Child and adolescent psychiatry and psychotherapy

The Child and Adolescent Psychiatry is concerned with the prevention , diagnosis and treatment of mental , psychosomatic and neurological disorders in childhood or adolescence occur. Today it represents an independent medical specialty. It developed from general psychiatry .

In Germany, the official name has been Child and Adolescent Psychiatry and Psychotherapy (KJPP) since 1993 . The KJPP is a neighboring subject of many other individual sciences (e.g. paediatrics , child neurology , social and developmental pediatrics , but also education ) that deal with children and adolescents and their families.

history

The subject of child and adolescent psychiatry began to establish itself shortly before 1900. In 1887 , Hermann Emminghaus published the first textbook on child psychiatry. The first clinical facility for child psychiatry in Germany was founded in Bonn in 1926 and headed by Otto Löwenstein . It was probably also the first of its kind in the world.

description

Typical diagnoses in child and adolescent psychiatry are listed in the chapter on mental disorders in childhood and adolescence of the ICD-10 (see F90-F98 , Chapter V). However, the diagnosis also covers all of the psychosocial references of a child or adolescent. The holistic view is based on the scientific standards of the field and is the basis for all child and adolescent psychiatric therapy measures ( psychotherapy , pharmacotherapy, etc.).

Diagnosis and therapy by a doctor specializing in child and adolescent psychiatry and psychotherapy may be indicated in the following situations:

• Psychological problems after acute stress or after traumatizing events ( abuse and sexual exploitation, family conflicts);
• Problems with attention and impulsiveness (e.g. ADHD ),
• Localized developmental disorders ( partial performance disorders ), massive school problems,
• Developmental abnormalities in motor skills, language, also in connection with brain dysfunction and other neurological developmental abnormalities;
• Problems of toilet training ,
• Emotional disorders (e.g. extreme anxiety and mood swings )
• Eating disorders (such as anorexia nervosa , bulimia nervosa, and obesity ),
• Psychosomatic complaints and reactive mental problems in chronic illnesses,
• Profound developmental disorders (e.g. autism spectrum disorders )
• Diseases from the group of psychoses ,
• Behavioral disorders in children and adolescents with intellectual disabilities ,
• Aggressive or rebellious, defiant behavior in the sense of a disorder of social behavior ,
• Abnormalities in sexual development, problems with one's own sexuality,
• Addiction problems (e.g. drug addiction , but also shopping addiction or computer game addiction ),
• Tic disorder or Tourette syndrome ,
• Epilepsies ,
• Help with custody and contact regulations, with out-of-home placement and with legal issues.

Specialist training

Child and adolescent psychiatrists are usually either resident or work in a child and adolescent psychiatric service (KJPD) , and of course in relevant clinics and universities.

In order to work as a specialist in child and adolescent psychiatry and psychotherapy in Germany after completing a medical degree , a five-year period of further training is required:

• 4 years of child and adolescent psychiatry and psychotherapy, including 2 years of ward work and
• 1 year in pediatrics or psychiatry and psychotherapy (periods from clinics for psychosomatic medicine or neurology are also eligible , see regulations of the medical association of the respective federal state).

The training takes place according to a fixed workload from the sample logbook of the German Medical Association , from which the valid logbooks of the individual federal states are derived. The designation was introduced in 1993 in the course of the new training regulations of the German Medical Association and replaced the title "Specialist in child and adolescent psychiatry" introduced in 1968.

From July 2020, a new further training regulation will apply in Hesse for all medical specialists in Hesse.

statistics

• In 2010 there were around 1600 specialists in child and adolescent psychiatry and psychotherapy working in Germany, around 750 of whom were resident.
• There are large regional differences in the supply of resident specialists and therapists for child / adolescent psychiatry and psychotherapy. On a national average, there are around 29 specialists in the mental health of children and adolescents for every 100,000 people up to the age of 18. However, more than 70% of all German districts and urban districts are below this average. In 15 circles not a single child and adolescent psychotherapist or psychiatrist has his or her office. The nationwide average is largely determined by a small number of cities with a significantly higher supply of care - at the most up to around 150 specialists per 100,000 children and young people.

