Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Child and Adolescent Psychiatry
Total Results:
11429
Genome-wide analyses identify 30 loci associated with obsessive-compulsive disorder
Obsessive-compulsive disorder (OCD) affects ~1% of children and adults and is partly caused by genetic factors. We conducted a genome-wide association study (GWAS) meta-analysis combining 53,660 OCD cases and 2,044,417 controls and identified 30 independent genome-wide significant loci. Gene-based approaches identified 249 potential effector genes for OCD, with 25 of these classified as the most likely causal candidates, including WDR6, DALRD3 and CTNND1 and multiple genes in the major histocompatibility complex (MHC) region. We estimated that ~11,500 genetic variants explained 90% of OCD genetic heritability. OCD genetic risk was associated with excitatory neurons in the hippocampus and the cortex, along with D1 and D2 type dopamine receptor-containing medium spiny neurons. OCD genetic risk was shared with 65 of 112 additional phenotypes, including all the psychiatric disorders we examined. In particular, OCD shared genetic risk with anxiety, depression, anorexia nervosa and Tourette syndrome and was negatively associated with inflammatory bowel diseases, educational attainment and body mass index.
PMID: 40360802
ISSN: 1546-1718
CID: 5844232
Journal of the American Academy of Child and Adolescent Psychiatry. 2025:64(6):699-709.DOI: 10.1016/j.jaac.2024.06.004
Implementing a Uniform Outcome Measurement Approach for Early Interventions of Autism Spectrum Disorders
OBJECTIVE:Naturalistic developmental behavioral interventions for children with autism spectrum disorder show evidence for effectiveness for specific social communication targets such as joint attention or engagement. However, combining evidence from different studies and comparing intervention effects across those studies have not been feasible due to lack of a standardized outcome measure of broader social communication skills that can be applied uniformly across trials. This investigation examined the usefulness of the Brief Observation of Social Communication Change (BOSCC) as a common outcome measure of general social communication skills based on secondary analyses of data obtained from previously conducted randomized controlled trials of 3 intervention models, Early Social Intervention (ESI), Early Start Denver Model (ESDM) and Joint Attention Symbolic Play Engagement and Regulation (JASPER). METHOD/METHODS:The subset of datasets from the 3 randomized controlled trials was created to examine differences in the BOSCC scores between intervention and control groups over the course of the interventions. RESULTS:Based on 582 videos from 207 caregiver-child dyads, the BOSCC noted significant differences between intervention vs control groups in broad social communication skills within 2 of the 3 intervention models, which were longer in duration and focused on a broad range of developmental skills. CONCLUSION/CONCLUSIONS:The BOSCC offers the potential to take a uniform measurement approach across different intervention models to capture the effect of intervention on general social communication skills but may not pick up the effects of some brief interventions targeting proximal outcomes. CLINICAL TRIAL REGISTRATION INFORMATION/BACKGROUND:Comparing Parent-Implemented Interventions for Toddlers With Autism Spectrum Disorders; https://www. CLINICALTRIALS/RESULTS:gov/; NCT00760812. Intensive Intervention for Toddlers With Autism (EARLY STEPS); https://www. CLINICALTRIALS/RESULTS:gov/; NCT00698997. Social and Communication Outcomes for Young Children With Autism; https://www. CLINICALTRIALS/RESULTS:gov/; NCT00953095.
PMID: 38964630
ISSN: 1527-5418
CID: 5695782
Global psychiatrists' opinions about hikikomori from biopsychosocial perspectives: International case vignette survey
AIM/UNASSIGNED:(prolonged social isolation), and how they formulate and treat such cases. METHODS/UNASSIGNED:case vignette was sent to psychiatrists of 34 countries around the world. Participants rated for the vignette: frequency of similar cases in one's practicing country; and aspects of formulation, diagnosis, suicide risk, and treatment plan. RESULTS/UNASSIGNED:In total, 344 complete responses from 34 countries were returned. Eight countries/areas had 10 or more respondents: Japan (61), South Korea (54), Nepal (48), Iran (40), Thailand (32), India (23), Hong Kong (12), and UK (10); the remainder were placed in the "others" group (64). Respondents from all countries except Thailand felt that similar cases were seen. Diverse patterns of response were obtained regarding formulation and treatment. Japan, South Korea, and "others" favored psychosocial aspects in the formulation, while Iran, Nepal, and India favored biological factors. Most respondents felt the case could be treated by an outpatient visit, while others preferred hospitalization. Psychotherapy was rated highly as an intervention; Iran, South Korea, and "others" also rated pharmacotherapy highly. CONCLUSION/UNASSIGNED:patients.
