Assessment & screening
Untangling ADHD and Anxiety as Comorbidities
“ADHD and anxiety presenting together is very common in children and adolescents. But it can be difficult to discern which is the primary condition and which to treat first,” explains Kari Overstreet, DNP, APRN, CPNP-PC, PMHS, a pediatric nurse practitioner focused on child psychiatry and a Patient-Centered Mental Health in Pediatric Primary Care (PPP)…
Read MoreHow Autism May Present at Different Ages
“No two kids with autism spectrum disorder are identical. The presentation often depends on the degree of severity and the age of the child,” explains Ruth E.K. Stein, MD, a Professor of Pediatrics at Albert Einstein College of Medicine and the Children’s Hospital at Montefiore. Now recognized as a spectrum disorder, autism may be…
Read MoreDiagnosing Seasonal Affective Disorder
“Seasonal Affective Disorder (SAD) is more than just the winter blues,” explains Maureen Montgomery, MD, a pediatrician based in Buffalo, NY. “It’s a subtype of clinical depression that has very specific characteristics.” As the name suggests, SAD is a seasonal and cyclical type of depression. In most cases, SAD occurs during the fall and…
Read MoreRacism as trauma: A pediatric mental health perspective
After learning about the alarming rise in suicide rates among Black children and adolescents, Brittainy Erby, MD, set out to understand the impact of racial trauma and how to improve pediatric patient care.
Read MoreManaging challenging behaviors in children
“There is a lot of research on programs to help parents manage their children’s behavior. It is not complex for clinicians to learn key evidence-based principles and share them with parents, even in brief office visits,” explains Elena Man, MD, a board-certified pediatrician and faculty member at The REACH Institute. We asked Dr. Man…
Read MoreResponding to the Alarming Rise of Depression in Adolescent Girls
Gain a deeper understanding of the challenges faced by adolescent girls and the proactive steps clinicians can take to support them.
Read MoreAssessing and treating substance abuse
“The risk of substance use starts at about age 10,” said Sam Chang, MD, a child and adolescent psychiatrist on the REACH faculty. “Prevention has to start before that. By the time kids reach adolescence, the horse has left the barn.”
Read MoreIs it ADHD? Or something else?
Attention-deficit hyperactivity disorder (ADHD) is one of the most common behavioral health disorders, affecting approximately 9% of all children and adolescents. About 75% of pediatric patients with ADHD have comorbid mental health conditions, ranging from oppositional-defiant disorder to anxiety and mood disorders.
What is a busy clinician to do? How do you discern whether a child who is, say, having difficulty focusing at school and at home has ADHD, anxiety, both, or something else?
Read MoreWhen and how to send kids to the emergency room
“The first thing I would say to any clinician is that it’s never wrong to send a child to the emergency room,” said Amy Dryer, MD, pediatrician and REACH faculty member.
Having spent 10 years in a hospital emergency department, Dr. Dryer is intimately familiar with the criteria ER physicians use to decide to admit psychiatric patients: a medical condition, suicidal ideation with a lethal plan, homicidal ideation, or active psychosis.
However, she emphasized that your decision to refer to the ER doesn’t hinge on whether the patient is likely to be admitted. “If what they’re telling you makes you uncomfortable,” she said, “go ahead and refer them.”
Read MoreAfter you screen for anxiety, then what?
As you’ve heard, the US Preventative Service Task Force (USPSTF) recently issued draft guidelines recommending that primary care providers (PCPs) screen all adults aged 19 to 64 for anxiety disorders. Guidelines recommending anxiety screening for children aged 8 to 18 were finalized last week. The question is, if the screener indicates that anxiety is an issue, then what do you do? Patty Gibson, MD, a psychiatrist on the REACH Adult Behavioral Health faculty, shared some basics from the course to answer the question.
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