Albermann Kurt, Wiegand-Grefe Silke, Winter Sibylle
Sozialpädiatrisches Zentrum (SPZ) Dept. Kinder- und Jugendmedizin Brauerstrasse 15, Postfach 834 CH-8401 Winterthur Schweiz https://www.ksw.ch/klinik/sozialpaediatrisches-zentrum-spz/.
Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik am Universitätsklinikum Hamburg Eppendorf Deutschland Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik.
Prax Kinderpsychol Kinderpsychiatr. 2019 Jan;68(1):6-26. doi: 10.13109/prkk.2019.68.1.6.
Child Protection in Families with Parental Mental Illness Children and adolescents from families with parental mental illness face an increased risk to experience abuse, neglect and maltreatment. The effects of imminent, intermittent or chronic distress on the development of the child and to differentiate these from neglect or maltreatment are not easily assignable in such families. Questionnaires and diagnostic instruments can be supportive tools for professionals in hospitals and private practices to identify and differentiate between burdens of children and families and potential endangerment. Different instruments are presented for the assessment of child abuse: For professionals the "Wahrnehmungsbogen für Kinderschutz" (Thurn et al., 2017). As methods of screening at risk the "Eltern-Belastungsbogen zur Kindeswohlgefährdung" (Deegener, Spangler, Körner, Becker, 2009) and the Childhood Trauma Questionnaire (Wingenfeld et al., 2010). For the comprehensive assessment of abuse, we present the Maternal Interview Child Maltreatment (Cicchetti, Toth, Manly, 2003). The prevalence of mentally ill parents is presented based on two samples of patients attending the child protection outpatient clinic or and the trauma outpatient clinic of the Charité. In the child protection outpatient clinic 15.8 % of the mothers and 11.4 % of the fathers fulfilled criteria for psychiatric disorders. In the trauma outpatient clinic we diagnosed a parental mental disorder in 20 % of all cases. A fictitious case report reveals the emotional maltreatment of a child by its mentally ill mother, which suffers from an isolated delusional disorder. Empirical based classification tools seem to be very appropriate to ascertain physical and sexual maltreatment and child neglect in children of parents with mental disorders, as permanent or severe neglect is frequently detectable in these families.
有父母患精神疾病家庭中的儿童保护 来自有父母患精神疾病家庭的儿童和青少年遭受虐待、忽视和 maltreatment 的风险增加。在这类家庭中,即将发生、间歇性或慢性痛苦对儿童发育的影响,以及将这些影响与忽视或 maltreatment 区分开来并不容易。问卷和诊断工具可以成为医院和私人诊所专业人员识别和区分儿童及家庭负担与潜在危险的辅助工具。本文介绍了用于评估儿童虐待的不同工具:对于专业人员而言,有 “儿童保护感知问卷”(图恩等人,2017 年)。作为筛查风险的方法,有 “儿童福利风险父母负担问卷”(德格纳、斯潘格勒、克纳、贝克尔,2009 年)和儿童创伤问卷(温根费尔德等人,2010 年)。为了全面评估虐待情况,我们介绍了母亲访谈儿童虐待量表(西凯提、托思、曼利,2003 年)。基于夏里特医院儿童保护门诊和创伤门诊的两个患者样本,给出了患精神疾病父母的患病率。在儿童保护门诊,15.8% 的母亲和 11.4% 的父亲符合精神疾病标准。在创伤门诊,我们在所有病例中诊断出 20% 的父母患有精神障碍。一个虚构的病例报告揭示了患有孤立性妄想障碍的精神疾病母亲对孩子的情感虐待。基于实证的分类工具似乎非常适合确定患有精神障碍父母的孩子遭受的身体虐待、性虐待和儿童忽视情况,因为在这些家庭中经常能发现长期或严重的忽视。