Abstract
To Our Readers:
In this issue you will find articles and reviews on selective serotonin reuptake inhibitor (SSRI) treatment of pediatric psychopathology, including generalized anxiety disorder (GAD), depression, and self-injurious behavior. Of particular interest is the article by Courtney et al. that uses data from a large British randomized controlled trial of psychotherapeutic treatment for depression (the IMPACT trial) to explore questions about the relationship between SSRI initiation and self-harm.
First, I would like to draw your attention to the upcoming May Mental Health Month campaign from the Child Mind Institute, YOU GOT THIS. In this campaign, celebrities and influencers will share stories about the mental health disorders, anxieties, doubts, and confusion of their own youth along with tips on how they got through it. Most importantly, they will offer reassurance that help is out there, and that dark days now do not mean dark days forever. Collectively, the campaign will offer an empowering message that “Yes, though things may be hard now, YOU GOT THIS!”
As clinician-researchers, we have important roles to play for the children, adolescents, and families we work to help. This can be as trusted medical professional, a pioneering scientist—or a conduit to helpful and empowering information. If you have the opportunity this May, please point a young person toward the YOU GOT THIS campaign at (childmind.org).
In “Multivariable prediction modeling of antidepressant initiation in unipolar depressed adolescents: a secondary analysis of the IMPACT trial,” Courtney et al. use antidepressant initiation data present in the original IMPACT data set to explore prescribing habits. In particular, they view these data through the lens of the United Kingdom's NICE (National Institute for Health and Care Excellence) guidelines for antidepressant prescribing.
“We found mixed evidence that clinicians are using depression symptom severity (consistent with NICE guideline recommendations) and self-injurious thoughts and behaviors (in contrast to NICE guideline recommendations) to make decisions around antidepressant prescriptions in adolescents with depression,” the authors write. This important article demonstrates the benefits of open data and is an example of how research can support the implementation of clinical guidelines.
A separate article from Strawn et al. reports on a multicenter flexible dosing trial of escitalopram (Lexapro) in youth aged 7 to 17 years with GAD with positive results. The study “replicates prior studies demonstrating the efficacy of escitalopram in adolescents with GAD and extends these findings to children aged 7–11,” the authors write. “For clinicians, these findings buttress data that SSRIs effectively reduce anxiety severity in anxious youth and lend support for including escitalopram in the pediatric anxiety disorders armamentarium.”
Elsewhere, Smith et al. discuss benzodiazepenes and electroconvulsive therapy for catatonia in profound autism, and Fani-Molky et al. explore corticosteroid-induced psychosis in children and adolescents.
I hope you find the articles in this issue helpful and informative, and that you look for the YOU GOT THIS campaign in May on (childmind.org).