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Lawrence Scahill

Publications and source records attributed to Lawrence Scahill.

59 records · Page 4Linked to original sources

Acute stress disorder symptoms in gunshot-injured youth.

PROBLEM: The prevalence of acute stress disorder symptoms (ASDS) and other psychiatric comorbidities in youth with recent gunshot injuries. METHODS: Children (n=20) admitted to an urban hospital ER for gunshot injuries over a 4-year period were evaluated for ASDS, co-morbid DSM-III-R diagnoses, legal and gang involvement, and psychiatric history; medically hospitalized children (n=36) similar in age, sex, race, and socioeconomic status served as a control group. FINDINGS: Gunshot-injured youth reported a 75% rate of ASDS compared to a 14% rate in medically ill youth (OR 18.6; chi2 = p < .0001). Parent ratings of ASDS closely corresponded with youth ratings. Youth rated reexperiencing the event as the most frequent distressing symptom. Gunshot injury was associated with legal problems, gang involvement, marijuana/alcohol dependence, conduct disorder, social phobia, and agoraphobia compared to youth with medical illness. CONCLUSIONS: Compared to youth with medical illness, gunshot-injured youth were 18.6 times (p = .0001) more likely to show symptoms of ASDS. Further research, developmentally appropriate assessment, prevention, and treatment are needed in this area.

Adolescent↗

The use of selective serotonin reuptake inhibitors in children and adolescents with major depression.

TOPIC: Recent warnings about suicidal thoughts and self-injurious behavior in youth treated with selective serotonin reuptake inhibitors raise fundamental questions about the risk-benefit ratio of this class of medications. METHODS: Data from placebo-controlled trials are used to elucidate the potential risks and benefits of the selective serotonin reuptake inhibitors (SSRIs) in children and adolescent with major depression. This analysis forms the basis of clinical recommendations. SOURCES: The review includes the six large-scale, placebo-controlled trials that have been published over the past decade. These data were augmented by information from regulatory hearings in 2003-2004 and selected open-label reports. CONCLUSIONS: Emerging data from several clinical trials show that the SSRIs have modest effects on childhood depression. In addition, SSRI treatment may be associated with behavioral activation, self-harm, and suicidal ideation. Appropriate use of SSRIs in children and adolescents requires careful diagnostic assessment, evaluation of co-occurring conditions, and diligent monitoring, especially within the first weeks of treatment.

Adolescent↗