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Available accessEditorialFirst published July, 2025pp. 531-536
Available accessReview articleFirst published July, 2025pp. 537-561, Margaret Kay Ho, Oscar Hou In Chou , [...]Since the onset of the COVID-19 pandemic, rates of anxiety and depression in youth have risen. Telepsychiatry is a potential mode of intervention for such digital natives. This systematic review aims to examine the effectiveness of telepsychiatry for youth with depression and/or anxiety.
Four electronic databases, PubMed, MEDLINE, Embase, PsycINFO, were searched from their inception to May 12, 2024. Included studies were assessed for study quality and risk of bias.
A search returning 29,944 records yielded 26 included studies, comprising 1,558 youths. Of 13 studies comparing depressive symptoms pre- and post-telepsychiatry intervention, symptom severity was significantly lower post-intervention compared to baseline (Hedges’ g: 0.83; 95% CI: 0.59, 1.08). Similarly, of six studies comparing pre- and post-telepsychiatry intervention anxiety symptoms, anxiety scores were significantly lower post-intervention (Hedges’ g: 1.15; 95% CI: 0.79, 1.50). Patients undergoing telepsychiatry also had superior outcomes when compared to waitlist control groups for depression (Hedges’ g: 0.54; 95% CI: 0.23, 0.85) but not anxiety (Hedges’ g: 0.50; 95% CI: −0.09, 1.10). Certainty of these estimates ranged from moderate to very low. Qualitative feedback noted subjective improvement in symptoms and high levels of satisfaction.
Telepsychiatry has potential as a therapeutic intervention for youth anxiety and depression. Further research with more controlled methodology is needed for development of recommendations that can guide growing use of this technology.
Effectiveness of Telemedicine in Treating Youth with Depression and/or Anxiety: Since the COVID-19 pandemic, many psychiatry providers have adopted the use of telemedicine. This study evaluates the effectiveness of telemedicine in treating youth, a population known as “digital natives,” with depression and/or anxiety. This study combined the findings from 26 studies involving 1,558 youths. Overall, in youths that were treated with telepsychiatry, depression and anxiety symptoms improved after treatment. For youths with depression, those who were treated with telepsychiatry had better outcomes compared to those who were put on a waitlist, but for youths with anxiety, it is uncertain whether there is a difference in outcomes between the two. This study suggests that telepsychiatry has potential as a treatment modality for youth, with additional benefits compared to conventional therapy such as convenience. However, we have moderate to low certainty in our conclusions, and more research is needed to support these findings and guide how this technology should be implemented.
Available accessReview articleFirst published July, 2025pp. 562-587Children and adolescents with autism spectrum disorder (ASD) frequently experience functional somatic symptoms (FSS), although the underlying causes often remain unclear. Various biological and psychological factors, both individual and within families, such as alexithymia or health anxiety, can intensify these symptoms, sometimes resulting in excessive and unnecessary medical interventions.
A narrative review of the literature was conducted, alongside the presentation of a case report involving a 13-year-old boy with ASD. The case illustrates how personal and familial factors can influence the presentation of FSS and the risks of inappropriate treatment.
The findings suggest that psychological and familial factors play a significant role in the manifestation of FSS in ASD. These factors can increase the risk of unnecessary medicalization, as they often lead to misinterpretation of symptoms by caregivers and healthcare providers. The case report further underscores how the interaction of personal and familial dynamics can complicate the management of FSS. A comprehensive biopsychosocial approach that addresses both the individual and the family is crucial for managing FSS in ASD. Future research should focus on developing targeted interventions that address these psychological and familial influences to enhance the quality of care and reduce unnecessary and potentially harmful healthcare utilization in ASD.
