Posts Tagged ‘psychiatry’

U.S. probes use of antipsychotic drugs on children.

If you thought kids are being put on Ritalin etc too often, you are obviously right. Reality is sinking in slowly, or maybe not so slowly in the psychiatric profession. Listen to audio below.

Extracts: Prescription of powerful anti-psychotic drugs for children has tripled. 1 in 10 Americans prescribed anti-depressants, including 1 in 4 women in 40s and 50s. Use of ADHD drugs increased by 50% in England.

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Federal health officials have launched a probe into the use of antipsychotic drugs on children in the Medicaid system, amid concern that the medications are being prescribed too often to treat behavioral problems in the very young.

Some doctors say there is too much emphasis on medicating children instead of working with them and their caregivers to understand what is triggering their behavior. Dr. Glenn Saxe, chairman of child and adolescent psychiatry at NYU-Langone Medical Center and a proponent of trauma-focused therapy, says psychiatry has missed “big opportunities to help children. This problem has led to kids being medicated more and more.”
Dr. Siles agrees that lots of children could be helped by trauma-centered therapy, “but there is no budget for it.”

Government Medicaid data indicate that some of the prescriptions are being written for very young children. An analysis by Mathematica found that in 2008, 19,045 children age 5 and under were prescribed antipsychotics through Medicaid.

Government Medicaid data indicate that some of the prescriptions are being written for very young children. An analysis by Mathematica found that in 2008, 19,045 children age 5 and under were prescribed antipsychotics through Medicaid, 3% of recipients under 20, up from 7,759 in 1999, according to James Verdier, a senior fellow at the organization.

Data from the inspector general’s five-state probe indicate that 482 children 3 and under were prescribed antipsychotics during the period in question, including 107 children 2 and under. Six were under a year old, including one listed as a month old. The records don’t indicate the diagnoses involved.

Texas said about five children under the age of 1 had been prescribed antipsychotics during the time period of the probe, including two who were five months old.

Dr. Stephen Cha, a chief medical officer at the Centers for Medicare & Medicaid Services, the HHS agency that foots some of the bill for drugs prescribed to Medicaid recipients, says the government wants to reduce what he termed “the unnecessarily high utilization of antipsychotics.” He urges doctors to consider other approaches, including therapy to help children and families cope with psychological trauma that could be at the root of behavior issues. – Source : Wall Street Journal

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The Briefing 08-16-13. Listen to full audio here.

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Listening to Ravi speak is often a treat for me. When you listen & get to what happened in a classic eureka “moment of truth” in the life of a very wealthy, but embittered divorced man, you may know what I mean. It’s not a matter of just telling a story, it’s really having the true life tales to tell through encounters with people over many years … and then being able to share those encounters in an engaging way. 🙂

Let My People Think on OnePlace.com – OnePlace.com – What Answer for the Wicked Human Heart, Part 1. Listen to full audio here & Part 2 here.

20130528-220905.jpgWhen “20% of all American kids have a mental disorder” (sic) and psychiatrists diagnose ADHD differently on a massive scale, 9% of American kids vs. less than 0.5% of French kids, what does that tell us? Listen below…

See also: Why French kids don’t have ADHD?“, as published in Psychology Today. Note the extract & bold portions below.

French child psychiatrists don’t use the same system of classification of childhood emotional problems as American psychiatrists. They do not use the Diagnostic and Statistical Manual of Mental Disorders or “DSM”.

To the extent that French clinicians are successful at finding and repairing what has gone awry in the child’s social context, fewer children qualify for the ADHD diagnosis. Moreover, the definition of ADHD is not as broad as in the American system, which, in my view, tends to “pathologize” much of what is normal childhood behavior. The DSM specifically does not consider underlying causes. It thus leads clinicians to give the ADHD diagnosis to a much larger number of symptomatic children, while also encouraging them to treat those children with pharmaceuticals.

The French holistic, psycho-social approach also allows for considering nutritional causes for ADHD-type symptoms—specifically the fact that the behavior of some children is worsened after eating foods with artificial colors, certain preservatives, and/or allergens.

And then, of course, there are the vastly different philosophies of child-rearing in the United States and France. These divergent philosophies could account for why French children are generally better-behaved than their American counterparts. Pamela Druckerman highlights the divergent parenting styles in her recent book, Bringing up Bébé. I believe her insights are relevant to a discussion of why French children are not diagnosed with ADHD in anything like the numbers we are seeing in the United States.

From the time their children are born, French parents provide them with a firm cadre—the word means “frame” or “structure.” Children are not allowed, for example, to snack whenever they want. Mealtimes are at four specific times of the day. French children learn to wait patiently for meals, rather than eating snack foods whenever they feel like it. French babies, too, are expected to conform to limits set by parents and not by their crying selves. French parents let their babies “cry it out” if they are not sleeping through the night at the age of four months.

French parents, Druckerman observes, love their children just as much as American parents. They give them piano lessons, take them to sports practice, and encourage them to make the most of their talents. But French parents have a different philosophy of discipline. Consistently enforced limits, in the French view, make children feel safe and secure. Clear limits, they believe, actually make a child feel happier and safer—something that is congruent with my own experience as both a therapist and a parent. Finally, French parents believe that hearing the word “no” rescues children from the “tyranny of their own desires.” And spanking, when used judiciously, is not considered child abuse in France.

As a therapist who works with children, it makes perfect sense to me that French children don’t need medications to control their behavior because they learn self-control early in their lives. The children grow up in families in which the rules are well-understood, and a clear family hierarchy is firmly in place. In French families, as Druckerman describes them, parents are firmly in charge of their kids—instead of the American family style, in which the situation is all too often vice versa.

AlbertMohler.com – The Briefing. Listen to full audio here.

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So, the criteria for the diagnosis for autism is being updated, one would wonder why…
“More than a year before a new definition is expected to appear in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders–the standard mental-health reference used by psychiatrists and insurers–a scientific catfight has erupted over the best way to recategorize the spectrum of symptoms that comprise autism disorders. Many experts say the proposed definition, which is still being assessed, will narrow the criteria for autism. The question is, How much?”

Source: Time Magazine

until we also hear that “nearly 40 percent of the children ever diagnosed with autism disorders didn’t currently have autism, the parents reported. That rate is much higher than ever found by autism recovery researchers. Outside experts said they doubt it reflects a true rate of recoveries. Autism could have been suspected and later ruled out for some of the children, the authors wrote.”

Source: Huffington Post (also in Time article, but not available there for free viewing, see link above)

AlbertMohler.com, The Briefing. Listen to full audio here.