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Publications
Publications (81)
When used appropriately, marijuana and its structurally
analogous derivatives have medicinal properties that humans
have exploited for centuries. Unfortunately, D9-THC-based
drugs beget both therapeutic and undesirable psychotropic actions
by activating CB1 cannabinoid receptors (CB1Rs) in the central
nervous system (CNS), which can potentially lea...
BACKGROUND: This study describes the relationship of irritable mood (IRR) with affective disorders in youths with attention deficit hyperactivity disorder (ADHD). METHODS: Five hundred ADHD subjects were assessed with the childhood version of the Schedule for Affective Disorder & Schizophrenia. Subjects were in a genetic ADHD protocol and limited t...
Neuropsychiatric comorbidity in ADHD is frequent, impairing and poorly understood. In this report, characteristics of comorbid and comorbid-free ADHD subjects are investigated in an attempt to identify differences that could potentially advance our understanding of risk factors. In a clinically-referred ADHD cohort of 449 youths (ages 6-18), age, g...
To better understand the familial transmission of attention deficit hyperactivity disorder (ADHD), a highly heritable disorder, the effects of paternal and maternal ADHD status on probands' ADHD symptoms and subtypes were investigated.
In 323 trios with ADHD, data from a structured interview and a self-report scale (score of >21) were used to deter...
ADHD (Attention Deficit Hyperactivity Disorder) has a complex, heterogeneous phenotype only partially captured by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. In this report, latent class analyses (LCA) are used to identify ADHD phenotypes using K-SADS-IVR (Schedule for Affective Disorders & Schizophrenia for School Age...
Attention-deficit/hyperactivity disorder (ADHD) and enuresis co-occur at a higher rate than expected; the cause for this is unclear.
Diagnostic and demographic variables were compared in 344 children ages 6 to 12 years, with and without enuresis, recruited in an ADHD genetic study. Sleep variables were investigated in a subgroup of 44 enuretic chil...
Attention-deficit hyperactivity disorder (ADHD) is a highly heritable, common developmental disorder. Although a few confirmed associations have emerged from candidate gene studies, these have shown the same limitations that have become evident in the study of other complex diseases, often with inconsistent and nonreplicated results across differen...
342 Caucasian subjects with attention deficit/hyperactivity disorder (ADHD) were recruited from pediatric and behavioral health clinics for a genetic study. Concurrent comorbidity was assessed to characterize the clinical profile of this cohort.
Subjects 6 to 18 years were diagnosed with the Schedule for Affective Disorders & Schizophrenia for Scho...
The cardiovascular safety of mixed amphetamine salts extended release (MAS XR) was evaluated in 2968 children 6-12 years of age with attention-deficit/hyperactivity disorder (ADHD).
In this prospective, open-label, noncomparative, community-based study, subjects whose symptoms of ADHD were well controlled with stimulant medication maintained their...
To explore time to first response and time to first persistent response of sertraline versus placebo and compare these parameters between children (6-11 years old, n = 177) and adolescents (12-17 years old, n = 199) with major depressive disorder.
A 10-week placebo-controlled treatment was followed by a 24-week open-label sertraline treatment. The...
The aim of this study was to assess the long-term safety, tolerability, and efficacy of sertraline 50-200 mg once-daily in children (6-11 year olds) and adolescents (12-18 year olds) with a Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnosis of major depressive disorder (MDD).
This study consisted of a 24-week open...
To assess the safety, tolerability, and effectiveness of mixed amphetamine salts extended release (MAS XR) in school-age children with attention-deficit/hyperactivity disorder (ADHD) treated in a community practice setting.
Children aged 6-12 years (N = 2968) with DSM-IV-defined ADHD entered a 9-week prospective, open-label, non-comparative study o...
Limited prior research suggests that depressed women are more likely to experience certain symptoms of depression than are depressed men. The purpose of this study was to examine whether such gender differences in depressive symptoms are present during adolescence.
The Childhood Version of the Schedule for Affective Disorders and Schizophrenia and...
We set out to examine psychotropic prescribing patterns among inner city children on public assistance admitted to a university-based inpatient service.
A chart review of children 9 years old and younger admitted between 1998 and 2001 recorded demographic variables, diagnoses, and admission and discharge medications.
