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Pediatric mood disorders

M Lambert, V Niehaus, C Correll
This review aims to describe the importance of i) detecting individuals at clinical high-risk for psychosis (schizophrenia) or bipolar disorder, especially in children and adolescents, in order to enable early intervention, and ii) evaluating different intervention strategies, especially pharmacotherapy, during the subsyndromal or "prodromal" stages of these severe and often debilitating disorders. The different approaches regarding the psychotic and bipolar clinical high-risk state are discussed, including reasons and evidence for early (pharmacological) intervention and risks of treatment vs...
October 13, 2016: Pharmacopsychiatry
Terry Lee
The diagnosis of bipolar disorder (BD) in youth is confusing and controversial. Controversy notwithstanding, youth diagnosed with BD have high behavioral health needs and are at elevated risk for problematic long-term psychosocial functioning and complex psychiatric medication regimens. Pediatricians and other primary care providers (PCPs) can play an important role in the assessment and treatment of youth diagnosed with BD and the recently created and also controversial diagnosis of disruptive mood dysregulation disorder (DMDD)...
October 1, 2016: Pediatric Annals
Amy E Green, John Ferrand, Gregory A Aarons
OBJECTIVE: The current study examines parent/caregiver and youth report of psychosocial and health-related functioning among youth served in public systems of care, with mood disorder only, comorbid mood disorder and chronic physical illness, and chronic physical illness only. METHOD: Participants were 539 youths (ages, 11-18; 64% male) with a mood disorder and/or chronic physical illness enrolled in a study of public sector care. Presence of mood disorder was based on youth report on the Diagnostic Interview Schedule for Children-IV...
October 2016: Journal of Developmental and Behavioral Pediatrics: JDBP
Robert A Kowatch
Diagnosing a pediatric patient with bipolar disorder can pose a challenge for clinicians. Children typically do not present with the full criteria for a mood episode and may have symptoms of other disorders such as attention-deficit/hyperactivity disorder, oppositional defiant disorder, anxiety disorders, and other mood disorders, which may complicate the diagnostic process. By diligently interviewing parents and children about behaviors, thoroughly reviewing family histories, and systematically ruling out other disorders, clinicians can provide an accurate diagnosis for their pediatric patients...
2016: Journal of Clinical Psychiatry
Heather A MacPherson, Sally M Weinstein, David B Henry, Amy E West
Mediation analyses can identify mechanisms of change in Cognitive-Behavioral Therapy (CBT). However, few studies have analyzed mediators of CBT for youth internalizing disorders; only one trial evaluated treatment mechanisms for youth with mixed mood diagnoses. This study evaluated mediators in the randomized trial of Child- and Family-Focused CBT (CFF-CBT) versus Treatment As Usual (TAU) for pediatric bipolar disorder (PBD), adjunctive to pharmacotherapy. Sixty-nine children ages 7-13 with PBD were randomly assigned to CFF-CBT or TAU...
October 2016: Behaviour Research and Therapy
Melissa Mulraney, Nardia Zendarski, Fiona Mensah, Harriet Hiscock, Emma Sciberras
OBJECTIVE: Irritable mood is common in children with attention-deficit/hyperactivity disorder. Research to date has primarily comprised cross-sectional studies; thus, little is known about the antecedents of irritability. Furthermore, existing cross-sectional studies generally focus on the association between irritability and comorbidities and do not examine broader aspects of functioning. Finally, previous research has neglected to include child-report of irritability. This study aimed to address these gaps using data from a longitudinal study of children with attention-deficit/hyperactivity disorder...
August 11, 2016: Australian and New Zealand Journal of Psychiatry
Mariely Hernandez, Ciro Marangoni, Marie C Grant, Jezelle Estrada, Gianni L Faedda
OBJECTIVES: Objectives: Early psychopathology in children diagnosed with Bipolar Disorder (BD) remains poorly characterized. Parental retrospective reports provide helpful details on the earliest manifestations and their evolution over time. These symptoms occur early in the course of BD, often before a formal diagnosis is made and/or treatment is implemented, and are of great importance to early recognition and prevention. METHODS: Parents of pre-pubertal children and adolescents with DSM-IV diagnoses of BD attending an outpatient mood disorders clinic provided retrospective ratings of 37 symptoms of child psychopathology...
August 1, 2016: Current Neuropharmacology
Usman Hameed, Cheryl A Dellasega
The goal of this article is to describe the concept of irritability in children and youth, which has been revisited in the DSM-5. Traditionally, this behavior has been more commonly associated with mood disorders, which may account for the rising incidence of bipolar disorder diagnosis and overuse of mood-stabilizing medications in pediatric patients. While not predictive of mania, persistent nonepisodic irritability, if undetected, may escalate to violent behavior with potentially serious outcomes. It is therefore important to educate clinicians about how to accurately assess irritability in pediatric patients...
2016: Primary Care Companion to CNS Disorders
Priscilla Caetano Guerra, Nilton Ferraro Oliveira, Maria Teresa de Sande E Lemos Ramos Ascensão Terreri, Claudio Arnaldo Len
OBJECTIVE: To assess sleep, quality of life and mood of nursing professionals of pediatric intensive care units. METHOD: Quantitative, cross-sectional and descriptive study. Professionals grouped by morning, afternoon and evening shifts were assessed by means of the instruments: Morningness-Eveningness Questionnaire; Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Generic questionnaire for the assessment of quality of life (SF-36); Beck Depression Inventory; Beck Anxiety Inventory; State-Trait Anxiety Inventory...
April 2016: Revista da Escola de Enfermagem da U S P
A Mestanikova, I Ondrejka, M Mestanik, I Hrtanek, E Snircova, I Tonhajzerova
Major depressive disorder (MDD) is characterized by dysphoric mood, which may be accompanied by suicidal ideation. It is supposed that MDD is associated with dysfunction of the autonomic nervous system, but studies in pediatric patients are rare. Therefore, we aimed to study the relationship between MDD and autonomic regulation in adolescence using the electrodermal activity as an index of sympathetic cholinergic control. We examined 25 adolescents suffering from MDD without comorbidities and prior to pharmacotherapy (13 girls, mean age 14...
2016: Advances in Experimental Medicine and Biology
Giulia Serra, Mai Uchida, Claudia Battaglia, Maria Pia Casini, Lavinia De Chiara, Joseph Biederman, Stefano Vicari, Janet Wozniak
Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania...
June 6, 2016: Current Neuropharmacology
Bernardo C Gomes, Ana Kleinman, Andrea Ferrari Carvalho, Tatiana Couto F Pereira, Ana Paola Gurgel, Beny Lafer, Geraldo F Busatto, Sheila C Caetano, Cristiana Castanho de Almeida Rocca
BACKGROUND: There have been few studies investigating quality of life (QoL) in pediatric bipolar disorder (BD) patients and none comparing it with that observed in unaffected offspring of parents with BD and healthy controls. METHODS: The self-report Youth Quality of Life Instrument-Research version (YQoL-R) was administered in 26 pediatric BD patients, 17 unaffected offspring of parents with BD, and 24 individuals with no history of DSM-IV Axis I psychiatric disorders...
September 15, 2016: Journal of Affective Disorders
Shinobu Watanabe-Galloway, Rachel Valleley, Katherine Rieke, Brittany Corley
Behavioral health diagnoses and service use may differ based on rurality. The purpose of this study was to examine the patterns of mental disorder diagnoses of urban, rural, and remote pediatric populations. This retrospective study used electronic medical records from integrated behavioral health clinics in Nebraska from 2012 to 2013. Bivariate and multivariable models were used to examine the differences in diagnoses. Adolescents with attention deficit and related disorders were more likely to be male, younger, have public insurance and rural/remote residents...
June 1, 2016: Community Mental Health Journal
Susan L Calhoun, Julio Fernandez-Mendoza, Alexandros N Vgontzas, Susan D Mayes, Duanping Liao, Edward O Bixler
Based on previous studies reporting on the association of objective sleep duration and physiologic changes (i.e., increased cortisol) in children, we examined the role of objective sleep duration on differentiating behavioral profiles in children with insomnia symptoms. Seven hundred children (ages 5-12, 47.8% male) from the Penn State Child Cohort underwent a nine-hour polysomnography and parent completed Pediatric Behavior Scale. Insomnia symptoms were defined as parent report of difficulty falling and/or staying asleep, sleep disordered breathing as an AHI of ≥1, and objective short sleep duration as a total sleep time < 7...
