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Race, Ethnicity, and the Medical "One-Liner": How Child and Adolescent Psychiatry Can Chart Its Own Antiracist Path Forward [Editorial]

Reliford, Aaron; Liu, Anni; Dhir, Sakshi; Schlechter, Alan
PMID: 37993762
ISSN: 1545-7230
CID: 5608602

Efficacy of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction for Depression Symptoms and Sleep-Wake Disruption in Older and Younger Adults: Secondary Age-Stratified Analysis of a Randomized Controlled Trial

Smagula, Stephen F; Gasperetti, Caitlin E; Buysse, Daniel J; Irwin, Michael R; Krafty, Robert T; Lim, Sarah E; Reynolds, Charles F; McCall, William V; Harvey, Allison G
OBJECTIVE:Perform a secondary analysis examining the efficacy of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) for depression symptom responses, and explore changes in potential target mechanisms. DESIGN/METHODS:Secondary analysis of a randomized controlled trial with convenience age subsamples (younger (20-49 year; n = 52) versus and older (50-71 years; n = 35)). SETTING/METHODS:Community mental health clinics. PARTICIPANTS/METHODS:Eighty-seven adults with serious mental illness. INTERVENTION/METHODS:TranS-C versus treatment as usual (TAU). MEASUREMENTS/METHODS:Outcomes were depression symptoms (Quick Inventory of Depression Symptoms), insomnia symptoms (Insomnia Severity Index), and objective sleep-wake rhythm measures (interdaily stability and relative amplitude). RESULTS: = 10.3, p = 0.001). There was a medium effect of TranS-C versus TAU on depression symptoms 6-months postintervention (Cohen's d = -0.40, 95% confidence interval (CI): -0.81, 0.01). In both age groups, there were large treatment effects on insomnia symptoms post-treatment (Cohen's d >0.90). In the older subsample, there were additionally medium treatment effects on post-treatment interdaily stability (Cohen's d = 0.60, 95% CI: -0.11, 1.61). Post-treatment reductions in insomnia symptoms correlated with depression symptom reduction 6-months later in the younger subsample (Spearman rho = 0.59, n = 20, p = 0.008). In older adults, postintervention increases in interdaily stability correlated with depression symptom reductions 6-months later (Spearman rho = -0.52, n = 15, p = 0.049). CONCLUSION/CONCLUSIONS:Confirmatory trials are needed, given the low age-specific sample sizes here, to determine if TranS -C's produces durable depression responses by increasing sleep-wake rhythm stability in older adults and improving insomnia symptoms in younger adults. BRIEF ARTICLE SUMMARY/UNASSIGNED:The authors evaluated preliminary efficacy of a behavioral intervention that targets sleep/sleep-wake rhythms, the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C), for depression symptoms in people with serious mental illness. TranS-C was associated with higher depression response rates than treatment as usual 6-months postintervention. The degree of depression symptom response 6-months later was related to the degree of treatment phase improvements in interdaily stability (in older adults) and reduction in insomnia severity (in younger adults). A pragmatic nonpharmacologic intervention, the Transdiagnostic Intervention for Sleep and Circadian Dysfunction, has preliminary efficacy for improving sleep-wake factors and depression symptoms.
PMID: 38040569
ISSN: 1545-7214
CID: 5616812

Youth Top Problems in an Acute Psychiatric Sample: Describing Consumer-Nominated Treatment Needs in an Adolescent Partial Hospital Setting

Chiu, Angela W; Desai, Payal; Skriner, Laura; Catarozoli, Corinne; Sullivan, Paul; Bennett, Shannon M
Given the wide range of diagnostic presentations treated in partial hospital programs, finding efficient ways to identify and measure progress on the chief concerns of consumers in these settings is important. The current study uses a self-administered version of the Top Problems Assessment to describe treatment targets identified by youth and their caregivers presenting for care at an adolescent partial hospital setting. Caregiver-youth agreement on these chief concerns upon admission and predictors of agreement were explored. About one-third (34.65%) of caregiver-youth pairs did not match on any target problems. Although anxiety and depression were the most commonly cited top problems in this sample, caregivers and youth exhibited disagreement on these domains. Treatment teams in acute care settings such as a partial hospital program can benefit from careful assessment surrounding the initial goals of treatment as youth and their caregivers may not agree on the referral problems upon entering a program.
PMID: 36074210
ISSN: 1573-3327
CID: 5337092

A state-of-the-art overview of candidate diagnostic biomarkers for Attention-deficit/hyperactivity disorder (ADHD)

Parlatini, Valeria; Bellato, Alessio; Gabellone, Alessandra; Margari, Lucia; Marzulli, Lucia; Matera, Emilia; Petruzzelli, Maria Giuseppina; Solmi, Marco; Correll, Christoph U; Cortese, Samuele
INTRODUCTION/UNASSIGNED:Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental conditions and is highly heterogeneous in terms of symptom profile, associated cognitive deficits, comorbidities, and outcomes. Heterogeneity may also affect the ability to recognize and diagnose this condition. The diagnosis of ADHD is primarily clinical but there are increasing research efforts aiming at identifying biomarkers that can aid the diagnosis. AREAS COVERED/UNASSIGNED:We first discuss the definition of biomarkers and the necessary research steps from discovery to implementation. We then provide a broad overview of research studies on candidate diagnostic biomarkers in ADHD encompassing genetic/epigenetic, biochemical, neuroimaging, neurophysiological and neuropsychological techniques. Finally, we critically appraise current limitations in the field and suggest possible ways forward. EXPERT OPINION/UNASSIGNED:Despite the large number of studies and variety of techniques used, no promising biomarkers have been identified so far. Clinical and biological heterogeneity as well as methodological limitations, including small sample size, lack of standardization, confounding factors, and poor replicability, have hampered progress in the field. Going forward, increased international collaborative efforts are warranted to support larger and more robustly designed studies, develop multimodal datasets to combine biomarkers and improve diagnostic accuracy, and ensure reproducibility and meaningful clinical translation.
PMID: 38506617
ISSN: 1744-8352
CID: 5640532

Parent-child emotion dynamics in families presenting for behavioral parent training: Is there a link with child behavior, parenting, and treatment outcome?

Fischer, Melanie S; Loiselle, Raelyn; Weber, Danielle M; Highlander, April; McCall, Madison P; Cain, Grace H; Forehand, Rex; Jones, Deborah J
OBJECTIVE:Behavioral parent training (BPT) is the standard of care for early onset behavior disorders (BDs), however, not all families benefit. Emotion regulation (ER) is one potential mechanism underlying BPT outcomes, yet there are challenges in capturing intra- and interpersonal aspects of emotion regulation within parent-child interactions that are central to BPT. This study examined how vocally encoded emotional arousal unfolds during parent-child interactions and how parents and children influence each other's arousal (Aim 1), the links between these emotion dynamics, child behavior, and parenting at baseline (Aim 2), and BPT outcome (Aim 3). METHOD/METHODS:₀) were modeled using actor-partner interdependence models (APIMs) and coupled linear oscillators (CLOs). RESULTS:₀ during the interaction was slowed for parents with more maladaptive parenting and children with more behavior problems at baseline. CONCLUSIONS:This preliminary characterization of f0 in families presenting for BPT provides insights into the emotion dynamics potentially underlying parenting behavior and child behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
PMID: 38512173
ISSN: 1939-2117
CID: 5640712

LovesCompany: evaluating the safety and feasibility of a mental health-focused online community for adolescents

Van Meter, Anna; Agrawal, Neha
PMID: 38504652
ISSN: 1728-0591
CID: 5640492

Common pitfalls, and how to avoid them, in child and adolescent psychopharmacology: Part I

Cortese, Samuele; Besag, Frank Mc; Clark, Bruce; Hollis, Chris; Kilgariff, Joe; Moreno, Carmen; Nicholls, Dasha; Wilkinson, Paul; Woodbury-Smith, Marc; Sharma, Aditya
As Faculty of the British Association for Psychopharmacology course on child and adolescent psychopharmacology, we present here what we deem are the most common pitfalls, and how to avoid them, in child and adolescent psychopharmacology. In this paper, we specifically addressed common pitfalls in the pharmacological treatment of attention-deficit/hyperactivity disorder, anxiety, bipolar disorder, depression, obsessive-compulsive disorder and related disorders, and tic disorder. Pitfalls in the treatment of other disorders are addressed in a separate paper (part II).
PMID: 38494948
ISSN: 1461-7285
CID: 5640022

