Children psychiatric disorders

Munroe-Blum, H., Boyle, M. H., Offord, D. R., Kates, N. (1989). Immigrant children Psychiatric disorder, school performance, and service utilization. American Journal of Orthopsychiatry, 59(4), 510-519. 

In general, following guidelines established for the treatment of other child psychiatric disorders would seem to be the most prudent initial approach to the question of discontinuation, with the caveats listed above. In the author s experience, continuing treatment for at least 6 months to a year following successful treatment of a psychiatric syndrome (assuming that the symptoms or syndrome was not situational, such as anxiety prior to a procedure or a resolved delirium) would seem to be a reasonable starting point. 

Reinherz HZ, Giaconia RM, Lefkowitz ES, Pakiz B and Frost AK (1993). Prevalence of psychiatric disorders in a community population of older adolescents. Journal of American Academy of Child and Adolescent Psychiatry, 32, 369-377. 

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). 

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 olanzapine/fluoxetine or any other antidepressant in a child or adolescent must balance this risk with clinical need. 

Warner V, Mufson L, Weissman MM (1995b) Offspring at high and low risk for depression and anxiety mechanisms of psychiatric disorder. J Am Acad Child Adolesc Psychiatry... 

Fergusson DM, Horwood J, Lynskey MT (1996) Childhood sexual abuse and psychiatric disorder in young adulthood 11. Psychiatric outcomes of childhood sexual abuse. J Am Acad Child Adolesc Psychiatry 34 1365-1374... 

Walter, G. and Rey, J.M. (1999) Use of St. John s wort by adolescents with a psychiatric disorder / Child Adolesc Psychopharmacol 9 307-311. 

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. 

Piven, J., Chase, G.A., Landa, R., Wzorek, M., Gayle, J., Cloud, D., and Folstein, S. (1991) Psychiatric disorders in the parents of autistic individuals. J Am Acad Child Adolesc Psychiatry 30 471— 478. 

Hendren, R.L., DeBacker, I., and Pandina, G. (2000) Review of neuroimaging studies of child and adolescent psychiatric disorders from the past ten years. / Am Acad Child Adolesc Psychiatry 39 815-828. 

Attention-deficit hyperactivity disorder (ADHD) is the most common juvenile psychiatric disorder presenting to mental health workers, child psychiatrists, and pediatricians. This disorder is one of the major clinical and public health problems because of its associated morbidity and disability in children, adolescents, and adults. Its relevance to society is significant in terms of financial cost, stress to families, and impact on academic and vocational activities, as well as the negative effects on self-esteem. 

Because the parents of depressed youth may also be experiencing depression and other psychiatric disorders (Weissman et ah, 1987 Klein et ah, 2001), parental depression itself may lead to adverse outcomes (Brent et ah, 1998). To treat the child successfully, the clinician should assess parents and refer them for their own treatment. 

C. Does the child have a comorbid psychiatric disorder ADIS-C/P, K-SADS, Youth Self-Report (YSR), Child Behavior Checklist (CBCL)... 

Hughes, C. and Preskorn, S. (1994) Pharmacokinetics in child/ado-lescent psychiatric disorders. Psychiatr Ann 24 76-82. 

McLeer, S.V., Callaghan, M., Henry, D., Wallen, J. (1994) Psychiatric disorders in sexually abused children. / Am Acad Child Adolesc Psychiatry 33 313-319. 

Stowell, J. and Estroff, T. (1992) Psychiatric disorders in substance abusing adolescent inpatients a pilot study. J Am Acad Child Adolesc Psychiatry 31 1036-1040. 

Wilens, T., Biederman, J., and Spencer, T. (1996) Attention deficit hyperactivity disorder and the psychoactive substance use disorders. In Jaffe, S., ed. Pediatric Substance Use Disorders Child Psychiatric Clinics of North America. Philadelphia W. B. Saunders, pp. 73-91. 

There have been numerous trials of use of the atypical antipsychotics in patients with developmental disabilities, but most of these trials were uncontrolled open-labeled studies or case reports (Aman and Madrid, 1999). Findings were reported for 86 adults and 1 child with prominent self-injury. The reports of adults assessed clozapine (1 report) and risperidone (4 reports). Improvement was observed for a majority of participants in all of these trials. The patients presented with a multitude of conditions, ranging from nonspecific MR and associated behavior problems, to pervasive developmental disorders (including autism), to various psychiatric disorders, including schizophrenia and manic disorder. Self-injury appeared to respond to treatment regardless of concomitant condition. In the only clozapine report with a child (who had autistic disorder), a mean dose of 283 mg/day caused a transient reduction in self-injury. 

Hooks, M.Y., Mayes, L.C., and Volkmar, F.R. (1988) Psychiatric disorders among preschool children. / Am Acad Child Adolesc Psychiatry 21 623—621. 

Lavigne, J.V., Gibbons, R.D., Christoffel, K.K., Arend, R., Rosenbaum, D., Binns, H., et al. (1996) Prevalence rates and correlates of psychiatric disorders among preschool children. J Am Acad Child Adolesc Psychiatry 35 204-214. 

Vitiello, B. in press Ethical issues in pediatric psychopharmacology research. In Rosenberg, D., Gershon, S., Davanzo P., eds.. Pharmacotherapy for Child and Adolescent Psychiatric Disorders. 

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