AFP Clinical Answers
Behavior Issues, Skin Cancer, Adolescent Depression, Prostate Cancer, Deprescribing Antipsychotics
Am Fam Physician. 2019 Feb 1;99(3):152.
What are some general parenting strategies for addressing common child behavior issues?
Effective parent training models share common principles that engage parents as partners with physicians in assessing and managing behavior problems. They also focus on reinforcing positive behaviors, especially while reading aloud and during play; ignoring low-level provocative behaviors; and providing clear, consistent, and safe responses to unacceptable behaviors.
Who should be offered counseling to reduce their risk of skin cancer?
The U.S. Preventive Services Task Force (USPSTF) recommends counseling young adults, adolescents, children, and parents of young children about minimizing exposure to ultraviolet (UV) radiation for persons six months to 24 years of age with fair skin types to reduce risk of skin cancer. The USPSTF recommends that clinicians selectively offer counseling to adults older than 24 years with fair skin types about minimizing their exposure to UV radiation to reduce risk of skin cancer.
How should adolescent depression be managed according to the American Academy of Pediatrics?
After an adolescent is diagnosed with mild depression, physicians should consider active support and monitoring for six to eight weeks before initiating treatment. Only treatments that have been proven effective for depression, such as cognitive behavior therapy and selective serotonin reuptake inhibitors, should be recommended. Even after symptoms resolve, patients being treated for depression should be monitored monthly for six to 12 months and up to two years for those being treated after a recurrence.
What is the AAFP recommendation for prostate cancer screening in men?
The American Academy of Family Physicians (AAFP) does not recommend routine prostate-specific antigen (PSA)-based screening for prostate cancer. For men 55 to 69 years of age who are considering periodic prostate cancer screening, physicians should discuss the risks and benefits and engage in shared decision-making that enables an informed choice. The AAFP recommends against screening for prostate cancer in men 70 years and older.
When should you deprescribe antipsychotics for behavioral and psychological symptoms of dementia?
In collaboration with the patient and his or her caregivers, antipsychotics should be deprescribed for behavioral and psychological symptoms of dementia (which includes psychosis, aggression, or agitation) when treated for at least three months with good therapeutic response or when there is no response to treatment.
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