Does Cannabis Prosecution Protect Young People's Health? On the Implementation of the Cannabis Act Different drug policy alternatives involve their respective opportunities and risks. When weighing up the options, a large number of stakeholders concluded that criminal prosecution of cannabis protects the bio-psycho-social health of young people less than decriminalisation. They demanded and welcome the new regulation of cannabis, also in terms of the protection of minors. The extent to which the legal status of cannabis influences the consumption patterns of the young population isn't assessed uniformly by studies in different countries. Against this background, a 'numbers competition' is less helpful than looking at other, validly proven parameters for mental illnesses including substance disorders, e.g. poverty and education. The article argues in favour of making the Cannabis Act helpful for young people through cooperation between the various stakeholders. Two examples of this are highlighted: early intervention in accordance with Section 7 KCanG and the topic of 'motivation-, counselling- and treatment-chains'. The latter takes the demands of the Transition Psychiatry Task Force (2021) further as a proposal.

Does Cannabis Legalization Endanger Children and Adolescents? The Cannabis Act (CanG) came into force on April 1, 2024. It regulates the "controlled supply of cannabis to adults for recreational purposes". In the USA, legalization has contributed to a decrease in the risk perception of the health hazards of consumption and an increase in risky consumption patterns, including among adolescents. The use of cannabis-related emergency and addiction treatment has risen sharply. Similar developments are now to be feared for Germany. For children and adolescents with cannabis-related disorders, a high standard of quality is maintained in the addiction departments of child and adolescent psychiatric and psychotherapeutic clinics with qualified withdrawal treatment and the subsequent treatment of comorbid mental disorders. However, the number of hospital beds is not sufficient to meet demand. This also applies to the medical rehabilitation measures for children and adolescents with the indications of cannabis abuse and addiction, which are too limited. There is a risk that children and young people will suffer in two ways as a result of the change in drug policy. Conclusion: The CanG sends the wrong signal for addiction prevention. Just a few months after the CanG came into force, the cannabis industry is already expanding. International evidence indicates that legalization endangers the health of the younger generation. Instead of a CanG, the better path for young people would have been to strengthen cannabis-related education and prevention in Germany.

Mindfulness in the Context of Addiction Disorders in Childhood and Adolescence: Overview of the Current State of Research Adolescents are at an increased risk of developing addictive disorders due to a variety of risk factors. Addictive behaviour is characterised by a limited ability to control one's own behaviour. The potential of improved self-regulation through mindfulness-based interventions is increasingly being investigated in connection with addictive behaviour. Whether a benefit also relates to addictive disorders in childhood and adolescence is still largely unclear. This overview summarises the current state of knowledge and classifies the potential of this approach for prevention and therapy in childhood and adolescence. Results from behavioural studies show that mindfulness is associated with and mitigates the risks for substance-related and non-substance-related addictive behaviours. Mindfulness is directly related to problematic forms of substance and media use and mediates the associations with key risk factors of addictive behaviours in adolescence. The effects of mindfulness-based interventions in children and adolescents in the area of addictive behaviour can so far only be inferred indirectly. On the one hand, too few high quality studies are available for children and adolescents. On the other hand, meta-analyses with adults show that although there is a preventive and therapeutic benefit, the effects decrease with increasing study quality. The translation of promising conceptual research into effective intervention models for the vulnerable group of children and adolescents remains an important goal for future research.

Gaming Disorder According to the ICD-11: Background, Criteria and Possible Implications Within 60 years, playing computer games - online or offline, with a computer, games console or smartphone - has developed from a niche activity for mostly young males into a global industry worth billions. Studies show that children and adolescents in particular tend to play digital games for several hours a day, making gaming one of the most common leisure activities for young people. A small proportion of young gamers may develop addictive behaviour with harmful effects on their psychosocial functioning. Following an intense discussion process lasting several years, the World Health Organisation (WHO) responded by introducing the new disorder category, "gaming disorder", which was placed as a second disorder alongside "gambling disorder" in the chapter on behavioural addictions. As with substance-related addiction disorders, computer game addiction is conceptualized within an "addiction triangle" framework, which considers a combination of individual risk factors, environmental factors and factors intrinsic to the game itself. This article presents a discussion of the recently proposed diagnosis of gaming disorder in the context of its diagnostic criteria and aetiological factors and concludes by discussing possible implications for clinical practice.

