BACKGROUND Virtual reality (VR) has been on the rise in recent years due to the better quality an... more BACKGROUND Virtual reality (VR) has been on the rise in recent years due to the better quality and accessibility of VR glasses and software. Despite the fact that VR is being used more often in psychiatric care, little is known about the possible applications of VR in forensic psychiatry. AIM To investigate which possible VR-applications already exist that can also be used in forensic psychiatry and what the possible risks are. METHOD Scientific literature was consulted in PubMed, Web of Knowledge, Embase en Cochrane Library to search for immersive VR-applications for aggression, motivation and the most prevalent psychopathologies in forensic psychiatry. RESULTS Several relevant VR-applications were found that can be used in the diagnosis or treatment of forensic psychiatric patients. Despite the limited number of empirical studies, several authors emphasize the potential benefits of VR for this target group. CONCLUSION Due to the low number of studies of good quality on the use of ...
BACKGROUND In participatory action research (par), researchers, practitioners and the community e... more BACKGROUND In participatory action research (par), researchers, practitioners and the community engage in a research process together. This research approach has the potential to assist in bridging the research-practice gap by starting from practice needs and using joint expertise and experiences to enrich scientific knowledge, optimise clinical practice and empower stakeholders from different backgrounds. AIM: To discuss the potential benefits of par for clients, professionals and researchers in the field of mental healthcare. METHOD: Starting from the literature on par, fundamental characteristics and benefits of this research approach in the field of mental healthcare are described and illustrated with an example from practice. RESULTS: par in mental healthcare can contribute to enriching prepositional and practical knowledge, facilitate positive social change in care delivery, empower all stakeholders, and ultimately make a significant contribution to the integration of research...
BACKGROUND Quality youth care and decisions about youth care should ideally be based on a combina... more BACKGROUND Quality youth care and decisions about youth care should ideally be based on a combination of empirical data, the clinical judgment of health professionals and the views and preferences of clients. Additionally, the treatment provided needs to fit in with the client's social and cultural background. Clients' views about their treatment are often collected via satisfaction measurements and particularly via satisfaction questionnaires. AIM To make a critical analysis of the factors that determine both client satisfaction and the content of the satisfaction questionnaires used as a measurement method in youth care. METHOD We made a selective study of the relevant literature. RESULTS Our results show that client satisfaction is not an indicator of the effectiveness of treatment and that the degree of client satisfaction varies according to the client's outlook and perspective. Apparently, there are many disadvantages of using questionnaires as a measurement method...
BACKGROUND Very little information is available concerning the prevalence of the use of medicatio... more BACKGROUND Very little information is available concerning the prevalence of the use of medication for treatment of individuals with autism spectrum disorder (ASD), particularly in European countries. Earlier studies have shown that a large number of patients with ASD use at least one psychoactive drug and that the numbers are increasing. Even in the nineties, studies suggested that the frequent use of psychoactive medication was widespread, although at the time there were only limited grounds for this assumption. AIM To assess the prevalence with which psychoactive medication and complementary and alternative medicine (CAM) are being used for treating young people with ASD, and also to investigate relations between medication use and a number of individual characteristics that are included in the Behavioral Model of Health Service Use. METHOD The study sample (0-17 years) in the province of Antwerp, Belgium, was recruited by various means. We used a questionnaire that had been prev...
