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Pediatric bipolar disorder

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https://www.readbyqxmd.com/read/29718601/diagnosing-bipolar-disorder-in-pediatric-patients
#1
Kiki D Chang
As many as 2 million youths in the US alone could have bipolar disorder. In this CME brief report, get up-to-date on common presentations of pediatric bipolar disorder, DSM-5 diagnostic criteria, and structured interviews and screening tools that can help you detect manic symptomatology.
March 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29706155/the-workforce-shortage-of-child-and-adolescent-psychiatrists-is-it-time-for-a-different-approach
#2
EDITORIAL
Robert L Findling, Ekaterina Stepanova
Psychiatric disorders affect a large number of children around the world. Recent data have reported that approximately 10% to 13% of children have a serious emotional disturbance with significant functional impairment, suggesting that at least 1 in 10 children require mental health services.1,2 Approximately half the adults with mental illness received their diagnosis before 15 years of age3 and close to three fourths of mental health disorders start by the mid-20s.4 Mental illnesses are associated with a large disease burden because these conditions lead to increases in morbidity, mortality, and financial costs...
May 2018: Journal of the American Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/29659209/improving-the-diagnosis-and-treatment-of-pediatric-bipolar-disorder
#3
Robert L Findling, Kiki D Chang
​​Reconsidering Insomnia as a Disorder Rather Than Just a Symptom in Psychiatric Practice Click to enlarge page Awareness of the prevalence and impact of bipolar disorder in pediatric patients has grown in recent years. Youths with this disorder are at risk for poor long-term outcomes, but with careful screening, clinicians may be able to detect early signs or subthreshold symptoms and provide a timely diagnosis and effective treatment. Although several pharmacologic options are available for patients aged 10 years and up, they differ in their safety and tolerability profiles...
March 27, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29651656/using-lithium-in-children-and-adolescents-with-bipolar-disorder-efficacy-tolerability-and-practical-considerations
#4
REVIEW
B Grant, J A Salpekar
Lithium has been an intriguing treatment option in psychiatry for over a century. While seemingly just a simple elemental compound, it has powerful treatment effects for both depression and bipolar disorder. The evidence base for treatment of pediatric bipolar disorder is relatively small, but, in recent years, additional clinical trial data have enabled lithium to re-emerge as a valuable and, in many cases, preferred treatment. Pharmacologically, lithium is complex, with varied effects at both intracellular and extracellular levels...
April 12, 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29564681/the-clinical-features-of-comorbid-pediatric-bipolar-disorder-in-children-with-autism-spectrum-disorder
#5
Dicle Sapmaz, Saliha Baykal, Seher Akbaş
The aim of this study was to describe clinical features of PBD comorbidity in children with ASD. Forty children with ASD and PBD aged 6-18 years, and 40 age- and sex-matched ASD subjects with no affective episodes were included in the study. Autism Behavior CheckList, Abberant Behavior CheckList, and Young Mania Rating Scale-Parent Version were completed. This study shows that PBD comorbidity in children with ASD involves a highly episodic course, with manic episodes, subsyndromal symptoms and interepisodic periods commonly being described in the manic symptom profile of these children...
March 21, 2018: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/29550609/hippocampal-subfield-volumes-in-children-and-adolescents-with-mood-disorders
#6
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
https://www.readbyqxmd.com/read/29505485/off-label-antidepressant-prescription-in-pediatric-outpatients-based-on-china-food-and-drug-administration-and-food-and-drug-administration-regulations-a-chinese-retrospective-study
#7
Shuhua Deng, Xiuqing Zhu, Bin Sun, Jinqing Hu, Dewei Shang, Weijia Chen, Haoyang Lu, Xiaojia Ni, Ming Zhang, Zhanzhang Wang, Yuguan Wen, Chang Qiu
The objective of this study was to evaluate the prevalence and relative risk of off-label prescription of antidepressants in Chinese pediatric outpatients according to China Food and Drug Administration (C-FDA) and USFDA regulations. Medical records of 18 459 pediatric outpatients were identified between 2013 and 2015. Patient characteristics, prevalence of off-label antidepressant prescriptions, and relative risk factors associated with off-label prescribing were analyzed. The results indicate that patients aged from 12 to 17 years account for 88...
