Study On The Mental Health Problem Of School-age Children And Collaborative Project Of Medical Service And School Health System To Care For Mental Health In Shanghai

Prat ?:Collaborative Project of Medical Service and School Health System to Care for School Age Children's Mental Health In ShanghaiObjective: To study the early screening and intervention model of cooperation in medical services and school health systems to care for mental health and to promote the mental health of school-age children in Shanghai.Methods: A group of stratified random sampling was used to investigate the mental health problems of students in grades 1 to 4 of 12 elementary schools in Shanghai.First,parents fill in the self-compiled general information,developmental coordination disorder questionnaire(DCDQ)and strength and difficulty questionnaire(SDQ)for screening.Children who were screened positive were interviewed by school-trained teachers using Mini International Neuropsychiatric Interview for Children and Adolescent(MINI-KIDS).The developmental behavioral pediatrician then performs a further personalized assessment of the MINI-KID positive to make a diagnosis.Eight-week personalized intervention for children with mental health problems,primarily attention deficit hyperactivity disorder(ADHD),were completed in schools and monitored by developmental behavioral pediatricians and therapists.Besides medication,they got individualized interventions,such as group play therapy,behavior therapy,language therapy,neuro-motor therapy and trainings about ADHD knowledge for school teachers and parents with ADHD children.The Swanson Nolan and Pelham,Version IV(SNAP-IV)Scale,SDQ,DCDQ and Self-esteem Scale were reassessed before and after the intervention.Results: A total of 4,789 children were valid,aged 5-12 years(8.10 ± 1.19).The detection rate of SDQ mental health problems was 19.23%(921/4789).The proportion of psychological disorders detected after MINIKID interview was 2.21%(106/4789,90 SDQ-positive patients fell off),and 65.10%(69/106)of all mental disorders were ADHD,the highest proportion.After assessment and diagnosis by developmental behavioral pediatricians,a total of 53 children with ADHD entered the comprehensive intervention phase.The core symptoms(attention deficit,hyperactivity)and functional impairment(opposing defiance,behavioral problems,academic performance,fine motor and self-esteem)were significantly improved in children with ADHD after intervention(p<0.05).Conclusion: It is feasible and effective for the combination of medical and educational screening and intervention models for the mental health of Shanghai school-age children.ADHD is the leading cause of behavioral and mental health problems in primary school children.Prat ?:Evaluation of the Intervention Mode Combining Medicine and Education in Children with Attention Deficit Hyperactivity DisorderObjective: Comparison before and after treatment between the combination of medical education group and the drug group,to evaluate the therapeutic effect of the intervention mode combining medicine and education on attention deficit hyperactivity disorder.Methods: For children with ADHD diagnosed in the pediatric outpatient clinic of our developmental behavior,the conventional drug treatment is the drug group.ADHD children in the school of medical education combined with the school as a medical education group.The children in the medical education group received personalized comprehensive intervention program.Children in control group only got routine treatment and follow-up in outpatient clinic.Treatment time is 8 weeks.The Chinese version of the Swanson Nolan and Pelham,Version IV(SNAP-IV)Scale,Strengths and Difficulties Questionnaire,Developmental Coordination Disorder Questionnaire and Self-esteem Scale were reassessed at the end of the intervention.Through self-control and compared to the control group,carry on the statistical analysis to the results.Results: After the intervention,the hyperactivity/impulsivity,attention deficit,and behavioral problems of the ADHD children in the intervention group and the control group before and after treatment were significantly improved.Compared with the control group,the intervention group improved more significantly(P<0.05).In the intervention group,the oppositional defiance,total psychological behavior problems,self-esteem,and academic performance of ADHD children were significantly improved(P<0.05).No improvement was observed in the control group(P>0.05).Conclusion: Conventional treatment in hospital is effective in improving the core symptoms of school-age ADHD patients,but not in oppositional disobedience,mental health problems,self-esteem and academic improvement.While comprehensive medical and educational treatment not only improved core symptoms,but also effectively improved oppositional disobedience,mental health problems,self-esteem and academic performance.Prat ?:Research of Functional Impairment in Children with Attention Deficit Hyperactivity DisorderObjective: To assess functioning in children with Attention Deficit Hyperactivity Disorder(ADHD),and to study functional impairment of ADHD children with different genders,ages,and intelligence quotient(IQ).Methods: A total of 1718 children with clinically suspected ADHD were investigated and interviewed from March 2018 to January 2019.Weiss functional impairment rating scale–parent Report(WFIRS-P)was used to evaluate functioning of all children.ADHD group was diagnosed according to DSM-5 criteria for ADHD and children who did not meet the diagnostic criteria belonged to non-ADHD group.Functional impairments were analyzed for two group children.Compare WFIRS-P scores between the two groups.The functional impairment of children with ADHD of different genders,age groups and intelligence levels was analyzed.Results: ADHD children had significant functional impairment in 6 dimensions,including family,school and learning,life skills,self-concept,social activities and risky activities(P<0.001).In ADHD group,boys had much severer deficits than girls in 2 dimensions of functioning such as social activities and risky activities;functional impairment of children over 9 years old were severer than younger children(under 9 years old)in family,school and learning,life skills,self–concept and social activities domains(P<0.05);three intelligent groups(IQ between 85-99,IQ between70-84 and IQ<70 had severer functional impairment than other two groups(IQ between100-114 and IQ between 115-129)in the dimension of school and learning(P < 0.05).Conclusion: ADHD children have significant functional impairment,and ADHD children with different gender,age and IQ level show different patterns of functional impairments.