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Current Evidence for Selecting Disaster Interventions for Children and Adolescents
Opinion statement The field of child disaster mental health has seen remarkable growth over the last several decades, and awareness of the needs of children in the context of disasters has translated into the creation and evaluation of multiple interventions. The sheer volume of intervention studies and the systematic attention to examining the evidence base are impressive. Many different types of interventions have been used with children and adolescents including preparedness interventions, psychological first aid, debriefing, psychoeducation, cognitive behavioral interventions, exposure and trauma narr...
Source: Current Treatment Options in Psychiatry - April 21, 2016 Category: Psychiatry Source Type: research

Pharmacologic Treatment of Pediatric Anxiety Disorders
Opinion statement The last decade has seen considerable advances in the treatment of anxiety disorders in children and adolescents and a considerable expansion of the evidence base for psychopharmacologic interventions in this population. The extant data suggest that, for fear-based anxiety disorders (e.g., generalized anxiety disorder, social phobia/social anxiety disorder, and separation anxiety disorder), selective serotonin reuptake inhibitors (SSRIs), and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are well tolerated and offer considerable benefit. However, the salutary effects of...
Source: Current Treatment Options in Psychiatry - April 21, 2016 Category: Psychiatry Source Type: research

Evidence-Based Pharmacotherapy for Autism Spectrum Disorders
Opinion statement Autism spectrum disorder (ASD) is an elusively heterogeneous disorder defined by core social impairment and repetitive interests and behaviors. To date, there are no medications approved by the US Food and Drug Administration (FDA) for treatment of the defining features of this disorder. Significant progress has been made in treatment of behavioral symptoms associated with ASD, particularly irritability and hyperactivity symptoms. Risperidone and aripiprazole have the most evidence supporting their use for irritability symptoms and are the appropriate medications to choose as first line ...
Source: Current Treatment Options in Psychiatry - April 10, 2016 Category: Psychiatry Source Type: research

Vocational Rehabilitation for Individuals with Schizophrenia
Opinion statement Contrary to popular belief, many individuals with schizophrenia and other severe mental illnesses want to work, but up to 80 % remain under- or unemployed. Traditional vocational models, which often withhold, or never offer help in finding competitive work until prevocational training, noncompetitive work positions, and other requirements, have been met, ultimately provide little or no benefit in helping people achieve their work goals. To address the need for effective work services, the supported employment model of vocational rehabilitation focusing on rapid attainment of competitive...
Source: Current Treatment Options in Psychiatry - April 7, 2016 Category: Psychiatry Source Type: research

Treating Negative Symptoms in Schizophrenia: an Update
Opinion Statement Interest in the negative symptoms of schizophrenia has increased rapidly over the last several decades, paralleling a growing interest in functional, in addition to clinical, recovery, and evidence underscoring the importance negative symptoms play in the former. Efforts continue to better define and measure negative symptoms, distinguish their impact from that of other symptom domains, and establish effective treatments as well as trials to assess these. Multiple interventions have been the subject of investigation, to date, including numerous pharmacological strategies, brain stimulati...
Source: Current Treatment Options in Psychiatry - April 7, 2016 Category: Psychiatry Source Type: research

Long-Term Treatment Strategies for Pediatric Bipolar Disorder
Opinion statement Bipolar disorder is a serious psychiatric disorder that frequently begins in childhood and lasts a lifetime. In the last 10–15 years, many advances have been made in the short-term treatment of bipolar disorder in children and adolescents, especially mixed and manic episodes. Less is known about long-term treatment and treatment of depressive episodes. This paper reviews recent literature on long-term treatment strategies for pediatric bipolar disorder. Pharmacologically, several second generation antipsychotics and mood stabilizers were recently studied in long-term treatment trials....
Source: Current Treatment Options in Psychiatry - April 5, 2016 Category: Psychiatry Source Type: research

Current Psychosocial Treatment Options for PTSD among Youth
Opinion statement Exposure to traumatic events represents a significant and all-too-common experience for many children and youth. A significant number of youth will receive a diagnosis of posttraumatic stress disorder (PTSD), a debilitating condition that without treatment will contribute to contemporaneous and long-term negative health consequences. Psychotherapy often has been advocated as the first line in PTSD treatments, and existing interventions have been primarily based on treating individual symptoms. Nevertheless, the deleterious effects of PTSD reverberate beyond the youth; parents, caregivers...
Source: Current Treatment Options in Psychiatry - April 5, 2016 Category: Psychiatry Source Type: research

The involvement of family members in the treatment of patients with schizophrenia
Opinion statement Schizophrenia is a severe, chronic, and disabling mental disorder characterized by a distinct cluster of symptoms. A variety of treatment approaches have been used, including antipsychotic medication, functioning rehabilitation, and family psychoeducation. Antipsychotic medications are effective in relieving schizophrenic symptoms, but its discontinuation often results in high relapse rates. Literature showed that family intervention in functioning rehabilitation is helpful for the schizophrenia patients. In addition, family psychoeducation is useful to rebuild the confidence of patients...
Source: Current Treatment Options in Psychiatry - April 3, 2016 Category: Psychiatry Source Type: research

