The Child's Doctor articles
The Child's Doctor, Journal of Children's Memorial Hospital, Chicago
The Child's Doctor is published by Children's Memorial Hospital twice a year for community-based physicians. The journal offers continuing medical education (CME) through articles authored by Children's Memorial's physicians. It also includes news articles on research at Children's Memorial. Read the latest issue of The Child's Doctor here.
Articles on topics in pediatric and adolescent psychology/psychiatry:
Pharmacologic Treatment of Pediatric Anxiety and Depression by Margery R. Johnson, MD Published Fall 2010
Treatment of depression and anxiety has become more a part of primary care medicine since the late 1980s, when the first selective serotonin reuptake inhibitor (SSRI) fluoxetine became available, spurring an increasing number of these newer medications that are safer and more effective in the pediatric population than the older medications for depression and anxiety. This article will review important issues involved in overseeing treatment with SSRIs, including medication initiation and discontinuation, monitoring for suicidal tendencies and other potential adverse effects, and the possibility of a bipolar disorder in patients with depression.
Impact of Traumatic Exposure and Community Violence: Incorporating a Trauma Lens into Pediatric Practice by Colleen Cicchetti, PhD, and Tali Raviv, PhD Published Spring 2010
There is growing awareness that increasing numbers of children and adolescents are exposed to traumatic events and experiences that may negatively impact their functioning. Pediatricians serve an important role in assessment for traumatic responses, education about handling normal reactions, and referrals to address the more severe symptoms of traumatic exposure. The pediatric community in particular needs to be aware of the risks of medical trauma and reactions that may arise in response to pain, injury, illness, invasive medical procedures or painful treatments.
Emotional and Behavioral Aspects of Pediatric Obesity by Kelly Walker Lowry, PhD Published Spring/Summer 2009
Children and adolescents who are overweight or obese are at increased risk for certain psychiatric disorders and impaired psychological functioning. Community practitioners are often the first (or only) point of evaluation and intervention for these youth. Being able to recognize common symptoms of impaired emotional or behavioral functioning is essential to developing appropriate treatment plans and referrals when necessary.
Early Identification of Autistic Spectrum Disorders by Julie Rinaldi, PhD Published Fall 2008
Autistic spectrum disorders (ASDs) are commonly seen in pediatric practice. Since early intervention is proven to be quite helpful for children with ASDs, early diagnosis is critical. To help pediatricians identify at-risk children at an earlier age, the American Academy of Pediatrics (AAP) recently issued a clinical report that calls for universal screening of all children at the 18-month preventive care visit, with a repeat screening at 24 months. The report also recommends ongoing surveillance and provides red flags that require immediate referral for comprehensive ASD evaluation needed for diagnosis. This article will review the clinical signs of ASDs, as well as the recommendations for screening and timely referrals for diagnostic evaluation and intervention services.
Research: Altered Gene Expression and Autism by Vita Lerman Published Fall 2008
Can the development of autism be prevented? Can the symptoms of this complex disorder be reversed? Children's Memorial Research Center's Laura Herzing, PhD, is optimistic that in 5 to 10 years we will have an epigenetically based treatment to help at least a subset of patients with autism, and potentially even prevent autism in some genetically susceptible children.
Treatment of Anxiety Disorders in Children and Adolescents by Rebecca Ford-Paz, PhD Published Spring 2008
Despite the emergence of promising treatments, child anxiety is often under-identified and under-treated due to the lack of developmentally appropriate and reliable assessment at points of entry into the health care system. Child anxiety is often disregarded due to the misperception that anxiety in children is developmentally appropriate and that children will outgrow their fears. To complicate matters, anxiety in children presents differently from anxiety in adults and, therefore, may be overlooked or mislabeled. Childhood anxiety, however, has been linked to adolescent and adult anxiety, other psychological disorders, and substance abuse. Thus it is important for pediatricians to be familiar with developmentally appropriate anxiety, the unique presentation of anxiety in children, and ways to determine when further treatment is necessary. Increased awareness about evidence-based treatment for child anxiety would help pediatricians make informed referrals for mental health care.
