The Best Parent's Guide to Understanding Adolescent Depression

The article reports on two studies published in the February 2009 issues of the Archives of General Psychiatry and the Archives of Pediatrics & Adolescent Medicine. The researchers studied the electronic media exposure of 4,142 and 93,297 subjects. "In the first study, [the researchers] studied the electronic media exposure of 4,142 non-depressed adolescents who were assessed for depression over seven years of follow-up, and found that greater television time was associated with higher odds of developing depression as young adults." In the second study the researchers "..conducted a study of 93,297 students (aged 15 years) from 31 largely European and North American countries and regions, and found that the more evenings the subjects spent out with their friends, the more likely they were to use cannabis." The researchers conclude that "There is a great need to learn more about the nature of evenings out with friends and related factors that might explain changes in adolescent cannabis use over time%u2026.Because there are many benefits to adolescent social interaction, it is important to determine how best to foster it without unduly increasing exposure opportunities for cannabis use." Based of our experience and expertise in treating adolescent substance abusers and depressed young adults, we offer several tips for parents First, parents should significant limit the amount of time that adolescents spend watching TV to two hours a day during the week and three hours a day during the weekend. Second, parents who suspect that their adolescent child is exhibiting the signs and symptoms of depression or engaging in the use and abuse of cannabis should seek an evaluation from a qualified mental health profession. Third, parents with adolescents who have been diagnosed with depression and/or a substance abuse problem should seek treatment from a qualified medical professional who can provide appropriate counseling, psychotherapy, and medication if necessary. Fourth, parents should know who their adolescents are socializing with and educate their adolescents about the dangers in the use of cannabis.

The Bottom Line: The results of these studies strongly support the conclusions that excessive TV watching in adolescence increases the risk of developing depression as an young adult and that adolescent socializing with friends increases the risk of cannabis use.

The study was published online ahead of print January 15, 2009, in the American Journal of Psychiatry.

Background

The TADS team randomly assigned 439 adolescents aged 12 to 17 to one of four treatment strategies for 36 weeks -the antidepressant fluoxetine only, cognitive behavioral therapy (CBT) only, the combination of the two, or placebo. TADS results can be found here.

The group that received placebo was then offered the TADS treatment of their choice after the first 12 weeks of the trial and treated openly. For this analysis, Betsy Kennard, Psy.D., of the University of Texas Southwestern Medical Center in Dallas, and colleagues compared the outcome of the "placebo/open group" to that of the active treatment groups combined to determine if the placebo treatment or the delay in getting active treatment affected the teens' long-term benefits. They also aimed to determine if the teens responded differently to subsequent active treatment than the groups who had been treated with active treatments throughout the study.

Results of the Study

At the end of the 36-week trial, 82 percent of the placebo/open group had responded to active treatment, compared to 83 percent of those in the active treatment groups. About 48 percent of the placebo/open group achieved remission, compared to 59 percent of the active group. The difference in remission rates was not statistically significant, but the researchers suggest that the small difference likely resulted because the active treatment group received treatment for a longer period of time than the placebo/open group.

Rates of worsening symptoms or adverse events such as suicidal thinking and behavior did not differ between the placebo/open group and the active treatment group. In addition, neither group was more likely to discontinue treatment compared to the other.

Significance

Scientists know little about the long-term outcomes of placebo treatment in pediatric antidepressant trials, leading to concerns about the impact of delaying active treatment with the use of placebo. However, a placebo-controlled study provides value by helping researchers better differentiate among treatments and treatment responses.

This study helped researchers conclude that 12 weeks of placebo does not cause harm for teens with depression, nor does it reduce the rate of response when the teens are given subsequent active treatments. Moreover, 73 percent of placebo participants elected to receive active, open treatment after the first 12 weeks, suggesting that participants are not reluctant to seek additional treatment after participating in a placebo condition.

The lack of difference in adverse events and drop-out rates also suggests that teens are able to tolerate placebo treatment and the potential waiting period before receiving active treatment without experiencing significant worsening of symptoms. The researchers conclude that the use of placebo for this amount of time is ethical, and the risk of harm in delaying active treatment is low.