Objective: Psychotic like experiences (PLEs) resemble psychotic symptoms but are more benign and ... more Objective: Psychotic like experiences (PLEs) resemble psychotic symptoms but are more benign and transient. They occur numerously in clinical and non-clinical samples and have a peak incidence in adolescence. PLEs can be linked to psychopathology and, in the presence of risk factors, PLEs can make a transition to psychotic symptoms and psychosis. The aim of this study was to measure the occurrence of PLEs in a Flemish clinical sample of adolescents using the CAPE (Community Assessment of Psychic Experiences). Gender, age, IQ differences and possible links with psychopathology, distress and impairment have been investigated. Method: 1176 adolescents between 12 and 17 years old were referred to a child and adolescent psychiatric outpatient clinic for psychiatric assessment. PLEs were measured using the CAPE, more precisely the CAPE positive experiences scale (CAPE-P, 20 questions). PLEs were divided into 5 subdimensions: Hallucination, Paranoia, Delusion, Grandiosity and Paranormal Belief. Results: 734 CAPEs were valid for research. 94.2% of adolescents in the clinical sample reported at least one PLE at least 'sometimes'. 62.3% of our population reported at least one PLE at least 'often', which was a higher rate than found in the general population. 83.2% of the population reported at least 'a bit distress' for at least one PLE, whereas 51% reported to be 'quite or very distressed' about at least one PLE. Girls reported more PLEs than boys and reported higher levels of distress. There was no significant general trend in PLEs found when looked at age or IQ distribution. PLEs with distress could be linked to psychopathology in general, but not to specific diagnoses. In comparison to the general population, adolescents in a clinical population experience PLEs more often and with a higher degree of distress. The CAPE can be used in a clinical population for follow up and identification in the risk of transition. Higher risk can be defined by a higher score of frequency and distress on the CAPE and the persistence of this score over time. Risk of transition increases with a certain degree of impairment (that might be caused by comorbid psychopathology) and the combination with specific risk factors for psychosis.
and metabolic disorders", and "eating disorders and metabolic disorders". Based on inclusion crit... more and metabolic disorders", and "eating disorders and metabolic disorders". Based on inclusion criteria (concerning a clear psychiatric disorder and concerning a metabolic disorder) 4441 titles and 249 abstracts were screened and resulted in 71 relevant articles. This thorough literature search provides child and adolescent psychiatrists with an overview of metabolic disorders associated with child psychiatric symptoms, their main characteristics and recommendations for further investigations.
Regular non-medical treatment of a 6-year-old female patient with autism spectrum disorder failed... more Regular non-medical treatment of a 6-year-old female patient with autism spectrum disorder failed due to comorbid compulsions and hallucinations. Differential diagnosis included obsessive-compulsive disorder and psychosis. The patient's young age complicated accurate diagnosis and management. In this case we opted for a diagnostic follow-up, resulting in treatment with a selective serotonin reuptake inhibitor because of the patient's frequent compulsions. This reduced the symptoms significantly.
16p11.2 microduplication is linked with a vulnerability for a range of psychiatric and somatic pr... more 16p11.2 microduplication is linked with a vulnerability for a range of psychiatric and somatic problems, with variable expression and penetration rate. We discuss the phenotypical expression of this microduplication with the case of a brother and sister. Both subjects went through child psychiatric diagnostics and treatment, where a varying degree of developmental delay and symptoms that match an attention deficit/hyperactivity disorder were observed in combination with short stature and low body mass index.
Research in developmental disabilities, Jan 16, 2015
The aim of this study was to explore the incidence, type and severity of motor impairment in male... more The aim of this study was to explore the incidence, type and severity of motor impairment in male adolescents with a disruptive behavior disorder (DBD) and evaluate the role of comorbid ADHD. The Bruininks-Oseretsky test of motor proficiency, Second Edition was administered to examine a detailed motor profile and to compare the motor abilities of individuals with DBD (n=99) to those of controls (n=87). Additional subgroup analyses were conducted within the clinical population and encompassed (1) analyzing differences in motor profiles between individuals diagnosed with oppositional defiant disorder (ODD) or conduct disorder (CD) and (2) comparing the motor profiles of individuals with or without comorbid ADHD. The results indicated that individuals with a DBD showed a mixed motor impairment profile. Even after controlling for IQ, the DBD group obtained significantly lower scores in comparison to controls. The ODD and CD subgroups showed a similar motor profile. Presence of comorbid ...
In this article we describe the clinical response of an 8-year-old boy with the Gilles de la Tour... more In this article we describe the clinical response of an 8-year-old boy with the Gilles de la Tourette syndrome (GTS) when treated with quetiapine. Upon admission for observation he received a trial course of quetiapine, to which he responded favourably. We searched the Medline and Psycinfo databases for information about the recommended dose of quetiapine for children with GTS. From the 12 case-studies and one open-label trial that we found, we conclude that the maximum dose of quetiapine for children with GTS is 200 mg. Data concerning the safety of quetiapine when administered to children are limited and contradictory.
BACKGROUND Virtual reality (VR) has been on the rise in recent years due to the better quality an... more BACKGROUND Virtual reality (VR) has been on the rise in recent years due to the better quality and accessibility of VR glasses and software. Despite the fact that VR is being used more often in psychiatric care, little is known about the possible applications of VR in forensic psychiatry. AIM To investigate which possible VR-applications already exist that can also be used in forensic psychiatry and what the possible risks are. METHOD Scientific literature was consulted in PubMed, Web of Knowledge, Embase en Cochrane Library to search for immersive VR-applications for aggression, motivation and the most prevalent psychopathologies in forensic psychiatry. RESULTS Several relevant VR-applications were found that can be used in the diagnosis or treatment of forensic psychiatric patients. Despite the limited number of empirical studies, several authors emphasize the potential benefits of VR for this target group. CONCLUSION Due to the low number of studies of good quality on the use of ...
BACKGROUND In participatory action research (par), researchers, practitioners and the community e... more BACKGROUND In participatory action research (par), researchers, practitioners and the community engage in a research process together. This research approach has the potential to assist in bridging the research-practice gap by starting from practice needs and using joint expertise and experiences to enrich scientific knowledge, optimise clinical practice and empower stakeholders from different backgrounds. AIM: To discuss the potential benefits of par for clients, professionals and researchers in the field of mental healthcare. METHOD: Starting from the literature on par, fundamental characteristics and benefits of this research approach in the field of mental healthcare are described and illustrated with an example from practice. RESULTS: par in mental healthcare can contribute to enriching prepositional and practical knowledge, facilitate positive social change in care delivery, empower all stakeholders, and ultimately make a significant contribution to the integration of research...
BACKGROUND Quality youth care and decisions about youth care should ideally be based on a combina... more BACKGROUND Quality youth care and decisions about youth care should ideally be based on a combination of empirical data, the clinical judgment of health professionals and the views and preferences of clients. Additionally, the treatment provided needs to fit in with the client's social and cultural background. Clients' views about their treatment are often collected via satisfaction measurements and particularly via satisfaction questionnaires. AIM To make a critical analysis of the factors that determine both client satisfaction and the content of the satisfaction questionnaires used as a measurement method in youth care. METHOD We made a selective study of the relevant literature. RESULTS Our results show that client satisfaction is not an indicator of the effectiveness of treatment and that the degree of client satisfaction varies according to the client's outlook and perspective. Apparently, there are many disadvantages of using questionnaires as a measurement method...
BACKGROUND Very little information is available concerning the prevalence of the use of medicatio... more BACKGROUND Very little information is available concerning the prevalence of the use of medication for treatment of individuals with autism spectrum disorder (ASD), particularly in European countries. Earlier studies have shown that a large number of patients with ASD use at least one psychoactive drug and that the numbers are increasing. Even in the nineties, studies suggested that the frequent use of psychoactive medication was widespread, although at the time there were only limited grounds for this assumption. AIM To assess the prevalence with which psychoactive medication and complementary and alternative medicine (CAM) are being used for treating young people with ASD, and also to investigate relations between medication use and a number of individual characteristics that are included in the Behavioral Model of Health Service Use. METHOD The study sample (0-17 years) in the province of Antwerp, Belgium, was recruited by various means. We used a questionnaire that had been prev...
