Child Psychiatry

Expert Q&A

Choosing Medications for ADHD

Topics: ADHD | Child Psychiatry

CCPR: Can you tell us about your current practice? Dr. Buchanan: I am responsible for pediatric ER and floor consults, I supervise the school crisis walk-in clinic, and I am responsible for high-risk intakes in the clinic.   CCPR: We hear a lot about overdiagnosis of ADHD. What are your thoughts? Dr. Buchanan: We all hear that the prob

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Research Update

Is Modafinil an Effective Alternative for the Treatment of ADHD?

Topics: ADHD | Child Psychiatry | Research Update

Review of: Wang SM et al, J Psychiatr Res 2017;84:292–300. Modafinil (Provigil) is FDA-approved for narcolepsy, obstructive sleep apnea, and shift work sleep disorder, but not for ADHD. Given that it has some of the same stimulating properties of psychostimulants, it should theoretically be effective. Wang and colleagues identified five randomized

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Research Update

Can Strattera Improve Reading Skills in Children With Dyslexia?

Topics: Child Psychiatry | Research Update

Review of: Shaywitz S et al, J Child Adolesc Psychopharmacol 2016;27(1):19–28. Dyslexia, a learning disability characterized by difficulty in reading skills, is highly prevalent, with rates between 5% and 17%. Treatments include non-medical interventions, which have limited success. Research suggests a critical role for attentional mechanisms in th

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Research Update

Understanding Tantrums in Autism Spectrum Disorder

Topics: Autism Spectrum Disorder | Child Psychiatry | Research Update

Review of: Mayes S et al, J Dev Phys Disabil 2017;29(4):587–596 Why do children with autism spectrum disorder (ASD) have tantrums? One theory is that these tantrums are due in part to children’s frustration with not being able to express themselves. This theory has led to a treatment approach called “mand training.” A mand is a verbal request

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CME Post-Test

Take The CME Post-Test for ADHD in Children and Adolescents, CCPR, September/October 2017

Topics: ADHD | Autism Spectrum Disorder | Child Psychiatry | Research Update

The post-test for this issue is available for one year after the publication date to subscribers only (October 31, 2018). By successfully completing the test you will be awarded a certificate for 2 CME credits. Click here to take your CME test. Note: All of the CME tests are available in the “My Account” section of the site when you are logge

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Article

Treatment of First Episode Psychosis in College Students: It Takes a Team

Topics: Antipsychotics | Child Psychiatry | Depressive Disorder

You are a psychiatrist working in a college student healthcare center when Anna, a junior, comes to your office escorted by her resident advisor. Anna describes feeling severely depressed. Sleeping excessively, she has missed most of her classes over the last two weeks. For the past week, she has heard voices telling her she is worthless and will never

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Expert Q&A

Evaluating Psychosis in Children

Topics: Antipsychotics | Child Psychiatry | Depressive Disorder

CCPR: First of all, how common is psychosis in children? Dr. Cepeda: It depends on what population you are talking about. It is quite uncommon among all kids who show up at a primary care provider’s office. But in a child psychiatric practice, about 3%–5% of children have psychosis, and among children needing hospitalization, the rates are much

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Research Update

Defining a Role for Nutrition in Managing Children With ADHD

Topics: ADHD | Child Psychiatry | Research Update

Review of: Lange KW et al, Curr Psychiatry Rep 2017;19(2):8. 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-

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Research Update

Is Minocycline Effective When Added to Risperidone for Autism Spectrum Disorder?

Topics: Autism Spectrum Disorder | Child Psychiatry | Research Update

Review of: Ghaleiha A et al, J Child Adolesc Psychopharmacol 2016;26(9): 784–791. The only medication treatments approved for autism spectrum disorder (ASD) are the antipsychotics risperidone and aripiprazole, which are indicated specifically to manage irritability associated with ASD. There’s been some interest in minocycline, which is a second-

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CME Post-Test

Take The CME Post-Test for Psychosis in Children and Adolescents, CCPR, August 2017

Topics: Antipsychotics | Child Psychiatry | Depressive Disorder

The post-test for this issue is available for one year after the publication date to subscribers only (December 31, 2017). By successfully completing the test you will be awarded a certificate for 1 CME credit. Click here to take your CME test. Note: All of the CME tests are available in the “My Account” section of the site when you are logged

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Article

PANDAS/PANS: A Constellation of Symptoms Searches for a Cause

Topics: Child Psychiatry | OCD

In the 1990s, investigators at the National Institute of Mental Health (NIMH), including pediatrician Susan Swedo, MD, were conducting studies on OCD in childhood and observed that some children had a very sudden onset of symptoms rather than the typical gradual increase in OCD behavior. The appearance of the symptoms was abrupt and intense enough (reac

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Expert Q&A

Diagnosing and Treating PANDAS/PANS: A View From the Clinic

Topics: ADHD | Child Psychiatry | OCD

CCPR: Dr. Greenberg, thanks for returning to CCPR. You gave great information in our March issue on Tourette’s disorder, and we know you also treat kids with PANDAS/PANS. How many kids have you seen with PANDAS/PANS? Dr. Greenberg: I devote one day a week to patients with PANDAS/PANS, and I see one to two new cases a week. I’ve probably seen 50

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CME Post-Test

Take The CME Post-Test for PANDAS, PANS, and Related Disorders, CCPR, June/July 2017

Topics: ADHD | Child Psychiatry | OCD

The post-test for this issue is available for one year after the publication date to subscribers only (December 31, 2017). By successfully completing the test you will be awarded a certificate for 2 CME credits. Click here to take your CME test. Note: All of the CME tests are available in the “My Account” section of the site when you are logg

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Article

Cannabis in 2017: Preparations and Modes of Delivery

Topics: Addiction | Child Psychiatry | Substance Abuse

While the age-old tradition of smoking cannabis remains very common, several other options for preparing the drug are becoming widely available and frequently used. In this article, we’ll update you on the modern preparations and routes of administration. The main psychoactive component of cannabis is ∆9-tetrahydrocannabinol (THC), which is pres

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Expert Q&A

Adolescent Marijuana Use and Clinical Practice

Topics: Child Psychiatry | Substance Abuse

CCPR: Clinicians working with adolescents have seen that kids are frequently using marijuana now—and stronger strains of it. What does this exposure mean for them? Is there any suggestion that marijuana use is affecting development? Dr. Cermak: There is conclusive evidence that marijuana use, particularly in early adolescence, can affect brain deve

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Article

The Neuroscience of Marijuana

Topics: Child Psychiatry | Neuroscience in Psychiatry | Substance Abuse

The neuroscience of cannabis has advanced at a remarkable pace. While it’s a complicated story, the basic effects of marijuana on our brains are pretty well established and fairly easy to grasp. Some knowledge of these effects can be clinically useful, particularly when it comes to predicting the potential effects of excessive THC that your patients m

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Article

Treating Tourette’s Disorder

Topics: Child Psychiatry | OCD | Practice Tools and Tips | Psychotherapy

David was a 12-year-old boy referred for consultation by his child psychiatrist for help in managing his severe Tourette’s disorder. David had developed onset of eye blinking at age 6 in the context of problems paying attention in his first-grade classroom. He tended to call out answers and wasn’t completing tests or his homework. By age 8, he had d

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Expert Q&A

Assessing and Diagnosing Tic Disorders

Topics: Child Psychiatry | OCD | Practice Tools and Tips

CCPR: Would you describe your clinical work in tic disorders and how that operates? I think readers will want to know about the number of patients you see and how the clinic is structured. Dr. Greenberg: I work in the obsessive compulsive disorder (OCD) and related disorders program, and I see both kids with tics and OCD or OCD-related disorders as w

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Expert Q&A

Evolution of the Autism Diagnosis

Topics: Autism Spectrum Disorder | Child Psychiatry | DSM

CCPR: Where did autism arise, and how do we understand its evolution over the last 50 years? Dr. Volkmar: The history of autism goes back many years. There is a small literature suggesting that some of the reports of so-called “feral children” in Europe starting in the very late 1700s/early 1800s, eg, Victor, the Wild Boy of Aveyron by Itard, may

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News of Note

Concerta: Brand vs Generic

Topics: Child Psychiatry | News of Note | Pharmaceutical Industry | Psychopharmacology

In November 2016, the FDA announced that it was requiring two companies to withdraw their generic versions of Concerta (OROS methylphenidate) because of efficacy concerns. Such actions are quite unusual, and when they occur, they tend to shake doctors’ confidence in the generic drug system—which branded drug companies are often eager to encourage. B

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