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Department/Unit:Child and Adolescent Psychiatry

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Rest assured: Promoting sleep health in undergraduate education

Nowlin, Haley; Badin, Emily; Shatkin, Jess P
BACKGROUND/UNASSIGNED:Sleep deprivation among young adults is a pervasive problem driven by high levels of stress, excessive screen time, disruptive school and living environments, irregular sleep habits, high academic demands, early school start times, and low rates of physical activity. Difficulties with emotion regulation, high rates of anxiety and depression, and poor academic performance are only a few of the struggles faced by sleep deprived young adults. Although sleep apps and wearables are increasingly popular, knowledge of positive sleep health without the proper tools to motivate and instill behavior change can contribute to anxiety and negative cognitions about sleep, which only further fuel the problem. METHODS/UNASSIGNED:In this report we describe a series of undergraduate university curricula, housed within a unique undergraduate department, designed to enhance not only knowledge of sleep, but also associated behavior changes that have been demonstrated to improve sleep, mood, and anxiety among university students. RESULTS/UNASSIGNED:Numerous courses within the Child and Adolescent Mental Health Studies (CAMS) department at New York University address sleep directly, teaching students about the science of sleep and how they can improve their own sleep to enhance overall wellbeing. Our work to date demonstrates that students find these courses desirable and impactful. CONCLUSION/UNASSIGNED:College courses present a unique opportunity to improve the health and wellbeing of young adults by teaching about sleep health. Undergraduate campuses may represent an underutilized locale from which to address population health.
PMCID:12596529
PMID: 41216182
ISSN: 2590-1427
CID: 5966592

An update on the comorbidity of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) and its clinical management

Petruzzelli, Maria Giuseppina; Matera, Emilia; Margari, Lucia; Marzulli, Lucia; Gabellone, Alessandra; Cotugno, Chiara; Annecchini, Federica; Cortese, Samuele
INTRODUCTION/UNASSIGNED:Over recent decades, research has identified both overlapping and distinct characteristics, risk factors, and genetic as well as neurobiological correlates associated with Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). This expanding body of evidence is increasingly informing the clinical management of individuals with comorbid ADHD and ASD. AREAS COVERED/UNASSIGNED:Based on a targeted PubMed search conducted up to March 24,2025,24.03.25, prioritizing meta-analyses or umbrella reviews over primary studies (whenever relevant), with terms encompassing autism, assessment, and treatment, this review addresses: 1) Shared and distinct phenotypic characteristics, neuropsychological features, and genetic and neuroimaging correlates of ADHD and ASD; 2) The assessment of individuals presenting with both ASD and ADHD symptoms; 3) Pharmacological and non-pharmacological strategies for the management for individuals with comorbid ASD and ADHD. EXPERT OPINION/UNASSIGNED:The comorbidity of ADHD and ASD should not be overlooked. Nevertheless, before diagnosing comorbid ASD and ADHD, clinicians should perform a thorough differential diagnosis, ensuring that ADHD symptoms are not better explained by ASD. Regarding treatment, further research is warranted to develop personalized approaches, support long-term management strategies, and evaluate real-world outcomes such as quality of life, which are often underrepresented in clinical trials.
PMID: 41388592
ISSN: 1744-8360
CID: 5978172

Health care utilization around the time of pregnancy by extent of disability in the United States, 2018-2020

Deierlein, Andrea L; Boege, Hedda L; Berube, Lauren T; Ryan, Rachel; Stein, Cheryl R
INTRODUCTION/BACKGROUND:Females with disabilities have greater preconception health risks and adverse perinatal outcomes than those without disabilities. Characterization of reproductive health care utilization among females with disabilities in the United States is limited. We examined health care receipt before, during, and after pregnancy by extent of disability among U.S. females with recent live births. METHODS:This cross-sectional study used Pregnancy Risk Assessment Monitoring System data (collected 2018-2020 and analyzed in 2025) from 24 states that included the Washington Group Short Set of Questions on Disability. Participants self-reported health care visits in the year prior to pregnancy; receipt and timing of prenatal care; and receipt of a postpartum checkup. Disability was assessed as extent of difficulty (none, some, and a lot of difficulty). Associations between extent of disability and health care utilization were estimated using multivariable modified Poisson regression (adjusted prevalence ratios, aPR, and 95% confidence intervals, CI). RESULTS:trimester initiation of prenatal care, but they had a 171% (aPR=2.71, 95% CI: 1.49-4.94) and 63% (aPR=1.63, 95% CI: 1.40-1.91) higher prevalence of not having any prenatal care and not having a postpartum checkup, respectively, than females with no difficulty. CONCLUSIONS:Females with some and a lot of difficulty reported lower receipt of reproductive, prenatal, and postpartum care than those with no difficulty. Strategies are needed to establish and coordinate comprehensive reproductive health care among females with disabilities.
PMID: 41352448
ISSN: 1873-2607
CID: 5975432

Restoration of sFRP3 preserves the neural stem cell pool and spatial discrimination ability in a mouse model of Alzheimer's disease

