OBJECTIVE: To review the current global status of social healthcare systems for mental disorders in children and adolescents, which provide systematic and continuous protection against mental disorders.DATA SOURCES: A computer-based search for relevant English articles in Medline database published between January 1980 and March 2005 was conducted with the key words of "mental disorder, children and adolescents, care". The Chinese full-text periodical database and Wanfang database were also searched for relevant Chinese articles published between January 1990 and March 2005 using equivalent Chinese key words of "mental disorder, children and adolescents, care".STUDY SELECTION: The articles that reviewed the current status of social healthcare system for mental disorders in children and adolescents were included for analysis, and those not categorized as reviews were excluded.DATA EXTRACTION: Totally 58 related articles were collected, among which 13 met the inclusion criteria and 45 were excluded.DATA SYNTHESIS: The current status of social healthcare systems for mental disorders in children and adolescents in Europe, North America,South America, Australia, Asia and Africa were described. The prevention and treatment for mental disorders in Europe and North America were well developed. The training, education and research of mental disease in children in South America were still developing, and the healthcare system in Australia needs further improvement. Lack of professional physicians is the major problem in Asia, whereas a complete protective system has not been well established in Africa and the families assume the role of primary defense against the disorder.CONCLUSION: The comprehensive healthcare services for mental disorders in children and adolescents has been lacking globally. Policy development, cultural understanding in the healthcare, recognition of the important role of nongovernmental organizations, epidemiological research, and professional training can be beneficial efforts to better protect the children and adolescents from mental disorders.

Objective:To research the risk factors of developing Oppositional Defiant Disorder (ODD).Methods:Among 427 students in an elementary school in Changsha, we screened out thirty-four children with ODD by the criteria of DSM-IV. They and other thirty-four normal children from the same school were included in the case-control study. Education levels, jobs and Cartel 16 Personality Factors (16PF) were filled out by their parents. Combined Raven's Test (CRT) was used to evaluate children's intelligence.Results:The prevalence rate of ODD in children increased with the decrease of their father's and mother's education level (for father's education level form advanced education, secondary education to primary, the rate increased from 6.6%,7.2% to 12.0%) and (for mother, 5.3%,7.5%,10.6%). The rate of ODD was highest in children with father and mother doing small business (16.7% and 16.5%, ?~2=12.67～12.68,P

Objective:To explore psychological characteristics and influential factors of impulsivity of 8～12 years-old children with attention deficit hyperactivity disorder.Methods:70 children with ADHD and 126 controls and their parents were evaluated with BIS,SCARED,DSRSC,CSD,TMD and WCST.Results:①Children with ADHD showed significantly more impulsivity,higher anxious mood and depressive mood,lower social desirability,and time management disposition(P

Objective: To evaluate the utility of the Werry-Weiss-Peters Activity Rating Scale (WWPARS) for children with a Chinese background. Methods:In the city of Changsha, 465 normal children aged 8～12 in two primary schools and 27 ADHD children in an outpatient department were tested with WWPARS. Psychometric properties of the scale were analyzed for reliability and validity. Results: While levels of activity increased with age for all children, there was no significant difference between the two groups assessed. The scale attained good reliability and validity. Conclusion: This scale can be applied for evaluation of activity levels for Chinese children.

Objective:To explore the clinical features of subtyp es of ADHD in DSM-Ⅳ.Method:126 children fulfilled ADHD criteria of D S M-Ⅳ were further divided into 3 subtypes:predominantly inattentive(PI,61 cases) , predominantly hyperactive-impulsive(HI,9 cases)and combined type(CT,56 cases).C om orbid mental disorders were compared among the three groups.Parents and teacher s of children in each group completed CBCL(child behavior checklist)and TRF(teach er's report form).CWISC(Wechsler intelligence scale for children,Chinese versio n )and attention tests were also applied in each group.Results:Childr e n in CT group had more conduct disorder,more externalizing,delinquent and aggres sive behaviors rating by parents and teachers,and more inattentive than children in PI group.School performance of children in PI group was better than that of the other two groups evaluated by teachers.Conclusion:ADHD CT subty pe had highest rate of comorbid conduct disorder.They have more externalizing b ehavior,more academic problems and more inattentive.This subtype may be the mos t impaired subtype.

