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Evaluating the tendencies of community practitioners who actively practice in child and adolescent psychiatry to diagnose and treat DSM-5 attenuated psychotic syndrome.

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Title: Evaluating the tendencies of community practitioners who actively practice in child and adolescent psychiatry to diagnose and treat DSM-5 attenuated psychotic syndrome.
Authors: Yilmaz Kafali, Helin1 dr.helinyilmaz@gmail.com, Solerdelcoll, Mireia2,3, Vujinovic, Lena4, Martsenkovskyi, Dmytro5,6, Awhangansi, Sewanu7, Noel, Camille8,9, Bora, Emre10,11, Arango, Celso12
Source: European Child & Adolescent Psychiatry. Oct2022, Vol. 31 Issue 10, p1635-1644. 10p. 2 Charts, 1 Graph.
Subject Terms: *MENTAL illness treatment, *PSYCHIATRIC diagnosis, *STATISTICS, *PSYCHIATRIC drugs, *CROSS-sectional method, *SCHIZOPHRENIA, *CHILD psychiatry, *ADOLESCENT psychiatry, *SURVEYS, *INTER-observer reliability, *CLINICAL competence, *CASE studies, *DESCRIPTIVE statistics, *CLASSIFICATION of mental disorders, *DATA analysis software, *PSYCHOTHERAPY
Abstract: The detection of individuals at clinical ultra-high risk for psychosis (CHR-P) may be a key limiting step for early interventions, and there is some uncertainty regarding the true clinical reliability of the CHR-P states. The aim of this study was to explore how practitioners who were in the direct treatment of children with psychiatric disorders [child psychiatry specialists/trainees (n = 227, n = 131), adult psychiatrists (n = 27), and child neurologists (n = 2)] perceive the DSM-5-Attenuated Psychosis Syndrome (DSM-5-APS), and their clinical routine practice in the treatment of it. Three vignettes describing fictional cases presented with symptoms of either DSM-5-Schizophrenia, DSM-5-APS, and no psychotic symptoms were created. We asked these practitioners to apply a DSM-5 diagnosis and to choose appropriate treatment(s) for these vignettes. Of the responders, 43% correctly diagnosed the APS vignette, whereas 37.4% mentioned that it had a full-blown psychotic episode. Regarding the therapeutic approach for the APS vignette, 72.1% of all practitioners chose a psychopharmacological intervention and 32% individual psychotherapy. This study showed that the diagnostic inter-rater reliability of the DSM-5-APS among child/adolescent mental health practitioners was consistent with the results from the DSM-5 field trials (Kappa = 0.46). Moreover, almost three in four practitioners endorsed psychopharmacological intervention as a treatment option for the DSM-5-APS case. The lack of evidence of psychopharmacological interventions in CHR-P situations emphasizes that the least harmful interventions should be recommended. Thus, our findings indicated a need for raising awareness regarding the CHR-P paradigm and its treatment as well as the development of solid guidelines that can be implemented in clinical practice. [ABSTRACT FROM AUTHOR]
Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Evaluating the tendencies of community practitioners who actively practice in child and adolescent psychiatry to diagnose and treat DSM-5 attenuated psychotic syndrome.
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  Data: <searchLink fieldCode="AR" term="%22Yilmaz+Kafali%2C+Helin%22">Yilmaz Kafali, Helin</searchLink><relatesTo>1</relatesTo><i> dr.helinyilmaz@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Solerdelcoll%2C+Mireia%22">Solerdelcoll, Mireia</searchLink><relatesTo>2,3</relatesTo><br /><searchLink fieldCode="AR" term="%22Vujinovic%2C+Lena%22">Vujinovic, Lena</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Martsenkovskyi%2C+Dmytro%22">Martsenkovskyi, Dmytro</searchLink><relatesTo>5,6</relatesTo><br /><searchLink fieldCode="AR" term="%22Awhangansi%2C+Sewanu%22">Awhangansi, Sewanu</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Noel%2C+Camille%22">Noel, Camille</searchLink><relatesTo>8,9</relatesTo><br /><searchLink fieldCode="AR" term="%22Bora%2C+Emre%22">Bora, Emre</searchLink><relatesTo>10,11</relatesTo><br /><searchLink fieldCode="AR" term="%22Arango%2C+Celso%22">Arango, Celso</searchLink><relatesTo>12</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22European+Child+%26+Adolescent+Psychiatry%22">European Child & Adolescent Psychiatry</searchLink>. Oct2022, Vol. 31 Issue 10, p1635-1644. 10p. 2 Charts, 1 Graph.
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  Group: Ab
  Data: The detection of individuals at clinical ultra-high risk for psychosis (CHR-P) may be a key limiting step for early interventions, and there is some uncertainty regarding the true clinical reliability of the CHR-P states. The aim of this study was to explore how practitioners who were in the direct treatment of children with psychiatric disorders [child psychiatry specialists/trainees (n = 227, n = 131), adult psychiatrists (n = 27), and child neurologists (n = 2)] perceive the DSM-5-Attenuated Psychosis Syndrome (DSM-5-APS), and their clinical routine practice in the treatment of it. Three vignettes describing fictional cases presented with symptoms of either DSM-5-Schizophrenia, DSM-5-APS, and no psychotic symptoms were created. We asked these practitioners to apply a DSM-5 diagnosis and to choose appropriate treatment(s) for these vignettes. Of the responders, 43% correctly diagnosed the APS vignette, whereas 37.4% mentioned that it had a full-blown psychotic episode. Regarding the therapeutic approach for the APS vignette, 72.1% of all practitioners chose a psychopharmacological intervention and 32% individual psychotherapy. This study showed that the diagnostic inter-rater reliability of the DSM-5-APS among child/adolescent mental health practitioners was consistent with the results from the DSM-5 field trials (Kappa = 0.46). Moreover, almost three in four practitioners endorsed psychopharmacological intervention as a treatment option for the DSM-5-APS case. The lack of evidence of psychopharmacological interventions in CHR-P situations emphasizes that the least harmful interventions should be recommended. Thus, our findings indicated a need for raising awareness regarding the CHR-P paradigm and its treatment as well as the development of solid guidelines that can be implemented in clinical practice. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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