Case Study: Antimanic Effectiveness of Dextroamphetamine in a Brain-Injured Adolescent

Max, Jeffrey E.; Richards, Larry; Hamdan-Allen, Ghada

doi:10.1097/00004583-199504000-00014

Cited by 129 publications

(61 citation statements)

References 10 publications

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“…1–6,21 In addition, a number of specific considerations arise in treating child and adolescent populations that are not always primary factors in adults, including unique presentations of symptoms (eg, increased somatization, irritability, and agitation), functional impairment in school and social activities during developmentally important years, significantly increased risk for suicidality, and influences from the family system. Although research concerning overlapping anxiety and depressive symptoms in this population is available, more work is warranted to gain a better understanding of the unique factors involved in child and adolescent presentations.…”

Section: Conclusion and Implications For Future Researchmentioning

confidence: 99%

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Comorbid Anxiety and Depressive Symptoms in Children and Adolescents

Melton

Croarkin

Strawn

et al. 2016

Journal of Psychiatric Practice

140

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Background. A large and extensive body of research has examined comorbid anxiety and depression in adults. Children and adolescents also frequently present with comorbid anxiety and depression; however, research and treatment require unique environmental and neurodevelopmental considerations in children. As a result, our understanding of comorbid anxiety and depression in children and adolescents is limited. Objective. The goal of this systematic review was to examine current literature focused on comorbid anxiety and depression in children and adolescents. The review included theoretical conceptualizations as well as diagnostic, neurobiologic, prevention, and treatment considerations. In addition, a proposed algorithm for the treatment of comorbid anxiety and depression in children/adolescents is provided. Methods. This systematic literature review included three discrete searches in Ovid SP Medline, PsychInfo, and Pubmed. Results. The review included and synthesized 115 articles published between 1987 and 2015. The available evidence suggests that anxiety and depression are common in clinical populations of children and adolescents, and that comorbidity is likely underestimated in children and adolescents. Children and adolescents with comorbid anxiety and depression have unique presentations, greater symptom severity, and treatment resistance compared with those who have either disease in isolation. A dimensional approach may be necessary for the future development of diagnostic strategies and treatments for this population. Nascent neuroimaging work suggests that anxiety and depression each represents a distinct neurobiological phenotype. Conclusion. The literature that is currently available suggests that comorbid anxiety and depression is a common presentation in children and adolescents. This diagnostic picture underscores the importance of comprehensive dimensional assessments and multimodal evidence-based approaches given high disease severity. Future research on the neurobiology and treatment of these common clinical conditions is warranted.

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Section: Conclusion and Implications For Future Researchmentioning

confidence: 99%

“…These complex and dynamic factors warrant specific assessment and treatment considerations, 1 particularly since comorbidity of anxiety and depression in pediatric patients has received little attention. 1 – 6 …”

mentioning

confidence: 99%

Comorbid Anxiety and Depressive Symptoms in Children and Adolescents

Melton

Croarkin

Strawn

et al. 2016

Journal of Psychiatric Practice

140

View full text Add to dashboard Cite

show abstract

“…9 Similarly high rates of comorbid DBDs have been reported in epidemiological studies of children and adolescents with bipolar disorders; specifically, ADHD (6–29%), ODD and/or CD (6–50%). 10,11 …”

Section: Introductionmentioning

confidence: 99%

Examination of Disruptive Behavior Outcomes and Moderation in a Randomized Psychotherapy Trial for Mood Disorders