Anorexia Nervosa in Pediatrics by Myra L. McSwain Kamran, MD (no longer at Children's Memorial Hospital) Published Spring 2007
Given the current health focus on childhood obesity, it is important to keep in mind that young patients, often with the family's involvement, may take weight loss efforts to the extreme, resulting in the development of an eating disorder. Anorexia nervosa is an eating disorder characterized by a patient's overwhelming desire for thinness, which usually leads to extreme weight loss. Age of onset ranges from preteen to adulthood and peaks bi-modally at ages 13 to 14 and 17 to 18 years. Although over 90% of patients with the disorder are females, males can suffer from anorexia. This disorder can affect patients of any ethnicity and socioeconomic status. Although anorexia is rare, patients usually require considerable attention from their pediatrician. It is particularly important for pediatricians to recognize precursor signs of anorexia and intervene, since early detection has been linked with better recovery.
Cognitive Sequelae of Pediatric Illnesses by Frank Zelko, PhD, and Lisa Sorensen, PhD Published Fall 2006
Many diseases of childhood and adolescence that were previously life threatening are now successfully treated and managed as chronic illnesses. While survival and overall quality of life have improved significantly in these conditions, a critical consideration is their impact upon children's cognitive functioning and school performance. This review will consider current knowledge about the effects of selected illnesses involving major organ systems, excluding primary central nervous system disorders and other conditions (eg, leukemia) for which adverse cognitive effects are broadly known.
Bullying in Schools: Pediatrician's Role in Identification and Prevention by Karen Gouze, PhD Published Spring 2006
Up to 30% of all students are either bullies, targets of bullying, or both, with highest prevalence of bullying occurring in elementary schools. Victims of this form of recurrent abuse commonly suffer from depression and suicidal ideation, at ages as early as 9 to 13 years. Chronically bullied children may also present with symptoms similar to those of domestic violence victims. Due to potentially severe psychosocial consequences, bullying has become recognized as a serious health issue that calls for involvement of physicians in its identi?cation and prevention. This review should help pediatricians recognize high risk patients, effectively screen potential victims of bullying, as well as discuss with parents antidotes to bullying and assertiveness training for children.
Bipolar Disorder in Pediatrics by Mina Dulcan, MD Published Fall 2005
Bipolar disorder (formerly called manic-depressive disorder) has become increasingly recognized in children and adolescents. It occurs even in preschool-aged children, although this is very rare. Prior to mid-adolescence, bipolar disorder manifests differently from the adult-onset type, and it can be mistaken by pediatricians for attention-deficit/hyperactivity disorder (ADHD). Differentiating these conditions is complicated by very high comorbidity of ADHD with pediatric bipolar disorder. Some symptoms of mania, such as hyperactivity and distractibility, overlap with ADHD, which contributes to misdiagnosis and inappropriate treatment. This review will discuss the presentation of mania in this age group, to help community physicians consider mania in the differential diagnosis of ADHD and in evaluation of children with poor response to ADHD medication. Children with suspected bipolar disorder will need child psychiatric referral for diagnosis, initial stabilization and treatment.
Helping Parents Manage Early Childhood Behavior Problems by Julie Rinaldi, PhD Published Spring 2005
Child behavior problems are among the most common mental health disorders in childhood, with 7% to 25% prevalence, depending on the population surveyed. According to a survey of primary care physicians in the Chicago area, 21% of children aged 2 to 5 years met criteria for a behavior disorder and 9% were rated as severe. The majority of these children may only have contact with a medical professional in a primary care setting. This review will help pediatricians to recognize cases that warrant referral and offer advice to parents who often feel ill equipped to manage their children's behavioral problems.
Ask the Experts: Psychiatric Hospitalization by Thomas Cummins, MD Published Spring 2004
When is hospitalization indicated in the treatment of severe psychiatric illness in children and adolescents
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