Intoxicated persons showing challenging behavior demand complexity interventions: a pilot study at the interface of the ER and the complexity intervention unit.

Intoxicated persons showing challenging behavior (IPCBs) under influence of alcohol and/or drugs frequently have trouble finding appropriate acute care. Often IPCBs are stigmatized being unwilling or unable to accept help. Separated physical and mental healthcare systems hamper integrated acute care for IPCBs.

Optimizing foster family placement for infants and toddlers: A randomized controlled trial on the effect of the foster family intervention.

The relationship between foster children and their foster carers comes with many risks and may be very stressful both for parents and children. We developed an intervention (foster family intervention [FFI]) to tackle these risks. The intervention focuses on foster children below the age of 5 years.

Training in psychiatry throughout Europe.

Psychiatry is the largest medical specialty in Europe. Despite efforts to bring harmonisation, training in psychiatry in Europe continues to be very diverse. The Union Européenne des Médecins Spécialistes (UEMS) has issued as from 2000 a charter of requirements for the training in psychiatry with an additional European Framework for Competencies in Psychiatry in 2009.

Raising a child with an Autism Spectrum Disorder: 'If this were a partner relationship, I would have quit ages ago'.

Background: The aim of the study was to determine the experiences of parents having a child with Autism Spectrum Disorder (ASD) and what kind of support parents would like to receive in primary care.

Methods: Interviews were held with 29 main caregivers, in combination with a standardized questionnaire on quality of life.

Results: Virtually all parents experienced tremendous shortcomings as a caregiver of their affected child and therefore felt guilty both towards their child with ASD and towards their other children.

Improving patient care for attention deficit hyperactivity disorder in children by organizational redesign (Tornado program) and enhanced collaboration between psychiatry and general practice: a controlled before and after study.

Background: Implementation of clinical guidelines for diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents is a challenge in practice due to insufficient availability of mental health specialists and lack of effective cooperation with primary care physicians. The Tornado program aims to reduce time between referral and start of treatment in eligible patients. This study aims to assess the effectiveness and efficiency of this program.

Temperament and character as endophenotype in adults with autism spectrum disorders or attention deficit/hyperactivity disorder.

Autism spectrum disorder and attention deficit/hyperactivity disorder overlap in several ways, raising questions about the nature of this comorbidity. Rommelse et al. published an innovative review of candidate endophenotypes for autism spectrum disorder and attention deficit/hyperactivity disorder in cognitive and brain domains.

Gender and age differences in the core triad of impairments in autism spectrum disorders: a systematic review and meta-analysis.

Autism is an extensively studied disorder in which the gender disparity in prevalence has received much attention. In contrast, only a few studies examine gender differences in symptomatology. This systematic review and meta-analysis of 22 peer reviewed original publications examines gender differences in the core triad of impairments in autism.

Salivary cortisol: a possible biomarker in evaluating stress and effects of interventions in young foster children?

Young foster children undergo an early separation from their caregiver(s) and often experience severe stress before placement. However, a considerable part of the children do not show apparent signs of distress, making it difficult for the foster carer to be aware of the amount of stress in their foster child. Potential evidence for using salivary cortisol levels as a dimension to evaluate the amount of stress in young foster children is reviewed.

Narrowly versus broadly defined autism spectrum disorders: differences in pre- and perinatal risk factors.

This study examined the differential contribution of pre- and perinatal risks in narrowly versus broadly defined autism spectrum disorder (ASD) and across core symptom domains, IQ and co-morbid problems. Children with a DSM-IV diagnosis of autistic disorder (AD) (n = 121) or pervasive developmental disorder not otherwise specified (PDD-NOS) (n = 75) were compared to a typical control sample (n = 311). Diagnoses were based on extensive assessments between 12 and 49 months of age (M = 33.

The state of psychiatry in the Netherlands: strength by quality, influence by capabilities.

Psychiatry and mental healthcare in the Netherlands has a long history of institutional care, slowly more adapted to the community, but differentiated from mainstream healthcare in terms of organization and remuneration. It is in a crucial phase of reconsideration. Along with harsh cuts on the budgets in healthcare, the field is in transition where training is concerned.

Visual scanning in very young children with autism and their unaffected parents.

This study of gaze patterns in very young children with autism and their parents included 23 cases (with 16 fathers and 19 mothers) and 46 controls (with 14 fathers and 28 mothers). Children (mean age 3.3 ± 1.

Effects of attentional/ hyperactive and oppositional/ aggressive problem behaviour at 14 months and 21 months on parenting stress.

Background:   To evaluate effects of attentional/ hyperactive (Att/Hi) and oppositional/ aggressive (Opp/Agg) behaviours of children at 14 and 21 months of age on parenting stress at 21 months.

Method:   107 children from the general population with low, intermediate, and high levels of disruptive behaviours at 14 months, as evaluated by parents on a 55-item checklist, participated. Parents completed the Child Behaviour Checklist 1.

Mental health 'cure and care' in the Netherlands: risks and opportunities.