Source: National Institute of Mental Health

Researchers in the NIMH Mood and Anxiety Disorders Program and colleagues reported these findings online October 31, 2008, in the journal Biological Psychiatry.

Background

Anxiety and depression are influenced by the processing of the mood-regulating brain chemical called serotonin. A protein known as the serotonin transporter directs serotonin from the space between nerve cells back into the cells, where it can be reused. Changes in the gene that codes for the serotonin transporter can lead to decreased transport of serotonin back into the brain's nerve cells. Abnormalities in the serotonin system are associated with anxiety and depression.

Everyone inherits two copies of the serotonin transporter gene-one from each parent. The gene has various versions-one version is short, and one version is long. A person may have two copies of the same version or one copy each of two different versions. Previous studies in adults have linked versions of the gene to increased risk for mood and anxiety disorders. Adults who have one copy of the short version tend to be more anxious and depressed than adults who have two copies of the long version.

Previous brain imaging studies in adults linked gene versions to different responses of the brain's fear hub-the amygdala-to frightened faces. In both healthy and affected adults who have at least one copy of the short version, the amygdala reacts more than it does in healthy or affected adults who have two copies of the long version of the gene. Whether these findings in adults also hold true for adolescents was unknown.

Using functional magnetic resonance imaging (fMRI), Jennifer Y. F. Lau, Ph.D., then at NIMH and now at the University of Oxford, U.K., and colleagues at NIH scanned the brains of 33 healthy teens and 31 teens with depression and anxiety disorders while they viewed pictures of frightened faces. Then the investigators compared the amygdala reactions in the two groups.

Findings of This Study

Lau and colleagues found that in healthy adolescents who have at least one copy of the short version of the gene, the amygdala reacts more than it does in healthy adolescents who have two copies of the long version. This result is the same in healthy adults. However, in anxious or depressed adolescents, the opposite results were found. In affected adolescents who have at least one copy of the short version, the amygdala reacts less than it does in affected adolescents who have two copies of the long version.

Significance

This finding in affected teens with two long version genes is the opposite of that observed in anxious or depressed adults. It is surprising because anxiety and depression during adolescence tend to predict these disorders during adulthood.

What's Next?

The unexpected finding may be explained by the fact that anxious adults and anxious adolescents react differently when presented with threats. But further research is needed to fully understand the difference, the investigators say.
Reference

Lau JY, Goldman D, Buzas B, Fromm SJ, Guyer AE, Hodgkinson C, Monk CS, Nelson EE, Shen PH, Pine DS, Ernst M. Amygdala Function and 5-HTT Gene Variants in Adolescent Anxiety and Major Depressive Disorder. Biological Psychiatry. 2008 Oct 23. [Epub ahead of print].

Sources: National Insittute of Mental Health

Q: What should I do if I am concerned about mental, behavioral, or emotional symptoms in my young child?

A: Talk to your child's doctor. Ask questions and find out everything you can about the behavior or symptoms that worry you. Every child is different and even normal development varies from child to child. Sensory processing, language, and motor skills are developing during early childhood, as well as the ability to relate to parents and to socialize with caregivers and other children. If your child is in daycare or preschool, ask the caretaker or teacher if your child has been showing any worrisome changes in behavior, and discuss this with your child's doctor.
Q: How do I know if my child's problems are serious?

A: Many everyday stresses cause changes in behavior. The birth of a sibling may cause a child to temporarily act much younger. It is important to recognize such behavior changes, but also to differentiate them from signs of more serious problems. Problems deserve attention when they are severe, persistent, and impact on daily activities. Seek help for your child if you observe problems such as changes in appetite or sleep, social withdrawal, or fearfulness; behavior that seems to slip back to an earlier phase such as bed-wetting; signs of distress such as sadness or tearfulness; self-destructive behavior such as head banging; or a tendency to have frequent injuries. In addition, it is essential to review the development of your child, any important medical problem he/she might have had, family history of mental disorders, as well as physical and psychological traumas or situations that may cause stress.
Q: Whom should I consult to help my child?