Barriers to Effective Healthcare for Autism with Physical Symptoms: A Holistic Approach: Children and adolescents with autism often experience physical symptoms like stomach aches or headaches, but doctors can struggle to find a medical reason for them. These are known as “functional somatic symptoms” (FSS), meaning the symptoms don't stem from any physical disease. This can lead to unnecessary medical tests and treatments. The study highlights how factors such as family stress and difficulty understanding emotions (a condition called alexithymia) play a role in making these symptoms worse. A case report of a 13-year-old boy with autism is discussed, where the family was suspected of fabricating or exaggerating the boy’s symptoms, resulting in numerous hospital visits and invasive tests. However, the study shows that these suspicions may stem from a misunderstanding of the boy's condition, emphasizing the need to assess both the emotional and family context when managing FSS in autism. By using a holistic biopsychosocial model, which takes into account the body, mind, and family environment, the study recommends that both the individual and family should be involved in the treatment plan. This approach can lead to better health outcomes and less strain on families.
Open accessResearch articleFirst published July, 2025pp. 588-610Mentalization is the ability to think about and interpret behaviours of both self and others in terms of thoughts and feelings. Caregiver’s capacity to mentalize can enhance the quality of parent-child relationships. The UK Reflective Fostering Programme (RFP) has been developed to enhance foster and kinship carers’ self-regulation and self-mentalizing.
To understand carers’ experiences, practical application, and perceived impact of the RFP.
A qualitative evaluation of the RFP using in depth interviews with twenty-four carers. Interviews were audio-recorded, transcribed verbatim and analysed thematically.
Three key themes were identified: (1) ‘
Our findings suggest the programme can successfully facilitate carer’s use of self-mentalizing, leading to greater self-regulation and capacity to support children in their care. Future research should explore experiences of male and kinship carers to inform tailoring.
Mentalization is the ability to think about what we or others are thinking or feeling. Research shows that when caregivers mentalize, they are better able to control their own feelings and reactions, which can in turn improve relationships with their children. In the UK, the Reflective Fostering Programme (RFP), a group-based programme, has been developed to improve foster and kinship carers’ ability to mentalize. To understand experiences of carers’ attending the programme, we interviewed twenty-four carers who had attended the programme. We wanted to know whether they applied what they had learnt and if it had helped their relationships with their children. Carers told us that hearing and sharing stories of challenging experiences during the sessions helped them to practise mentalizing and understand why they or their children behave or react in certain ways. Most carers understood mentalization as the ability to think about what they or others are thinking or feeling. However, some male and kinship carers felt mentalizing is unhelpful because one cannot know for sure what other people are thinking or feeling. Most carers said that mentalizing had helped them to stop and think about what others are thinking or feeling, before reacting. By doing this some participants reported having less heated arguments with their children and others said mentalizing had helped them to cope better with stressful situations and had helped improved communication with their children. Overall, our findings suggest that by attending the programme, carers were better able to behave in ways that can improve relationships with their children. However, more work needs to be done to understand whether male or kinship carers experience the programme differently, and whether changes need to be made to help them benefit more from the programme.
Open accessResearch articleFirst published July, 2025pp. 611-631Care-experienced young people (CEYP) have far higher rates of mental ill-health than their peers. Less is known about their wellbeing and the overlap between mental health and wellbeing in this population. Drawing on two samples of CEYP, we explored mental health and wellbeing profiles, the overlap between these, and basic predictors of symptom severity.
We recruited two samples of CEYP: 269 10-13-year-olds and 155 16-17-year-olds, and their primary caregiver. All participants were either in local authority (out-of-home) care or had been adopted from the care system in England and Wales. Participants completed standardised measures of anxiety-, depression-, PTSD-, and externalising symptoms, as well as standardised wellbeing measures.
The majority of young people in both samples reported clinically-elevated symptomology, with mental health and wellbeing particularly poor in the late adolescents sample. Almost half of the 16-17 year old sample rated their wellbeing as poor. Overall, we found moderate associations between mental health and wellbeing. In early adolescents, these associations were less clear (many with clinically-elevated mental health reported average wellbeing), but for older teens poor mental health was closely related with the poorest reported wellbeing. There was no consistent evidence that age, gender, or ethnicity predicted wellbeing, but mental health was generally the poorest for older teens in residential care placements.
