4 Troubled Teens Blog

The American Psychiatric Association is proposing changes to its Diagnostic and Statistical Manual of Mental Disorders (DSM). The Association is asking for help from psychiatrists and the public to help define mental diseases for the DSM-5, the first new edition in 10 years.

The following are among the proposed changes:

• "Substance abuse" and "substance dependence" would become "addiction and related disorders," including "substance use disorders," such as "alcohol use disorder" and "heroin use disorder."
  
• "Behavioral addictions" would include gambling, but not addictions to sex or the Internet.
• Young children now diagnosed with bipolar disorder could instead be diagnosed with "temper dysregulation with dysphoria," which would include behavioral and mood problems.
• Asperger's Syndrome would no longer be a separate diagnosis but included under the term "autism spectrum."
• Binge eating would be recognized as an eating disorder.

DSM-5 is slated to be published in 2013.

Labels: dsm-v, mental_health, mental_illness

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The number of preschoolers diagnosed with bipolar disorder doubled in the past ten years, according to new research in the Journal of the American Academy of Child and Adolescent Psychiatry. The number of children under 18 years old diagnosed with the disorder has increased by forty times over in the same period.

• About 1.5 percent of children ages two to five years old are now taking some kind of psychotropic drug, according to the new study by Dr. Mark Olfson, professor of clinical psychiatry at Columbia University.
  
• These drugs may include antipsychotics, mood stabilizers, stimulants or antidepressants.
• Bipolar disorder, which involves severe mood changes, was once thought only to appear in late adolescence.
  

It is hard to diagnose psychiatric disorders in very young children because bipolar disorder, Attention Deficit Hyperactivity Disorder, sexual abuse and family dysfunction can produce similar symptoms.

Dr. Olfson said that physicians should prescribe drugs to preschoolers only after they have tried other interventions, "but that's not happening if you look at the billing records" from insurance and drug companies.

Labels: bipolar, mental_health, mental_illness

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Using reports from parents and teachers, a research team was able to predict which kindergartners would outgrow their mental problems and which were likely to develop severe mental problems by the end of elementary school.

"We did a phenomenal job of picking up those kids very early," said Dr. Marilyn Essex, lead author of the study. "Now those findings need to be replicated by others."

• Dr. Essex and her research team had mothers and teachers report mental symptoms of 328 children, starting in kindergarten through grade five.
• Some children acted out their symptoms through conduct problems, inattention, impulsivity, and aggression.
• Others internalized their symptom through depression and anxiety.
• The children who needed the most help by fifth grade were those who showed both internalizing and externalizing symptoms for at least two consecutive years.
• The children in the study are now 17 and 18 years old, and research is ongoing.

"We were able to tell in kindergarten and grade one which children were very likely to develop this pattern of mental health problems," Dr. Essex said. "We were able to predict quite well long-term patterns from early behavioral issues."

The study appeared in the Journal of Child Psychology and Psychiatry.

Labels: mental_illness, teachers, parents

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As the global economic recession continues, states are being forced to slash an increasing number of community services to balance budgets. One the unintended consequences is that young people with mental illnesses are being treated in jail cells rather than counselors offices.

An Aug. 9 article by New York Times writer Solomon Moore provided the following details about the problem:

About two-thirds of the nations juvenile inmates -- who numbered 92,854 in 2006, down from 107,000 in 1999 -- have at least one mental illness, according to surveys of youth prisons, and are more in need of therapy than punishment.

"We're seeing more and more mentally ill kids who couldnt find community programs that were intensive enough to treat them," said Joseph Pen, a child psychiatrist at the Texas Youth Commission. "Jails and juvenile justice facilities are the new asylums."

Nearly 35 states have cut community mental health programs by an average of five percent, the Times reported, and many plan to double those reductions for the 2010 fiscal year.

Labels: mental_illness, jails, young_adults

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Doctors should consider irritability as a symptom of bipolar disorder in children, according to a new study from Bradley Hospital and the Warren Alpert Medical School of Brown University:

• Dr. Jeffrey Hunt studied 361 children ages seven to 17 years old, when they were in the manic stage of bipolar disorder.
• He classified their symptoms into elation-only, irritable-only or elation-irritable.
• Only 10 percent of these children fell into the irritable-only category, and elation-only was 15 percent.
• The vast majority (75 percent) were in the elation-irritable category.

"Diagnosing children with bipolar disorder is challenging," Dr. Hunt said. "One of the chief controversies is whether irritability should be included among the criteria for the diagnosis because it can overlap with a number of other psychiatric disorders such as Attention Deficit Hyperactivity Disorder. Our findings confirm that irritable-only mania is uncommon, but it does exist -- particularly in younger children -- and should be considered in a bipolar diagnosis."

The number of children diagnosed with bipolar disorder has increased dramatically over the last decade. Bipolar disorder is characterized by dramatic mood swings.

Dr. Hunt's study appeared in the Journal of the American Academy of Child and Adolescent Psychiatry.

Labels: bipolar, mental_illness, irritability

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Two new studies reveal the degree to which being abused as a child can inflict serious long-term damage.

The first study was conducted by Dr. Magdalena Romanowicz of the Mayo Clinic.