Fu, Chia-Hsuan; Park, Jin; Tosi, Umberto; Blanco, Francisco A; Silva-Pérez, Manuel; Muralidharan, Kavitha; You, Jason C; Lee, Minjung; Stephens, Gabriel S; Zhang, Xiaohong; Zheng, Yi; Scharfman, Helen; Tolias, Kimberley F; Chin, Jeannie
Individuals with Alzheimer's disease (AD) have an increased incidence of seizures, which worsen cognitive decline. Using a transgenic mouse model of AD neuropathology that exhibits spontaneous seizures, we previously found that seizure activity stimulates and accelerates depletion of the hippocampal neural stem cell (NSC) pool, which was associated with deficits in neurogenesis-dependent spatial discrimination. However, the precise molecular mechanisms that drive seizure-induced activation and depletion of NSCs are unclear. Here, using mice of both sexes, we performed RNA-sequencing on the hippocampal dentate gyrus and identified differentially-expressed regulators of neurogenesis in the Wnt signaling pathway that regulates many aspects of cell proliferation. We found that the expression of sFRP3, a Wnt signaling inhibitor, is altered in a seizure-dependent manner and might be regulated by ΔFosB, a seizure-induced transcription factor. Increasing sFRP3 expression prevented NSC depletion and improved spatial discrimination, suggesting that the loss of sFRP3 might mediate seizure-driven impairment in cognition in AD model mice, and perhaps also in AD.Significance statement There is increased incidence of seizures in individuals with Alzheimer's disease (AD), but it is unclear how seizures contribute to cognitive decline. Here, we uncover a molecular mechanism by which seizures in AD induce expression of a long-lasting transcription factor in the hippocampal dentate gyrus that suppresses expression of sFRP3, an inhibitor of neural stem cell division, accelerating the depletion of a finite pool of neural stem cells and dysregulating adult hippocampal neurogenesis. We found that restoring sFRP3 expression prevents accelerated use and depletion of neural stem cells and improves performance in an adult neurogenesis-dependent cognitive task. Our findings have implications for AD, epilepsy, and other neurological disorders that are accompanied by seizures.
PMID: 41136336
ISSN: 1529-2401
CID: 5957542

Where There’s Fire…: Diagnoses Associated with Firesetting Behaviors in Youth in Child Welfare Settings

Phillips, Victoria; Feder, Michael; Milone, Lisa; Filton, Beryl; Weis, J. Rebecca; Mendoza, Angel; Nikulina, Valentina
ORIGINAL:0017850
ISSN: 0009-4021
CID: 5979962

Universal Unconditional Cash Transfers for Pregnant and Postpartum Women: Necessary but Insufficient [Editorial]

Kerker, Bonnie D
PMCID:12614006
PMID: 41223353
ISSN: 1541-0048
CID: 5966812

The sleep-circadian connection: pathways to understanding and supporting autistic children and adolescents and those with attention-deficit hyperactivity disorder

Lok, Renske; Deshpande, Neha; Nair, Siddhi; Andrillon, Thomas; Gatera, Grace; Hill, Catherine M; Cortese, Samuele; Chellappa, Sarah L
Autism and attention-deficit hyperactivity disorder (ADHD) are among the most common neurodivergent neurotypes worldwide. Epidemiological evidence shows that sleep and circadian disturbances, such as difficulty initiating and maintaining sleep, and delayed sleep-wake phase, are highly prevalent in autistic children, children with ADHD, and those with both neurotypes. Despite scientific advancements, a comprehensive framework integrating sleep and circadian mechanisms with targeted interventions for autism and ADHD remains underdeveloped. In this Review we examine sleep and circadian rhythm differences in autistic children and adolescents, and in those with ADHD or both neurotypes, focusing on the underlying biological mechanisms. We discuss recent advances in the genetic and molecular links between sleep, circadian rhythms, and neuroplasticity, alongside the influence of these systems on physiology and therapeutic strategies. Both pharmacological and non-pharmacological interventions are considered, with an emphasis on the need for an integrated support model that accounts for the dynamic interplay between sleep and circadian rhythms in these populations. We identify key gaps in the current evidence base, particularly in relation to non-pharmacological interventions, and outline future research directions. Although most randomised controlled trials in children and adolescents have focused on behavioural sleep interventions, we also discuss emerging findings from trials using alternative approaches, such as targeted light therapy in adults, with implications for paediatric populations. Finally, we emphasise the importance of incorporating the perspectives of autistic children and adolescents and those with ADHD, as well as their parents and caregivers, into research designs.
PMID: 41075809
ISSN: 2352-4650
CID: 5952562

Complementary, alternative and integrative medicine for autism: an umbrella review and online platform

