Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Child and Adolescent Psychiatry
Total Results:
11211
Economic burden of attention-deficit/hyperactivity disorder among children and adolescents in the United States: a societal perspective
OBJECTIVE/UNASSIGNED:To provide a comprehensive evaluation of the economic burden associated with attention-deficit/hyperactivity disorder (ADHD) among children and adolescents from a US societal perspective. MATERIALS AND METHODS/UNASSIGNED:Direct healthcare costs of children (5-11 years) and adolescents (12-17 years) with ADHD were obtained using claims data from the IBM MarketScan Research Databases (01/01/2017-12/31/2018). Direct non-healthcare and indirect costs were estimated based on literature and government publications. Each cost component was estimated using a prevalence-based approach, with per-patient costs extrapolated to the national level. RESULTS/UNASSIGNED:The total annual societal excess costs associated with ADHD were estimated at $19.4 billion among children ($6,799 per child) and $13.8 billion among adolescents ($8,349 per adolescent). Education costs contributed to approximately half of the total excess costs in both populations ($11.6 billion [59.9%] in children; $6.7 billion [48.8%] in adolescents). Other major contributors to the overall burden were direct healthcare costs ($5.0 billion [25.9%] in children; $4.0 billion [29.0%] in adolescents) and caregiving costs ($2.7 billion [14.1%] in children; $1.6 billion [11.5%] in adolescents). LIMITATIONS/UNASSIGNED:Cost estimates were calculated based on available literature and/or governmental publications due to the absence of a single data source for all costs associated with ADHD. Thus, the quality of cost estimates is limited by the accuracy of available data as well as the study populations and methodologies used by different studies. CONCLUSION/UNASSIGNED:ADHD in children and adolescents is associated with a substantial economic burden that is largely driven by education costs, followed by direct healthcare costs and caregiver costs. Improved intervention strategies and policies may reduce the clinical and economic burden of ADHD in these populations.
PMID: 35068300
ISSN: 1941-837x
CID: 5154282
Human-centered design exploration with Kenyan health workers on proposed digital mental health screening and intervention training development: Thematic analysis of user preferences and needs
Background/UNASSIGNED:Health providers' perceived sense of knowledge, competency, and self-efficacy to support the needs of their patients contributes to optimal patient health outcomes. With regards to mental health service delivery in Kenya, this area needs further exploration. Guided by the e-health technology acceptance mode, the needs and preferences of health care providers around mental health training for clinical management and their ability to intervene in peripartum adolescent mental health care are explored. We probed how well-equipped service providers are, their engagement with technology to learn and offer services. The health care provider's technology use preferences were also explored. Method/UNASSIGNED:Guided by a human-centered design-focused qualitative inquiry we interviewed 20 specialists around their needs, perspectives, and preferences for digitized mental health screening and intervention. Mean age was 44.2 years, (range of 32-58 years), 25% (5) males and 75% (15) females. After a written consenting process, the online interviews (30-45 min) were conducted in April 2021, once personal information was de-identified interviews were transcribed and coded. Thematic analysis was used and we combined rapid appraisal of Google Jamboard online storyboards to do individual human-centered design personas alongside. Results/UNASSIGNED:Our participants were well-exposed to digital technologies. Prohibitive costs of data bundles, lack of funds for consistent online engagement, high workload, and instability of access to appropriate gadgets were found to be barriers to e-health training. Emerging opportunities were well-identified adolescent mental health service and intervention needs, willingness to take online courses offered on learning platforms, and wish for these to be disseminated through diverse social media. Other recommendations were the need to have a user-friendly interface such as data-light engaging and practical materials including animations, short, group-based learning. Conclusion/UNASSIGNED:Understanding contextual factors that influence perceived usefulness and ease of use of the remote/digital components would be critical for e-training development and its uptake.
PMCID:9014722
PMID: 35444811
ISSN: 2055-2076
CID: 5218392
Mega-analysis methods in ENIGMA: The experience of the generalized anxiety disorder working group
The ENIGMA group on Generalized Anxiety Disorder (ENIGMA-Anxiety/GAD) is part of a broader effort to investigate anxiety disorders using imaging and genetic data across multiple sites worldwide. The group is actively conducting a mega-analysis of a large number of brain structural scans. In this process, the group was confronted with many methodological challenges related to study planning and implementation, between-country transfer of subject-level data, quality control of a considerable amount of imaging data, and choices related to statistical methods and efficient use of resources. This report summarizes the background information and rationale for the various methodological decisions, as well as the approach taken to implement them. The goal is to document the approach and help guide other research groups working with large brain imaging data sets as they develop their own analytic pipelines for mega-analyses.
