Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by executive dysfunction occasioning symptoms of inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and otherwise age-inappropriate.
Paroxetine, sold under the brand names Paxil and Seroxat among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, post-traumatic stress disorder, generalized anxiety disorder, and premenstrual dysphoric disorder. It has also been used in the treatment of premature ejaculation and hot flashes due to menopause. It is taken orally.
Atomoxetine, sold under the brand name Strattera, is a medication used to treat attention deficit hyperactivity disorder (ADHD) and, to a lesser extent, cognitive disengagement syndrome. It may be used alone or along with psychostimulants. It is also used as a cognitive and executive functioning enhancer to improve self-motivation, persistence, attention, inhibition, and working memory. Use of atomoxetine is only recommended for those who are at least six years old. It is taken orally. Atomoxetine is a selective norepinephrine reuptake inhibitor and is believed to work by increasing norepinephrine and dopamine levels in the brain. The effectiveness of atomoxetine is comparable to the commonly prescribed stimulant medication methylphenidate.
The Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) is a test to rate the severity of obsessive–compulsive disorder (OCD) symptoms.
Martin Keller is an American psychiatrist. He is Professor Emeritus of Psychiatry and Human Behavior at Brown Medical School in Providence, Rhode Island.
Attention deficit hyperactivity disorder management options are evidence-based practices with established treatment efficacy for ADHD.
Child and adolescent psychiatry is a branch of psychiatry that focuses on the diagnosis, treatment, and prevention of mental disorders in children, adolescents, and their families. It investigates the biopsychosocial factors that influence the development and course of psychiatric disorders and treatment responses to various interventions. Child and adolescent psychiatrists primarily use psychotherapy and/or medication to treat mental disorders in the pediatric population.
Charles H. Zeanah Jr. is a child and adolescent psychiatrist who is a member of the council (Board) of the American Academy of Child and Adolescent Psychiatry (AACAP).
Harold Samuel Koplewicz is a nationally known child and adolescent psychiatrist. He is the founder and president of the nonprofit Child Mind Institute and editor-in-chief of the Journal of Child and Adolescent Psychopharmacology.
The Journal of the American Academy of Child and Adolescent Psychiatry is a peer-reviewed medical journal covering pediatric psychiatry. It is published by Elsevier and is the official journal of the American Academy of Child and Adolescent Psychiatry. The editor-in-chief is Douglas Novins.
The relationship between antidepressant use and suicide risk is a subject of medical research and has faced varying levels of debate. This problem was thought to be serious enough to warrant intervention by the U.S. Food and Drug Administration to label greater likelihood of suicide as a risk of using antidepressants. Some studies have shown that the use of certain antidepressants correlate with an increased risk of suicide in some patients relative to other antidepressants. However, these conclusions have faced considerable scrutiny and disagreement: A multinational European study indicated that antidepressants decrease risk of suicide at the population level, and other reviews of antidepressant use claim that there is not enough data to indicate antidepressant use increases risk of suicide.
Daniel A. Geller is an Australian American pediatrician and psychiatrist who specializes in the treatment of pediatric obsessive–compulsive disorder (OCD). Geller is triple board certified in Pediatrics, Psychiatry, and Child & Adolescent Psychiatry, and is director of the Pediatric OCD Program at Massachusetts General Hospital.
Study 329 was a clinical trial which was conducted in North America from 1994 to 1998 to study the efficacy of paroxetine, an SSRI anti-depressant, in treating 12- to 18-year-olds diagnosed with major depressive disorder. Led by Martin Keller, then professor of psychiatry at Brown University, and funded by the British pharmaceutical company SmithKline Beecham—known since 2000 as GlaxoSmithKline (GSK)—the study compared paroxetine with imipramine, a tricyclic antidepressant, and placebo. SmithKline Beecham had released paroxetine in 1991, marketing it as Paxil in North America and Seroxat in the UK. The drug attracted sales of $11.7 billion in the United States alone from 1997 to 2006, including $2.12 billion in 2002, the year before it lost its patent.
The Disruptive Behavior Disorders Rating Scale (DBDRS) is a 45-question screening measure, completed by either parents or teachers, designed to identify symptoms of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder in children and adolescents.
The Spence Children's Anxiety Scale (SCAS) is a psychological questionnaire designed to identify symptoms of various anxiety disorders, specifically social phobia, obsessive-compulsive disorder, panic disorder/agoraphobia, and other forms of anxiety, in children and adolescents between ages 8 and 15. Developed by Susan H. Spence and available in various languages, the 45 question test can be filled out by the child or by the parent. Alternatively, an abbreviated form of the test has been developed, with only 19 questions. It has shown equally valid results while reducing stress and response burden in younger participants. There is also another 34 question version of the test specialized for children in preschool between ages 2.5 and 6.5. Any form of the test takes approximately 5 to 10 minutes to complete. The questionnaire has shown good reliability and validity in recent studies.
The Yale Global Tic Severity Scale (YGTSS) is a psychological measure designed to assess the severity and frequency of symptoms of disorders such as tic disorder, Tourette syndrome, and obsessive-compulsive disorder, in children and adolescents between ages 6 and 17.
The Weinberg Screen Affective Scale (WSAS) is a free scale designed to screen for symptoms of depression in children and young adults ages 5–21. It can be used as an initial treatment scale and can be used to follow up on treatment efficacy. There are 56 self-report questions that screen for symptoms in 10 major categories of depression: dysphoric mood, low self-esteem, agitation, sleep disturbance, change in school performance, diminished socialization, change in attitude towards school, somatic complaints, loss of usual energy, and unusual change in weight and/or appetite. The scale is based on previously proposed criteria for depression in children. A study looking at the agreement between scales for depression diagnosis found 79.4% agreement between the DSM-III and the WSAS in a sample of 107 children.
The Child Mania Rating Scales (CMRS) is a 21-item diagnostic screening measure designed to identify symptoms of mania in children and adolescents aged 9–17 using diagnostic criteria from the DSM-IV, developed by Pavuluri and colleagues. There is also a 10-item short form. The measure assesses the child's mood and behavior symptoms, asking parents or teachers to rate how often the symptoms have caused a problem for the youth in the past month. Clinical studies have found the CMRS to be reliable and valid when completed by parents in the assessment of children's bipolar symptoms. The CMRS also can differentiate cases of pediatric bipolar disorder from those with ADHD or no disorder, as well as delineating bipolar subtypes. A meta-analysis comparing the different rating scales available found that the CMRS was one of the best performing scales in terms of telling cases with bipolar disorder apart from other clinical diagnoses. The CMRS has also been found to provide a reliable and valid assessment of symptoms longitudinally over the course of treatment. The combination of showing good reliability and validity across multiple samples and clinical settings, along with being free and brief to score, make the CMRS a promising tool, especially since most other checklists available for youths do not assess manic symptoms.
The Autism Treatment Evaluation Scale (ATEC) is a 77-item diagnostic assessment tool that was developed by Bernard Rimland and Stephen Edelson at the Autism Research Institute. The ATEC was originally designed to evaluate the effectiveness of autism treatments, but it may also be beneficial as a screening tool for children. The questionnaire, which is completed by a parent, takes about 10–15 minutes to complete and is designed for use with children ages 5–12. The ATEC is currently available in 17 different languages.
Stan Kutcher is a Canadian Senator and Professor Emeritus of Psychiatry at Dalhousie University. He was appointed to the Senate of Canada on 12 December 2018.
