Searched for: school:SOM
Department/Unit:Child and Adolescent Psychiatry
In utero exposure to methylphenidate, amphetamines and atomoxetine and offspring neurodevelopmental disorders - a population-based cohort study and meta-analysis
Bang Madsen, Kathrine; Larsson, Henrik; Skoglund, Charlotte; Liu, Xiaoqin; Munk-Olsen, Trine; Bergink, Veerle; Newcorn, Jeffrey H; Cortese, Samuele; Lichtenstein, Paul; Kuja-Halkola, Ralf; Chang, Zheng; D'Onofrio, Brian; Hove Thomsen, Per; Klungsøyr, Kari; Brikell, Isabell; Garcia-Argibay, Miguel
The use of Attention-Deficit/Hyperactivity Disorder (ADHD) medications during pregnancy is increasing, raising concerns about potential long-term effects on offspring. This study investigates in utero exposure to methylphenidate, amphetamines and atomoxetine and risk of offspring neurodevelopmental disorders (NDDs). The population-based cohort study identified from Swedish registers included 861,650 children born by 572,731 mothers from 2008-2017. We categorized exposure based on redeemed medication during pregnancy and compared exposed children to those whose mothers discontinued medication before conception. Main outcomes were any NDD, including ADHD and autism spectrum disorder (ASD). Cox proportional hazards regression estimated hazard ratios (HRs), adjusting for maternal psychiatric and sociodemographic factors. Sensitivity analyses included stratifications by medication type, timing, and duration of exposure, and sibling comparisons. We also performed a meta-analysis combining data from the present study with those from a previous Danish study. Results showed no increased risk for any NDD (HRadjusted 0.95, 95% CI 0.82-1.11), ADHD (HRadjusted 0.92, 95% CI 0.78-1.08), or ASD (HRadjusted 0.86, 95% CI 0.63-1.18). Sensitivity analyses showed consistent patterns of no increased risks across different exposure durations, medication types and between siblings. Meta-analyses further supported the findings (pooled HR for any NDD 1.00, 95% CI 0.83;1.20). Our study provides evidence that in utero exposure to ADHD medications does not increase the risk of long-term NDDs in offspring. This study replicates safety data for methylphenidate and extends it with new safety data on amphetamines and atomoxetine. These findings are crucial for informing clinical guidelines and helping healthcare providers and expectant mothers make informed decisions.
PMID: 40148550
ISSN: 1476-5578
CID: 5817072
From focus to function: Longitudinal insights into infant attention and emerging executive functions via remote webcam eye tracking
Werchan, Denise M; Hume, Amy; Zhang, Maggie; Vo, Tram; Brito, Natalie H
Growing evidence suggests that infant attention may predict subsequent cognitive outcomes. However, prior studies have predominantly tested small samples of infants in tightly controlled laboratory settings that differ from the complex, visually rich environments that infants experience in their day-to-day lives. The present study addresses this gap by measuring infant sustained attention in the home using novel remote webcam eye tracking methodology. A large, demographically diverse sample of 3- to 12-month-old infants (N = 160; 49% = female; 65% from low- to extremely low-income households; 48% White, 18% Black, 16% Hispanic/Latine, 9% more than one race, 5% Asian, and 4% other) were recruited across the United States. Infants were remotely administered a free-viewing video task previously validated in lab-based studies, and infant look durations and gaze shifts were measured using remote webcam eye tracking. Our results revealed expected age-related changes in infant look durations and no effects of family demographics on variations in infant attention. Notably, we also found that variation in infant attention predicted emerging executive functions in a subset of infants (N = 78) who participated in a subsequent longitudinal assessment using the Early Executive Functions Questionnaire. This research adds to a growing literature validating the use of at-home remote assessments for objective measurement of infant cognition. This is a notable step toward advancing ecological validity and accessibility of developmental psychology studies in diverse samples. Ultimately, these findings may have important implications for characterizing normative developmental trajectories and for understanding how early sociocultural contexts shape these trajectories. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
PMID: 40111879
ISSN: 1939-0599
CID: 5813582
Prevalence and Geographic Variation of Serious Mental Illness Among Young Adults Enrolled in Medicaid in New York State
Rodwin, Aaron H; Layman, Deborah; Finnerty, Molly; Patel, Sadiq Y; Jeong, Junghye; Chen, Qingxian; Munson, Michelle R
PURPOSE/OBJECTIVE:To estimate the prevalence and geographic variation of serious mental illness (SMI) among young adults enrolled in Medicaid and to identify individual and community-level factors associated with SMI. METHODS:We used New York Medicaid data for over 1.6 million young adults aged 18-34 years with continuous Medicaid enrollment from April 2021 through March 2022. We merged 3 additional county and zip code-level datasets, including the Distressed Communities Index, Area Health Resource File, and New York homelessness data. We used descriptive analyses, data visualization methods, and multivariable logistic regression to estimate the prevalence of SMI and identify individual- (sex, race and ethnicity, age, disability aid, and homelessness) and community-level (geography, community distress, number of hospital beds, and community mental health centers per capita) factors associated with SMI. RESULTS:The 12-month prevalence of SMI was 8.3% in New York State, with wide geographic variation by zip codes, ranging from 0% to 39%. Young adults identifying as Asian, Black, and Latinx (compared to White), and those living in zip codes with the most community distress were associated with lower odds of SMI, odds ratios (OR) ranged from 0.47 (Asian) (95% confidence interval [CI] [0.46-0.49]) to 0.95 (Latinx) (CI [0.93-0.97]). Young adults identifying as female (compared to male), receiving disability, experiencing homelessness, and rural residence were associated with higher odds of SMI, ORs ranged from 1.64 (female) (95% CI [1.62-1.66]) to 5.49 (homelessness) (95% CI [5.33-5.66]). DISCUSSION/CONCLUSIONS:SMI prevalence varies by individual- and community-level factors, including homelessness and rural residence, signaling the need for specific interventions and policies.
