In patients with a suboptimal response to clozapine, the addition of risperidone improved overall symptoms and positive and negative symptoms of schizophrenia. The combination appears to be safe and well tolerated. Augmentation of clozapine with risperidone may provide additional clinical benefit for patients who are nonresponsive or only partially responsive to clozapine alone.

The results failed to show that elevated prolactin accelerates bone mineral density loss. However, sustained hyperprolactinemia did have an impact on the rate of bone metabolism. Perhaps higher prolactin levels over longer time periods are necessary before the metabolic processes become uncoupled, leading to bone mineral density loss.

Psychiatric care for children and adolescents is limited in remote and underserved areas because of the shortage of child and adolescent psychiatrists. Telepsychiatry has the potential to alleviate this problem. This article reviews the procedures used to develop telepsychiatry, equipment needed for videoconferencing in telepsychiatry, benefits and limitations of telepsychiatry, and confidentiality issues in telepsychiatry. Many questions regarding confidentiality, legality, reimbursement, cost-effectiveness, and technology still need to be resolved. However, telepsychiatry has the potential to be a useful treatment alternative.

Major depressive disorder (MDD) with atypical features has been described in adults. Furthermore, several studies have suggested that tricyclic antidepressants were less effective for MDD with atypical features than for MDD without atypical features. Thus, it may be important to determine whether atypical features are present in MDD. To date, only one study has examined the diagnosis of depression with atypical features in children and adolescents by using the DSM-IV criteria. Current knowledge suggests the DSM-IV criteria for depression with atypical features in children and adolescents may need to be reconsidered, as biological, hormonal, developmental, and psychological factors in this age group may be different from those of adults with atypical depression.

The aim of this study was to examine the acceptability and reliability of telephone administration of the parent's version of the Children's Interview for Psychiatric Syndromes (P-ChIPS), a diagnostic interview examining 21 separate psychiatric syndromes, compared with face-to-face administration. Parents of 12 participants-seven boys and five girls-completed this preliminary study. The mean age of the children was 12.2 years (SD, 3.9 years). In comparing telephone and face-to-face administrations of the P-ChIPS, the percent agreement for each diagnosis was 75% to 100%, with an average percent agreement of 93.8% across all disorders assessed. Results of the face-to-face and telephone administration of the P-ChIPS were comparable, but this needs to be confirmed using a larger sample.