Child Psychiatry

Expert Q&A

What to Do About School Refusal? A Conversation With Two Experts

Topics: Child Psychiatry | School Refusal

Editor’s note: School refusal is a common problem, affecting up to 5% of schoolchildren. Even so, there are few clear guidelines on how to manage this problem. After seeing their article on the subject, we were able to talk with a child psychiatrist and a clinical child psychologist who focus a significant portion of their work on treating school refu

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Expert Q&A

Anxiety Everywhere: Grappling With a Pervasive Symptom

Topics: Anxiety | Child Psychiatry

CCPR: Can you tell us a little about your background? Dr. Rynn: I’ve been doing clinical research examining new medications for children with anxiety disorders. My passion is working with children who have failed first-line, evidence-based treatments. How do we help these children? What are our options? I look at new treatments or changing the intens

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Article

Wilderness Therapy: Dangerous Waste of Money or an Effective Therapeutic Intervention?

Topics: Child Psychiatry | Wilderness Therapy Programs

Wilderness therapy programs, aka “outdoor behavioral health programs,” purport to offer structured outdoor experiences for adolescents or adults that lead to psychological shifts and better functioning. Programs vary in length from a few days to months, although 30–90 days is common. The outdoor experiences include camping, canoeing, hiking, rock

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Article

Note From the Editor-in-Chief

Topics: ADHD | Child Psychiatry

In this issue we tackle a range of challenges, including differentiating ADHD from bipolar disorder, understanding suicide risk in college students, managing assertions about the safety of weed, and assessing and treating violent behavior in our patients. How do we think about the future of kids with ADHD? Dr. Mark Katz offers a hopeful approach. We als

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Article

Evaluating and Treating Co-Occurring ADHD and Bipolar Disorder

Topics: ADHD | Bipolar Disorder | Child Psychiatry

Early into the evaluation of a 10-year-old boy, you note the following symptoms: inattention, hyperactivity, impulsivity, sleep problems, racing thoughts, and moodiness. The boy’s parents came to your office convinced that their son has ADHD, but thinking through the case, you recognize that the same symptoms could signal bipolar disorder (BD). You ha

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Article

Assessing and Treating Violence in Patients

Topics: Child Psychiatry | Practice Tools and Tips

School shootings keep happening in the US, and most of us have wondered at times whether one of our patients might carry out a violent act, shooting or otherwise. This article will help you assess and treat violent youth and advise families who are grappling with these issues. Most people with mental health conditions do not hurt others—our patients

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Article

Antidepressant-Induced Suicidality: What It Is and What You Should Do

Topics: Child Psychiatry | Depressive Disorder | Practice Tools and Tips

Do antidepressants actually cause children to be suicidal? If so, how do we detect it, and what should we do about it? In this article, we’ll give you a brief review of the most recent findings on antidepressant-induced suicidality (AIS) in children and adolescents, and then move on to some practical tips for how to evaluate and prevent this problem.

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Expert Q&A

Current Use of Antidepressant Medication in Children

Topics: Child Psychiatry | Depressive Disorder | Practice Tools and Tips

Editor’s note: The issue of emergent suicidal thinking has weighed on us since the 2004 black box warning—amplified by the re-analysis of the now infamous study 329, which found the emergence of previously under-reported suicidal thinking. How do we offer hope for effective use of medication while balancing the potential risks? Dr. Danella Hafeman h

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Expert Q&A

Depression in Transition to Adulthood: A Case Study

Topics: Child Psychiatry | Depressive Disorder

Editor’s note: Recently, CCPR presented the following hypothetical case to leading child and adolescent development authority Calvin Colarusso, MD, for his advice on how to help a young man presenting with a possible major depressive disorder (MDD). The case: As he struggles to complete his senior college research project, a 23-year-old majoring in

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Research Update

Resilience Networks in Adolescent Females at Risk for Major Depression

Topics: Child Psychiatry | Research Update

Review of: Fischer AS et al, JAMA Psychiatry 2018;75(5):493–502 One of our biggest in-office challenges is how to enhance teen resilience, the process of adapting to and recovering from stressful life experiences. Some neuroscientists hypothesize that resilience is related to the limbic system, which plays a vital role in emotion processing, motiva

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Article

Adolescents With ADHD and Substance Use Disorders: A Primer

Topics: Addiction | ADHD | Child Psychiatry | Substance Abuse

You are evaluating a 16-year-old boy referred for mandated substance use treatment by his high school, where he was found drinking alcohol and smoking cannabis with a friend in the restroom. As you gather his history, he says, “One doctor told me I have ADHD. That’s why I smoke pot—it helps me focus. But I think I’d do better with some Adderall.

