Abstract We will give an overview of the status of early intervention services for psychosis in Germany. We recently established a website which provides people in Germany with the nearest early detection an intervention service available (https://www.psycho-check.com). However, the overall implementation rate of early detction in Germany is quite heterogenous. We will also present recent research and ongoing projects from Germany including the first evaluation of specialized inpatient services for early psychosis, first evaluations of Individual placement and support and a mindfulness based group intervention in people with early psychosis as well as a newly desigend youth mental health service called soulspace (www.soulspace-berlin.de). Disclosure of Interest None Declared
Abstract Background The World Health Organization (WHO) acknowledges the importance of preschool children taking part in comprehensive physical activities supporting, among other things, their motor development, and competencies. A growing number of children attend early childhood education and care (ECEC), and expectations that this will support the development and learning of the youngest children are high. ECEC are governed by different policies embodied in both laws and curricula, and the framework of a curriculum plays a key role in ensuring the quality of ECEC services. The documents represent the content society wants the ECEC institutions to disseminate, and set out the values, objectives, and content of the work of pre-school teachers and serve as a point of reference for ECEC teachers and schools. The purpose of this study was to examine the values of movement and physical activity (MoPA) using government policy documents ECEC from Denmark, Finland, Iceland, Norway, and Sweden. Methods This descriptive, comparative study was designed based on curriculum theory and used word count and content analyses to examine values of MoPA and to identify similarities and differences in the ECEC policies of Nordic countries. Results Seven terms were identified as MoPA related; body, motor, move, physical activity, physical education, coordination, idrott/liikunta. These terms occurred in various content contexts: development, environment, expression, health and well-being, learning and play, albeit sparsely and were referred to as both a goal in itself and as a mean of achieving other goals (e.g., learning or development in another area). Formulations dedicated to MoPA as a goal were present in the Danish and Finnish curricula and, to some extent, also in the Norwegian, while the Icelandic and Swedish curricula mentioned MoPA only as a mean. Conclusion Findings indicated that MoPA, which are important for children's development, health, and well-being, is a low-priority value, to varying degrees, in the ECEC policies enacted by the Nordic countries. Thus, the guidance provided to educators and stakeholders therein is inexplicit. The low priority of the MoPA domain in the ECEC policies might negatively affect the possibility for young children to be physically active in preschools.
Introduction The positive attitude towards students with Diabetes Mellitus type 1(DM1) and the teacher’s knowledge seem to be important conditions both for the practical support of children with type 1 ED in primary education and for the self-efficacy of teachers in the school context. Self-efficacy involves the belief that a person has the ability to create change through personal actions. Objectives To investigate the level of knowledge of Primary Education teachers about DM1, their attitudes towards students with insulin-dependent diabetes, as well as their levels of self-efficacy in the management of diabetes in the school environment. Methods This is a cross-sectional study, where the sample consisted of 150 teachers working in Public Primary Schools of Athens, the capital of Greece. The following questionnaires were used to collect the data: (a) socio-demographic characteristics questionnaire, (b) primary education teachers’ knowledge and attitudes questionnaire about insulin-dependent diabetes, and (c) the generalized self-efficacy scale. Results 24.7% of participants were male and the mean age was 43.79 (±10.11). The average percentage of correct answers to the knowledge questionnaire was 86.00 (±9.01), also, the average score of perceptions about the role of the school nurse was 90.53 (±9.39), for the role of students with DM1 89.17 (±11.42), for the readiness of teachers/educational system to manage students with DM1 48.10 (±13.22), and of the self-efficacy was 30.71 (±13, 67). The questions with the lowest percentage of correct answers were: “What is the normal range of blood sugar values when we are fasting?” (62.70%) and “If you find a child with DM1 unconscious what should you do immediately?” (52.70%). The percentage of correct responses was found to have a positive statistically significant correlation with self-efficacy score (p=0.05), years of service (p=0.003), age (p=0.014), teachers who had at some point students with DM1 in their classroom versus those who did not (p=0.045). Conclusions Experienced and qualified staff could effectively support students not only practically by assisting them with daily activities but also by creating an environment based on understanding and acceptance. Disclosure of Interest None Declared
