Saturday, September 13, 2008

Neuroscience: No, we really DON'T understand kids

This editorial in Nature Neuroscience raises a key children's health issue issue:
Our understanding of the neurobiology and treatment of psychiatric illness in children remains poor. Prominent psychiatrists have now been accused of concealing the extent of their financial ties to the drug industry. We urgently need to encourage more science in this area and we need vigorous regulation to restore some neutrality to the field.
Here's a brief excerpt:
Diagnosing mental disorders can be tricky even under the best of circumstances. God biomarkers for psychiatric disorders (pediatric or adult) are nonexistent. Our knowledge of the neurobiology of these complex disorders also has glaring holes;

And if you are the parent of a child with a mental disorder, you can at least have the peace of mind of knowing that, if you think this :
... there is an urgent need to put more science behind child psychiatry. We need an independent, objective assessment of the efficacy and safety of these medications, comparing existing generics and new products, and comparing non-drug or combination interventions to drug-only approaches. One option is to pool money from both industry and the government or other funding bodies, bringing together public and private money to fund such studies (similar to the ‘Innovative Medicines Initiative’ proposed by the European Commission). The raw data generated by clinical trials should be available for independent scrutiny. We also need to consider ways to increase recruitment in clinical trials, such as an alternate trial design where all patients initially get access to active treatment (Klein, D.F. JAMA 299, 1063–1065 (2008)) . Urgent action is needed to restore some objectivity and neutrality to this field; the stakes are simply too high to remain complacent.
... you have expert company.

For some reason, Nature Neuroscience is not making this editorial "Credibility crisis in pediatric psychiatry" (Nat Neurosci. 2008 Sep;11(9):983.) available free online yet, but you mightbe able to read the rest through a library with journal subscriptions.

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