From Psychopharmacological Evidence to Clinical Practice: Unmet Needs in Child & Adolescent Psychiatry – Reflections on Kölch & Plener

Research in clinical psychopharmacology has advanced the evidence base for the treatment of various child psychiatric disorders. In their selective review in this journal, Kölch and Plener [1] relate the efforts that have been made in recent decades. Although the available studies provide invaluable insights into effects, adverse events, and mechanisms of psychotropic drugs in children and youth, clinical practice requires further steps, some of which will be reflected in this commentary.

• References

• 1 Kölch M, Plener PL. Pharmacotherapy in psychiatric disorders of children: current evidence and trends. Pharmacopsychiatry 2016; 49: 219-225
• 2 Schmäl C, Becker K, Berg R. et al. Pediatric psychopharmacological research in the post EU regulation 1901/2006 era. Z Kinder Jugendpsychiatr Psychother 2014; 42: 441-449
• 3 Franke C, Fegert JM, Krüger U. et al. Prescriptions of psychotropic drugs to children and adolescents in Germany. Z Kinder Jugendpsychiatr Psychother 2016; 44: 259-274
• 4 Kennard B, Silva S, Vitiello B. et al. Remission and residual symptoms after short-term treatment in the Treatment of Adolescents with Depression Study (TADS). J Am Acad Child Adolesc Psychiatry 2006; 45: 1404-1411
• 5 Emslie GJ, Mayes T, Porta G. et al. Treatment of Resistant Depression in Adolescents (TORDIA): week 24 outcomes. Am J Psychiatry 2010; 167: 782-791
• 6 Holtmann M, Bölte S, Poustka F. Suicidality in depressive children and adolescents during treatment with selective serotonin reuptake inhibitors. Review and meta-analysis of the available randomized, placebo-controlled trials. Nervenarzt 2006; 77: 1332-1337
• 7 Cipriani A, Zhou X, Del Giovane C. et al. Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis. Lancet 2016; pii: S0140-6736(16)30385-3 [Epub ahead of print]
• 8 Cortese S, Holtmann M, Banaschewski T. et al. Practitioner review: current best practice in the management of adverse events during treatment with ADHD medications in children and adolescents. J Child Psychol Psychiatry 2013; 54: 227-246
• 9 Faraone SV, Asherson P, Banaschewski T. et al. Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers 2015; 1: 15020
• 10 Curry J, Rohde P, Simons A. et al. Predictors and moderators of acute outcome in the Treatment for Adolescents with Depression Study (TADS). J Am Acad Child Adolesc Psychiatry 2006; 45: 1427-1439
• 11 Hinshaw SP, Arnold LE. For the MTA Cooperative Group . ADHD, multimodal treatment, and longitudinal outcome: evidence, paradox, and challenge. Wiley Interdiscip Rev Cogn Sci 2015; 6: 39-52
• 12 Sonuga-Barke EJ, Brandeis D, Cortese S. et al. Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry 2013; 170: 275-289
• 13 Schmidt SJ, Schimmelmann BG. Progress, challenges and new perspectives in psychotherapy research in children and adolescents. Z Kinder Jugendpsychiatr Psychother 2015; 43: 85-90
• 14 Döpfner M, Breuer D, Schürmann S. et al. Effectiveness of an adaptive multimodal treatment in children with Attention-Deficit Hyperactivity Disorder – global outcome. Eur Child Adolesc Psychiatry 2004; 13: 117-129