• Dr. Romanowicz found that a history of child abuse is linked to an increase in suicide attempts, depression, earlier onset of mental illnesses, more psychiatric hospitalizations, and higher rates of personality disorders.
• Presenting her findings at the American Psychiatric Association meeting, Dr. Romanowicz said that her study shows a need for "a more aggressive approach" to stopping child abuse.

The second study was by Professor Lauren Wise of Boston University.

• Prof. Wise studied records of 35,000 African-American women ages 21 to 69 years old from the Black Women Health Study.
• More than 43 percent of the women Prof. Wise studied had been physically abused, and 18 percent had been sexually abused.
• The women who had been abused as children were 26 percent more likely to menstruate early (before age 12 years old).
• Prof. Wise's study was published in the American Journal of Public Health.

Child abuse and neglect remain serious problems both in the United States and throughout the world. Parents who were abused as children may grow up to become abusers themselves, which can continue a destructive cycle of youth mental health and substance abuse disorders.

Labels: child_abuse, mental_illness

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A study that was conducted at the University of Oxford (England) has revealed that children whose fathers suffer from depression are at increased risk of developing anxiety, depression, and substance abuse disorders. In a May 3, 2009, article on British news website Telegraph.co.uk, medical correspondent Kate Devlin reported the following about the Oxford study:

Children whose parents suffer from depression in the weeks after their birth are twice as likely to go on to develop behavioural and emotional problems.

Teenage children of depressed fathers are also more likely to go onto develop depression themselves and even consider suicide, while alcoholic fathers are more likely to have children who suffer from mood disorders, depression and get hooked on drink and drugs.

The report also shows that teenagers whose parents suffer from manic depression, also called bipolar disorder, are up to 10 times more likely than their classmates to develop the condition themselves and between three and four times more likely to develop other psychiatric illnesses.

Previous studies have noted that as many as 20 percent of all teenagers suffer from depression, with more than 70 percent of teen depression cases going undiagnosed or untreated.

Labels: depression, mental_health, mental_illness, teenagers, fathers

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Your teenager's next visit to the doctor could include an emotional check-up as well as a physical one. The U.S. Preventative Services Task Force recently recommended that kids between the ages of 12 and 18 be regularly screened for depression -- a recommendation that has moved teen depression to the forefront of adolescent care.

Major depression affects more than 5 percent of teens and is linked with suicide, substance abuse and other serious problems. Yet it often goes undiagnosed and untreated. (Source: USA Today)

The Task Force has urged the screening for all teenagers, not just those who appear to be "troubled," and recommends a simple questionnaire as a starting point.

Regular screening should continue throughout adolescence, the task force recommended, even if no "red flags" are raised during the initial evaluation.

Labels: depression, mental_health, mental_illness, teenagers

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Physical exercise elevates the mood of people with serious mental diseases, according to a new study from Indiana University.

Dr. Bryan McCormick placed monitors on study participants and also paged them at random moments to inquire about their mood and activities:

• Most of the participants, who lived in psychiatric hospitals, were sedentary.
• The least active had the least positive moods.
• Walking was a particularly effective activity for elevating the moods of participants.

This study appeared in the Journal of Social Psychiatry.

Labels: mental_health, mental_illness, exercise

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Almost half of young adults have mental disorders - and most do not seek treatment for their problems - according to a new government study published in the December 2008 edition of Archives of General Psychiatry.

Researchers used data that was collected on 5,000 people ages 19 to 25 years old who participated in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions. They compared the participants' answers to criteria for mental illnesses as listed in the Diagnostic and Statistical Manual of Mental Disorders, which is used by doctors to diagnose mental illness.

Among college students in the study, 20 percent had alcohol abuse or dependency and 18 percent exhibited symptoms consistent with personality disorders, such as obsessive-compulsive, anti-social, and paranoid disorders. Eleven percent had depression, bipolar or other mood disorders. About 46 percent of college students had at least one psychiatric problem, as did 48 percent of non-college students.

Non-college students were more likely to seek treatment for alcohol and drug dependency, but treatment levels for both groups were low. The study found that fewer than 25 percent of the college students got treatment for mental problems. One recommendation was to create more university programs to screen for mental illnesses and provide interventions.

Labels: mental_health, mental_illness

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More teenagers today are suffering from mental health challenges than physical conditions, including diabetes and asthma, according to a new survey from the National Institute of Mental Health.

Psychiatric problems affect one in five adolescents, and about half will meet the criteria for some disorder at least once in their lifetimes.

• Dr. Kathleen Merikangas and her colleagues analyzed data from the National Comorbidity Study-Adolescent Supplement, which includes surveys of more than 10,000 teenagers ages 13 to 18 years old.
• They found that 11% had mood disorders such as depression or bipolar disorder, 10% had behavioral disorders such as attention deficit hyperactivity, and 8% had anxiety.
• All of these were considered "severely impaired."
• Most of these problems began before age 13 years old, except for substance abuse, which started around age 15. Children of parents with less education or who were divorced were at higher risk for mental disorders.

The study appears in the Journal of the American Academy of Child and Adolescent Psychiatry.
 

Labels: mental_health, mental_illness, teenagers

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