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This article focuses on potential neurological side effects secondary to psychotropic agents. Clinicians often have to manage these relatively commonly occurring neurological side effects. These potential side effects, if not managed in a timely manner, could be a significant negative factor impacting compliance and tolerability as well as efficacy. This article reviews mechanism of action, assessment, diagnosis, and management of extrapyramidal side effects including akathisia, acute dystonia, parkinsonism, and tardive dyskinesia, as well as motor tics, tremors, myoclonus, seizures, and delirium. Prescribing clinicians need to be cognizant of these potential side effects and knowledgeable in assessing and managing them. [ Psychiatr Ann . 2021;51(9):402–409.]

Pregnancy can be a colossal change for some women, with the commencement of motherhood possibly generating emotional health problems, including peripartum depression (PPD). PPD significantly affects the parent-child relationship, which is the foundation for the socioemotional development of the child. In this article, we reviewed the association between PPD and resilience, and identified their mediators and moderators. Eight studies were included after a rigorous screening process. There was a significant relationship between PPD and childhood resiliency, resulting in an increased risk of psychiatric disorders in children and adolescents. Maternal sensitivity and emotional availability were possible mediators. Maternal education, income level, maternal trauma, life adversities, marital conflicts, and perceived social support were reported moderators. This article highlights the need for timely recognition and treatment of PPD with targeted interventions to improve the parent-child relationship. [ Psychiatr Ann . 2021;51(7):322–330.]

Autism is a fascinating topic that has attracted the interest of researchers and the lay public alike. The history of autism is filled with accomplishments of people who were astute observers of childhood psychopathology. Autism spectrum disorder affects a diverse group of children who share certain commonalities. There are ongoing attempts to understand its etiology and to refine diagnostic criteria for improved and timely recognition. In recent years, rapidly evolving research has highlighted the limits of our understanding of a disorder that at one time was considered rare, but now presents itself in 1 in every 59 children in the United States. This article particularly focuses on the history of autism as well as the changing criteria in the Diagnostic and Statistical Manual of Mental Disorders . [ Psychiatr Ann . 2019;49(3):103–108.]

Generalized anxiety disorder (GAD), despite being among the most common psychopathology of children and adolescents, often goes undetected and untreated. GAD is characterized by excessive worry for more than 6 months about a variety of situations, events, or activities (especially school performance among children), inability to control the worry, and presence of at least one physical symptom. The interplay of various risk factors (genetic, environmental, and psychosocial) and protective factors is seen in youth with GAD, and comorbidity is common. GAD is associated with significant distress and disability independent of comorbid disorders. A multimodal approach that includes psychoeducation, psychological therapies (in particular cognitive-behavioral therapy), family therapy, and pharmacological treatment provides the best outcome for children and adolescents with GAD. [ Psychiatr Ann. 2017;47(10):497–501.]

Depressive disorders in children and adolescents constitute a significant burden on social and public health. The impairment can affect several domains of functioning including family, school, and social. Depression is also a significant risk factor in suicide and other psychiatric disorders. The prevalence of major depressive disorder is estimated to be 2% in children and 4% to 8% in adolescents. The rates are much higher in subsyndromal depression, which also affects the functioning of youth. Most youth do recover; however, recurrence is common, with 40% to 70% of youth experiencing relapse within 3 to 5 years. Biopsychosocial assessment of depression requires gathering information from multiple informants and synthesizing the information to diagnose depression. Treatment of pediatric depression consists of social, psychological, and pharmacological interventions. [ Psychiatr Ann. 2017;47(10):502–506.]

Pediatric obsessive-compulsive disorder (OCD) is a complex neuropsychiatric disorder that is characterized by the presence of distressing and impairing recurrent obsessions and/or compulsions. OCD affects up to 4% of children and adolescents, and constitutes a significant societal burden and causes marked distress and functional impairments in affected people and their families. The assessment of pediatric OCD should comprehensively capture comorbid conditions. Cognitive-behavioral therapy (CBT) is the first-line treatment for pediatric OCD. For moderate to severe cases, CBT may be combined with pharmacological treatment. First-line medications for pediatric OCD are selective serotonin reuptake inhibitors, and the US Food and Drug Administration has approved fluoxetine, sertraline, and fluvoxamine for use in pediatric OCD. Most children with OCD achieve remission or significant improvement in their symptoms. [ Psychiatr Ann. 2017;47(10):512–518.]

Children and adolescents are susceptible to developing posttraumatic stress disorder (PTSD), which has serious consequences for their emotional, physical, social, and cognitive development. Sources of traumatic stress in children are many, such as loss of a loved one, accidents, community or school violence, domestic violence, physical or sexual abuse, man-made or natural disasters, and terrorism. Due to the wide range of reactions seen in children according to their age and developmental levels, it is not possible to directly apply adult PTSD criteria to them. This article discusses issues related to etiology, assessment, and diagnosis of PTSD in children and adolescents. It describes the comorbidities and the neurobiological basis of PTSD symptomatology and critically evaluates current psychological and pharmacological treatments of PTSD in the pediatric population. [ Psychiatr Ann . 2017;47(3):139–144.]

Autism spectrum disorder (ASD) is characterized by early-onset socialization and communication difficulties associated with restricted interests and behavioral rigidities. Recent epidemiologic studies show that 1 in 68 children has autism. This complex condition is among the least-understood developmental disorders of childhood but there is a growing body of research on ASD, making it critically important that clinicians are well informed about these conditions. Recent changes in the Diagnostic and Statistical Manual of Mental Disorders , fifth edition, regarding ASD criteria can affect how the diagnosis is made. Various comorbidities can have a huge impact on assessment and management. There are various behavioral and pharmacologic strategies focusing on cluster symptoms of hyperactivity/inattention, irritability, aggression, self-injurious behaviors, and ritualistic behaviors. In the past few years, the US Food and Drug Administration has approved psychotropic medications for treating irritability associated with autism. Speech and language assessment and interventions, parent education, and appropriate educational programs are integral parts of management. [ Psychiatr Ann . 2016;46(1):58–62.]

The recent advances in the field of pharmacogenetics have led to personalized medicine in pediatric psychiatry. Currently, the US Food and Drug Administration reports more than 100 prescription medications, of which approximately 30% are psychotropic, have pharmacogenomic information on their product labels. A high percentage of psychotropic medications are metabolized by the cytochrome P450 enzymes (CYP450). Enzymes that are most relevant include CYP450, 1A2, 2B6, 2C9, 2C19, 2D6, and 3A4. Psychopharmacogenomics offers personalized psychiatry leading to individually adapted plans after taking into consideration the genetic variability in drug metabolism. For clinicians, it results in a better-informed decision for the patient's clinical care. CYP450 testing can also predict individual response to treatment while minimizing side effects or avoiding poor outcome by avoiding metabolism through the polymorphic pathway. This review focuses on the current state regarding pharmacogenomics in pediatric psychiatry with discussion about metabolism of psychotropic medications and understanding of the CYP450 enzymes. [ Psychiatr Ann . 2016;46(1):52–57.]

Sleep problems are common among children and adolescents, with up to 50% of children experiencing sleep difficulties and as many as 4% receiving a formal sleep disorder diagnosis. Early identification of sleep problems may prevent negative consequences, such as daytime sleepiness, misdiagnosis, learning difficulties, or poor academic performance. This article provides an overview of common sleep disorders in children and adolescents, including common presenting symptoms, diagnosis, and treatment. [ Psychiatr Ann . 2016;46(1):39–44.]