Suchergebnisse

Abstract
Purpose Early detection and timely treatment of child psychiatric problems require multi-professional collaboration and interaction between primary and specialized health care. The "eHealth Services for Child and Adolescent Psychiatry (eCAP), 2015-2018" project aims at improving child psychiatric services in peripheral areas by developing eHealth tools facilitating better cooperation between professionals working with children with mental health problems.
Methods The online booking system allows the primary healthcare professionals in Pohjois-Savo region to book a video conference (VC) with experts in child psychiatry for consultation, supervision or follow-up of care. Background information gathered from the parents, teacher and the child by online forms helps the consult to prepare for the meeting, which can be carried out on computer, laptop, table or smartphone. The developed services will be evaluated based on the log data and user experiences from the pilot phase.
Results The services will improve the quality, availability and cost-effectiveness of child psychiatric outpatient services in the region. Increased multi-professional collaboration among professionals will support preventive work, early identification and treatment in natural developmental environments of children. The travel needs for families are expected to decrease.
Conclusions eHealth can help to meet the global challenge of providing sufficient, timely child psychiatric services in remote, sparsely populated areas with limited resources, but information security and compatibility of different technical applications require innovative solutions. Furthermore, the people-related factors are crucial in introducing a sustainable change: the users must understand the benefits and receive training to adopt the new tools and routines for their work.

Psychiatric hospital treatment (PHT) is expensive and indicates a severe disorder. Investigation of the early identification of this small patient group has though been hindered by small samples or unsatisfactory assessment in childhood. The present study aims to study the predictive association between psychopathology at age 8 using multi-informant assessment and later PHT. A nationwide birth cohort of Finnish children (n = 5,346) was assessed at age 8 to obtain information about psychopathology using the Rutter parent and teacher reports and self-reports of depressive symptoms. The main outcome was admission to any hospital with a primary diagnosis of any psychiatric disorder according to the Finnish National Hospital Discharge Register between age 13 and 24. Between age 13 and 24, 6.2% of the males and 4.1% of the females had been admitted for PHT. Among males, PHT was independently predicted by non-intact family and adult reports of conduct and of emotional symptoms, while among females by self-reported depressive symptoms. However, the combination of conduct and emotional problems was the strongest predictor for PHT in both sexes. Admission due to psychosis among males was associated with childhood conduct, attention, and emotional problems, but with emotional problems among females. Psychopathology at age 8 can be seen as a long-lasting increased risk of severe psychiatric disorders requiring hospital treatment in adolescence or early adulthood. Attention should be paid to self-reports among females and of comorbid conduct and emotional problems in both sexes in the early identification of this patient group.