Abstract Children with learning disabilities have been shown to experience complex emotional and conduct difficulties due to late diagnosis and inappropriate parental management. Parenting support have been deemed necessary for a holistic management of learning disabilities. The current presentation reports on the methodology and initial results of a program offered to parents of children aged 8-12 years with learning difficulties at the region of Crete in Greece, during the school year 2020-2021. The program aimed at improving parenting skills and parent-child interaction, through a short training (four meetings) and a set of seven techniques offered to parents for boosting children’s positive response. All children diagnosed with a learning disability by an interdisciplinary team of experts serving a mobile unit, were approached and their parents were offered a personalised intervention plan and a package of counselling services including a six-week program, based on the “A Six Week Parenting Program For Child Compliance” (Cipani, 2005). Parents were randomly assigned to an intervention (n = 40, 6-week parenting program) and a control group (n = 29, no intervention). A pre- and post evaluation design, with self-administered questionnaires, was used to assess changes in parental skills and performance as well as the quality of parent-child interaction (Parenting Style Questionnaire; the Family Quality of Life Scale (FQOL)). Most of the participants were mothers (n = 63), of low educational level (n = 26) and low income (n = 49). Statistically significant improvements were evident in the intervention group at post-intervention level in parenting skills as compared to baseline scores. Significant differences were also observed in the parenting skills at post-intervention level, between the intervention and the control group. Findings are expected to highlight new approaches towards improving the parental role, with an impact on the quality of life of families. Key messages • Training on parenting skills should be included in family support services offered to children with learning disabilities. • Professionals working with learning disabilities should be trained to assess deficits in parenting skills and offer brief counseling to parents.
Abstract Background Children’s health is generally considered a complex interplay between multiple factors. Interventions building on community-based participatory research and system dynamics have shown promising potential in improving children's health behavior and well-being. This presentation aims to present how physical literacy can be used to guide and evaluate a systemic approach to health promotion. Methods System dynamics techniques such as group model building, is used to engage a whole community in a rural area of Denmark and develop local actions for enhancing among other physical activity. A central health outcome in The Child-COOP Denmark study is physical literacy, which is measured by using DAPL (the Danish version of CAPL). Physical literacy will be used as a central element to guide and evaluate the project. The evaluation design includes repeated measures of childhood health behavior, physical literacy and well-being among 100 children (6-13 y) attending the local primary school. With data collection at baseline and at 2 and 4 years of follow up. Results Furthermore, physical literacy results throughout the project period will also be used to guide new local actions in the environment aiming to enhance the local children’s health, well-being and physical activity. Discussion The potential of using physical literacy measures to guide and evaluate a participatory systems approach in order to solve complex health problems, is discussed and debated with the audience.
Abstract Minors affected by child welfare practices in Switzerland during the last century had a high risk for exposure to childhood trauma and maltreatment. Several studies with this cohort demonstrated substantially higher levels of clinically-relevant psychopathology in older adult survivors in comparison to non-affected control individuals. However, these studies also revealed that not all affected individuals developed mental health disorders over their lifespan. To date, this mental health resilience in survivors of an advanced age is still insufficiently understood. Therefore, this study aimed to assess and compare the resilience profiles of older adults who were formerly affected by child welfare-related trauma and maltreatment (risk group, RG; n = 132; Mage = 71 years) and non-affected, age-matched controls (control group, CG; n = 125). Within the RG, approximately one-third of the individuals had no current or lifetime DSM-5 mental health disorders. In comparison to the survivors with a history of mental ill-health, these individuals were older, had a higher income, and expressed a higher subjective satisfaction with their socio-economic status. Furthermore, they reported less early-life physical abuse, and had lower levels of neuroticism, as well as empathy-related characteristics. In addition, they showed higher levels of self-esteem and trait resilience. Group differences between the RG and CG highlight the importance of considering past adversity in the understanding of mental health resilience in later life.
