Pediatric Insomnia.

Insomnia is the most common sleep disorder among all ages; unfortunately, however, child and adolescent insomnia is infrequently addressed. Given the importance of adequate sleep for proper brain development, pediatric populations are particularly vulnerable to the negative effects of insomnia. Therefore, proper clinical assessment and treatment of pediatric insomnia is crucial. This article is the result of a comprehensive literature review and serves as a guide to the disorder and how it presents differently across child development.

The Psychological, Academic, and Economic Impact of COVID-19 on College Students in the Epicenter of the Pandemic.

Initial research has indicated that college students have experienced numerous stressors as a result of the pandemic. The current investigation enrolled the largest and most diverse sample of college students to date (N = 4714) from universities in New York (NY) and New Jersey (NJ), the epicenter of the North American pandemic in Spring 2020. We described the impact on the psychological, academic, and financial health of college students who were initially most affected and examined racial/ethnic group differences. Results indicated that students' mental health was severely affected and that students of color were disproportionately affected by academic, financial, and COVID-related stressors. Worry about COVID-19 infection, stressful living conditions, lower grades, and loneliness emerged as correlates of deteriorating mental health. COVID-19's mental health impact on college students is alarming and highlights the need for public health interventions at the university level.

Myths and Evidence Regarding Melatonin Supplementation for Occasional Sleeplessness in the Pediatric Population.

Occasional sleeplessness in children is common, with as many as 25% of all healthy children experiencing a problem sleeping at some point over the course of their childhood. Occasional sleeplessness is poorly understood, has a significant impact on quality of life in children and their families, and is often challenging to manage. There is substantial evidence supporting the safe and effective use of the widely available dietary supplement melatonin for children with chronic conditions. This article summarizes the views expressed in a recent Consensus Panel meeting convened to evaluate the use of melatonin in children, as well as the published scientific literature related to the effectiveness and safety of melatonin, with a focus on occasional sleeplessness in healthy children. We provide an evidence-based framework for the implementation of a standard process to effectively manage occasional sleeplessness in children and adolescents. Unsubstantiated concerns in the past may have limited melatonin's use in children with conditions for which the supplement may support a better sleep pattern and, by doing so, may help to improve quality of life. Melatonin dietary supplements using high quality standards may be provided to children together with cognitive-behavioral therapy after proper sleep evaluation and after improved sleep hygiene, family education, and sleep diary activities have failed to resolve sleep difficulties. [Pediatr Ann. 2021;50(9):e391-e395.].

Pediatric Insomnia.

Insomnia is the most common sleep disorder among all ages; unfortunately, however, child and adolescent insomnia is infrequently addressed. Given the importance of adequate sleep for proper brain development, pediatric populations are particularly vulnerable to the negative effects of insomnia. Therefore, proper clinical assessment and treatment of pediatric insomnia is crucial. This article is the result of a comprehensive literature review and serves as a guide to the disorder and how it presents differently across child development.

Mental Health Promotion and Disease Prevention: It's About Time.

Over the past decade, our field has observed rapidly rising rates of mental illness in children and adolescents. The numbers are sobering. Nearly 50% of teens 13 to 18 years of age meet DSM criteria for at least 1 disorder and 27.6% meet criteria for a "severe disorder."1 Adverse childhood experiences affect more than 50% of children and predispose these individuals to not only academic and behavioral problems throughout their youth, but also future physical disability, such as obesity, hypertension, and diabetes, as adults.2 By 14 years of age, accidents, suicide, and homicide assert themselves as the leading causes of death among our youth, accounting for more than 85% of the mortality among teens and young adults and holding fast to that ranking until 35 years of age.3 Most addictive behavior starts in adolescence, accounting for the 3 greatest causes of preventable death-smoking, obesity, and alcohol abuse-that take the lives of approximately 1 million adults in the United States annually.4 In addition, if there were ever a statistic to be held on the tip of every psychiatrist's tongue, it would be that 50% of all mental illnesses begin by 14 years of age and 75% begin by 24 years.5.

