Faculty Bibliography

The development of antidepressant agents has been underway since their first use in the 1950s. Types of agents include monoamine oxidase inhibitors, tricyclic antidepressants (TCAs), and selective serotonin reuptake inhibitors (SSRIs). The utility of these agents in adult populations has led to multiple approved indications by the Food and Drug Administration. Although there are only two approved indications in pediatric age groups--major depressive disorder (MDD) and obsessive-compulsive disorder (OCD)--physicians have been prescribing antidepressants to children and adolescents in increasing numbers. In previous years, the TCAs had documented cardiotoxic potential, and there were several sudden unexpected deaths associated with their administration in youths. In December 2003, Great Britain's drug regulatory agency contraindicated the use of four SSRIs in childhood populations. This decision was based on the increased rates of developed suicidal thinking or gestures observed in the pooled data of >4,000 pediatric aged subjects treated with an antidepressant versus placebo. In October 2004, after careful consideration, the FDA placed a black box warning on all antidepressants, alerting clinicians to the potential of developing similar behaviors upon receiving these agents. These findings underscore the importance of using the increasing evidence base of well-designed, double-blind studies to guide the usage of these antidepressants in conditions where efficacy is established. This article reviews that body of literature in conditions such as MDD, OCD, attention-deficit/ hyperactivity disorder, selective mutism, and anxiety disorders. (journal abstract)

Clinically, benzodiazepines are used in adult populations much more frequently than in children and adolescents. There may be a number of reasons for this disparity including a dearth of well controlled clinical studies and the issue of dependence associated with long term use. However, over a ten year span there has been nearly a three fold increase in the use patterns for these agents in the child population. In open studies much of the literature has indicated potentially useful results, but these findings have not been replicated when more refined methodological studies have been conducted. The lack of encouraging results in these later studies may be attributable to a number of factors such as modest sample sizes and less than optimal patient selection. Nonetheless, with increasing prescriptions being written for these agents it is not clear what is compelling clinicians to use them. In this paper we will review the available literature on benzodiazepine use in the child and adolescent population, focusing primarily on psychiatric applications

The etiology and pathophysiology of body dysmorphic disorder (BDD) have not been delineated. The authors report a 24-year-old man who developed BDD at age 21 after an inflammatory brain process. Neuroimaging studies showed new atrophy in the frontotemporal region. The authors review cases from the literature with similar clinical features and neuroimaging findings as well as discuss the possible correlation between the neuroanatomic lesion and the clinical presentation of BDD in the patient

This study evaluated children's symptoms 3 and 9 months after the 1993 bombing of the World Trade Center, and the relationship between parent and child reactions when only the children had been in the building. Nine children who had been trapped in an elevator, 13 who had been on the observation deck, and 27 controls completed the Posttraumatic Stress Reaction Index and a Fear Inventory. Parents completed these measures about the children and comparable measures about themselves. Exposed children reported posttraumatic stress disorder (PTSD) symptoms and disaster-related fears; their parents reported experiencing PTSD symptoms. Only parents rated children's symptoms as decreasing significantly over time. Association between child symptoms and parent symptoms increased over time. Children's initial distress predicted parents' distress 9 months postdisaster

Examined postchemotherapy nausea and its relations to cancer patients' anxiety and cancer adaptation. 63 cancer patients (aged 17-70 yrs) were assessed for anxiety and nausea intensity during the period immediately prior to treatment to 2 days subsequently. Additional collected data included symptoms diaries concerning anxiety, nausea, vomiting, and other somatic effects. Results show that Ss with relatively higher levels of nausea reported higher levels of anxiety prior to chemotherapy and lower levels of adaptation to cancer. Findings suggest that psychological factors as well as pharmacological variables are related to nausea intensity. (PsycINFO Database Record (c) 2007 APA, all rights reserved)