Introduction According to the World Health Organisation (March 2022), it is estimated that one in 100 children worldwide has autism spectrum disorder (ASD). People with ASD very often face stigma, discrimination, and violations of their human rights. The aim of this study was to examine the knowledge and the attitudes of the general population regarding autism spectrum disorder as well as to raise awareness and promote appropriate behaviors towards people with ASD. Objectives The purpose of this study was to investigate the knowledge, attitudes, and the behaviors of the general population towards people with autism spectrum disorder in Greece. As far as is known, this is the first study carried out in Greece on this research topic. Methods A cross-sectional study was conducted online via social media and completed by 642 participants with various characteristics. The questionnaires were anonymous, their completion was voluntary and included the “Societal Attitudes Towards Autism” (SATA) scale. Linguistic validation and cultural adaptation of the SATA scale into the Greek language was based on the World Health Organization specifications. Data analysis was performed using the Statistical Package for the Social Sciences. Results A total of 642 people participated in the survey, 81.2% women and 18.8% men. The majority had a very good knowledge of autism (mean score 9.1 out of 13). However, women achieved significantly higher scores than men (p = 0.003). Respondents showed moderate to positive attitudes towards people with ASD (mean score 57.9 out of 80). The knowledge score is associated with the level of education, the place of residence, the existence of a person with autism in their friend or family environment, their income and occupation. The highest scores were observed in psychiatrists, following by teachers and other mental health professionals. Notably, 220 people believed autism to be caused by vaccination. Conclusions Educational and public health interventions should be organized in the general population in Greece to discard childhood vaccination as a causative factor of autistic spectrum disorder. There is significant need to educate the public in acquiring knowledge about autistic spectrum disorder. Disclosure of Interest None Declared
Introduction The Covid 19 pandemic has worsened mental health of teenagers and young adults in particular and highlighted the lack of data for children aged 3 -11 years living in France. To fill this gap, Santé publique France, the national public health agency set up the first nationwide study, Enabee, in 2022. Objectives Enabee (National study on Children wellbeing) aims at monitoring wellbeing and most frequent mental health disorders of children and at understanding associated factors, gathering information from children, parents and teachers. First analyses will be focused on children’ and teachers’ point of view. Methods Enabee is a nationwide cross sectional study. Elementary and nursery schools were randomly selected in Metropolitan France. Then a maximum of four classes were randomly selected in each school. Elementary school children (from 6 to 11 years old) gave their own assessment of wellbeing and mental health using the following self-administrated questionnaires on tablets: the Kindl and the Dominique Interactive. To get a comprehensive evaluation, parents and teachers also filled the web-administrated Strengths and Difficulties Questionnaire for each child. The parents’ questionnaire also included questions on child’s life habits and global health, parenting attitudes, parent’s mental health, covid 19, major life events and household social situation. A pilot study was launched in January to assess the feasibility and the acceptance before implementing the study at a nationwide level. Key stakeholders of education, family and health participated at the setting up of the study. Results 706 schools were selected and 399 participated (participation rate 57%). Data were collected from May 2nd to July 31st 2022. In those schools, 1357 classes participated, representing 29 414 children. We collected 15 206 questionnaires filled by children of elementary schools and 21 016 questionnaires filled by teachers for children in nursery and elementary schools. Analysis are ongoing. By March 2023, we will produce weighted estimates of prevalence of children internal and externals disorders based on the children self-assessment and the teachers’ assessment respectively and different dimensions of wellbeing. Prevalences will be presented by sex, age and school levels. Conclusions Enabee will provide a representative picture of French children wellbeing and mental health and protective and risks factors. This milestone is essential to guide national policies and build dedicated actions for children in order to promote and improve their wellbeing and mental health. Beyond this edition, Enabee is the first step of a long term monitoring system that will provide regularly updated data and will be completed by ancillary and ad hoc studies. Disclosure of Interest None Declared
