A Preliminary Study of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Mania Rating Scale for Children and Adolescents

Axelson, David; Birmaher, Boris; Brent, David A.; Wassick, Susan; Hoover, Christine; Bridge, Jeffrey A.; Ryan, Neal D.

doi:10.1089/104454603322724850

Cited by 278 publications

(211 citation statements)

References 19 publications

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“…Measures of mood symptoms, global functioning, and symptom severity and improvement were collected at each visit using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode (K-SADS)-Depression Rating Scale (KDRS; Chambers et al 1985;Ambrosini et al 1989), K-SADS-Mania Rating Scale (KMRS; Axelson et al 2003), CGAS, and the Clinical Global Impressions Severity and Improvement Scales (CGI-S, CGI-I: National Institute of Mental Health 1985), respectively.…”

Section: Methodsmentioning

confidence: 99%

Nutritional and Safety Outcomes from an Open-Label Micronutrient Intervention for Pediatric Bipolar Spectrum Disorders

Frazier

Gracious²,

Arnold³

et al. 2013

Journal of Child and Adolescent Psychopharmacology

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Objective: The purpose of this study was to report the safety, tolerability, and serum micronutrient concentrations and their correlations with mood changes from an 8 week pilot feasibility study of a 36 ingredient multinutrient supplement, EMPowerplus (EMP+), for pediatric bipolar spectrum disorders (BPSD). Methods: Ten children ages 6-12 received EMP + escalating from one to four capsules t.i.d., with four children increased to the maximum suggested dose, five capsules t.i.d. Outcome measures were micronutrient concentrations in serum and red blood cells, vital signs, body mass index (BMI), dietary intake (Food Frequency Questionnaire and 24 hour dietary recall interview), and mood and global functioning ratings. Results: Seven children (70%) completed the study. Three (30%) terminated early for tolerability and compliance issues. Adverse effects were mild and transient, and chiefly consisted of initial insomnia or gastrointestinal (GI) upset. No differences occurred in BMI ( p = 0.310) or waist-hip ratio (WHR; p = 0.674) pre-to postsupplementation. Four of the tested serum vitamin concentrations increased from pre-to postsupplementation: vitamin A-retinol, vitamin B6, vitamin E-a-tocopherol; and folate (all p < 0.05). The increase in serum 25-OH vitamin D approached significance ( p = 0.063). No differences were found in dietary intake pre-to postsupplementation, suggesting that blood nutrient level increases were caused by EMP + . Conclusions:In this open prospective study, short-term use of EMP + in children with BPSD appeared safe and welltolerated, with a side effect profile preferable to first-line psychotropic drugs for pediatric bipolar spectrum disorders. A double-blind, randomized clinical trial is feasible, appears safe, and is warranted by open-label clinical outcomes and plausible mechanisms of action, combined with documentation of increased serum concentrations of specific micronutrients.

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Section: Methodsmentioning

confidence: 99%

Nutritional and Safety Outcomes from an Open-Label Micronutrient Intervention for Pediatric Bipolar Spectrum Disorders

Frazier

Gracious²,

Arnold³

et al. 2013

Journal of Child and Adolescent Psychopharmacology

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“…The five symptom variables were rated using the K-SADS Depression and Mania Rating Scale (1 to 6) system (Kaufman et al, 1997;Axelson et al, 2003). These Likert-type items capture the frequency, duration, and severity of each symptom.…”

Section: Diagnosis and Symptomatology: Ksads-pl-mentioning

confidence: 99%

“…A subset of six cases was coded on each of these 12 variables by two independent raters. Interrater reliabilities, determined based on absolute agreement, are presented in Table 1.The five symptom variables were rated using the K-SADS Depression and Mania Rating Scale (1 to 6) system (Kaufman et al, 1997;Axelson et al, 2003). These Likert-type items capture the frequency, duration, and severity of each symptom.…”

