Hard-to-treat or hard-to-catch? Clinical features and therapeutic outcomes of help-seeking foster care youths with mood disorders

被引：1

作者：

Benarous, Xavier ^{[1
,2
]}

Lahaye, Helene ^{[1
,2
]}

Pellerin, Hugues ^{[3
]}

Consoli, Angele ^{[3
]}

Cohen, David ^{[3
,4
]}

Labelle, Real ^{[5
,6
]}

Renaud, Johanne ^{[7
,8
]}

Gerardin, Priscille ^{[9
]}

El-Khoury, Fabienne ^{[10
]}

van der Waerden, Judith ^{[10
]}

Guile, Jean-Marc ^{[1
,2
,11
]}

机构：

[1] Amiens Univ Hosp, Dept Child & Adolescent Psychopathol, Amiens, France

[2] Univ Picardy Jules Verne UPJV, Res Grp Anal Multimodal Cerebral Funct, INSERM, Unit U1105, Amiens, France

[3] Pitie Salpetriere Univ Hosp, APHP, Dept Child & Adolescent Psychiat, Paris, France

[4] Sorbonne Univ, Inst Intelligent Syst & Robot, CNRS, UMR 7222, Paris, France

[5] Univ Quebec Montreal, Dept Psychol, Montreal, PQ, Canada

[6] Univ Quebec Montreal, Ctr Res & Intervent Suicide Eth Issues & End Of Li, Montreal, PQ, Canada

[7] McGill Univ, Douglas Mental Hlth Univ Inst, Manulife Ctr Breakthroughs Teen Depress & Suicide, Montreal, PQ, Canada

[8] McGill Univ, Dept Psychiat, Montreal, PQ, Canada

[9] Rouen Univ Hosp, Dept Child & Adolescent Psychopathol, Rouen, France

[10] Sorbonne Univ, Inst Pierre Louis Epidemiol & Sante Publ, Equipe Rech Epidemiol Sociale, INSERM, Paris, France

[11] Etab Publ Sante Mentale Somme, Pole Psychiat Enfant & Adolescent, Paris, France

来源：

FRONTIERS IN PSYCHIATRY | 2023年 / 14卷

关键词：

depressive disorder; early-onset bipolar disorder; disruptive mood dysregulation disorder; child adversity; complex psychotrauma; developmental psychotrauma; adverse chilhood experiences; MENTAL-HEALTH; CHILDHOOD MALTREATMENT; BIPOLAR DISORDER; DEPRESSIVE SYMPTOMS; CHILDREN; ADOLESCENTS; DYSREGULATION; IMPACT; PSYCHOPATHOLOGY; INTERVENTIONS;

D O I：

10.3389/fpsyt.2023.1211516

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

IntroductionThe high level of emotional problems in youths placed in foster care contrasts with the limited use of evidence-based treatments. This study aims to better characterize the clinical features and therapeutic outcomes of foster care youths with mood disorders.MethodsA secondary analysis of data collected in the context of a French-Canadian clinical research network on pediatric mood disorders in four sites was conducted to compare three groups of patients with depressive or bipolar disorder: those without exposure to child welfare intervention (WCWI, n = 181), those who received non-placement psychosocial intervention (NPI, n = 62), and those in placement interventions (PI, n = 41).ResultsWe observed a very high rate of academic problems in patients in the groups NPI/PI compared to those in the WCWI group. Patients in the PI group had more disruptive behavioral disorders (OR = 6.87, 95% CI [3.25-14.52]), trauma-related disorders (OR = 3.78, 95% CI [1.6-8.94]), and any neurodevelopmental disorders (OR = 2.73, 95% CI [1.36-5.49]) compared to the other groups (NPI/WCWI). Among inpatients, the Clinical Global Impression-Improvement scale and the change in the Children Global Assessment Scale during the hospital stay did not differ across the three groups. We observed a higher prescription rate of antipsychotics in the PI group compared to the NPI/WCWI groups, but no significant difference for antidepressants and mood stabilizers.DiscussionThese findings support the view that, when provided with dedicated support, fostered inpatient youths can improve in a range comparable to other inpatients. Undetected neurodevelopmental disorders and academic problems are likely important contributors of the burden of mood disorders in these youths.

引用

页数：11