Research from the Field
Some interesting news for our readers. Everything we post here is a summary and has a notation of its source. Enjoy.
Psychotherapy for Early Childhood OCD
A small randomized trial at the Bradley Hasbro Children’s Research Center found that family cognitive behavioral therapy treatment reduced symptoms in children with obsessive-compulsive disorder. 69% of the children who received this therapy with their families achieved remission of their symptoms compared to 20% in a control group. The 42 children were ages 5 to 8. Even though this was a preliminary study, the authors concluded that this is a worthwhile intervention to consider for treatment.
Journal of the American Academy of Child and Adolescent Psychiatry (May 2008)
Abdominal Fat Boosts Later Dementia Risk
Research at Kaiser Permanente of Northern California has found that people who develop abdominal fat as they age are at higher risk of developing cardiovascular disease and type 2 diabetes than those whose weight is more evenly distributed. Patients had their abdomens measured at age 40 to 45 and were tracked to find how many had developed dementia three decades later, when they were 73 to 87. Finds were that the greater the abdominal measurement in middle age, the greater the risk of dementia in old age. The risk held even after adjusting for body mass index. While is was known that obesity increases the chanced of developing Alzheimer’s disease and other dementias, this is the first to show how abdominal fat is particularly risky.
Neurology (March 26, 2008)
Regular Family Meals May Reduce the Risk of Eating Disorders in Girls
Studies at the University of Minnesota suggest that when adolescent girls eat five or more meals with their families per week were less likely to develop eating disorders or engage in binge eating and chronic dieting. They were also significantly less likely to report taking aggressive steps to lose weight such as using diet pills and laxatives, or vomiting. Those who ate fewer than five meals with their families per week engaged in these behaviors at a 9% higher rate. This study found that family meals reduced the development of eating disorders but did not eliminate them. Meals seem to provide some protection but the exact mechanism was not determined.
Archives of Pediatric and Adolescent Medicine (Jan. 2008)
Top Reasons for Seeking Medical Care
In 2005 the Agency for Healthcare Research and Quality found that mental health problems ranked first in the top three reason Americans sought medical treatment. That year 156 million sought help for mental health problems, 139 million sought help for back problems, and 133 million sought help for trauma and injuries. They also reported that mental health visits have increased 30% since 1996.
Agency for Healthcare Research and Quality (2005)
Treating Preschoolers with Psychiatric Disorders
Treatment decisions, which are always complicated, are especially so when it comes to preschoolers. In 2000 Harvard Psychiatrist Joseph Coyle warned that psychiatrists might be prescribing medication as a quick fix rather than offering the type of multidisciplinary therapy that improves outcomes. The same year the American Academy of Child and Adolescent Psychiatry recommended the development of medication guidelines to use when treating preschoolers with psychiatric disorders.
Medications can and do affect brain functioning as well as other organs like the liver and kidneys. It is important to keep this in mind when contemplating medication for preschoolers. However, psychiatric disorders affect the brain adversely, too, and skew development. The impaired peer and family relationships that come out of childhood mental health conditions can lead to adult mental health problems.
The Academy recommended several steps, starting with a thorough assessment and evaluation done by qualified mental health professionals. This assessment process will gather information from all domains of the child’s life. Tracking of symptoms on a daily basis is critical and is the only way to establish a baseline and determine if treatment is working. Step two recommends the family pursue the appropriate psychotherapy based on the assessment findings. After three to six months of regular therapy accompanied by changes the parents make in their management at home, if progress is not satisfactory, it is time to consider the addition of medication. Therapy continues to monitor medication and to use its effect as a window of opportunity for further progress. After six months medication can be discontinued to reassess progress and determine the overall importance of the medication.
Parents will need to find professionals who are qualified to do this type of work. This approach takes some time and requires the active engagement of parents on the home front, however, when carefully followed, it produces very favorable outcomes for both the child and family.
Journal of the American Academy of Child and Adolescent Psychiatry (December 2007)
