Kerstin J von Plessen

• MD, PhD
• Professor (Full) at Division of Child and Adolescent Psychiatry

Background The 40-Hz auditory steady state response (ASSR) is reduced in patients with schizophrenia and bipolar disorder. Recent evidence suggests that ASSR may be altered in clinical high risk and familial high-risk populations. Here, we hypothesize that children aged 11-12 years with familial high risk for schizophrenia and bipolar disorder exhi...

Background The atypical antipsychotics risperidone and aripiprazole are metabolized by the cytochrome P450 2D6 (CYP2D6), as are ~20% of currently prescribed medications. According to the enzyme level of activity, individuals can be categorized as ultrarapid, normal, intermediate, or poor (UM, NM, IM and PM, respectively) CYP2D6 metabolizers. Greate...

Background: Phasic irritability, expressed through temper outbursts, is a common cause of seeking help for adolescents with behavioural problems (i.e., externalizing problems). Previous studies have investigated this phenomenon from a quantitative perspective, leaving the subjective lived experiences largely unexplored. Objective: This qualitative...

Manual video annotation for observing behaviours in clinical settings is time-consuming, subject to potential bias, and resource-intensive. We developed an automated pipeline to analyse unscripted videos involving 2–5 individuals, including children with a range of neurodevelopment disabilities in art therapy sessions. Using YOLOv8, MediaPipe, OSNe...

Background It is known that impairments in linguistic ability and motor function tend to co-occur in children, and that children from families with parental mental illness such as schizophrenia tend to perform poorly in both domains, but the exact nature of these links has not yet been fully elucidated. Design In this study, we leveraged the first...

Background: Lifestyle is a key determinant of physical and mental health. Reducing unhealthy behaviors, such as inadequate sleep, physical inactivity, and poor diet among children and adolescents may prevent serious long-term consequences on physical and mental health. However, empirical evidence on the temporal dynamic interrelationships of multip...

Background: Lifestyle is a key determinant of physical and mental health. Reducing unhealthy behaviors, such as inadequate sleep, physical inactivity, and poor diet among children and adolescents may prevent serious long-term consequences on physical and mental health. However, empirical evidence on the temporal dynamic interrelationships of multip...

Among youths, pathological irritability is highly prevalent and severely disabling. As a frequent symptom, it often leads to referrals to child and adolescent mental health services. Self-regulatory control (SRC) processes are a set of socio-psycho-physiological processes that allow individuals to adapt to their ever-changing environments. This con...

Background Tourette syndrome (TS) is associated with neuropsychiatric comorbidities, such as autism spectrum disorder (ASD), attention‐deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Even though comorbidities are the main source of impairment in individuals with TS, family aggregation between TS and other neuropsychia...

Introduction: Clinical High Risk for Psychosis (CHR) states are associated with an increased risk of transition to psychosis. However, the predictive value of CHR screening interviews is dependent on pretest risk enrichment in referred patients. This poses a major obstacle to CHR outreach campaigns since they invariably lead to risk dilution throug...

Non-suicidal self-injury (NSSI) is an increasing mental health issue among adolescents. General practitioners and pediatricians play a crucial role in detecting, evaluating, and managing these behaviors. This article aims to provide recommendations for the first line surrounding the young person, such as the appropriate stance to adopt and the use...

Background & Objectives: Terror catastrophizing, defined as an ongoing fear of future terrorist attacks, is associated with a higher incidence of anxiety disorders, among other psychological impacts. However, previous studies examining terror catastrophizing’s relationship to other mental health disorders are limited. The current study sought to de...

Objectives This systematised review aimed to examine European literature reporting data about adaptative skills and global external functioning of unaccompanied minors (UAMs). Methods We conducted a systematised screening of four databases (APA PsycINFO Ovid, Medline Ovid ALL, Embase.com and Web Of Science Core Collection) using a research strateg...

Introduction Oxytocin has been implicated as a biological mechanism within obsessive-compulsive disorder (OCD). Few studies only involving adults have investigated this hypothesis and found inconsistent results. We investigated whether salivary oxytocin concentrations differed between children and adolescents with and without OCD and qualified our...

Adolescence is a time of increased vulnerability to mental health conditions, which may necessitate hospitalization. This study sought to identify and characterize patterns of adolescent (re-)hospitalizations. The one-year (re-)hospitalization patterns of 233 adolescents were analyzed. The sequences of hospitalization and discharge was examined usi...

