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This presentation will introduce the innovative approach to child and youth mental health and psychiatry using the neurosequential model of therapeutics (NMT). This is a neuro-developmentally sensitive and trauma informed approach and acknowledges the importance of early experiences shaping the organization of the brain. An outline of the stress response and its relevance to hyper-arousal and dissociative responses will be discussed as this impacts attachment and the reward neuro-biology. The hierarchy of brain development will be emphasized in the clinical approaches to child psychiatry especially in reference to child maltreatment and neglect. The critical role of sensory integration, self regulation, relational health and cognitive development in treatment planning will be discussed versus the categorical diagnosis of ADHD, autism, bipolar disorder and depression. This has profound economic and psychopharm practice implications in child and youth mental health treatments. Consequently the importance of these concepts in informing public policy for early child development and school mental health literacy will be emphasized. Additionally the outcome of these approaches on the reduction of staff turnover, critical incidents in schools and residential placements will be shared. [ABSTRACT FROM AUTHOR]

Background Major depressive disorder (MDD) affects approximately 15% of youth, half of who do not respond to standard treatment. One promising intervention is repetitive transcranial magnetic stimulation (rTMS). However, response is limited, highlighting the need to focus on biomarkers to predict treatment response. Objectives To explore baseline biomarkers of response associated with rTMS treatment in adolescent MDD. Aims To determine the association between dorsolateral prefrontal cortex (DLPFC) glutamate levels, cortical thickness, and cerebral blood flow (CBF) with MDD symptomatology decrease after rTMS intervention. Methods Twenty-four MDD youth underwent 3 weeks of rTMS, baseline and post-intervention magnetic resonance imaging scans, and short echo proton magnetic resonance spectroscopy. Response was determined by a 50% reduction of depression scores. Results Depressive symptoms decreased with rTMS ( t = 8.304, P = 0.00). Glutamate levels differed significantly between responders and non-responders ( t = 2.24, P = 0.0039), where higher glutamate changes were associated with a better response ( r = 0.416, P = 0.038). Responders also exhibited thinner DLPFC ( r = –0.797, P = 0.000) and lower CBF levels. Conclusions The development of biomarkers for rTMS represents a novel and encouraging technique for a personalized and effective treatment while reducing ineffective treatment costs and personal burden in adolescent MDD. [ABSTRACT FROM AUTHOR]

Background: Considerable evidence now links childhood adversity to a variety of adult health problems. Unfortunately, almost all of these studies have relied upon retrospective assessment of childhood events, creating a vulnerability to bias. In this study, we sought to examine three associations using data sources that allowed for both prospective and retrospective assessment of childhood events., Methods: A 1994 national survey of children between the ages of 0 and 11 collected data from a 'person most knowledgeable' (usually the mother) about a child. It was possible to link data for n = 1977 of these respondents to data collected from the same people in a subsequent adult study. The latter survey included retrospective reports of childhood adversity. We examined three adult health outcomes in relation to prospectively and retrospectively assessed childhood adversity: major depressive episodes, excessive alcohol consumption and painful conditions., Results: A strong association between childhood adversities (as assessed by both retrospective and prospective methods) and major depression was identified although the association with retrospective assessment was stronger. Weaker associations were found for painful conditions, but these did not depend on the method of assessment. Associations were not found for excessive alcohol consumption irrespective of the method of assessment., Conclusions: These findings help to allay concerns that associations between childhood adversities and health outcomes during adulthood are merely artefacts of recall bias. In this study, retrospective and prospective assessment strategies produced similar results.