May 2018: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29490377/lithium-treatment-in-children-and-adolescents
#8
Anne Duffy, Paul Grof
INTRODUCTION: There is a resurgence of interest in lithium treatment of bipolar disorders in part related to its unique anti-suicidal and neuroprotective effects. METHODS: This is a narrative review of key studies pertaining to the effectiveness and tolerability of lithium treatment in pediatric populations. RESULTS: Evidence supports that lithium is an effective and generally well-tolerated acute treatment for pediatric mania compared to placebo...
February 28, 2018: Pharmacopsychiatry
https://www.readbyqxmd.com/read/29396996/intranasal-ketamine-and-its-potential-role-in-cancer-related-pain
#9
REVIEW
Vinita Singh, Theresa W Gillespie, Robert Donald Harvey
Cancer-related pain continues to be a significant therapeutic challenge, made more difficult by contemporary opioid use and diversion concerns. Conventional treatment using a tiered approach of nonsteroidal antiinflammatory drugs (NSAIDs), opioids, and adjuvant agents is limited; and alternatives are needed for patients with rapidly progressing pain and those who develop hyperalgesia and tolerance to opioids. Ketamine, an N-methyl-d-aspartate (NMDA) selective antagonist, has historically been used for anesthesia in adult and pediatric populations but has also been investigated for depression, bipolar disorder, and general and postoperative pain management...
March 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29373050/diagnostic-accuracy-of-the-casi-4r-psychosis-subscale-for-children-evaluated-in-pediatric-outpatient-clinics
#10
Sabeen H Rizvi, Stephanie Salcedo, Eric A Youngstrom, Lindsey K Freeman, Kenneth D Gadow, Mary A Fristad, Boris Birmaher, Robert A Kowatch, Sarah M Horwitz, Thomas W Frazier, L Eugene Arnold, H Gerry Taylor, Robert L Findling
Diagnostic accuracy of the Diagnostic and Statistical Manual of Mental Disorders-oriented Child and Adolescent Symptom Inventory (CASI-4R) Psychotic Symptoms scale was tested using receiver operating characteristic analyses to identify clinically significant psychotic symptoms. Participants were new outpatients (N = 700), ages 6.0 to 12.9 years (M = 9.7, SD = 1.8) at 9 child outpatient mental health clinics, who participated in the Longitudinal Assessment of Manic Symptoms (LAMS) Study baseline assessment...
January 26, 2018: Journal of Clinical Child and Adolescent Psychology
https://www.readbyqxmd.com/read/29361347/preliminary-mapping-of-the-structural-effects-of-age-in-pediatric-bipolar-disorder-with-multimodal-mr-imaging
#11
Ryan P Cabeen, David H Laidlaw, Amanda Ruggieri, Daniel P Dickstein
This study investigates multimodal structural MR imaging biomarkers of development trajectories in pediatric bipolar disorder. T1-weighted and diffusion-weighted MR imaging was conducted to investigate cross-sectional group differences with age between typically developing controls (N = 26) and youths diagnosed with bipolar disorder (N = 26). Region-based analysis was used to examine cortical thickness of gray matter and diffusion tensor parameters in superficial white matter, and tractography-based analysis was used to examine deep white matter fiber bundles...
March 30, 2018: Psychiatry research. Neuroimaging
https://www.readbyqxmd.com/read/29228982/electroconvulsive-therapy-for-manic-state-with-mixed-and-psychotic-features-in-a-teenager-with-bipolar-disorder-and-comorbid-episodic-obsessive-compulsive-disorder-a-case-report
#12
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
https://www.readbyqxmd.com/read/29173781/psychopharmacology-of-bipolar-disorders-in-children-and-adolescents
#13
REVIEW
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
https://www.readbyqxmd.com/read/29170943/asenapine-treatment-in-pediatric-patients-with-bipolar-i-disorder-or-schizophrenia-a-review
#14
REVIEW
Ekaterina Stepanova, Bradley Grant, Robert L Findling
Asenapine, administered as a twice-daily (BID) sublingual tablet, is approved in the US as monotherapy for the acute treatment of manic and mixed episodes of bipolar I disorder in children and adolescents aged 10-17 years based on the positive results of one 3-week, double-blind, placebo-controlled study; the recommended dose is 2.5-10 mg BID. Although asenapine has been studied in pediatric patients with schizophrenia, it is not approved for this indication. Asenapine is not approved for pediatric use in bipolar I disorder or schizophrenia in other major markets...
