Advancing Pediatrics sat down with Paramjit Joshi, MD, Director of Psychiatry
and Psychology at Children's National, to talk about behavioral medicine and her new role as President of the American Academy of Child and Adolescent Psychiatry (AACAP).
Q. Why is Children's National Health System focused on mental health as a priority issue?A.
The facts speak for themselves: Approximately 20 percent of U.S. children and adolescents have a diagnosable mental disorder, yet 20 percent of those children receive treatment. Suicide is the third-leading cause of death in teenagers, and half of all patients with a psychiatric disorder experience symptoms before age 14. Mental health is first and foremost a children's issue.
Q. How is Children's National advancing the understanding and treatment of mental illness in children?A.
On the research side, we're working to better understand the phenotype presentations and the genomics of mental illness. We know many disorders -- including depression, bipolar disorder, schizophrenia, and ADHD -- are heritable conditions. We're also looking at environmental and biologic effects, and functional imaging studies have shed light on how the circuitry of the brain is impacted in some of these disorders.
Mental illness is like any other disease -- earlier it is identified and treated, the better the outcomes. We've made a push to offer mental services in schools. The goal is to identify antecedents and catch emotional and behavioral problems early. We are one of the few hospitals with an infant and toddler mental health program, and we see patients as young as they come.
Q. What are your primary research interests?A.
I am particularly interested in the etiology and phenotypic presentation of depression and bipolar disorder. In prepubertal children especially, bipolar disorder is underdiagnosed, overdiagnosed, and misdiagnosed all at the same time. We just completed a multisite, federal funded study of the treatment of early-age mania. It was one of the largest, most rigorous treatment studies to date and we are currently preparing to publish some findings.
Q. What are you priorities as president-elect of AACAP?A.
Given that there is such a dearth of child and adolescent psychiatrists in the world, it is imperative the AACAP share what we have in goodwill, resources, and materials with colleagues worldwide. While we celebrate and pride ourselves in the unique aspects of each culture and country that define and separate us, there is much more that unites us. The mental well-being of all children and adolescents globally is a common goal that we all share.
Q. What do you enjoy most about working at Children's National?A.
I came from an institution that cared for patients of all ages to a hospital that's all about pediatrics. I love working with children, and everything here breathes kids.
Read more about hand surgery in the fall 2013 issue of Advancing Pediatrics
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