Objective: Psychotic like experiences (PLEs) resemble psychotic symptoms but are more benign and ... more Objective: Psychotic like experiences (PLEs) resemble psychotic symptoms but are more benign and transient. They occur numerously in clinical and non-clinical samples and have a peak incidence in adolescence. PLEs can be linked to psychopathology and, in the presence of risk factors, PLEs can make a transition to psychotic symptoms and psychosis. The aim of this study was to measure the occurrence of PLEs in a Flemish clinical sample of adolescents using the CAPE (Community Assessment of Psychic Experiences). Gender, age, IQ differences and possible links with psychopathology, distress and impairment have been investigated. Method: 1176 adolescents between 12 and 17 years old were referred to a child and adolescent psychiatric outpatient clinic for psychiatric assessment. PLEs were measured using the CAPE, more precisely the CAPE positive experiences scale (CAPE-P, 20 questions). PLEs were divided into 5 subdimensions: Hallucination, Paranoia, Delusion, Grandiosity and Paranormal Belief. Results: 734 CAPEs were valid for research. 94.2% of adolescents in the clinical sample reported at least one PLE at least 'sometimes'. 62.3% of our population reported at least one PLE at least 'often', which was a higher rate than found in the general population. 83.2% of the population reported at least 'a bit distress' for at least one PLE, whereas 51% reported to be 'quite or very distressed' about at least one PLE. Girls reported more PLEs than boys and reported higher levels of distress. There was no significant general trend in PLEs found when looked at age or IQ distribution. PLEs with distress could be linked to psychopathology in general, but not to specific diagnoses. In comparison to the general population, adolescents in a clinical population experience PLEs more often and with a higher degree of distress. The CAPE can be used in a clinical population for follow up and identification in the risk of transition. Higher risk can be defined by a higher score of frequency and distress on the CAPE and the persistence of this score over time. Risk of transition increases with a certain degree of impairment (that might be caused by comorbid psychopathology) and the combination with specific risk factors for psychosis.
and metabolic disorders", and "eating disorders and metabolic disorders". Based on inclusion crit... more and metabolic disorders", and "eating disorders and metabolic disorders". Based on inclusion criteria (concerning a clear psychiatric disorder and concerning a metabolic disorder) 4441 titles and 249 abstracts were screened and resulted in 71 relevant articles. This thorough literature search provides child and adolescent psychiatrists with an overview of metabolic disorders associated with child psychiatric symptoms, their main characteristics and recommendations for further investigations.
Regular non-medical treatment of a 6-year-old female patient with autism spectrum disorder failed... more Regular non-medical treatment of a 6-year-old female patient with autism spectrum disorder failed due to comorbid compulsions and hallucinations. Differential diagnosis included obsessive-compulsive disorder and psychosis. The patient's young age complicated accurate diagnosis and management. In this case we opted for a diagnostic follow-up, resulting in treatment with a selective serotonin reuptake inhibitor because of the patient's frequent compulsions. This reduced the symptoms significantly.
16p11.2 microduplication is linked with a vulnerability for a range of psychiatric and somatic pr... more 16p11.2 microduplication is linked with a vulnerability for a range of psychiatric and somatic problems, with variable expression and penetration rate. We discuss the phenotypical expression of this microduplication with the case of a brother and sister. Both subjects went through child psychiatric diagnostics and treatment, where a varying degree of developmental delay and symptoms that match an attention deficit/hyperactivity disorder were observed in combination with short stature and low body mass index.
Research in developmental disabilities, Jan 16, 2015
The aim of this study was to explore the incidence, type and severity of motor impairment in male... more The aim of this study was to explore the incidence, type and severity of motor impairment in male adolescents with a disruptive behavior disorder (DBD) and evaluate the role of comorbid ADHD. The Bruininks-Oseretsky test of motor proficiency, Second Edition was administered to examine a detailed motor profile and to compare the motor abilities of individuals with DBD (n=99) to those of controls (n=87). Additional subgroup analyses were conducted within the clinical population and encompassed (1) analyzing differences in motor profiles between individuals diagnosed with oppositional defiant disorder (ODD) or conduct disorder (CD) and (2) comparing the motor profiles of individuals with or without comorbid ADHD. The results indicated that individuals with a DBD showed a mixed motor impairment profile. Even after controlling for IQ, the DBD group obtained significantly lower scores in comparison to controls. The ODD and CD subgroups showed a similar motor profile. Presence of comorbid ...
In this article we describe the clinical response of an 8-year-old boy with the Gilles de la Tour... more In this article we describe the clinical response of an 8-year-old boy with the Gilles de la Tourette syndrome (GTS) when treated with quetiapine. Upon admission for observation he received a trial course of quetiapine, to which he responded favourably. We searched the Medline and Psycinfo databases for information about the recommended dose of quetiapine for children with GTS. From the 12 case-studies and one open-label trial that we found, we conclude that the maximum dose of quetiapine for children with GTS is 200 mg. Data concerning the safety of quetiapine when administered to children are limited and contradictory.
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Papers by D. Van West