Adolescent Psychiatry (eBook)

A Contemporary Perspective for Health Professionals

Leo Sher, Joav Merrick (Herausgeber)

eBook Download: PDF

2013 | 1. Auflage
260 Seiten
Walter de Gruyter GmbH & Co.KG (Verlag)
978-3-11-031661-2 (ISBN)

Infos

Psychiatric disorders in adolescents are an important social problem which is relevant to almost all healthcare professionals. According to the results of The National Comorbidity Survey-Adolescent Supplement (NCS-A), the lifetime prevalence of anxiety, behavior, mood, and substance use disorders among adolescents was 31.9%, 19.1%, 14.3%, and 11.4%, respectively. Approximately 40% of participants in this survey with one class of disorder also met criteria for another class of lifetime disorder. Comorbidity is increasingly recognized as a key feature of mental disorders among adolescents. Female adolescents are more likely than males to have mood and anxiety disorders, but less likely to have behavioral and substance use disorders.

Regretfully, medical professionals are not sufficiently trained about adolescent psychiatric disorders. For example, primary care providers correctly identify less than a fourth of youth with a depressive or anxiety disorder. Also, many clinicians underestimate the importance of the problem of adolescent psychiatric illnesses and suicidal behavior. Lack of skilled medical providers impedes the delivery of needed services to adolescents with mental health issues. This coupled with a lag in the ability of primary health care services to incorporate psychiatric interventions, and a failure of public health initiatives to pay attention to adolescent mental health problems has led to continuing gaps in care over decades despite the public pronouncements of needs.

In this book you will find relevant information for health professionals, since we believe that the mental health of adolescents is essential for sustaining healthy and productive societies.

Leo Sher, James J. Peters Veterans' Administration Medical Center, Bronx, New York, USA; Joav Merrick, Ministry of Social Affairs and Social Services, Jerusalem, Israel.

Inhalt

Author index 13
Introduction 17
Education of health professionals about adolescent psychiatry 19
References 20
Section I: Neurobiological aspects 21
1 Adolescents with psychiatric disorders: brain structural and functional changes 23
1.1 Introduction 23
1.2 Neuroanatomical and functional changes in the normal adolescent brain 25
1.3 Models of brain functional changes in adolescents with psychiatric disorders 27
1.4 Structural and functional changes in schizophrenia 29
1.5 Neuroimaging in adolescents with anxiety disorders 31
1.6 Neuropathology in adolescents with depression 32
1.7 Neuropathology in the adolescent brain and substances of abuse 33
1.8 Gene variants and functional neuroimaging 34
1.9 Conclusions 35
References 36
2 Ecstasy and the serotonin syndrome 41
2.1 Introduction 41
2.2 SSRI efficacy and toxicity in adolescents and young adults 42
2.3 MDMA use in adolescents treated with SSRIs 43
2.4 Serotonin syndrome 44
2.5 Ecstasy in combination with SSRI increasing the risk of serotonin syndrome 45
2.6 Conclusions 46
References 47
3 Testosterone levels and suicidal behavior 51
3.1 Introduction 51
3.2 Testosterone and suicide 52
3.2.1 Testosterone and suicidal behavior in adolescents and young adults 53
3.2.2 Testosterone and suicidal behavior in older men 55
3.3 Conclusions 56
References 57
4 Buprenorphine in the treatment of non-suicidal self-injury 61
4.1 Introduction 61
4.2 Clinical approach 62
4.3 Case descriptions 63
4.4 Discussion 68
4.5 Conclusions 69
References 70
Section II: Depression 73
5 Antidepressants for major depressive disorder in children and adolescents 75
5.1 Introduction 75
5.2 Treating child and adolescent depression: an overview 76
5.3 Efficacy 77
5.4 Safety 79
5.5 Clinical recommendations 81
5.6 Conclusions 82
References 82
6 Suicide prevention in depressed adolescents 85
6.1 Introduction 85
6.2 Adolescence as a phase of human development 86
6.3 Depression in adolescence 87
6.3.1 Neurobiology of adolescent depression 87
6.3.2 Treatment 88
6.3.3 Suicidality in depressed adolescents 89
6.3.4 Relation of adolescent suicidality to medications (SSRIs) which are frequently used to treat depression 91
6.4 Education of health care trainees and professionals 92
6.4.1 How to teach health care trainees and professionals to recognize and manage adolescent depression and suicidality in adolescents in psychiatric and primary care? 93
References 94
Section III: Violence and abuse 99
7 Child sexual abuse and suicide in adolescents and adults 101
7.1 Introduction 101
7.1.1 Literature search 102
7.2 Child sexual abuse and psychopathology associated with suicidal behavior 102
7.3 Child sexual abuse and impulsivity 103
7.4 Sexual abuse and suicide 103
7.5 CSA and adolescent suicidality 104
7.6 Discussion 105
References 107
8 Improving future physicians’ responses to adolescent maltreatment 109
8.1 Introduction 109
8.2 Our project 113
8.2.1 Measures 114
8.2.2 Procedures 115
8.2.3 What we found 117
8.3 Conclusions 117
8.4 Appendices 120
8.4.1 Appendix A 120
8.4.2 Appendix B 120
8.4.3 Appendix C 120
8.4.4 Appendix D 121
References 121
9 Bullying, psychiatric pathology and suicidal behavior 123
9.1 Introduction 123
9.2 Definition 124
9.3 Demographics of bullying behavior 124
9.4 Bullying and suicidal behavior 125
9.5 Bullying and psychiatric pathology 125
9.6 Bullying and depression 125
9.7 Bullying and PTSD 126
9.8 Bullying and anxiety disorders 126
9.9 Bullying and substance and alcohol abuse and dependence 126
9.10 Philosophical considerations 127
References 128
10 Dating violence and suicidal behavior in adolescents 131
10.1 Introduction 131
10.1.1 Literature search 132
10.2 Findings 132
10.2.1 Risk factors 133
10.2.2 Psychiatric and social consequences of dating violence 134
10.2.3 Dating violence and suicidality 134
10.3 Discussion 135
References 136
Section IV: Post-traumatic stress disorder 139
11 Post-traumatic stress disorder, medical illness and suicidal behavior 141
11.1 Introduction 141
11.2 PTSD and suicidality 142
11.3 PTSD, medical illness and suicidality 142
11.4 How PTSD and medical illness interact to influence suicidal behavior? 143
11.5 Implications for children and adolescents 144
References 144
12 Prevention of suicidal behavior in adolescents with post-traumatic stress disorder 147
12.1 Introduction 147
12.2 PTSD and suicidal behavior in adolescents 148
12.3 Prevention 152
12.3.1 Means restriction 152
12.3.2 Physician education and training 153
12.3.3 Mental health care 154
12.3.4 Gatekeeper training 154
12.3.5 Public education programs 155
12.3.6 Media guidelines 156
12.3.7 Multi-dimensional prevention methods 159
References 159
Section V: Substance abuse 165
13 Attention-deficit hyperactivity disorder and dual disorders: educational needs for an underdiagnosed condition 167
13.1 Introduction 167
13.1.1 Literature search 168
13.2 Epidemiology 169
13.3 Clinical characteristics of ADHD 170
13.3.1 The road to DSM-IV-TR 170
13.3.2 New DSM, more changes. What is new in DSM-5? 171
13.4 Interrelationship 172
13.4.1 Epidemiological evidence of the comorbidity of ADHD with SUD 172
13.4.2 The relationship between ADHD and comorbid SUD. Nature of the association 174
13.5 Assessment 175
13.5.1 Screening and assessment instruments for ADHD 176
13.5.2 Assessment of comorbid substance abuse or dependence in patients with ADHD 179
13.6 Conclusions 179
References 180
14 Cannabis and youth seeking treatment for primary mood or anxiety concerns 189
14.1 Introduction 189
14.2 Our project 190
14.2.1 Participants 191
14.2.2 Demographics 191
14.2.3 Questionnaires 191
14.2.4 Analyses 192
14.3 Findings 193
14.3.1 Diagnostic characteristics 193
14.3.2 Coping styles 194
14.3.3 Participant risk behaviors 194
14.3.4 Psychiatric and SUD symptoms 194
14.3.5 Multiple regression 195
14.4 Discussion 196
References 197
Section VI: Veterans’ issues 199
15 Military sexual trauma as a determinant in the development of mental and physical illness in male and female veterans 201
15.1 Introduction 201
15.1.1 Recognition of MST 202
15.1.2 Civilian traumatic experiences and MST 203
15.1.3 Literature search 203
15.2 Findings 203
15.2.1 MST and psychiatric illness in females 204
15.2.2 MST and psychiatric illness in males 205
15.2.3 MST and medical illness 205
15.2.4 MST and medical illness in females 205
15.3 Discussion 206
15.3.1 Pre-military abuse as a predictor of PTSD and mediator between MST and mental and physical illness 206
15.3.2 Prevention and treatment 207
References 208
16 Educating medical professionals about suicide prevention among military veterans 211
16.1 Introduction 211
16.2 Prevalence of suicidal behavior 212
16.3 Risk factors for veteran suicide 212
16.4 Suicide prevention and assessment 214
16.5 Veteran suicidal ideation follow-up care and treatment 215
References 215
Section VII: Public health, cultural, and legal issues 219
17 Does the physician density affect suicide rates among adolescents and young adults? 221
17.1 Introduction 221
17.2 Project 223
17.3 Findings 224
17.4 Discussion 224
References 230
18 Suicidal behavior in Indian adolescents 233
18.1 Introduction 233
18.2 Indian psyche 234
18.3 Suicide in India 235
18.3.1 Adolescent suicide in India 237
18.3.2 Immigration and suicide 237
18.3.3 Preventing suicidal behavior in Indian adolescents 238
References 239
19 American juvenile justice system: history in the making 243
19.1 Introduction 243
19.2 Juvenile courts 244
19.3 The Supreme Court of the United States ’ role in defining the juvenile justice system 245
19.4 More recent changes 246
19.5 Current controversies 247
19.6 Summary 247
References 248
Section VIII: Acknowlegements 249
20 About the editors 251
21 About Ichan School of Medicine at Mount Sinai and the James J. Peters Veterans ’ Administration Medical Center, New York City, United States 253
22 About the National Institute of Child Health and Human Development in Israel 255
22.1 Mission 255
22.2 Service and academic activities 255
22.3 Research activities 255
22.4 National collaborations 256
22.5 International collaborations 256
22.6 Targets 257
22.7 Contact 257
Index 259

Produkt-Details

• Erscheint lt. Verlag: 14.10.2013
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Pädiatrie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Psychiatrie / Psychotherapie
• Themenwelt: Pflege ► Fachpflege ► Neurologie / Psychiatrie
• ISBN-10: 3-11-031661-7 / 3110316617
• ISBN-13: 978-3-11-031661-2 / 9783110316612