Child and adolescent psychiatric clinics of North America
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Child Adolesc Psychiatr Clin N Am · Oct 1999
ReviewTraumatic brain injury in children and adolescents.
Traumatic brain injury is an insult to the brain caused by an external force that results in an impairment (transient or permanent) of cognitive, behavioral, emotional, or physical function. Traumatic brain injury encompasses shearing injury, which might be seen in a shaken infant, as well as penetrating injury from a foreign body, such as a bullet. This article addresses the recovery phase and functional sequelae following traumatic brain injury. Research and clinical experience over the past decade have led to a better understanding of the pathophysiology of head injury and, in turn, improved management.
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Child Adolesc Psychiatr Clin N Am · Oct 1999
ReviewImmune mechanisms in pediatric neuropsychiatric disorders. Tourette's syndrome, OCD, and PANDAS.
The authors have reviewed recent data supporting the presence of immune abnormalities in several neuropsychiatric disorders (TS, OCD, and PANDAS). Several groups agree that there is a subset of patients with TS and OCD (perhaps about 10%) for whom there is a clear streptococcal trigger, validating the PANDAS concept. ⋯ If this line of research reveals definable, and relatively specific, immune abnormalities in at least some cases of TS and OCD, it will likely have important implications for the diagnosis and treatment of these common neuropsychiatric disorders, particularly in children who respond poorly to conventional therapies. Child psychiatrists are encouraged to stay tuned.
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Headache is common in children and adolescents. A thorough history, examination, and a neurologic evaluation with charting of the temporal pattern of the headache and evaluation of psychosocial factors will allow the correct diagnosis to be made. ⋯ Psychological factors are important in all forms of headache and should be evaluated in each and every case. A comprehensive approach to the patient's problem, including medical and psychological interventions, will usually result in improvement.
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Child Adolesc Psychiatr Clin N Am · Oct 1998
ReviewA developmental and psychoeducational approach to reducing conflict and abuse in little league and youth sports. The sport psychiatrist's role.
To stress a point made earlier, whether backyard or Little League, the tone of the youth sports experience is greatly influenced by the player and team selection process. All possible steps should therefore be taken to ensure that the draft is held on high moral ground, and that the adult participants, even on the Major Little League level, behave cooperatively rather than competitively. If it is the community's hope that Little League will "build character, and not characters," it must embrace Shields and Bredemeier's work and flood the Draft Room with the four virtues of compassion, fairness, sportspersonship, and integrity. ⋯ Baseball is no longer the national pasttime and, as we approach the millennium, American children have too many other attractive, competing interests and time demands to spontaneously organize a pick-up game. One coach shared with the author that his saddest moment in CAP League came when he arrived at 6 PM at a field that had been "reserved" for his team, and found a group of boys who were playing a pick-up game. The coach's impulse was to set his boys fre
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Child Adolesc Psychiatr Clin N Am · Jul 1998
Police and mental health professionals. Collaborative responses to the impact of violence on children and families.
Coordinating responses through the Child Development-Community Policing Program has led to multiple changes in the delivery of clinical and police services. Mental health clinicians and police officers have developed a common language for assessing and responding to the needs of children and families who have been exposed to or involved in violence. Learning from each other, these unlikely partners have established close working relationships that improve and expand the range of interventions they are able to provide while preserving the areas of expertise and responsibilities of each professional group. ⋯ The institutions that function in the inner city--schools, police, mental health and child welfare agencies, churches--are all concerned about the same children and families. By working together, with a shared orientation to the best interests of the children, they can intervene earlier and more effectively: first, to disrupt the trajectory leading to violence; and, second, to help those children who are already caught in the web of exposure to violent crime and inner-city trauma. The experience with community-based policing and mental health in New Haven, now being replicated throughout the United States, can thus stand as a model of an active social response to an overwhel