Tuesday, October 1st, 2013
The number of children who are being prescribed medications for mental health conditions including attention deficit hyperactivity disorder (ADHD) and anxiety is stabilizing, even as the number of children diagnosed with those disorders continues to rise. More from Time.com:
From the early 1990s to the early 2000s, the number of young children on psychotropic drugs, which include anti-depressants, stimulants, mood stabilizers and anti-anxiety agents, increased by two- to three- fold. Some drugs, including several ADHD medications, have been approved for use in children ages six to 12, while others have not studied long term in younger patients.
But in a new study published in the journal Pediatrics, researchers report that psychotropic drug treatments among children is stabilizing, according to data from a national sample of more than 43,000 kids between the ages of two and five. These drug prescriptions peaked between 2002 and 2005, and leveled off from 2006 to 2009.
While more refined guidelines for diagnosing mood and behavioral disorders among children may explain some of the change in medication use, more stringent warnings about the potential risks of psychotropic drugs on youngsters probably also played a role. In the mid-2000s, the Food and Drug Administration started adding its strictest black box warning to antidepressant medications, alerting doctors and patients to the serious risks these treatments could pose for children and adolescents. For those reasons, more pediatric groups advise doctors to start their youngest patients on behavioral therapies first, before relying on medications to treat their symptoms. “Our findings underscore the need to ensure that doctors of very young children who are diagnosing ADHD, the most common diagnosis, and prescribing stimulants, the most common kind of psychotropic medications, are using the most up-to-date and stringent diagnostic criteria and clinical practice guidelines,” the authors conclude.
However, some recent research showed that more than one in five specialists who diagnose and recommend treatment for preschoolers with ADHD turn to drug therapy first, either alone or in tandem with behavior therapy.
Image: Child with prescription bottle, via Shutterstock
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Monday, September 30th, 2013
Up to a quarter of US kids may meet the criteria for a diagnosable anxiety disorder, according to new data from the National Institutes of Mental Health. Psychologist Lawrence J. Cohen, writing for Time.com, describes the situation:
Nowadays, there are still 10-20% with that reactive temperament, but the number of children with a diagnosable anxiety disorder has skyrocketed, up to 25% according to the National Institute of Mental Health. A report from the National Institutes of Health adds, “There is persuasive evidence from a range of studies that anxiety disorders are the most frequent mental disorders in children and adolescents….” These new numbers must be viewed skeptically, of course, because of the trend towards looser and broader definitions of mental illness. Many commentators have linked this trend to the influence of pharmaceutical companies on diagnosis and prescription patterns.
Despite these caveats, however, I believe that childhood anxiety is indeed on the rise at every level, from fears of monsters under the bed to phobias and panic attacks to severe anxiety disorders.
Last year I gave a lecture on childhood anxiety to parents at a public elementary school. I heard about children who couldn’t be in a different room from their parents, even to use the bathroom, children who were too afraid of the water to swim or even take a shower, and children who were too afraid of making a mistake to function well in the classroom.
Of course, these were parents who chose to attend a lecture on childhood anxiety, but many teachers have told me that they now have a number of highly anxious children in every class. What struck me most in this group was that none of these children was in therapy, and none had received an “official” diagnosis of an anxiety disorder (though I did give out a few business cards).
Image: Worried child, via Shutterstock
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Friday, September 13th, 2013
Group therapy sessions may prevent episodes of depression in at-risk teens, especially those whose parents are also depressed, according to a new study conducted at Boston Children’s Hospital. Reuters has more:
“What was exciting was the sustained effect over the length of the follow-up,” said lead author Dr. William R. Beardslee of the psychiatry department at Boston Children’s Hospital.
He and his coauthors had previously found a reduced risk of depression nine months after the cognitive behavioral therapy sessions began. The new results show that risk was still reduced two years after they ended.
The study included 316 teenagers of parents with current or past depressive disorders.
