Advances in College Mental Health

Topics: ADHD | adolescents | college mental health | COVID-19 | Suicide

TCPR: What are the most common psychiatric conditions in the college mental health setting? Dr. Riba: Anxiety and depression are the most common psychiatric conditions. It is very difficult to get timely psychiatric evaluations and evidence-based treatment. It has been especially difficult during the last two years during COVID, but telehealth has ce

Intravenous Ketamine for Teen Depression

Topics: adolescents | Depression | Free Articles | Ketamine | Suicidality

REVIEW OF: Dwyer JB et al, Am J Psychiatry 2021;178(4):352–362 TYPE OF STUDY: Randomized midazolam-controlled trial Treatment-resistant depression (TRD) is a growing concern in teenagers. Although intravenous ketamine has shown clear and immediate improvement of TRD in adults, there is little research to show its effectiveness in teens, and each

Teen Drinking: Risks and Responses

Topics: adolescents | Alcohol | Alcohol Poisoning | Risk of Addiction | Sexual Abuse | Substance Use Disorder

CCPR: Welcome, Dr. Yule. How prevalent is teen drinking? Dr. Yule: While there has been a decline in alcohol use since the 1980s, alcohol remains the substance most widely used by adolescents. When we look at past-month use by 12th graders in 2019, 5.7% had smoked cigarettes, 22.3% had used cannabis, and 29.3% had used alcohol (www.niaaa.nih.gov/public

The Effect of Age and Pubertal Stage on Mental Health in Gender-Incongruent Youths

Topics: adolescents | children | GAMC | GDD | Gender Affirming Medical Care | Gender Dysphoric Disorder | Hormone Replacement Therapy | HRT | Mental Health | Suicidality

Review of: Sorbara JC et al, Pediatrics 2020;146(4):e20193600 Gender incongruence means that a young person identifies with a gender that’s different from the one they were born with. These youths have an elevated risk of suicide and other psychiatric problems. Gender-affirming medical care (GAMC), such as hormonal therapies, can reduce those risks

Duty to Warn? Debating Antidepressant Suicidality

Topics: adolescents | Antidepressants | children | Depression | emergent suicidality

CCPR: We are here with Dr. Ignaszewski and Dr. Spielmans to review the latest on emergent suicidality in children and adolescents during antidepressant treatment. Dr. Spielmans, please give us the context of this issue and how your recent article fits in (Spielmans GI, Spence-Sing T, and Parry P, Front Psychiatry 2020;11:18). Dr. Spielmans: In 2004, th

Oral Contraceptive Users and Depressive Symptoms

Topics: adolescents | Depression | Oral Contraceptives | teens

Review of: de Wit AE et al, JAMA Psychiatry 2019;77(1):52–59 Since the dawn of their widespread use in the 1960s, we’ve worried about the impact of oral contraceptives (OCP) on mood. But the research to date has been inconsistent, with studies reporting negative, positive, or no effects on mood. Heterogeneity in study population and design may un

Adolescents and Sleep: Parents Can Make a Difference

Topics: adolescents | Sleep | teens

Review of: Peltz JS et al, Sleep 2019;zsz287 We know that sleep deprivation is an important contributor to mental health problems in teenagers. Studies show that adolescents need around 9.25 hours of sleep for optimal functioning, but most do not get adequate sleep for several reasons. Teens have a developmental drive to stay up later and sleep in lo

Highlights From This Issue

Topics: ADHD | adolescents | Child Psychiatry | Teen | teens

The long-term effects of ADHD on longevity support assertive treatment in childhood and adolescence. Most reading programs that are heavily marketed do not have direct research demonstrating their efficacy; however, we can learn the important principles and offer families guidance. There are many practical strategies to help families manage AD

Are Target Symptoms More Important Than Diagnosis?

Topics: ADHD | adolescents | Research | Teen | teens

Recently I evaluated Caroline, a 15-year-old patient who presented with symptoms of depression, including insomnia, poor appetite, loss of interest in friends and activities, and inability to focus on her schoolwork. In addition, Caroline described a sad, dark view of herself, the state of the world, and her future. It seemed clear that I needed to addr

Transcranial Magnetic Stimulation (TMS) for Depression in Children and Adolescents

Topics: adolescents | Brain Devices | children | Depression | Free Articles | pediatric | safety | teens | TMS | Transcranial Magnetic Stimulation

Editor’s note: This article is about the “usual” TMS that we have been hearing about for many years. We are covering trigeminal nerve stimulation (eTNS) separately in this issue in a News of Note as it is far newer with far less clarity about its utility. The search for safer treatment With concerns about both safety and efficacy surrounding 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

Practical Approaches to Vetting Clinical Research

Topics: adolescents | children | Clinical practice | inquiry | pediatric | PICOT | Practice Tools and Tips | Research | teens

CCPR: Tell us a bit about your current work. What is your population? Whom do you treat? Dr. Courtney: My clinical population are patients with concurrent addictions and mental health issues. These patients present complex clinical challenges, and so I have made efforts to use a method to think about and sort through those problems. CCPR: Please sha

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

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

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

Steroid-Induced Psychosis in the ­Pediatric Population

Topics: adolescents | Child Psychiatry | children | Free Articles | 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

Risk of Psychosis With Stimulants in ADHD Patients

Topics: ADHD | adolescents | amphetamine | Child Psychiatry | children | Free Articles | 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

Growing Rate of Suicide in Teens: Assessment and Prevention

Topics: adolescents | Assessment | Risk | teens | Treatment planning

Clinicians treating children and adolescents regularly encounter patients with suicidal thoughts. And with rising rates of adolescent suicide and shrinking inpatient stays, we’re seeing more of these suicidal kids in our offices. This article examines some of the novel risk factors and offers management and prevention strategies for you to consider ut