Child Psychiatry

Editor’s Note

Note From the Editor-in-Chief

Topics: Child Psychiatry

In this double issue, we tackle a range of questions. First, does TMS help kids and teens with depression? Is it safe? Since many clinics are advertising TMS, we thought it was worth a close look. This leads us to a broader question: How should we develop and then try to answer the questions that come up in daily clinical practice? Our interview with Dr

Read More
Expert Q&A

Medications for Depression

Topics: adolescents | Child Psychiatry | children | Depression | pediatric | Psychopharmacology | teens | treatment

CCPR: You recently published an article reviewing the ­placebo-controlled trials done over the past 10 years on depression in kids (Ignaszewski MJ and Waslick B, J Child Adolesc Psychopharmacol 2018;Epub ahead of print). Can you tell us about your findings? Dr. Ignaszewski: Historically, there’s been a lot of controversy about the effectiveness of a

Read More
News of Note

FDA Approves Adhansia XR

Topics: Adhansia XR | ADHD | adolescents | Attention Deficit Hyperactivity Disorder | Child Psychiatry | children | extended-release | methylphenidate | News of Note | pediatric | teens | treatment

We are always in need of a new formulation of stimulant medication that might capture a few more of our patients who just do not quite tolerate or respond well enough to the many existing formulations. So whenever a new one is released, we try to set aside our natural skepticism and take a look at the stated facts before judging its merit. Adhansia X

Read More
News of Note

First Non-Drug Treatment Approved by FDA for Treating Children With ADHD

Topics: ADHD | adolescents | Attention Deficit Hyperactivity Disorder | Brain Devices | Child Psychiatry | children | efficacy | eTNS | News of Note | pediatric | safety | teens | treatment | Trigeminal Nerve Stimulation

NeuroSigma made a splash by announcing that the FDA has granted medical device approval for its external Monarch Trigeminal Nerve Stimulation (eTNS) System for treating kids with ADHD ages 7–12 who are not currently taking medications. What does medical device approval mean? The FDA reviewed the Monarch eTNS System through the de novo ­pre-market

Read More
Research Update

Prescribing Patterns for Children With Anxiety Disorders

Topics: adolescents | Anxiety | Child Psychiatry | children | Medication | prescribing patterns | Research Update | teens | treatment pediatric

Review of: Bushnell GA et al, J Clin Psychiatry 2018;79(1):pii:16m11415 Anxiety disorders are some of the most common conditions we encounter in children and adolescents, and clinicians employ a variety of medications to treat them. This study examined prescribing patterns for the initial treatment of pediatric anxiety. Researchers analyzed a larg

Read More
Research Update

Steroid-Induced Psychosis in the ­Pediatric Population

Topics: adolescents | Child Psychiatry | children | pediatric | Psychosis | Research Update | steroids | teens

Review of: Hodgins GE et al, J Child Adolesc Psychopharmacol 2018;28(5):354–359 Childhood psychosis is a rare disorder, and accurate diagnosis is crucial. Recently, clinicians at the University of Miami Miller School of Medicine reported a case of steroid-induced psychosis in a pediatric patient. In the case report, a 12-year-old Haitian girl wa

Read More
Research Update

Risk of Psychosis With Stimulants in ADHD Patients

Topics: ADHD | adolescents | amphetamine | Child Psychiatry | children | Medication | methylphenidate | pediatric | Psychosis | Research Update | stimulant | teens

Review of: Moran LV et al, N Engl J Med 2019;380(12):1128–1138 In 2007, the FDA required stimulant manufacturers to warn of possible psychosis with stimulants. But what is the real incidence? This study set out to find and discern if there is a difference between methylphenidate and amphetamine classes of medications. Drawing from two large comm

Read More
Article

Do Antidepressants Work for Kids?

