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Evaluating a first episode of psychosis in college students is challenging—it’s not clear from the outset if the episode will represent a one-time occurrence or the start of a lifelong illness. The differential diagnosis is large and includes depression with psychotic features, bipolar disorder, a primary psychotic disorder like schizophrenia or schizoaffective disorder, drug-induced psychosis, and transient psychotic episodes.

If a kid without psychosis says Freddy Krueger’s in the closet and his parents assure him that no one is in there, he will eventually settle down and fall asleep. A psychotic child will not be able to fall asleep and will persist in his belief no matter how much reassurance he receives. Another important clue is if the child has these fears during the day or at school.

Parents of kids with ADHD often ask about the role of diet and nutrition in their child’s symptoms, and research has uncovered some interesting possibilities. For example, there is some evidence that concentrations of long-chain polyunsaturated fatty acids (LC-PUFAs, which includes omega-3 fatty acids) may be lower in people with ADHD.

Why would an antibiotic be helpful in psychiatry? Minocycline crosses the blood-brain barrier and may have neuroprotective effects. A recent study tested whether minocycline might be useful as an adjunct to risperidone for ASD.

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 1 CME credit.

After reading these articles, you should be able to…

PANS and PANDAS--a hitherto normal child suddenly develops severe OCD symptoms. These may include refusing to leave the house, engaging in constant checking and washing rituals, asking repeatedly if the door is locked, making odd facial movements, having full-on tantrums with kicking and screaming, wetting the bed, and being unable to perform in school. “I lost my child overnight” was, and is, a common refrain.

How do you confidently diagnose a child that you suspect is presenting with PANDAS/PANS? (See lead article for definition.) And if you do make that diagnosis, how should treatment proceed? Child psychiatrist Erica Greenberg sees new cases almost every week. We turned to her for some boots-on-the-ground guidance.

Diagnosing ADHD continues to be difficult, time-consuming, and expensive. Having an “objective,” valid test for ADHD would be of value to clinicians and families alike. Continuous performance tests (CPT) are gaining popularity as a complement to clinical examination, rating scales, and interviews with parents and teachers.