Half were assigned to the therapy program, which involved eight weekly 90-minute group sessions with a trained therapist followed by six monthly sessions, and the other half received standard care. The kids had symptoms of depression, but not diagnosable depressive disorders.
The researchers tracked teens’ “depressive episodes” lasting at least two weeks, as reported by the kids and their parents.
During the study and the two-year follow-up period – a total of 33 months – 37 percent of kids assigned to the therapy sessions had at least one depressive episode, versus 48 percent of those in the comparison group.
But that difference was only seen among teens whose parents were not clinically depressed when the study began.
When parents were not depressed at the time of the study, cognitive behavioral therapy prevented one depressive episode for every six kids in the program, the researchers found. However, for kids with currently depressed parents, therapy sessions didn’t seem to have an effect, they wrote in JAMA Psychiatry.
“First, we need to understand how current parental depression is related to differential outcomes,” Beardslee told Reuters Health. “Then, we need to target these factors to reduce their effects on child outcome.”
Image: Teens talking, via Shutterstock
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Thursday, September 12th, 2013
Adopted children may be more likely to attempt or commit suicide than their non-adopted siblings, according to a new study by researchers at the University of Minnesota. More from Reuters:
Researchers urged doctors to be on the lookout for signs of trouble in adopted teen patients but said parents should not be overly alarmed by the results.
“While our findings suggest that adoptees may have an elevated risk for suicide attempt, the majority of the adopted individuals in our study were psychologically well-adjusted,” lead author Margaret Keyes, a psychologist at the University of Minnesota in Minneapolis, said.
Suicide is the third leading cause of death for young people between the ages of 10 and 24 years old, according to the Centers for Disease Control and Prevention. According to the agency, 4,600 youth deaths each year in the U.S. are suicides, and a much larger number of young people make attempts to take their own lives.
Previous research in Sweden found that adopted kids in that country were more likely to attempt suicide than nonadopted kids, but no comparable study had been done in the U.S., according to Keyes and her coauthors writing in the journal Pediatrics.
Image: Sad teenager, via Shutterstock
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Tuesday, August 13th, 2013
Chronic stomach pain suffered by children but without medical explanation may be an indication of an anxiety disorder, according to new research published in the journal Pedaitrics. More from Reuters:
By the time kids with stomach pain reached age 20, just over half had had symptoms of an anxiety disorder at some point, most often social anxiety, researchers found.
Anxiety tended to start in early childhood, around the same time as the chronic stomach problems.
Past studies suggest between eight and 25 percent of all youth have chronic stomach pain, researchers noted. When there’s no clear medical cause for the pain – such as inflammatory bowel disease or celiac disease – it’s known as functional abdominal pain.
“It’s very prevalent, and it’s one of the most common reasons that children and adolescents end up in their pediatrician’s office. It’s one of the most common reasons kids are missing school,” said Dr. Eva Szigethy, head of the Medical Coping Clinic at the Children’s Hospital of Pittsburgh Inflammatory Bowel Disease Center.
One small study of children with that type of pain found they were at a higher than average risk of anxiety disorders as young adults.
To build on those findings, Lynn Walker from the Vanderbilt University School of Medicine in Nashville, Tennessee, and her colleagues followed 332 children who visited a doctor for unexplained stomach pain between age eight and 17.
For comparison, they also tracked 147 youth from the same area schools without stomach problems.
When participants were 20 years old, on average, the researchers interviewed them in person or over the phone about symptoms of anxiety and depression. At that point, four in 10 of those with a history of stomach pain still had a gastrointestinal disorder.
Based on the interviews, Walker’s team found 51 percent of people with stomach pain as children had ever had an anxiety disorder and 30 percent currently met the criteria for a diagnosis.
In comparison, 20 percent of people in the no-stomach pain group had ever had an anxiety disorder and 12 percent currently had one.
“What was striking was the extent to which anxiety disorders were still present at follow-up,” Walker told Reuters Health.
Image: Boy having stomach pain, via Shutterstock
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