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https://www.readbyqxmd.com/read/28800802/special-considerations-in-the-pediatric-psychiatric-population
#1
REVIEW
Genevieve Santillanes, Ruth S Gerson
Youth with psychiatric and behavioral complaints commonly present to emergency departments (EDs), which often lack dedicated mental health staff. This article addresses techniques EDs can use to better care for children in need of psychiatric assessment and medical clearance, specifically addressing the evaluation of youth with suicidal ideation and coexisting medical and psychiatric needs. The evaluation and management of youth with agitation and aggression are also discussed. The article concludes with a discussion of systems changes needed to truly improve emergency care for psychiatrically ill youth...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28760727/randomized-trial-comparing-the-electronic-composite-psychosocial-screener-youthchat-with-a-clinician-interview-assessment-for-young-people-a-study-protocol
#2
Hiran Thabrew, Arden Corter, Felicity Goodyear-Smith, Mary Goldfinch
BACKGROUND: Psychosocial problems such as depression, anxiety, and substance abuse are common and burdensome in young people, particularly those with long-term physical conditions such as asthma and diabetes. In New Zealand, "screening" for such problems is undertaken routinely only with Year 9 students in low-decile schools and opportunistically in pediatric settings using a nonvalidated and time-consuming clinician-administered Home, Education/employment, Eating, Activity, Drugs, Sexuality, Suicide/depression, Safety (HEEADSSS) interview...
July 31, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28725956/non-suicidal-self-injury-in-pediatric-bipolar-disorder-clinical-correlates-and-impact-on-psychosocial-treatment-outcomes
#3
Heather A MacPherson, Sally M Weinstein, Amy E West
Non-suicidal self-injury (NSSI) in childhood is not well documented, especially among youth with pediatric bipolar disorder (PBD). The current study evaluated prevalence and correlates of NSSI, and its impact on intervention response, in a randomized trial of Child- and Family-Focused Cognitive-Behavioral Therapy (CFF-CBT) versus Treatment As Usual (TAU), adjunctive to pharmacotherapy. This study included 72 children ages 7-13 (58% male) with PBD. NSSI and correlates were assessed at baseline; mood and psychiatric severity were measured longitudinally...
July 20, 2017: Journal of Abnormal Child Psychology
https://www.readbyqxmd.com/read/28716803/psychiatric-boarding-in-the-pediatric-inpatient-medical-setting-a-retrospective-analysis
#4
Katherine A S Gallagher, I Simona Bujoreanu, Priscilla Cheung, Christine Choi, Sara Golden, Kerry Brodziak, Gabriela Andrade, Patricia Ibeziako
BACKGROUND AND OBJECTIVES: Psychiatric concerns are a common presenting problem for pediatric providers across many settings, particularly on inpatient medical services. The volume of youth requiring intensive psychiatric treatment outnumbers the availability of psychiatric placements, and as a result many youth must board on pediatric medical units while awaiting placement. As the phenomenon of boarding in the inpatient pediatric setting increases, it is important to understand trends in boarding volume and characteristics of pediatric psychiatric boarders (PBs) and understand the supports they receive while boarding...
July 17, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28716517/lethal-suicide-attempt-with-a-mixed-drug-intoxication-of-metoprolol-and-propafenone-a-first-pediatric-case-report
#5
Ivana Kacirova, Milan Grundmann, Martin Kolek, Erika Vyskocilova-Hrudikova, Romana Urinovska, Petr Handlos
INTRODUCTION: The β1 adrenergic receptor blocker metoprolol is often prescribed together with the antiarrhythmic drug propafenone. Both are metabolized by cytochrome P450 2D6 and propafenone is also an inhibitor of this enzyme. We present a pediatric case showing metoprolol and propafenone intoxication in combination. CASE: A 14-year-old girl was admitted to a local emergency department after ingestion of metoprolol (probably 1g) and propafenone (probably 1.5-3g) in a suicide attempt...
June 29, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28708330/mortality-in-children-with-low-grade-glioma-or-glioneuronal-tumors-a-single-institution-study
#6
Santhosh A Upadhyaya, Yahya Ghazwani, Shengjie Wu, Alberto Broniscer, Fredrick A Boop, Amar Gajjar, Ibrahim Qaddoumi
BACKGROUND: While pediatric low-grade glioma/glioneuronal tumors (LGG/LGGNTs) are considered slow-growing, indolent tumors with excellent long-term prognosis, mortality due to the disease is not unknown. Few studies have addressed the cause of death in this population. METHODS: Retrospective review of clinicopathologic and radiologic data for children 21 years or younger with LGG/LGGNT who died at St. Jude Children's Research Hospital between April 1985 and June 2015...