A: First, consult your child's doctor. Ask for a complete health examination of your child. Describe the behaviors that worry you. Ask whether your child needs further evaluation by a specialist in child behavioral problems. Such specialists may include psychiatrists, psychologists, social workers, and behavioral therapists. Educators may also be needed to help your child.
Q: How are mental disorders diagnosed in young children?

A: Similar to adults, disorders are diagnosed by observi">Medications Chart in this booklet shows the most commonly prescribed medications for children with mood or anxiety disorders (including OCD).
Stimulant Medications

There are four stimulant medications that are approved for use in the treatment of attention deficit hyperactivity disorder (ADHD), the most common behavioral disorder of childhood. These medications have all been extensively studied and are specifically labeled for pediatric use. Children with ADHD exhibit such symptoms as short attention span, excessive activity, and impulsivity that cause substantial impairment in functioning. Stimulant medication should be prescribed only after a careful evaluation to establish the diagnosis of ADHD and to rule out other disorders or conditions. Medication treatment should be administered and monitored in the context of the overall needs of the child and family, and consideration should be given to combining it with behavioral therapy. If the child is of school age, collaboration with teachers is essential.
Antidepressant and Antianxiety Medications

These medications follow the stimulant medications in prevalence among children and adolescents. They are used for depression, a disorder recognized only in the last 20 years as a problem for children, and for anxiety disorders, including obsessive-compulsive disorder (OCD). The medications most widely prescribed for these disorders are the selective serotonin reuptake inhibitors (the SSRIs).

In the human brain, there are many "neurotransmitters" that affect the way we think, feel, and act. Three of these neurotransmitters that antidepressants influence are serotonin, dopamine, and norepinephrine. SSRIs affect mainly serotonin and have been found to be effective in treating depression and anxiety without as many side effects as some older antidepressants.
Antipsychotic Medications

These medications are used to treat children with schizophrenia, bipolar disorder, autism, Tourette's syndrome, and severe conduct disorders. Some of the older antipsychotic medications have specific indications and dose guidelines for children. Some of the newer "atypical" antipsychotics, which have fewer side effects, are also being used for children. Such use requires close monitoring for side effects.
Mood Stabilizing Medications

These medications are used to treat bipolar disorder (manic-depressive illness). However, because there is very limited data on the safety and efficacy of most mood stabilizers in youth, treatment of children and adolescents is based mainly on experience with adults. The most typically used mood stabilizers are lithium and valproate (Depakote®), which are often very effective for controlling mania and preventing recurrences of manic and depressive episodes in adults. Research on the effectiveness of these and other medications in children and adolescents with bipolar disorder is ongoing. In addition, studies are investigating various forms of psychotherapy, including cognitive-behavioral therapy, to complement medication treatment for this illness in young people.

Effective treatment depends on appropriate diagnosis of bipolar disorder in children and adolescents. There is some evidence that using antidepressant medication to treat depression in a person who has bipolar disorder may induce manic symptoms if it is taken without a mood stabilizer. In addition, using stimulant medications to treat co-occurring ADHD or ADHD-like symptoms in a child with bipolar disorder may worsen manic symptoms. While it can be hard to determine which young patients will become manic, there is a greater likelihood among children and adolescents who have a family history of bipolar disorder. If manic symptoms develop or markedly worsen during antidepressant or stimulant use, a physician should be consulted immediately, and diagnosis and treatment for bipolar disorder should be considered.
Q: What difference does it make if a medication is specifically approved for use in children or not?

A: Approval of a medication by the FDA means that adequate data have been provided to the FDA by the drug manufacturer to show safety and efficacy for a particular therapy in a particular population. Based on the data, a label indication for the drug is established that includes proper dosage, potential side effects, and approved age. Doctors prescribe medications as they feel appropriate even if those uses are not included in the labeling. Although in some cases there is extensive clinical experience in using medications for children or adolescents, in many cases there is not. Everyone agrees that more studies in children are needed if we are to know the appropriate dosages, how a drug works in children, and what effects there are on learning and development.
Q: What does "off-label" use of a medication mean?