Exploring Interventions for Sleep Disorders in Adolescent Cannabis Users.

This review summarizes the available literature on the intersection of adolescent cannabis use and sleep disturbances, along with interventions for adolescent cannabis users who suffer sleep impairments. Adolescents are susceptible to various sleep disorders, which are often exacerbated by the use of substances such as cannabis. The relationship between cannabis and sleep is bidirectional. Interventions to improve sleep impairments among adolescent cannabis users to date have demonstrated limited efficacy, although few studies indicating the benefits of behavioral interventions-such as Cognitive Behavior Therapy for Insomnia or Mindfulness Based Stress Reduction-appear promising in the treatment of sleep disorders, which are present for users of cannabis. Further research is necessary to elucidate the precise mechanisms by which cannabis use coexists with sleep impairments, along with effective interventions for those users who suffer sleep difficulties.

Impact of a sleep course on sleep, mood and anxiety symptoms in college students: A pilot study.

OBJECTIVE: To examine the impact of a sleep course on sleep-related behaviors, mood, and anxiety in college students. PARTICIPANTS: Participants were 145 students enrolled in either the sleep course (n = 70) or a psychology course (n = 75); data were collected in September 2014, November 2014, and February 2015. METHODS: Sleep characteristics and symptoms of depression and anxiety were assessed using validated questionnaires and sleep logs. Linear, logistic and proportional odds regression models were used to test course effects. RESULTS: In November, sleep course students reported significant differences in sleep hygiene (SHI; p < .001), perceived sleep latency (PSQI; p < .05), and circadian sleep phase (MEQ; p < .05), compared to controls. In February, the sleep course students maintained most of the aforementioned gains and reported fewer symptoms of depression (CES-D; p = .05) and anxiety (BAI; p < .05). CONCLUSIONS: These positive preliminary results indicate that focused education has the potential to improve sleep among college students.

Almost Psychiatry: The Impact of Teaching Child and Adolescent Mental Health Studies to Undergraduate College Students.

OBJECTIVE: The Child and Adolescent Mental Health Studies (CAMS) program is housed in a Liberal Arts undergraduate college of a large research university. Psychiatrists, clinical psychologists, and social workers at the university's medical center teach the courses. The purpose of this study is to evaluate the extent to which CAMS encourages graduates of the program to pursue a career in child and adolescent mental health (CAMH). METHODS: In 2015-2016, graduates of the CAMS program were invited to participate in a mixed methods study. In addition to statistical analyses, qualitative thematic analyses were performed to interpret free-text responses. RESULTS: Forty-five percent (314/702) of invited graduates completed the online survey. Interviews were conducted with 11% (34/314) of participants by study staff over the phone. Quantitative results suggested that 81% (149/185) of participants enrolled in educational programs after graduation due to an interest in CAMH. A significantly higher proportion of the total sample (t = 3.661, p < .001) reported that they changed their career goals while undergraduate students compared to those who did so after graduation. Results of qualitative interviews with 34 participants uncovered five key themes unique to CAMS that may explain the program's influence on graduates' career choices and career development: practitioners-as-instructors, instructor mentorship, novel course content, experiential learning opportunities, and career training and skills. CONCLUSIONS: Quantitative and qualitative results indicated that teaching college undergraduate students about CAMH encourages them to set career goals within the field. These findings suggest the utility of implementing similar programs at other undergraduate colleges.

Insomnia: the Sleeping Giant of Pediatric Public Health.