Background Therapeutic drug monitoring (TDM) is strongly recommended for olanzapine due to its high pharmacokinetic variability. This study aimed to investigate the impact of various clinical factors on olanzapine plasma concentrations in patients with psychiatric disorders. Methods The study used TDM data from the PsyMetab cohort, including 547 d...

Psychiatrists play a crucial role in evaluating requests and treatment indications for individuals experiencing gender incongruence, while also providing support throughout the transition process. Their work involves addressing both the psychological and somatic aspects of this journey, facilitating the profound identity changes it entails.

Aim: We aim to give an insight into the current situation in Switzerland concerning the pathways to care of young people with clinical high risk of psychosis. In a second step we propose a procedure of optimizing pathways to care developed within the project PsyYoung. Methods: A qualitative survey derived and adapted from Kotlicka‐Antczak et al. (...

Objective: The aim of this study was to evaluate valproate dose association with weight change, blood glucose, lipid levels, and blood pressure in a psychiatric population. Methods: Data from 215 patients taking valproate for up to 1 year were collected from 2 longitudinal studies that monitored metabolic variables between 2007 and 2022. Linear mix...

Over half of children with Attention-Deficit/Hyperactivity Disorder (ADHD) display interpersonal and social problems. Several lines of research suggest that suboptimal decision making, the ability to adjust choices to different risk-varying options, influences poorer choices made in social interventions. We thus measured decision making and its pre...

Background Metabolic side effects of psychotropic medications are a major drawback to patients’ successful treatment. Using an epigenome-wide approach, we aimed to investigate DNA methylation changes occurring secondary to psychotropic treatment and evaluate associations between 1-month metabolic changes and both baseline and 1-month changes in DNA...

Autism spectrum disorder (ASD), Tourette syndrome (TS), and attention-deficit/hyperactivity disorder (ADHD) display strong male sex bias, due to a combination of genetic and biological factors, as well as selective ascertainment. While the hemizygous nature of chromosome X (Chr X) in males has long been postulated as a key point of “male vulnerabil...

The transgenerational effects of parental diagnoses, trauma and coping mechanisms on children’s internalizing symptoms are not well understood. In a population-based study of 933 families combining data from a web-based survey and the Danish registers, we used an online survey of parents to examine how parental diagnoses, trauma and coping mechanis...

Atypical neurocognitive functioning has been found in adult patients with obsessive–compulsive disorder (OCD). However, little work has been done in children and adolescents with OCD. In this study, we investigated neurocognitive functioning in a large and representative sample of newly diagnosed children and adolescents with OCD compared to non-ps...

Objective This study aimed to better understand the temporal interrelationships among self‐control, response inhibition, and anger (i.e., momentary state and rumination) on both the within‐ and between‐person levels in male adolescents. Method We applied temporal network analyses among 62 male adolescents with a wide range of behavioral difficulti...

Background and hypotheses: Impaired executive control is a potential prognostic and endophenotypic marker of schizophrenia (SZ) and bipolar disorder (BP). Assessing children with familial high-risk (FHR) of SZ or BP enables characterization of early risk markers and we hypothesize that they express impaired executive control as well as aberrant br...

Background Despite advances in the etiology of anorexia nervosa (AN), a large subgroup of individuals does not profit optimally from treatment. Perfectionism has been found to be a risk factor predicting the onset, severity, and duration of AN episodes. To date, perfectionism has been studied predominantly by the use of self‐report questionnaires,...

Aims: Psychotic disorders are one of the main causes of chronic disability in young people. An at-risk mental state (ARMS) is represented by subclinical symptoms that precede the first episode of psychosis (FEP). The PsyYoung project aims to optimize the detection of an ARMS while reducing unnecessary psychiatric treatments. It investigates the eff...

Background and hypothesis: Individuals with schizophrenia or bipolar disorder have attenuated auditory mismatch negativity (MMN) responses, indicating impaired sensory information processing. Computational models of effective connectivity between brain areas underlying MMN responses show reduced connectivity between fronto-temporal areas in indivi...

Objective: The objective of this study was to investigate the predictive value of sex, age, body mass index (BMI), Eating Disorder Examination (EDE) score, social risk factors, and psychiatric comorbidities for hospitalization and hospitalization duration among children and adolescents suffering from eating disorders. Method: This prospective co...

Background The exact etiology of Tourette Syndrome (TS) remains unclear, making the search for impaired neuropsychological functions possibly connected to the underlying cause of TS as important as it is challenging. One neuropsychological domain of interest is fine motor skills. Method This study compared fine motor skill performance on the Purdu...