July 14, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28657951/firearm-deaths-in-america-can-we-learn-from-462-000-lives-lost
#7
Shelby Resnick, Randi N Smith, Jessica H Beard, Daniel Holena, Patrick M Reilly, C William Schwab, Mark J Seamon
OBJECTIVE: We sought to determine whether state firearm legislation correlated with firearm-related fatality rates (FFR) during a 15-year period. BACKGROUND: The politicized and controversial topic of firearm legislation has been grossly understudied when the relative impact of American firearm violence is considered. Scientific evidence regarding gun legislation effectiveness remains scant. METHODS: Demographic and intent data (1999-2013) were collected from the Centers for Disease Control and Prevention's Web-Based Injury Statistics Query and Reporting System database and compared by state firearm legislation rankings with respect to FFR...
June 27, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28639299/understanding-suicide-across-the-lifespan-a-united-states-perspective-of-suicide-risk-factors-assessment-management
#8
Ian H Steele, Natasha Thrower, Paul Noroian, Fabian M Saleh
Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States...
June 21, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28573672/memo-an-mhealth-intervention-to-prevent-the-onset-of-depression-in-adolescents-a-double-blind-randomised-placebo-controlled-trial
#9
Robyn Whittaker, Karolina Stasiak, Heather McDowell, Iain Doherty, Matthew Shepherd, Shireen Chua, Enid Dorey, Varsha Parag, Shanthi Ameratunga, Anthony Rodgers, Sally Merry
BACKGROUND: Depression often starts in adolescence making it an ideal time to intervene. We developed a universal cognitive behavioural therapy-based programme (MEMO CBT) to be delivered via multimedia mobile phone messages for teens. METHODS: We conducted a prospective multicentre, randomised, placebo-controlled superiority trial in 15 high schools in Auckland, New Zealand, comparing MEMO CBT with a control programme [MEMO control] matched for intensity and type of message but with alternative content not targeting depression...
June 2, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28538605/the-heads-ed-evaluating-the-clinical-use-of-a-brief-action-oriented-pediatric-mental-health-screening-tool
#10
Mario Cappelli, Roger Zemek, Christine Polihronis, Nathalie R Thibedeau, Allison Kennedy, Clare Gray, Mona Jabbour, Sarah Reid, Paula Cloutier
OBJECTIVES: This effectiveness study aimed to evaluate the clinical use of the HEADS-ED tool for patients presenting to a pediatric emergency department (PED) for mental health (MH) care. METHODS: In this pragmatic trial, PED physicians used the HEADS-ED to guide their assessment and identify areas of MH need in 639 patients (mean [SD], 15.16 [1.40] years; female, 72.6%) who presented to the emergency department with MH concerns between May 2013 and March 2014. RESULTS: The HEADS-ED guided consultation to psychiatry/crisis, with 86% receiving a recommended consult...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28536190/pediatric-firearm-related-injuries-in-the-united-states
#11
REVIEW
Kavita Parikh, Alyssa Silver, Shilpa J Patel, Sabah F Iqbal, Monika Goyal
Pediatric firearm-related deaths and injuries are a national public health crisis. In this Special Review Article, we characterize the epidemiology of firearm-related injuries in the United States and discuss public health programs, the role of pediatricians, and legislative efforts to address this health crisis. Firearm-related injuries are leading causes of unintentional injury deaths in children and adolescents. Children are more likely to be victims of unintentional injuries, the majority of which occur in the home, and adolescents are more likely to suffer from intentional injuries due to either assault or suicide attempts...
May 23, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28510296/pharmacokinetics-and-safety-of-single-dose-inhaled-loxapine-in-children-and-adolescents
#12
Sally Selim, Robert Riesenberg, James Cassella, Jeevan Kunta, Edward Hellriegel, Mark A Smith, Alexander A Vinks, Laura Rabinovich-Guilatt
This multisite open-label study sought to characterize the pharmacokinetics and safety of a single dose of inhaled loxapine in children and adolescents. Loxapine powder for oral inhalation was administered via a single-use handheld drug device to children and adolescents (aged 10-17 years) with any condition warranting chronic antipsychotic use. Patients were dosed according to body weight and cohort (<50 kg [n = 15], 2.5 or 5 mg; ≥50 kg [n = 15], 5 or 10 mg); the first 6 patients (cohort 1) enrolled in each weight group received the lower dose...
May 16, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28503110/pediatric-mania-the-controversy-between-euphoria-and-irritability
#13
Giulia Serra, Mai Uchida, Claudia Battaglia, Maria Pia Casini, Lavinia De Chiara, Joseph Biederman, Stefano Vicari, Janet Wozniak
Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania...
