Behavioural activation for the treatment of low-income, African American adolescents with major depressive disorder: a case series.

Behavioural activation (BA) is a psychosocial treatment that has shown promise in the treatment of adults suffering from major depressive disorder (MDD). Recent studies have shown that BA may also be effective for treating depressed adolescents. There are no studies that have reported on the BA treatment of depressed and low-income African American adolescents; thus, the current study reports on the effectiveness of a version of BA adapted for the treatment of African American adolescents who were diagnosed with MDD (n = 3). Participants were allowed to attend a maximum of 17 sessions of weekly psychotherapy. Based on results taken from structured interviews, two of the three participants no longer met criteria for MDD at the end of treatment, and the severity of clinician-rated depressive symptoms and impairment decreased for all participants at post-treatment assessment. Additionally, all participants and their caregivers reported satisfaction with treatment. Implications of these findings, study limitations and suggestions for future directions are discussed.

Establishing a telepsychiatry consultation practice in rural Georgia for primary care physicians: a feasibility report.

OBJECTIVE: One approach to solving mental health care disparity issues in rural areas is by establishing a telepsychiatry consultation practice for children, in which a psychiatrist sees a child via videoconferencing for a limited number of sessions and then provides a treatment plan to that child's primary care physician and family. METHOD: The present study offered a 2-session telepsychiatry consultation clinic, consisting of a psychiatric evaluation session and a recommendation session, with patients located remotely in rural Georgia. RESULTS: Fifteen consultations with children aged 4 to 18 years (M = 9.73, SD = 3.39) with varying diagnoses were completed. Parental satisfaction with the telepsychiatry consultation model was high, overall mean of 4.58 (SD = 0.63) on a 5-point scale (n = 11). CONCLUSION: Establishing a child telepsychiatry consultation practice is feasible in rural areas. This report describes the benefits and challenges of our telepsychiatry consultation clinic with rural pediatric patients.

Adolescent female with withdrawal psychosis following abrupt termination of ziprasidone.

It is widely known that discontinuation reactions can occur after neuroleptics are stopped resulting in dyskinesia through its effect on the nigrostriatal pathway. Less discussed is the concept of "supersensitivity psychosis" which has been described as a rapid onset of psychosis after a neuroleptic medication has been withdrawn. Although the concept of supersensitivity psychosis has been described with the discontinuation of some neuroleptics, it has not been described with ziprasidone. Furthermore, the following case report is the first time that this phenomenon has been described in an adolescent patient who has discontinued ziprasidone. Reasons for supersensitivity psychosis are explored in addition to suggestions about precautions about prescribing neuroleptics in young people.