Commonly Asked Questions About Child and Adolescent Psychiatry

Samina Aziz M.B.B.S.

Psychiatric illnesses in children and adults are often inherited in the same way as hypertension and diabetes are. Yet treatment for psychiatric illness is often delayed because of difficulty with obtaining treatment or concerns about psychiatric treatments.

As a child psychiatrist, I feel it is very important that children should receive treatment for psychiatric illnesses because not only do these illnesses have an immediate impact, but left untreated they can also impact emotional and social development.

Here are some questions that I am often asked about treatment of psychiatric disorders in children and adolescents.

How common are psychiatric illnesses in children?

According to NIMH, one in 10 children in the United States suffers from a psychiatric illness severe enough to warrant treatment. It is estimated that as many as 3-5% of children and adolescents in the United States have ADHD, and that between 2-4% have major depression. Suicide is the third-leading cause of death in 15-24 year olds and the fourth-leading cause of death in 10-14 year olds.

How do I know if my child should be evaluated?

If your child is experiencing problems at home, at school or with friends that are impairing his or her functioning, and the primary pediatrician has ruled out medical causes, it is appropriate to seek a consultation. It is particularly important to consider this if there is a family history of depression, anxiety, bipolar illness or any other psychiatric illness.

Another reason may be if there has been a recent stress in your family such as death or divorce and you believe your child is having difficulty with this.

Who is a child psychiatrist?

A child psychiatrist is a medical doctor who has, after graduation from a medical school, completed residency training in general psychiatry (3-4 years) and has completed a fellowship in child and adolescent psychiatry (2 years). The physician may have also completed a series of examinations that result in obtaining a board certification by the American Board of Psychiatry and Neurology (ABPN). A child psychiatrist is able to complete evaluations and use both medications and therapy in the treatment of children and adolescents. With the parents’ consent, child psychiatrists co-ordinate care with pediatricians, psychologists and other therapists, as well as teachers and other school officials.

If I take my child to see a psychiatrist, does that mean they will have to take medications?

No. Medications may be part of a treatment regimen, but are never the only treatment. You should expect that the psychiatrist would interview the child and parents together, and/or separately, and make recommendations for treatment. These may include testing by a psychologist, individual or family therapy, and medications with therapy.

Are medications safe?

There are medications that have been approved by the FDA for use in children and are safe. In some circumstances, a psychiatrist may recommend a medication that has not yet been approved by the FDA due to a lack of recent data. It is important to discuss risks and benefits of medications, as well as interactions between medications. It is acceptable and encouraged that you ask your psychiatrist detailed questions about the medications. As a parent, you have the right to consent or refuse medications. It is important to emphasize that medications are only a part of the treatment and not the entire treatment.

Where can I learn more about common psychiatric illnesses and treatment?

The American Academy of Child and Adolescent Psychiatrists has an excellent website at www.aacap.org and the NIMH website at www.nimh.nih.gov also has information about mental illness in children.