June 1, 2016: Journal of Abnormal Child Psychology
David J Miklowitz, Larissa C Portnoff, Casey C Armstrong, Danielle Keenan-Miller, Elizabeth C Breen, Keely A Muscatell, Naomi I Eisenberger, Michael R Irwin
UNLABELLED: Adults with bipolar disorder (BD) and major depressive disorder (MDD) have higher circulating levels of proinflammatory cytokines than healthy controls. However, it is not known whether pediatric-onset patients with BD or MDD show increases in levels of inflammation or activation of nuclear factor kappa B (NF-κB), a key transcription factor in inflammatory signaling. Circulating levels of inflammatory cytokines, as well as spontaneous and stimulated levels of activated NF-κB in total peripheral blood mononuclear cells, monocytes and lymphocytes were measured in adolescents with BD (n=18), MDD (n=13), or no psychiatric history (n=20)...
July 30, 2016: Psychiatry Research
Rashmi Tiwari, Vivek Agarwal, Amit Arya, Pawan Kumar Gupta, Pooja Mahour
BACKGROUND: Children with chronic non-episodic irritability were frequently diagnosed as suffering from pediatric bipolar disorder. Therefore in DSM-5 a new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) was included for such children. AIMS: This study aimed to identify DMDD in children and adolescents in Indian child and adolescent psychiatry clinic and elicit its phenomenology and co-morbidities. METHODS: Children of 6-16 years, presenting with irritability for more than one year were assessed using DSM 5 diagnostic criteria to make a diagnosis of DMDD...
June 2016: Asian Journal of Psychiatry
Diana T Noller
This article outlines diagnostic criteria and features of the newly established diagnosis disruptive mood dysregulation disorder (DMDD), and discusses how this disorder differs from bipolar disorder in childhood. The chronic, severe, nonepisodic irritability seen in patients with DMDD contrasts with the characteristic episodic mood swing symptoms of bipolar disorder. Differentiating between the two diagnoses is important in regard to prognostic and treatment considerations, as children with DMDD are more likely to develop a mood disorder later in life rather than to develop classic bipolar disorder...
June 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Francesca Letizia Rocca, Elena Finotti, Fabio Pizza, Francesca Ingravallo, Michela Gatta, Oliviero Bruni, Giuseppe Plazzi
STUDY OBJECTIVES: To investigate behavioral aspects and quality of life in children and adolescents with type 1 narcolepsy (NT1). METHODS: We performed a case-control study comparing 29 patients with NT1 versus sex- and age-matched patients with idiopathic epilepsy (n = 39) and healthy controls (n = 39). Behavior and quality of life were evaluated by self-administered questionnaires (Child Behavior Checklist, Pediatric Quality of Life Inventory). Patient groups were contrasted and scale results were correlated with clinical and polysomnographic parameters, and cerebrospinal fluid hypocretin-1 levels...
2016: Sleep
Jennifer L Rosenthal, Joan F Hilton, Ronald J Teufel, Patrick S Romano, Sunitha V Kaiser, Megumi J Okumura
BACKGROUND AND OBJECTIVE: The hospital-to-hospital transfer of pediatric patients is a common practice that is poorly understood. To better understand this practice, we examined a national database to profile pediatric interfacility transfers. METHODS: We used the 2012 Kids' Inpatient Database to examine characteristics of hospitalized pediatric patients (<21 years; excluding pregnancy diagnoses) with a transfer admission source. We performed descriptive statistics to compare patient characteristics, utilization, and hospital characteristics between those admitted by transfer versus routine admission...
June 2016: Hospital Pediatrics
Lisa L Giles, D Richard Martini
Most prescriptions for psychotropic medications are written by primary care physicians, yet pediatricians, many of whom are teaching residents and medical students about pediatric psychopharmacology, often feel inadequately trained to treat mental health concerns. Over the past several decades, the number, size, and quality of psychopharmacologic studies in youth has greatly increased. Here we review the current evidence for efficacy and safety of each of the major pharmacologic drug classes in youth (psychostimulants, antidepressants, mood stabilizers, and antipsychotics)...
August 2016: Academic Pediatrics
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