Dr. Henry Paul, MD

Psychiatrist, Author and Educator

SCREENING PRESCHOOLERS FOR DEPRESSION IS A GOOD IDEA

August 22nd, 2014

Depression can strike at any age, even among preschoolers, researchers report. CBS News

A very interesting study came out this month that looked at depression in preschoolers. The study found that preschoolers who are depressed are two and a half times more likely to continue to experience symptoms in elementary and middle school.

The study, published recently in the American Journal of Psychiatry, was done at Washington University by a team headed by Dr. Joan Luby, who directs the university’s Early Emotional Development Program. It included 246 preschool children, ranging from three to five years of age. Luby’s team evaluated the children for depression and other psychiatric conditions over time.

At the onset of the study, 74 of the children were diagnosed with depression. Six years later, 79 of the children met the criteria for clinical depression, including about half of the 74 children diagnosed with depression when the study began. Of the 172 children who were not depressed as preschoolers just 24 percent of them went on to develop depression later.

The study identified a higher risk of depression for children whose mothers had suffered from depression, and those who were diagnosed with a conduct disorder while in preschool.

When I was in training, we were taught that young children could not suffer from depression because they were not old enough to have a superego — a mental structure described by Sigmund Freud that develops at about eight years old. This theory, which denied the obvious, which was that we often saw depressed young children, flew in the face of reality and caused depressed children to be left untreated up until the last few decades.

Today, we know that people of all ages can suffer from depression, especially young children who grow up in stressful circumstances. If untreated, this depression can lead to severe consequences including further depression, educational slowing, behavior disorders and other syndromes.

I agree with the researchers that children as early as three years old should be screened. Childhood depression can be treated, and there are a host of interventions that help including psychotherapy, family therapy, and medication.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

SHOCK EM’ OUT OF AUTISM?

August 21st, 2014

Jennifer Msumba is on the autism spectrum. For seven years, she was treated at the Judge Rotenberg Center in Canton, Massachusetts, where she received painful electric shocks aimed at modifying her behavior. She describes being strapped, spread-eagle to a restraint board and shocked multiple times before she left the center in 2009. CBS Evening News.

Autism Spectrum Disorder (ASD), also known as Pervasive Development Disorder, is a diagnosis that is more prevalent than ever before and one that is concerning not only for the medical community, but for the parents and families of those diagnosed with it, too.

Back in March of this year, a CDC study reported that one in 68 children has Autism (ASD). This was a 30 percent increase since the agency estimated just two years before that one child in 88 suffered from the disorder. There is some controversy as to the validity of the reported increase in diagnosis but ASD remains a major issue in this country. It is one of a parent’s most feared diagnoses.

The CBS News story is the first to really “out” electric shock as a treatment for those with ASD. After watching the segment, you certainly can see there is controversy attached to its usage, as well.

ASD is a condition that has a number of variables, and those are specific to each person diagnosed with it. Some people cannot communicate at all while others are social. Some can be compulsive and inflexible, preoccupied with similar ritualized behaviors that can go on for hours. Others can be aggressive and prone to angry outbursts or temper tantrums. Some have mood swings, can be hyperactive, and the list goes on. The important thing to recognize is that all these symptoms do not show up in every person diagnosed with ASD.

Without knowing the full story and seeing the diagnoses of the patients included in the news story, I cannot render an appropriate opinion on specific treatment recommendations, but I can say that the use of shock therapy for these types of children seems far-fetched to me. Using shock conditioning seems primitive, if not downright out of the realm of accepted standards of care. When I treat young people with ASD I almost always recommend medication and behavioral therapy, as well as proper educational placement. I have never recommended electric shock and find it difficult to imagine ever prescribing.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.