The Brown University Child and Adolescent Behavior Letter最新文献

After 8 years of sharing monthly thoughts about child and adolescent mental health, this will be my last commentary. I retired last winter, so I'll turn this over to an editor still active in the scholarly and clinical world. It's the daily practice that creates opinions and ideas to research and write about. I'm looking forward to seeing what the following newsletters bring.

Last fall, the Food and Drug Administration (FDA), together with the Centers for Disease Control and Prevention (CDC), released data from the 2024 National Youth Tobacco Survey (NYTS) on youth tobacco use in the Morbidity and Mortality Weekly Report: “Tobacco Product Use Among Middle and High School Students — ­National Youth Tobacco Survey, United States, 2024.”

Researchers have found that screen time was associated with alcohol, nicotine, and cannabis experimentation in young teens. With each additional hour spent on social media, texting, and video chatting, the odds of any substance experimentation went up. The study is based on data from the Adolescent Brain Cognitive Development (ABCD) study of the National Institutes of Health, which funded the research.

Integrated behavioral health care is an umbrella term that describes methods of delivering behavioral health services in a familiar medical setting to facilitate patient access to care and increase utilization by improving convenience, reducing weight times, and reducing the stigma of seeking mental health care. There are a number of models of integrated care, with the collaborative care and primary care behavioral health models being the most well-known and evidence-supported (Kallenberg & Sieber, 2024; Reiter et al., 2018; Yonek et al., 2020). Currently, integrated behavioral health exists in multiple forms in Rhode Island. In this article we will describe the current landscape and future directions of integrated behavioral health (IBH) at Hasbro Children's Pediatric Primary Care Clinic, including the team makeup, goals, and common reasons for consultation. Our aim is to help community providers, both pediatric and behavioral health providers better understand the IBH team and describe the types of services provided.

“Transition-age youth” sounds like fancy talk for coming-of-age years. In fact, it's a time when youth are particularly vulnerable to stress, and also when serious mental health problems can derail their move into adulthood. The years of being home and protected by parents, perhaps, are over. College, jobs, and concerns about the “real world” can take over. Furthermore, the inner world — depression, anxiety, suicide, substance use, bullying, romance, even possible first-episode psychosis which takes place during these years, can emerge. Medically, the pediatrician is probably leaving the child's medical team, and new providers — adult providers — will be taking over. These providers don't know the child the way the pediatrician does.

Attention-deficit hyperactivity disorder (ADHD) is treated by medications, most recently, by viloxazine (Qelbree). Researchers in China looked at clinical trials to try to determine the best dose. Viloxazine was associated with better outcomes than placebo, with a bell-shaped response curve suggesting that doses greater than 400 mg or greater than 7 mg/kg might not be linked to greater efficacy. Ascent curves tapered off about weeks 4 to 6. The curve for only 100 mg/d declined more rapidly, while the curves for 200 mg/dl and 400 mg/dl declined more gradually. In terms of adverse effects, there was a higher risk of discontinuation with viloxazine compared to placebo. The discontinuation rate due to adverse effects was 4.15% in the viloxazine group.

Substance use among youth aged 12 to 17 presents a major public health concern in the United States with statistics revealing that one in eight youths have engaged in illicit substance misuse within the past year (National Center for Drug Abuse Statistics, 2023). The long-term consequences of youth substance use include complicated medical issues, mental health disorders, impaired brain development, social and behavioral issues, addiction and dependence problems, and financial and legal consequences. By comprehending, preventing, and addressing factors of youth substance use, parents, educators, and healthcare providers can protect the well-being of young individuals, their families, and the community.

The outgoing president of the American Academy of Pediatrics listed the many ways in which the organization has protected children over the past year, but parents clearly need to be there as well. Keeping health insurance and access to mental health care, promoting vaccine confidence, keeping children safe online, challenging bans on gender-affirming care and reproductive health services are just some of the important protections for children.