0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Book Reviews   |    
Practical Child and Adolescent Psychopharmacology
Reviewed by Annette M. Matthews, M.D.
Psychiatric Services 2004; doi: 10.1176/appi.ps.55.1.93-a
View Author and Article Information

edited by Stan Kutcher; Cambridge, England, Cambridge University Press, 2002, 467 pages, $60 softcover

text A A A

Practical Child and Adolescent Psychopharmacology is the ninth book in the Cambridge Series on Child and Adolescent Psychiatry. Each book has the stated goal of a "thorough critical review of the etiology, natural history, management, prevention, and impact on later adult adjustment." An interesting tension runs throughout the pages of this particular book as it shows the struggle of child psychiatry to define itself as a field, to set a standard of care, and to carve out a role in the future.

The book begins with a historical chapter that looks at the development of our thinking about child psychopharmacology. Readers will be struck by the newness of the field as the book traces the beginning of child psychopharmacology to the 1930s—less than 100 years ago. The chapter also presents a timeline of the shifts in the philosophy of prescribing for children.It describes a shift from a complete taboo on such prescribing to a more recent realization that children had been denied the benefits of the pharmacologic revolution. It describes a move from a "protective" strategy to a strategy of efficacy; from prescribing the lowest effective dose to dosing for the most effective response.

The idea of dosing for the most effective response has resulted in a new empiricism toward prescribing for children. As if to counter this, chapter 3, "Clinical Aspects of Child and Adolescent Psychopharmacology," describes how to take a history from a child and the child's family, how to place the information in context, and how to begin to think systematically about prescribing. It contains many interesting tables, including one that lists behavioral variables that are amenable to pharmacotherapy and another that lists considerations when choosing a medication. This chapter also subtly suggests that despite the newness of child psychopharmacology, there is a standard of care. It challenges the use of empirical prescribing by proposing a more formal strategy.

Most of the rest of the book contains chapters that directly address the major axis I disorders. There are also chapters on pervasive development disorders, aggressive behavior, Tourette's syndrome, and medical psychiatric conditions. Discussion of each of the disorders includes a review of what is known about prescribing for them, much of it from research among adults. Some of the chapters make it seem as though the diagnostic boundaries of these disorders as they present in childhood may still be quite unrefined. For example, the chapter on pervasive developmental disorders describes the gradual differentiation of these disorders into categories such as low- and high-functioning autism and Aperger syndrome and then suggests that still more delineation may be yet to come.

Practical Child and Adolescent Psychopharmacology would be an excellent book to use as an introduction to child psychiatry for residents, nurse practitioners, and others in training; it provides sound and conservative advice on the current practices in the field. It also provides a sense of both the history and potential future of child pharmacotherapy.

Dr. Matthews is a resident in psychiatry at Oregon Health and Science University in Portland.

+

References

+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Books
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 1.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 45.  >
The American Psychiatric Publishing Textbook of Psychiatry, 6th Edition > Chapter 34.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 45.  >
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 12.  >
Topic Collections
Psychiatric News
PubMed Articles