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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.
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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.
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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.
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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.
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Dr. Joshua Feder studied mathematics and medicine at Boston University, Psychiatry at Naval Regional Medical Center San Diego, serving the first Gulf War in child and adolescent psychiatry fellowship at Tripler Army Medical Center in Honolulu, and eventually became Chief of Child Psychiatry at the National Naval Medical Center in Bethesda, MD. Dr. Feder now practices in Solana Beach, California, and serves as Executive Medical Director at Positive Development, providing relationship-based support for families, with research at UCSD, SDSU, Fielding Graduate University, An Najah National University, Quicksilver Software, Autism Is inclusion program, and Programmatic Lead for the International Networking Group on Peace Building with Young Children, with projects in the US, Northern Ireland, and the Middle East. Dr. Feder co-authored the first American Academy of Child & Adolescent Psychiatry Practice Parameter on Autism and serves as Co-Chair of the Disaster & Trauma Committee at AACAP. Dr Feder was founding policy chair for the California Association for Infant Mental Health and advocates worldwide on access to care, climate policy, and peacebuilding. His recent books include Child Medication Fact Book for Psychiatric Practice, Second Edition (2023) and Prescribing Psychotropics (2021).
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