Child and Adolescent Neuropsychiatry
When the neuropsychiatry clinics began in 1978, they were pediatric clinics. Dr. Gualtieri, the founder of
the clinics, is a board-certified specialist in child and adolescent psychiatry. The original focus of the clinic had to do with ADHD in children, autism and developmental disabilities, pediatric seizure disorders and unusual conditions like Tourette's syndrome, Cornelia deLange syndrome, Williams syndrome, etc. Although the clinic was always primarily a neuropsychiatry clinic, there've always been referrals of children with anxiety or mood disorders, or even psychotic disorders.
As the years passed, and we got older, so did our patients. Today, child and adolescent patients comprise about half of all referrals to the neuropsychiatry clinics. We also see adults, and even elderly patients.
We have done clinical trials of many of the medications that are used to treat children and adolescents. We've done research having to do with drug side effects in children and adolescents, including the fears that certain anti-depressant drugs might be making children suicidal. There is an association, but it is not a strong one, and it can be managed.
We are, however, concerned with the overuse, and inappropriate use, of psychiatric medications in children. Children and adolescents are not just "small adults" when it comes to the manifestation of cognitive, behavioral, and emotional disorders, or when it comes to their response to medications that affect the brain. So, we are equally concerned with the inappropriate application of adult psychiatric categories to children, for example, the widely misused "bipolar disorder." One has to be quite conservative with the diagnosis of childhood disorders, and the problems that occur in children are not necessarily continuous with, or predictive of, disorders in adult life.