The prevalence of mental health disorders in this country has nearly doubled in the past 20 years. Who is treating all of these patients? Clinical psychologists and therapists are charged with the task, but many are falling short by using methods that are out of date and lack scientific rigor. This is in part because many of the training programs especially some Doctorate of Psychology (PsyD) programs and forprofit training centers are not grounded in science.

A new report in Psychological Science in the Public Interest, a journal of the Association for Psychological Science, by a panel of distinguished clinical scientists Timothy Baker (University of WisconsinMadison), Richard McFall (Indiana University), and Varda Shoham (University of Arizona) calls for the reform of clinical psychology training programs and appeals for a new accreditation system to ensure that mental health clinicians are trained to use the most effective and current research to treat their patients.

There are multiple practices in clinical psychology that are grounded in science and proven to work, but in the absence of standardized sciencebased training, those treatments go unused.

For example, cognitivebehavioral therapy (CBT) has been shown to be the most effective treatment for PTSD and has the fewest sideeffects, yet many psychologists do not use this method. Baker and colleagues cite one study in which only 30 percent of psychologists were trained to perform CBT for PTSD and only half of those psychologists elected to use it. That means that six of every seven sufferers were not getting the best care available from their clinicians. Furthermore, CBT shows both longterm and immediate benefits as a treatment for PTSD; whereas medications such as Paxil have shown 25 to 50 percent relapse rates.

The report suggests that the escalating cost of mental health care treatment has reduced the use of psychological treatments and shifted care to general health care facilities. The authors also stress the importance of coupling psychosocial interventions with medicine because many behavioral therapies have been shown to reduce costs and provide longer term benefits for the client.

Baker and colleagues conclude that a new accreditation system is the key to reforming training in clinical psychology. This new system is already under development the Psychological Clinical Science Accreditation System (PCSAS pcsas.org).

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Kevin Lyn Sisson

The American Psychological Association is calling on Congress to reexamine the Juvenile Justice and Delinquency Prevention Act based on findings from psychological research pointing to the importance of treatment and rehabilitation for young offenders.

Since the law was signed 35 years ago, the disposition of juvenile cases has shifted more in the direction of punishment, with some youths being tried in adult court, APA noted.

“Since incarceration is expensive and less effective at promoting healthy development than communitybased alternatives, APA believes it should be a last resort for young offenders,” said Gwendolyn Puryear Keita, PhD, APAs executive director for public interest. “APA recognizes the importance of reauthorizing this critical law and urges lawmakers to consider recent psychological research and address the significant mental health needs of the juvenile justice population.”

A large body of developmental and neuroscientific research strongly supports a developmentally appropriate response to juvenile crime. Such factors as immaturity and vulnerability are characteristic of adolescence and should mitigate the culpability of young people for their actions in certain instances.

Additionally, recent research shows that those detained in the juvenile justice system experience diagnosable mental and behavioral health disorders at rates three to four times higher than the general population under age 18. And a 2003 report from the Government Accountability Office documented alarming reports of parents relinquishing their rights to the legal and physical custody of their children to juvenile justice agencies in the hope of obtaining critically needed mental health services for them. Similarly, in 2004, the U.S. House Committee on Government Reform reported that individuals as young as 7 years old, some of them without charges pending against them, were being held in secure juvenile justice facilities as they awaited access to mental health services.

“In reauthorizing this law, Congress needs to effectively address the seriously troubling reports of parental relinquishment to juvenile justice agencies to obtain care by providing communitybased mental health services for troubled youth,” Keita said. “In so doing, we still need to provide an appropriate range of critical services in the juvenile justice system. In addition, we need to meet the goal of not housing individuals in secure detention facilities when they are not facing criminal charges.”

APA also urged the federal judicial system to consider psychological research when examining sentencing guidelines for juvenile offenders. In July, APA filed an amicus brief in the joined U.S. Supreme Court cases Graham v. Florida and Sullivan v. Florida. These cases focus on juvenile sentencing and whether the Supreme Courts 2005 decision in Roper v. Simmons, which declared the death penalty unconstitutional for juveniles, should be applied to sentences of life without the possibility of parole for those who committed crimes as juveniles. APAs brief supports the petitioners, citing evidence countering the position that a sentence of life in prison with no chance for parole is an appropriate level of punishment for juvenile offenders. The cases are set to be heard by the Supreme Court in its next term.

