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Pediatric mood disorders

Jonika Tannous, Henrique Amaral-Silva, Bo Cao, Mon-Ju Wu, Giovana B Zunta-Soares, Iram Kazimi, Cristian Zeni, Benson Mwangi, Jair C Soares
The hippocampus has been implicated in various mood disorders, with global volume deficits consistently found in patient populations. The hippocampus, however, consists of anatomically distinct subfields, and examination of specific subfield differences may elucidate the possible molecular mechanisms behind psychiatric pathologies. Indeed, adult studies have reported smaller hippocampal subfield volumes in regions within the cornu ammonis (CA1 and CA4), dentate gyrus (DG), and hippocampal tails in both patients with Major Depressive Disorder (MDD) and Bipolar Disorder (BD) compared to healthy controls...
March 12, 2018: Journal of Psychiatric Research
Oliviero Bruni, Stefania Sette, Marco Angriman, Emma Baumgartner, Lara Selvaggini, Cristina Belli, Raffaele Ferri
OBJECTIVES: To identify different profiles of pediatric insomnia, based on the most frequent clinical presentations (nocturnal awakenings, difficulty in falling asleep, nocturnal restlessness, early morning awakenings). STUDY DESIGN: A structured parent interview was conducted in 338 children (mean age 21.29 months, SD 10.56) referred by pediatricians because of insomnia resistant to behavioral approaches and common drug treatments. The aim was to assess the characteristics of insomnia in children, together with family sleep-related history...
March 15, 2018: Journal of Pediatrics
Raquel Langdon, Sharief Taraman
After sustaining a concussion or mild traumatic brain injury, headaches are one of the most common complaints. The pathophysiologic changes that occur in the setting of injury likely contribute to or cause posttraumatic headaches. Posttraumatic headaches often present as migraine or tension-type headaches. Unlike pain from other types of injuries, headaches following mild traumatic brain injury are more likely to persist. Preexisting conditions such as migraine and mood disorders may influence posttraumatic headache and complicate management...
February 1, 2018: Pediatric Annals
Kiran Maski, Judith Owens
PURPOSE OF REVIEW: This article provides an overview of the clinical features, diagnosis, and treatment of insomnia, restless legs syndrome, periodic limb movements of sleep, parasomnias, narcolepsy, and sleep-related breathing disorders among children and adolescents. RECENT FINDINGS: Pediatric presentations of sleep disorders differ from adult presentations, making diagnosis challenging. Specific clinical syndromes, such as cataplexy in children with narcolepsy type 1, can have an altogether different presentation compared to adult-onset symptoms, contributing to diagnostic delays and potential misdiagnoses...
February 2018: Continuum: Lifelong Learning in Neurology
Xiuqing Zhu, Jinqing Hu, Bin Sun, Shuhua Deng, Yuguan Wen, Weijia Chen, Chang Qiu, Dewei Shang, Ming Zhang
OBJECTIVES: This study aims to compare the prevalence of unlicensed and off-label use of antipsychotics among child and adolescent psychiatric outpatients with guidelines proposed by the China Food and Drug Administration (CFDA) and the U.S. Food and Drug Administration (FDA), and to identify factors associated with inconsistencies between the two regulations. METHODS: A retrospective analysis of 29,326 drug prescriptions for child and adolescent outpatients from the Affiliated Brain Hospital of Guangzhou Medical University was conducted...
January 16, 2018: Journal of Child and Adolescent Psychopharmacology
Moya Vandeleur, Lisa M Walter, David S Armstrong, Philip Robinson, Gillian M Nixon, Rosemary S C Horne
BACKGROUND: We aimed to investigate the relationship between sleep quality, mood and health-related quality of life (HRQOL) in children with CF and controls. METHODS: Children (7-12years) and adolescents (13-18years) with CF and controls completed sleep evaluation: overnight oximetry and 14days of actigraphy. Age-appropriate questionnaires assessed mood (Children's Depression Inventory; CDI or Beck's Depression Inventory), HRQOL (CF Questionnaire-Revised; CFQ-R or PedsQL), and sleepiness (Pediatric Daytime Sleepiness Scale)...
December 24, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Olof Rask, Klara Suneson, Eva Holmström, Beata Bäckström, Björn Axel Johansson
BACKGROUND: Comorbidity of bipolar disorder and obsessive-compulsive disorder is common in adolescence. Obsessive-compulsive disorder symptoms may be episodic and secondary to alterations in mood, and display specific features. Management of pediatric bipolar disorder-obsessive-compulsive disorder is challenging, as pharmacotherapy of obsessive-compulsive disorder may induce or exacerbate manic episodes and there is limited evidence of treatment efficacy. Electroconvulsive therapy is sparsely used in children and adolescents, but is documented to be a safe and efficacious intervention in adults with bipolar disorder...
