Screening for dysfunction in the children of outpatients at a psychopharmacology clinic

Article Abstract:

Although children of psychiatric patients have an increased risk for psychiatric dysfunction, few clinicians treating patients who are parents inquire about their children. Most studies have reported high rates of psychiatric disorders in the children of psychiatric patients, regardless of the type of disorder of the parent. It would be beneficial if there was a quick and easy screening test to identify children at risk for psychiatric dysfunction so that they could be identified and treated as early as possible. The Pediatric Symptom Checklist is a short and simple questionnaire for parents that is used to identify psychosocial functioning in their children. This study examined the usefulness of this questionnaire, which was administered in an outpatient psychopharmacology clinic, in identifying psychosocial dysfunction in the children of psychiatric patients. The questionnaire was given to 74 patients, who had a total of 100 children. Demographic variables and data on the parents' psychological diagnoses were also examined. Scores on the checklist were above the cutoff point for 21 (21 percent) of the children. This compared with a rate of 12 percent in two pediatric study groups. Seven (41 percent) of 17 children whose parents had an axis II diagnosis (according to the Diagnostic and Statistical Manual of Mental Disorders) had scores above the cutoff point, while 14 (17 percent) of the children whose parents had a diagnosis other than an axis II disorder had scores above the cutoff point. For children living in a single-parent home, 42 percent had scores above the cutoff point, versus 14 percent of those who lived in double-parent homes. When the parents' occupational status was considered, 38 percent of the children whose parents were in the lower status, 21 percent whose parents were in the middle status, and 14 percent whose parents were in the higher status had scores above the cutoff point. Data on current psychiatric treatment status was available for 19 of the children who scored above the cutoff point. Only 12 of the 19 were currently receiving psychiatric treatment. These results indicate that the Pediatric Symptom Checklist is useful for screening the children of psychiatric patients for psychiatric dysfunction. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Risk factors, Child psychology, Mental illness, Mental disorders, Psychological tests for children, Childhood psychological tests

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Adjunctive buspirone in benzodiazepine treatment of four patients with panic disorder

Article Abstract:

Treatment with buspirone, a nonbenzodiazepine drug used in treating generalized anxiety, is thought to have certain advantages over the more commonly used diazepam. For one thing, buspirone does not produce euphoria and sedation to the extent that diazepam does. For another, when taken in higher doses, buspirone can cause depression and unrest, and therefore the potential for abuse of buspirone is minimized. Benzodiazepines are effective in reducing panic attacks but often the general anxiety levels of patients remain high. Although when used alone buspirone is not effective in reducing panic attacks, its use in conjunction with benzodiazepines in patients who suffer from both panic and anxiety attacks may offer an effective remedy. Four patients suffering from panic and anxiety attacks and who were also long-term users of benzodiazepines were examined. The condition of all four patients improved when given buspirone as an adjunct to their normal treatment with benzodiazepine. Panic attacks remained under control and a marked reduction of general anxiety levels was observed when given both drugs for an average period of seven months. No follow-up data concerning discontinuation was obtainable because the patients were reluctant to discontinue this dual therapy regime. Another advantage of adjunctive buspirone therapy may be the reduction of benzodiazepine dosages, which was achieved with three of the four patients. Dosage reduction of high-potency benzodiazepines may prevent side effects as well as dependance or abuse. However, it was recommended that benzodiazepine reduction not be started immediately after the addition of buspirone and if begun, it be done gradually to prevent benzodiazepine withdrawal symptoms.

Health aspects, Drug therapy, Dosage and administration, Antidepressants, Anxiety, Benzodiazepines, Buspirone hydrochloride, Buspirone

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"Anger attacks": possible variants of panic and major depressive disorders

Article Abstract:

Sudden outbursts of anger that are extremely out of proportion to any existing stress and are of short duration may be related to organic disorder such as brain dysfunction as a result of trauma, or to an affective disorder such as schizophrenic or paranoid disorders. Sudden spells of anger outbursts have also been reported to resemble panic attacks (except they are not accompanied by fear and anxiety) in otherwise healthy individuals without prior history of psychiatric disorder. Several such cases have been reported of these 'anger attacks' that are unexpected and uncharacteristic of the individual. Four cases are presented in which the individuals were treated with antidepressants, which resulted in substantial behavior improvement. A review of these four cases shows that the two most characteristic features are that the outbursts of anger grossly exceeded any type of appropriate response, and that each episode lasted a short period of time. Other symptoms included rapid heart beat, flushing, sweating, and feelings of loss of control over behavior. The successful treatment of these four patients with tricyclic antidepressants suggests that these anger attacks may be a form of panic disorder or depression. Also, the patients reported having feelings of frustration and helplessness, which also indicates the possibility of a panic or depressive disorder. Although this article presents retrospective case analyses that have limitations, it is hypothesized that these 'anger attacks' are a secondary feature of depression or anxiety. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Depression, Mental, Anger

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