Increasing Use of Antipsychotics for Disruptive Behavior in Children

Kermit Cole
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Canadian researchers systematically reviewed all randomized controlled trials of second-generation antipsychotics (SGAs) and placebo in the treatment of disruptive behavior disorders in children, finding support for short-term, low-dose risperidone in youth with below-average IQ. “Placebo-controlled evidence is weak or nonexistent for SGAs other than risperidone, and is weak in youth with an average IQ.” The researchers examine reasons for the disconnect between evidence and clinical practice, including “extrapolation from studies in youth with autism or a subaverage IQ to normally developing youth … unavailability of psychosocial treatments; limited familiarity with other pharmacological options; clinical and cultural norms; and the influence of the pharmaceutical industry.”

Abstract →

Of further interest:
New concerns about antipsychotics for children: Antipsychotics used to treat disruptive behaviour: study (Ottawa Citizen)

Pringsheim, T., Gorman, D.; Second-Generation Antipsychotics for the Treatment of Disruptive Behaviour Disorders in Children: A Systematic Review. Canadian Journal of Psychiatry. December 2012; 57(12):722–727

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]

5 COMMENTS

  1. Sounds like a lot of blaming going on. Maybe the reason is a lack of skill in understanding youth’s behavior, or even a lack of genuine empathy for the youth in their care. A careful reading of just this abstract should tell any parent to stay far away from psychiatrists in seeking help for their kids – they seem very willing to ignore scientific evidence in favor of “clinical and cultural norms” that are useless or harmful to their own clients.

    —- Steve

    • In order to truly help a child one would need to know WHY they are acting as they are acting. Numbing them with medication or telling them to fix it is not going to do anything over the long term. Find the REASON and you can begin to help them, but those reasons will be different for everyone.

    • The only good thing that can come from that is the fact that they are now being honest and admitting that all they are doing is offering symptom relief, IF they are offering anything at all. Of course they ignore the fact that the side effects are usually much much worse than the initial symptoms ever were. But admitting you are not treating a brain disease and are instead offering symptomatic relief is a slight sign of honesty, if one can classify anything psychiatrists do as honest. Of course there is the opposite side to this and that is that since they are now just medicating symptoms they now have justified reasons in there own eyes at least for putting people on multi drug coctails. But for me a psychiatrist admitting they are not treating a brain disease and are instead simply offering symptomatic relief is them admitting the brain disease really is not working out.

  2. From Abstract:

    “Original Research

    Electronic Media Use and Addiction Among Youth in Psychiatric Clinic Versus School Populations

    Susan Baer, MD, PhD; Kelly Saran, MD; David A Green, PhD; Irene Hong, BA

    Correspondence: Dr Susan Baer, British Columbia Children’s Hospital, Box 141, 4500 Oak Street, Vancouver, BC V6H 3N1; Clinical Assistant Professor, University of British Columbia, British Columbia Children’s Hospital, Vancouver, British Columbia. [email protected].

    Objective: Electronic media use is highly prevalent among today’s youth, and its overuse in the general population has been consistently associated with the presence of psychiatric symptoms. In contrast, little information exists about electronic media use among youth with psychiatric disorders. Our study aims to compare patterns of television and computer and gaming station use among youth in psychiatric clinic and community-based school populations.
    Method: Surveys were completed by 210 youth and parents, from school (n = 110) and psychiatric clinic (n = 100) populations. Duration and frequency of television, video gaming, and nongaming computer activities were ascertained, along with addictive features of use. Descriptive and comparative analyses were conducted, with a statistical threshold of
    P < 0.05.
    Results: Quantitative and qualitative differences were identified between the patterns of use reported by the 2 groups. The mean reported daily duration of exposure to electronic media use was 6.6 hours (SD 4.1) for the clinic sample and 4.6 hours (SD 2.6) for the school sample (P < 0.01). Self-reported rates of addictive patterns related to computer and gaming station use were similar between the 2 populations. However, the clinically based sample favoured more violent games, with 29% reporting playing mature-rated games, compared with 13% reported by the school-based sample (P = 0.02). Youth with externalizing disorders expended greater time video gaming, compared with youth with internalizing disorders (P = 0.01).
    Conclusions: Clinically based samples of youth with mental illnesses spend more time engaged in electronic media activities and are more likely to play violent video games, compared with youth in the general population. Further research is needed to determine the long-term implications of these differences.

    Key Words: computer addiction, Internet addiction, adolescence, video games, psychiatric disorders, electronic media"

    I call it electromagnetic neurotoxicity. Watch this man's violence after sudden disconnect from electromagnetic source. And be sure to understand the lyrics.

    http://youtu.be/nzqF_gBpS84
    Kate Bush – Deeper Understanding – Official Video

    As the people here grow colder
    I turn to my computer
    And spend my evenings with it
    Like a friend.
    I was loading a new program
    I had ordered from a magazine
    "Are you lonely, are you lost?
    This voice console is a must"
    I press Execute.

    Hello, I know that you've been feeling tired.
    I bring you love and deeper understanding.
    Hello, I know that you're unhappy.
    I bring you love and deeper understanding.

    Well I've never felt such pleasure
    Nothing seemed to matter
    I neglected my bodily needs
    I did not eat, I did not sleep
    The intensity increasing
    'Til my family found me and intervened.
    But I was lonely, I was lost
    Without my little black box
    I pick up the phone and go Execute.

    Hello, I know that you've been feeling tired.
    I bring you love and deeper understanding.
    Hello, I know that you're unhappy.
    I bring you love and deeper understanding.

    I turn to my computer like a friend.
    I need deeper understanding.
    Give me deeper understanding.

    "The mean reported daily duration of exposure to electronic media use was 6.6 hours (SD 4.1) for the clinic sample and 4.6 hours (SD 2.6) for the school sample (P < 0.01)."

    For the "clinic" sample, the indicators are HIGHER? Does that mean people aren't doing their jobs?

    AS THE PEOPLE HERE GROW COLDER
    I TURN TO MY COMPUTER

    Nice original research. Thanks for sharing it with the World.

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