Children and Adolescents

A “not otherwise specified” (NOS) diagnosis is often used when an individual may have some symptoms related to a psychiatric diagnosis but does not meet enough criteria to warrant a particular diagnosis. A new study, published online ahead of print in Psychiatric Services, reveals that the proportion of mental health visits resulting in such NOS diagnoses rose to nearly fifty percent, and that these diagnoses do not result in more conservative psychiatric drug prescriptions.

Joan Cook, professor of Psychology at Yale, writes than in her work with military veterans she realized that her psychotherapy techniques mattered much less than her training had indicated. Instead, what mattered was “the bond forged over years of therapy,” known as “the therapeutic alliance.”

More than ten-percent of adults in the United States are currently prescribed at least one psychiatric medication but there is currently a lack of research on the prevalence of adverse drug events (ADEs) associated with these prescriptions outside of clinical trials.

The results of epidemiological studies of the prevalence of hallucinations strongly imply that psychosis exists on a spectrum, according to the Scientific American. This suggests “that the standard treatment for a psychotic episode might be due for an overhaul.”

NPR reports on study, published in BMJ, that found computer-assisted therapy to be no more effective than care provided by a primary care doctor. "We do still need the human touch or the human interaction, particularly when people are depressed."

For the New York Times Well blog, Katherine Ellision writes about how the rise in ADHD diagnoses globally is sparking “debates about the validity of the diagnosis and the drugs used to treat it.”

A paradigm is a way of thinking about things. For the past 60 or so years, our thinking about mental health and illness has been dominated by what can be referred to as the "DSM (Diagnostic and Statistical Manual of Mental Disorders) paradigm." What this looks like in everyday practice is that when a child is referred to my behavioral pediatrics practice for anxiety, the questions that parents, referring doctors, and teachers ask is, "Does he have anxiety disorder?" followed by "How to we manage his behavior?" and "Does he need medication?"

Infants exposed to SSRIs and benzodiazepines during pregnancy show impaired neurologic functioning in the first month after birth, according to a new study published in the American Journal of Psychiatry. While infants exposed SSRIs alone showed neurobehavioral effects throughout the first month, those exposed to an SSRI and a benzodiazepine had more significant problems.

“My vegetable beds have even buoyed me through more acute stressors, such as my medical internship, my daughter’s departure for college, and a loved one’s cancer treatment,” writes Dr. Daphne Miller. Now neuroscientists are attempting to study the antidepressant effects of soil microbes in hopes of unlocking the secrets of a powerful mood enhancer.

Different types of child abuse have equivalent psychological effects, according to a study in JAMA Psychiatry. It has previously been assumed that emotional and verbal abuse could have different or less harmful impact on a child’s psychology than physical or sexual abuse, but research now suggests that these forms of abuse can be just as damaging.

The American Academy of Pediatrics came out with new recommendations that suggest doctors screen all of their child patients for hunger. About 16 million children in the US live in food scarcity and poverty that can lead to physical health issues as well as behavioral issues, which can then be misdiagnosed.

In this month’s Schizophrenia Bulletin, a person diagnosed with autism, OCD, obsessive-compulsive personality disorder, and major depressive disorder provides a first-hand close reading and description of their own psychiatric experiences.

Reuters covers a new study in JAMA Psychiatry that suggests that children exposed to physical abuse and emotional abuse suffer from similar psychological and behavioral problems. “Even though doctors and parents often believe physical or sexual abuse is more harmful than emotional mistreatment or neglect, the study found children suffered similar problems regardless of the type of maltreatment endured.”

ServiceNet, a mental health and human service agency in western Massachusetts, received a three year, two million dollar grant to launch a program designed to support young adults who have recently experienced their first episode of psychosis. The Prevention and Recovery Early Psychosis (PREP) program is funded by the Massachusetts department of mental health and is designed to treat psychosis as a symptom, not an illness, resulting from other illnesses, substance abuse, trauma, or extreme stress.

In the Boston Globe, Sarah Schweitzer tells the story of a young boy brutally abused by his parents then given to his grandparents who struggled with extreme poverty and homelessness. “Researchers now understood that trauma could alter the chemistry of developing brains and disrupt the systems that help a person handle stress, propelling a perpetual state of high alert. The consequences could be lifelong. As an adult, he’d be more likely to suffer anxiety and depression and heart disease and stroke. His ability to hold a job, manage money, and make good decisions could be compromised. And there was evidence, controversial but mounting, that he could pass on these traits to his children.”

Researchers recently completed a first of its kind, large-scale international survey of attitudes about mental health and they were surprised by the results. According to their analysis published in this month’s issue of the Journal of Affective Disorders, people in developed countries, like the United States, are more likely to assume that ‘mental illnesses’ are similar to physical illnesses and biological or genetic in origin, but they are also much less likely to think that individuals can overcome these challenges and recover

In the third major verdict of its kind, drug giant Johnson & Johnson was ordered to pay a Maryland man who grew female breasts while taking the antipsychotic Risperdal. The company failed to warn doctors, patients, and regulators of the risk of abnormal breast development in young males and now faces about 5,400 lawsuits involving the drug.

The Washington Examiner reports that the manufacturer of the antipsychotic Abilify is seeking FDA approval for new digitized pills that would alert doctors if patients fail to take their drugs on schedule.

The German news agency DW features a video report on whether cannabidiol, an active substance derived from marijuana, can help relieve the symptoms of schizophrenia.

New York Times columnist, Nicholas Kristof, relates the story of Andrew Francesco, a boy who began taking Ritalin at age five and died from complications with Seroquel when he was fifteen. His father, a former pharmaceutical industry executive, reveals the industry’s greed in his memoir “Overmedicated and Undertreated.” Now the industry is pushing for a first-amendment right to market its drugs for off-label uses.

The National Institute of Mental Health (NIMH) is increasingly shifting its research emphasis toward attempting to uncover biomarkers for “mental diseases,” which may have dramatic consequences for research and training in clinical psychology. In an article to be published in next month’s Professional Psychology: Research and Practice, Marvin Goldfried outlines how the shift in funding priorities for psychological research is tied to the needs of pharmaceutical companies and the biological model in psychiatry.

Two companies have committed to FDA review for video games that they claim can be used to treat “ADHD,” but many scientists remain skeptical. “At the annual meeting of the American Academy of Child & Adolescent Psychiatry on Wednesday, Akili Interactive Labs presented data from a pilot study of its video game, Project: EVO, that showed some positive results in children with attention-deficit hyperactivity disorder (ADHD).”

In 2014, then National Institute of Mental Health (NIMH) director, Thomas Insel, speculated that ketamine “might be the most important breakthrough in antidepressant treatment in decades.” A recent review of the research suggests that while ketamine may produce a rapid short-term improvement in depression, the effect is short-lived and the potential for addiction and dependence warrants considerable caution.

At Alternet, Jay Syrmopoulos of The Free Thought Project discusses new research on the use of medical marijuana as a treatment for ADHD within the context of the ongoing debate over the validity of the ADHD diagnosis.

I was a psychiatrist who participated in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). Although I welcomed the positive headlines that heralded the study's results, the reports left me with mixed feelings. What happened to render the notion that talking to people about their experiences and helping them find jobs or go back to school is something novel?