The Carlat Child Psychiatry Report

In the US, 60% of children report exposure to violence, abuse or other trauma in the past year. Traumatized children like Karina can present to treatment with a range of symptoms, including anxiety, irritability, disruptive behaviors, mood dysregulation, and developmental regression.

Head injuries occur in 110 to 400 out of every 100,000 adults each year, but are much more common in children—around 692 per 100,000 children younger than 15. Mild traumatic brain injury (TBI) occurs in 75% to 85% of these cases.

When presented with a self-injuring patient, the first thing I try to find out is what the function of the self injury is. Is it suicidal? Did the patient want to die or think he or she might die? Often the answer is “no.”

The gold standards of treatment for ADHD are the stimulants amphetamine and methylphenidate. They are old friends, having been used for decades, and there is a wealth of patient experience with them. Although we use them all the time, an occasional review of the tools in our toolbox is always helpful.

I first met Christina when she was 14. She had been diagnosed with borderline personality disorder and bipolar disorder.

Making the decision to put a child on a psychiatric medication is hard enough. The process of discussing this possibility with parents can be even more challenging.