Gosling, Corentin J; Boisseleau, Laure; Solmi, Marco; Sandbank, Micheal; Jurek, Lucie; Nourredine, Mikail; Porcu, Gabriella; Murgia, Elisa; Radua, Joaquim; Fusar-Poli, Paolo; Kovarski, Klara; Caparos, Serge; Cartigny, Ariane; Cortese, Samuele; Delorme, Richard
The use of complementary, alternative and integrative medicine (CAIM) is highly prevalent among autistic individuals, with up to 90% reporting having used CAIM at least once in their lifetime. However, the evidence base for the effects of CAIM for autism remains uncertain. Here, to fill this gap, we conducted an umbrella review of meta-analyses exploring the effects of CAIM in autism across the lifespan and developed a web platform to disseminate the generated results. Five databases were searched (up to 31 December 2023) for systematic reviews with meta-analyses exploring the effects of CAIM in autism. Independent pairs of investigators identified eligible papers and extracted relevant data. Included meta-analyses were reestimated using a consistent statistical approach, and their methodological quality was assessed with AMSTAR-2. The certainty of evidence generated by each meta-analysis was appraised using an algorithmic version of the GRADE framework. This process led to the identification of 53 meta-analytic reports, enabling us to conduct 248 meta-analyses exploring the effects of 19 CAIMs in autism. We found no high-quality evidence to support the efficacy of any CAIM for core or associated symptoms of autism. Although several CAIMs showed promising results, they were supported by very low-quality evidence. The safety of CAIMs has rarely been evaluated, making it a crucial area for future research. To support evidence-based consideration of CAIM interventions for autism, we developed an interactive platform that facilitates access to and interpretation of the present results ( https://ebiact-database.com ).
PMID: 40877399
ISSN: 2397-3374
CID: 5910622

Attention problems in children born very preterm: evidence from a performance-based measure

Camerota, Marie; Castellanos, Francisco Xavier; Carter, Brian S; Check, Jennifer; Helderman, Jennifer; Hofheimer, Julie A; McGowan, Elisabeth C; Neal, Charles R; Pastyrnak, Steven L; Smith, Lynne M; O'Shea, Thomas Michael; Marsit, Carmen J; Lester, Barry M
BACKGROUND:Children born very preterm (VPT) are at high risk for attention problems. This study's purpose was to describe the Conners Kiddie Continuous Performance Test (K-CPT) assessment in children born VPT, including rates of clinically elevated scores, change over time, and associations between K-CPT scores and parent reported attention problems. METHODS:We studied 305 children from a multi-site study of children born VPT who completed at least one K-CPT assessment at age 5, 6, and/or 7 years. Parent-reported ADHD symptoms and diagnosis were also collected. We calculated K-CPT completion rates, mean scores, and rates of clinically elevated scores at each timepoint. Linear mixed models examined change over time in K-CPT scores. Correlations and generalized linear models investigated associations between K-CPT scores and ADHD symptoms and diagnoses. RESULTS:K-CPT scores showed expected age-related improvements from age 5-7, with significant intra- and inter-individual variability. Up to 1/3 of children had clinically elevated attention problems and another 1/3 had subclinical elevations. K-CPT scores were modestly correlated with parent-rated ADHD symptoms and children with a parent-reported ADHD diagnosis performed worse on nearly all K-CPT metrics. CONCLUSION/CONCLUSIONS:Performance-based measures like the K-CPT can be useful for research and clinical practice in VPT populations. IMPACT/CONCLUSIONS:Attention problems are a specific area of weakness for children born very preterm. Performance-based tests of attention have benefits and drawbacks compared to parent report measures yet are understudied in this population. We examined one performance-based measure (the Conners Kiddie Continuous Performance Test [K-CPT]) in 305 children born very preterm. We observed improving task scores from age 5-7 years with significant intra- and inter-individual variability, a sizable proportion of children with clinically and subclinically elevated scores, and modest associations between K-CPT scores and parent reported attention problems. The K-CPT could be a useful clinical and research tool in this population.
PMID: 40204869
ISSN: 1530-0447
CID: 5823992

Safety Planning for Youth in the Emergency Department Who Have Suicide Risk

Foster, Ashley A; Hoffmann, Jennifer A; Berg, Kathleen; Cheng, Tabitha; Claudius, Ilene; Dietrich, Ann M; Hooley, Gwen; Lam, Samuel H F; Li, Joyce; Lin, Sophia; Mendez, Donna; Mroczkowski, Megan; Rice, Lauren E; Saidinejad, Mohsen; Sandelich, Stephen; Santillanes, Genevieve; Sulton, Carmen; Waseem, Muhammad; Walls, Theresa
Suicide remains a leading cause of death among US youth. The emergency department (ED) is a critical access point for identifying suicide risk and initiating interventions to reduce that risk. Key strategies include developing individualized safety plans and counseling on reducing access to lethal means. This article reviews the current evidence supporting ED safety planning for youth at risk of suicide and presents a practical framework for its delivery. It also explores strategies to enhance the implementation of safety planning and lethal means counseling, including using clinical pathways, training of staff, optimizing reimbursement, and integrating resources into the electronic medical record system. Finally, the article highlights emerging innovations aimed at improving the reach of safety plan interventions in the ED setting.
PMCID:12639307
PMID: 41281737
ISSN: 2688-1152
CID: 5967912