Topics: Antidepressants | Child Psychiatry

What a bind we seem to be in. On the one hand, we are short several thousand child psychiatrists in the United States, and parents are beating down our (generalist) doors to get their children medicated. On the other hand, every other piece of news about childhood psychopharmacology seems either bad or lukewarm. In this issue, TCR takes a stab at

Read More
Article

How to Evaluate Adolescents

Topics: Child Psychiatry | Practice Tools and Tips

Every so often the stars align themselves in such a way that you will be referred an "easy" adolescent. This is a teenager who looks and dresses like you, who is seeking help on his or her own urging, who describes depressive or anxiety symptoms articulately, and who responds well to standard treatment. This article is for the rest of the time. In

Read More
Expert Q&A

Dr. Jeff Bostic on Treating Pediatric Depression

Topics: Child Psychiatry | Depression

TCR: Dr. Bostic, what are your clinical and research responsibilities? Dr. Bostic: I work in five different school districts, doing school consultations, helping the mental health and teaching staff deal more effectively with kids. I'm involved with the STAART grant funded by NIMH which is a study of children with autism at 8 sites throughout the count

Read More
Research Update

Melatonin for Insomnia in Patients With Autism

Topics: Autism | Child Psychiatry | Research Update | Sleep Disorders

Review of: Maras A et al, J Child Adolesc Psychopharmacol 2018;28(10):699–710 Treating sleep problems in youth with autism spectrum disorder (ASD) is tricky at best. One promising treatment is pediatric prolonged-release melatonin ­(PedPRM) sold under the name Slenyto. In 2017, a randomized controlled trial (funded by the manufacturer) assigned 11

Read More
Editor’s Note

Note From the Editor-in-Chief

Topics: Child Psychiatry

Welcome to the fall issue of the Carlat Child Psychiatry Report. This issue will help you assess and manage substance use disorders in teens. It features interviews with cutting-edge people: Dr. Sandra ­Gomez-Luna on the outpatient management of opiate use; Dr. ­Gabriella Gobbi on the impact of cannabis, its interaction with depression, and the conund

Read More
Article

Psychiatric Aspects of Mild Traumatic Brain Injury in Children and Adolescents

Topics: Child Psychiatry | Trauma

Editor’s note: Mild traumatic brain injury (mTBI) accounts for about 90% of all TBI cases in children and adolescents, or about 180 out of every 100,000 cases in the US. With 2 million cases between 2005 and 2009, we are seeing many patients who have TBI as part of their history. How does it affect them? What do we do about it? Dr. Jeffrey Max spoke o

Read More
Expert Q&A

Building Self-Regulation in Children

Topics: Anxiety | Child Psychiatry | Self-Regulation

“Self-regulation” has become a buzz phrase to help children manage stress, become resilient, and stave off depression, anxiety, and post-traumatic stress disorder. To gain a better understanding of this concept, we interviewed Stuart Shanker, PhD, founder and CEO of the MEHRIT Centre (https://self-reg.ca). Dr. Shanker sets up self-regulation program

Read More
Research Update

Rapid-Onset Gender Dysphoria in Adolescents and Young Adults

Topics: Child Psychiatry | Gender Dysphoria | Research Update

Review of: Littman L, PLOS ONE 2018;13(8):e0202330 Rapid-onset gender dysphoria (ROGD) is a newly coined but non-standardized characterization of gender dysphoria (GD). In this conceptualization, GD begins abruptly during or after puberty in adolescents or young adults (AYAs) with no prior symptoms of GD. Clusters of GD outbreaks have been noted by p

Read More
Research Update

How Helpful Is Computerized Testing for ADHD?

Topics: ADHD | Child Psychiatry | Research Update | Technology

Review of: Hollis C et al, J Child Psychol Psychiatry 2018;59(12):1298–1308 With busy clinic schedules and the ever-burgeoning load of documentation, computerized diagnostic aids are in more demand than ever. For ADHD, the gold standard is still a clinical assessment with information from parents and teachers, but those reports are difficult to obt

Read More
Research Update

Would Treating Kids With ADHD Help Their Mothers?

Topics: ADHD | Child Psychiatry | Research Update | Working With Families

Review of: Gokcen C et al, J Child Adolesc Psychopharm 2018;28(5):350–353 Parenting a child with ADHD can be challenging. Parents often report feeling stressed, burned out, or depressed while caring for their children with ADHD. When ADHD medications lead to significant improvements in a child’s behavior, can that alleviate symptoms in parents? A

Read More
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

Read More
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

Read More
Article

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

Topics: Child Psychiatry | Free Articles | 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

Read More