Mental development of children is strongly associated with later life outcomes, and appropriate care for children who encounter mental problems is, therefore, of significant importance. To optimize quality of care for children and adolescents with psychiatric problems, new developments in care suggest that a more personalized approach is required. That is, knowledge regarding risk factors associated with mental problems, and factors that might be protective, including predicting treatment success, at the level of individual children and adolescents is key. Currently, such information is limited.
To enable personalized treatment for children and adolescents with psychiatric problems, it is crucial to analyze large amounts of data collected in the course of daily clinical practice, combined with deep phenotyping data. To this end, academic child and adolescent psychiatry centers in the Netherlands have combined their forces, thereby creating DREAMS. Currently, four centres are participating (i.e., Accare, LUMC Curium, Karakter, Levvel) representing a large part of the Netherlands. We envision that DREAMS will grow into a national collaboration, providing a great resource to study mental health and wellbeing of children in the Netherlands.
Sleep problems, such as problems falling asleep and maintaining sleep, are highly prevalent in children and adolescents. The main aim of this study is to investigate the prevalence of sleep problems in youth admitted for mental health care at the DREAMS centers. We also want to examine the type of sleep problems these children and adolescents experience and whether these differ for children of different ages.
Further, we aim to investigate whether sleep problems are associated with other problems, including internalizing problems (e.g., anxiety or depressive symptoms) or externalizing problems (e.g., rule-breaking behavior or hyperactivity). For this study, data from intake questionnaires are used.
If a child is admitted to a child and adolescent psychiatry center, there may be grounds for neuropsychological examination. For example, if there are concerns about information processing difficulties which may lead to psychological problems, problems at school and/or may interfere with treatment success. A neuropsychological assessment is also useful in children with a (suspected) congenital or acquired developmental disorder, to tailor care and education to the needs of the child.
There appear to be differences between the DREAMS centers in when and how this care is provided. In this project, led by Nanda Rommelse and Marjolein Luman, we will investigate how we can provide this care as optimally as possible.
Child and adolescent mental health and wellbeing in times of COVID-19
The COVID-19 pandemic has left children and adolescents largely unaffected in terms of infectious morbidity and mortality. A greater challenge for this age group, though, is expected in dealing with societal COVID-19 lockdown restrictions that may push children into crises and destabilize families. Undoubtedly, the current societal restrictions are a vast environmental ‘game changer’ in the lives of all Dutch children and adolescents. For this project, we collect questionnaire data at several time points and organize group discussions with children and youth, including experts by experience, to translate our findings into recommendations for policy and care.
You can read more about our COVID-19 project on this page (in Dutch).
Profiling the landscape of Dutch child and adolescent psychiatry
A first project of DREAMS entails providing an outline of the current landscape of child and adolescent psychiatry in the Netherlands, based on the DREAMS cohort. We will provide an overview of available demographics, DSM classifications, treatment duration, and medication use.
We will also identify future challenges in creating a collective data infrastructure, such as the use of different terminology, patient record systems, data collection systems, and treatment evaluation procedures.
Some of the children and adolescents in treatment at one of the DREAMS-centres are prescribed medication as part of their treatment plan. The goal of the medication project is to gain better insight into what kind of medications are prescribed, and to whom. Questions that we want to answer are, for instance: How do prescription trends change over time? What kind of factors are associated with prescription of medication? Are medications prescribed according to professional guidelines? We also want to investigate whether there are potential differences in prescription practices between DREAMS-centres and why these differences might exist, so that we can share best practices with one another. By answering these questions, we hope to contribute to optimizing the use of medication as part of the treatment plan.