Assessment and Treatment of Attachment-Related Aspects in Adolescents with Personality Disorders In recent years the relevance of attachment-related aspects in psychotherapy research has increased. This approach offers an opportunity to test the effectiveness of specific psychotherapeutic procedures for personality disorders in adulthood. Although there are a number of novel psychotherapeutic interventions for personality disorders that were adapted for adolescents, there is still a lack of research on studies that consider attachment-related characteristics. The present study demonstrates attachment-related aspects in a large sample of in-patient adolescents with personality disorders. Therapeutic implications of these findings will be outlined and discussed in the context a new attachment-based intervention tool. This tool might be particularly useful to help patients facing individual aspects of their attachment trauma and to develop more adaptive emotion regulation strategies in interpersonal contexts.

Developmental, Behavioral and Emotional Disorders with Onset in Childhood and Adolescence - Changes and Implementation in ICD-11and a Comparison to the DC:0-5 The 11th and latest revision of the International Statistical Classification of Diseases and Related Health Problems, ICD-11, is available and brings significant changes and innovations to the field of child and adolescent psychiatry and psychotherapy. Many of these changes relate to developmental, behavioural and emotional disorders with onset in childhood and adolescence and are particularly important for diagnosis and treatment in (early) childhood. This paper describes the ICD-11 diagnostic criteria for the most important disorders in this age group and highlights structural and substantive changes. A comparison is also made with the diagnostic criteria of the DC:0-5, a classification system for mental health and developmental disorders in infants, toddlers and preschool children.

Sexual Self in Disquiet - Gender Incongruence in ICD-11 The ICD-11 represents a shift in the clinical conceptualization and diagnostic assessment of variant gender identity developments. The revised approach to describing individuals whose gender identity does not align with their natal sex is reflected in the departure from the previous pathogenetic understanding and is demonstrated by the introduction of the diagnosis of "gender incongruence" as a "condition related to sexual health". In this article, the diagnostic and theoretical revisions in the ICD-11 are discussed in the context of previous and ongoing debates about the appropriate classification of this phenomenon in children and adolescents. The practical implications for the treatment of minors are then examined, with a particular focus on adolescents after the onset of puberty. At this age, requests for body-modifying procedures are frequently expressed and present significant clinical and ethical challenges in treatment practice. The diagnostic revisions in the ICD-11 are recognized as a pivotal advance in the de-stigmatization of variant gender identity developments. At the same time, this article argues for the necessity of a clinically oriented approach, which includes careful differential diagnosis and psychotherapeutic exploration, to address the complex needs of adolescent patients, particularly those who seek irreversible body-modifying interventions and often experience significant psychological distress.

Prevention of Acute Alcohol Intoxication in Children and Adolescents: Drinking Circumstances and Recommendations from the Perspective of Affected Parents and Adolescents Alcohol consumption among children and adolescents in Germany is showing a downward trend. However, a significant number of minors reports risky drinking patterns that lead to alcohol intoxication requiring inpatient treatment. Findings on drinking circumstances that precede alcohol intoxication and on rules on alcohol consumption are essential for the further development of effective prevention strategies. Quantitative data analyses and qualitative interviews were used to investigate drinking circumstances that precede acute alcohol intoxication in children and adolescents as well as rules for alcohol consumption before and after the event of the intoxication. N = 201 children and adolescents took part in the survey on drinking circumstances that precede acute alcohol intoxication. While 31.3 % of respondents did not habitually consume alcohol at risk, 15.9 % reported binge drinking on a monthly basis and 15.9 % on a weekly or more frequent basis. Particular risk situations are the consumption of spirits, consumption in private settings and being found outdoors. In-depth interviews were conducted with N = 8 children and adolescents and N = 9 guardians. Young people emphasized strategies to minimize risk and communication with guardians as helpful, while parents recommended increased monitoring, communication and prohibitions. The greatest uncertainty was reported in dealing with non-compliance with rules. Preventive measures should start early, provide information about drinking circumstances that often precede intoxication and give clear recommendations for drinking rules.

