Children and Adolescents

In a major story, the New York Times presents the re-analysis by David Healy, Jon Jureidini, Mickey Nardo and others of Study 329, published in...

Huffington Post and journalist Steve Brill have combined to launch a 15 part series about how Johnson & Johnson illegally violated FDA restrictions by pushing the antipsychotic drug, Risperdal, for use with adolescents and the elderly. The series, entitled “America’s Most Admired Lawbreaker,” launched yesterday and will include mixed media, videos, podcasts, source documents, as well as 15 written chapters. Click more for a synopsis of part 1.

I imagine that everybody on this side of the issue knows by now that the eminent psychiatrist Jeffrey Lieberman, MD, Chief Psychiatrist at Columbia, and past President of the APA, called Robert Whitaker "a menace to society." The grounds for Dr. Lieberman's vituperation were that Robert had dared to challenge some of psychiatry's most sacred tenets! But in all the furor, it was largely ignored that in the same interview Dr. Lieberman had said something else that warrants additional discussion.

New data on the effects of social support after early onset of psychosis suggests that patients with intense social support function better than those without such help, but than once supports are removed the effects diminish.

Amid growing criticism about the over-prescription of psychotropic medication in foster care, Pennsylvania commissioned PolicyLab to conduct an analysis of the use of psychiatric drugs among all of the state’s Medicaid-enrolled children. The report, released in June, found that the rate of psychotropic prescriptions among youth in Medicaid and foster care was higher than previously reported.

The Chronicle of Education has called the soaring rates of anxiety and depression among college student an “Epidemic of Anguish.” PBS interviews Jennifer Ruark, the editor of the Chronicle series, and Micky Sharma, the director of counseling at Ohio State University. Ruark reports that about “1 in 4 students reporting to campus counseling centers now are already on some kind of psychotropic medication.” Sharma adds that “just because a student is crying does not mean he or she needs psychotherapy. Sometimes that’s actually the type of emotional response that I would want to see.”

Antipsychotics are currently the predominant treatment for individuals diagnosed with schizophrenia, but there is an accumulating body of research that links the use of these drugs to structural abnormalities in the brain. A recent meta-analysis suggests that gray matter loss in the brain may depend on the dose and class of the antipsychotic.

New York State has investigated five large insurance companies for violating state and federal mental health parity laws by illegally denying to cover claims for behavioral health conditions and drug abuse treatment, according to a report by North County Public Radio (ncpr).

New research finds that brain matter loss in patients diagnosed with schizophrenia is correlated with antipsychotic use, according to Psych Central. The analysis suggests that the continued use of antipsychotics is linked with progressive cortical gray matter loss.

This month’s issue of JAMA Psychiatry ran an editorial commenting on recent research revealing that the majority of youth prescribed antipsychotics have not been diagnosed with a mental disorder.

A new study out of the University of Missouri examines the relationship between forgiveness and depression. Medical Daily reports, “while your therapist might tell you to forgive yourself when times get tough, it’s not always just self-forgiveness that decreases depression. Rather, forgiving others seems to have the most positive impact.”

On Tuesday, NPR told the story of DeAngelo Cortijo. DeAngelo became a foster kid at age 3 after his mother attempted suicide. He was “diagnosed with bipolar and anxiety disorders, attachment disorder, intermittent explosive disorder or posttraumatic stress disorder,” and was prescribed “a combination of antipsychotics, antidepressants and stimulants, and was told that taking them was his only hope of being normal.” Through equine therapy, DeAngelo was eventually able to get off all of his medication. Now, California is hoping to pass reforms that would prevent foster kids, like DeAngelo, from being “prescribed antipsychotic drugs at double to quadruple the rate of that not in foster care.”

“We are consistently seeing sensory, motor, and cognitive issues pop up more and more in later childhood, partly because of inadequate opportunities to move and play at an early age,” writes Angela Hanscom in The Washington Post.

In addition to hosting the Panorama programs and The Famous Grouse history of Study 329, Study329.org has a comprehensive timeline on the origins of concerns about the SSRIs and the risk of suicide, initially with Prozac and subsequently with Paxil/Seroxat. The hope is to provide a comprehensive repository for anyone who wants to study SSRIs, RCTs, and Study 329 in particular.

MedPageToday reports that Janssen Pharmaceuticals omitted data from a 2003 study that connected Risperdal with serious side effects. Janssen was previously sued by the FDA for marketing Risperdal for off-label uses and settled for $2.2 billion in 2013. Earlier this year, a man with autism was awarded $2.5 million after growing breasts while on Risperdal. According to MedPage, documents from this latest case reveal missing data tables from a 2003 study “designed to ferret out potential adverse effects of long-term risperidone use.” The missing tables were related to elevated prolactin levels and side effects, including gynecomastia in men.

Parents Opposed to Pot, a group opposed to the legalization of marijuana, criticizes a recent University of Pittsburgh study which found no correlation between pot use and mental health. They contest the results and insist that since the long-term study began in 1987, “skunk” or high THC pot has been on the rise.

Bertha Madras, professor of psychobiology at Harvard Medical School, has printed a critique listing 20 flaws to a recent study finding no differences in physical or mental health problems between users and non-users of marijuana.

On Saturday morning, Susan Inman, writing for HuffPost Canada, published “What You’re not Hearing About the Hearing Voices Movement.” In it, she criticizes HVM for “failing to differentiate between the needs of people who actually have psychotic disorders and those who don't.” On Sunday the Bay Area Hearing Voices Network published an open letter in response, writing: “Ms. Inman has profoundly mischaracterized hearing voices networks (HVNs) and also demonstrates a troubling lack of understanding of the empirical literature on psychosis, optimal psychosocial intervention and recovery.”

The International Business Times covers a new study showing “trials for new antidepressant medications may not be applicable to the population at large.” “The finding, published in the Mayo Clinic Proceedings, shows recent trials are less generalizable than the prior studies, as researchers excluded most depressed patients from drug company-sponsored treatment studies.”

Healthline reports that as five second-generation antipsychotics (SGAs) lose patent protection, Medicaid expenditures for antipsychotics are projected to be cut in half over the next five years. But some worry that the decrease in spending may lead policymakers to lift existing restrictions on antipsychotics at a time when most SGAs are prescribed to children for off-label reasons.

What would happen if the mental health system fully recognized the pervasive and profound impacts of trauma on their clients? How might a deeper appreciation of the multi-faceted sequelae of childhood maltreatment and toxic stressors reshape mental health services? While the implementation of trauma-informed care in mental health programs has made significant inroads, the dominant bio-reductionist model continues to constrain and undermine progress.

Former DSM-IV task force chair Allen Frances takes aim at the “massive overuse of psychotropic medication in children” in an article for the Psychiatric Times. He shares a checklist of questions for doctors to consider before prescribing medication to children. Frances warns: “We simply don’t know what will be the long-term impact of bathing a child’s immature brain with powerful chemicals.”

In this week’s NY Times Modern Love blog Hannah Louise Poston tells the story of living with her severely depressed boyfriend, Joe, and how her decision to buy a kitten improved their relationship. “The next morning when we woke up, the first words out of Joe’s mouth were, ‘Where’s the kitten?’ And the kitten’s first act, when she heard his voice, was to ice-pick her way up the quilt and jump on his face. That same summer, Joe mustered the energy to make major changes in his life…”

“When people with early-stage symptoms took omega-3 supplements for three months, they had much lower rates of progression than those who did not,” according to research out of Australia covered in this month’s issue of the New Scientist.

The majority of children, adolescents and young adults prescribed antipsychotic medications have not been diagnosed with a mental disorder, according to a recent study published in JAMA Psychiatry.