Promoting child and adolescent mental health
The needs of young people with mental health disorders have recently been the subject of a major review (National CAMHS Review, 2008). The most comprehensive statistical survey of the prevalence of mental disorders in Great Britain to date found that 10% of children and young people aged between five and 15 had a clinically diagnosable mental disorder that is associated with significant functional impairment in everyday life. Prevalence rates vary according to gender, with problems more frequent among boys than girls, and most common in early adolescence; characteristically these are emotional, conduct or hyperkinetic disorders (ADHD), or other rarer neurodevelopmental conditions such as autism spectrum disorders. The review makes a number of recommendations for providing better services through the CAMHS network, and for the rationalization of relationships between services at different tiers of specialization. There is also an emphasis on the importance of devising working relationships between community paediatric and psychiatric services.
Research on mechanisms has led to major advances in our understanding of neurocognitive and neural mechanisms that contribute to the development of autistic disorders, and associated genetic influences, in collaboration with international partners in US/Europe. The underlying neurobiological and neuropsychological deficits of anorexia nervosa and their implications for intervention have been investigated. An international collaborative study on nosology of early onset eating disorders using surveillance methodology has been conducted. The neural substrates of developmental amnesia are being investigated. New assessment procedures include the 3Di for autism spectrum disorders, which is increasingly being used globally; the Child EDE, the gold standard diagnostic assessment for early onset eating disorders; the Ravello profile, the standard neuropsychological battery for eating disorders research; the Story Stem Assessment Profile, used in Europe and the US for examining attachment relationships in children; FRAMEA, a tool for recognition of emotional abuse; and the Early Child Attention Battery (ECAB) to test selective attention in infancy and early childhood. New interventions under development include audio-conferencing based group CBT in children with anxiety disorders, cognitive remediation therapy for early onset anorexia nervosa, CBT interventions for selective eating, and group work for mothers of infants with feeding disorders. Treatment and service evaluation work includes development of a web-based multi-media health monitoring system for a wide range of mental and physical illnesses, which is being used in pharmacovigilance in European clinical trials; and some of the largest RCTs of psychological interventions with children and adolescents in the world, including a Targeted Mental Health in Schools evaluation, START for MST, and the IMPACT study in adolescent depression. Trials of pharmacological interventions include the largest ever RCT of risperidone in conduct disorder and trials of stimulants in ADHD which have been used in developing NICE and European Guidelines. We are carrying out research on the impact of maternal eating disorders on child developmentand on why adolescents develop eating disorders.
Key departments and research groups
The Anna Freud Centre (AFC)
Clinical Psychopharmacology Unit (CPU
Developmental Risk and Resilience Unit (DRRU)
Institute of Child Health
Visual Development Unit
MSc Cognitive Behavioural Therapy for Children and Young People
MSc Psychoanalytic Developmental Psychology
MSc Psychodynamic Developmental Neuroscience
MSc Social Cognition