Sexual Risks in Young Patients in Inpatient Child and Adolescent Psychiatric and Psychotherapeutic Addiction Treatment Engaging in fulfilling and low-risk sexual relationships is a developmental task in adolescence and young adulthood. At the same time, sexual contact is associated with risks, including early and/or unwanted pregnancies, sexually transmitted infections (STIs) and negative sexual experiences. In the present study, n = 84 inpatients in child and adolescent psychiatric and psychotherapeutic addiction treatment aged between 13 and 19 years were examined. The aim was to determine how many participants had experienced sexual risks due to (1) sexual contact under the influence of alcohol and/or drugs, (2) sexual contact without a condom outside of a committed relationship and (3) regretted sexual contact. It was also checked whether there was a state of intoxication during the situation in the three risk situations. 69.7 % of adolescent SUD patients stated that they had had sexual contact under the influence of alcohol and/or drugs. 46.1 % of SUD patients reported unprotected sexual intercourse in the last 12 months. A total of 53.6 % of female and 12.5 % of male adolescent SUD patients reported regretting sexual contact. 90 % of cases occurred while intoxicated, regardless of gender. No connection to comorbid disorders was found, but there was a clear connection to the impulsivity factor urgency. The figures indicate that young SUD patients are at considerable risk of having unwanted sexual experiences. Preventive measures should take into account aspects of managing urgency.

School Absence as Functional Impairment of Juveniles with Personality Disorders Based on ICD-11 This longitudinal study focused on the question whether specialized treatment with applied transference focused psychotherapy in a day hospital program can improve school dysfunction in adolescents with borderline and other personality disorders (PD). Moreover, we investigated influential factors for the improvement of school attendance. Among the 175 juvenile patients, before treatment 60 % showed school absence. Our results indicate that the treatment could improve school attendance significantly. At the same time, we could show that some psychological variables can be considered essential predictors for the development of attending school regularly. More conduct problems and dissocial behavior diminished the likelihood to attend school increasingly regular; the higher borderline and avoidance PD criteria were fulfilled, the higher were the odds to improve school attendance. With respect to the changes regarding functional impairment of PD in the upcoming ICD-11 our results could generate knowledge that school dysfunction in adolescents with PD can be improved significantly with applied transference focused psychotherapy in a day hospital program, especially in juveniles with borderline and avoidant PD. The alteration in ICD-11 with its focus on functional impairment enables to assess and treat this problem earlier in adolescence. A specific focus for future research based on ICD-11 should address the issue how juveniles with pd, school dysfunction and conduct problems can benefit more from treatment.

New Media and Addiction in Youth New media, such as digital games, social media, and video streaming services, have emerged as fundamental channels for socialization and leisure activities among young people. Platforms such as TikTok, Fortnite, and YouTube do not only provide entertainment, enjoyment, and opportunities for social connection, but also carry the risk of excessive use. Particularly vulnerable youth, who turn to media to escape real-world problems and conflicts, can quickly become trapped in a vicious cycle, resulting in problematic usage habits with significant psychosocial consequences. This review presents the current state of research on Digital Media Use Disorders (DMUD) in youth. It outlines diagnostic criteria, presents recent data on epidemiology, etiology, and treatment approaches, and discusses implications for prevention. DMUD in youth remains a serious health issue in the aftermath of the pandemic. Parents and schools play a crucial role in guiding children and adolescents towards media literacy and self-regulated use of digital media. But also game and platform providers, who often employ manipulative mechanisms that prevent a self-regulated use, need to be held accountable. The introduction of the European Digital Services Act represents a crucial step in this direction.

