Report of the Working Group on Psychotropic Medications for Children and Adolescents
Psychopharmacological, psychosocial, and combined interventions for childhood disorders: Evidence base, contextual factors, and future directions

Introduction

There has been an increased recognition of the prevalence and substantial morbidity associated with child and adolescent mental disorders. Estimates suggest that up to 15% of children and adolescents suffer from a mental disorder of sufficient severity to cause some level of functional impairment (Roberts, Atkinson, & Rosenblatt, 1998; Shaffer, Fisher, Dulcan, & Davies, 1996). Of concern are data indicating that only one in five of these children receive services provided by appropriately trained mental health professionals (Burns et al., 1995; Centers for Disease Control, 2004; U.S. Department of Health and Human Services, 1999). For many of these interventions, the short-term efficacy for decreasing symptoms is fairly well demonstrated. Evidence supporting the acute impact of treatment on daily life functioning and the long-term impact on both symptoms and other functional outcomes is less well documented.

Given a recent increase in the number of efficacy studies of psychosocial, psychopharmacological, and combined interventions for mental health disorders in youth, including several recent clinical trials sponsored by the National Institutes of Health (NIH) (Vitiello, 2006), and growing public recognition of the existence of these disorders, the APA Working Group on Psychotropic Medications for Children and Adolescents was charged with reviewing the literature and preparing a comprehensive report on the current state of knowledge concerning the effective use, sequencing, and integration of psychotropic medications and psychosocial interventions for children and adolescents. In preparing its report, the working group reviewed the existing literature in peer-reviewed journals (included as part of MEDLINE and PsycINFO), as well as Food and Drug Administration (FDA) data concerning safety. For the psychological disorders most prevalent in children and adolescents, the various psychosocial, psychotropic, and combination treatments were reviewed, including the effect of each therapy, the strength of evidence for its efficacy, and the limitations and side effects of each treatment in the short- and the long-term. An Efficacy Summary Table for treatments targeting each type of child psychopathology appears at the end of each section.

Disorders included in the report are attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), Tourette and tic disorder, obsessive–compulsive disorder (OCD), anxiety disorders, depression and suicidality, bipolar disorder, schizophrenia spectrum disorder, autism spectrum disorder, and elimination disorders. Information regarding specific psychosocial, psychopharmalogical, and combined treatments for each disorder can be found in the main report.

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