E240 - 2024 NEI Congress Extended Q&A with Dr. Katherine Dahlsgaard, Dr. Roger McIntyre, Dr. Thomas Schwartz, and Lisa Tremayne
Nov 13, 2024
auto_awesome
Join Dr. Katherine Dahlsgaard, an expert in child social anxiety, as she shares innovative strategies like cognitive behavioral therapy for pediatric patients. Dr. Roger McIntyre discusses the fascinating link between inflammation, diet, and mental health, emphasizing the importance of nutrition in treating depression. Dr. Thomas Schwartz provides insights on sleep disorders, highlighting effective use of caffeine and melatonin for better rest. Together, they tackle vital topics that intertwine mental health, childhood anxiety, and lifestyle choices.
Effective management of selective mutism in children combines exposure-based cognitive-behavioral therapy with the potential adjunct of SSRIs to facilitate speech initiation.
Therapists should prioritize the treatment of anxiety disorders in youth, as alleviating anxiety can significantly alleviate co-occurring depressive symptoms.
Emerging research suggests a connection between inflammation and mental health disorders, warranting further exploration of dietary influences and their role in treatment.
Deep dives
Understanding Selective Mutism in Children
Selective mutism is a severe form of social anxiety disorder that manifests in children who speak normally at home but fail to communicate in social settings like school. This disorder is often linked to a behaviorally inhibited temperament characterized by heightened reactivity to unfamiliar situations, as identified by Jerome Kagan. Managing selective mutism typically involves exposure-based cognitive-behavioral therapy (CBT), where children gradually learn to speak in anxiety-inducing situations through a structured hierarchy of speech tasks. These tasks progress from making voiceless sounds to answering questions, with a focus on initiating speech in social contexts like school, often incorporating rewards for success.
The Role of Medication in Treating Selective Mutism
In certain cases of selective mutism, especially when children struggle to initiate speech, medication such as selective serotonin reuptake inhibitors (SSRIs) may be beneficial. SSRIs are generally well tolerated in young children and can effectively facilitate speech initiation, which is a crucial aspect of treatment. Parents often express concern over the use of medications in small children, but it is important to communicate the potential advantages of SSRIs, including the possibility of enhancing natural speech initiation in social situations. Consequently, medication can serve as a valuable adjunct to CBT, helping children overcome significant challenges in communicating.
Addressing Fear of School Violence Through Exposure Therapy
When children experience anxiety about returning to school due to fear of violence, a therapeutic approach of gradual exposure is recommended. Exposure-based CBT aims to confront these fears in a structured manner, treating avoidance of school as detrimental. The therapist guides the child back to school environments while managing anxiety, emphasizing that the actual risk of violence is relatively low compared to their fears. In cases where children have prior exposure to violence, it may be essential to first address any post-traumatic stress symptoms to facilitate a safe return to a learning environment.
Linking Anxiety Disorders and Depression in Youth
When treating children and teens presenting with both anxiety and depression, it is advisable to prioritize the treatment of anxiety disorders, as alleviating anxiety can significantly reduce depressive symptoms. Anxiety typically emerges before depressive symptoms in this age group, often leading to withdrawal and avoidance that exacerbates depressive states. As anxiety is addressed through exposure and CBT, children can re-engage in previously avoided activities, sparking behavioral activation that can alleviate depression. Additionally, irregular sleep patterns are often linked to these disorders, and improving sleep can enhance overall treatment outcomes.
The Impact of Inflammation on Mental Health
Current discussions in psychiatry include the potential link between inflammation and various mental illnesses, particularly depression. Some studies indicate that inflammatory markers might be associated with the likelihood of responding to antidepressant treatment, such as SSRIs. While the topic has garnered significant attention, further research is necessary to establish a clear causal relationship, as well as to determine whether routine tests of inflammatory markers would be beneficial in clinical practice. Additionally, dietary choices have been shown to influence inflammation and mental health, prompting investigations into whether diet modifications could serve as effective treatment strategies.
This episode includes extended Q&A sessions that address your unanswered questions from the following presentations delivered at the 2024 Congress in Colorado Springs, Colorado:
(00:23) Panic On the Playground! Managing Social Anxiety in Pediatric Patients by Katherine Dahlsgaard, PhD, ABPP and Jeffrey Strawn, MD (Q&A with Dr. Dahlsgaard)
(15:12) Inflammatory Remarks: Our Evolving Understanding of the Role of Inflammation in Mental Health by Roger McIntyre, MD, FRCPC and Vladimir Maletic, MD, MS (Q&A with Dr. McIntyre)
(35:33) Wake Me Up Before You Go-Go: Strategies for Improving Sleep-Wake Issues by Thomas Schwartz, MD
(51:32) Beyond the Blues: Risk, Recognition, and Relief from Perinatal Mood and Anxiety Disorders by Lisa Tremayne, RN, PMH-C, CBC (lisa.tremayne@rwjbh.org)
Never miss an episode!🎙SUBSCRIBE to the NEI Podcast– available on all your favorite platforms: https://nei.global/podcast
Interested in Psychopharmacology? Learn about the NEI Master Psychopharmacology Program: https://nei.global/mpp
Stay updated with email alerts and join our conversations on social. Follow us on: