Year : 2019  |  Volume : 61  |  Issue : 8  |  Page : 153--154

Preamble for clinical practice guidelines for child and adolescent psychiatric disorders


Shiv Gautam1, Ajit Avasthi2, Sandeep Grover2,  
1 Gautam Hospital and Research Center, Jaipur, Rajasthan, India
2 Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Prof. Sandeep Grover
Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh
India




How to cite this article:
Gautam S, Avasthi A, Grover S. Preamble for clinical practice guidelines for child and adolescent psychiatric disorders.Indian J Psychiatry 2019;61:153-154


How to cite this URL:
Gautam S, Avasthi A, Grover S. Preamble for clinical practice guidelines for child and adolescent psychiatric disorders. Indian J Psychiatry [serial online] 2019 [cited 2020 Jan 22 ];61:153-154
Available from: http://www.indianjpsychiatry.org/text.asp?2019/61/8/153/250050


Full Text



It gives us immense pleasure to place Clinical Practice Guidelines (CPG) for Child and Adolescent Psychiatric Disorders in your hands. Like other issues of CPG, it involved selection of experts who have substantially contributed to this area. Forty-six experts from all over the country were identified by the Clinical Practice Guidelines meeting, and 13 were assigned to prepare the lead papers which were discussed in small groups and larger group at Jaipur on August 4 and 5, 2018; the outcome of discussion was added to the draft papers which were put on Indian Psychiatric Society (IPS) website for comments by fellows and members. The comments were reviewed by editors, and after final editing, the document has been prepared. We feel that it is an outcome of collective wisdom and consensus which is in your hands.

Children and adolescents still form the largest subgroup of population in the country, and there is a need to focus on proper assessment and management of various psychiatric disorders in this age group, as many of the childhood disorders form the gateway for psychiatric disorders in adulthood. One good thing which has happened in this country is that few centers in the country have also started DM courses and postdoctoral fellowship program in Child and Adolescent Psychiatry in the country. Accordingly, it can be said that the Child and Adolescent Psychiatry is now taking the shape of a well-recognized subspecialty in this country. Hence, there is a need to have CPGs for various psychiatric disorders seen in children and adolescents.

The tradition of publishing CPGs by the IPS started in 2005. The basic aim of publishing these guidelines was to have minimum standards for the membership of IPS in providing clinical care to much needy patients in the background of the available resources. The first issue of CPGs for the management of various psychiatric disorders in children and adolescents was published in 2008. These guidelines covered 13 topics such as Psychiatric Assessment of Children and Adolescents, Management of Cerebral Palsy, Assessment and Treatment of Attention-Deficit/Hyperactivity Disorder, Diagnosis and Management of Children with Mental Retardation, Assessment and Management of Specific Learning Disorders, Treatment of Depression in Children and Adolescents, Management of Pediatric Somatoform Disorders, Management of Dissociative Disorders in Children and Adolescents, Management of Substance Abuse Disorders in Children and Adolescents, Practice Parameters or Childhood Autism, Treatment of Children and Adolescents with Affective Disorders, Treatment of Conduct Disorder, and School Mental Health Program.

Over the last one decade, more information has emerged in the assessment and management of various psychiatric disorders in children and adolescents. Keeping this in mind, it was decided to update the guidelines published in 2008. The revised guidelines attempt to provide an update on some of the topics covered in previous guidelines by emphasizing what has emerged further in the field. However, it is still recommended that new set of guidelines be read in conjunction with the earlier version of the CPGs of IPS for children and adolescents. Compared to the previous version of the CPGs, the revised versions of the CPGs now have separate guidelines for schizophrenia, obsessive–compulsive disorders, and assessment of child sexual abuse. In addition, the revised version also provides a snapshot of the impact of Mental Health Care Act, 2017 on the practice of children and adolescents, with respect to the inpatient care and use of electroconvulsive therapy. The recommendations suggested as part of these CPGs are based on the available evidence base, expert consensus, and feedback obtained from the membership.

Multiple factors influence the decision-making. However, there are certain common ingredients of any management plan [Table 1]. For the management of various psychiatric disorders in children and adolescents, it is important to carry out thorough assessment of symptoms, psychosocial factors, life events, and comorbidities including substance use disorders. Sociocultural factors should also be given due importance. The general goals of management should be to decrease or ameliorate the symptoms and maximize the functioning of the children and adolescents.{Table 1}

As with all other CPGs issued by IPS, these guidelines are not recommended for any specific treatment setting and it is understood that the clinicians may have to modify the recommendations to some extent to suit the needs of patients in a particular treatment setting, a particular patient, and their caregivers.

Although these guidelines focus on the management of specific disorders, it is well known that many children and adolescents will have comorbidities, and accordingly, the clinicians are expected to focus on the person per se rather than the disorder per se.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.