John Pearce

Practical approaches to reduce the impact of bullying

Bullying has serious long term consequences for all concerned. The cost of ignoring bullying is great, and it is no longer acceptable to view bullying as a normal part of everyday life that children have to learn to tolerate. Effective strategies exist to reduce the frequency of bullying and to make this type of aggressive behaviour less likely to occur.

Child health surveillance for psychiatric disorder: practical guidelines.

Children who have a psychiatric disorder are often seen as difficult rather than disturbed and the significance of the emotion or the behaviour may easily be missed. The distinction between normal and pathological behaviour is important because reassurance is appropriate in the first case and dangerous in the latter. A psychiatric disorder can be classified as a change in behaviour, emotions, or thought processes (the three main aspects of mental functioning), which is so prolonged and/or so severe that it interferes with everyday life and is a handicap for the child or those who care for the child. The childs stage of development and the sociocultural context in which the disorder occurs must also be taken into account (table 1). Rarely, a childs mental state may be so bizarre or extreme that it only has to occur once to be regarded as abnormal. Deliberate self injury, delusions, or hallucinations are good examples of this. Child psychiatric disorder, as defined above, has a one year prevalence rate of roughly 10% in the general population, which is much the same as it is for adults. This rate is influenced by a number of risk and protective factors.

Collaboration Between the NHS and Social Services in the Provision of Child and Adolescent Mental Health Services: A Personal View

The quality of collaborative links between the NHS and Social Services in the field of child mental health is dependent on the culture of co-operation set at the highest level of government. There needs to be an understanding of the different theoretical models that underpin working practices. The importance of personality factors, power struggles and misperceptions is highlighted. Constructive suggestions are made on how to ensure that collaboration works effectively.

Attention deficit hyperactivity disorder: A rational guide to paediatric assessment and treatment

Attention deficit hyperactivity disorder (ADHD) has become a cause ceH le‘ bre. Barely a week goes by without media interest steadily raising the profile of the disorder. Health and educational services are confronted with harassed parents demanding that their children are assessed for the condition. Consequently, paediatric and child psychiatric clinics face an exponential increase in referrals requesting a service for this condition. It is nearly a century since the syndrome was first described by Professor George Frederick Still, the same children’s physician who described Still’s disease. 1 However, our understanding of ADHD is rudimentary and the provision of specialist help for the disorder remains something of a lottery in the UK today. This contrasts sharply with the USA where nearly 2% of school-age children have been diagnosed as having ADHD, many of whom are now benefiting from sophisticated therapeutic interventional programmes.

Behavioural disturbance and organic brain dysfunction

Abstract It is not surprising that there should be a link between dysfunction of the central nervous system and disturbed behaviour. However, the association is not invariable. Children with significant brain damage may show no evidence of behaviour disorder, while children with normal brain function can show a wide range of problem behaviours that are similar to those seen in children with brain damage. The absence of a one to one relationship between brain and behaviour is also reflected in the absence of any behaviour that is specifically related to abnormal CNS function. This lack of specificity suggests that there must be other mediating factors such as temperament, development stage and premorbid level of functioning. The complexity of these interacting factors requires close collaboration between psychiatrists, paediatricians and other relevant specialists in the assessment and treatment of children with cerebral dysfunction.

Neurological Complications of Glandular Fever

multiple cutaneous metastases. Meningitis followed a hypophysectomy on 11 February 1965 and she died soon afterwards. At necropsy the pancreas showed islet tissue present in normal amounts, and there was no abnormality in the histology. Case 3.-Female aged 62 years. Carcinoma of left lung with pleural effusion. She was treated with cyclophosphamide 100 mg. daily from 15 June 1964 to 11 September 1964, thereafter 50 mg. daily. Glycosuria was first observed on 12 December 1964 and a glucosetolerance test on 8 March 1965 showed fasting level 100 mg./100 ml.; after 50 g. of glucose: at I hour 220 mg./100 ml. ; at 1 hour 210 mg./ 100 ml.; at 1! hours 230 mg./100 ml.; and at 2 hours 210 m-./100 ml. Control of the bloodsugar level has been achieved with a low-carbohydrate diet. There was no family history of diabetes in any of these patients.

THE COLLOIDAL BENZOIN REACTION IN THE CEREBRO-SPINAL FLUID: COMPARED WITH OTHER TESTS.

THE object of this work was to test the colloidal benzoin reaction (C.B.R.) under routine hospital conditionis, comparing it with the other well known tests carried out simultaneously on the same specimens. The cases (over 200 in number) were chiefly derived from the wards and out-patient departments of the Westminster Hospital and the West End Hospital for Nervous Diseases, and we wish to acknowledge our indebtedness to the staff of both hospitals. In classifying our results we have used the diagnoses received with the specimen of cerebro-spinial fluid. It must be clearly understood, however, that in maniy cases the diagnosis was admittedly tentative, and, indeed, depended on the result of the examination. Thus suchl comments as we may make on the diagnoses are entirely without prejudice. The routine examinations made on every specimen of fluid were cytology, globulin reaction (G.R.), albumin percentage, Wassermann reaction (W.R., using Metlhod 4 of the Medical Research Council). In many cases also the Wassermann reaction was done on the blood, but not in all cases. The full technique of the colloidal benzoin reaction may be obtained from that most excellent pamphlet, La J2egaction du Benjoin Colloidal, by G. Guillain, G. Laroche, and P. Lechelle (1922).