April 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28423145/brief-behavioral-therapy-for-pediatric-anxiety-and-depression-in-primary-care-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
V Robin Weersing, David A Brent, Michelle S Rozenman, Araceli Gonzalez, Megan Jeffreys, John F Dickerson, Frances L Lynch, Giovanna Porta, Satish Iyengar
Importance: Anxiety and depression affect 30% of youth but are markedly undertreated compared with other mental disorders, especially in Hispanic populations. Objective: To examine whether a pediatrics-based behavioral intervention targeting anxiety and depression improves clinical outcome compared with referral to outpatient community mental health care. Design, Setting, and Participants: This 2-center randomized clinical trial with masked outcome assessment conducted between brief behavioral therapy (BBT) and assisted referral to care (ARC) studied 185 youths (aged 8...
June 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28402749/mental-health-concerns-and-insurance-denials-among-transgender-adolescents
#15
Leena Nahata, Gwendolyn P Quinn, Nicole M Caltabellotta, Amy C Tishelman
PURPOSE: Transgender youth are at high risk for mental health morbidities. Based on treatment guidelines, puberty blockers and gender-affirming hormone therapy should be considered to alleviate distress due to discordance between an individual's assigned sex and gender identity. The goals of this study were to examine the: (1) prevalence of mental health diagnoses, self-injurious behaviors, and school victimization and (2) rates of insurance coverage for hormone therapy, among a cohort of transgender adolescents at a large pediatric gender program, to understand access to recommended therapy...
June 2017: LGBT Health
https://www.readbyqxmd.com/read/28385326/identifying-local-hot-spots-of-pediatric-chronic-diseases-using-emergency-department-surveillance
#16
David C Lee, Stella S Yi, Hiu-Fai Fong, Jessica K Athens, Joseph E Ravenell, Mary Ann Sevick, Stephen P Wall, Brian Elbel
OBJECTIVE: To use novel geographic methods and large-scale claims data to identify the local distribution of pediatric chronic diseases in New York City. METHODS: Using a 2009 all-payer emergency claims database, we identified the proportion of unique children aged 0 to 17 with diagnosis codes for specific medical and psychiatric conditions. As a proof of concept, we compared these prevalence estimates to traditional health surveys and registry data using the most geographically granular data available...
April 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28384699/sudden-unexpected-death-in-epilepsy-among-patients-with-benign-childhood-epilepsy-with-centrotemporal-spikes
#17
Kyra Doumlele, Daniel Friedman, Jeffrey Buchhalter, Elizabeth J Donner, Jay Louik, Orrin Devinsky
Importance: Children with benign epilepsy with centrotemporal spikes (BECTS) have traditionally been considered to have a uniformly good prognosis. However, benign may be a misnomer because BECTS is linked to cognitive deficits, a more severe phenotype with intractable seizures, and the potential for sudden unexpected death in epilepsy (SUDEP). Objective: To determine if cases of BECTS are present in the North American SUDEP Registry (NASR). Design, Setting, and Participants: The NASR is a clinical and biospecimen repository established in 2011 to promote SUDEP research...
June 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28349246/suicide-patterns-in-children-and-adolescents-a-review-from-a-pediatric-institution-in-england
#18
REVIEW
Khairul Zainum, Marta C Cohen
Suicide is a catastrophic event to both families and communities yet it is potentially preventable. This study aims to determine incidence and patterns of suicide in children and young adolescents in our region, raise awareness of this entity as a potentially preventable cause of death in this age group, and identify its possible associated risk factors. We retrospectively reviewed suicide cases presenting as sudden unexpected death in children and adolescents that underwent coronial post-mortems at our institution...
June 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28281893/universal-adolescent-suicide-screening-in-a-pediatric-urgent-care-center
#19
Aimy Patel, Catherine Watts, Sheri Shiddell, Karla Couch, Amber M Smith, Michael J Moran, Gregory P Conners
The aim of this article is to describe the implementation of a 2-question suicide screening tool in a pediatric urgent care center to identify patients at risk of suicide. Adolescents presenting during a 12-month period completed the screening tool. Positive response to either question triggered further social work evaluation, including a Columbia-Suicide Severity Rating Scale (C-SSRS). Of 4,786 patients screened, 95 (2%) responded positively. Of these, 75 (79%) also had a positive C-SSRS. Only 7 (7%) had chief complaints related to mental health...
March 10, 2017: Archives of Suicide Research: Official Journal of the International Academy for Suicide Research
https://www.readbyqxmd.com/read/28262260/-suicidal-attempts-in-child-and-adolescent-and-bipolar-disorders
#20
N Dugand, S Thümmler, C Pradier, F Askenazy
BACKGROUND: Child and adolescent psychiatrists are frequently confronted with suicide attempts and comorbid mood disorders. Diagnoses of juvenile bipolar disorders (BD) are rare and controversial and standardized assessment is helpful for a reliable diagnosis. The main objective of this study was to identify the number of juvenile bipolar disorder diagnoses according to DSM-5 criteria in a population of children and adolescents hospitalized for suicide attempts. Secondary objectives were the assessment of a patient's characteristics and the comparison of suicide attempt recurrence during 12 months of follow-up...
March 2, 2017: L'Encéphale
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