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Expert Q&A

Talking to Parents and Adolescent Patients About Substance Use

Topics: Addiction | Child Psychiatry | Practice Tools and Tips | Substance Abuse

CATR: To start us off, how does addiction differ in adolescents vs adults? Dr. Quigley: In adolescents it can be subtle. For example, there are culturally normative behaviors with alcohol and cannabis use, and kids get missed because people write it off as “just partying.” They miss the fact that the substance use has become extremely impairing. Ad

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Article

Note From the Editor-in-Chief

Topics: Autism Spectrum Disorder | Child Psychiatry

Welcome to the autism issue! We interviewed Dr. Serena Wieder on evidence-based developmental approaches for kids with ASD, ones that bring the humanity back into autism treatment by returning our focus to the nurturing relationships between parents and children, building on children’s ideas to improve communication and learning. These belong at the t

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Article

Prescribing Antipsychotics in Aggressive Children With ADHD

Topics: Autism Spectrum Disorder | Child Psychiatry

It’s a vexing question: At what point do you consider prescribing antipsychotics for aggressive children? The potential side effects—weight gain, sedation, possible movement side effects, and metabolic abnormalities—encourage us to think long and hard about this, and there are few good evidence-based guidelines. The recent Treatment of Severe C

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Expert Q&A

Including Parents in Autism Intervention

Topics: Autism Spectrum Disorder | Child Psychiatry | Practice Tools and Tips

CCPR: Can you begin by telling us what is unique about the Profectum Foundation? Dr. Wieder: At Profectum, relationships are the driving force of intervention. We embraced the DIR (Developmental, Individual Difference, and Relationship-based) Model I developed with the late Dr. Stanley Greenspan. DIR was revolutionary. It redefined functional emotional

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Expert Q&A

Acceptance and Commitment Therapy (ACT) for Children and Adolescents

Topics: Child Psychiatry | Psychotherapy

CCPR: Welcome, Dr. Scarlet. We hear a lot about a variety of therapies for children and adolescents, including cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). More recently, we are hearing a lot about acceptance and commitment therapy (ACT). Can you tell us what ACT is? Dr. Scarlet: ACT seeks to teach us to mindfully observ

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Research Update

Simvastatin as Adjunctive Therapy for Irritability in Autism

Topics: Autism Spectrum Disorder | Child Psychiatry | Research Update

Review of: Moazen-Zadeh E et al, J Child Adolesc Psychopharmacol 2018;28(1):82–89. Disorders of lipid metabolism—specifically inefficient metabolism of lipids—have been implicated as part of the metabolic complexity in children with autism spectrum disorder. Research points to the neuroprotective effects of simvastatin over other statins, due t

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Article

From Infantile Autism to Autism Spectrum Disorder

Topics: Autism Spectrum Disorder | Child Psychiatry | DSM | Free Articles

Changes in diagnostic criteria not only affect the clinical and public perception of a disorder, but also its perceived prevalence. Such is the case with autism. The evolution of the autism diagnosis since it was introduced into the Diagnostic and Statistical Manual (DSM) in 1980 inarguably has altered its reported prevalence, rising from an estimated 1

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Article

Taking Back Control in Binge Eating Disorder

Topics: Child Psychiatry | Eating Disorders | Free Articles

Confined to the appendix in previous editions of the Diagnostic and Statistical Manual (DSM), binge eating disorder (BED) took a leap into the spotlight with its inclusion as an official diagnosis in 2013’s DSM-5. It is one of the more controversial of DSM-5 disorders, with some claiming that BED inappropriately turns overeating and obesity into a psy

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Article

Conduct Disorder and Oppositional Defiant Disorder: A Primer

Topics: Child Psychiatry | Cognitive Behavioral Therapy | Free Articles | Practice Tools and Tips | Psychotherapy

Vignette: Richie was a 15-year-old boy referred for evaluation after multiple run-ins with the police for drug possession, fighting, and shoplifting. Richie was the oldest of three boys and looked up to a gang-involved cousin who was in prison for drug trafficking. The patient was enrolled in multisystemic therapy (MST) for both treatment and further e

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