Psychological problems of children and young people are problem. which paediatricians can counteract with primary preventive measures.
The term "new morbidity in childhood ”, ie the shift from somatic diseases to disorders of emotionality and social behavior in children and adolescents, ran through the 4th prevention conference of the German Medical Association (BÄK) on May 13th in Berlin.
This shift was already evident in the KiGGS study, the first representative inventory of children's health in Germany, which the Robert Koch Institute (RKI ) collected between 2003 and 2006. 7.2 percent of all children between the ages of three and 17 are classified as psychologically "abnormal" and 7.5 percent as psychologically "borderline". "Children and adolescents from socially disadvantaged families are particularly affected," reported Prof. Dr. Bärbel-Maria Kurth from the RKI, who was responsible for the study. The proportion of mentally problematic children in "incomplete" families is also higher; if there are many conflicts in the family, the risk of alcohol and drug use by children increases.
"The socio-economic status and the psychosocial living conditions determine the development of child far more than biological factors," emphasized Prof. Dr. med. Hans Georg Schlack, former head of the Children's Neurological Center in Bonn. If child's basic psychological needs are not met, they run the risk of “failing in their developmental tasks”. Anxiety disorders (ten percent), social behavior disorders (7.6 percent), depression (5.4 percent) and attention deficit and hyperactivity disorder (ADHD) (2.2 percent) are the result. These figures come from the BELLA study, module of the KiGGS study, which examined the course and condition factors of mental abnormalities.
Forward-looking advice
"The treatment of these disorders is difficult, lengthy and also very expensive, ”said Schlack. He therefore believes it makes sense to intervene much earlier and to set the course for primary preventive purposes in the pediatrician practice. "Without the participation of paediatricians, comprehensive prevention of mental disorders will not succeed," is his thesis. This primary prevention could take place in "forward-looking consultation" in discussions with parents, in the medical consultation or attached to an early diagnosis examination (U).
Psychological problems of children and young people are problem. which paediatricians can counteract with primary preventive measures.
The term "new morbidity in childhood ”, ie the shift from somatic diseases to disorders of emotionality and social behavior in children and adolescents, ran through the 4th prevention conference of the German Medical Association (BÄK) on May 13th in Berlin.
This shift was already evident in the KiGGS study, the first representative inventory of children's health in Germany, which the Robert Koch Institute (RKI ) collected between 2003 and 2006. 7.2 percent of all children between the ages of three and 17 are classified as psychologically "abnormal" and 7.5 percent as psychologically "borderline". "Children and adolescents from socially disadvantaged families are particularly affected," reported Prof. Dr. Bärbel-Maria Kurth from the RKI, who was responsible for the study. The proportion of mentally problematic children in "incomplete" families is also higher; if there are many conflicts in the family, the risk of alcohol and drug use by children increases.
"The socio-economic status and the psychosocial living conditions determine the development of child far more than biological factors," emphasized Prof. Dr. med. Hans Georg Schlack, former head of the Children's Neurological Center in Bonn. If child's basic psychological needs are not met, they run the risk of “failing in their developmental tasks”. Anxiety disorders (ten percent), social behavior disorders (7.6 percent), depression (5.4 percent) and attention deficit and hyperactivity disorder (ADHD) (2.2 percent) are the result. These figures come from the BELLA study, module of the KiGGS study, which examined the course and condition factors of mental abnormalities.
Forward-looking advice
"The treatment of these disorders is difficult, lengthy and also very expensive, ”said Schlack. He therefore believes it makes sense to intervene much earlier and to set the course for primary preventive purposes in the pediatrician practice. "Without the participation of paediatricians, comprehensive prevention of mental disorders will not succeed," is his thesis. This primary prevention could take place in "forward-looking consultation" in discussions with parents, in the medical consultation or attached to an early diagnosis examination (U).Training programs to promote parental competence - such as Triple-P - would also be suitable.
The prerequisite for this is more socio-pediatric competence on the part of paediatricians, which they can acquire through special further training, suggested Schlack. "For this we need doctors who are interested in the living conditions of child, who acquire systemic perspective and who also have transcultural competence." Pediatricians should increasingly cooperate with the youth welfare office, daycare centers, schools and with child psychiatrists and psychotherapists. "So far there have only been few committed initiatives."