December 12, 2017: Journal of Medical Case Reports
Michael Zech, Katharina Poustka, Sylvia Boesch, Riccardo Berutti, Tim M Strom, Wolfgang Grisold, Werner Poewe, Juliane Winkelmann
SOX5 encodes a conserved transcription factor implicated in cell-fate decisions of the neural lineage. SOX5 haploinsufficiency induced by larger genomic deletions has been linked to a recognizable pediatric syndrome combining developmental delay with intellectual disability, mild dysmorphism, inadequate behavior, and variable additional features including motor disturbances. In contrast to SOX5 -involving deletions, examples of pathogenic SOX5 small coding variations are sparse in the literature and have been described only in singular cases with phenotypic abnormalities akin to those seen in the SOX5 microdeletion syndrome...
2017: Case Reports in Genetics
Ekaterina Stepanova, Robert L Findling
Bipolar disorder is a debilitating illness that often leads to functional impairment when untreated. Monotherapy with mood stabilizers is preferable, although combination therapy may be necessary in refractory cases. Most studies focus on the use of lithium, anticonvulsants, and second-generation antipsychotics in the treatment of acute manic or depressive phases, as well as maintaining adequate response after the episode. More research is needed in the area of psychopharmacology of pediatric bipolar disorder to bridge the gap between clinical needs and the available data...
December 2017: Pediatric Clinics of North America
Mariela Mosheva, Stav Eyal, Omri Weisman, Reut Gilad, Yael Fishman, Ronnie Weinberger, Abraham Weizman, Doron Gothelf
22q11.2 deletion syndrome (22q11.2DS) is a relatively common genetic disorder. Due to improvement in pediatric care, affected individuals live into adulthood, some of whom marry or have committed relationships, and reproduce. The current study aimed to identify the factors that discriminate between married and unmarried adults with 22q11.2DS. In the presents study, 90 adults with 22q11.2DS (48 men/42 women), aged 29.8 ± 10.3 years, were included in the analysis. Psychiatric comorbidities, IQ score, and adaptive functioning were assessed using gold-standard diagnostic tools...
November 24, 2017: American Journal of Medical Genetics. Part A
D-L Zhang, X-M Liu, J-Q Zhao
Depression is one of the most debilitating worldwide mental illnesses, which is included in the Diagnostic and Statistical Manual of Mental Disorders. The main risk factors for the development of depression are female gender, early life stress family history of mood disorders, former anxiety disorders, substance abuse and life events. The present review article is focused on the various causative factors like childhood early life stress, cortisol or cortisol awakening response. The review would update readers with regards to the current view of factors responsible for pediatric depression, which in turn helps to plan better therapeutic approaches in the near future...
October 2017: European Review for Medical and Pharmacological Sciences
James C Gay, Bonnie T Zima, Tumaini R Coker, Stephanie K Doupnik, Matthew Hall, Jonathan Rodean, Margaret O'Neill, Rustin Morse, Kris P Rehm, Jay G Berry, Naomi S Bardach
OBJECTIVES: To determine the proportion of US children hospitalized for a primary mental health condition who are discharged to postacute care (PAC); whether PAC discharge is associated with demographic, clinical, and hospital characteristics; and whether PAC use varies by state. STUDY DESIGN: Retrospective cohort study of a nationally representative sample of US acute care hospitalizations for children ages 2-20 years with a primary mental health diagnosis, using the 2009 and 2012 Kids' Inpatient Databases...
November 18, 2017: Journal of Pediatrics
Sarah N Biggs, Knarik Tamanyan, Lisa M Walter, Aidan J Weichard, Margot J Davey, Gillian M Nixon, Rosemary S C Horne
OBJECTIVE: This study aimed to determine whether overweight and obesity increased the detrimental effects of pediatric sleep-disordered breathing (SDB) on cognition, behavior, mood, and quality of life. METHODS: Children and adolescents (8-16 years) with clinically diagnosed SDB were categorized into two groups: healthy weight (Body Mass Index (BMI) z-score <1.04, N = 11) and overweight/obese (BMI z-score ≥ 1.04, N = 10). Age-matched healthy weight, non-snoring controls (N = 25) were recruited from the community...