Insomnia among children and adolescents is ubiquitous and takes a great toll on youth and their families, impacting academic achievement, mood, social functioning, and a variety of developmental outcomes. Unfortunately, however, pediatric insomnia most often remains unidentified and untreated. When treatment is provided, it is most often in the form of medications, which are not FDA approved for that indication in children and adolescents. A comprehensive literature review was employed to establish the recommendations in this report. This article provides a review of sleep physiology and both current and recommended approaches to assessing and treating pediatric insomnia. Comprehensive assessment, accurate diagnosis, and evidence-based treatment of insomnia is imperative to the healthy development of children and adolescents. While clinicians often prescribe a variety of medications to treat pediatric insomnia, there is insufficient data to demonstrate efficacy and endorse their routine use. At this time, behavioral techniques, such as cognitive behavior therapy for insomnia and sleep hygiene education, should remain the first line of treatment. As a second-line consideration, melatonin, a dietary supplement, may be effective. Pediatric insomnia has an enormous impact on children, adolescents, and their families that requires adequate attention from clinicians and parents alike.

Psychiatry's Next Generation: Teaching College Students About Mental Health.

OBJECTIVE: The authors describe an integrated area of study for undergraduate college students that targets an increase in knowledge of mental health issues in children, adolescents, and emerging adults; encourages mental health service utilization on college campuses; and exposes young minds to the possibilities of working with children and adolescents in the mental health field. METHODS: An overview of the program is provided, including the resources required to oversee and manage the program, student requirements, a description of the role that clinicians and researchers play as the program faculty, and an explanation of the tuition model. RESULTS: The program currently includes 40 courses with an annual enrollment of over 3000 students, resulting in departmental revenues that currently exceed $11 million per year. Student evaluations of the courses are very positive, and in a program survey students reported that their participation in the program had a positive impact on their life (84.2%) and impacted their career choice (60.2%). CONCLUSIONS: The benefits of the program include a valuable outreach to college students regarding the importance of seeking help for mental health issues, a positive influence on early career decision-making, opportunities for clinical and research educators to develop their scholarly areas of interest, and a significant source of departmental discretionary revenues.

Video-teleconferencing with medical students to improve exposure to child and adolescent psychiatry.

OBJECTIVE: The chronic workforce shortage in child and adolescent psychiatry (CAP) remains a germane issue that has been difficult to deal with effectively. Collaboration between medical schools without sufficient CAP resources and those with enough to share may help improve interest in the field. METHOD: This lecture series piloted a collaborative effort between CAP residents from a Midwest academic center and student-led interest groups from two osteopathic medical schools. CAP residents led nine interactive lectures with medical students on relevant topics, using video-teleconferencing. Baseline and follow-up surveys were used to assess attitudes and responses to the lecture series. RESULTS A group of 175 students completed the baseline survey; 43 students completed the follow-up survey; 21 of 43 (48%) reported that the lectures would positively influence their career choice toward CAP. CONCLUSION: Interactive lectures via video teleconferencing demonstrated potential to improve medical students' exposure to CAP, and they were well received in this initial pilot study.

The use of herbal medications and dietary supplements by people with mental illness.

This study examined the relationship between herbal medication and dietary supplement (HMDS) use and mental health characteristics. Data are drawn from a national household survey of the United States' civilian, non-institutionalized population (N = 9,585). Psychiatric medication and HMDS use, psychiatric diagnoses and treatment needs, utilization and satisfaction were assessed. Compared to non-users, HMDS users were more likely to perceive themselves as having mental health needs, to have received mental health and primary care treatment, and to be dissatisfied with their overall healthcare. Psychiatric medication use was not related to HMDS use, and in multivariate analyses, HMDS use was associated with perceived mental health needs. Differences in use of specific HMDS between those with and without a psychiatric disorder were also examined. The use of HMDS warrants particular attention in persons with perceived mental health problems as these individuals may be turning to HMDS use for treatment of their symptoms.

Parasomnias and movement disorders in children and adolescents.

Childhood parasomnias and movement disorders arise from a variety of etiologic factors. For some children, psychopathology plays a causal role in sleep disorders; in other cases, recurrent parasomnia episodes induce psychopathology. Current research reveals complex interconnections between sleep and mental health. As such, it is important that clinicians consider the impact psychiatric disorders have on childhood parasomnias. This article describes common parasomnias and movement disorders in children and adolescents, with emphasis on psychologic and behavioral comorbidities.

