Child and adolescent psychiatry: past scientific achievements and challenges for the future

Abstract

The worldwide history of scientific achievements in child and adolescent psychopathology is reviewed from the mid-twentieth century onwards. Attention is drawn, e.g., to diagnostic distinctions, measures of psychopathology, the several roles of epidemiological longitudinal studies, temperament and personality, developmental psychopathology, the use of 'natural experiments' to test causal inferences, environmental risks, the importance of gene-environment interplay, the relative coming together of initially diverse psychological therapies, the use of randomized-controlled trials to assess treatment efficacy, and the value and limitations of pharmacotherapy. The article ends with a look ahead to the most important opportunities and challenges for child and adolescent psychiatry, plus the hazards that need to be avoided.

Prevalence of behavioral and emotional problems among seven to eleven year old children in selected schools in Kandy District, Sri Lanka

“…As listed in Table 2 types 1AB and 1C are having least problems and types 2 and 3 showing the highest internalizing problems. Michael Rutter in his work has established that better managed schools have lesser emotional and behavioral problems (Rutter and Taylor, 2002). The fact that students in schools with advanced level studies do better may suggest that these schools are better managed.…”

To what extent can we predict the future?

“…Rutter [19] has provided an overview of our current knowledge of risk factors which can be assessed in longitudinal studies to assess developmental psychopathological trajectories. Family risks factors are of obvious importance for several disorders (e.g., for anxiety disorders see [8]) and can be extended to include prenatal factors [20].…”

Seclusion and restraints: a neglected area of research in child and adolescent psychiatry?

“…Despite the ongoing advances in evidence-based medicine in our field [5,6], significant gaps of knowledge and guidelines are being brought to our attention and ought to spur on our research and clinical thinking.…”