A: Many medications that are on the market have not been officially approved by the FDA for use in children. Treatment of children with these medications is called "off-label" use. For some medications, the off-label use is supported by data from well-conducted studies in children. For instance, some antidepressant medications have been shown to be effective in children and adolescents with depression. For other medications, there are no controlled studies in children, but only isolated clinical reports. In particular, the use of psychotropic medications in preschoolers has not been adequately studied and must be considered very carefully by balancing severity of symptoms, degree of impairment, and potential benefits and risks of treatment.
Q: Why haven't many medications been tested in children?

A: In the past, medications were not studied in children because of ethical concerns about involving children in clinical trials. However, this created a new problem: lack of knowledge about the best treatments for children. In clinical settings where children are suffering from mental or behavioral disorders, medications are being prescribed at increasingly early ages. The FDA has been urging that products be appropriately studied in children and has offered incentives to drug manufacturers to carry out such testing. The NIH and the FDA are examining the issue of medication research in children and are developing new research approaches.
Q: Does the FDA approve medications for different age groups among children?

A: Yes. However, this is based on the data provided to the FDA by the drug manufacturer and the policies in effect at the time of approval. For example, Ritalin® is approved for children age 6 and older, whereas Dexedrine® is approved for children as young as 3. When Ritalin® was tested for efficacy by its manufacturer, only children age 6 and above were involved; therefore, age 6 was approved as the lower age limit for Ritalin®.

Source: National Institute of Mental Health

* Child and Adolescent Mental Health(Center for Mental Health Services) - http://mentalhealth.samhsa.gov/publications/allpubs/CA-0004/default.asp
* Understanding Your Teenager's Emotional Health(American Academy of Family Physicians) - http://familydoctor.org/online/famdocen/home/children/parents/parents-teens/590.printerview.html
Also available in Spanish http://familydoctor.org/online/famdoces/home/children/parents/parents-teens/590.printerview.html

Overviews

* Child and Adolescent Mental HealthFrom the National Institutes of Health(National Institute of Mental Health) - http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/index.shtml

Latest News

* Teen TV Time Tied to Adult Depression(02/02/2009, HealthDay) - http://www.nlm.nih.gov/medlineplus/news/fullstory_74940.html
* Weight Affects White, Hispanic Kids' Mental Health(01/27/2009, Reuters Health) - http://www.nlm.nih.gov/medlineplus/news/fullstory_74375.html
* Some Teens More Prone to Depression from Bullying(01/15/2009, Reuters Health) - http://www.nlm.nih.gov/medlineplus/news/fullstory_73842.html
* More News on Teen Mental Health http://www.nlm.nih.gov/medlineplus/alphanews_t.html#teenmentalhealth

Diagnosis/Symptoms

* Comprehensive Psychiatric Evaluation(American Academy of Child and Adolescent Psychiatry) - http://www.aacap.org/page.ww?name=Comprehensive+Psychiatric+Evaluation&section=Facts+for+Families
Also available in Spanish http://www.aacap.org/page.ww?section=Informacion+para+la+Familia&name=Evaluacion+Siquiatrica+Comprensiva+No.+52
* Teen Mental Health Problems: What Are the Warning Signs(Center for Mental Health Services) - http://mentalhealth.samhsa.gov/publications/allpubs/Ca-0023/default.asp

