Priority Mental Health Disorders of Children and Adolescents in Primary-care Pediatric Settings in India 2: Diagnosis, Pharmacological Treatment and Referral

Abstract

The advent of pediatric psychopharmacology has enormously improved psychiatric care of children and adolescents. Nonetheless, our practice of diagnosis, treatment and referral in primary-care pediatric settings is not optimum as current evidence based knowledge is not regularly applied in the actual clinical circumstances. To help primary-care pediatricians minimise this in research-clinical practice, pharmacological treatment and referral in their clinical practice, they need to follow a two-tier diagnostic and multi axial treatment approach. The two-tier diagnostic approach of using a screening measure followed by confirmation of the screen positive cases with reference standard clinical criterion, improves the sensitivity and specificity. The multiaxial treatment has the advantage of offering a holistic approach to the intervention and improve prognosis from the interacting axes. The primary-care physician should be aware of the medications of choice for the Priority Mental Health Disorders and their drug interactions. Finally, referral of cases with atypical presentations, multiple comorbidities and poor response to the first-line of treatment needs referral to the next tier in the system.

Statin and rottlerin small-molecule inhibitors restrict colon cancer progression and metastasis via MACC1

“…Rottlerin-treated animals showed significantly reduced MACC1 expression ( p < 0.05), confirming that rottlerin acts as a transcriptional inhibitor of MACC1 and thus inhibits MACC1-induced metastasis formation in vivo. We analyzed further rottlerin-induced effects by determining the mRNA expression levels of genes that can be regulated by rottlerin (CDC20, mTor, and SKP2) [38–40]. No significant expression regulation upon treatment with rottlerin was observed (S3 Fig).…”

Perspectives in Pediatric Psychopharmacology

“…Weight based dosing is commonly used to calculate the necessary dosage for pediatric population as a step down model from evidences available in adult psychopharmacological literature. [1] Pejovic-Milovancevic et al conducted a study on use of psychotropic medication in pediatric inpatients and found that the most commonly prescribed medications were antipsychotics (45.9%), antidepressants (17.2%), mood stabilizers (16.1%), benzodiazepines (14.4%), and other psychotropic drugs (6.4%). Their study also showed that the most frequently prescribed antipsychotic was Risperidone and the most frequently prescribed antidepressant was selective serotonin reuptake inhibitor (SSRI).…”

Increasing core competencies in child and adolescent psychiatry

“…The advent of pediatric psychopharmacology has enormously improved psychiatric care of children and adolescents;[2] however, there is hesitancy in the use of medication in children. Evidence-based pediatric psychopharmacology is essential for better care and avoiding legal issues.…”