Advice and outside accommodation

• Advice centers for psychological and psychiatric problems of children and adolescents (up to 18 years of age or pupils up to 21 years of age) are usually located in local health services , often in connection with the child and youth health service or school health service ; These facilities, which are equipped with specialist doctors , may also be assigned to the group of people in Section 35 of Book VIII of the Social Code .
• Certain counseling services (independent health or youth welfare organizations) deal with special problem situations such as suicide risk, drugs, stuttering and the like. a.
• The youth counseling service JOKER was a special facility for the psychosocial care of young people .
• Day and night facilities take on diagnostic tasks (usually over a 6-week stay as well as medium and long-term accommodation). Such clinics with child and adolescent psychiatric facilities often belong to large psychiatric clinics, usually privately owned or run by university hospitals.
• At short notice and for further clarification, those affected can also be accommodated in child and youth emergency services and in clearing houses.
• A home is an educationally supervised residential facility for children in accordance with SGB ​​VIII, § 34; the supervised youth living takes care of over 15-year-olds.
• The closed residential care is a special form of residential care. However, a child or adolescent can only be accommodated in a closed home with judicial approval at the request of custodians, because this is an accommodation associated with deprivation of liberty according to § 1631b BGB.

literature

history

• Annette Waibel: Prof. Dr. Otto Löwenstein and the founding years of the provincial children's institution for mentally abnormalities in Bonn 1926–1933. Dissertation . Rheinische Friedrich-Wilhelms-Universität zu Bonn, Bonn 1998.
• Rolf Castell, Jan Nedoschill, Madeleine Rupps, Dagmar Bussiek: History of child and adolescent psychiatry in Germany from 1937 to 1961. Vandenhoeck & Ruprecht, Göttingen 2003, ISBN 3-525-46174-7 .
• Gerhardt Nissen : Cultural history of mental disorders in children and adolescents. Klett-Cotta, Stuttgart 2005, ISBN 3-608-94104-5 .
• Gerhardt Nissen (ed.): Psychiatry of the school age. Neuroanatomical, psychopathological, anthropological, curative educational, cerebral organic, psychodynamic and psychopharmacological aspects. [in memoriam of Prof. Dr. Otto Schrappe (1924–1983)]. Bern 1984.
• Gerhardt Nissen, with the collaboration of Francisco Alonso-Fernandez (Ed.): Psychiatry of puberty age. Endocrinological, anthropological, adolescent psychiatric, psychosexual, psychodynamic, learning psychological, psychopathological and psychopharmacological aspects. Bern 1985.
• Gerhardt Nissen (ed.): Psychiatry of adolescence. Endomorphic, anthropological, neurochemical, organic brain, psychodynamic, family therapeutic, psychopathological and psychopharmacological aspects. Bern 1986.
• Gerhardt Nissen, with the collaboration of Francisco Alonso-Fernandez: (Ed.): Somatogenic psychosyndromes and their therapy in childhood and adolescence. Medical historical, neurological, neurophysiological, neuropsychological, psychological, neurosurgical, endocrinological, psychiatric, prognostic and therapeutic aspects. Bern 1990.

Textbooks

• Helmut Remschmidt (Ed.): Child and adolescent psychiatry. A practical introduction. 3rd, revised and expanded edition. Thieme Verlag, Stuttgart et al. 2000, ISBN 3-13-576603-9 .
• Helmut Remschmidt, Martin Schmidt, Fritz Poustka (eds.): Multiaxial classification scheme for mental disorders of children and adolescents according to ICD-10 of the WHO. With a synoptic comparison of ICD-10 with DSM-IV. 4th, completely revised and expanded edition. Huber, Bern et al. 2001, ISBN 3-456-83516-7 .
• German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy eVua (Ed.). Editor: A Warnke, G Lehmkuhl. Child and adolescent psychiatry and psychotherapy in Germany. The care of mentally ill children, adolescents and their families. 4th edition. Schattauer, Stuttgart 2011, ISBN 978-3-7945-2685-7 .

Web links

• German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
• Professional association for child and adolescent psychiatry, psychosomatics and psychotherapy in Germany

Individual evidence

1. ↑ Helmut Siefert : Child and Adolescent Psychiatry. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 739, here: p. 739 f.
2. ↑ LVR-Klinik BN-Geschichte ( Memento of the original from November 22, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. 
3. ↑ Martin Fuchs, Andreas Karwautz: Epidemiology of mental disorders in children and adolescents . In: Neuropsychiatry . tape 31 , no. 3 , 2017, p. 96-102 , doi : 10.1007 / s40211-017-0238-x ( link.springer.com [PDF]).
4. ↑ Bundesärztekammer (Association of German Medical Associations): (Sample) Further Training Regulations 2003. (PDF) p. 97 , accessed on January 3, 2018 (in the version of October 23, 2015). 
5. ^ Landesärztekammer Hessen: Hessisches Ärzteblatt June 2020. In: Portal of the Landesärztekammer Hessen https://laekh.de . May 2020, accessed June 1, 2020 . 
6. ↑ Medical statistics. German Medical Association , 2018, accessed on May 9, 2020 . 
7. ↑ Health fact check. Regional differences in health care. Bertelsmann Foundation, 2011.