Diese Untersuchung vergleicht psychisch kranke Eltern und unbelastete Eltern hinsichtlich ihrer Stressbelastung durch die Elternschaft. Zudem werden die Zusammenhänge zwischen elterlicher Stressbelastung und psychischer Symptomatik der Kinder analysiert und untersucht, inwiefern sich psychisch kranke Eltern bezüglich dieser Zusammenhänge von unbelasteten Eltern unterscheiden. In die Studie wurde eine klinische Stichprobe (N=83) mit einem psychisch kranken Elternteil sowie eine „nicht-klinische“ Vergleichsstichprobe (N=121) einbezogen. Die elterliche Stressbelastung wurde im Selbsturteil, die kindliche Symptomatik im Fremdurteil (Eltern) erfasst. Die Ergebnisse zeigten, dass die elterliche Stressbelastung bei den psychisch kranken Eltern stärker ausgeprägt war als bei den unbelasteten Eltern. Es fand sich außerdem eine signifikante Wechselbeziehung zwischen der Ausprägung der Symptome der Kinder und dem Stresserleben der Eltern. Dieser Zusammenhang war in der Gruppe der psychisch kranken Eltern wesentlich stärker ausgeprägt als in der Vergleichstichprobe. Das Ergebnis verweist auf einen negativen Zirkel, in dem sich viele Familien mit einem psychisch kranken Elternteil befinden, und impliziert familienzentrierte Interventionen.

Most psychotropic drugs used in the treatment of children and adolescents are applied "off label" with a direct risk of under- or overdosing and a delayed risk of long-term side effects. The selection of doses in paediatric psychiatric patients requires a consideration of pharmacokinetic parameters and the development of central nervous system, and warrants specific studies in children and adolescents. Because these are lacking for most of the psychotropic drugs applied in the Child and Adolescent and Psychiatry, therapeutic drug monitoring (TDM) is a valid tool to optimise pharmacotherapy and to enable to adjust the dosage of drugs according to the characteristics of the individual patient. Multi-centre TDM studies enable the identification of age- and development-dependent therapeutic ranges of blood concentrations and facilitate a highly qualified standardized documentation in the child and adolescent health care system. In addition, they will provide data for future research on psychopharmacological treatment in children and adolescents, as a baseline for example for clinically relevant interactions with various co-medications. Therefore, a German-Austrian-Swiss "Competence Network on Therapeutic Drug Monitoring in Child and Adolescent Psychiatry" was founded [1] introducing a comprehensive internet data base for the collection of demographic, safety and efficacy data as well as blood concentrations of psychotropic drugs in children and adolescents.

Objective: The aim of this study was to identify the “real-life” prevalence of psychotropic medications in children and adolescents in Germany and related behavioral and emotional problems. Data from the nationwide representative National German Health Interview and Examination Survey for Children and Adolescents (KiGGS) were analyzed. Method: A total of 17,450 subjects aged 0–17 years from 167 communities were examined as part of the KiGGS in Germany between 2003 and 2006 to determine their use of antidepressants, antipsychotics, anxiolytics, and sedatives within the 7 days prior to being interviewed. Medication use was assessed by a medical doctor who conducted a computer-assisted personal interview (CAPI) with the parents, and related emotional and behavioral problems were assessed using the Strength and Difficulties Questionnaire (SDQ). Results: The overall prevalence for these medications was moderate (4.81/1000; 95% confidence interval [CI], 3.70–6.26), but prevalence varied across the different classes of drugs (sedatives > antipsychotics > antidepressants > anxiolytics). Rates of off-label use were high for antipsychotics and antidepressants. About 30% of the medication, especially sedatives, was used without prescription. Subjects using psychotropic medication obtained higher scores in the screening for emotional or behavioral problems than the total sample, but 40% of the children did not show abnormal scores. Conclusion: The indication for antipsychotics was mostly behavioral symptomatology, while antidepressants were used for a wide variety of symptoms. The high proportion of children and adolescents using psychotropic medication with normal scores in the emotional and behavioral screening was remarkable. It cannot be determined whether in these cases low scores were related to improvement in symptoms or whether medication was being misused.

There is evidence that military service increases the risk of psychosocial burden for not only service members but also their spouses and children. This meta-analysis aimed to systematically assess the association between military deployment of (at least one) parent and impact on children’s mental health. For this meta-analytic review, publications were systematically searched and assessed for eligibility based on predefined inclusion criteria (studies between 2001 until 2017 involving children with at least one parent working in military services). Measurements were determined by total problem scores of the children as well as symptoms of anxiety/depression, hyperactivity/inattention, and aggressive behavior. Meta-analyses aggregated the effect sizes in random-effect models and were calculated separately for the relation between parental deployment and civilian/normative data and for the relation between parental deployment and non-deployment. Age of the children was used as moderator variable to explore any potential source of heterogeneity between studies. Parental military deployment was associated with problems in children and adolescents compared to civilian/normative samples. Significant effect sizes reached from small to moderate values; the largest effect sizes were found for overall problems and specifically for anxious/depressive symptoms and aggressive behavior. Within the military group, children of deployed parents showed more problem behavior than children of non-deployed parents, but effect sizes were small. Age of the children had no moderating effect. The results emphasize that children of military members, especially with a deployed parent, should be assessed for emotional and behavioral problems.

Information about therapeutic serum levels of fluoxetine (FLX) and its major metabolite norfluoxetine (NORFLX) in children and adolescents is scarce. Therapeutic drug monitoring (TDM) of FLX was routinely performed in 71 subjects treated for a major depressive disorder (MDD) (10–60 mg/d FLX, median: 20 mg/d). Correlations between serum concentration and dosage, age, gender, smoking habits and adverse events were analysed. Serum concentrations of the active moiety (FLX + NORFLX) ranged from 21 to 613 ng/mL (mean concentration of 213±118 ng/mL, median: 185 ng/mL). High inter-individual variability in serum concentrations of the active moiety of FLX at each dosage level was observed and no relationship between serum concentration and clinical outcome was found. Apart from smoking, none of the factors tested had a significant effect on the serum concentration. It was shown that serum concentrations of the active moiety of FLX in children and adolescents seem to be similar to those in adults, with a high level of inter-individual variation. The proportion of patients who showed benefits from treatment with a dose of 20 mg/d FLX was high.

E-mental health and home treatment are treatment approaches that have proven to be effective, but are only slowly implemented in the German health care system. This paper explores the attitudes toward these innovative treatment approaches. Data was collected in two large, non-clinical samples representative of the German population in spring 2020 (N = 2,503) and winter 2020/2021 (N = 2,519). Statistical associations between variables were examined using two-tailed tests. Binary and multinomial logistic regressions were performed to predict attitudes toward online-based treatment concepts and home treatment approaches. Only few (<20%) people preferred online-based treatment approaches, while a larger proportion (~50%) could imagine being treated at home. Overall, younger subjects were more open to online-therapy approaches, while people with lower education preferred more often a traditional therapy setting. Acceptance of online-therapy did not raise significantly during the first months of the COVID-19 pandemic. When different online-based treatment options were available, the probability of accepting home treatment significantly increased with increasing levels of therapeutic support. Further promotion of acceptance for online-therapy and home treatment seems to be necessary. In the future, more information on innovative treatment approaches should be actively provided.