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Thomas F. Boat, MD1; Stephanie Filigno, PhD1,2; Raouf S. Amin, MD1 JAMA Pediatr. Published online July 24, 2017. doi:10.1001/jamapediatrics.2017.1682 Families of children with chronic health disorders (long-term physical conditions) are at increased risk of psychosocial problems. This editorial outlines a number of strategies for supporting them including brief behavioural interventions, mindfulness and relaxation skills, and screening for parental anxiety and depression. http:...

Schoeler T, Petros N, Di Forti M. Lancet Psychiatry. 10 July 2017.  DOI: http://dx.doi.org/10.1016/S2215-0366(17)30233-X This study of almost 400 young people with first-episode psychosis showed that continued cannabis use predicted poor outcome, including risk of relapse, number of relapses, length of relapse, and care intensity at follow-up. Around 20-36% of the adverse effect of cannabis use was mediated by poorer medication adherence.  The authors suggest more actively focusing on r...

Atkin T, Nunez N, Gobbi G. JCPP. 5 May 2017. DOI: 10.1111/jcpp.12735 The treatment of depressive and mixed states in people with paediatric bipolar disorder often causes more confusion than the treatment of mania.  This review included 45 studies and found that there is sufficient evidence for a Grade A recommendation for the use of olanzapine plus fluoxetine to treat depressive symptoms during bipolar depression and high dose quetiapine to treat depressive symptoms during mixed episodes...

Parry P, Allison S, Bastiampillai T. Child and Adolescent Mental Health. 17 July 2017. DOI: 10.1111/camh.12231 This re-examination of 12 studies included in a 2011 review by Van Meter et al  (doi: 10.4088/JCP.10m06290) finds that the previously reported rate of paediatric bipolar disorder of 1.8% was grossly over-estimated.  The inclusion of few participants under 12 years of age, discrepancies between US and non-US study results, and combination of parent and child report data despite ...

Ramchand R, Ahluwalia SC, Xenakis L, et al.   Prev Med. 2017 Aug;101:156-170.  doi: 10.1016/j.ypmed.2017.06.008. Epub 2017 Jun 8. (Review) PMID: 28601621 Peer support interventions are being promoted widely within mental health arena.  However, the evidence for their effectiveness is rarely discussed.  This comprehensive review demonstrated more null than positive effects across existing interventions.  Notable exceptions included group-based interventions using peers as educators ...

JR Larsen et al.  JAMA Psychiatry 74 (7), 719-728. 01 Jul 2017 Jul. Obesity is one of the most significant side-effects of antipsychotic medication.  Current management of this problem includes weight monitoring, dietary advice and the use of glucose-lowering medicines such as metformin.  Liraglutide is a glucagon-like peptide 1 receptor agonist and a relatively new medication for diabetes.  This is one of the first studies to investigate its value in preventing diabetes in people receivi...

Pagsberg A, Jeppesen P, Klauber DG, et al. Lancet Psychiatry 6 June 2017. DOI: http://dx.doi.org/10.1016/S2215-0366(17)30166-9 This rare double-blind, placebo-controlled head to head trial of antipsychotic medications quetiapine ER and aripiprazole in 12-17 year olds with early-onset psychosis showed no significant difference in effectiveness between these medications.  There were some differences in side effects though, with quetiapine ER being associated with more metabolic side-effect...

ED Barker et al. J Child Psychol Psychiatry. 2017 Jul 24. Why do some children who experience adversity develop problems and not others?  This review suggests that differences in DNA methylation may result in different reactions to stress, diet and exposure to neurotoxins. Further work is needed to establish a definite causal link. https://www.ncbi.nlm.nih.gov/labs/articles/28736860/    

C de Roos et al. J Child Psychol Psychiatry. 2017 Jun 28. This randomized controlled trial of Eye Movement Desensitization Reprocessing Therapy (EMDR), Cognitive Behavioural Writing Therapy (CBWT) and waitlist included 103 children with Post-Traumatic Stress Disorder (PTSD).  It found that both EMDR and CBWT were more effective than waitlist at reducing symptoms of PTSD with 92.5% of children who received EMDR and 90.2% of children who received CBWT no longer meeting diagnostic criteria fo...

Whitehouse AJO, Granich J, Avarez G, et al. J Child Psychol Psychiatry. 25 May 2017. DOI: 10.1111/jcpp.12752 This paper describes a randomized controlled trial of TOBY, an app-based learning curriculum designed to complement early behavioural intervention in children with Autism Spectrum Disorder. Significant improvements were found in Autism Treatment Evaluation Checklist scores, fine motor, visual reception and some improvement was found on measures of adaptive functioning.  The only down...