Background: Attachment quality may affect psychological functioning. However, evidence on attachment representations and their correlates in children born to parents with schizophrenia and bipolar disorder is sparse. Methods: We compared attachment representations in a Danish sample of 482 children aged 7 years at familial high risk of schizophr...

Mind My Mind (MMM) cognitive behavioral therapy (CBT) manualized treatment is effective in the management of common emotional and behavioral mental health problems in youth, yet not all individuals respond satisfactorily to treatment. This study explored potential effect modifiers, i.e., baseline factors associated with a differential treatment eff...

Background: Knowledge on adverse events in psychotherapy for youth with OCD is sparse. No official guidelines exist for defining or monitoring adverse events in psychotherapy. Recent recommendations call for more qualitative and quantitative assessment of adverse events in psychotherapy trials. This mixed methods study aims to expand knowledge on...

Patients suffering from mental disorders are at high risk of developing cardiovascular diseases, leading to a reduction in life expectancy. Genetic variants can display greater influence on cardiometabolic features in psychiatric cohorts compared to the general population. The difference is possibly due to an intricate interaction between the menta...

The aims of this study were to investigate the associations of major depressive disorder (MDD) and its subtypes (atypical, melancholic, combined, unspecified) with actigraphy-derived measures of sleep, physical activity and circadian rhythms; and test the potentially mediating role of sleep, physical activity and circadian rhythms in the well-estab...

Gestion des soins. Selon un rapport sur la densité des soins médicaux ambulatoires dans les différents cantons, le recours aux prestations psychiatriques et psychologiques serait en partie supérieur à la moyenne. Le volume des ressources mises à disposition ne serait donc pas adapté aux besoins. Mais est-ce vraiment le cas?

Versorgungssteuerung. Psychiatrisch-psychologische Leistungen werden laut einem Bericht zur Dichte der ambulanten medizinischen Versorgung in den einzelnen Kantonen teilweise überdurchschnittlich in Anspruch genommen. Der Umfang der bereitgestellten Ressourcen wäre somit nicht bedarfsgerecht. Aber ist das wirklich der Fall?

Le département de l'instruction publique, de la formation et de la jeunesse (DIP) et le département de la sécurité, de la population et de la santé (DSPS) ont mandaté deux experts afin de réaliser une analyse sur les prestations de pédopsychiatrie, psychologie scolaire et pédagogie spécialisée du Canton de Genève. Les auteurs de cette analyse son...

Background: Dysregulation of the HPA-axis, perceived stress and interpersonal trauma are associated with an elevated risk for schizophrenia and bipolar disorder. Being at familial high-risk of these two mental disorders also constitutes an increased risk. In this study, we aimed to investigate hair cortisol concentrations and perceived stress amon...

Background: Antipsychotic-induced metabolic adverse effects are risk factors for cardiometabolic comorbidities. Whether dose lowering could mitigate such effects remains unclear. The present study aims to investigate the associations between clozapine doses and modifications of weight, blood pressure, blood glucose, and lipid levels. Study design...

This study investigates early onset of treatment response as predictor of symptomatic and functional outcome 3 years after initiation of methylphenidate (MPH) administration in a naturalistic, clinical cohort of children and adolescents with ADHD. Children were followed across an initial 12-week MPH treatment trial and after 3 years, with ratings o...

Background Several studies have shown associations between maternal interpersonal violence-related posttraumatic stress disorder (PTSD), child mental health problems, and impaired socioemotional development. However, the existing literature lacks evidence linking constellations of risk factors such as maternal interpersonal-violence-related PTSD, p...

Background: Tourette Syndrome (TS) is a childhood-onset neurodevelopmental disorder of complex genetic architecture, characterized by multiple motor tics and at least one vocal tic persisting for more than one year. Methods: We performed a genome-wide meta-analysis integrating a novel TS cohort with previously published data, resulting in a samp...

In bipolar disorder, dysregulation of affect is a core feature while knowledge on affective lability in schizophrenia is sparse. Research on affective lability in partners to individuals with schizophrenia or bipolar disorder is also lacking. The objective of this study was to investigate affective lability in parents with schizophrenia or bipolar...

Introduction In this study, we aimed to examine the association between aggressive ideations and aggressive behaviors in everyday life, as well as the role of processes related to self-regulatory control (i.e., self-control, ego depletion, and emotional states), using experience sampling methods (ESM). Methods A total of 62 male adolescents perfor...

Background: Motor abnormalities have clinical relevance as a component of psychotic illness; they are not only a proxy of altered neurodevelopment, but also intimately related to psychotic risk. We aimed to assess motor development and its association with psychotic experiences in children with familial high risk (FHR) of schizophrenia or bipolar...

Many psychiatric and neurodevelopmental disorders are known to be heritable, but studies trying to elucidate the genetic architecture of such traits often lag behind studies of somatic traits and diseases. The reasons as to why relatively few genome-wide significant associations have been reported for such traits have to do with the sample sizes ne...

Background Cardiometabolic dysfunction is common in young people with psychosis. Recently, the Psychosis Metabolic Risk Calculator (PsyMetRiC) was developed and externally validated in the UK, predicting up-to six-year risk of metabolic syndrome (MetS) from routinely collected data. The full-model includes age, sex, ethnicity, body-mass index, smok...

Background and hypotheses: Impaired interference control is a potential prognostic and endophenotypic marker of schizophrenia (SZ) and bipolar disorder (BP). Assessing children with familial high-risk (FHR) of SZ or BP enables characterization of early risk markers and we hypothesize that they express impaired interference control as well as aberra...

Background Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder which affects up to 3% of children and adolescents. OCD in children and adolescents is generally treated with cognitive behavioural therapy (CBT), which, in more severely affected patients, can be combined with antidepressant medication. The TECTO trial aims to co...

Background Several psychotropic drugs can induce weight gain and metabolic alterations. The authors compared metabolic evolutions of patients switching versus continuing psychotropic treatments with different risk profiles. Methods Patients either switched from a high- to a medium- (N = 36) or low-risk drug (N = 27), from a medium- to a low-risk d...

PurposeKnowledge about representativity of familial high-risk studies of schizophrenia and bipolar disorder is essential to generalize study conclusions. The Danish High Risk and Resilience Study (VIA 7), a population-based case–control familial high-risk study, creates a unique opportunity for combining assessment and register data to examine coho...

Tourette Syndrome (TS) is a complex neurodevelopmental disorder characterized by vocal and motor tics lasting more than a year. It is highly polygenic in nature with both rare and common previously associated variants. Epidemiological studies have shown TS to be correlated with other phenotypes, but large-scale phenome wide analyses in biobank leve...

Introduction Many psychotropic drugs can induce weight gain with differences in their metabolic risk profiles (i.e. high, medium or low-risk). Objectives To compare the weight evolution of patients switching versus patients keeping their psychotropic drugs with different risk-profiles. Methods Data for patients switching or keeping the same drug...

Introduction Metabolic side effects of psychotropic medications are a major drawback to patients’ effective treatment. Among the mechanisms underlying their development, DNA methylation may be involved. Objectives The aim of this study was to estimate DNA methylation changes occurring secondary to psychotropic treatment and evaluate associations b...

Introduction High BMI has been associated with psychiatric rehospitalisation. Objectives We aimed to replicate this finding in a large Swiss psychiatric cohort and to examine whether other metabolic disturbances are independently associated with psychiatric readmission. Methods Data on 16’727 hospitalizations of 7’786 patients admitted between Ja...

Objectives: Emotion regulation is a predictor of overall life outcome. Problems of emotion regulation are associated with multiple psychiatric disorders and could be a potential treatment target for improving well-being and functioning. Children at familial high risk of severe mental illness have a markedly increased risk of various psychopatholog...

Background: Psychiatric disorders are highly polygenic and show patterns of partner resemblance. Partner resemblance has direct population-level genetic implications if it is caused by assortative mating, but not if it is caused by convergence or social homogamy. Using genetics may help distinguish these different mechanisms. Here, we investigated...

Background Prior studies have shown high heritability estimates regarding within-function transmission of neurocognition, both in healthy families and in families with schizophrenia but it remains an open question whether transmission from parents to offspring is function specific and whether the pattern is the same in healthy families and families...

Background Infrequent deviants in a rapid sequence of sounds elicit a negative cortical potential over the frontocentral midline (mismatch negativity, MMN) followed by a positive deflection (P3a). Both cortical potentials are consistently attenuated in patients with schizophrenia (SZ), and, to a lesser degree, in patients with bipolar disorder (BP)...

Objective: Studies on parental socioeconomic status (SES) and family risk factors for eating disorders (EDs) have yielded inconsistent results; however, several studies have identified high parental educational attainment as a risk factor. The aim was to evaluate associations of parental SES and family composition with anorexia nervosa (AN), bulim...

