The use of mobile apps and technologies in child and adolescent mental health

Question: This review will aim to critically evaluate the currently available literature concerning the use of online mobile-based applications and interventions in the detection, management and maintenance of children and young people’s mental health and well-being. Study selection and analysis: A systematic literature search of six electronic databases was conducted for relevant publications until May 2019, with keywords pertaining to mental health, well-being and problems, mobile or internet apps or interventions and age of the study population. The resulting titles were screened and the remaining 92 articles were assessed against the inclusion and exclusion criteria with a total of 4 studies included in the final review. Findings: In general, young people seem to engage very well with this type of tools, and they demonstrate some positive effects in emotional self-awareness. There have been some studies about this issue and many of the outcomes were notstatistically significant. However, it is still a sparsely documented area, and more research is needed in order to prove these effects. Conclusions: Mental health apps directed at young people have the potential to be important assessment, management and treatment tools, therefore creating easier access to health services, helping in the prevention of mental health issues and capacitating to self-help in case of need. However, a limited number of studies are currently available, and further assessments should be made in order to determine the outcomes of this type of interventions

SafeSpot:An innovative app and mental health support package for Scottish schools - a qualitative analysis as part of a mixed methods study

Aims: The aim of the study was to investigate teachers’ and pupils’ perceptions about the effect of the SafeSpot mental health curriculum on the well‐being of young people and on their knowledge of mental health conditions. This trial intends to determine the acceptability and benefits of web and mobile technology in delivering emotional well‐being in schools, through use of the SafeSpot programme. Background: With 10% of young people aged 5 to 16 diagnosed with a mental disorder, there is pressure for schools to address their pupils’ emotional well‐being. However, many educators report that their schools have insufficient provisions and feel inadequately equipped to support pupils’ mental health. Methods: This qualitative analysis was embedded within a randomly allocated stepped‐wedge design, conducted in six West of Scotland secondary schools. A total of 2320 pupils (aged 11 to 14 years) and 90 teachers were included. Young people’s understanding of health‐seeking, and teacher’s confidence in delivering and accessing well‐being information was assessed qualitatively. Results: Qualitative analysis revealed themes highlighting the beneficial nature of SafeSpot, including pupil engagement, content of tutorials, perceived impact of SafeSpot and level of training provided for teachers. Conclusions: Web technology could potentially offer a more structured way for staff to support their pupils’ mental health, whilst reducing stigma. SafeSpot was perceived, by pupils and teachers, to be engaging

Investigation of neuropsychiatric aspects of Sydenham’s Chorea: case series review

Hypthesis: There is an association with the severity of chorea symptoms in Sydenham's chorea and psychiatric diagnosis. Primary Objective: To identify, using a validated, structured diagnostic interview, the prevalence of psychiatric diagnoses before, during, and after the presence of chorea in a regional, clinic-based case series of children and adolescents with a history of Sydenham's chorea. Method: The study interviewed twelve children who had been diagnosed with SC by Neurology and were referred to a psychiatric liaison team with psychiatric symptoms within the study period. The interview consisted of semi structured validated questionnaire screening tools including the ESSENCE questionnaire, the KIDDIE-SADS PL, and the Chorea rating scale (USCRS) that included a video recording. Results: Although all twelve children had a history of psychiatric symptoms, all but three children had a history of psychiatric symptoms prior to diagnosis of SC. During and after the chorea developed all children developed new or more severe psychiatric symptoms and there was an overall increase in range of psychiatric symptoms experienced. At the time of the study all but two children were screened as having current psychiatric diagnoses with KSADS-PL. The psychiatric diagnoses were not correlated with whether the child had chorea at the time of the study or not. Conclusions: The study suggests that the majority of children who develop psychiatric problems in the context of a diagnosis of Sydenham’s chorea are likely to have pre-morbid vulnerability to psychiatric symptoms. New onset of psychiatric symptoms developed in three children following the diagnosis of SC. The remaining nine children already had pre-existing psychiatric symptoms and vulnerabilities however, overall, this latter group of children also reported more symptoms developing after they developed SC

Effectiveness of a pilot school-based intervention on improving scottish students’ mental health: a mixed methods evaluation