Mentoring in psychiatric residency programs: a survey of chief residents.

OBJECTIVE: Mentorship is an important component of graduate education. This study assessed the perceptions of general psychiatry chief residents regarding the adequacy of mentorship provided during training. METHODS: The authors surveyed 229 chief residents participating in the APA National Chief Residents Leadership Program in 2004 and 2005. The survey assessed domains such as work hours, didactics, home and family life, and mentorship. RESULTS: Of the chief psychiatric residents surveyed, 49% reported that they did not have a clearly defined career development mentor, and 39% reported that they did not feel adequately mentored. Gender, race/ethnicity, marital status, moonlighting, medical school (American versus international), and type of residency program (academic versus community based) did not show significant association with either "having a clearly defined mentor" or "feeling adequately mentored," based on chi-squared tests for independence. Chief residents who had authored peer-reviewed publications were significantly more likely to report having a clearly defined mentor and to feel adequately mentored than those who did not author publications. Logistic regression analysis showed that having a clearly defined mentor was associated with twice the odds for feeling well prepared to practice psychiatry upon graduation compared with those who did not have a clearly defined mentor, even after controlling for gender, race, medical school, and residency program type. CONCLUSION: Half of the psychiatric chief residents surveyed reported the lack of a clearly defined career development mentor. In addition, a chief resident's response of lacking a clear mentor was associated with the perception of being less prepared to practice psychiatry upon graduation. Psychiatric residency training programs may benefit from further clarification and implementation of effective mentorship programs.

A 2-year progress report of the AACAP-Harvard Macy Teaching Scholars Program.

OBJECTIVE: The American Academy of Child and Adolescent Psychiatry (AACAP) has partnered with the Harvard Macy Program for Healthcare Educators so that selected child and adolescent psychiatry academic faculty might enhance their teaching expertise in order to possibly enhance recruitment of medical students into child and adolescent psychiatry. METHODS: Thirteen child psychiatry faculty have graduated from the AACAP-Harvard Macy Teaching Scholars Program (HMTSP). There are 10 additional child and adolescent psychiatry faculty members in the process of completing the program. A survey was created to broadly assess the effect of the AACAP-HMTSP training on the first 13 graduates of the program as a pilot to guide future study of the program. Three teaching scholars who are the first authors of this article (JH, DS, MH) conducted this survey and the data interpretation for this study. RESULTS: Thirteen of the scholars submitted responses to the survey. All participants indicated a high degree of satisfaction with the HMTSP and with the overall usefulness of the concepts learned. All but one of the scholars reported that the program enhanced their teaching effectiveness. The scholars reported increased teaching of medical students (9 of 13) and psychiatry residents (6 of 13) after the HMTSP. CONCLUSION: The AACAP-Harvard Macy Teaching Scholars reported high levels of satisfaction with the overall program. Whether the reported increase in medical student and psychiatry resident mentoring and teaching will eventually lead to increased medical student recruitment into child and adolescent psychiatry remains to be determined.

The Child and Adolescent Mental Health Studies (CAMS) Minor at New York University.

OBJECTIVE: The authors describe the Child and Adolescent Mental Health Studies (CAMS) undergraduate college minor at New York University. METHODS: The authors detail the development, structure, and operation of the CAMS minor. They describe the importance of identifying program goals, building coalitions, creating an advisory board, selecting teaching materials and instructors, and establishing a viable financial model. RESULTS: The authors present student evaluations from the first course, which demonstrate great satisfaction with the program. CONCLUSION: The successful development of the CAMS minor demonstrates that Schools of Medicine (more specifically, the departments of Psychiatry and Child and Adolescent Psychiatry) can have a positive impact on undergraduate student education, which may later translate into an increased number of students who consider entering medical school and child psychiatry.