This study examined changes in the prevalence of psychiatric diagnoses at admission among children and adolescents treated for mental health problems in psychiatric inpatient settings between 1995 and 2000. Using a large, nationwide database (MarketScan) of private health insurance claims, our sample consisted of 5,346 children under the age of 18 who received psychiatric inpatient services, out of a total of 1,723,681 covered children. Odds ratios were used to measure changes in the prevalence of specific mental health disorders between 1995 and 2000. The study identified several significant changes, most notably, that the proportion of hospitalized children treated for bipolar or eating disorder doubled between 1995 and 2000. Significant decreases were observed for adjustment, anxiety, oppositional, and substance abuse disorders. This study lends support to recent concerns that the prevalence of bipolar disorder among the youth is increasing. Further research is needed to identify the underlying reasons for these observed changes.
[Show abstract][Hide abstract] ABSTRACT: Over the years since the inception of clinical psychology, the role of the clinical psychologist has evolved tremendously.
Clinical psychology has grown from a profession that in many aspects was founded within a medical model of treatment, and
de facto, relegated to a subservient role in the treatment of persons with mental health disorders. Over the decades, since
the formal beginnings of clinical psychology, the role of the clinical psychologist has gained in credibility, scope, and
autonomy of practice. In recent decades, the role of clinical psychology in relation to pharmacological treatments has grown
– albeit with much debate and little clarity as to what role clinical psychologists should play in the pharmacological treatment
of persons with mental health disorders (Gutierrez & Silk, 1998). This chapter presents a model for clinical psychologists
with phasmacological training in the supervision of mental health practitioners with phasmacological training.
[Show abstract][Hide abstract] ABSTRACT: Lithium (Li) is frequently used in the treatment of bipolar disorder (BPD), a debilitating condition that is increasingly diagnosed in children and adolescents. Because the symptoms of BPD in children are different from the typical symptoms in adulthood and have significant overlap with other childhood psychiatric disorders, this disorder is notoriously difficult to diagnose. This raises the possibility that some children not affected by BPD are treated with Li during key periods of brain development. The objective of this investigation was to examine the long-term effects of Li on the developing brain via a series of behavioral and molecular studies in rats. Rat pups were reared on Li chow for 3 weeks. Parallel groups were tested while on Li chow or 2 and 6 weeks after discontinuation of treatment. We found increased measures of anxiety-like behavior at all times tested. Gene microarray studies of the amygdala revealed that Li affected the expression of gene transcripts of the synapse and the cytoskeleton, suggesting that the treatment induced synaptic adjustments. Our study indicates that Li can alter the trajectory of brain development. Although the effects of Li on the normal brain seems unfavorable, effects on the abnormal brain cannot be determined from these studies alone and may well be therapeutic. Our results indicate that Li administration to the normal brain has the potential for lasting adverse effects.
The Journal of Neuroscience : The Official Journal of the Society for Neuroscience 06/2006; 26(22):6031-9. DOI:10.1523/JNEUROSCI.0580-06.2006 · 6.34 Impact Factor
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