Treatment

* 11 Questions to Ask Before Psychiatric Hospitalization of Your Child or Adolescent(American Academy of Child and Adolescent Psychiatry) - http://www.aacap.org/page.ww?name=11+Questions+To+Ask+Before+Psychiatric+Hospitalization+Of+Your+Child+Or+Adolescent&section=Facts+for+Families
Also available in Spanish http://www.aacap.org/page.ww?section=Informacion+para+la+Familia&name=11+Preguntas+a+Hacerse+Antes+de+Comenzar+el+Tratamiento+Siquiatrico+de+su+Nino+o+Adolescente+No.+32
* Antidepressants for Children: Explore the Pros and Cons(Mayo Foundation for Medical Education and Research) - http://www.mayoclinic.com/print/antidepressants/MH00059/METHOD=print
* Continuum of Care for Children and Adolescents(American Academy of Child and Adolescent Psychiatry) - http://www.aacap.org/page.ww?name=The+Continuum+Of+Care+For+Children+And+Adolescents&section=Facts+for+Families
Also available in Spanish http://www.aacap.org/page.ww?section=Informacion+para+la+Familia&name=el+Cuidado+Continuo+%28%22Continuum+of+Care%22%29+Para+Ninos+y+Adolescentes+No.+42
* Going to a Therapist(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/therapist.html
* How Can I Stop Cutting?(Nemours Foundation) - http://kidshealth.org/teen/your_mind/problems/resisting_cutting.html
* Mental Health Provider Degrees and Certifications(Mayo Foundation for Medical Education and Research) - http://www.mayoclinic.com/print/mental-health/MH00077/METHOD=print
* Psychiatric Medications for Children and Adolescents Part III: Questions to Ask(American Academy of Child and Adolescent Psychiatry) - http://www.aacap.org/page.ww?name=Psychiatric+Medication+For+Children+And+Adolescents+Part+III%3A+Questions+To+Ask&section=Facts+for+Families
Also available in Spanish http://www.aacap.org/page.ww?section=Informacion+para+la+Familia&name=Medicamentos+Siquiatricos+para+Ninos+y+Adolescentes+Parte+III%3A+Preguntas+Acerca+de+Ellos+No.+51
* Psychotherapies for Children and Adolescents(American Academy of Child and Adolescent Psychiatry) - http://www.aacap.org/page.ww?name=Psychotherapies+For+Children+And+Adolescents&section=Facts+for+Families
Also available in Spanish http://www.aacap.org/page.ww?section=Informacion+para+la+Familia&name=La+Sicoterapia+Para+Ninos+y+Adolescentes+No.+86
* Questions and Answers on Antidepressant Use in Children, Adolescents, and Adults(Center for Drug Evaluation and Research) - http://www.fda.gov/cder/drug/antidepressants/QA20070502.htm

Coping

* Coping with Cliques(Nemours Foundation) - http://kidshealth.org/teen/your_mind/problems/cliques.html
* Dealing with a Health Condition(Nemours Foundation) - http://kidshealth.org/teen/your_mind/problems/deal_chronic_illness.html
Also available in Spanish http://kidshealth.org/teen/en_espanol/mente/deal_chronic_illness_esp.html
* Helping Children and Adolescents Cope with Violence and Disasters: What Parents Can DoFrom the National Institutes of Health(National Institute of Mental Health) - http://www.nimh.nih.gov/health/publications/helping-children-and-adolescents-cope-with-violence-and-disasters-what-parents-can-do.shtml
* Helping Your Children Navigate Their Teenage Years: A Guide for Parents(White House Council on Youth Violence) - http://mentalhealth.samhsa.gov/publications/allpubs/SVP-0013/default.asp

Specific Conditions

* Age-Related Reactions to a Traumatic Event(National Child Traumatic Stress Network) - Links to PDF - http://www.nctsn.org/nctsn_assets/pdfs/age_related_reactions.pdf
* Anxiety Disorders(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/anxiety.html
* Bipolar Disorder(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/bipolar.html
* Body Image and Self-Esteem(Nemours Foundation) - http://kidshealth.org/teen/your_mind/body_image/body_image.html
Also available in Spanish http://kidshealth.org/teen/en_espanol/mente/body_image_esp.html
* Cutting(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/cutting.html
Also available in Spanish http://kidshealth.org/teen/en_espanol/mente/cutting_esp.html
* Depression(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/depression.html
Also available in Spanish http://kidshealth.org/teen/en_espanol/mente/depression_esp.html
* Fears and Phobias(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/phobias.html
* Let's Talk Facts about Teen Suicide(American Psychiatric Association) - Links to PDF - http://healthyminds.org/factsheets/LTF-TeenSuicide.pdf
Also available in Spanish http://healthyminds.org/multimedia/teensuicideespanol.pdf
* Obsessive-Compulsive Disorder(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/ocd.html
* Posttraumatic Stress Disorder(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/ptsd.html
* Seasonal Affective Disorder(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/sad.html
Also available in Spanish http://kidshealth.org/teen/en_espanol/mente/sad_esp.html
* Social Phobia(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/social_phobia.html
Also available in Spanish http://kidshealth.org/teen/en_espanol/mente/social_phobia_esp.html
* Trichotillomania(Nemours Foundation) - http://kidshealth.org/teen/your_mind/mental_health/trichotillomania.html
* Understanding Child Traumatic Stress(National Child Traumatic Stress Network) - http://www.nctsn.org/nccts/nav.do?pid=ctr_aud_prnt_under
Also available in Spanish http://www.nctsn.org/nctsn_assets/pdfs/edu_materials/Entendamoselestrtraumtico.pdf