Objectives Our objective was to evaluate the cost-effectiveness of the transdiagnostic psychotherapy program Mind My Mind (MMM) for youth with common mental health problems using a cost-utility analysis (CUA) framework and data from a randomized controlled trial. Furthermore, we analyzed the impact of the choice of informant for both quality-of-lif...

This study investigates indicators of disorganized caregiving among caregivers of children who have a familial predisposition of schizophrenia spectrum psychosis (SZ) or bipolar disorder (BP), and whether indicators of disorganized caregiving are associated with the caregivers’ and children’s level of functioning as well as the children’s internali...

Cognitive heterogeneity characterizes individuals with schizophrenia and bipolar disorder; however, little is known of cognitive heterogeneity within young children at familial high-risk of schizophrenia or bipolar disorder. This study aimed to investigate heterogeneity across social cognitive and language functions in children at familial high-ris...

UNSTRUCTURED Artificial intelligence (AI) tools have the potential to objectively identify youth in need of mental health care. Speech signals have demonstrated promise as a source for predicting various psychiatric conditions and transdiagnostic symptoms. Thus, we designed a study testing the association between obsessive compulsive disorder (OCD)...

Background Artificial intelligence tools have the potential to objectively identify youth in need of mental health care. Speech signals have shown promise as a source for predicting various psychiatric conditions and transdiagnostic symptoms. Objective We designed a study testing the association between obsessive-compulsive disorder (OCD) diagnosi...

Background Children born to parents with severe mental illness are at increased risk of mental and behavioral difficulties during childhood. We aimed to investigate the occurrence of clinically significant behavioral difficulties in 7-year-old children of parents diagnosed with schizophrenia or bipolar disorder as well as in control children by usi...

Study objectives Insomnia disorders as well as cardiometabolic disorders are highly prevalent in the psychiatric population compared to the general population. We aimed to investigate their association and evolution over time in a Swiss psychiatric cohort. Methods Data for 2861 patients (8954 observations) were obtained from two prospective cohort...

Rationale Transition in psychiatry refers to the period where young people transit from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). Discontinuity of care during this period is well-documented but little is known about provisions and transition characteristics and policies across Switzerland. The aim o...

Background: Atypical antipsychotics can induce metabolic side effects, but whether they are dose-dependent remains unclear. Objective: To assess the effect of risperidone and/or paliperidone dosing on weight gain and blood lipids, glucose, and blood pressure alterations. Methods: Data for 438 patients taking risperidone and/or its metabolite (pal...

We investigated whether a novel visitation model for school-aged youth with mental health problems based on a stage-based stepped-care approach facilitated a systematic identification and stratification process without problems with equity in access. The visitation model was developed within the context of evaluating a new transdiagnostic early tre...

Abstract Background The factors involved in the transmission of mood disorders are only partially elucidated. Aside from genes, the family environment might play a crucial role in parent–child transmission. Our goals were to (1) assess the associations of parental bipolar disorder (BPD) and Major Depressive Disorder (MDD) with individual or shared...

Abstract Background Cognitive behavioural therapy (CBT) is the recommended first-line treatment for children and adolescents with obsessive-compulsive disorder (OCD), but evidence concerning treatment-specific benefits and harms compared with other interventions is limited. Furthermore, high risk-of-bias in most trials prevent firm conclusions rega...

Deficits in self-regulatory control (SRC) represent a core characteristic of externalizing (EXT) symptoms (e.g., rule-breaking behavior or aggressive behaviors) in adolescents. This review aims to specify the added value of ecologically valid assessments at a micro-level when examining the associations between SRC and EXT symptoms in adolescents. T...

Objectives: Childhood trauma increases the risk of developing mental illness as does being born to parents with schizophrenia or bipolar disorder. We aimed to compare prevalence of lifetime childhood trauma among 11-year-old children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) compared with population-based control...

Background Facing multiple risk factors, relative to single risk factor exposure early in life can have great implications for negative child development. Objective We aim to examine whether the prevalence of early risk factors is higher among children with familial high risk for schizophrenia or bipolar disorder compared to controls. Further, to...

Introduction Adults who have histories of childhood trauma have been noted to display greater somatization, dissociative symptoms and affect dysregulation. What happens in the parent-child relationship when those traumatized children become parents? A potential link to somatization in the child has been suggested by several prior studies. Children...