Boylan

MacPherson

Fristad

2013

Journal of the American Academy of Child & Adolescent Psych

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Objective Multi-family psychoeducational psychotherapy (MF-PEP) is an efficacious treatment for children with mood disorders. Given comorbidity between disruptive behaviors and mood disorders, this study examined associations among disruptive behaviors and impairment, impact of MF-PEP on disruptive behaviors, and whether disruptive behaviors affected treatment response of mood symptoms. Method Secondary analyses examined the randomized controlled trial of MF-PEP versus waitlist control (N = 165 children ages 8–11 with mood disorders and their parents). Comorbid behavioral diagnoses occurred in 97% of children. All participants continued treatment as usual. Results Greater degree of disruptive behaviors was associated with worse mood symptoms and impairment. Between-group analyses examining outcome of disruptive behaviors were non-significant. Within-group analyses and between-group effect sizes suggest MF-PEP was associated with reductions in attention-deficit/hyperactivity disorder (d = 0.39), oppositional defiant disorder (d = 0.30), and overall disruptive behavior symptoms (d = 0.30), but not conduct disorder symptoms. Baseline severity of disruptive behaviors did not impact treatment response of mood symptoms to MF-PEP. Conclusions MF-PEP is an effective intervention for children with mood disorders and provides some benefit for disruptive behaviors. Given that disruptive behavior severity does not impact children’s ability to experience improved mood symptoms, MF-PEP may be an important early intervention for children with comorbid mood and disruptive behavior disorders. Subsequent intervention targeting behavioral symptoms after improvement in mood may be beneficial. Studies examining treatment sequencing for children with comorbid mood and disruptive behavior disorders are needed. Clinical trial registration information—Family psychoeducation for children with mood disorders; http://www.clinicaltrials.gov; NCT00050557.

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“…Bipolar disorder (BD) is a common medical illness that causes extreme shifts in mood, energy, and functioning, and is estimated to affect 3% of adults in the United States alone1, but also can affect children and adolescents 2,3. Untreated, this disorder is associated with greater risk for the development of alcohol and substance abuse addictions, interpersonal and academic problems as well as suicide 2–4.…”

Section: Introductionmentioning

confidence: 99%

Combined Diffusion Tensor Imaging and Transverse Relaxometry in Early-Onset Bipolar Disorder

Gönenç¹,

Frazier²,

Crowley³

et al. 2010

Journal of the American Academy of Child & Adolescent Psych

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OBJECTIVE Transverse relaxation time (T2) imaging provides the opportunity to examine membrane fluidity, which can affect a number of cellular functions. The objective of the present work was to examine T2 abnormalities of children with unmodified DSM-IV-TR Bipolar disorder (BD) in bilateral cingulate-paracingulate (CPC) white matter. METHOD Twenty-one children and adolescents with BD and sixteen controls underwent magnetic resonance imaging at 1.5 Tesla and compared using a region-of-interest analysis. A post-hoc diffusion tensor imaging (DTI) analysis was also performed on selected subjects. RESULTS The T2 values were significantly decreased on the right hand side of the subjects with BD compared with controls. Hemispheric difference was also observed in BD group, with decreased T2 on the right hand side compared with the left. No significant difference was observed between left and right CPC T2 in controls. For those participants who had both T2 and DTI measurements, significant DTI differences were observed: On the left, fractional anisotropy was reduced and trace and radial diffusivity were increased, whereas on the right trace was increased and T2 was decreased in BD subjects compared with the controls. CONCLUSIONS Our findings suggest that the observed T2 difference is a reflection of cerebral blood flow rather than the alteration of the fluidity of cell membranes. It is possible that myelin damage happens on the left hand side in early onset BD in addition to changes in the blood flow. Prospective studies with larger numbers of subjects are warranted to further explore the relevance of the presented results.

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Case Study: Antimanic Effectiveness of Dextroamphetamine in a Brain-Injured Adolescent

Cited by 129 publications

References 10 publications

Comorbid Anxiety and Depressive Symptoms in Children and Adolescents

Comorbid Anxiety and Depressive Symptoms in Children and Adolescents

Examination of Disruptive Behavior Outcomes and Moderation in a Randomized Psychotherapy Trial for Mood Disorders

Combined Diffusion Tensor Imaging and Transverse Relaxometry in Early-Onset Bipolar Disorder

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