c4c work in children’s mental health – Dr. Carmen Moreno


Mental health has become less of a taboo topic in recent years and is considered as a part of our overall health. This change is thanks in part to an increase in mental health research and discussion in media. While this has led to great progress in diagnosis and treatment for such disorders in adults, tailored treatments are still lacking for children in this area.

We had an interesting conversation with Dr. Carmen Moreño, who gave us a good overview of mental health disorders in children and what research is being undertaken. Carmen is a psychiatrist and Head of the Institute of Psychiatry and Mental Health (Instituto de Psiquiatría y Salud Mental) at the Hospital Gregorio Marañón in Madrid.

Expression of mental health disorders in children

There are some differences between the mental health disorders that manifest in children as compared with adults, Carmen says. Some disorders are more frequent in childhood or adolescence, while others are similar in both age groups but are expressed differently in children. This is important to understand as it can affect health care practitioners’ (and caretakers’) ability to correctly identify such disorders, as emphasized by Carmen: “We need to make sure that we can understand how the child expresses the symptoms and how we can see the signs of an illness in a child.” The most commonly identified mental health disorders in children are anxiety disorders (including phobias) and neurodevelopmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD).

Treatment options are not always studied in younger age groups

Psychotherapy can be a useful treatment option for some conditions, but medication may also be helpful, as these and other mental health disorders in children often have a biological component. “It’s so important to really understand the condition so that effective treatments can be discussed with the parents,” says Carmen. “They should have choices whenever possible.”

While some disorders have approved treatments for children, such as insomnia associated with autism spectrum disorders, other conditions have not been fully studied in children. Dr. Moreno explains, ” we may have to use medications that are used or studied for adults or for other conditions to treat a particular patient. That’s problematic.”

One challenge for providing treatment for children, as well as getting children into mental health trials, is that there may be hesitancy from parents who do not have experience with or around mental health issues. However, if there is a good, clear diagnosis and both the pros and cons of available treatments are discussed with the parents, they are generally willing to consider a treatment for their child.

Paediatric clinical trials for mental health conditions

Thanks to new requirements from regulatory agencies such as the European Medicines Agency (EMA) and the US Food and Drug Agency (US FDA), more clinical trials of mental health treatments for children are being conducted. More research is now incorporating trial designs developed specifically for paediatric studies, which is a huge step forward to getting the right data.  However, some paediatric trials still use clinical symptoms displayed by adults as reference points, which may not be appropriate if the symptoms in children are different.

Carmen says that it is important to “learn from physicians what conditions are being seen in the clinic to be treated with medication. These are the situations that need to be treated.”

c4c work in children’s mental health

c4c is a pan-European project facilitating paediatric clinical trials across Europe. c4c is quite active in the area of children’s mental health, with a number of ongoing projects. Carmen is part of an expert group on psychiatric disorders that provide advice for clinical trials in children. This expert group is also connecting with young people directly, organizing groups of young mental health patients to provide suggestions on paediatric mental health clinical trial design and the processes involved. A publication is in development discussing unmet needs in child and infant health conditions.

Do you want to learn more about this project and its work to improve children’s health? Read about it here.