PMCID:12099068
PMID: 40416471
ISSN: 2769-2558
CID: 5855052
Journal of the American Academy of Child and Adolescent Psychiatry. 2025.DOI: 10.1016/j.jaac.2025.05.013
Editorial: Physical Exercise as a Treatment for Anxiety and Depression in Children and Adolescents? The Devil is in the Details [Editorial]
PMID: 40449582
ISSN: 1527-5418
CID: 5854642
Inpatient Child and Adolescent Psychiatry Youth with Autism and/or Intellectual Disabilities: Clinical Characteristics and Considerations
Children and adolescents with autism spectrum disorder and/or an intellectual disability (ASD/ID) are psychiatrically hospitalized at disproportionately higher rates than youth without ASD/ID. Despite this, few studies have compared the clinical courses of youth with and without ASD/ID in inpatient (IP) child and adolescent psychiatry (CAP) settings. This study used a cross-sectional design of all youth (M = 14.0 years, SD = 2.6 years) admitted to an urban IP unit between 2018 and 2021 to examine differences between ASD/ID and non-ASD/ID youth across dimensions of sociodemographic and psychiatric history and clinical course. 1101 Patients were included in the study and 170 (15.4%) had a history of ASD/ID. ASD/ID youth were more likely to be younger, be male, have histories of violence, and on average have more prior hospitalizations and existing psychotropic prescriptions than their non-ASD/ID counterparts. ASD/ID youth were less likely than their non-ASD/ID peers to be admitted for suicidality and more likely to be admitted for aggression; they had longer average lengths of stay, received more IP emergency medications for agitation, and experienced greater polypharmacy at discharge. The IP psychiatric clinical course of ASD/ID youth differs from that of non-ASD/ID youth, suggesting that ASD/ID youth often present to IP settings with externalizing symptoms. Findings highlight the importance of clinical strategies tailored to the unique needs of ASD/ID youth to improve their care in general IP CAP settings.
PMID: 40437185
ISSN: 1573-3432
CID: 5854652
Characterizing Long COVID Symptoms During Early Childhood
IMPORTANCE:Recent studies have identified characteristic symptom patterns of long COVID (LC) in adults and children older than 5 years. However, LC remains poorly characterized in early childhood. This knowledge gap limits efforts to identify, care for, and prevent LC in this vulnerable population. OBJECTIVES:To identify symptoms that had the greatest difference in frequency comparing children with a history of SARS-CoV-2 infection to those without, to identify differences in the types of symptoms by age group (infants/toddlers [0-2 years] vs preschool-aged children [3-5 years]), and to derive an index that can be used in research studies to identify young children with LC. DESIGN, SETTING, AND PARTICIPANTS:This was a multisite longitudinal cohort study with enrollment from over 30 US health care and community settings, including infants, toddlers, and preschool-aged children with and without SARS-CoV-2 infection history. Study data were analyzed from May to December 2024. EXPOSURE:SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES:LC and 41 symptoms among infants/toddlers and 75 symptoms among preschool-aged children. RESULTS:The study included 472 infants/toddlers (mean [SD] age, 12 [9] months; 278 infected with SARS-CoV-2; 194 uninfected; 234 male [50%]; 73 Black or African American [16%]; 198 Hispanic, Latino, or Spanish [43%]; 242 White [52%]) and 539 preschool-aged children (mean [SD] age, 48 [10] months; 399 infected with SARS-CoV-2; 140 uninfected; 277 female [51%]; 70 Black or African American [13%]; 210 Hispanic, Latino, or Spanish [39%]; 287 White [54%]). The median (IQR) time between first infections and completion of symptom surveys was 318 (198-494) days for infants/toddlers and 520 (330-844) days for preschool-aged children. A research index was derived for each age group based on symptoms most associated with infection history. The index is calculated by summing scores assigned to each prolonged symptom that was present, where higher scores indicate greater magnitude of association with history of SARS-CoV-2 infection: poor appetite (5 points), trouble sleeping (3.5 points), wet cough (3.5 points), dry cough (3 points), and stuffy nose (0.5 points) for infants/toddlers, and daytime tiredness/sleepiness/low energy (6.5 points) and dry cough (3 points) for preschool-aged children. Among infants/toddlers with infection, 40 of 278 (14%) were classified as having probable LC by having an index of at least 4 points. Among preschool-aged children, 61 of 399 (15%) were classified as having probable LC by having an index of at least 3 points. Participants with higher indices often had poorer overall health, lower quality of life, and perceived delays in developmental milestones. CONCLUSIONS AND RELEVANCE:This cohort study identified symptom patterns and derived research indices that were distinct between the 2 age groups and differed from those previously identified in older ages, demonstrating the need to characterize LC separately across age ranges.
