Child Psychiatry

Article

Embracing Conflict in the Consent Process

Topics: Child Psychiatry | Practice Tools and Tips

What do you do when your teen patient declines an offer of medication yet the parents insist on it? How about if the teen is coming to you for medication and the parents are opposed to the idea? Does the teen have the right to request and receive medication? And what if the teen is using substances? CBD? Do you still treat, or do you refer elsewhere?

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Expert Q&A

Considerations When Prescribing Psychotropic Medications

Topics: Child Psychiatry | Pharmacology Tips

CCPR: Thank you for joining us. To start things off, how do you approach using psychotropic medications for children and adolescents? Dr. Chenven: Most parents do not want to start medications. I empathize with them, which then makes it possible to move together toward medications when indicated. I quote Dr. Oliver Wendell Holmes, Sr., who said, “If

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Article

Metformin to Control Antipsychotic-Induced Weight Gain in Children

Topics: Antipsychotics | Child Psychiatry | Pharmacology Tips

Metformin has been used off-label for weight loss in psychiatry for many years, much of it for help with adult weight gain as a side effect of atypical antipsychotics. However, most trials of metformin for weight loss were actually conducted on the child and adolescent population. This article will look at the quality of the data in our pediatric pop

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Article

Tips for Good Medication Practice

Topics: Child Psychiatry | Pharmacology Tips

Good practice using psychotropic medications with children and adolescents requires a psychiatrist to pay attention to a number of elements. The following are some recommendations from child psychiatrist Mark Chenven, MD, of the things you should observe and the rules you might want to follow while prescribing medications: Start low, go slow: Most

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Research Update

Youth, Antidepressant Medications, and Type 2 Diabetes

Topics: Antidepressants | Child Psychiatry | Psychopharmacology Tips

Review of: Burco M et al, JAMA Pediatrics 2017;171(12):1200–1207 Over the last decade, several published studies have reported an increased risk of type 2 diabetes associated with antidepressant use in adults. But does the same hold true for children and adolescents? This paper is the first population-based study to examine the risk of onset of

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Article

Note From the Editor-in-Chief

Topics: Anxiety | Child Psychiatry

Anxiety is a broad concept that permeates pretty much all of our work. In particular, anxiety often compromises cognitive ability and drives acting-out behavior. So, for our 2018 run at the topic, we speak with Dr. Ira Glovinsky about how anxiety manifests as behavioral dysregulation and is often misconstrued as misbehavior. How do we learn to pick up t

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Article

Benzodiazepines in Children and Adolescents

Topics: Benzodiazepines | Child Psychiatry | Pharmacology

Michael, who’s 9, is brought in by his parents for his first psychiatric assessment. His parents report that lately, Michael has been worrying all the time. He asks to sleep in his parents’ bed. This past month, he also began having problems separating from his parents in the morning for school. Michael’s therapist suggested a medication assessmen

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Article

Differentiating ADHD From Anxiety: Tips for Clinicians

Topics: ADHD | Anxiety | Child Psychiatry | Practice Tools and Tips

When parents bring in their kids for concentration, attention, and learning issues, it’s common to assume a provisional diagnosis of ADHD. In many children, however, anxiety can be the real cause of these problems. Studies have long shown that about two-thirds of children and adolescents who present for ADHD evaluation have comorbid conditions, inc

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Expert Q&A

Acting Out: Is It Anxiety?

Topics: Anxiety Disorder | Child Psychiatry

CCPR: We see so many kids who are acting out. Can you begin by telling us about how anxiety can be hidden in oppositional or other acting-out behavior? Dr. Glovinsky: I see that all the time. What you’re bringing up are two groups. One group looks like oppositional behavior with comorbid anxiety underneath. The other is a group of kids who are hav

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Research Update

Azithromycin for Acute-Onset Obsessive-Compulsive Disorder in Children

Topics: Child Psychiatry | OCD | Research Update

Review of: Murphy et al, J Child Adolesc Psychopharmacol 2017; 27(7):640–651 Pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric syndrome associated with streptococcus (PANDAS) have been the subject of many debates in the field. From obsessions, compulsions, and tics, to personality changes and opposi