Common pitfalls, and how to avoid them, in child and adolescent psychopharmacology: Part II

Cortese, Samuele; Besag, Frank Mc; Clark, Bruce; Hollis, Chris; Kilgariff, Joe; Moreno, Carmen; Nicholls, Dasha; Wilkinson, Paul; Woodbury-Smith, Marc; Sharma, Aditya
As Faculty of the British Association for Psychopharmacology course on child and adolescent psychopharmacology, we present here what we deem are the most common pitfalls, and how to avoid them, in child and adolescent psychopharmacology. In this paper, we specifically addressed common pitfalls in the pharmacological treatment of autism and intellectual disability, eating disorders, neuropsychiatric correlates of epilepsy, and psychosis. Pitfalls in relation to the treatment of other disorders are addressed in a separate paper (Part I).
PMID: 38494873
ISSN: 1461-7285
CID: 5640002

The power of many brains: Catalyzing neuropsychiatric discovery through open neuroimaging data and large-scale collaboration

Lu, Bin; Chen, Xiao; Xavier Castellanos, Francisco; Thompson, Paul M; Zuo, Xi-Nian; Zang, Yu-Feng; Yan, Chao-Gan
Recent advances in open neuroimaging data are enhancing our comprehension of neuropsychiatric disorders. By pooling images from various cohorts, statistical power has increased, enabling the detection of subtle abnormalities and robust associations, and fostering new research methods. Global collaborations in imaging have furthered our knowledge of the neurobiological foundations of brain disorders and aided in imaging-based prediction for more targeted treatment. Large-scale magnetic resonance imaging initiatives are driving innovation in analytics and supporting generalizable psychiatric studies. We also emphasize the significant role of big data in understanding neural mechanisms and in the early identification and precise treatment of neuropsychiatric disorders. However, challenges such as data harmonization across different sites, privacy protection, and effective data sharing must be addressed. With proper governance and open science practices, we conclude with a projection of how large-scale imaging resources and collaborations could revolutionize diagnosis, treatment selection, and outcome prediction, contributing to optimal brain health.
PMID: 38519398
ISSN: 2095-9281
CID: 5640992

Postacute Sequelae of SARS-CoV-2 in Children

Rao, Suchitra; Gross, Rachel S; Mohandas, Sindhu; Stein, Cheryl R; Case, Abigail; Dreyer, Benard; Pajor, Nathan M; Bunnell, H Timothy; Warburton, David; Berg, Elizabeth; Overdevest, Jonathan B; Gorelik, Mark; Milner, Joshua; Saxena, Sejal; Jhaveri, Ravi; Wood, John C; Rhee, Kyung E; Letts, Rebecca; Maughan, Christine; Guthe, Nick; Castro-Baucom, Leah; Stockwell, Melissa S
The coronavirus disease 2019 (COVID-19) pandemic has caused significant medical, social, and economic impacts globally, both in the short and long term. Although most individuals recover within a few days or weeks from an acute infection, some experience longer lasting effects. Data regarding the postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC) in children, or long COVID, are only just emerging in the literature. These symptoms and conditions may reflect persistent symptoms from acute infection (eg, cough, headaches, fatigue, and loss of taste and smell), new symptoms like dizziness, or exacerbation of underlying conditions. Children may develop conditions de novo, including postural orthostatic tachycardia syndrome, myalgic encephalomyelitis/chronic fatigue syndrome, autoimmune conditions and multisystem inflammatory syndrome in children. This state-of-the-art narrative review provides a summary of our current knowledge about PASC in children, including prevalence, epidemiology, risk factors, clinical characteristics, underlying mechanisms, and functional outcomes, as well as a conceptual framework for PASC based on the current National Institutes of Health definition. We highlight the pediatric components of the National Institutes of Health-funded Researching COVID to Enhance Recovery Initiative, which seeks to characterize the natural history, mechanisms, and long-term health effects of PASC in children and young adults to inform future treatment and prevention efforts. These initiatives include electronic health record cohorts, which offer rapid assessments at scale with geographical and demographic diversity, as well as longitudinal prospective observational cohorts, to estimate disease burden, illness trajectory, pathobiology, and clinical manifestations and outcomes.
PMID: 38321938
ISSN: 1098-4275
CID: 5632602