The Juvenile Justice and Delinquency Prevention Act, which is the nations most important law pertaining to the treatment of juvenile offenders and the prevention of delinquency among atrisk youth, was signed into law by President Gerald Ford on Sept. 7, 1974. It is the only law that sets out federal standards for the custody and care of youth in the juvenile justice system. It also provides direction and support for juvenile justice system improvements.

Read more information on the Juvenile Justice and Delinquency Prevention Act

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A shocking 92 per cent of the British public believes that admitting to having a mental illness would damage someones career [1].

The three careers most damaged were doctors (56 per cent), emergency services (54 per cent) and teachers (48 per cent). However, only 21 per cent of respondents thought that it would be damaging to the career of an MP, despite it being illegal for someone to work as an MP with a history of mental illness.

The survey commissioned for the antistigma campaign Time to Change [2] also found that as mental illness rises during the recession people may find it more difficult to get jobs if they admitted their mental illness in a job interview.

The study asked more than 2000 people around the UK to imagine that they were interviewing someone for a job, and the interviewee admitted that from time to time they suffered from depression. Despite the respondents considering this person the best candidate for the job, more than half [56 per cent) would not employ them because of their mental illness.

The survey found that of these respondents nearly one in five (17 per cent) would not offer the best candidate the job because they considered that mental illness would make them unreliable, while 10 per cent would worry that if the employee took time off sick, theyd get the blame for employing them. A further 15 per cent worried that they wouldnt work as well as other employees, or that other employees would react negatively towards them, undermining team morale.

Reponses from the survey were also broken down by professions, such as health workers, lawyers and banking. It found that bank workers were the most likely to discriminate against someone with a mental illness. Almost half of respondents (46 per cent) working in this sector were either reluctant to employ someone with a mental illness because theyd be unreliable or worried that theyd get the blame for employing them if they went off sick. This is worrying for members of the banking industry, a sector hit by the recession, when they attempt to get new jobs.

Andy Harley, 37, worked for six years as a business analyst for a bank, until he developed depression and gave up work for a year to get better. He undertook 150 interviews before he could get another job. He said

My experience of getting a job in the banking sector following my depression backs up the findings of this survey. I admitted to depression on application forms and didnt get interviews despite my experience. My mental illness set off alarms bells. My depression was a major concern in the interviews that I did get, with the interviewers worrying that I wouldnt be reliable or able to cope with stress.

The discrimination in the banking sector is outdated. They saw my illness not me. Im not foremost a person with a mental illness. They didnt take into account my own personal circumstances, or the fact that I had worked well for six years in a highpressured environment. Anyone can get ill at any time. I was eventually forced to seek work in another sector entirely.

Sue Baker, Director of Time to Change, said

The issue of mental health in the workplace is never more important than in time of recession. We need to be able to have a discussion about mental health problems in the workplace, and to put an end to discriminatory attitudes that prevent capable people from working.

Notes

1. All figures are from YouGov Plc. Total sample size was 2082 adults. Fieldwork was undertaken between 31st July and 3rd August 2009. The figures have been weighted and are representative of all GB adults (aged 18+).

2. Time to Change is Englands most ambitious programme to end the discrimination faced by people with mental health problems, and improve the nations wellbeing. Mind and Rethink are leading the programme, funded with £16m from the Big Lottery Fund and £4m from Comic Relief, and evaluated by the Institute of Psychiatry at Kings College, London. For further information go to timetochange.org.uk

The Big Lottery Funds support for Time to Change comes from its £165m Wellbeing programme. The Big Lottery Fund has been rolling out grants to health, education, environment and charitable causes across the UK since its inception in June 2004. It was established by Parliament on 1 December 2006. Full details of the work of the Big Lottery Fund, its programmes and awards are available on the website biglotteryfund.org.uk

A report issued by the House of Commons Justice Committee highlights deep concerns about the treatment of people with mental health problems in the criminal justice system. According to the report, the Crown Prosecution Service is failing victims and witnesses with any history of mental distress by dropping cases before they even get to court, and where their mental health is in question, failing to support them to give good evidence even though the support systems are in place.