Aims The new United Kingdom Foundation Programme Curriculum was implemented in 2021 and emphasizes the importance of Foundation Trainees (FTs) acquiring mandatory core skills and knowledge in mental health. The primary aim of our study was to enquire if the FTs perceive the new psychiatry competencies to be important and relevant to their needs. Secondarily we compared what the curriculum is offering with what FTs wished to have been offered. Methods A hybrid questionnaire was delivered online via Google forms to all foundation doctors before and after their psychiatry rotation. Data collection took place between August 2021 and March 2023 from a sample of 85 FTs. The quantitative data were elicited via 5-point Likert scales that mapped FTs' perception of importance across areas of required knowledge and core psychiatric skills from ‘not at all’ important to ‘extremely’ important. The data were imported into Microsoft Excel and analysed via descriptive statistics. The qualitative component of eliciting what FTs want by using open-ended questions was analysed using content analysis. Results The entry survey data show a combined median perceived importance of 4 (Very important) for recognizing, assessing, and managing mental health conditions. Out of these, personality disorder rated lowest with a median answer of 3 (Fairly important). These scores have seen a significant improvement in the exit survey with an overall combined median result of 5 (Extremely important). But not all areas have seen improvement, for example, eating disorders and Somatisation disorders remained unchanged with a median of 4. Interestingly, the median perceived importance of practicing core skills and managing clinical scenarios has not shown an improvement, but a slight decrease over a few categories, going from a median answer of 5 to 4. The qualitative data show that FTs would have liked to learn more about Child and Developmental Psychiatry, Bereavement, and acute health context teaching. They also wanted to learn communication skills and about psychiatry career paths and academic opportunities. Conclusion The overall baseline perceived importance of psychiatry competencies was satisfactory, with most conditions being rated as very important. Post placements there was a shift in responses, with the same conditions being rated as extremely important. Supraspecialised areas continue to be perceived as least important and curiously, FT's importance perception of practicing core skills in the acute setting decreased. Future research should qualitatively look at why their perceptions changed and how we can improve context teaching in a heterogeneous group.
Introduction Screening instruments can be crucial in child and adolescent mental healthcare practice by allowing to triage the patient flow in a limited resource setting and help in clinical decision making. However, for a screening procedure to work, we must be sure that the screening tools used have reasonable validity and clinical utility in the population they are used in. Objectives Our study aimed to examine the psychometric and predictive properties of the parent-report version of the Strengths and Difficulties Questionnaire (SDQ), with the application of the original UK-based scoring algorithm, in a clinical psychiatric population sample of Latvian children and adolescents. Methods 363 outpatients aged 2 to 17 years from two outpatient child psychiatry centres in Latvia were screened with the parent-report version of the SDQ and assigned clinical psychiatric diagnoses. The basic psychometric properties, and ability of the SDQ to predict the clinical diagnosis in major diagnostic groups (emotional, conduct, hyperactivity, and developmental disorders) was assessed. Results Most of the study participants were male (n=230, 63%). The mean age was 9,28 (SD=3,82) years for males and 10,93 (SD=4,11) years for females. Emotional problems, hyperactivity, and prosocial subscales of the SDQ, as well as the externalising and total difficulties scales, demonstrated acceptable internal consistency (Cronbach’s alfa > 0,7). The results for the conduct problems and internalising difficulties scales were also close to being on the acceptable level (0,68 and 0,69 respectively). The peer problems subscale was the only SDQ scale with poor internal consistency (0,57). The subscales of the parent-report SDQ showed significant correlation with the corresponding clinical diagnoses. The sensitivity and specificity of appropriate subscales of the parent-report SDQ were 67% CI [0,57,0,77] and 57% CI [0,50, 0,64] for any emotional disorder, 78% CI [0,67, 0,89] and 57% CI [0,50, 0,64] for any conduct disorder, 65% CI [0,55, 0,75] and 78% CI [0,73, 0,83] for the hyperkinetic disorder, 72% CI [0,63, 0,81] and 44% CI [0,36, 0,52] for developmental disability. Overall, none of the subscales of the SDQ has reached the interval of potential usefulness for clinical decision-making in specialized psychiatric settings, based on the positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio estimates. Conclusions We suggest the SDQ rather be used in primary healthcare settings, where it can be an essential tool to help family physicians recognise children needing further specialised psychiatric evaluation. There is a need to assess the psychometric properties and validate the SDQ in a larger populational sample in Latvia, determine the population-specific cut-off scores, and reassess the performance of the scale in primary healthcare practice. Disclosure of Interest None Declared