PMID: 40100185
ISSN: 1879-1972
CID: 5813252
Expectancy Effects, Failure of Blinding Integrity, and Placebo Response in Trials of Treatments for Psychiatric Disorders: A Narrative Review
Huneke, Nathan T M; Fusetto Veronesi, Guilherme; Garner, Matthew; Baldwin, David S; Cortese, Samuele
IMPORTANCE/UNASSIGNED:Expectancy effects are significant confounding factors in psychiatric randomized clinical trials (RCTs), potentially affecting the interpretation of study results. This narrative review is the first, to our knowledge, to explore the relationship between expectancy effects, compromised blinding integrity, and the effects of active treatment/placebo in psychiatric RCTs. Additionally, we present statistical and experimental approaches that may help mitigate the confounding impact of expectancy effects. The review concludes with recommendations to enhance the reliability of RCTs in psychiatry. OBSERVATIONS/UNASSIGNED:The placebo response comprises both specific and nonspecific elements, with expectation being a key specific component. Evidence from experimental and clinical studies suggests that expectancy can influence treatment responses in RCTs. Blinding integrity may be compromised by perceived treatment efficacy and adverse effects, introducing bias into outcome assessments. Treatment expectations can lead to unblinding during RCTs, and meta-analytic data from studies in the fields of psychedelics and anxiety disorders indicate that this can influence effect sizes. Therefore, controlling for expectancy effects is essential when interpreting RCT results. Novel statistical methods, though still in need of further validation, offer strategies to address this issue. Another approach may involve experimental medicine models, which aim to develop objective improvement markers (readouts) less affected by expectancy effects. CONCLUSIONS AND RELEVANCE/UNASSIGNED:Expectancy effects represent a significant confound in psychiatric RCTs. We recommend collecting data on treatment expectations alongside monitoring blinding integrity to more accurately interpret study results. Additionally, developing objective readouts that are less confounded by expectancy effects offers another promising avenue for mitigating these confounding influences in psychiatric RCTs.
PMID: 40072447
ISSN: 2168-6238
CID: 5808482
The neural basis of dialectical thinking: recent advances and future prospects
Hu, Xiaomeng; Ma, Han-Qing; Tian, Ying-Qi; Hu, Yong-Heng; Chen, Sylvia Xiaohua; Castellanos, Francisco Xavier; Peng, Kai-Ping; Yan, Chao-Gan
Dialectical thinking represents a cognitive style emphasizing change, contradiction, and holism. Cross-cultural studies reveal a stark contrast of dialectical thinking between East Asian and Western cultures, highlighting East Asians' superior ability to embrace contradictions and foresee transformation, fostering psychological resilience through emotional complexity and tolerance for contradictions. Despite its importance, the neural basis of dialectical thinking remains underexplored. This review synthesizes current neuroscientific findings and introduces the dialectical-integration network (DIN) hypothesis, which identifies key brain regions such as the dorsal anterior cingulate cortex (dACC), medial prefrontal cortex (mPFC), dorsal lateral prefrontal cortex (DLPFC), nucleus accumbens, basal ganglia, and amygdala. These regions, along with networks like the default mode network (DMN) and frontoparietal network (FPN), facilitate holistic reasoning, conflict resolution, and sensory-emotional integration. The psychological benefits of dialectical thinking include enhanced cognitive flexibility, reduced emotional extremes, and improved conflict resolution. This review emphasizes the need for cross-cultural and neuroscientific research to explore the principle of change, a core aspect of dialectical cognition. By bridging cultural psychology and cognitive neuroscience, this work offers theoretical and methodological insights into culturally shaped cognitive styles, with practical applications in education, mental health, and intercultural communication. The DIN model provides a framework for future research on dynamic neural interactions supporting dialectical thinking.
