Child and Adolescent Psychiatry
This group has focused on the links between physical and mental health in child and adolescent psychiatry, health services use and cultural aspects.
One key area of activity is child and adolescent mental health in primary care. We previously reported high levels of depression amongst adolescents attending primary care, and subsequently demonstrated that this applies to practices across the psychosocial spectrum, that depression is closely linked to physical complaints and that it is persistent. We have developed and evaluated a GP training programme (TIDY) specifically addressing the identification and management of adolescent depression in primary care and are now testing the general applicability and efficacy of this therapeutic technique. Our research, funded by the Department of Health and conducted in collaboration with the National Primary Care Research and Development Centre in Manchester, has found scarce national provision of mental health services for children and adolescents in primary care. It has identified the newly-developed primary child and adolescent mental health care worker posts (PMHW) as the most significant means of increasing primary/specialist interface work , and documented factors likely to contribute to the success of these posts.
Another research topic has been psychiatric aspects of the chronic fatigue syndrome and paediatric ill health. Our work has highlighted the centrality of impairment in chronic fatigue syndrome of childhood as well as the considerable emotional (anxiety and depressive) disorder co-morbidity. We have also shown that the majority of even severely affected children recover in time.
A third research area addresses the psychiatric adjustment of children with both acute and chronic paediatric disorders and that of their families. We have documented surprisingly high levels of new psychiatric disorderes following critical pediatric llness (meningococcal disease) and are now researching illness-related biological and neuropsychological changes which may modulate psychosocial adjustment.
