pediatrics
Acute and Posttraumatic Stress Disorders (ASD and PTSD) in Children and Adolescents
Treatment
Trauma-based psychotherapies Supportive psychotherapy Selective serotonin reuptake inhibitors (SSRIs) and sometimes antiadrenergic medications Trauma-based psychotherapies have been reported to be efficacious in children with PTSD ( Treatment references ). Trauma-based psychotherapy involves short-term interventions that use cognitive-behavioral techniques to modify distorted thinking, negative reactions, and behavior. It can also include teaching parents stress reduction and communication skills. Supportive psychotherapy may help children who have adjustment issues associated with trauma, as may result from disfigurement due to burns. Behavioral therapy can be used to systematically desensitize children to situations that cause them to reexperience the event ( Exposure therapy ). Behavioral therapy is clearly effective in reducing distress and impairment in children and adolescents with PTSD. There are no medications approved for PTSD in children because adequate clinical trials remain to be conducted. However, in youths with comorbid anxiety, depression, sleep difficulties, selective serotonin reuptake inhibitors (SSRIs) can be helpful ( Treatment references ). [ Treatment references ], 1.Kowalik J, Weller J, Venter J, et al: Cognitive behavioral therapy for the treatment of pediatric posttraumatic stress disorder: A review and meta-analysis.J Behav Ther Exp Psychiatry42(3):405-413, 2011. doi: 10.1016/j.jbtep.2011.02.002 2.Kataoka SH, Stein BD, Jaycox LH, et al: A school-based mental health program for traumatized Latino immigrant children.J Am Acad Child Adolesc Psychiatry42(3):311-318, 2003. doi: 10.1097/00004583-200303000-00011 3.McMullen J, O'Callaghan P, Shannon C, et al: Group trauma-focused cognitive-behavioural therapy with former child soldiers and other war-affected boys in the DR Congo: A randomised controlled trial.J Child Psychol Psychiatry54(11):1231-1241, 2013. doi: 10.1111/jcpp.12094 4.Deblinger E, Steer RA, Lippmann J: Two-year follow-up study of cognitive behavioral therapy for sexually abused children suffering post-traumatic stress symptoms.Child Abuse Negl23(12):1371-1378, 1999. doi: 10.1016/s0145-2134(99)00091-5 5.Strawn JR, Keeshin BR, DelBello MP, et al: Psychopharmacologic treatment of posttraumatic stress disorder in children and adolescents: A review.J Clin Psychiatry71(7):932-941, 2010. doi: 10.4088/JCP.09r05446blu 6.Connor DF, Grasso DJ, Slivinsky MD, et al: An open-label study ofguanfacineextended release for traumatic stress related symptoms in children and adolescents.J Child Adolesc Psychopharmacol23(4):244-251, 2013. doi: 10.1089/cap.2012.0119 7.Keeshin BR, Ding Q, Presson AP, et al: Use ofprazosinfor pediatric PTSD-associated nightmares and sleep disturbances: A retrospective chart review.Neurol Ther6(2):247-257, 2017. doi: 10.1007/s40120-017-0078-4 