Original keynote abstract by Johannes Hebebrand (University of Duisburg-Essen, Germany) on Pre- and postnatal Screening: Implications for Child and Adolescent Psychiatry (ESCAP 2017 Congress in Geneva, Switzerland). Scheduled for Tuesday, 11 July 2017, 09:45AM.
In this selective review we provide an overview of the current pre- and postnatal screenings up to 18 years; wherever appropriate and possible, we will reference the findings of the United States Preventive Services Task Force. Whereas national differences in screening programs definitely exist, the overlap is substantial in Western European countries in particular for neonatal screening programs. Most of the screening procedures are related to the diagnosis of somatic disorders; among these both chromosomal and monogenic disorders figure prominently in prenatal and neonatal screening programs. Despite the substantial combined disease burden in childhood and adolescence, screening for (symptoms of) mental disorders is infrequently performed; suboptimal specificity and sensitivity of established screening instruments for mental symptoms entail questions as to feasibility. In addition, an effective treatment outcome needs to be documented in order to warrant initiation of screening for mental disorders. In essence, the benefits of such screening procedures should outweigh the risks. In adults, initially perceived benefits of screening programs have been subjected to scientific scrutiny with a special focus on the implications of positive screening findings; in some instances, initial recommendations were retracted. Thus, there is a need to broaden the evidence basis related to medical screenings especially for children and adolescents. Potential future developments of pre- and postnatal screenings are illustrated including their societal impacts. The lack of an early detection of mental health problems is pointed out; at the same time, we illustrate the requirements that should be fulfilled prior to initiation of screening programs for mental disorders. An interdisciplinary collaboration and research is required to accumulate evidence with regard to screenings and to consider health economic and ethical aspects.