Mental health difficulties are prevalent among children and young people and there is strong evidence-base for the effectiveness of school-based programmes in promoting mental health and resilience; however, there is a need for further trial and evaluation of such programmes in different contexts. The present study aims to evaluate a pilot mental health programme, SafeSpot, trialled in a secondary school, assessing the impact of the programme on students’ mental health as well as teachers’ opinions and experiences. A mixed-methods design was employed. Results revealed significantly lower self-reported emotional distress post-intervention compared to pre-intervention. Teachers’ overall experiences were positive, supporting the delivery of mental health content in schools and sharing perceived limitations and recommended adaptations to programme content. Preliminary findings are promising and further research into the programme is recommended. Mixed methods research is a useful tool for the evaluation of school-based interventions, and should be considered by researchers undertaking such projects

Weight loss in an adolescent girl

No abstract available

Neuropsychiatric manifestations of Sydenham's chorea: a systematic review

Aim: Sydenham's chorea is a post-streptococcal, autoimmune, neuropsychiatric movement disorder. Sydenham's chorea is a major criterion for diagnosis of acute rheumatic fever with the implication of potential long-term sequelae including cardiac complications. It is well established that there is psychiatric comorbidity in Sydenham's chorea, but there are variations in the literature regarding the nature and prevalence of psychiatric diagnoses associated with Sydenham's chorea. The aim of this review was to systematically evaluate the evidence for psychiatric symptoms presenting with Sydenham's chorea. Knowledge of comorbid psychiatric symptomatology will support early diagnosis and treatment, leading to improved long-term outcomes for children with Sydenham's chorea. Method: The study used a systematic search strategy, using MEDLINE, MEDLINE in Process, EMBASE, and The Cochrane Library. Abstracts were screened to identify relevant papers which were then assessed further. Eligible papers were summarized. Results: A total of 1429 abstracts of relevant studies were found, and 49 papers reporting neuropsychiatric symptoms in Sydenham's chorea were summarized. Obsessive-compulsive disorder was the most commonly studied, and hence reported, neuropsychiatric symptom in children with Sydenham's chorea. The studies analysed used a variety of tools to identify affected children and used different methods for analysing results. Attention-deficit–hyperactivity disorder, affective disorders, tic disorders, executive function disturbances, and psychotic features were also reported as comorbidities. Interpretation: There is good evidence of neuropsychiatric comorbidities in Sydenham's chorea. In countries with a high prevalence of rheumatic fever, the early recognition of salient cognitive and psychiatric symptoms may aid in the management of Sydenham's chorea

Neuropsychiatric manifestations of Sydenham's chorea: a systematic review

Aim: Sydenham's chorea is a post-streptococcal, autoimmune, neuropsychiatric movement disorder. Sydenham's chorea is a major criterion for diagnosis of acute rheumatic fever with the implication of potential long-term sequelae including cardiac complications. It is well established that there is psychiatric comorbidity in Sydenham's chorea, but there are variations in the literature regarding the nature and prevalence of psychiatric diagnoses associated with Sydenham's chorea. The aim of this review was to systematically evaluate the evidence for psychiatric symptoms presenting with Sydenham's chorea. Knowledge of comorbid psychiatric symptomatology will support early diagnosis and treatment, leading to improved long-term outcomes for children with Sydenham's chorea. Method: The study used a systematic search strategy, using MEDLINE, MEDLINE in Process, EMBASE, and The Cochrane Library. Abstracts were screened to identify relevant papers which were then assessed further. Eligible papers were summarized. Results: A total of 1429 abstracts of relevant studies were found, and 49 papers reporting neuropsychiatric symptoms in Sydenham's chorea were summarized. Obsessive-compulsive disorder was the most commonly studied, and hence reported, neuropsychiatric symptom in children with Sydenham's chorea. The studies analysed used a variety of tools to identify affected children and used different methods for analysing results. Attention-deficit–hyperactivity disorder, affective disorders, tic disorders, executive function disturbances, and psychotic features were also reported as comorbidities. Interpretation: There is good evidence of neuropsychiatric comorbidities in Sydenham's chorea. In countries with a high prevalence of rheumatic fever, the early recognition of salient cognitive and psychiatric symptoms may aid in the management of Sydenham's chorea