Mind the gap: integrating physical and mental healthcare for children with functional symptoms

Heyman, Isobel

doi:10.1136/archdischild-2019-317854

Cited by 7 publications

(3 citation statements)

References 7 publications

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“…There is a need for collaboration between paediatric and mental health services. Once a positive diagnosis of functional tic-like attacks has been made, optimum management is likely to include integration of paediatric and mental healthcare 7 and ensuring children and families understand the diagnosis and the usefulness of behavioural/psychological intervention. 8 There are new data showing that referrals to child mental health services in September 2020 were 72% higher than in September 2019.…”

Section: Functional Symptoms As a Part Of An Overall Increase In Mentmentioning

confidence: 99%

COVID-19 related increase in childhood tics and tic-like attacks

Heyman

Liang

Hedderly³

2021

Arch Dis Child

Self Cite

103

138

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Section: Functional Symptoms As a Part Of An Overall Increase In Mentmentioning

confidence: 99%

COVID-19 related increase in childhood tics and tic-like attacks

Heyman

Liang

Hedderly³

2021

Arch Dis Child

Self Cite

103

138

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“…Our previous research with the 2004 British Child and Adolescent Mental Health Survey (BCAMHS) demonstrated that compared to children without a LTC, CYP with any LTC had higher SDQ total difficulties scores at baseline (adjusted mean difference 1.4, 1.1-1.6) and followup (1.1, 0.8-1.4), and were more likely to have a psychiatric disorder at baseline (adjusted odds ratio [aOR] 1.59, 1.34-1.89) and follow-up (1.75, 1.44-2.12) [13]. Considering the high rates of physical-mental health comorbidity in CYP, previous research has highlighted the importance of developing integrated approaches toward mental and physical health [14,15]. Identifying the risk factors for the onset and persistence of mental health disorders in CYP with pLTCs could help (a) detect potential aetiological processes, (b) recognise high-risk cases to be targeted for early intervention services, and (c) identify factors that interventions should aim to influence.…”

Section: Introductionmentioning

confidence: 99%

Risk of new onset and persistent psychopathology in children with long-term physical health conditions: a population-based cohort study

Panagi

White

Dai

et al. 2023

Eur Child Adolesc Psychiatry

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Children and young people (CYP) with long-term physical health conditions (pLTCs) have increased risk of psychopathology compared to physically healthier peers. We explored risk factors for new onset and persistent psychiatric disorders in CYP with pLTCs compared to CYP without pLTCs. This 3-year follow-up study involved a UK representative sample of CYP from the British Child and Adolescent Mental Health Surveys (N = 7804). We examined potential baseline predictors of new onset and persistent psychiatric disorders at follow-up in four groups of children based on the presence of any physical and/or any psychiatric conditions at baseline. Psychiatric disorders were assessed using standardised multi-informant diagnostic assessment. Separate multivariable binary logistic regressions were conducted for each group. In CYP with pLTCs, rented housing (aOR = 1.42, 95% CI 1.01 to 1.99), non-traditional family structure (aOR = 2.08, 95% CI 1.42 to 3.05), increased parental distress (aOR = 1.09, 95% CI 1.04 to 1.14), and greater peer relationship difficulties (aOR = 1.29, 95% CI 1.19 to 1.39) predicted future psychiatric disorder. Only peer relationship difficulties predicted persistent disorder (aOR = 1.27, 95% CI 1.17 to 1.38) in this group. A greater number of factors predicted the onset of psychiatric disorder in CYP with pLTCs compared to physically healthier peers and similarly, a higher number of factors predicted persistent disorder in CYP without pLTCs. CYP with pLTCs might comprise a group with different vulnerabilities, some of which are potentially tractable and may be useful indicators of patients who require preventable or management interventions.

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“…5,6 Multidisciplinary management with an integrated psychiatric assessment and psychotherapy is the recommended standard of care. [7][8][9][10] Previous research has suggested that emotional disorders and adjustment disorders are common in children and adolescents with PNES. 1,2 However, recent studies indicate an occurrence of a wider spectrum of psychiatric disorders, including neurodevelopmental disorders.…”

mentioning

confidence: 99%

Psychiatric Disorders in Children and Adolescents With Psychogenic Nonepileptic Seizures

et al. 2021

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Objective:Knowledge regarding psychiatric disorders in children and adolescents with psychogenic nonepileptic seizures (PNES) is limited. This study outlines the spectrum and risk of psychiatric disorders in childhood-onset PNES.Methods:A nationwide matched cohort study of children and adolescents with PNES aged 5-17 years at time of diagnosis between January 1, 1996 and December 31, 2014. Two matched comparison groups were included: children and adolescents with epilepsy (ES), and children and adolescents without PNES or epilepsy, termed healthy controls (HC). Outcomes were prevalent psychiatric disorders prior to index (i.e. date of diagnosis or corresponding date for HCs), and incident psychiatric disorders two years after index. Relative risks (RRs) were calculated and adjusted for potential confounders.Results:We included 384 children and adolescents with validated PNES, 1,152 with epilepsy, and 1,920 healthy controls. Among the PNES cases, 153 (39.8%) had prevalent psychiatric disorders and 150 (39.1%) incident psychiatric disorders. As compared to the epilepsy and healthy controls, children and adolescents with PNES had elevated risks of both prevalent psychiatric disorders (adjusted RRPNES/ES: 1.87, 95% CI: 1.59–2.21, adjusted RRPNES/HC: 5.54, 95% CI: 4.50–6.81), and incident psychiatric disorders (adjusted RRPNES/ES: 2.33, 95% CI: 1.92–2.83, adjusted RRPNES/HC: 8.37, 95% CI: 6.31–11.11). A wide spectrum of specific psychiatric disorders displayed elevated RRs.Conclusions:Children and adolescents with PNES are at higher risk of a wide range of psychiatric disorders as compared to children and adolescents with epilepsy and healthy controls. A careful psychiatric evaluation is warranted to optimize and individualize treatment.

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Mind the gap: integrating physical and mental healthcare for children with functional symptoms

Cited by 7 publications

References 7 publications

COVID-19 related increase in childhood tics and tic-like attacks

COVID-19 related increase in childhood tics and tic-like attacks

Risk of new onset and persistent psychopathology in children with long-term physical health conditions: a population-based cohort study

Psychiatric Disorders in Children and Adolescents With Psychogenic Nonepileptic Seizures

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