Critical incidents are common among hospitalized adolescents and result in a poorer outcome. Increased structure during the evenings, problem-solving and social skills programmes for patients, and specific training for staff regarding management and minimization of critical incidents should be provided.

Objective: The purpose of the current preliminary study was to estimate the nature and occurrence of metabolic abnormalities among adolescent inpatients receiving psychiatric treatment and to pilot a health promotion and life style intervention program. Method: A total of 107 adolescents admitted over a 12-month period were evaluated for physical, clinical and metabolic parameters in two inpatient psychiatric units in Sydney, Australia, where a health promotion and life style intervention program was provided under the leadership of a Sports Psychologist. Results: 46% of subjects were found to be "at risk for adverse health outcome" with one or more metabolic abnormalities and 4.6% qualified for a diagnosis of Metabolic Syndrome meeting 3 or more of the modified criteria for Metabolic Syndrome in young people. 13% of the sample was overweight with abnormal Body Mass Index (BMI). While two thirds recognized the importance of staying physically active, only a quarter were maintaining adequate level of physical activity. Regarding quality of life, only 30 to 40% reported good life and health satisfaction. Conclusion: Our findings suggest that metabolic abnormalities are not uncommon among young psychiatric patients and that they are often missed. Regular monitoring for the presence of metabolic abnormalities and clinical risk factors should be part of the comprehensive management with special focus on preventative programs.

The purpose of this study was to evaluate the outcome of adolescents with anxiety-based school attendance problems enrolled in a specialist adolescent educational and mental health program that provides educational assistance and social skills development, and to suggest key elements that may account for its apparent effectiveness. Young people attending the Sulman Program in Sydney, Australia, between March 2003 and December 2004 were identified. Baseline information was gathered from the medical records, pre and postintervention personal development questionnaires were given to students, and pre and postratings of function were made. Those attending the program showed improvement in their general level of functioning indicated by completion of a year-long course of study (17 of 24), preparation for employment (17), increased independent travel (5), and self-rated improvement in social skills, stress tolerance and emotional literacy. Pre and poststaff ratings on the Health of the Nation Outcomes Scales Child and Adolescent (HoNOSCA), Children's Global Assessment Scale (CGAS) and Global Assessment of Functioning (GAF) indicated improvement in personal and social functioning. Parental satisfaction was rated as high. The findings confirm the effectiveness of, and need for, flexible programs to support adolescents with social anxiety disorder and other longer-term mental health problems to offset the adverse consequences of early withdrawal from educational and social environments. Several elements may help to explain the program's effectiveness and provide guidance for similar programs elsewhere.

Purpose: Post-traumatic stress disorder (PTSD) rates among hospitalised adolescents are between 21% and 32%, and there is a lack of evidence-based interventions for this population. Trauma-focused cognitive behaviour therapy (TF-CBT) is an evidence-based intervention for children and adolescents with PTSD; however, it has not been implemented in an acute adolescent inpatient unit. This study examines the implementation of an intensive form of TF-CBT in an adolescent inpatient unit. Method: An uncontrolled open trail study was conducted where 15 adolescents diagnosed with PTSD were treated with an intensive form of TF-CBT. Measures used were the University of California, Los Angeles’ (UCLA) PTSD Reaction Index for Diagnostic and Statistical Manual of Mental Disorders (4th ed., Adolescent Version; DSM-IV-Adolescent Version), the National Stressful Events Survey PTSD Short Scale (NSESSS) and the Children’s Global Assessment Scale (CGAS) Results: Adolescents received an average of nine sessions of TF-CBT over a period of 28 days. The average NSESSS on admission was 23.73 and 8.27 at discharge; the CGAS average on admission was 19 and on discharge was 48.7; both were statistically significant changes. Conclusion: Preliminary findings support the use of an intensive form of TF-CBT to treat adolescents with PTSD admitted to acute adolescent inpatient units indicating the need for further research in this area.