Minds Chief Executive Paul Farmer said

“Everyone has a right to seek justice for the crimes committed against them, but people with mental distress are being locked out of the system and denied the same rights to justice as anyone else. The CPS and the criminal justice system as a whole is working on the assumption that any experience of mental distress, from postnatal depression to anxiety attacks 20 years previously, means that your evidence cannot be considered reliable. The blanket assumption that people who have had a mental health problem cannot be trusted in court is ludicrous, and reflects a view of mental health that is out of date and out of touch. Dropping cases on these grounds shouldnt even be an option.

“Where mental health is a consideration in a case, its vital that prosecutors find out whether mental health is actually going to affect someones testimony or not, and support them to give their best evidence rather than simply giving up on victims. The measures to support people with mental distress are already in place, but what we are witnessing here is institutional reluctance to treat mental health fairly and appropriately, which is standing in the way of justice.

“The CPS has committed to training prosecutors around mental health, but justice professionals have to be willing to change their longheld stereotypes around mental health, so we can change how people with mental distress are treated by the justice system.

The case of FB vs DPP in January 2009 highlighted the problems people with mental distress can encounter when taking crimes to court. FB had his ear bitten off in an assault, but his case was dismissed by the CPS before it got to court on the grounds that a history of mental health problems meant he could not give reliable evidence on the crime committed against him. Read the Mind press release.

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Psychotherapy consists of a series of techniques for treating mental health, emotional and some psychiatric disorders. Psychotherapy helps the patient understand what helps them feel positive or anxious, as well as accepting their strong and weak points. If people can identify their feelings and ways of thinking they become better at coping with difficult situations.

According to Medilexicons medical dictionary, psychotherapy is “Treatment of emotional, behavioral, personality, and psychiatric disorders based primarily on verbal or nonverbal communication and interventions with the patient, in contrast to treatments using chemical and physical measures.” Simply put, psychotherapy aims to alleviate psychological distress through talking, rather than drugs.

Psychotherapy is commonly used for psychological problems that have had a number of years to accumulate. It only works if a trusting relationship can be built up between the client and the psychotherapist (in psychology “client” can mean “patient”). Treatment can continue for several months, and even years. Psychotherapy may be practiced on a onetoone basis, or in pairs, and even in groups. Generally, sessions occur about once a week and last one hour.

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Some people refer to psychotherapy as “talking treatment” because it is generally based on talking to the therapist or group of people with similar problems. Some forms of psychotherapy also used other forms of communication, including writing, artwork, drama, narrative story or music. Sessions take place within a structured encounter between a qualified therapist and a client or clients. Purposeful, theoretically based psychotherapy started in the 19th century with psychoanalysis; it has developed significantly since then.

A psychotherapist may be a psychologist, marriage and family therapist, occupational therapist, licensed clinical social worker, counselor, psychiatric nurse, psychoanalyst, or psychiatrist. In the UK psychotherapy will be free if the patient is referred by a GP (general practitioner, primary care physician).

One of the main problems with psychotherapy, according to experts, is that the client stops coming to sessions. A study carried out by researchers from Northwestern Universitys Feinberg School of Medicine found that when patients receive psychotherapy for depression over the phone, most of them continue with the therapy.Talking versus drugsPsychologists generally view individual distress as the result of human relationship problems, rather than as the result of a personal disorder. A psychologist who specializes in psychotherapy will generally consider the wider context of relations within a family or at work. Psychiatrists and medical doctors tend to take a more medical approach to mental health and are more inclined to prescribe drugs to alleviate stress. This is a general difference between a psychologists approach and a psychiatrists however, there are many psychiatrists who also use psychotherapy.

Many psychologists comment that medical approaches usually see distress as a symptom of a disorder in the same way they may view a signs or symptoms of physical problems, illnesses, and conditions. Therefore, a psychiatrist or perhaps a neurologist will link a diagnosis of, e.g. OCD (obsessivecompulsive disorder), depression, or posttraumatic stress disorder to the prescription of specific medications, as well as possible psychological interventions.

Many studies have demonstrated that the most effective treatments for mental illnesses and problems, especially depression, involve a combination of both medication and psychotherapy this study found that a combination of psychotherapy and antidepressant medication appears to be the most effective treatment for adolescents with major depressive disorder.