Related Issues

* BAM! Guide to Getting Along(Centers for Disease Control and Prevention) - http://www.bam.gov/sub_yourlife/yourlife_conflict.html
* Common Questions about Child and Teen Mental Health(American Psychiatric Association) - http://healthyminds.org/expertopinion20.cfm
* Homesickness(Nemours Foundation) - http://kidshealth.org/teen/your_mind/emotions/homesickness.html
* How Can I Deal with My Anger(Nemours Foundation) - http://kidshealth.org/teen/your_mind/emotions/deal_with_anger.html
Also available in Spanish http://kidshealth.org/teen/en_espanol/mente/deal_with_anger_esp.html
* How Can I Help a Friend Who Cuts?(Nemours Foundation) - http://kidshealth.org/teen/your_mind/problems/friend_cuts.html
Also available in Spanish http://kidshealth.org/teen/en_espanol/mente/friend_cuts_esp.html
* Partnering with Your Child's School: A Guide for Parents(HSC Foundation) - Links to PDF - http://www.hscfoundation.org/aboutus/publications/partnering_with_schools_english_guide.pdf
Also available in Spanish http://www.hscfoundation.org/aboutus/publications/partnering_with_schools_spanish_guide.pdf
* Peer Pressure(Nemours Foundation) - http://kidshealth.org/teen/your_mind/relationships/peer_pressure.html
Also available in Spanish http://kidshealth.org/teen/en_espanol/mente/peer_pressure_esp.html
* Talking to Kids about Mental Illnesses(American Academy of Child and Adolescent Psychiatry) - http://www.aacap.org/page.ww?name=Talking+To+Kids+About+Mental+Illnesses&section=Facts+for+Families
Also available in Spanish http://www.aacap.org/page.ww?section=Informacion+para+la+Familia&name=Cuando+se+Habla+a+los+Ninos+Acerca+de+las+Enfermedades+Mentales+No.+84
* When Your Child Needs Substance Abuse Treatment(Substance Abuse and Mental Health Services Administration) - http://www.family.samhsa.gov/get/treatment.aspx
* Why Am I in Such a Bad Mood?(Nemours Foundation) - http://kidshealth.org/teen/your_mind/emotions/bad_mood.html
Also available in Spanish http://kidshealth.org/teen/en_espanol/mente/bad_mood_esp.html

Clinical Trials

* ClinicalTrials.gov: Teen Mental HealthFrom the National Institutes of Health(National Institutes of Health) - http://clinicaltrials.gov/search/open/term=%22mental+health%22+AND+%28teen+OR+adolescents%29

Source: National Institute of Mental Health

A native of Pennsylvania, Dr. Speller attended undergraduate school at Haverford College in Haverford, Pennsylvania, receiving a B.A. in Philosophy. During his senior year Dr. Speller was a national finalist for the Rhodes Scholarship. He received an M.D. and M.B.A. from Harvard University, Cambridge, Massachusetts. He completed his post-graduate medical education and residency training in psychiatry at the Massachusetts General Hospital/McLean Division, Harvard Medical School. Dr. Speller is certified in adult and adolescent psychiatry and is licensed to practice medicine, psychiatry, and psychopharmacology in both Massachusetts and New Hampshire. Dr. Speller is a former member of the faculty of Harvard Medical School. Dr. Speller has over twenty years of professional experience. Dr. Speller is the co-founder and co-director of Psychopharmacology Associates of New England and the co-author of Dr. Jeff's and Dr. Tanya's Blog.To schedule an appointment please call: Dr. Speller or Dr. Korkosz at: (781) 641-0700.