The sample (N = 301) was 78% ma...
Children aged 6-12 years (n=2,968) with DSM-IV-defined attention-deficit/ hyperactivity disorder (ADHD) participated in a prospective, open-label, multicentre, non-comparative community assessment study. Baseline stimulant treatment regimen (Adderall® [Shire US Inc, Newport, KY, USA] immediate-release methylphenidate, or Concerta® [McNeil Consumer...
The efficacy, safety, and tolerability of selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with major depressive disorder (MDD) are well established. Comparatively few data are available on the effects of SSRIs in depressed children and adolescents.
To evaluate the efficacy and safety of sertraline compared with placebo in...
The diverse programme covered recent advances in developmental neurobiology, genetics, psychotherapy and pharmacotherapy. Presentations included clinical consultation breakfasts, with experts in their specialities, clinical case conferences, media theatre events, symposia, special interest groups, workshops and poster presentations. Several awards...
A taxometric analysis was conducted to test the hypothesis that the latent structure of melancholia in adolescents is categorical. Two taxometric procedures were used: Mean Above Minus Below a Cut (MAMBAC) and Maximum Covariance (MAXCOV) analyses. Participants were 378 adolescents presenting for a depression evaluation. Indicators of melancholia we...
Critiqued the published double-blind, placebo-controlled studies of antidepressant pharmacotherapy in child and adolescent major depressive disorder to assess their overall efficacy. The pharmacological mechanism of antidepressant action also was discussed. At best, antidepressant treatment for depressed youths is only modestly effective. In partic...
The review examined the historical progression and current status of pharmacotherapy of child and adolescent major affective disorder.
A MEDLINE search was used to identify double-blind, placebo-controlled studies of child and adolescent major depression. Only studies that used reliable diagnostic and recovery parameters were included.
Few well-des...
To review the historical development, reliability, validity, administrative characteristics, and uses of the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS).
The various past and current K-SADS editions were reviewed as was the literature describing their uses.
Three DSM-IV-compatible versions of the K-SADS are i...
Few studies have examined the involvement of the central dopaminergic system in the pathophysiology of mood disorders. The study of prolactin (PRL) secretion may be an informative indirect method for the assessment of the dopaminergic system in children with major depressive disorder (MDD).
Plasma PRL concentrations were measured at 20-min interval...
The aim of this multicenter outpatient study was to assess the therapeutic benefits, response patterns, and safety of sertraline in adolescent major depressive disorder (MDD).
Fifty-three adolescent outpatients with MDD were treated in an open-label, 10-week, acute-phase trial with sertraline and, if responders, for an additional 12-week continuati...
Discusses the prevalence and genetic basis of attention deficit hyperactive disorder and reviews in detail its course and various treatment options including use of stimulant drugs and their adverse effects, antidepressant drugs, alpha-adrenergic agonist drugs, psychosocial interventions as well as other nondrug treatments. It is concluded that met...
A preliminary clinical observation suggests the possibility of changes in valproate level when coadministered with guanfacine. Two pediatric inpatients (8 and 9 years of age) were treated with valproic acid and guanfacine concurrently. In one child, when guanfacine was tapered and discontinued, the plasma valproate concentration decreased by 41% fr...
Beck Depression Inventory (BDI) scores of 328 adolescents referred to a depression clinic were factor analyzed to test the discriminant validity of each factor. Three of the four factors (Negative Self Attitude. Performance Difficulty, and Somatic Symptoms) discriminated depressed adolescents from those with a behavior disorder or no diagnosis; the...
Adolescents with major depressive disorder (N = 25) were treated with nortriptyline 100 mg for 6 to 10 weeks. Clinical change was assessed by three treatment outcome measures: the Schedule for Affective Disorders and Schizophrenia (K-SADS-III-R) (to assess syndromal recovery, i.e., no longer fulfilling diagnostic criteria for the disorder), the sel...
Plasma prolactin concentrations were measured at 20-min intervals over a 24-hr period in 49 adolescents with major depressive disorder (MDD) and 39 normal control adolescents. Neither the pattern nor the amount of prolactin secretion was significantly different between these two groups. There were significant gender differences, with girls secretin...