PMCID:8675407
PMID: 32596977
ISSN: 1097-0193
CID: 5364742
Journal of child psychology & psychiatry & allied disciplines. 2022:63(1):122-125.DOI: 10.1111/jcpp.13478
Editorial Perspective: Challenges of research focusing on child and adolescent mental health during the COVID-19 era: what studies are needed? [Editorial]
This editorial perspective focuses on the challenges of research on child and adolescent mental health during the COVID-19 pandemic. Common limitations of published/ongoing studies are (i) being conducted in one or few countries, (ii) the survey being available in one or few languages, (iii) targeting selected samples (e.g., clinical populations and health workers) rather than the general population, (iv) only recruiting/reporting on non-representative samples, (v) focusing often on a restricted set of mental health outcomes, missing the broader picture of mental and physical health, quality of life and functioning, (vi) failing to use a longitudinal design and (vii) collecting only parental ratings or self-rated questionnaires from children and adolescents, but not both. We discuss how the Collaborative Outcomes Study on Health and Functioning during Infection Times (COH-FIT) was designed to address some of these challenges, also highlighting its limitations.
PMCID:8447458
PMID: 34341995
ISSN: 1469-7610
CID: 5066682
Automated Brain Masking of Fetal Functional MRI with Open Data
Fetal resting-state functional magnetic resonance imaging (rs-fMRI) has emerged as a critical new approach for characterizing brain development before birth. Despite the rapid and widespread growth of this approach, at present, we lack neuroimaging processing pipelines suited to address the unique challenges inherent in this data type. Here, we solve the most challenging processing step, rapid and accurate isolation of the fetal brain from surrounding tissue across thousands of non-stationary 3D brain volumes. Leveraging our library of 1,241 manually traced fetal fMRI images from 207 fetuses, we trained a Convolutional Neural Network (CNN) that achieved excellent performance across two held-out test sets from separate scanners and populations. Furthermore, we unite the auto-masking model with additional fMRI preprocessing steps from existing software and provide insight into our adaptation of each step. This work represents an initial advancement towards a fully comprehensive, open-source workflow, with openly shared code and data, for fetal functional MRI data preprocessing.
PMID: 34129169
ISSN: 1559-0089
CID: 4916432
Effects of the Parental Friendship Coaching Intervention on Parental Emotion Socialization of Children with ADHD
Parental emotion-related socialization behaviors shape children's socioemotional functioning and appear important for children with attention-deficit/hyperactivity disorder (ADHD). The Parental Friendship Coaching (PFC) intervention teaches parents to coach their children with ADHD in friendship skills, which includes managing emotions. We examined whether PFC, relative to psychoeducation and social support (Coping with ADHD through Relationships and Education; CARE), improved parental emotion-related socialization behaviors, child affect with a friend, and child social behaviors related to emotional difficulties. Participants were 172 families of children with ADHD (ages 6-11, 30% female), randomized to PFC or CARE. At baseline, children and their real-life friends interacted and their affect was coded. Parents coached their child in friendship skills before and after the child-friend interaction, and parents' praise, warmth, criticism, and discussion of emotion-related friendship strategies were coded. Parents and teachers reported children's withdrawn/depressed and aggressive behaviors. Results suggested that PFC (relative to CARE) led to parents providing more emotion strategies and praise at post-treatment and follow-up, and more warmth at follow-up, and to children showing less withdrawn/depressed behavior at follow-up. For bidirectional relationships from baseline to post-treatment, more parental warmth was associated with less child withdrawn/depressed behavior, and more parental criticism with more child aggression. More child withdrawn/depressed behavior and positive affect at post-treatment were associated with more parental criticism at follow-up. After corrections for multiple comparisons, only PFC effects on praise and emotion strategies at post-treatment, and praise and withdrawn/depressed behavior at follow-up, maintained. Implications are discussed for supporting socioemotional functioning in children with ADHD.
PMID: 34037888
ISSN: 2730-7174
CID: 4887912
Following up internet-delivered cognitive behaviour therapy (CBT): A longitudinal qualitative investigation of clients' usage of CBT skills
BACKGROUND:While the acquisition and application of Cognitive Behaviour Therapy (CBT) skills is a core component and likely mechanism of effect maintenance in all CBT-based treatments, the extent of post-therapeutic CBT skills usage among internet-delivered CBT (iCBT) clients remains under-researched. METHOD/METHODS:Nested within a pragmatic randomized controlled trial, 241 participants received an 8-week supported iCBT intervention for anxiety and/or depression and answered open-ended questions about their use and experience of CBT skills at 3-, 6-, 9-, and 12-month follow-up. Recurrent, cross-sectional qualitative analysis following the descriptive and interpretive approach was used to create a taxonomy, through which all qualitative data was coded. RESULTS:In total, 479 qualitative responses across 181 participants were analysed. Participants reported using a wide range of CBT skills and associated helpful and hindering experiences and impacts. The reasons for discontinued CBT skills usage were diverse, ranging from rare adverse effects to healthy adaptation. CONCLUSION/CONCLUSIONS:The study shows how clients receiving iCBT in routine care learn CBT skills during treatment and utilize them in productive ways post-treatment. Findings coincide with similar research in face-to-face CBT and may inform future research to drive innovation and iCBT intervention development.
PMID: 34048613
ISSN: 1099-0879
CID: 5262522
Cortical thickness across the lifespan: Data from 17,075 healthy individuals aged 3-90 years
Delineating the association of age and cortical thickness in healthy individuals is critical given the association of cortical thickness with cognition and behavior. Previous research has shown that robust estimates of the association between age and brain morphometry require large-scale studies. In response, we used cross-sectional data from 17,075 individuals aged 3-90 years from the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) Consortium to infer age-related changes in cortical thickness. We used fractional polynomial (FP) regression to quantify the association between age and cortical thickness, and we computed normalized growth centiles using the parametric Lambda, Mu, and Sigma method. Interindividual variability was estimated using meta-analysis and one-way analysis of variance. For most regions, their highest cortical thickness value was observed in childhood. Age and cortical thickness showed a negative association; the slope was steeper up to the third decade of life and more gradual thereafter; notable exceptions to this general pattern were entorhinal, temporopolar, and anterior cingulate cortices. Interindividual variability was largest in temporal and frontal regions across the lifespan. Age and its FP combinations explained up to 59% variance in cortical thickness. These results may form the basis of further investigation on normative deviation in cortical thickness and its significance for behavioral and cognitive outcomes.
PMID: 33595143
ISSN: 1097-0193
CID: 4799902
Coronavirus outbreak from early career psychiatrists' viewpoint: What we have learned so far
PURPOSE/OBJECTIVE:Since the World Health Organization declared the coronavirus outbreak a global pandemic several million cases and more than three million deaths have been already confirmed worldwide due to COVID-19. DESIGN AND METHODS/METHODS:Early Career Psychiatrists from all over the world present an overview of what happened in their own countries and what they have learned so far by this experience in everyday clinical practice. PRACTICE IMPLICATION/CONCLUSIONS:We tried to take a real time picture of this unexpected situation, drawing useful hints for now and the future.
PMID: 34061999
ISSN: 1744-6163
CID: 4891232
Reciprocal relationships between sleep and smell
Despite major anatomical differences with other mammalian sensory systems, olfaction shares with those systems a modulation by sleep/wake states. Sleep modulates odor sensitivity and serves as an important regulator of both perceptual and associative odor memory. In addition, however, olfaction also has an important modulatory impact on sleep. Odors can affect the latency to sleep onset, as well as the quality and duration of sleep. Olfactory modulation of sleep may be mediated by direct synaptic interaction between the olfactory system and sleep control nuclei, and/or indirectly through odor modulation of arousal and respiration. This reciprocal interaction between sleep and olfaction presents novel opportunities for sleep related modulation of memory and perception, as well as development of non-pharmacological olfactory treatments of simple sleep disorders.
PMCID:9813672
PMID: 36619661
ISSN: 1662-5110
CID: 5400412