PMID: 40068932
ISSN: 2191-0200
CID: 5808402
Exploring Serotonergic Psychedelics as a Treatment for Personality Disorders
Carrithers, Brennan M; Roberts, Daniel E; Weiss, Brandon M; King, Jacob D; Carhart-Harris, Robin L; Gordon, Alexandra R; Pagni, Broc A; Moreau, Miltiadis; Ross, Stephen; Zeifman, Richard J
Both psychotherapeutic interventions and pharmacological agents have demonstrated limited efficacy in the treatment of personality disorders (PDs). Emerging evidence suggests that psychedelic therapy, already showing promise in treating various psychiatric conditions commonly comorbid with PDs, may exert therapeutic effects by promoting adaptive changes in personality. Thus, psychedelic therapy could hold potential for addressing core features of PDs through shared mechanisms of personality modulation. Although historical literature and observational studies suggest the potential clinical utility of psychedelics in treating PDs, rigorous research is lacking, and individuals with PDs are often excluded from modern psychedelic therapy trials. In the present review, we first discuss research on the effects of psychedelics in individuals with a PD through the conventional lens of the Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.; DSM-5-TR) categorical model. Next, using the dimensional DSM Alternative Model of Personality Disorders (DSM-AMPD) as a framework, we examine how psychedelics may affect self-functioning, interpersonal functioning, and pathological personality traits. We conclude by discussing the clinical relevance of psychedelic therapy as a treatment for personality pathology, including safety considerations, gaps and limitations, and recommendations for approaching psychedelic therapy within these more complex clinical populations.
PMID: 40081794
ISSN: 1873-7064
CID: 5808842
Large-scale evidence of a general disease ('d') factor accounting for both mental and physical health disorders in different age groups
Sun, Hongyi; Carr, Hannah; Garcia-Argibay, Miguel; Cortese, Samuele; Solmi, Marco; Golm, Dennis; Brandt, Valerie
BACKGROUND:It is unknown whether there is a general factor that accounts for the propensity for both physical and mental conditions in different age groups and how it is associated with lifestyle and well-being. METHODS:factor, lifestyles, and well-being was further explored. RESULTS:factor scores significantly correlated with lifestyle and well-being, suggesting healthier lifestyles were associated with a reduced likelihood of physical and mental health comorbidities, which in turn improved well-being. CONCLUSIONS:Contrary to the traditional dichotomy between mental and physical conditions, our study showed a general factor underlying the comorbidity across mental and physical diseases, related to lifestyle and well-being. Our results inform the conceptualization of mental and physical illness as well as future research assessing risk and pathways of disease transmission, intervention, and prevention. Our results also provide a strong rationale for a systematic screening for mental disorders in individuals with physical conditions and vice versa, and for integrated services addressing multimorbidity.
PMID: 40066566
ISSN: 1469-8978
CID: 5808292
Publisher Correction: Adapting the Parent Connector program for caregivers of adults with SMI: the Family Connector experience
Cervantes, Paige E; Gendler, Charlotte; Markowitz, Lori; Rose, Meggin; Shorter, Priscilla; Mason, Sally; Hernandez, Tanya; Hoagwood, Kimberly E
PMID: 40055435
ISSN: 2731-4251
CID: 5807982
Advancing the evidence base for child and adolescent psychopharmacology [Editorial]
Cortese, Samuele; Moreno, Carmen
This editorial focuses on the seven studies published in the BMJ Mental Health topic collection Advances in Clinical Psychopharmacology in Children and Young People. Collectively, these articles provide evidence that informs key steps in the psychopharmacological management of children and adolescents with mental health or neurodevelopmental conditions. Papers in this collection contribute to strengthen evidence-based psychopharmacological practice. We look forward to further developments in the field, supported by adequate research funding.
PMCID:11877239
PMID: 40032555
ISSN: 2755-9734
CID: 5809662
Stop and Think: A Case Study Illustrating the Implementation of Bright IDEAS-YA Being Delivered via Telehealth to a Young Adult Cancer Patient
Reese, Samantha; Bono, Madeline H; DÃaz, Diana B; Donovan, Kristine A; Sahler, Olle Jane Z; Barnett, Marie E; Levonyan-Radloff, Kristine; Devine, Katie A
Bright IDEAS-Young Adults (Bright IDEAS-YA) is a problem-solving skills training intervention that has been adapted for young adults with cancer. Presently, a multisite randomized control trial is being conducted to determine Bright IDEAS-YA's efficacy in supporting a young adult population. This case study demonstrates the young adult adaptation of Bright IDEAS - Bright IDEAS-YA - being delivered to a young adult cancer patient via telehealth. Telehealth is a novel delivery method for Bright IDEAS and Bright IDEAS-YA that was established due to COVID-19 safety precautions. The patient, who reported challenges in several life domains, was taught how to apply the Bright IDEAS-YA framework over six telehealth sessions. After completing the Bright IDEAS-YA framework, the patient reported increased feelings of confidence in managing new stressors, which was corroborated through outcome measures delivered during and following intervention. This case illustrates how early psychosocial intervention following a cancer diagnosis, delivered via telehealth, can help patients develop and implement personal strategies to reduce stress levels.
PMCID:11403064
PMID: 38491206
ISSN: 1573-3572
CID: 5712312