Children and Adolescent Psychiatric

The most commonly used instruments are listed in table 41.2 and can be subdivided into two groups first, semi-structured interviews such as the Kiddie Schedule for Affective Disorders, and Schizophrenia, Epidemiologic version (K-SADS-E), the Interview for Childhood Disorders and Schizophrenia (ICDS) and the Children and Adolescent Psychiatric Assessment (CAPA). These... 

Malone, R.P., Sheikh, R., and Zito, J.M. (1999) Novel antipsychotic medications in the treatment of children and adolescents. Psychiatric Serv 50 171-174. 

Kutcher SP, Reiter S, Gardner DM, et al. The pharmacotherapy of anxiety disorders in children and adolescents. Psychiatr Clin North Am 1992 15 41-67. 

Wagner CD. Generalized anxiety disorder in children and adolescents. Psychiatric Clin North Am 2001 24 139-153. 

American Academy of Child and Adolescent Psychiatry Practice parameters for the assessment and treatment of children and adolescents with substance abuse disorders. J Am Acad Child Adolesc Psychiatry 37 122—126, 1998 American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000... 

Ross, C. A. (1996). Epidemiology of dissociation in children and adolescents Extrapolations and speculations. Child Adolescent Psychiatric Clinics of North America, 5, 273-284-... 

Roerig JL, Mitchell JE, Myers TC, et al. Pharmacotherapy and medical complications of eating disorders in children and adolescents. Child Adolesc Psychiatr Clin North Am 2002 11(2) 365-385. 

Suicidaiity in chiidren and adoiescents Antidepressants increased the risk of suicidal thinking and behavior (suicidaiity) in short-term studies in children and adolescents with major depressive disorder (MDD) and other psychiatric disorders. Anyone... 

Suicidality in children and adolescents Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of trazodone or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Trazodone not approved for use in pediatric patients (see Clinical worsening and suicide risk and Children sections in Warnings). 

Carrey NJ, Wiggins DM, Milin RP. Pharmacological treatment of psychiatric disorders in children and adolescents focus on guidelines for the primary care practitioner. Drugs 1996 51(5) 750-9. 

Instead of hippocampal atrophy, the children and adolescents with PTSD were found to have smaller intracranial and cerebral volumes than matched controls increased right, left, and total lateral ventricle volume and decreased volume of the medial and posterior portions of the corpus callosum (CC) (De Beilis et ah, 1999). Consistent with this investigation, in a recent abstract, psychiatric inpatients with a history of mal-... 

Denckla, M. (1989) Neurological examination. In Rapoport, J., ed. Obsessive-Compulsive Disorder in Children and Adolescents. Washington, DC American Psychiatric Press, pp. 107-115. 

Cummings, J.L. and Cunningham, K. (1992) Obsessive-compulsive disorder in Huntington s disease. Biol Psychiatry 31 263-270. Denckla, M.B. (1989) Neurological examination. In Rapoport, J.L., ed. Obsessive-Compulsive Disorder in Children and Adolescents. Washington, DC American Psychiatric Press, pp. 107-118. Douglass, H.M., Moffit, T.E., Dar, R., McGee, R., and Silva, P. (1995) Obsessive-compulsive disorder in a birth cohort of 18 year olds prevalence and predictors. / Am Acad Child Adoles Psychiatry 34 1424-1431. 

Lenane, M.C., Swedo, S.E., Leonard, H.L., Pauls, D.L., Sceery, W, and Rapoport, J.L. (1990) Psychiatric disorders in first-degree relatives of children and adolescents with obsessive compulsive disorder. / Am Acad Child Adolesc Psychiatry 29 407-412. 

Thomsen, P.H. and Mikkelsen, H.U. (1991) Children and adolescents with obsessive-compulsive disorder the demographic and diagnostic characteristics of 61 Danish patients. Acta Psychiatr Scand 83 262-266. 

Pynoos, R.S. and Nader, K. (1993) Issues in the treatment of post-traumatic stress disorder in children and adolescents. In Wilson, J. and Raphael, B., eds. The International Handbook of Traumatic Stress Syndromes Washington, DC American Psychiatric Press, pp. 535-549. 

Teicher, M.H. and Baldessarini, R.J. (1987) Developmental pharmacodynamics. In Popper, C., ed. Psychiatric Pharmacosciences of Children and Adolescents. Washinton, DC American Psychiatric Association Press, pp. 47-80. 

Gutgessel, H., Atkins, D., Barst, R., Buck, M., Franklin, W., Humes, R., Ringel, R., Shaddy, R., and Taubert, K.A. (1999) AHA Scientific Statement cardiovascular monitoring of children and adolescents receiving psychiatric drugs. / Am Acad Child Adolesc Psychiatry 38 1047-1050. 

Sallee, F.R., Miceli, J.J., Wilner, K.D., and Robarge, L. (2000b) Pharmacokinetics of ziprasidone in children and adolescents with Tourette s syndrome. In New Research Abstracts from the American Psychiatric Association Annual Meeting, Chicago, IL NR563. 

A targeted biopsychosocial developmental history from key informants should be included in the initial assessment. In addition to the information contained in Figure 31.1, a history of stress and trauma should also be gathered. In children and adolescents this includes caretaker absence, neglect, physical, sexual, and emotional abuse, as well as transfer to a foster home, divorce, or psychiatric disorder in a close family member. 

This review of instruments for assessing psychopathology in toddlers, children, and adolescents is not intended to be comprehensive. For readers seeking more details, we recommend an extensive textbook, the Handbook of Psychiatric Measures, (Rush et ah, 2000), a detailed chapter (Aman and Pearson, 1999), and the disorder-specific chapters in Part III-B of this volume. Before describing specific instrument options, we summarize some basic principles that are applicable in clinical practice and in research on psychoactive medication. Although we use attention-deficit hyperactivity disorder (ADITD) as a frequent example, the principles are generally applicable to assessment of most disorders. 

Major depressive disorder (MDD) is a familial recurrent illness associated with poor psychosocial and academic outcome an increased risk for other psychiatric disorders, suicide, and suicide attempts and a high rate of depression and psychological difficulties in adult life (Birmaher et ah, 1996b Goodyer et ah, 1997 Lewin-sohn et ah, 1999 Pine et ah, 1998 Rao et ah, 1999 Weissman et ah, 1999a,b). The prevalence of MDD in children and adolescents is approximately 2% and 6%, respectively (Birmaher et ah, 1996b). Thus, early identification and prompt treatment of this disorder at its early stages is critical. 

For most children and adolescents, multimodal therapies are recommended. However, if antidepressant medications are used alone, psychosocial maintenance strategies should be implemented to help the patient manage inner and interpersonal conflicts, improve coping and social skills, deal with the psychosocial and personal scars left by the depression, and improve academic and social functioning. The reduction of family stress, promotion of a supportive environment, and the effective treatment of parents and siblings with psychiatric disorders may also help diminish the risk for... 

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