We found high levels of disorder-specific mental health symptomology in CEYP, with 16–17-year-olds having particularly high levels of mental health difficulties and low wellbeing. Results highlight the crucial role of early intervention and prevention in this group, before difficulties become entrenched and affect wider aspects of wellbeing.
There is a lack of research on the mental health and wellbeing of care-experienced young people, which has an impact on the support young people receive. Our paper highlights common mental health symptoms (e.g. anxiety, depression, post-traumatic stress) among care-experienced young people over two key ages: early and late adolescence. We show that mental health and wellbeing are distinct but overlapping constructs, and that this overlap is particularly strong by late adolescence. Our findings highlight the urgent need for early intervention and preventative support for care-experienced young people, to reduce the likelihood of mental health difficulties and poor wellbeing as they approach adulthood.
Available accessResearch articleFirst published July, 2025pp. 632-652, Naomi Payne, Megan Reynolds , [...]The number of children and young people (CYP) experiencing mental health crises in the UK is increasing. The NHS Long Term Plan (2019) prioritises crisis care for CYP. There is a lack of research and understanding into staff views and understandings of these services. The Crisis and Home Treatment Service (CAHTS) is a service within Child and Adolescent Mental Health Services (CAMHS) across Bath and Northeast Somerset, Swindon, and Wiltshire (BSW) and is a key component of the crisis mental health care for CYP. The aims of this study were to gain an insight into staff’s views and understandings of the CAHTS, and to explore and identify areas for improvement for future practice and policy for the CAHTS.
The study employed a mixed-methods design, obtaining quantitative and qualitative data, by distributing online surveys (
Participants ‘agreed’ that CAHTS were acting in accordance with their core principles and were ‘highly likely’ to use the service in the future. The thematic analysis revealed seven themes, the four most dominant themes identified were: good qualities of the CAHT service, working collaboratively, good clinician skills and understaffed for demand.
The data provides insight into staff’s views and understandings of the CAHTS. From the themes derived, the study identified various implications for the CAHTS including further training for staff.
This study focuses on staff views and understanding of the new Crisis and Home Treatment Service, and provides qualitative data, recommendations for the service, conclusions and implications.
Open accessResearch articleFirst published July, 2025pp. 653-669, Trinity De Simone, Rebecca Appleton , [...]The pressures on community Children and Young People’s Mental Health Service (CYPMHS) clinicians to manage and maintain caseloads can be immense, therefore discharging young people from CYPMHS in a safe and timely way is often discussed as a priority. However, there is limited research into how discharge can be done well, especially for discharge occurring prior to children and young people (CYP) reaching the upper age limit of CYPMHS. Thus, this study aimed to gain a better understanding of the barriers and facilitators discharging CYP from community CYPMHS, by exploring clinicians experiences of discharging CYP from their service.
Semi-structured interviews of 30–40 minutes were conducted with 12 clinicians working at different CYPMHS in England and analysed using codebook thematic analysis.
Six themes were identified. These included, “perfectionistic approach towards treatment outcomes”, “reducing dependence on CYPMHS through empowerment”, “a lack of flexibility in the wider system”, “lack of collaborative care”, “an increasing pressure on the service” and “keeping the focus on discharge”.
Clinicians face multiple barriers when discharging CYP which should be addressed, alongside enhancing the use of reported facilitators to ensure timely, safe and well-managed discharges.
Little research has been conducted on the discharge pathway at child and adolescent mental health services (CYMPHS) despite it being the way in which many young people will leave the service. Additionally, the few studies which are present, indicate that discharge is poorly managed and can be delayed. They have also mainly focused on young people who were around 16–18 years old. Thus, this study aimed to gain a better understanding of the discharge pathway, specifically the barriers and facilitators of discharging children and young people across all ages from CYMPHS. The researchers interviewed twelve clinicians from CYMPHS across the UK. We found that multiple barriers affected the ability of clinicians to carry out a timely, and well-planned discharge such as families becoming too attached, a disjointed and inflexible mental health care system, lengthy waiting times, high staff turnover and a lack of focus on discharge planning from the outset. However, there were also some facilitators, which included helping families become self-confident, regular communication with all relevant parties, and using supervision to keep the focus on discharge. The findings of this study can be used to improve the current discharge pathway at CYMPHS, and to hopefully bring attention to this topic which has been so far fairly neglected.
