The Provision and Utilization of Telehealth within Academic Mental Health Clinics in North America during the COVID-19 Pandemic.

Objective: To document the experience of 14 academic child and adolescent psychiatry programs in transitioning to and managing telehealth services during the COVID-19 pandemic. The goal was to understand how programs adopted and sustained telehealth during the pandemic. Telehealth was defined as services delivered via videoconferencing and telephony.

Predictors of COVID-19 vaccine uptake among youth with bipolar disorder spectrum disorders and their caregivers.

Background: Little is known about rates of COVID-19 vaccine uptake among youth with bipolar spectrum disorders (BSD). As such, the aim of this study is to assess rates and predictors of COVID-19 vaccine uptake among youth with BSD and their caregivers in the United States.

Methods: Youth and their main caregiver were recruited from a large pragmatic study cohort.

Adherence Rates and Barriers to Second-Generation Antipsychotic Medication Use in Youth with Bipolar Spectrum Disorders Who Have Overweight/Obesity.

Youth with bipolar spectrum disorders (BSD) are frequently prescribed second-generation antipsychotics (SGAs). Nonadherence to treatment often results in increased mood symptoms and diminished quality of life. We examined SGA adherence rates and adherence barriers among youth who have overweight/obesity and are diagnosed with BSD enrolled in a multisite pragmatic clinical trial.

Metformin for Overweight and Obese Children With Bipolar Spectrum Disorders Treated With Second-Generation Antipsychotics (MOBILITY): Protocol and Methodological Considerations for a Large Pragmatic Randomized Clinical Trial.

Objective: Youth with bipolar spectrum disorders may experience improved mood stability when treated with second generation antipsychotics (SGAs); however, SGAs are associated with unhealthy weight gain and adverse metabolic effects. Metformin may mitigate this weight gain but is rarely prescribed by community mental health practitioners. Its long-term efficacy, safety, and acceptability in usual care, and factors that might moderate these effects, are unknown.

The Transition of Academic Mental Health Clinics to Telehealth During the COVID-19 Pandemic.

Objective: A consortium of 8 academic child and adolescent psychiatry programs in the United States and Canada examined their pivot from in-person, clinic-based services to home-based telehealth during the COVID-19 pandemic. The aims were to document the transition across diverse sites and to present recommendations for future telehealth service planning.

Method: Consortium sites completed a Qualtrics survey assessing site characteristics, telehealth practices, service use, and barriers to and facilitators of telehealth service delivery prior to (pre) and during the early stages of (post) the COVID-19 pandemic.

Measurement-Based Care in the Treatment of Attention-Deficit/Hyperactivity Disorder and Disruptive Behavior Disorders.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood psychiatric diagnoses. The core symptoms of ADHD include inattention, impulsivity, and hyperactivity. ADHD entails impairments that have extensive and profound detrimental effects on many critical developmental areas.

The Importance of Second-Generation Antipsychotic-Related Weight Gain and Adherence Barriers in Youth with Bipolar Disorders: Patient, Parent, and Provider Perspectives.

The objective of this research was to understand physician, patient, and parent perspectives on barriers to second-generation antipsychotic (SGA) medication adherence in youth with bipolar spectrum disorders, and attitudes toward treatment of SGA-related weight gain. Patients diagnosed with bipolar disorder before age 18, parents of children diagnosed before 18, and clinicians with experience prescribing SGAs for these patients completed surveys regarding SGA-related side effects, adherence barriers, and acceptability of weight management strategies. Patients ( = 225), parents ( = 128), and clinicians ( = 54) reported weight gain as the most concerning SGA-related side effect (45.

Demographics and Outcomes of Patients With Eating Disorders Treated in Residential Care.

The use of residential eating disorder (ED) treatment has grown dramatically in the United States, yet there has been minimal evaluation of treatment outcomes. Thus, outcome data on weight restoration, purging behaviors, and/or Global Assessment of Functioning (GAF) for 1,421 patients treated over an 8-year period in residential ED programs are described. Results suggest that, (1) for patients who needed weight restoration upon admission, adolescent and adult patients gained 2.

Excessive exercise among adolescents with eating disorders: examination of psychological and demographic variables.

Background While a large number of patients with eating disorders (EDs) engage in excessive exercise (EE), both for weight control and mood regulation, there has been minimal research evaluating the relationship between EE and demographic and psychological factors, especially in adolescent patients. Purpose The goals of this study were to identify the occurrence of EE compared to other ED behaviors and to develop a regression model examining psychological, behavioral and demographic predictors of EE among adolescents with EDs. Methods Demographic and clinical information was determined for 217 adolescent patients in several levels of care (126 outpatient, 61 day program, 28 inpatient) with diagnoses of anorexia nervosa (AN) (24.

Correlates of Subjective Caregiver Strain in Caregivers of Youth Evaluated in a Pediatric Psychiatric Emergency Room.

