Children of war carry the trauma long after power has shifted and the ink has dried on peace treaties. An editorial in the Journal of Pediatric and Adolescent Medicine laments PTSD, a long-term consequence of trauma for children, has received little attention despite how prevalent it will become. In Africa, one in ten is estimated to be seriously affected by either war or HIV/AIDs, and sometimes both The author, Rep. Jim McDermott (D-Wash.), is also a pediatric psychiatrist and was recently selected as one of four by the House leadership to work on health reform.
Psychiatric Services reports a general downward trend in the use of antidepressants for anxiety disorders and depression, a decline for prescribing for kids that started before the 2004 black-box warnings.This trend has increased, note the authors of an article in the Archives of General Psychiatry. While there's been a decline in diagnosing depression among primary care providers, there has been a simultaneous increase in psychotherapy.
The swing back to marrying psychotherapy with medication presents yet another dilemma given how many clinicians might not be updating their tools with current information. The greatest influence on updating practices, note the authors of a study asking this pointed question, comes from mentors, such as other therapists. Empirical evidence counts for little, and perhaps this explains the 17 year gap in disseminating information noted by the Institute of Medicine.
A free article in the June issue of JAMA asks whether adolescents can learn skills to re-frame symptoms of depression? The authors compare adolescents whose parents have depression with those whose don't, and conclude that cognitive behavioral therapies seem to have a higher rate of success among those whose parents did not have the disorder.
The link between substance use disorder and schizophrenia is the subject director of the National Institute of Drug Abuse, Nora Volkow, tackles in the May issue of Schizophrenia Bulletin. She explains some of the more promising directions in research and treatment, including atypical drugs such as clozapine. A different question about variations in symptoms, pathology and outcomes for schizophrenia led other investigators to ask what is factually known about schizophrenia, a disorder for which many theories, myths, and misunderstandings. Their project attempts "to distinguish more precisely the areas of agreement and disagreement between theories of schizophrenia." The sub-title says a lot: "Findings that every theory of schizophrenia should explain." Twenty-two explanations and debates are presented.
The May-June issue of Health Affairs, is devoted entirely to broad sweeping aspects of policy, delivery, case studies and personal narrative. A companion conference was videotaped and several participants expand or amplify their written words.
Most of the above require subscription. Schizophrenia Bulletin is free one year following publication.