November 23, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/29162345/postacute-care-after-pediatric-hospitalizations-for-a-primary-mental-health-condition
#15
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...
February 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29126592/pediatric-bipolar-disorder-a-case-presentation-and-discussion
#16
Gretchen Weeks, Regena Spratling
No abstract text is available yet for this article.
March 2018: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/29044718/child-and-family-focused-cognitive-behavioral-therapy-for-pediatric-bipolar-disorder-applications-for-suicide-prevention
#17
Sally M Weinstein, Rick A Cruz, Ashley R Isaia, Amy T Peters, Amy E West
Despite high rates of suicide ideation (SI) and behavior in youth with pediatric bipolar disorder (PBD), little work has examined how psychosocial interventions impact suicidality among this high-risk group. The current study examined SI outcomes in a randomized clinical trial comparing Child- and Family-Focused Cognitive Behavioral Therapy (CFF-CBT) for PBD versus psychotherapy treatment-as-usual (TAU). Although not designed for suicide prevention, CFF-CBT addresses child and family factors related to suicide risk and thus was hypothesized to generalize to the treatment of suicidality...
October 16, 2017: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/28992395/changes-in-white-matter-microstructure-predict-lithium-response-in-adolescents-with-bipolar-disorder
#18
Vivian Kafantaris, Linda Spritzer, Vishal Doshi, Ema Saito, Philip R Szeszko
OBJECTIVES: To investigate whether response to lithium treatment in pediatric bipolar disorder can be predicted by changes in white matter microstructure in key cortico-limbic tracts involved in emotion regulation. METHODS: Eighteen clinically referred lithium-naive patients (mean age 15.5 years) were administered clinical rating scales and diffusion tensor imaging (DTI) examinations at baseline and following 4 weeks of lithium treatment. Clinical ratings were repeated following 8 weeks of treatment...
November 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28944987/the-international-society-for-bipolar-disorders-task-force-report-on-pediatric-bipolar-disorder-knowledge-to-date-and-directions-for-future-research
#19
Benjamin I Goldstein, Boris Birmaher, Gabrielle A Carlson, Melissa P DelBello, Robert L Findling, Mary Fristad, Robert A Kowatch, David J Miklowitz, Fabiano G Nery, Guillermo Perez-Algorta, Anna Van Meter, Cristian P Zeni, Christoph U Correll, Hyo-Won Kim, Janet Wozniak, Kiki D Chang, Manon Hillegers, Eric A Youngstrom
OBJECTIVES: Over the past two decades, there has been tremendous growth in research regarding bipolar disorder (BD) among children and adolescents (ie, pediatric BD [PBD]). The primary purpose of this article is to distill the extant literature, dispel myths or exaggerated assertions in the field, and disseminate clinically relevant findings. METHODS: An international group of experts completed a selective review of the literature, emphasizing areas of consensus, identifying limitations and gaps in the literature, and highlighting future directions to mitigate these gaps...
November 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28922591/baseline-characteristics-and-early-response-at-week-1-predict-treatment-outcome-in-adolescents-with-bipolar-manic-or-mixed-episode-treated-with-olanzapine-results-from-a-3-week-randomized-placebo-controlled-trial
#20
Le Xiao, Stephen J Ganocy, Robert L Findling, Kiki Chang, Melissa P DelBello, John M Kane, Mauricio Tohen, Yu-Tao Xiang, Christoph U Correll
BACKGROUND: Early predictors of response and remission in pediatric mania are lacking, requiring further study. METHODS: This was a post hoc analysis of a 3-week, randomized, placebo-controlled trial of olanzapine conducted between November 2002 and May 2005 in 161 adolescents aged 13-17 years who were diagnosed with a DSM-IV acute manic or mixed episode of bipolar I disorder. Data from the olanzapine arm were analyzed to investigate the predictive power of early response or early nonresponse (≥25% or < 25% reduction in Young Mania Rating Scale [YMRS] score, respectively) at week 1 for ultimate response or nonresponse (≥ 50% or < 50% reduction in YMRS score, respectively) and for remission (YMRS total score ≤ 12 [standard definition] or ≤ 8 [stringent definition]) at week 3...
November 2017: Journal of Clinical Psychiatry
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