Objective: To develop the norm of Piers-Harris Children's Self-concept Scale (PHCSS) in Chinese urban children and test the reliability and validity. Method: A total of 1698 children with the mean age 12?3 year-old (846 boys and 852 girls) from 20 cities in China completed the scale. Results: The test-retest reliability, split-half and Crobach were in 0.695～0.858, the correlation between each item score and total score were in 0.078～0.467, showed better item differentiation except for 3 items. The validity was perfect, represented by significant correlation (r=0.051～0.353) between the score and Conners Parent Symptom Questionnaire and Teacher Rating Scale. Conclusion: The results demonstrate the scale are suitable for demands of psychometrics and applicable in Chinese children.

Objective: To investigate the cerebral cognitive function and intelligence in children with learning disorder (LD). Method:Thirty children with LD were examined with Wisconsin Card Sorting Test (WCST) and the Wechsler intelligence Scale for Children-Chinese Revised (WISC-CR). The results were then compared between LD and healthy control.Results:Compared with healthy control, the correct categories of WCST and correct responses in LD group were significantly lower (4.3?1.3/5.1?1.2). The persistent errors (38.6?10.7/23.9?8.4), total trials and total errors of WCST in LD were significantly higher than those in healthy control. In LD group, the full intelligence quotient (FIQ)(89.0?14.3/112.6?17.0) and the verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ) of WISC were all significantly lower than those in healthy control. So did scores of four factors of WISC, such as arithmetic, comprehension, and block design and object assembly. The incidence of abnormal intelligence structure in LD (80%) was significantly higher than that in healthy control (30%). The IQ in LD children was positively correlated with the correct categories and correct responses of WCST, and negatively with the total trials and the total errors and persistent errors of WCST.Conclusion:LD children suffered the frontal executive function deficits and cognitive dysfunction.

Objective: To study the pattern of parent rearing and the b ehavior of children with ADHD (attention deficiency and hyperactivity disorders) Method: 30 children with ADHD and 30 normal children were ass e ssed with PLOC (the parenting locus of control scale), Conners PSQResu l t: The parents of children with ADHD had higher scores of effect, obliga tion, belief of fate or chance, control of the behavior of children in PLOC So m e factors were associated with behavior problems Conclusion:C h ildren with ADHD have more behavior problems, which are associated with their pa rents’ rearing pattern

Objective :To explore the behavior characters of children diagnosed as ODD with ADHD symptoms. Methods: The diagnosis of ODD was made according to the ICD-10 criteria . 40 Children having ODD with ADHD symptoms (combined group ) and 22 Children having ODD but without ADHD symptoms (ODD group) were collected from outclinics. The parents of all subjects completed Achenbach Child Behavior Checklist (CBCL) and a family information list. Results: The onset and help-seeking age of the combined group were younger than that of ODD group. They had more disobey, attacking, and extroversive behaviors. Their fathers were more agitative. Parents of the combined group used more beating and scolding in parenting. Conclusion: ODD children with ADHD symptoms had more behavior problems and incur worse parenting style. Their family need more help in early age.

s Objective: To investigate the comorbidity of depression and anxiety in primary school students. Methods:565 pupils ranged from 2 to 6 grade in a primary school were tested by The Screen for Child Anxiety Related Emotional Disorders (SCARED) and Depression Self-Rating Scale for Children (DSRSC). Results: There were 140 pupils with a total score higher than cut-off point of SCARED; 97 pupils with a total score higher than cut-off point of DSRSC; 43 pupils with total scores higher than cut-off point of both SCARED and DSRSC, and the positive rate of comorbidity of anxiety and depression was 7.61%. 30.71 percent of children with anxiety disorder was considered co-morbiding depression; 44.33 percent of children with depressive disorder was considered comorbiding anxiety. Chil-dren with comorbidities had higher scores in Withdrawn(mean rank 297.7 ) than Anxiety group(220.8) and Depressive group(202.2);Somatic Complaints(268.2)than Anxiety group (232.2 ) and Depressive group(206.2 ) , Anxious/Depressed (277.2 )than Anxiety group (227.7 ) and Depressive group(219.2 )of CBCL(?~2 =16.72～22.71,P