The Link - January 2025

As pediatricians in the community, we have an incredibly important and worthwhile duty to care for the physical, mental and social wellbeing of our patients. We must be particularly diligent with our patients, who are often unable to advocate for and protect themselves. This way of thinking becomes particularly important when it comes to child physical abuse. Child physical abuse is a serious public health issue and has been shown to result in significant lifelong consequences for those who are impacted, including both physical and mental health sequelae. Child protective services investigates millions of cases of child abuse and neglect each year, and around 10% of these cases are related to physical abuse.

The field of pediatric obesity treatment is rapidly growing, with new options to help patients improve health habits and achieve healthier weight in managing the chronic disease of obesity.

The foundation of the treatment “house” is intensive health behavior and lifestyle treatment. Beyond evidence-based nutrition and physical activity recommendations and mental health topics (the “what”), this approach includes the “how” to make and sustain these healthy changes for the whole patient (mind, body, spirit and emotions), at home, school and other environments in a patient- and family-centered way. Using motivational interviewing can aid shared decision-making and selection of achievable family goals. Requesting frequent follow-up visits is a part of treatment. Seeing patients regularly enables primary care providers (PCPs) to monitor health behavior changes and helps families adopt healthy changes. It also helps to sustain or improve emotional health as well as weight and body mass index (BMI). It supports patients in their whole person health journey. Involving other health professionals such as behavioral health providers and registered dietitians can be very helpful for patients needing mental health support and additional nutrition guidance.

Depression and You:

According to the Centers for Disease Control and Prevention (CDC), 4% of children aged 3-17 have a current diagnosis of depression while 79% of these children obtained counseling or treatment. This article serves as a practical guide for depression diagnosis and treatment in the general practitioner’s office.

Depression:

The American Academy of Pediatrics recommends universal screening for depression in adolescents to provide early identification and intervention. There are several screening tools for assessing depression in children and adolescents. The two most widely used are the Patient Health Questionnaire 9 (PHQ-9) and the Columbia Depression Scale.