Available accessReview articleFirst published July, 2025pp. 670-682, Shannon Webb, Choong-Siew YongMore adolescents than ever are being hospitalised in mental health units. As with all forms of clinical intervention, psychiatric inpatient admission poses its own risks of harm resulting from treatment (iatrogenesis), of which there is minimal literature. In this article we explore the factors that contribute to iatrogenic processes in the adolescent inpatient environment. Of note, the socialization of unsafe behaviours in these environments can contribute to poorer treatment outcomes as well as the harmful effects of experiencing, or witnessing, coercive and traumatising clinical practices. Inpatient admissions also have a systemic impact on family and community ecosystems that can detrimentally influence young people while they are in hospital and even after returning to the community. Recommendations for minimizing and preventing iatrogenic harm for adolescents in inpatient environments are outlined, as well as the patient characteristics that might make young people more vulnerable to these deleterious processes.
When Hospital Harms More Than Helps: How Mental Health Hospital Admissions can Sometimes be Harmful for Teenagers: Hospital admission is considered a last resort treatment for teenagers suffering from mental health conditions. Teenagers admitted to hospital are usually those with the most severe and complex mental health disorders, and at risk of hurting themselves or others. Whilst admission to psychiatric units is generally helpful, they can also sometimes lead to a worse outcome for both teenagers and their families. In this article, we explore the various ways that hospital can be more harmful than helpful for teens undergoing mental health crises. These include the impact of experiencing, or witnessing, traumatic and coercive treatments while in hospital (such as physical restraint or sedation) as well as the risk of negative influence from peers. We also outline how hospital admission can have various impacts on parents and families – making it hard for teenagers to return home at the end of their admission. Based on our review of the literature and our experiences working in adolescent inpatient units, we provide some recommendations for how to minimize the potentially harmful impact of hospital admissions, such as by arranging planned and time-limited stays, maximising time spent outside of hospital, and involving parent-caregivers as much as possible.
Available accessResearch articleFirst published July, 2025pp. 683-698, Carly E Milliren, Kathleen Waddicor , [...]Adolescence and pregnancy are sensitive periods for the development or worsening of anxiety and/or depression. Pediatric clinicians often diagnose pregnancy, but little is known about the assessment and treatment of anxiety and/or depression during this sensitive period.
We completed a retrospective chart review of patients who presented to an Adolescent/Young Adult Medicine clinic between April 2018 and March 2023 with a positive pregnancy test. Investigators reviewed medical records and abstracted patient data by unique pregnancy (
Of the pregnancies reviewed, 135 (42.5%) had a diagnosis of anxiety and/or depression while 183 (57.6%) had neither. Overall, 28 (8.8%) had anxiety, 68 (21.4%) had depression only, and 39 (12.3%) had both anxiety and depression. Mental health was discussed during 62.6% of visits though patients with prior diagnoses of anxiety and/or depression (
We highlight the need to assess for anxiety and depression in all pregnant adolescents/young adults. We encourage future research investigating patient preferences for mental health supports and strengthening of clinical programs that seek to treat and understand anxiety/depression in this unique population.