The practice of psychiatry and mental health services is influenced by social, economic and cultural factors. In this paper evidence from the Netherlands is presented. Like many other countries, shift from asylums to community care has meant a number of significant challenges.

Neural correlates of language comprehension in autism spectrum disorders: when language conflicts with world knowledge.

In individuals with ASD, difficulties with language comprehension are most evident when higher-level semantic-pragmatic language processing is required, for instance when context has to be used to interpret the meaning of an utterance. Until now, it is unclear at what level of processing and for what type of context these difficulties in language comprehension occur. Therefore, in the current fMRI study, we investigated the neural correlates of the integration of contextual information during auditory language comprehension in 24 adults with ASD and 24 matched control participants.

Assessment of psychopathology in 2- to 5-year-olds: Applying the Infant-Toddler Social Emotional Assessment.

The information provided by parents is indispensable for the early identification of psychopathology; for this reason, developmentally appropriate, reliable, and valid questionnaires are needed to gather their information. This study was designed to examine the utility of the Infant Toddler Social Emotional Assessment (ITSEA), a parent-report questionnaire covering a wide range of behavior and emotional problems and competencies, in preschoolers referred for child psychiatric evaluation. The fathers and mothers of 85 children (23.

Pervasive microstructural abnormalities in autism: a DTI study.

Background: Recent studies have reported abnormal functional connectivity patterns in the brains of people with autism that may be accompanied by decreases in white matter integrity. Since autism is a developmental disorder, we aim to investigate the nature and location of decreases in white and grey matter integrity in an adolescent sample while accounting for age.

Methods: We used structural (T1) imaging to study brain volumetrics and diffusion tensor imaging (DTI) to investigate white and grey matter integrity in people with autism.

Basic abnormalities in visual processing affect face processing at an early age in autism spectrum disorder.

Background: A detailed visual processing style has been noted in autism spectrum disorder (ASD); this contributes to problems in face processing and has been directly related to abnormal processing of spatial frequencies (SFs). Little is known about the early development of face processing in ASD and the relation with abnormal SF processing. We investigated whether young ASD children show abnormalities in low spatial frequency (LSF, global) and high spatial frequency (HSF, detailed) processing and explored whether these are crucially involved in the early development of face processing.

How useful is the Social Communication Questionnaire in toddlers at risk of autism spectrum disorder?

Background: The Social Communication Questionnaire (SCQ) is a screening instrument with established validity against the Autism Diagnostic Interview-Revised (ADI-R) in children aged 4 years and older. Indices of diagnostic accuracy have been shown to be strong in school-aged samples; however, relatively little is known about the performance of the SCQ in toddlers at risk of autism spectrum disorder (ASD).

Methods: This study replicates and extends previous research by Corsello et al.

Do candidate genes discriminate patients with an autism spectrum disorder from those with attention deficit/hyperactivity disorder and is there an effect of lifetime substance use disorders?

Objective: Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are developmental disorders that overlap in a number of domains, sometimes complicating clinical distinction between both disorders. Although there is some evidence for a genetic overlap, there are no reports on genes that could differentiate between ASD and ADHD. Furthermore, it is not known whether this genetic overlap is influenced by co-morbid substance use disorders (SUD).

Randomized controlled trial of the focus parent training for toddlers with autism: 1-year outcome.

This randomized controlled trial compared results obtained after 12 months of nonintensive parent training plus care-as-usual and care-as-usual alone. The training focused on stimulating joint attention and language skills and was based on the intervention described by Drew et al. (Eur Child Adolesc Psychiatr 11:266-272, 2002).

Improved diagnostic validity of the ADOS revised algorithms: a replication study in an independent sample.

Recently, Gotham et al. (2007) proposed revised algorithms for the Autism Diagnostic Observation Schedule (ADOS) with improved diagnostic validity. The aim of the current study was to replicate predictive validity, factor structure, and correlations with age and verbal and nonverbal IQ of the ADOS revised algorithms for Modules 1 and 2 in a large independent Dutch sample (N = 532).

Advancing early detection of autism spectrum disorder by applying an integrated two-stage screening approach.

Background: Few field trials exist on the impact of implementing guidelines for the early detection of autism spectrum disorders (ASD). The aims of the present study were to develop and evaluate a clinically relevant integrated early detection programme based on the two-stage screening approach of Filipek et al. (1999), and to expand the evidence base for this approach.

Treatment seeking adults with autism or ADHD and co-morbid substance use disorder: prevalence, risk factors and functional disability.

Background: Little is known about Autism Spectrum Disorder (ASD) in adults, especially not about ASD with co-morbid Substance Use Disorder (SUD). We wanted to examine how adults with ASD compare to adults with ADHD on prevalence and risk factors for co-morbid SUD, and on disability levels associated with SUD.

Methods: We stratified 123 treatment seeking adults with ASD (n=70) or ADHD (n=53), into current, former and no history of SUD (SUD+, SUD(wedge), and SUD-), and conducted interviews to explore associated risk factors and current levels of disability.