November 2017: Sleep Medicine
Eric T Dobson, Brooks R Keeshin, Anna M Wehry, Shannon N Saldaña, Lekha R Mukkamala, Michael T Sorter, Melissa P DelBello, Thomas J Blom, Jeffrey R Strawn
BACKGROUND: Despite the high prevalence of suicidality in psychiatrically hospitalized youth, its risk factors and impact on inpatient psychopharmacologic treatment are unknown. We identified characteristics associated with suicidality in psychiatrically hospitalized youth and determined the association of suicidality with subsequent psychopharmacologic interventions. METHODS: Medical records from consecutive psychiatric admissions to a large, acute care, urban, pediatric hospital were analyzed retrospectively (N = 1,309)...
November 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
Stacy Kurtz, Jack Levine, Marcy Safyer
Postpartum mood and anxiety disorders (PMADs) are a significant source of toxic stress for young children and can disrupt developing brain architecture resulting in long-lasting deleterious effects. Thus, screening for PMADs must be considered as an essential task of a pediatric primary care provider (PCP) and the pediatric medical home. Problems in parenting capacity in mothers with PMADs can lead to disorders in attachment and a range of other emotional and developmental challenges for a young child. Therefore, all PCP office visits with mothers should include surveillance as well as formal screening at regular, pre-determined intervals...
October 2017: Current Problems in Pediatric and Adolescent Health Care
Polina Umylny, Miguelina German, Alexa Lantiere
Postpartum psychiatric disorders represent a significant public health problem that has not been readily addressed, particularly in the primary care setting. As maternal mood and anxiety difficulties are associated with a number of adverse outcomes for the mother, her offspring and the family system, addressing these concerns during the perinatal period is of critical importance. Although researchers and clinicians have become increasingly aware of the problem, postpartum mood and anxiety disorders (PMADs) remain widely unrecognized and poorly understood by both patients and providers...
October 2017: Current Problems in Pediatric and Adolescent Health Care
Amy Lewis Gilbert, Casey Balio, Nerissa S Bauer
Postpartum depression (PPD), part of a larger spectrum of perinatal mood and anxiety disorders, affects up to 15% of women following the birth of an infant. Fathers may also be affected. PPD not only affects caregivers, but also impacts infants through mechanisms such as inadequate caregiver-infant interactions and non-adherence to safety practices. The negative impact on infants may extend across the life course through adulthood. This article seeks to move the needle toward universal screening for PPD using validated tools in pediatric primary care settings for new caregivers by making the legal and ethical case for this course of action in a manner that is both compelling and accessible for clinicians...
September 12, 2017: Current Problems in Pediatric and Adolescent Health Care
James G Waxmonsky, Susan D Mayes, Susan L Calhoun, Julio Fernandez-Mendoza, Daniel A Waschbusch, Brianna H Bendixsen, Edward O Bixler
BACKGROUND: Many youth experience persistent irritability and recurrent temper outbursts, conceptualized by DSM-5 as Disruptive Mood Dysregulation Disorder (DMDD). Sleep deprivation impairs emotion regulation which could increase rates of DMDD symptoms, especially in those with preexisting regulatory impairments, as seen with ADHD. However, there has been little examination of the relationship between chronic sleep problems and DMDD symptoms. METHODS: Associations between DMDD symptoms and sleep parameters in children were assessed using parent-report and objective measures of sleep in a general population sample (N = 665) and an ADHD sample (N = 784)...
September 2017: Sleep Medicine
Bader Alyahya, Marjorie Friesen, Bénédicte Nauche, Martin Laliberté
CONTEXT: Lamotrigine is a broad-spectrum anticonvulsant commonly used to treat seizure and bipolar mood disorders. Evidence from case series and retrospective studies indicate that lamotrigine overdose is usually benign. However, there are reported cases of cardiac arrest and mortality following lamotrigine overdose. We undertook a systematic review of the literature on lamotrigine overdoses to better understand the clinical severity, the relevance of serum concentrations, and therapeutic interventions for overdose...
September 1, 2017: Clinical Toxicology
Jeffrey R Strawn, Jeffrey A Mills, Gary J Cornwall, Sarah A Mossman, Sara T Varney, Brooks R Keeshin, Paul E Croarkin
OBJECTIVES: An increasing number of abandoned clinical trials have forestalled efforts to advance the evidence base for the treatment of mood and anxiety disorders in children and adolescents. With this in mind, we sought to present and validate a Bayesian approach for the reanalysis of summary data in abandoned clinical trials and to review and re-evaluate available pharmacokinetic, tolerability, and efficacy data from two large, randomized controlled trials of buspirone in pediatric patients with generalized anxiety disorder (GAD)...
February 2018: Journal of Child and Adolescent Psychopharmacology
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