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What is psychology? What are the branches of psychology?

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What is PostTraumatic Stress Disorder (PTSD)? What causes PTSD?

What is anorexia? What is bulimia?

What is anxiety? Anxiety symptoms and causes.

What is autism? What causes autism?

What is bipolar disorder?

What is dementia? What causes dementia? What are the symptoms of dementia?

What is depression? What causes depression?

What is dyspraxia? How is dyspraxia treated?

What is hypochondria?

What is mental health? What is mental disorder?

What is schizophrenia?The majority of psychiatrists, however, do say that psychotherapy is a crucial part of mental health treatment, and is often the only necessary effective treatment in many cases. The American Psychiatric Association stated “Many mental health problems can be resolved with psychotherapy alone, and psychotherapy is often a crucial component in the success of treatment with medication”. However, what people say and what they actually do not always match this study found that a declining number of officebased psychiatrists appear to be providing psychotherapy to their patients.

In a study, German scientists demonstrated that cellular biological markers could be associated with response to psychotherapy.Some types of psychotherapiesBehavior therapy

This type of therapy focuses on helping the client understand how changing his/her behavior can eventually lead to changes in how they are feeling. Emphasis is made on focusing on increasing the persons engagement in positive or socially reinforcing activities. This approach carefully measures what the client is doing and then tries to increase the probability that he/she has positive experiences.

Put simply, behavior therapy aims to substitute undesirable behavior responses with desirable ones.
Cognitive therapy

How we feel is determined by what we think this is the theory behind cognitive therapy. For example, if a person has depression it may be the result of having the wrong thoughts and/or beliefs. If these faulty beliefs are corrected then the clients view of events and his/her emotional state may change for the better. According to several studies, people with depression often have erroneous beliefs about themselves they may relate negative events to themselves without any evidence, they may see life situations in absolute terms (black and white), and they may see only the negative aspects of things and commonly distort the importance of particular events.

Put simply, the way we think about things affects how we feel emotionally. Cognitive therapys thrust is on our current thinking, behavior and communication, rather than looking into the past.

The cognitive therapist works with the client to confront, or challenge the erroneous thoughts by pointing out other ways of viewing situations. By doing this it is hoped that the clients mood improves. Cognitive therapy has been found to be especially effective in treating posttraumatic stress disorder (PTSD), as this article explains.

There are doubts about the effectiveness of cognitive therapy for elderly people with depression. This study, which explains that further studies are required, found that there was not enough compelling evidence showing the effectiveness of cognitive therapy for elderly patients with depression.

A counseling method called cognitive behavioral therapy (CBT) seems to amplify tinnitus patients quality of life, even when the volume of the noise remains the same, a study revealed. (tinnitus = ringing in the ears).
Family therapy

A family therapist sees the clients symptoms in the context of the family. For example, if a client has depression, this could be because of an issue within the family, such as may be the case with a teenager whose parents are having marital problems. Cognitive therapy, behavior therapy, and especially interpersonal therapy may be employed in family therapy.

Put simply, family therapy identifies family patterns that contribute to behavior disorder or mental illness it helps family members break those habits/patterns.

Family therapy generally involves discussion and problemsolving sessions with the client and his/her family session may be in a group, in couples, or onetoone.

A family therapist may use a genorgam this is a family tree constructed by the therapist. It looks at past relationships and events and what impact these may have had on the clients emotional state. Often, family therapy focuses on improving communication within the family clients are taught to listen, ask questions and respond openly rather than defensively.

Researchers into postpartum depression at Boston University School of Social Work found that, unlike other psychotherapies, the presence and contribution of the infant are unique to motherinfant treatment and act to catalyze change throughout the therapeutic process.

Patients suffering from bulimia, aged 1219, respond better to familybased treatments than supportive psychotherapy, according to researchers from the University of Chicago.
Interpersonal therapy

Here the clients interpersonal relationships are the focus. For example, a depressed clients problem may be treated by improving his/her communication patterns how he/she relates to others may be having an impact on his/her depression. The therapist may start by helping the client identify what his emotion is and where it is coming from. The client will also be helped in learning how to express emotions in a healthy way. For example, if a client usually responds to a feeling of being neglected by his spouse with anger and sarcasm this results in the spouse reacting negatively. The client will learn to express his hurt and anxiety calmly, increasing the chances that the spouse will react in a more positive way.