PMID: 40554463
ISSN: 2168-6211
CID: 5911972
Journal of the American Academy of Child and Adolescent Psychiatry. 2025.DOI: 10.1016/j.jaac.2025.05.009
Unveiling Disparities: The Case for Group-Specific Analyses in Child Psychiatry [Editorial]
PMID: 40414283
ISSN: 1527-5418
CID: 5855022
Breaking the Cycle: Predicting Agitation Crises in Child and Adolescent Inpatient Psychiatry
This study examined biopsychosocial factors associated with the use of intramuscular (IM) agitation emergency medication in child and adolescent psychiatric inpatients. A retrospective review of 1,101 patients hospitalized between June 2018-November 2021 at an urban teaching hospital identified predictors of IM medication use through linear regression analysis. Among these patients, 196 received IM medication during their stay. Female sex was associated with a lower likelihood of receiving IM treatment, while factors such as prior involvement with child protective services, a history of violence, previous psychiatric hospitalizations, and use of multiple home psychiatric medications increased the likelihood. Agitation episodes pose risks to both patients and staff, underscoring the importance of early identification and intervention. Understanding these risk factors may guide proactive strategies to reduce the frequency and severity of agitation and limit reliance on emergency pharmacological interventions. Further research is needed to refine predictive models and explore non-pharmacological management approaches.
PMID: 40377832
ISSN: 1573-3327
CID: 5844742
Increased excitability of dentate gyrus mossy cells occurs early in life in the Tg2576 model of Alzheimer's disease
BACKGROUND:Hyperexcitability in Alzheimer's disease (AD) is proposed to emerge early and contribute to disease progression. The dentate gyrus (DG) and its primary cell type, granule cells (GCs) are implicated in hyperexcitability in AD. Hence, we hypothesized that mossy cells (MCs), important regulators of GC excitability, contribute to early hyperexcitability in AD. Indeed, MCs and GCs are linked to hyperexcitability in epilepsy. METHODS:Using the Tg2576 model of AD and WT mice (~ 1 month-old), we compared MCs and GCs electrophysiologically and morphologically, assessed the activity marker c-Fos, Aβ expression and a hippocampal- and MC-dependent memory task that is impaired at 3-4 months of age in Tg2576 mice. RESULTS:Tg2576 MCs had increased spontaneous excitatory events (sEPSP/Cs) and decreased spontaneous inhibitory currents (sIPSCs), increasing the excitation/inhibition ratio. Additionally, Tg2576 MC intrinsic excitability was enhanced. Consistent with in vitro results, Tg2576 MCs showed enhanced c-Fos protein expression. Tg2576 MCs had increased intracellular Aβ expression, suggesting a reason for increased excitability. GCs showed increased excitatory and inhibitory input without changes in intrinsic properties, consistent with effects of increased MC activity. In support, increased GC activity was normalized by an antagonist of MC input to GCs. Also in support, Tg2576 MC axons showed sprouting to the area of GC dendrites. These effects occurred before an impairment in the memory task, suggesting they are extremely early alterations. CONCLUSIONS:Alterations in Tg2576 MCs and GCs early in life suggest an early role for MCs in increased GC excitability. MCs may be a novel target to intervene in AD pathophysiology at early stages.
PMCID:12079945
PMID: 40375112
ISSN: 1758-9193
CID: 5844672
The Impact of Parenting Avoidance (IPA): Scale Development and Psychometric Evaluation Among Parents of Transgender Youth
Parental support and acceptance are strong protective factors for better mental health outcomes among transgender and gender diverse youth. Psychological inflexibility, specifically in the role of parenting, or "parenting inflexibility", refers to an over-reliance on avoidance strategies at the expense of parenting values. Parenting inflexibility may be related to parental support, making it a useful target of intervention for parents of transgender youth. The aim of the present study was to develop a brief clinically useful measure of parenting inflexibility based on a synthesis of existing measures and to evaluate the psychometric properties across two study populations. Study 1 used exploratory factor analysis to examine this measure among parents in the general population recruited using MTurk. Study 2 used confirmatory factor analysis to examine the measure among parents of transgender youth recruited from a clinic. The final measure, the Impact of Parenting Avoidance (IPA) scale, is a one-factor 7-item measure of parenting inflexibility that is easy to administer and interpret in a pediatric health setting. The resulting measure demonstrated acceptable reliability, and it was significantly correlated with important outcome variables, such as negative parenting practices and lower perceived parental support among transgender and gender diverse youth.
PMCID:12109312
PMID: 40426402
ISSN: 2076-328x
CID: 5855232
