The use of antipsychotics in children and adolescents is controversial. The advent of newer atypical antipsychotics with a lower risk of adverse effects has opened the possibility of more frequent use of them in children with behavioral problems. In an analysis of data from Tennessee Medicaid, Cooper et al found that the use of these medications among 2- to 18-year-olds doubled between 1996 and 2001. Their use for attention-deficit/hyperactivity disorder and affective disorders increased 2.5-fold; that for Tourette syndrome and schizophrenia remained constant. Use of antipsychotics increased by 61% among preschoolers during this period.
Recent studies indicate that bullying is associated with adverse outcomes for both the victim and bully. Data from the Health Behaviour in School-aged Children Study provide a unique opportunity to compare bullying rates across 25 countries. Of 113 200 children surveyed, involvement in bullying varied dramatically from 9% to 54%. In all countries, bullying was associated with poorer psychosocial adjustment, greater health problems, and an increased risk of substance abuse. Bullying is a common, frequent, and important health issue for children globally.
As highly active antiretroviral therapies have substantially expanded the quality and lifespan of persons with human immunodeficiency virus (HIV) infection, children are increasingly confronted with the consequences of this illness in their parents. This randomized controlled trial was designed to improve coping skills for parents with HIV and their adolescents. Six years postintervention, adolescents participating in the coping skills program were more likely to be employed or in school, less likely to have psychosomatic symptoms, and had better problem-solving and conflict resolution skills. This intervention provides a model for future psychosocial interventions to improve the lives of young people affected by HIV infection.
Prior research has indicated that maternal depression potentially has important effects on children's health and well-being. Kahn and colleagues examined whether fathers' mental health symptoms could influence the effect of the mothers' mental health on their children. The risk of a child having a high level of behavior problems was increased 9-fold if both parents reported poorer mental health compared with neither parent in poor mental health. Fathers' poorer mental health did not have an independent effect on their children's behavior problems but did affect the influence of the mothers' problems on the child.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2004;158(8):719. doi:10.1001/archpedi.158.8.719