Put more simply, interpersonal psychotherapy focuses on the clients relationship with family members and peers and the way the client sees himself/herself. It explores issues in relationships with other people. The aim is to help the client identify and modify interpersonal problems, understand them, and to manage relationship problems.

The majority of women with recurrent depression may be able to prevent subsequent depressive episodes with monthly maintenance interpersonal psychotherapy, say researchers from the University of Pittsburgh School of Medicine.
Group therapy

In group therapy there are usually between 6 to 12 clients and one therapist in a session. All the clients have related problems. The clients benefit from the therapist, and also by observing how other clients suffer and respond to feedback. Getting feedback from other people with related problems gives the clients a different perspective and is frequently helpful in triggering improvement and change.

Taking part in group psychotherapy can help men who have erectile dysfunction to overcome their problem, and adding sildenafil (Viagra) to group therapy was found to be more effective than sildenafil alone, according to a team of Cochrane researchers.
Psychodynamic therapy

This is also called insightoriented therapy. It focuses on the automatic processes as they are exhibited in a persons current behavior. This type of therapy aims to increase the clients selfawareness and understanding of the impact of the past on present behavior. It enables the client to take a good look at unresolved issues and symptoms that arise from past dysfunctional relationships and exhibit themselves in the need and desire to abuse substances.

Put simply, psychodynamic therapy helps people understand the roots of emotional distress, usually by exploring unconscious motives, needs and defenses.

Psychodynamic therapy is especially effective for people with complex mental disorders, personality and chronic mental disorders, as this metaanalysis revealed. Another study carried out by researchers at the NewYorkPresbyterian Hospital/Weill Cornell Medical Center found that psychodynamic therapy is efficacious in treating panic disorder.What does psychotherapy treat? Psychotherapy is used for treating many different problems. Some alone, and some in combination with drugs. The most commons ones are listed belowDepressionAnxietyPosttraumatic stress disorderLow selfesteemAnxiety disorder, including phobiasEmotional crisesMarital problemsFamily disputesObsessivecompulsive disorderPersonality disordersAlcoholismAddictionProblems stemming from child abuseBehavioral problemsBipolar disorder (in combination with drugs) Schizophrenia (in combination with drugs) What are the benefits of psychotherapy? Professor Mick Cooper, of the University of Strathclyde, England, writes that the most important factor in successful therapy is the client, not the therapist.

Participating in psychotherapy offers a number of benefits for the client. It is usually helpful to have somebody who really does understand you. Therapy may give the client a fresh perspective on a difficult problem and direct the client towards a solution. Most patients will say that the benefits of psychotherapy includeBeing able to understand yourself and your personal goals and values better. Developing skills for improving relationships. It helps the client overcome certain problems, such as an eating disorder, depression, or anxiety. Obtaining a solution to the problems or concerns that made the client seek therapy. What are the disadvantages of psychotherapySome clients may find that the treatment results in changes they had not expected, or did not want. Some people do not like to have to relive unpleasant events (not all psychotherapy techniques make the client do this).

New plans to improve the support and care for individuals and their families living with dementia were announced by Health Minister Edwina Hart.

Statistics from Alzheimers Society show that there are currently more than 37,000 people with dementia in Wales, and this is set to rise to almost 50,000 within 20 years. One in three people over 65 are expected to die with a form of dementia, according to the charity.

The Assembly Government asked a group of experts led by Ian Thomas, the Director of Alzheimers Society, to develop a Dementia Action Plan for Wales and this is now being issued for a 12 week consultation.

The plan draws together current policies and strategies and proposes a series of actions for Wales to meet the challenges of planning and delivering better services for people with dementia.

Mrs Hart said

“Dementia is a distressing and debilitating condition for the individual and can be equally as distressing for their loved ones. It will affect us all in one way or another in our lifetime.

“The National Dementia Action Plan has drawn together current policies and strategies and proposes a number of actions to be taken in Wales over both the short and long term to help us meet some very major challenges.