A study of mental health concerns in pregnant adolescents/young adults at an urban outpatient clinic:
Available accessResearch articleFirst published July, 2025pp. 699-716, Nidhita Singh, Clara Lee , [...]Intensive community treatment services are emerging as an alternative to admission to hospital, in order to support young people to remain at home close to their local communities. This paper aims to assess how does the treatment journey could look like and factors associated with treatment. We conducted a service evaluation using routinely collected data from an intensive community treatment service between 2016 and 2023. 141 adolescents aged 12 to 17 received intensive community treatment over 8 years. The average treatment duration was 29.3 weeks, significantly longer than the initial 12-week pathway proposed. Those who were treated for significantly longer seemed to have more complex mental health needs. Those who were not attending school, were part of an ethnic minority or were treated by more than one specialist service at the time, required longer time on treatment. The results suggest that a longer treatment pathway might be necessary in intensive community care, so a 24-week treatment pathway was proposed. General functioning also improved over the course of treatment, and 89.4% were discharged back to their local community teams, rather than being admitted to hospital. The involvement of multiple specialist services and the presence of specific diagnoses (e.g., autism) deserve consideration. Future evaluations will clarify if adapting treatment pathways to particular conditions (e.g., autism, trauma) would be beneficial.
Available accessResearch articleFirst published July, 2025pp. 717-734, Rashmi Tiwari, Samant Pushpak Kumar JenaThis study aimed to examine the efficacy of the Coping Cat program, a CBT intervention, for Indian children (11–13 years) with high anxiety.
A total of 240 children were screened, and 120 children with high anxiety were randomly assigned to either a treatment group (
The therapeutic process consisted of a modified CBT protocol, comprising 16 sessions of 40–45 minutes each. The Coping Cat program was specifically designed to address anxiety symptoms in children.
A linear mixed-effects model was used to analyze the data, accounting for both fixed effects (e.g., time and intervention) and random effects (e.g., individual differences). This approach was particularly suited for the repeated-measures design. A follow-up study was conducted one year after the intervention to assess its long-term effects.
Significant differences were observed between the treatment and control groups, indicating the efficacy of the Coping Cat program in reducing anxiety symptoms. Notably, treatment gains were maintained at the one-year follow-up. Conclusion: The findings suggest that the Coping Cat program is an effective CBT-based intervention for reducing anxiety symptoms in highly anxious children.
The results indicated the efficacy of Coping Cat CBT in highly anxious young children.
The present research aims to explore the scientific strategies and methods using an established CBT manual to help young children aged 11–13 years to recognise, understand and learn coping skills to overcome and handle their severe fears, and feelings of nervousness, raised due to any difficult situations. Also, acknowledge their physical symptoms and practice ways to overcome them gradually.
Available accessResearch articleFirst published July, 2025pp. 735-751This study aims to investigate the specific effects of Flash Technique (FT) on adolescents with test anxiety. This follow-up study consists of 38 adolescents, 14–17 years of age (
Test anxiety is defined as a set of reactions that include negative thoughts, emotions, and bodily sensations that arise from the possibility of failure during an exam or evaluation. Adolescence is a period marked by significant changes in cognitive, psychosocial, and emotional development, which can make test anxiety particularly critical during this time. Test anxiety has a two-factor structure, encompassing emotional-physical and cognitive aspects. Additionally, prolonged test anxiety can lead to adverse outcomes such as sleep disorders, depression, crying spells, and eating disorders. In some cases, it may even result in self-harm and suicidal thoughts. Also, parental acceptance, control, and modeling may be associated with anxiety symptoms in children. Test anxiety can carry traumatic traces from students' past experiences of failure or fears related to the potential outcomes of exams. In this context, it is suggested that EMDR might help individuals reprocess irrational beliefs about past failures and develop more functional, positive beliefs. EMDR is thought to positively affect test anxiety by addressing negative thoughts, bodily sensations, and emotions. One novel trauma-related intervention is the Flash technique (FT). Although FT was initially created as a supplement to the preparation stage of EMDR, it has evolved to a stand-alone trauma therapy currently. FT is quickly alleviating the distress caused by disturbing memories. It is aimed at investigating the specific effects of the FT on adolescents with test anxiety. In the present study, adolescents with test anxiety showed significant improvements in anxiety severity and their traumatic events impact levels decreased. As a result of our study, a 12-week FT treatment was observed to be effective for adolescents with test anxiety.