Current Treatment Trends of Psychosis in Youth with Schizophrenia
Opinion statement Given the current state of the literature, we recommend using evidence-based antipsychotic selection and empirically supported dosing for medications, data for which have only recently become available. Despite the paucity of evidence supporting psychosocial interventions in youth with psychosis, we extrapolate effectiveness conclusions from both the first-episode psychosis and the adult literature. We recommend interventions such as cognitive behavioral therapy, social skills, multi-family group therapy, and some briefer forms of cognitive rehabilitation training. Additionally, we have ...
Source: Current Treatment Options in Psychiatry - February 12, 2016 Category: Psychiatry Source Type: research

Electroconvulsive Therapy (ECT) and Suicide Prevention
Opinion statement Electroconvulsive therapy (ECT) is an effective treatment for reducing suicidal ideation and intent in acutely depressed patients with mood and psychotic disorders. Modern ECT and anesthesia techniques have made contemporary ECT much safer and better tolerated than in the past. Patients with severe depression who are suicidal should be offered ECT as a treatment option early in the course of their illness. The reluctance to prescribe ECT, a result of unfamiliarity with, and prejudice against it, is likely responsible for preventable deaths by suicide, as well as prolongation of suffering...
Source: Current Treatment Options in Psychiatry - February 12, 2016 Category: Psychiatry Source Type: research

Posttraumatic Stress Disorder, Aggressive Behavior, and Anger: Recent Findings and Treatment Recommendations
Opinion statement While cognitive-behavioral treatment has been shown to be effective in treating anger in the general population, there is little empirical evidence to support the utility of these interventions in reducing anger, hostility, and aggression among patients with posttraumatic stress disorder (PTSD). Furthermore, many existing interventions for anger do not directly target hostile cognitive scripts or discuss processes of risk for aggressive behavior, two notable anger-related constructs that are reported at higher rates for patients with PTSD compared to those without PTSD. Thus, the authors...
Source: Current Treatment Options in Psychiatry - February 10, 2016 Category: Psychiatry Source Type: research

Simultaneous Treatment of Co-occurring Posttraumatic Stress Disorder and Substance Use Disorder
Opinion statement Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) frequently co-occur. Existent evidence suggests that SUD often develops in reaction to PTSD symptoms, as individuals attempt to “self-medicate” their PTSD symptoms. Once the SUD develops, the disorders establish a bi-directional loop, with PTSD driving further substance use behaviors, and the SUD symptoms mirroring and reinforcing symptoms of PTSD. Once this bi-directional cycle is locked in, the disorders become more resistant to treatment and result in poorer prognoses and worse health outcomes versus having only...
Source: Current Treatment Options in Psychiatry - February 10, 2016 Category: Psychiatry Source Type: research

Treatment of Comorbid Substance Use Disorders and ADHD in Youth
Opinion statement There has been great interest in the overlap between attention-deficit hyperactivity disorder (ADHD) and substance use disorder (SUD). Studies have shown that ADHD increases the risk of SUD and that 25–40 % of adults and adolescents with SUD have ADHD. The mechanism linking these disorders probably encompasses various behavioral, biologic, and genetic factors. Early pharmacotherapy of ADHD does not increase SUD and in fact, appears to reduce cigarette smoking and SUD. In individuals with ADHD and SUD, stabilization of SUD is recommended initially with consideration of adjunct non-stim...
Source: Current Treatment Options in Psychiatry - February 5, 2016 Category: Psychiatry Source Type: research

Yoga as an Intervention for PTSD: a Theoretical Rationale and Review of the Literature
Opinion statement There is evidence to suggest that yoga may reduce PTSD symptoms. It is unclear at this point, however, whether or not yoga reduces PTSD symptoms any more than a non-specific intervention given inconsistent findings and methodological limitations. Nonetheless, additional research in this area is important because of the high level of interest in and acceptability of yoga. Ultimately, yoga may be most effective when taught using trauma-sensitive guidelines and within a framework that helps the practitioner to apply the experience to coping with symptoms. (Source: Current Treatment Options in Psychiatry)
Source: Current Treatment Options in Psychiatry - January 30, 2016 Category: Psychiatry Source Type: research

Couple Therapy for PTSD
Opinion statement Research has consistently documented a bidirectional association between posttraumatic stress disorder (PTSD) symptoms and intimate relationship functioning. PTSD symptoms are associated with greater relationship distress, higher likelihood of divorce, decreased emotional intimacy, and increased sexual dysfunction. Conversely, specific relational factors and interaction patterns (e.g., hostility, partner accommodation of PTSD symptoms) can serve to maintain or exacerbate PTSD symptoms. Given this reciprocal relationship, several couple therapies for PTSD have been created and empirically...
Source: Current Treatment Options in Psychiatry - January 29, 2016 Category: Psychiatry Source Type: research