“I hope that people will read the groups document and through this consultation exercise let us know what their views are so that the Welsh Assembly Government can develop and provide improved dementia services that meet the needs of the people of Wales.”Ian Thomas, said

“This is an unrivalled opportunity for people to give their views on how we can change the lives of families living with dementia in Wales. The numbers of people with dementia are set to soar and this action plan takes us closer to making sure that everyone affected receives the vital support they need, both now and in the future.

“With the right leadership and proper investment, this plan has the potential to change lives. Alzheimers Society, will continue to work closely with Welsh Assembly Government to ensure it becomes a reality.”

A Minnesota program that provides psychiatric medications to lowincome patients received a 2009 Community Leadership Award honorable mention from Americas Health Insurance Plans. The awards, which were announced at AHIPs annual Institute in San Diego, recognize programs that address a community need.

The Mental Health Drug Assistance Program provides 24/7 access to stopgap psychiatric drugs to lowincome patients with severe mental health conditions such as major depression, schizophrenia and bipolar disorder. Administered by HealthPartners, MHDAP includes more than 25 local public and privatesector organizations.

The program prevents psychiatric crises that lead to emergency hospitalization and incarcerations which cost an average of $12,00015,000 compared to the average cost of $165 for a psychiatric prescription. A 2007 study of Twin Cities found that 40 to 50 emergency room patients with serious mental health conditions are admitted every month to hospitals in the Minneapolis/St. Paul metro area because they do not have access to community resources.

“This safety net program is more critical since the state is eliminating General Assistance Medical Care, which provides health insurance for adults living below the poverty line,” said Donna Zimmerman, HealthPartners vice president of government and community relations. “Seventy to eighty percent of the services we provide for GAMC are for patients who suffer from a mental illness and as they and other people lose their insurance they will also lose access to medications,” she added.

In the first year, MHDAP provided prescriptions to 300 patients. In a survey, patients reported that the program reduced the need for hospitalization by 26 percent. These results and the potential savings to the community, have prompted the MHDAP collaborative to explore expanding the program locally and to explore potential national applications,

MHDAP is funded by HealthPartners/Regions Hospital, HealthEast and United Hospitals as well as by grants from the Saint Paul Foundation and F.R. Bigelow Foundation.

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The kids are playing in the backyard and enjoying their break from school. Your husband is enjoying the day on the golf course. And youre cleaning up the house, folding laundry and cooking three meals. Sound familiar?

Although summer is a time known for enjoying the sun, most women continue on with their normal routine of caring for their family and do not treat themselves to a break. Summer is the ideal time to channel the energy normally used to help others into a vacation, private time and break from daily responsibility. This technique can aid in preventing physical and emotional struggles that occur when a woman makes caring for others her top priority and neglects herself.

Jacqueline Dawes, founder and owner of Brookhaven Retreat, a multidisciplinary treatment facility for women, says that women must adapt their daily routine to focus on their own needs, and find the time to nurture themselves.

“I have recently encountered several women who sought treatment following an emotional breakdown, all of whom were hesitant to leave their daily family responsibilities,” said Dawes. “There must be a healthy balance between caring for your family and caring for yourself.”

Studies show that most emotional breakdowns are caused by stress and that women are more likely than men to experience said struggle. Women tend to experience anxiety due to work responsibilities, finances and family stresses. The breakdown typically occurs following an ongoing emotional fight during which the body crosses a threshold.

“If a woman sets in place healthy, adaptive strategies and goals that create an environment in which she is relaxed, she can then further care for herself and her family, and happily,” said Dawes. “A woman needs the foresight to break from daily practice and enjoy some time off in order to prevent against emotional breakage.”

A few suggestions for relieving stress during the Summer months

Treat yourself to a weekend getaway
Dine out instead of in
Indulge in a manicure, pedicure or massage
Enlist family and friends to pitch in on routine tasks
Plant a garden with your favorite herbs and vegetables
Go swimming, hiking or running
Sip some freshly squeezed lemonade

The antidepressant citalopram does not appear to reduce the occurrence of repetitive behaviors in children and teens with autism spectrum disorders, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Although the U.S. Food and Drug Administration has not approved any drugs to treat the core symptoms of autism and related disorders, medications are increasingly being used in this population, according to background information in the article. Citalopram belongs to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which interfere with the way the brain regulates the neurotransmitter serotonin.