Available accessResearch articleFirst published July, 2025pp. 752-766, Daniel I Lipin, Thomas K Swoboda , [...]High school students in the U.S. face the effects of using substances like alcohol, tobacco, and illegal drugs. Our study looked at national survey data to understand how many high school students use these substances and what factors might influence their use. We found that about one in three high school students had used these substances in the past year, and the rate of use increased as students moved from freshman to senior year. Students who argued or fought with their parents, or who were involved in school or group fights, were more likely to use these substances. On the other hand, students who participated in religious activities or held religious beliefs tended to use fewer of these substances. Based on these findings, we believe it is important to create programs that help reduce negative behaviors, like fighting, and provide positive support for students, like participation in religious groups or other community-based programs. By focusing on reducing conflict and promoting healthy, supportive environments, schools and communities can work together to guide students toward better choices and improve their overall well-being.
Open accessResearch articleFirst published July, 2025pp. 767-782, Oliver Hawthorne, Tamara LeeuwerikTransgender young people are more likely than their cisgender peers to experience trauma. Through talking about trauma, services may be able to support transgender young people to manage the impact of these events. However, research has highlighted that many trans people are concerned that disclosing trauma would be used to discredit their sense of their gender identity.
To explore how transgender young people experience having conversations about trauma with services and how they understand these conversations.
Six semi-structured interviews were carried out with young transgender people. Interpretative phenomenological analysis was used.
The study found that all participants were aware of discourses linking experiences of trauma with transgender identities. All participants recognised these conversations as significant. Some experienced conversations to be supportive and transformative. Others found them deeply distressing, reminiscent of trauma experiences. Relationships with professionals seemed to influence these experiences, as did transphobia and relationships with other services.
A trauma-informed approach should be used and professionals are encouraged to consider the potential for harm that can arise from these conversations, as well as the therapeutic element. Clinical implications and future research directions are discussed, in particular considering the recently published Cass Review (2024).
Transgender people experience more trauma than the general population. There are different ideas about the relationship between trauma and trans identities. Some think trauma can cause trans identities. Some trans people find this view point harmful and dismissive. Because trans people have high levels of trauma, this study looked at how trans young people found the conversations they've have about trauma with professionals. Six interviews about this topic were held with young trans people who were being seen by the Gender Identity Development Service. This study found that all of these young people had thought about the link between trauma and their trans identity. Some wanted to explore this with professionals. Others were scared of talking to professionals about this. All thought these conversations had had a significant impact on them. For some, talking about their trauma with professionals made a big positive difference to their life. For others, these conversations were upsetting and had features that were similar to trauma experiences. The relationships with the professionals seemed to be important in how people found these conversations. Other factors that affected it included people's previous experiences with services and the way trans people can be treated negatively by wider society. The authors suggest that trauma-informed practices, which are gaining popularity in other areas of clinical practice, should be applied to working with this population. Professionals should be aware these conversations can be harmful as well as positive. Professionals should be are clear about why they are asking about trauma, and what the effects of these conversations might be. This will help people have informed choice about whether or not they want to have these conversations. Professionals should also remember that young people come to services with other experiences that may impact how they find these conversations.
Open accessResearch articleFirst published July, 2025pp. 783-799, Ellie Roberts , [...]Obsessive-compulsive disorder (OCD) and autism spectrum disorder (ASD) often co-occur and have overlapping symptom profiles. Detection and diagnosis of ASD in youth with OCD can therefore be challenging but is crucial to inform care planning.
The current study aimed to provide a psychometric evaluation of the Social Communication Questionnaire (SCQ), a widely used parent-report measure for assessing ASD traits, in youth with OCD.
In total, 484 young people with an ICD-10 diagnosis of OCD completed a battery of measures as part of a specialist clinical assessment.
