Faculty Bibliography

Child and adolescent psychiatrists (CAPs) work at the intersections of families, cultures, and systems, which affect engagement in care, assessment, and treatment planning. There are several practical strategies that CAPs can apply to practice cultural humility, to join with families, to facilitate difficult conversations and to work through misalignment. Culturally inclusive family-based care can promote greater understanding and lead to stronger outcomes with families as well as help mitigate mental health impact of structural racism and social inequities.

Objectives: The United States is among the most diverse nations worldwide, boasting a majority percentage of the population comprised of ethnic minorities. Despite this, there remains a longstanding and pervasive history of racism toward several minority ethnic groups. According to a 2019 report from the Pew Research Center, race relations in America have worsened in recent times. Racism is a social determinant of health. Experiences of racism significantly impact the identity and self-perception of children and adolescents. It is therefore critical to examine how the unique racial experience of prominent ethnic minority groups shapes their developing identities and to accurately inform best practices in mental health diagnosis and treatment.
Method(s): Presenters will review the historical context of racism in the United States for the following prominent minority groups: African American, Latinx, East Asian, and South Asian. Each presenter will expand on the experience of racism specific to each ethnic group, identify unique negative biases, and review how these dynamics of discrimination impact adolescent identity development. Presenters will also share clinical pearls for how to explore topics of racial discrimination with youth in treatment.
Result(s): The experience of racism in adolescence has a significant impact on the developing adolescent identity and increases the risk of poor self-esteem, social isolation, and mental illness.
Conclusion(s): Racism is an unquestionably prevalent social issue affecting Americans of varying ethnic backgrounds. The experience of racism can be unique for differing ethnic groups. Because racism has a significant impact on the identity of developing youth and can increase the risks of mental illness, it is imperative for psychiatrists to consider race and ethnic bias in our discussions, assessments, and treatment of our patients. ETHN, ADOL, IDD
Copyright

The aim of this editorial is to evaluate the evidence for using pimavanserin for the treatment of Parkinson's disease psychosis (PDP) from randomized controlled trials (RCTs). We only identified two published trials that evaluated the use of pimavanserin among individuals with PDP. Both studies found that pimavanserin improved psychotic symptoms among individuals with PDP when compared to placebo. Pimavanserin was fairly well tolerated in both studies and did not appear to cause significant sedation or worsen motor symptoms among individuals with PDP. However, given the limited data, additional confirmatory studies are required before pimavanserin can be considered as a first line agent for the treatment of psychotic symptoms among individuals with PD.

Psychotic disorders are not uncommon in late life. These disorders often have varied etiologies, different clinical presentations, and are associated with significant morbidity and mortality among the older adult population. Psychotic disorders in late life develop due to the complex interaction between various biological, psychological, social, and environmental factors. Given the significant morbidity and mortality associated with psychotic disorders in late life, a comprehensive work-up should be conducted when they are encountered. The assessment should not only identify the potential etiologies for the psychotic disorders, but also recognize factors that predicts possible outcomes for these disorders. Treatment approaches for psychotic disorders in late life should include a combination of nonpharmacological management strategies with the judicious use of psychotropic medications. When antipsychotic medications are necessary, they should be used cautiously with the goal of optimizing outcomes with regular monitoring of their efficacy and adverse effects.