Coordinated by Marianne Zdeblick Wamboldt, M.D.
Wednesday, October 24
8:00 – 11:00 a.m. (open)
Clinical Case Conference 1
Child Psychiatric Treatment Failures: Understanding and Responding to Partial Recovery
Stuart A. Copans, M.D., David V. Keith, M.D., Robert A. King, M.D., W. Peter Metz, M.D., Ramon Solhkhah, M.D., Fred R. Volkmar, M.D., Janet Wozniak, M.D., Boris Birmaher, M.D.
The goal of this Clinical Case Conference is to encourage child and adolescent psychiatrists to begin the process of talking openly about the topic of treatment failure. What is treatment failure? How can we recognize it? How do we define success and failure when we are managing a chronic illness? When we do recognize that our treatments have not returned a child’s function to baseline, what can we do? What is the next step for the patient, their parents, or the agency responsible for their care? Finally, how do we measure failure and success in our patients? As a way of beginning this discussion, six experts present cases in the diagnosis of bipolar disorder, depression, Asperger’s disorder, substance abuse, ADHD, and obsessive compulsive disorder.
1:00 – 4:00 p.m. (open)
Clinical Case Conference 2
The Complex Case of a 4-Year Old with Catatonia
Benjamin W. Jordan, M.D., Marilyn B. Benoit, M.D., Allan M. Josephson, M.D., Judith L. Rapoport, M.D., Paramjit T. Joshi, M.D.
In this panel, master clinicians consider the significant diagnostic challenge presented by a preschool-aged child with a decompensation into unresponsive catatonia. Attention is given to the broad diagnostic possibilities, including potential medical causes, current understandings of catatonia in early childhood, potential underlying psychological factors, including trauma, and the potential causal or contributing role of family and cultural issues. The patient presentation includes historical and collateral information, video recordings of an early outpatient visit, and more severe symptoms exhibited while an inpatient, as well as discussion of the medical work up performed.
Thursday, October 25
8:00 – 11:00 a.m. (open)
Clinical Case Conference 3
Contributions from Child Psychoanalysis: First Child Interviews-Formulating Clinical Approaches
Nathaniel Donson, M.D., Carol Austad, M.D., Alexandra M. Harrison, M.D., Martin J. Drell, M.D., Timothy Dugan, M.D., Theodore Shapiro, M.D.
This panel offers a series of interviews by master clinicians demonstrating sensitive clinical observing, listening, interviewing, and responding at the onset of contact. The program focuses on first interviews only, stressing what is dynamic, developmental, and “psychoanalytic.” Most children are profoundly conflicted, resistant, and at the same time urgent to reveal their inner life, even to an unknown stranger. Several narratives and video tapes of first interviews are shown and discussed.
Sponsored by the AACAP Psychotherapy Committee
2:00 – 5:00 p.m. (open)
Clinical Case Conference 4
The Politics of Childhood: Therapeutic Implications
Lenore C. Terr, M.D., Michael Jellinek, M.D., Martin J. Drell, M.D., Stanley I. Greenspan, M.D., Paula K. Rauch, M.D., Stewart E. Teal, M.D.
This Clinical Case Conference considers the issue of childhood politics from the standpoint of how psychotherapy deals with it at the various phases and how children then respond. The presentation examines the question of how childhood relationships with various family members, teachers, peers, camp friends, fellow athletes/musicians, and /or those of the same or opposite gender, influence the child’s sense of well being, identity formation, and severity of psychiatric disorder.
Friday, October 26
8:00 – 11:00 a.m. (open)
Clinical Case Conference 5
Integrating Multiple Clinical Perspectives to Enhance Multimodal Treatment Planning
Anna M. Georgiopoulus, M.D., Gagan Joshi, M.D., Alexandra M. Harrison, M.D., Robert E. Reifsnyder, Ed.D., Anna C. Muriel, M.D., M.P.H.
The objective of this Clinical Case Conference is to demonstrate effective integration of psychopharmacologic, psychodynamic, family systems, and medical liaison perspectives in case formulation and treatment planning, using the complex case of a seven-year old boy with cystic fibrosis and psychiatric symptoms. A video-taped segment of the patient seen in his family context assists the panel and audience in generating hypotheses.
Saturday, October 27
8:00 – 11:00 a.m. (open)
Clinical Case Conference 6
Bipolar Disorder Disguised: Diagnostic and Treatment Dilemmas
Marjorie L. Shuer, M.D., FRANZCP, Melissa P. DelBello, M.D.
Bipolar disorder in adolescents often manifests as a depressive disorder during initial presentation. Thus, not only is the illness treated with less than appropriate psychopharmacology, but the average delay to accurate diagnosis can range from two to nine years. Two detailed case studies are presented that were incorrectly diagnosed during initial and subsequent presentations. The Clinical Case Conference demonstrates how an all inclusive encompassing evaluation, and if necessary re-evaluation, remains the cornerstone for an accurate diagnosis and treatment of bipolar disorder in adolescents.