“Because of suggested similarities between repetitive behavior in autism spectrum disorders and obsessivecompulsive disorder and the findings of serotonin system abnormalities in autism, antiobsessional agents such as SSRIs have long been of interest,” the authors write. Repetitive behaviors in children with autismincluding inflexible routines and repetitive playtend to persevere over time and predict the endurance of an early autism diagnosis. “Despite the relative dearth of evidence supporting their use, SSRIs are among the most frequently used medications for children with autism, partially because of their perceived safety.”

Bryan H. King, M.D., of Seattle Childrens Hospital and the University of Washington, Seattle, and colleagues conducted a randomized controlled trial to determine the safety and efficacy of citalopram in children with autism spectrum disorders who had at least moderate levels of repetitive behavior. Of 149 children age 5 to 17 (average age 9.4) with autism spectrum disorders who participated, 73 were randomly assigned to receive citalopram (at an average maximum dosage of 16.5 milligrams per day) and 76 to receive a placebo for 12 weeks. Most of the participants (82.6 percent) completed the 12week trial.

At the end of the treatment period, there were no differences between the treatment group and the placebo group in the number of children who demonstrated improvements on scales measuring repetitive behavior (32.9 percent vs. 34.2 percent). “Citalopram use was significantly more likely to be associated with adverse events, particularly increased energy level, impulsiveness, decreased concentration, hyperactivity, stereotypy [mechanical repetition of the same posture or movement], diarrhea, insomnia and dry skin or pruritis,” the authors write.

“There is growing recognition that children and adolescents with autism spectrum disorders have serious behavioral problems and psychiatric symptoms that may be appropriate targets for pharmacotherapy,” they continue. “To date, there are few largescale trials to guide clinical practice, so clinicians are left to address these problems with inadequate information. The results of this trial indicate that citalopram is not an effective treatment for children having autism spectrum disorders with moderate or greater repetitive behavior. The results also highlight the urgent need for placebocontrolled trials of medications commonly used for children with autism spectrum disorders to determine whether the risks of specific drugs substantially outweigh their benefits.”

Arch Gen Psychiatry. 2009;66[6]583590.

Alastair Campbell has won Minds Champion of the Year Award for his significant contribution to raising awareness of mental health. He beat fellow nominee and chat show host Paul OGrady, among other mental health campaigners, to the prestigious award announced yesterday evening.

Winning 52% of the vote, Alastair has clearly won public confidence and support for speaking openly and candidly about his experience of mental health. His nomination for the award recognised his tireless campaigning to improve attitudes towards mental health.

In the last year, as well as fronting the current major antistigma campaign Time to Change, Alastair produced a BBC2 documentary Cracking Up exploring his own experiences of a psychotic breakdown, and his book All in the Mind, the semiautobiographical story of a troubled psychotherapist.

Mind Champion 2009 Alastair Campbell said “Change is happening, and I really feel we are close to the tipping point in terms of peoples greater understanding and societys greater openness about mental illness. I am pleased and proud that people think I have played a part in that. This award recognises that I have used my voice, and taken it to the public platform that I can, to raise awareness of the fantastic work that charities like Mind carry out.”

Paul Farmer, Minds Chief Executive said “I am very happy that we did not need to select the winner for this award and that it was down to a public vote! This years shortlist was of an exceedingly high level and saw a very eclectic mix vie for the accolade. Alastair has offered tremendous support through his public discussion of his experiences of mental distress. He has done so much for the mental health movement and this award expresses the appreciation of the public for his hard work.”

The other people on the shortlist were Anne Savage, who fought and won a historic legal battle for the rights of mental inpatients, MP Lynne Jones, cochair of the All Party Parliamentary Group on Mental Health, and the Hearing Voices Networks Chair Jacqui Dillon. Paul OGrady, better known for his alter ego Lily Savage, was also nominated for dedicating an entire series of his talk show to mental health, and speaking out about his experience of depression.

The award was given alongside the highly contended Book of the Year, which was given to Sathnam Sangera for his memoirs The Boy with the Topknot. Journalist of the Year was won by Eleanor Harding from local newspaper Wandsworth Guardian, beating writers for national newspapers The Observer and The Daily Mail to the title. Nottingham Universitys student newspaper Impact saw its journalist, Nicola Byrom, named Student Journalist of the Year.