Child & Adolescent Psychiatry

The articles in this Special Report, although far from comprehensive, address an intriguing sample of the many key topics in child and adolescent psychiatry today.

Child and adolescent psychosomatic medicine, usually in the realm of the pediatric psychiatric consultation-liaison service, seeks to address the complex relationship between a child's physical illness and affective state with the goal of improving the child's emotional well-being.

The American Academy of Child and Adolescent Psychiatry recently published a practice parameter with evidence-based guidelines for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Recommendations for the best treatment practices were made based on empirical evidence and clinical consensus, and the strength of these recommendations was based on the extent and degree of these variables. This column will provide a summary of the parameter.

There is no shortage of hyperbole when politicians of all stripes describe the nature and effects of video games. Republican presidential candidate Mitt Romney proclaimed, "Pornography and violence poison our music and movies and TV and video games.

Attachment may be defined as a composite of behaviors in an infant, toddler, or young child that is designed to achieve physical and emotional closeness to a mother or preferred caregiver when the child seeks comfort, support, nurturance, or protection.

In our presentation at the 2006 annual meeting of the American Academy of Child and Adolescent Psychiatry, we suggested that child psychiatrists who come across a child with the profile of the following hypothetical case should consider whether the child may have deficits that are not currently covered by DSM-IV nosology: either a nonverbal learning disability (NVLD) or a sensory processing disorder (SPD).

One of the major challenges in child psychiatry is teaching the essentials of the field to the general physician or medical school student who needs some understanding of developmental issues and psychopathology. Dorothy Stubbe's contribution to this challenge is a small and well-written handbook published as part of the series, Practical Guides in Psychiatry.

Numerous studies have documented the increasing prevalence of mental health and substance abuse issues in youths nationwide. As many as 1 in 5 children and adolescents in the United States have a behavioral or emotional disorder.

Assessing bullying behavior and suicide attempts in victims of bullying.

Recent imaging studies have shown that patients with autism spectrum disorders (ASDs) who were presented with images of human faces had lower responses in amygdala activity than controls. These studies strengthen the connection between the amygdala and the abnormal social-emotional behavior seen in patients with ASDs, said Chris Ashwin, PhD, senior research associate at the Autism Research Centre in the Department of Psychiatry at the University of Cambridge, UK.

Persons with childhood-onset schizophrenia appear to have the poorest outcome among those in whom schizophrenia is diagnosed.

New Act by Congress Gives Boost to Autism Research

Until recently, there has been a relative paucity in the selection of comprehensive child psychiatry textbooks for clinicians. Child and Adolescent Psychiatry: The Essentials finds a place in this special niche by providing comprehensive yet practical information that can be used in a variety of settings.

Sleep disorders are very common and are often underrecognized and underreported in children. If left untreated, these disorders can cause serious developmental and physiologic problems.

The continuation of the epidemic of childhood obesity and overweight has major implications and consequences for future research in psychopathology.

Infant, or developmental, psychiatry is a subspecialty of child and adolescent psychiatry that focuses on the promotion of mental health in infants, toddlers, preschoolers, and their families through the consultation, assessment, and treatment of clinical problems.

Current treatments for autistic spectrum disorders (ASD) are useful in some cases, but have little enduring impact. This had lead to many parents seeking nonconventional treatments that often border on quackery.

Cognitive-behavioral therapy (CBT) for children with anxiety disorders may be especially effective when the family is included in treatment.

autism, mirror neuron defect

A black box warning about increased suicidality in pediatric patients is now required for all antidepressant medications. This column reviews a number of studies on this topic that were published after the FDA advisory was issued.

Evidence-Based Therapies in Child and Adolescent Psychiatry by Jon McClellan, M.D. Given the lack of large, randomized controlled studies of psychiatric medications that involve children and adolescents, it can be difficult to establish evidence-based therapies that are effective for this population. However, there are studies that have shown the effectiveness of various medications, as well as for various psychotherapy techniques.

Antiepilepsy drug use in children presents special challenges because, unlike adults, treatment-emergent neuropsychological deficits occur against the backdrop of cognitive and psychosocial development, with treatment decisions having lifelong implications.

This article will provide an overview of treatment modalities, with emphasis on the future direction of interventions targeting aggression in children with autism.

Treating bipolar disorder in young patients can often result in aggravation, irritability or even reactivation depending on the type of medication used. What are typical examples of medication-induced rebound and what are the implications of these types of responses in children?

In an attempt to reframe the either-or debate over the impact of genetics versus environment on emotional makeup, a panel convened at the American Psychoanalytic Association’s Winter 2005 Meeting in New York City. This article highlights studies presented at the meeting.

Autism is a highly prevalent, highly heterogeneous disorder of unknown etiology. Studies to clearly establish the efficacy of various classes of psychoactive drugs are scarce. Nonetheless, available findings do support the efficacy of atypical antipsychotics and antidepressants in treating the core symptoms of repetitive behavior.

Bipolar disorder in children is particularly difficult to treat. A treatment algorithm combining pharmacology with psychotherapy in order to get optimal results is presented.

The diagnosis of bipolar disorder in children remains controversial. One of the more disturbing facets of its presentation in such young patients is the presence of hypersexual behavior. How can these behaviors be differentiated from the effects of abuse and other psychiatric disorders?

With the increase in child and adolescent patients comes an increase in challenging cases. Dr. Schowalter introduces this Child and Adolescent Psychiatry Special Report and provides perspective on articles discussing approaches to initiating care with a teen-ager, collaborating with pediatricians and other clinical topics.

Many children today are receiving inadequate mental health care due to a decrease in the number of well-trained providers, while the prevalence of children's mental health problems is increasing. Legislation is pending in the U.S. House and Senate to address these issues.