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Research Update

Celecoxib as Adjunctive Treatment in Acute Mania

Topics: Bipolar Disorder | Child Psychiatry | OCD | Research Update

Review of: Mousavi et al, J Child Adolesc Psychopharmacol 2017; 27(6):494–500 Emotional stress can trigger an inflammatory cascade response and increase blood levels of proinflammatory cytokines—including IL-1, IL-6, and tumor necrosis factor (TNF-α). These same inflammatory markers intensify in acute episodes of depression and mania. So, would

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Research Update

Negative Efficacy of Desvenlafaxine and Fluoxetine for Children and Adolescents With MDD

Topics: Child Psychiatry | Research Update

Review of: Weihs et al, J Child Adolesc Psychopharmacol 2018;28(1):36–46 The debate about whether antidepressants work in children has been with us since the tricyclic era. A recent study evaluated the short-term efficacy and safety of a newer agent, desvenlafaxine (Pristiq). This multi-center, randomized, double-blind, placebo-controlled study

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Expert Q&A

Helping Clinicians Manage Teen Suicide Risk

Topics: Child Psychiatry | Practice Tools and Tips

CCPR: Thank you, Dr. Pfeffer, for participating in this interview on youth suicide. To start us off, how have clinicians come to understand risk factors for teen suicide? Dr. Pfeffer: Historically, psychiatrists did not focus on identifying and treating risk factors for child and adolescent suicidal behavior. But after an increase in youth suicide r

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Research Update

Evidence Behind Aripiprazole for the Treatment of Tourette’s Disorder

Topics: Child Psychiatry | Psychopharmacology Tips | Research Update

Review of: Sallee F et al,   J Child Adolesc Psychopharmacol 2017;27(9):771–781 Tourette’s disorder (TD) is a movement disorder emerging during childhood that causes persistent motor and vocal tics. TD is treated with a variety of medications, but often with an off-label designation. There are only three medications that are FDA approved for

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Research Update

Efficacy and Safety of SSRIs and SNRIs for Child and Adolescent Psychiatric Disorders

Topics: Child Psychiatry | Depressive Disorder | Research Update

Review of: Locher C et al,  JAMA Psychiatry 2017;74(10):1011–1020 Since the 2004 FDA black-box warning on all antidepressants for pediatric use, controversy continues over the use of SSRIs and SNRIs in children and adolescents. Both classes of medication are still commonly used for pediatric depressive disorders, anxiety disorders, and obsessive-

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Article

Tips on Managing Medications With Adolescents

Topics: Child Psychiatry | Practice Tools and Tips

Discussing medications with adolescents can be challenging. In general, my approach during the initial evaluation is to have a first evaluation appointment with the parents alone to gather relevant history, and then bring the teen back for a separate and individual appointment. Oftentimes, however, and particularly with older teens, I will see the famil

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Expert Q&A

Understanding Risk-Taking in Adolescents

Topics: Child Psychiatry | Practice Tools and Tips | Psychotherapy

CCPR: Hello, Dr. Shatkin. Your latest book, Born to Be Wild, is about understanding why adolescents are impulsive and take so many risks. Why did you decide to write about this topic? Dr. Shatkin: I’ve long been interested in the public health perspective of psychiatry and the importance of prevention, and I began further exploring the reasons for

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Research Update

Does Methylphenidate Use in Children and Young Adults Increase Risk of Suicide?

Topics: ADHD | Child Psychiatry | Research Updates

Review Of: Man KKC et al, JAMA Psychiatry 2017;74(10):1048–1055 Some studies have indicated that patients with ADHD may be at an increased risk of suicide. While these studies have shown associations between methylphenidate use and suicide, it is not clear whether the stimulant actually causes suicidality or whether patients taking stimulants are s

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Article

An Integrative Approach to Attention Deficit Hyperactivity Disorder

Topics: ADHD | Child Psychiatry | Psychotherapy

Integrative approaches to treating ADHD have become increasingly sought after by parents, especially those who are concerned about the side effects and potential overuse of psychostimulant medication. Surveys report that over 60% of child psychiatry patients are employing integrative tools on their own such as vitamins, specific diets, and herbal remedi

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Article

Official 2017 Carlat ADHD Pediatric Stimulant Comparison Table

Topics: ADHD | Child Psychiatry

Our official 2017 Carlat ADHD Stimulant Comparison table, an easy-to- use reference that you’ll find handy. Table: Official 2017 Carlat ADHD Pediatric Stimulant Comparison Table (Click here to view as full-sized PDF.)

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