Guest guest Posted January 22, 2008 Report Share Posted January 22, 2008 In todays NY Times there is an MD columnist Dr. Greene who answered a question about childhood mental health issues - specifically observable differences between ADHD and bipolar disorder in young children. I am sending along the lengthy answer so you don't have to subscribe to the online edition altho I believe it is free. . Notably he makes the following statement about ADHD drug use in children: As for using medications in young children, I prefer starting with other solutions where practical. As is the case with OTC medications for the common cold, some mental health medications may have more side effects and less benefit for children. For this reason, I like options such as the nutrition solution for ADHD studied in a prospective, double-blind, placebo-controlled trial first reported in the June 2004 Archives of Diseases in Childhood. That study found that removing the chemical preservative sodium benzoate and chemical dyes from the diet was as effective as prescription ADHD drugs at reducing hyperactivity scores. January 21st, 2008 4:16 pm What’s your opinion about diagnosing children as young as 2 or 3 years old with a mental disorder, like bipolar or ADHD? What about treatment of such disorders in young children with medications? — Posted by Grohol 4. January 21st, 2008 4:48 pm When people develop mental disorders, more often than not the problem starts in childhood or adolescence, according to a study published in the Archives of General Psychiatry in June 2005. Researchers from Harvard Medical School conducted face-to-face surveys of almost 10,000 adults to learn about how common psychological problems are in the general population, and at what ages they begin. Across the board, half of all disorders in adults had started by age 14. This surprises many people. The average age for the start of anxiety disorders and impulse-control disorders was even younger, at age 11. The starting ages were concentrated in a surprisingly narrow range for most of the disorders studied. For instance, half of all impulse-control disorders started between ages 7 and 15. Most of the illnesses were minor at the outset and not diagnosed at the time. This calls for a change in our priorities and awareness. Mental disorders in children are real. Mental disorders in children are important. While conditions such as ADHD may be overdiagnosed, most children with mental disorders don’t get the help they need. Insurance coverage for mental health is spotty at best. Children deserve better access to care, and better mental health screening training by their doctors, teachers, social workers, and juvenile justice workers. Recognizing these conditions can be a powerful contribution to children’s lives. In children as young as ages 2 or 3, diagnosis of mental disorders can be especially tricky. Overdiagnosing and underdiagnosing are probably both common. When children are inattentive and very active, for instance, they may mistakenly be diagnosed with the more popular diagnosis, ADHD, when the real problem is bipolar disorder. I’m a fan of young children seeing a child mental health professional that specializes in ADHD and bipolar disorder before a diagnosis is made. As for using medications in young children, I prefer starting with other solutions where practical. As is the case with OTC medications for the common cold, some mental health medications may have more side effects and less benefit for children. For this reason, I like options such as the nutrition solution for ADHD studied in a prospective, double-blind, placebo-controlled trial first reported in the June 2004 Archives of Diseases in Childhood. That study found that removing the chemical preservative sodium benzoate and chemical dyes from the diet was as effective as prescription ADHD drugs at reducing hyperactivity scores. Many mental health medications have not been well studied in very young children. About 69 percent of depressed children, ages 6 to 17, improved significantly while taking Zoloft for their depression, according to a study published in JAMA on August 27, 2003. But data suggest to me that another option may be an even better choice for some children. To me, what was most striking about the study was that fully 59 percent of depressed children taking a placebo pill had significant improvement in their depression and followed a very similar pattern of benefit to those taking the drug. At the beginning of the study, the children had an average CDSR-R depression score of about 64 points. Over the entire 10 weeks, those taking Zoloft had significant improvement, an average of 22.84 points. Those taking the placebo also improved significantly, but clearly not quite as much — an average of 20.19 points. Depressed children deserve all the help they can get. It seems to me that identifying and addressing depression may be an even more important intervention than the modest extra benefit afforded by the prescription. Far too many depressed children suffer without this important help. --------------------------------- Looking for last minute shopping deals? Find them fast with Search. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.