Background: Although caregiver burden is relevant to the outcome for psychiatrically ill youth, most studies have focused on caregiver burden in the community or research settings. Therefore, we aimed at evaluating the subjective caregiver strain (SCS) at the time of presentation of youth to a pediatric psychiatric emergency room (PPER), assessing potential correlates to provide leads for improvements in formal support systems.

Methods: In this retrospective cohort study, the internalized, externalized, and total SCS were assessed in caregivers of youth <18 years of age consecutively evaluated at a PPER during a 1 year period using the Caregiver Strain Questionnaire.

Eating disorders in adolescents: review of treatment studies that include psychodynamically informed therapy.

In clinical practice, psychodynamic approaches represent an important component of the treatment for young people with eating disorders (EDs), even though the research literature remains modest regarding the most effective treatment for children, adolescents, or adults with an ED. Although there are very few clinical research studies of individual or family psychodynamic treatments of EDs, there is some evidence for efficacy from clinical trials. This article reviews studies of psychodynamically informed therapies for the treatment of EDs and discusses how the findings, although limited, suggest that further research into psychodynamic treatments of EDs in youth is warranted.

Frequency and correlates of inappropriate pediatric psychiatric emergency room visits.

Background: Despite increasing pediatric psychiatric emergency room service (PPERS) visits, data are lacking regarding visit characteristics and appropriateness.

Method: This retrospective cohort study consecutively assessed youngsters aged < 18 years between January 1 and December 31, 2002, utilizing data from a 12-page semistructured institutional evaluation form. Appropriateness, severity, acuity, and harm potential of PPERS visits were rated on a Likert scale.

Anorexia nervosa and pregnancy: having a baby when you are dying to be thin--case report and proposed treatment guidelines.

Objective: Pregnant women with anorexia nervosa (AN) are at risk for multiple complications to both the woman and fetus. This report examines when to obtain a psychiatric evaluation or admission to an inpatient psychiatric unit to ensure the safety of both the woman and fetus.

Method: A case report of a pregnant woman with AN describes the risks of extreme weight loss during pregnancy and the deleterious effects on the fetus's viability and mother's health.

What may underlie differing perceptions of family functioning between mothers and their adolescent daughters with eating disorders?

Unlabelled: Daughters with eating disorders (ED) were found to perceive family functioning more negatively than their mothers. This study examined variables that may underlie these differences in a subgroup of adolescent girls and their mothers from the original study.

Methods: Participants were 77 mother-adolescent daughter dyads.

Is perceived family dysfunction related to comorbid psychopathology? A study at an eating disorder day treatment program.

The role of the family in the development of eating disorders has been a predominant research focus. However, few studies of patients in an eating disorder (ED) day treatment program (DTP) have explored the relationship between self-reported family system functioning, self-reported comorbid psychopathology and current comorbid psychological symptom status. This study examined patients at presentation to an ED DTP, their self-reported perception of family functioning and the relationship with characteristics of their own comorbid psychopathology characteristics.

The relationship between eating pathology and perceived family functioning in eating disorder patients in a day treatment program.

This study examines the perceived levels of family functioning and their relationships with eating pathology across three eating disorder diagnostic groups. Charts of 65 day treatment female patients, ranging in age from 12 to 27 years, were studied by diagnosis and assessed using the FACES-II and EDI-2. Using multiple regression analyses, it was determined that perceived family functioning yielded significant predictions for various EDI-2 subscales within both Anorexia Nervosa and Eating Disorder Not Otherwise Specified diagnoses.

Do daughters with eating disorders agree with their parents' perception of family functioning?

Objective: The current study compared the perceptions of family functioning between daughters with eating disorders (EDs) and their parents. This investigation was an expansion of the Fornari et al (Compr Psychiatry 1999;40:434-441) study, which investigated the relationship between the perceived family functioning and depressive symptoms in individuals with ED patients receiving outpatient services.

Method: One hundred twenty-six female subjects, ranging in age from 13 to 34 years (mean 18.

Three case reports on the relationship between anorexia nervosa and obsessive compulsive disorder.

The literature has demonstrated that both food-related and non food-related obsessions and compulsions are common in patients with eating disorders and that eating disorders are common in patients with obsessive-compulsive disorder (OCD). It has become increasingly important, therefore, to evaluate the clinical and etiological relationships between these disorders. The authors present three patients with anorexia nervosa and obsessive-compulsive disorder.

Cultural factors in orthodox Jewish adolescents treated in a day program for eating disorders.

This study explores the specific role of culture and religion in the development of eating disorders (ED) in Orthodox Jewish female adolescents. We present eight cases admitted to a Day Treatment Program (DTP) for Eating Disorders. Additionally, some preliminary comparisons are examined between Orthodox and all other patients, and also between ultra and modern Orthodox patients.

Psychosexual development and eating disorders.

The relationship among eating disorders (EDs), psychosexual and identity development, and physical maturation (puberty) is reviewed. The developmental tasks of adolescence are summarized, and research from both community studies and clinical samples on the association between the development of an ED and putative risk factors that include pubertal development and psychosexual behaviors and attitudes for children and adolescents is reviewed. Specific issues explored include the role of child and adolescent abuse and EDs in males.