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Adolescent major depressive disorder (MDD) prevalence has nearly doubled in the past decade. The US Preventive Services Task Force endorses universal adolescent MDD screening in primary care; however, most adolescents lack preventive health care, resulting in worsening disparities in MDD screening and treatment. To evaluate the effectiveness of universal adolescent MDD screening in the school setting in an effort to reduce disparities and improve MDD identification and treatment initiation. This randomized clinical trial, conducted from November 6, 2018, to November 20, 2020, compared the usual school practice of targeted or selected screening based on observable behaviors of concern with universal MDD screening. Students within an identified school were randomized by grade to 1 of the 2 study groups. Study groups were compared using mixed-effects logistic regression. Participants included students in grades 9 through 12 enrolled at 1 of the 14 participating Pennsylvania public high schools. In targeted screening, students with behaviors prompting concern for MDD were referred to the Student Assistance Program (SAP), mandated in all Pennsylvania schools. The SAP determined follow-up recommendations. In universal screening, all students completed the Patient Health Questionnaire-9 (PHQ-9); students with positive scores proceeded to SAP. The universal screening group could also have targeted referral to SAP for concerning behavior independent of the PHQ-9. The primary outcome was initiation of MDD treatment or services based on data collected by school SAP teams during the academic year. A total of 12 909 students were included (median age, 16 years [range, 13-21 years]; 6963 male [53.9%]), of whom 2687 (20.8%) were Hispanic, 2891 (22.4%) were non-Hispanic Black, 5842 (45.3%) were non-Hispanic White, and 1489 (11.5%) were multiracial or of other race or ethnicity. A total of 6473 students (50.1%) were randomized to universal screening, and 6436 (49.9%) were randomized to targeted screening. Adolescents in the universal screening group had 5.92 times higher odds (95% CI, 5.07-6.93) of being identified with MDD symptoms, 3.30 times higher odds (95% CI, 2.49-4.38) of SAP confirming follow-up needs, and 2.07 times higher odds (95% CI, 1.39-3.10) of initiating MDD treatment. No differences were identified in initiation for planned subgroup analyses by sex or race and ethnicity. In this randomized clinical trial, universal school-based MDD screening successfully increased identification of MDD symptoms and treatment initiation among adolescents, confirming the value of this approach to address this rising public health concern. ClinicalTrials.gov identifier: NCT03716869.

This undergraduate textbook covers the classification, causes, treatment and prevention of psychological disorders in the infant through the adolescent years. Chapters balance the social and historical context of psychopathology with the physiological roots of abnormal behavior, leading students to a comprehensive understanding of child psychopathology. The book is totally up-to-date, including coverage of the DSM5 and criticisms of it. In four sections, this textbook describes the empirical bases of child psychopathology as well as the practice of child psychologists, outlining the classification and causes of disorders in addition to methods of assessment, intervention and treatment. Students will be able to evaluate the treatments used by professionals and debunk popular myths about atypical behavior and its treatment. Complementing the lively writing style, text boxes, clinical case studies and numerous examples from international cultures and countries add context to chapter material. Study questions, diagrams and a glossary offer further learning support.-- Source other than Library of Congress.

Clinical Child Psychiatry THIRD EDITION Making a psychiatric diagnosis in children can be challenging: some clinicians say the incidence of some childhood disorders, such as bipolar disorder and ADHD, is over-diagnosed while others say they are undiagnosed, undertreated, and are a large burden on society. The drug treatment of child psychiatric disorders can also be controversial in children and adolescents. This book fulfills the need for an objective, clinically relevant source to dispel this confusion. Clinical Child Psychiatry is a textbook of current clinical practice in child and adolescent psychiatry. It is designed as a reference for clinicians that is both easily usable and authoritative, a \"chairside\" reference for the consultation room. This book addresses a defined series of clinical entities that represent the bulk of current treatment modalities and disorders encountered in 21st century practice. It is authoritative in the areas addressed while at the same time being rapidly accessible in format. To facilitate access, it presents disorders in declining order of frequency. The authors believe that worthwhile clinical work must be informed by both evidence-based practice and by psychiatry's traditional attention to internal and interpersonal dynamics. They are committed to an approach that is broadly biopsychosocial while based on current clinical evidence for a pragmatic, clinical focus. The book is divided into four sections. The first, Fundamentals of Child and Adolescent Psychiatric Practice, addresses assessment, treatment modalities, and planning. Common Child and Adolescent Psychiatric Disorders and Developmental Disorders cover the diagnosis and treatment of the large majority of disease entities encountered in practice. The final section, Special Problems in Child and Adolescent Psychiatry, includes a variety of topics such as foster care and adoption, loss and grief, and forensics. * New evidence relating to the areas of depression, psychosis, trauma. * New insights from genetics, genomics, and proteomics cleverly integrated into chapters on the individual disease with focus on their clinical application. * New chapter on consultation and collaboration within systems of care. The book addresses a need for clinicians, many of whom are beginners, non-psychiatrists, or psychiatrists entering unfamiliar territory, to come up to speed rapidly in providing more than perfunctory service to needy populations. This challenge grows ever greater.

Objective To compare the effectiveness of classroom based cognitive behavioural therapy with attention control and usual school provision for adolescents at high risk of depression.Design Three arm parallel cluster randomised controlled trial. Setting Eight UK secondary schools.Participants Adolescents (n=5030) aged 12-16 years in school year groups 8-11. Year groups were randomly assigned on a 1:1:1 ratio to cognitive behavioural therapy, attention control, or usual school provision. Allocation was balanced by school, year, number of students and classes, frequency of lessons, and timetabling. Participants were not blinded to treatment allocation.Interventions Cognitive behavioural therapy, attention control, and usual school provision provided in classes to all eligible participants.Main outcome measures Outcomes were collected by self completed questionnaire administered by researchers. The primary outcome was symptoms of depression assessed at 12 months by the short mood and feelings questionnaire among those identified at baseline as being at high risk of depression. Secondary outcomes included negative thinking, self worth, and anxiety. Analyses were undertaken on an intention to treat basis and accounted for the clustered nature of the design.Results 1064 (21.2%) adolescents were identified at high risk of depression: 392 in the classroom based cognitive behavioural therapy arm, 374 in the attention control arm, and 298 in the usual school provision arm. At 12 months adjusted mean scores on the short mood and feelings questionnaire did not differ for cognitive behavioural therapy versus attention control (−0.63, 95% confidence interval −1.85 to 0.58, P=0.41) or for cognitive behavioural therapy versus usual school provision (0.97, −0.20 to 2.15, P=0.12).Conclusion In adolescents with depressive symptoms, outcomes were similar for attention control, usual school provision, and cognitive behavioural therapy. Classroom based cognitive behavioural therapy programmes may result in increased self awareness and reporting of depressive symptoms but should not be undertaken without further evaluation and research.Trial registration Current Controlled Trials ISRCTN19083628.

The Second Edition of the Handbook of Adolescent Behavioral Problems clarifies the current state of treatment and prevention through comprehensive examinations of mental disorders and dysfunctional behaviors as well as the varied forces affecting their development. New or revised chapters offer a basic framework for approaching mental health concerns in youth and provide the latest information on how conditions (e.g., bipolar disorder, suicidality, and OCD) and behaviors (e.g., sex offenses, gang activities, dating violence, and self-harm) manifest in adolescents. Each chapter offers diagnostic guidance, up-to-date findings on prevalence, biological/genetic aspects, risk and resilience factors, and a practical review of prevention and treatment methods. Best-practice recommendations clearly differentiate among what works, what might work, what doesn't work, and what needs further research across modalities, including pharmacotherapy. Key topics addressed include: Families and adolescent development. Adolescent mental health and the DSM-5. Oppositional Defiant Disorder and Conduct Disorder. Autism spectrum disorder. Media and technology addiction. School failure versus school success. Bullying and cyberbullying. The Second Edition of the Handbook of Adolescent Behavior Problems is a must-have reference for researchers, clinicians, allied practitioners and professionals, and graduate students in school and clinical child psychology, education, pediatrics, psychiatry, social work, school counseling, and public health.

Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section on “Special Populations” is the sixth of six guidelines articles. Results: Recent studies inform the treatment of MDD in children and adolescents, pregnant and breastfeeding women, women in perimenopause or menopause, and the elderly. Evidence for efficacy of treatments in these populations is more limited than for the general adult population, however, and risks of treatment in these groups are often poorly studied and reported. Conclusions: Despite the limited evidence base, extant data and clinical experience suggest that each of these special populations can benefit from the systematic application of treatment guidelines for treatment of MDD.

Approaching the 30th anniversary of the discovery of resting state functional magnetic resonance imaging (rsfMRI) functional connectivity, we reflect on the impact of this neuroimaging breakthrough on the field of child and adolescent psychiatry. The study of intrinsic functional brain architecture that rsfMRI affords across a wide range of ages and abilities has yielded numerous key insights. For example, we now know that many neurodevelopmental conditions are associated with more widespread circuit alterations across multiple large-scale brain networks than previously suspected. The emergence of population neuroscience and effective data-sharing initiatives have made large rsfMRI datasets publicly available, providing sufficient power to begin to identify brain-based subtypes within heterogeneous clinical conditions. Nevertheless, several methodological and theoretical challenges must still be addressed to fulfill the promises of personalized child and adolescent psychiatry. In particular, incomplete understanding of the physiological mechanisms driving developmental changes in intrinsic functional connectivity remains an obstacle to further progress. Future directions include cross-species and multimodal neuroimaging investigations to illuminate such mechanisms. Data collection and harmonization efforts that span multiple countries and diverse cohorts are urgently needed. Finally, incorporating naturalistic fMRI paradigms such as movie watching should be a priority for future research efforts.