Abstract
Dr. Weisbrot is an associate professor of psychiatry and the director of the child and adolescent psychiatry outpatient service at The State University of New York at Stony Brook. She is also the co-author of The Essential Patient Handbook.
Dr. Hendren has been the chief of several divisions of child and adolescent psychiatry, including at the University of New Mexico and the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson, directed the MIND Institute at the University of California, Davis, and is presently professor and vice chair of psychiatry and director of child and adolescent psychiatry at the University of California, San Francisco. Dr. Hendren is also a past president of the American Academy of Child and Adolescent Psychiatry. He has written extensively on pediatric psychopharmacology in both peer-reviewed journals and in textbooks, and has a comprehensive understanding of the treatment of child and adolescent psychiatric disorders.
Dr. Leventhal is the former chief of child and adolescent psychiatry at the University of Chicago and was the director of the Center for Child Mental Health and Developmental Neuroscience at the Institute for Juvenile Research at the University of Illinois. He is currently the deputy director of New York State's Nathan S. Kline Institute for Psychiatric Research. For more than 25 years Dr. Leventhal has been the co-chair of the Program Committee for the annual meeting of the American Academy of Child and Adolescent Psychiatry. Over this period, he has reviewed literally every poster, workshop, and symposium that have been presented at the field's premier scientific meeting. Dr. Leventhal is a master teacher, clinician, and a mentor to dozens of trainees, many of whom have gone on to become leaders in our field.
Dr. Leventhal will also be writing the Psychopharmacology Update column. His first column in the Journal addresses the complex problem that many clinicians face concerning the use of selective serotonin reuptake inhibitors and the ongoing controversy that surrounds these medications.
We also thank Drs. Glenn Hirsch and Raul Silva for their many years of service to the journal. Dr. Hirsch has been associate editor of Brief Reports and Letters to the Editor for over 10 years, and Dr. Silva was the first associate editor of the Psychopharmacology News and Views column.
Also in this issue, we present several original articles, two of which are from our overseas colleagues in Poland and Germany. One is concerned with the assessment of boys with attention-deficit/hyperactivity disorder (ADHD), while the other focuses on the age-specific prevalence, incidence, and treatment of the disorder. Hanć et al. address the enduring issue of height and conclude that there is no difference between stimulant-naïve boys with ADHD and healthy controls. Noteworthy is the fact that there may be a tendency for obesity in this population. This finding continues the controversy concerning stimulant medication and growth rates and contradicts the conclusions of studies suggesting that growth deviations seen in children with ADHD may be due to the disorder and not the treatment. This relatively large study is a welcome addition to our knowledge base as we seek to understand more about childhood behavioral disorders and the first-line medications we use to treat them.
The article from our German colleagues addresses the issue of how commonly the diagnosis is made and how quickly treatment is initiated, if at all. Interestingly, Lindemann et al. note that ADHD is “common” even though the prevalence of new diagnoses in Germany, as noted in the paper, is 2.5%. This should invite attention from an American audience, where studies have consistently put prevalence at 5%–9%. Sadly, Lindemann et al. find that the majority of children with the diagnosis do not receive treatment with stimulant medications.
Three other articles address the assessment and treatment of children with autism spectrum disorders. Pearson et al. report a high concordance of parent and teacher reports concerning ADHD behaviors in children with autism. The concordance is high enough, the paper suggests, that during periods when school is out of session clinicians can rely on parent observations to be accurate. It should be noted that parents tend to find higher rates of symptomatology than teachers.
Storch et al. address anxiety in the autism spectrum disorder (ASD) patient group and uncover an interesting conundrum for the clinician. While the accepted knowledge about anxiety symptoms in typically developing children is that they are best identified by patient report, the paper suggests that parents are “better” reporters of clinical levels of anxiety when a child's ASD interferes with his or her communication. For this reason, “the burden is placed on the parent to recognize these disorders and to communicate observations to the clinician.”
Finally, we have important findings concerning aripiprazole, an atypical antipsychotic frequently used in this population. Ho et al. have studied the drug's effects on cardiac functioning via electrocardiography, and find not only that it appears to affect children in a similar manner as adults but also that it poses low risk for adverse reactions.
I hope you enjoy this informative issue of the journal.