Employees in child and adolescent psychiatry navigate a complex field of ethical requirements. At the Clinic for Children and Adolescents of the University Psychiatric Clinics Basel (UPKKJ), these areas of tension were examined in a project that spanned across numerous departments and professional groups. Based on a survey study and a narrative literature review, ethical guidelines were developed: the UPKKJ Ethics Compass. The Ethics Compass highlights various areas such as participation, child welfare, justice and developmental health, which are relevant to the relationships between children, adolescents, parents, and the treatment team. To implement these principles in everyday clinical practice, the Ethics Compass is now regularly used in case work and as a communication aid with external partners. Furthermore, a procedural action plan was developed for collaboration with the Department of Clinical Ethics at the University Hospitals in Basel.

Prevention of Child Sexual Abuse: Prevention Programs and Safeguarding Concepts in the Context of Sports, Musical Education, and Religious Organizations Prevalence rates of child sexual abuse by caregivers in private and non-public institutions underscore the need for implementing safeguarding concepts. However, factors driving the implementation of prevention and safeguarding in the field are not well understood. What supportive and inhibiting factors can be identified in the implementation of safeguarding concepts and prevention programs? Content analysis of semi-structured interviews with professional and volunteer staff in clubs and institutions (n = 10, 69 % female) as well as with individuals who experienced child sexual abuse during their childhood (n = 3, 66 % female). Safeguarding concepts in clubs or religious institutions were primarily initiated by umbrella organizations. Current incidents of child maltreatment, public pressure, and media attention substantially increased the need for preventive actions. The provision of training, resources, and networking structures by umbrella organizations further facilitated their implementation. Main implementation challenges included limited personnel and time resources, lack of expertise, insufficient training opportunities, and absence of guidelines and support from umbrella organizations. Due to club leaders' limited knowledge and resources an independent implementation of safeguarding concepts is largely lacking without concrete guidelines and support from umbrella organizations. To upscale safeguarding, public policies or incentive systems such as state-funded child protection certifications are thus paramount.

Implicit and explicit bias and distortions of perception are partly responsible for the unequal and significantly deficient psychotherapeutic and psychiatric care situation for children and adolescents with intellectual disabilities and additional behavioral problems. The extent to which these biases influence misdiagnoses and treatment errors, refusals and exclusions from professional care, and grossly hostile rejections of people with disabilities requires empirical evidence (Bartig et al., 2021). The fact that all forms occur - probably to a considerable extent - contradicts the ethical principles of the medical and psychotherapeutic profession. In order to avoid misdiagnosis and treatment as a result of bias, this must be openly addressed. Selfawareness, supervision and second views, the concept of working diagnosis and, above all, the full application of child and adolescent psychiatric standards help to reduce bias.

The Treatment of Children and Adolescents with Substance-Related Disorders in the German Health Care System - a Quantitative Study This study evaluates the minimum characteristics of OPS code 9-694 for specific treatment in special settings for substance-related disorders in children and adolescents. The research questions to be answered are the extent to which given minimum characteristics and potentials are assessed as practical, up-to-date, needs-oriented and necessary. The survey was conducted using a nationwide online survey in special wards of child and adolescent psychiatric clinics. Given minimum characteristics reflect everyday clinical practice and are assessed as practical, up-to-date and relevant. Nevertheless, setting- and method-specific potential for further development was identified, most of which has already been implemented in the clinics but has not yet been incorporated into the minimum characteristics. The topic has received little research attention to date. The findings of the original study can provide a basis for the optimization and adaptation of minimum characteristics and treatment offers for children and adolescents with substance-related disorders and lead to the further development of the OPS code. A theory-practice transfer tailored to the target group requires the networking of individual players in the help system as well as the health policy discussion and gradual adaptation of the content of given minimum characteristics and potential for change.