acting injectable risperidone plus treatment as usual (RLAI+TAU) versus TAU alone for relapse, rehospitalization, and urgent care events in patients with bipolar disorder in routine care settings.

Methods: This was a 12-month randomized open comparison of RLAI+TAU (n = 20) and TAU alone (n = 25) in adults with rapid cycling, Mini International Neuropsychiatric Interview-confirmed bipolar I/II disorder and 4 or more illness relapses in the preceding 12 months. Clinical outcome was assessed every 2 weeks using the Longitudinal Interval Follow-up Evaluation instrument.