Navigation Links
Child mental health experts issue psychiatric medication treatment guidelines for preschoolers
Date:12/3/2007

The number of preschool-age children being treated with stimulants, antidepressants and other psychiatric drugs is on the rise, despite limited research and a lack of clinical practice guidelines. In a first step toward standardizing treatment approaches, child mental health professionals from the Bradley Hasbro Childrens Research Center and 11 other institutions have developed recommendations for specific disorders to help clinicians who are considering medications for children ages 3 to 6.

These guidelines from the Preschool Psychopharmacology Working Group which includes clinicians and researchers in early childhood psychiatric disorders, psychopharmacology, general and behavioral pediatrics, neurodevelopmental processes, and clinical psychology are published in the December issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

Without established treatment guidelines, clinicians and families face a delicate balancing process. If child continues to have severe or dangerous symptoms after non-medication treatments, the physicians and families must weigh the potential risks of medications with the risks of not intervening in complex clinical situations, said lead author Mary Margaret Gleason, M.D., of the Bradley Hasbro Childrens Research Center.

Our goal was to begin to close the gap between practice and evidence by clearly defining the current state of psychopharmacological treatment of preschoolers, encouraging judicious practice, and using existing evidence and clinical consensus to provide treatment guidelines for these young children, added Gleason, whos also a clinical assistant professor of psychiatry at The Warren Alpert Medical School of Brown University.

Gleason and colleagues developed treatment algorithms for nine common mental health disorders based on a review of existing literature on the use of psychiatric medications in preschoolers, knowledge about preschoolers development, available data on school-age children and adolescents, and expert clinical experience.

The algorithms guide the clinician through recommended assessment and treatment steps. The first step in each algorithm is a comprehensive diagnostic assessment, taking into consideration the childs emotional and behavioral symptoms, relationship patterns, medical history and developmental history and status.

If a psychiatric diagnosis is confirmed, the authors recommend clinicians start with family-focused psychotherapy such as parent management training or dyadic (parent-child) psychotherapy before considering medication. However, if the child is not responding and medication is deemed necessary, they suggest it be used in conjunction with psychotherapy.

Treatment algorithms were established for attention deficit and hyperactivity disorder, disruptive behavior disorders, major depressive disorder, bipolar disorder, anxiety disorders, posttraumatic stress disorder, obsessive-compulsive disorder, pervasive developmental disorders (such as autism), and primary sleep disorders.

These guidelines emphasize the importance of a family-focused assessment by clinicians with experience working with young children, the use of psychotherapy as the first line treatment for young children with severe psychiatric disorders, and the value of careful monitoring of symptoms and side effects when treating young children, said Gleason. They are not intended to promote the use of medications; rather, we anticipate that application of these guidelines may actually reduce the number of preschoolers who are taking psychiatric drugs.

The algorithms share five common factors:

  • Assessment and diagnosis at every decision point in order to reassess the diagnosis and formulation both of which are critical, given the rapid development of preschoolers
  • Psychotherapeutic interventions
  • Each step is marked by the level of evidence supporting the recommendation, allowing clinicians to consider the body of evidence and apply it to the individual patient
  • Recommendations for a discontinuation trial after successful medication treatment to reassess the childs symptoms and appropriate treatment
  • Consultation with an expert in child psychiatry if the physician arrives at the end of the algorithm with ongoing impairment and distress

The authors stress that the algorithms represent their best attempt to integrate data and clinical experience; however, clinicians may determine that an alternative approach is indicated in a particular clinical situation.

We hope this information will be useful for clinical practice, highlight opportunities to advocate for the well-being of young children, and encourage future clinical research in treating very young children with both medication and therapy something thats urgently needed in this preschool population, said Gleason.


'/>"/>

Contact: Jessica Collins Grimes
jgrimes2@lifespan.org
401-432-1328
Lifespan
Source:Eurekalert

Related medicine news :

1. Children of depressed moms do better when dad is involved, SLU researcher finds
2. High pollution linked to poor lung function growth in children in Mexico City
3. Genetic predisposition increases childhood asthma risk
4. NYC-area 1st: Morgan Stanley Childrens Hospital performs transcatheter pulmonary valve replacement
5. Obese Children Miss More School Days
6. Treating diabetes during pregnancy can break link to childhood obesity
7. Ultra-Runner to Run 63 Marathons in 63 Days for Children with Incurable Disease
8. Chinas 1-child policy could backfire on its elderly
9. Psoriasis Cure Now offers Back to School Resources for Parents of Children with Psoriasis
10. Researchers estimate about 9 percent of US children age 8 to 15 meet criteria for having ADHD
11. Majority of 2.4 Million U.S. Children With ADHD Not Diagnosed or Consistently Treated, According to New Gold Standard Study by Cincinnati Childrens Researchers
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... TX (PRWEB) , ... June 25, 2016 , ... Austin ... of the American College of Mohs Surgery and to Dr. Russell Peckham for medical ... and highly effective treatment for skin cancer. The selective fellowship in Mohs Micrographic Surgery ...
(Date:6/25/2016)... ... ... First Choice Emergency Room , the largest network of independent freestanding emergency ... its new Mesquite-Samuell Farm facility. , “We are pleased to announce Dr. Ogunleye ... M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. , Dr. Ogunleye ...
(Date:6/25/2016)... ... ... On Friday, June 10, Van Mitchell, Secretary of the Maryland Department of Health and ... their exemplary accomplishments in worksite health promotion. , The Wellness at Work Awards took ... the BWI Marriott in Linthicum Heights. iHire was one of 42 businesses to receive ...
(Date:6/24/2016)... ... , ... Those who have experienced traumatic events may suffer from a complex ... as drug or alcohol abuse, as a coping mechanism. To avoid this pain and ... a traumatic event. , Trauma sufferers tend to feel a range of emotions, from ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... and Scientific Sessions in Dallas that it will receive two significant new grants ... grants came as PHA marked its 25th anniversary by recognizing patients, medical professionals ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... June 23, 2016 Roche (SIX: RO, ROG; ... for its Elecsys BRAHMS PCT (procalcitonin) assay as a ... septic shock. With this clearance, Roche is the first ... integrated solution for sepsis risk assessment and management. ... infection and PCT levels in blood can aid clinicians ...
(Date:6/23/2016)... 23, 2016 Bracket , a leading clinical ... generation clinical outcomes platform, Bracket eCOA (SM) 6.0, at ... 26 – 30, 2016 in Philadelphia , ... Outcome Assessment product of its kind to fully integrate with ... Bracket eCOA 6.0 is a flexible platform for electronic clinical ...
(Date:6/23/2016)... Revolutionary technology includes multi-speaker listening ... industry leaders in advanced audiology and hearing aid technology, ... ™, the world,s first internet connected hearing aid that ...      (Photo: http://photos.prnewswire.com/prnh/20160622/382240 ) , ... ,world firsts,: , TwinLink™ - the first ...
Breaking Medicine Technology: