Journal of the American Academy of Child Psychiatry

Forty-eight nonpsychiatrically disturbed 11–12-year-olds were asked to describe their conscience, to draw a picture of it, and to describe their internal and external responses to personal transgressions and acts of moral goodness. Three stages of conceptualization emerged, represented by both verbal description and pictorial presentation. The reporting of emotional responses of physiological discomfort, persistent thoughts, and depressive symptoms showed statistically significant variation at the three stages. There were also significant sex differences.Journal of the American Academy of Child Psychiatry, 24, 5:630–636, 1985.

Three children with terminal cancer, ages 7, 9, and 14 years, who exhibited severe symptoms of depression and anxiety, were treated with a combination of low dose amitriptyline (1–2 mg/kg/24 hours) and haloperidol (0.05–0.10 mg/kg/24 hours). Anxiety decreased, mood improved, vegetative symptoms were alleviated, and requirements for narcotic analgesia decreased within 1 week of inception of pharmacotherapy. Symptoms reemerged in two patients when the medications were discontinued. Importantly, the psychopharmaco-logic interventions allowed the patients and their families to deal with the dynamic issues involved in chronic illness and death and dying.

AbstractIt is generally held that the prescription of stimulants for hyperkinesis does not predispose children to later stimulant abuse. The case of a 13-year-old hyperactive boy who abused methylphenidate after two years of therapeutic treatment is reported in this paper. During a research hospitalization, he was administered methylphenidate in a double-blind placebo-controlled fashion to assess the mood changes induced by the drug and to verify expected therapeutic effects. The child met the research criteria of hyperkinesis and did demonstrate a therapeutic effect of methylphenidate. He did not, however, demonstrate the pattern of mood changes characteristic of adult stimulant users. Possible risk factors for later substance abuse in prepubertal patients on prescribed stimulant medications are discussed.

This study had a threefold purpose: (1) to focus on the very young asthmatic (14-30 months) and to evaluate his autonomous and self-assertive strivings; (2) to study the motherchild relationship as a transactional, reciprocal process of mutual adaptation; and (3) to look for a possible relationship between allergic factors and the psychological variables. We evaluated 40 asthmatic children and their mothers, following an observational methodology, both at home and in the hospital. The results led us to question the theory of a “psychosomatic type” of mother-child relationship in childhood asthma as well as the inverse reciprocity between allergy and psychopathology which has been described in the literature. The implications of this study for pediatric and child psychiatric practice and for future research are also described

Fenfluramine was administered to 14 outpatients with the syndrome of autism in a double blind crossover study (ABA design) to determine its effects on blood serotonin concentrations, platelet counts, and symptomatic behaviors. Blood serotonin concentrations decreased an average of 51% after 1 month on medication and returned to baseline levels within 1 month after return to placebo. Platelet counts were unaffected. Serial observation scales, developmental profiles, intelligence scales, and parental interviews and diaries were obtained. They revealed that certain symptoms improved significantly while patients were on medication and worsened when placebo was reinstituted. Patients with both normal and elevated baseline serotonin had symptomatic improvements. No adverse reactions to medication nor clinically significant side effects were noted. Definitive conclusions regarding relationships among initial serotonin levels, clinical features, and symptom responses cannot yet be drawn since data are available on only 14 patients. The encouraging findings in these 14 patients are being studied further at 18 medical centers throughout the United States on approximately 150 patients.

The relationship between parental composition (mother-father compared with mother-only families) and the likelihood of a youth demonstrating conduct problems was examined in a national probability sample of 12–17-year-olds. The mediating effect of parental supervision of the youths' activities was also explored. Sex, income, and race were controlled. Youths from father-absent households were more likely to demonstrate conduct problems than those from father-present ones. However, it was the youths from father-absent households with low parental supervision who showed the greater likelihood of conduct problems. In households with a high degree of supervision, youths from father-absent families were no more likely than those from father-present families to demonstrate conduct problems.

Growth hormone response to α-adrenergic receptor agonists such as clonidine has been reported to be useful in assessing changes in the responsiveness of central α-adrenergic receptors. In the present study, growth hormone response to 2.5–5.3 μg/kg, PO of clonidine was studied in 18 children with Tourette's syndrome (TS) and in 26 children with short stature. Subjects ranged in age from 4 to 17 years, with a mean age of 12 years. TS children were studied prior to and following a minimum of 3 weeks of oral clonidine. After controlling for the effects of age, weight, and dose, children with short stature were found to have a significantly higher growth hormone peak (p < 0.05) and earlier peak time (p < 0.01) compared to TS children in pretreatment conditions. These effects were most notable at 60 and 90 min following oral clonidine. With chronic treatment with this agent, the growth hormone response in the TS children increased toward that observed in children of short stature although the peak time remained delayed. The pretreatment growth hormone response was not useful in predicting therapeutic response to clonidine in TS.

Demonstrates the ways in which data from a study of children within different age groups might be used. A survey was conducted in which 1 child between the ages of 6 and 18 was described by mothers in 1,034 randomly selected households. Using a factor analytic approach, the behavior variables were grouped according to age, sex, and income. Behaviors rated included bed wetting, the child's relationships with other children, negativism, and auditory hallucinations. Since the prerequisite for the normal unfolding of any stage of development is an undisturbed unfolding of the previous stage, it is important to diagnose and treat children who suffer from disturbances promptly. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

This study examines shifts in the relationship between the Brooklyn Family Court and Kings County Hospital, a child-adolescent municipal psychiatric hospital. It focuses on the 4,532 psychiatric admissions during three periods (1960–1962, 1972–1974, and 1975–1977), which represent periods of historical change in the relationship between the Family Courts and municipal psychiatric hospitals. A comparison of the admissions during these periods indicates that the addition of a large mental health screening staff in the courts (1972–1974) and increased mental health facilities in Brooklyn (1975–1977) led to a significant decrease in the hospitalization of social rather than psychiatric emergencies that resulted in a major improvement in the care that could be given to the psychiatric emergencies.

This paper reports the results of a comparison of degrees of violence in adolescents psychiatrically hospitalized in the late 1960s and adolescents hospitalized 10 years later. The authors studied a random sample of 51 adolescents, including 26 boys and 25 girls in the late 1960s, and a random sample of 51 adolescents matched for sex and race 10 years later. Psychiatrically hospitalized girls in the 1970s were significantly more violent than psychiatrically hospitalized girls in the 1960s. The implications of these findings are discussed.