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confidence: 99%

correlates of high expressed emotion attitudes among parents of bipolar adolescents

et al. 2008

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High expressed emotion (EE) attitudes among parents are associated with an increased likelihood of relapse among bipolar patients, but the origins of these attitudes are unclear. This study examined characteristics of bipolar disorder in adolescents that might be associated with high EE attitudes among parents. We hypothesized that an earlier onset of mood disorder and greater current illness severity would predict higher levels of criticism and emotional overinvolvement among parents. Demographic, diagnostic, and EE data were collected from interviews with parents of 44 bipolar adolescents (mean age 14.5 yrs.). Current illness severity and functioning were not associated with high-EE attitudes. Parents of girls, however, were more likely to be high in criticism than parents of boys. Parents of girls expressed more critical comments when the child had an adolescent compared to a childhood onset of bipolar disorder, whereas the reverse pattern was evident among parents of boys. We encourage prospective investigations of the developmental correlates of parental EE attitudes in larger, more heterogeneous samples of bipolar adolescents and children. KeywordsExpressed Emotion; Age at Onset; Bipolar Disorder; Gender; Developmental Psychopathology Early-onset bipolar disorder is characterized by severe and maladaptive shifts in mood, energy level, and behavior (Lewinsohn, Klein, and Seeley, 2000;Wilkinson, Taylor, & Holt, 2002). Symptoms of irritability, especially if phasic or episodic, are believed to be behavioral precursors of more classic bipolar symptoms in later childhood or adulthood (Fergus et al., 2003;Leibenluft, Cohen, Gorrindo, Brook, & Pine, 2006). Between 50% and 67% of bipolar patients experience illness onset before the age of 18, and 13% -28% before age 13 (Perlis et al., 2004).Factors that influence the onset of bipolar disorder may differ from factors that influence the course of the illness once diagnosed. Although heritability plays a central role in the etiology of the disease (Faraone, Glatt, & Tsuang, 2003), the family environment accompanying illness episodes may influence the frequency and timing of relapses. Bipolar adults who live with highly critical, hostile, or emotionally overinvolved (high expressed emotion, or high-EE) parents are significantly more likely to experience a relapse within one year after an acute episode than adult patients whose parents are low in EE (Miklowitz, Goldstein, Nuechterlein, Snyder, and Mintz, 1988;Yan, Hammen, Cohen, Daley, & Henry, 2004).Pediatric bipolar patients are usually under the direct care of their parents, and appear to be highly susceptible to variations in the emotional climate of the family (Jarbin, Grawe, & Hansson, 2000;Kim, Miklowitz, Biuckians, & Mullen, 2007;Fristad & Goldberg, 2003). However, few studies have examined the role of EE or other family environmental factors in the course of childhood bipolar disorder. Among patients with prepubertal or early adolescent bipolar disorder, Craney and Geller (2003) found that children wh...

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“…adolescents were interviewed using the Depression and Mania Rating Scales of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-DRS/MRS; Axelson et al, 2003;Kaufman et al, 1997). Interviewers administered the DRS and MRS to each adolescent and one parent in separate interviews.…”

Section: The Depression and Mania Rating Scales Of The K-sads (K-sadsmentioning

confidence: 99%

Behavioral activation, inhibition and mood symptoms in early-onset bipolar disorder

Biuckians

Miklowitz

Kim

2007

Journal of Affective Disorders

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Background-Hypomania/mania and depression are hypothesized to correspond to high and low expressions of behavioral activation system (BAS) activity, respectively, in bipolar individuals. In contrast, behavioral inhibition system (BIS) activity is hypothesized to regulate anxiety. The aim of the present study was to examine whether self-reported levels of BAS functioning in bipolar adolescents corresponded with levels of concurrent manic and depressive symptomatology. The secondary aim was to investigate whether self-reported BIS levels were associated with self-reported anxiety symptoms.

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A Preliminary Study of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Mania Rating Scale for Children and Adolescents

Abstract: The K-SADS-MRS shows promise as a rating scale for measuring manic symptom severity in pediatric bipolar patients.

Cited by 278 publications

References 19 publications

Nutritional and Safety Outcomes from an Open-Label Micronutrient Intervention for Pediatric Bipolar Spectrum Disorders

Nutritional and Safety Outcomes from an Open-Label Micronutrient Intervention for Pediatric Bipolar Spectrum Disorders

correlates of high expressed emotion attitudes among parents of bipolar adolescents

Behavioral activation, inhibition and mood symptoms in early-onset bipolar disorder

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