Autism has recently hit the radar screen in psychiatry and pediatrics. This is partly due to an increase in prevalence that has been widely reported in the media, coupled with ongoing debate regarding whether vaccines are causing this so-called "autism epidemic.”

The last time we did an entire issue on ADHD was in September of 2006. In this brief article, we’ll bring you up to date on some recent developments.

Dr. Fassler, you are a child psychiatrist and you testified at the original FDA hearings leading to the black box warnings on antidepressants. Can you give us some insight into how that process played out?

A recent NIMH-sponsored eight week trial compared two atypical antipsychotics, olanzapine (Zyprexa) and risperidone (Risperdal), to the first-generation antipsychotic, molindone (Moban) in the treatment of 116 youths with schizophrenia or schizoaffective disorder.

In the September 2007 issue of TCPR, we reviewed the very mixed literature on whether it makes sense to increase the dose of an antidepressant to achieve a response. We concluded that there is insufficient evidence, but that as long as you can avoid side effects, there is no compelling reason not to try dose escalation.

Two recent meta-analyses examined the comparative efficacy of antidepressants versus psychotherapy in the treatment of depression and dysthymia (Cuijpers P et al., J Clin Psychiatry 2008, online ahead of print; Imel et al., J Affect Dis 2008;110:197-206).

After reading these articles, you should be able to…

One way to enhance the quality of our care of patients is to learn and implement expert practice guidelines. But there are some problems. First of all, there are so many guidelines out there that it is hard to know which ones to learn.

Should we use outcome scales in psychiatric practice? If so, which ones? Which are actually feasible in terms of time and utility?

The PHQ-9 is the Patient Health Questionnaire-9. It was adapted from an instrument originally funded by Pfizer, the PRIME-MD, which was developed as a tool for primary care doctors to screen their patients for psychiatric disorders.