"Early signs of mental disorders can be recognized in the pediatrician practice," emphasized Rudolf Henke, board member of the BÄK and chairman of the committee for health promotion, prevention and rehabilitation. He therefore thinks it is “high time” that the Federal Joint Committee changes the guidelines for early detection examinations and enables doctors to place greater emphasis on the early detection of mental disorders, but also on lack of exercise or poor nutrition. The US are so far only focused on the early detection of diseases, but not on prevention.
Henke also spoke out in favor of the prevention courses of the health insurances according to § 20 SGB V providing more offers to strengthen parents and children and that the insurances should coordinate more closely with the doctors. “The federal government should address these points in the prevention strategy it has announced,” he demanded.
"Doctors are not yet adequately represented in primary prevention," emphasized Norbert Paland, the ministerial director of the Federal Ministry of Health. And this despite the fact that, according to survey by the Federal Center for Health Education, 98 percent of parents prefer to get advice in person. “That is why paediatricians and general practitioners should play bigger role in the national prevention strategy.”
Interdisciplinary cooperation
Pointed out that developmental disorders or “sociogenic” disorders in children are also social problem Dr. med. Jan Leidel, former head of the Cologne health department, added: "They refuse school, drop out more often, have hardly any chances on the job market, are more often drug addicts and delinquent." Years ago, he had child and adolescent psychiatric at the Cologne health department Have an advice center set up. “Doctors should act as guard and network,” demanded Leidel.Training programs to promote parental competence - such as Triple-P - would also be suitable.
The prerequisite for this is more socio-pediatric competence on the part of paediatricians, which they can acquire through special further training, suggested Schlack. "For this we need doctors who are interested in the living conditions of child, who acquire systemic perspective and who also have transcultural competence." Pediatricians should increasingly cooperate with the youth welfare office, daycare centers, schools and with child psychiatrists and psychotherapists. "So far there have only been few committed initiatives."
"Early signs of mental disorders can be recognized in the pediatrician practice," emphasized Rudolf Henke, board member of the BÄK and chairman of the committee for health promotion, prevention and rehabilitation. He therefore thinks it is “high time” that the Federal Joint Committee changes the guidelines for early detection examinations and enables doctors to place greater emphasis on the early detection of mental disorders, but also on lack of exercise or poor nutrition. The US are so far only focused on the early detection of diseases, but not on prevention.
Henke also spoke out in favor of the prevention courses of the health insurances according to § 20 SGB V providing more offers to strengthen parents and children and that the insurances should coordinate more closely with the doctors. “The federal government should address these points in the prevention strategy it has announced,” he demanded.
"Doctors are not yet adequately represented in primary prevention," emphasized Norbert Paland, the ministerial director of the Federal Ministry of Health. And this despite the fact that, according to survey by the Federal Center for Health Education, 98 percent of parents prefer to get advice in person. “That is why paediatricians and general practitioners should play bigger role in the national prevention strategy.”
Interdisciplinary cooperation
Pointed out that developmental disorders or “sociogenic” disorders in children are also social problem Dr. med. Jan Leidel, former head of the Cologne health department, added: "They refuse school, drop out more often, have hardly any chances on the job market, are more often drug addicts and delinquent." Years ago, he had child and adolescent psychiatric at the Cologne health department Have an advice center set up. “Doctors should act as guard and network,” demanded Leidel.
Interdisciplinary cooperation with child and adolescent psychiatrists and psychotherapists, social psychiatric centers, educational counseling and with child and youth welfare, daycare centers and schools is maintained by the Munich pediatrician Dr. med. Stephan Böse-O’Reilly for indispensable. In order to get all these networking discussions remunerated and also to be able to employ prevention assistants, psychologists or social pedagogues, he considers social pediatric agreement - analogous to the social psychiatry agreement of child psychiatrists - with the health insurance companies to be sensible.
If you do not counteract the new morbidity spectrum early on, some children can only be helped with an inpatient stay. The head of the Clinic for Child and Adolescent Psychiatry at the Center for Psychiatry Weissenau, Prof. Dr. med. Renate Schepker, reports that 88 percent of all mental disorders are not recognized by the time they start school. Schepker believes that prevention in the form of parental work, addiction prevention through the treatment of ADHD, networks for children with mentally ill parents and “zero tolerance for school refusal” are necessary.
Petra Bühring
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