Exploratory factor analyses (EFA) suggested a multidimensional factor solution for the SCQ, although an adequate factor solution was not identified due to cross-loading and/or weak loading items. The SCQ had good internal consistency (KR20 = 0.85), and good convergent validity with the Strengths and Difficulties Questionnaire (SDQ) Prosocial Behaviour subscale (
The current findings support the use of the SCQ as a measure of ASD traits in youth with OCD, suggesting that this quick and easy-to-administer measure could aid detection of ASD in this population.
Obsessive-compulsive disorder (OCD) and autism spectrum disorder (ASD) often occur together and have some similar symptoms. Because of this, identifying ASD in young people with OCD can be difficult but is important for planning their care. This study looked at how well the Social Communication Questionnaire (SCQ), a parent-completed questionnaire commonly used to identify ASD traits, works for young people with OCD. The study involved 484 young people who had been diagnosed with OCD. Their parents completed different questionnaires as part of a specialist clinical assessment. Scores on the SCQ were related to other measures of social behaviour, and less strongly related to measures of other difficulties, meaning that the SCQ seems to measure what it is supposed to. The SCQ was able to distinguish between those with and without an ASD diagnosis with a reasonable level of accuracy. The findings suggest that the SCQ is a useful tool for detecting ASD traits in young people with OCD. Since it is quick and easy to use, it could help professionals identify ASD in this group more effectively.
Available accessResearch articleFirst published July, 2025pp. 800-808, Polina Perlman Danieli, Mariela Mosheva , [...]Capgras syndrome (CS) is characterized by the delusional belief that a person, usually a close relative, has been replaced by an imposter. This study focuses on the co-occurrence of CS and Obsessive-Compulsive Disorder (OCD) in children.
We present two cases of children diagnosed with CS and OCD treated at our inpatient child psychiatric unit.
We describe the cases of an 11-year-old male who believed his parents were demonic entities and a 12-year-old female who believed her parents were robots. Both children exhibited additional psychiatric manifestations such as depression, catatonia, obsessive-compulsive (OC) symptoms, persecutory delusions, reduced food intake, and suicidal ideation. Our treatment approach combines antipsychotic medication, selective serotonin reuptake inhibitors (SSRIs), and gradual exposure therapy accompanied by parent training, has yielded favorable outcomes in managing the patients’ psychiatric symptoms.
We provide insights into CS with comorbid OCD in children and discuss the behavioral treatment approach employed in our cases. We also discuss similar cases of CS comorbid with OCD from the English literature.
Introduction: Capgras syndrome (CS) is a rare mental condition where someone believes a familiar person, usually a family member, has been replaced by an impostor. This condition often appears in adults with schizophrenia and is very rare in children. Our study focuses on two cases of children with both CS and obsessive-compulsive disorder (OCD). Case Presentations: Case 1: “Michael,” an 11-year-old boy, developed severe OCD symptoms and delusions that his parents were impostors. He engaged in compulsive hygiene rituals, became aggressive, and experienced emotional distress. Traditional treatments were ineffective. At our psychiatric unit, we used gradual exposure therapy (gradual, controlled exposure to his parents) combined with antipsychotic and SSRI medications. Over a few months, Michael's condition improved significantly, allowing him to reconnect with his family and return to normal activities. Case 2: “Dana,” a 12-year-old girl, experienced sudden severe behavior changes, believing her parents were robots. She also had catatonia, depression, and OCD. Initial treatments were not effective. At our unit, she received gradual exposure therapy and adjusted medications. This treatment led to significant improvements, allowing her to interact positively with her parents and manage her delusions. Discussion and Conclusion: Our study suggests that combining gradual exposure therapy with antipsychotic and SSRI medications can effectively treat children with both CS and OCD. This therapy helped the children gradually accept their parents and reduced their delusional thoughts. While exposure therapy is typically used for OCD, it showed promising results for CS as well. By sharing these rare cases, we aim to enhance understanding and treatment of CS in pediatric patients. Further research is needed to explore these innovative treatment methods and improve outcomes for children with CS.