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140919EPA childabuse-smThe cost of abuse to a child lasts a lifetime, for individuals and our country as a whole.

In a study of 17,000 adults, those abused as children were more likely to become suicidal and have heart disease, cancer, chronic lung disease and liver disease; twice as likely to be smokers, severely obese and to become alcoholics; and three times as likely to develop a drug addiction.

Of children abused, 22 percent have learning disorders requiring special education, and 27 percent become delinquents, compared with 17 percent of children in the general population.

In 2007, Stanford University researchers found that children suffering post-traumatic stress disorder and exposure to severe trauma actually have smaller brains. Severe trauma includes parental homicide, sexual assault, sexual abuse, school shootings and ongoing community violence. Researchers found a nearly 9 percent reduction in the size of the hippocampus, a horseshoe-shaped sheet of neurons that controls memory and emotions.

A study conducted in 2009 showed an increased risk of sexually transmitted diseases in childhood abuse or neglect survivors tracked over time. In the same year, another study found, beyond the mental health impacts, childhood maltreatment reduces immune function, an effect that can linger long after the maltreatment has ended.

The cost to our country is approximately $124 billion annually, according to a recent report by the Centers for Disease Control and Prevention. And the estimated average lifetime cost per victim of nonfatal child maltreatment is approximately $210,000, in 2010 dollars.

That includes
  • $32,648 childhood health care
  • $10,530 adult medical care
  • $144,360 productivity losses
  • $7,728 child welfare
  • $6,747 criminal justice
  • $7,999 special education

Prevention of child abuse and neglect requires public education and a commitment from communities to provide emotional, social and financial support systems for families.

Research shows that investing in child abuse prevention programs yields a 19 to 1 savings over the long-term costs to society of child abuse. These programs include parent education classes, safety programs designed to make children less vulnerable targets for abuse and home visitation.

If your child is a victim of child abuse, or you need help as a parent, reach out to the Relief Nursery, a local non-profit committed to strengthening families and keeping our children safe.

Posted by on in News

140701 EPABlogImageThrive1A traditional pediatric practice helps lots of kids, but I am convinced it barely scratches the surface of what many children need. The physical health of a child is only a portion of wellness. The other key aspect is mental and behavioral/developmental health.

Eugene-Springfield has many wonderful mental and behavioral health caregivers and agencies for kids, but coordinating care with pediatricians is always a challenge. After nearly 15 years in practice here, I became frustrated with the limitations in my traditional practice to meet the needs of the children we serve.

So, one sunny autumn afternoon last year, I asked my favorite child psychologist, Dr. Jenny Mauro, to have coffee and talk about the exciting possibilities of pediatricians working side by side with child psychologists, developmental pediatricians and child psychiatrists.

If that happened, I could step out of my exam room and grab a specialist in child mental health and development to get a “curbside consult.” My families could meet a behavioral health care provider for a momentary “hello” and know whom they would meet during an upcoming visit. And scheduling the behavioral health visit at the same location would be a breeze.

Coordination of care would be so easy and even fun. Brown bag lunches with my doctors sitting around the same table with psychologists and other behavioral specialists would make it easy to discuss children in need of our team approach.

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140403eatingdissordersblog 1When I was sixteen, I started to diet. My exercise habits increased in intensity, and as the weight melted away, friends at school complimented me. I felt a surge of control over my body and in my life that became addictive. Soon, I was 45 pounds less than my regular weight. I was anorexic.

My parents knew something was very wrong, but eating disorders were not well understood by many physicians in the 1980s. The years I spent struggling with anorexia nervosa had a profound impact on my physical and emotional health as a young adult. But, gladly, I was one of the lucky patients with an eating disorder who made a full recovery. One of my many goals in becoming a pediatrician was to help youth affected by this potentially deadly set of diseases.

Eating disorders can negatively impact every organ system in the human body. Malnutrition leads to shrinking of cardiac muscle, with loss of proper contractility and electrical signaling in the heart. Brain cells affected by the acids that a starving body uses as fuel do not function well, leading to changes in cognitive ability, thought processes and behavior. Bone-density decreases can lead to easy injury and fractures. Attempts by the body to conserve critical organ function leads to turning down, or off, of less vital organs such as ovaries and the thyroid gland. Cold intolerance, blue hands and feet, hair loss and skin deterioration are common.

Emotional changes evident during eating disorders can include depression, anxiety, obsessive-compulsive behaviors, self-harming and suicidal tendencies.

Posted by on in News

130826epa postpartum1Postpartum depression may appear to be the baby blues at first, but the signs and symptoms are more intense and longer lasting. It’s not uncommon that new mothers are irritable, easily moved to tears and anxious, or have feelings of being overwhelmed.

But when the common symptoms and emotional upheaval of new motherhood stretch beyond the first weeks after giving birth, it’s time to take notice. They can eventually interfere with your ability to care for your baby and to handle other daily tasks.

Postpartum depression symptoms may include:

• Loss of appetite
• Insomnia
• Intense irritability and anger
• Overwhelming fatigue
• Loss of interest in sex
• Lack of joy in life
• Feelings of shame, guilt or inadequacy
• Severe mood swings
• Difficulty bonding with your baby
• Withdrawal from family and friends
• Thoughts of harming yourself or your baby

Individually, any one sign may be insignificant, especially if it’s mild. Postpartum depression is marked by an acute sense of anger, agitation or anxiety. Untreated, postpartum depression may last for many months or longer.

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EPA-childpsychoEugene Pediatrics is the first pediatric office in Lane County to have an on-site psychiatrist working alongside pediatricians. With child psychiatrist Dr. Jacqueline Amato, a board-certified psychiatrist, at the same location as your child’s physicians, we better meet the medical needs of your children.

Studies show that as many as 70 percent of primary care visits in the United States are related to psychosocial issues. Integrating primary and mental health care can improve the overall health of patients through the coordination of care between psychiatrists and primary care physicians.

If you are concerned about the behavioral health of your child, talk first to your child’s pediatrician about a referral. Pediatricians can often diagnose and treat common behavioral issues. Our pediatricians work with parents to decide whether it's best or needed to refer their child to Dr. Amato, or a psychologist.

Parents most commonly request a referral when they observe in their children extreme depression, anxiety or Attention Deficit Hyperactivity Disorder (ADHD).

Parents often view evidence of these behavioral issues as a defeat, as an example of bad parenting, or as a terrifying prospect, and they desperately want to help their child. You should consider having your child see a psychiatrist if:

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