A native of Massachusetts, Dr. Korkosz attended Smith College, Northampton, Massachusetts, receiving a B.A. in Physics. She completed the two-year Premedical Program at the Massachusetts Institute of Technology with a straight A average (GPA 4.0). She received the M.D. degree from Tufts University School of Medicine, Boston, Massachusetts. She completed her post-graduate medical education and training in psychiatry at Cambridge Hospital, Harvard Medical School and Saint Elizabeth's Hospital, National Institutes of Health. Dr. Korkosz is licensed to practice medicine, psychiatry, and psychopharmacology in both Massachusetts and New Hampshire. Dr. Korkosz is a former member of the faculty of Harvard Medical School. Dr. Korkosz has over twenty years of professional experience. Dr. Korkosz is the co-founder and co-director of Psychopharmacology Associates of New England and the co-author of Dr. Jeff's and Dr. Tanya's Blog.To schedule an appointment please call: Dr. Speller or Dr. Korkosz at: (781) 641-0700.

While a person can feel better after a good talk with a friend or relative, for moderate or severe psychiatric symptoms, this relief is only temporary. Being professionally evaluated and treated with appropriate psychiatric medication will often alleviate the psychiatric symptoms quickly and effectively. With more than more than forty years of combined professional experience, Dr. Jeffrey Speller and Dr. Tanya Joanne Korkosz are Harvard-trained physicians and psychiatrists who specialize in the use of psychiatric medication for adolescents (12 to 19) and adults. They are highly trained to evaluate and treat your psychiatric disorder with state-of-the-art psychiatric medication in a way that helps you to feel better quickly. We offer you an opportunity to face your difficulties constructively and confidently; freeing you to enjoy all the good things life has to offer.

Psychopharmacology Associates of New England is an independent psychiatric practice specializing in the use of state-of-the-art psychiatric medications in the treatment of adolescents (12 to 19) and adults who are challenged by attentions issues, depression, anxiety, social phobias, mood instability, and other psychiatric disorders. We are a team of licensed physicians and psychiatrists. Collectively, we have over 40 years of experience working with adolescent and adult patients. We offer comprehensive psychiatric evaluations, medication management, individual medication consultations, and second opinions about current medications regimes.

In addition to psychopharmacological services, we offer BrainSmart life coaching services that instructs individuals on how to manage their day-to-day lives in a way that promotes the healthy long-term functioning of their brain. With BrainSmart coaching individuals can often successfully reduce the doses of their medications, the number of medications prescribed, and the duration of their medication treatment. For parents of adolescent patients we also offer ParentSmart coaching to assist parents in better parenting their adolescent children who have psychiatric issues.

Psychopharmacology Associates of New England is conveniently located at 94 Pleasant Street in Arlington, Massachusetts. We are a self-pay practice that does not accept insurance. To schedule an appointment please call: Dr. Speller or Dr. Korkosz at: (781) 641-0700.

WHAT AGE GROUPS DO YOU TREAT?
Psychopharmacology Associates of New England provides state-of-the-art psychopharmacology services to adolescents (12 to 19) and adults.

ARE YOU ACCEPTING NEW PATIENTS?
Yes, Dr. Speller and Dr. Korkosz are both currently accepting new patients.

DO YOU ACCEPT INSURANCE?
We offer the services of practice on a fee-for-service, self-pay basis only. We do not accept insurance including ppo plans.

WHERE CAN I FIND MORE INFORMATION ABOUT DRS. SPELLER AND KORKOSZ?
For up-to-date information about Drs. Speller's and Dr. Korkosz's thoughts about mental health and mental illness, go to Dr. Jeff's and Dr. Tanya's Blog

Office Location:
94 Pleasant Street
Arlington, MA 02476

Phone: (781) 641-0700