Responds to a letter by J. S. Werry (see record
1994-42410-001) noting that the dilemma is how to address the hypothesis that desipramine may be cardiotoxic so that antidepressants will be used judiciously in youths. The authors stress the importance of reporting adverse effects in youths taking antidepressants and suggest that a proper epidemiolo...
Part II of this review critically evaluates antidepressants' (AD) efficacy in children and adolescents with anxiety, physical, and behavioral disorders as well as AD's side-effect spectrum. AD are administered increasingly to youths with specific anxiety syndromes phenomenologically paralleling those in adults which are responsive to AD (e.g., pani...
This study examined measures of functional impairment and family relations in a sample of 62 adolescents with major depressive disorder (MDD) and 38 normal controls with no history of psychiatric illness.
Ratings of the following domains were obtained: mother-child relations, father-child relations, spousal relations, sibling relations, peer relati...
Part I of this review critically evaluates antidepressants' benefits for children and adolescents with affective disorders. The effectiveness of antidepressants is characterized with specific references regarding diagnostic methodology, measurement characteristics, response definitions, recovery rates, length of treatment, and plasma level monitori...
The purpose of the study was to determine whether the dexamethasone suppression test (DST) would discriminate between outpatient adolescents with major depressive disorder and normal adolescent comparison subjects.
Depressed patients were accepted into the study only if they fulfilled the Research Diagnostic Criteria for major depressive disorder....
This article reviews findings of sleep, growth hormone (GH), and cortisol measures from a number of separate controlled studies of prepubertal and adolescent depression carried out by Puig-Antich and colleagues since 1978. New data are presented comparing 24-hour GH measures in adolescents with major depressive disorder (MDD) (N = 44; mean age = 14...
The authors report a study of 24-hour serial cortisol determinations, measured during baseline and after the administration of 0.25 and 0.5 mg of dexamethasone in a sample of predominantly outpatient children with major depressive disorder, nonaffective psychiatric controls, and normal controls. In this sample, 24-hour baseline cortisol and the dex...
Kinetic constants of platelet imipramine binding were determined in youths with major depression, and a contrast group. Subjects actively depressed (N = 10) had significantly fewer imipramine binding sites (Bmax) (877 +/- 148 fmol/mg protein) than recovering depressives (N = 12) (1220 +/- 428 fmol/mg protein) and contrasts (N = 10) (1270 +/- 230 fm...
Because of its neuroendocrine effects, amphetamine infusion has been used as a probe to investigate neurobiological correlates of depressive illness. In two separate studies, a total of 72 adolescents with major depressive disorder and 66 normal adolescents were given dextroamphetamine, 0.15 mg/kg, intravenously. Their cortisol, growth hormone, and...
In an effort to evaluate whether differences exist in the hypothalamic-pituitary-thyroid axis of depressed children, a thyrotropin releasing hormone (TRH) stimulation test was administered to 55 prepubertal subjects who were divided into three groups matched for age and sex: a depressed group (endogenous N = 15, nonendogenous N = 15), a psychiatric...
The concurrent validity of the Beck Depression Inventory (BDI) was evaluated in 122 outpatient adolescents referred to a clinic for depression. Criterion validators were Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) generated diagnoses and a 17-item clinician-rated depression scale extracted from the K-SADS. Initial BDI scores...
Videotaped interrater reliability was assessed with the K-SADS-III-R on 25 children with a mean age of 10:9. Kappa statistics were computed in syndromes with a frequency rate of at least 20%. The following mean kappas were obtained: major depression = 0.83; overanxious disorder = 0.85; separation anxiety = 0.85; simple phobic disorder = 0.64; oppos...
Plasma cortisol concentrations were determined every 20 min for 24 h, in a nonstressful environment, among 48 rigorously assessed, mostly outpatient, drug-free adolescent subjects during an episode of major depression (MDD) and among 40 normal adolescent subjects. There were no significant differences in the 24-h mean, peak, or nadir, or the time o...
AbstractMany adolescents with major depressive disorder have at most partial response to standard tricyclic antidepressants despite appropriate dosage and adequate length of treatment. This paper reports a series of 23 such adolescents who were treated with monoamine oxidase inhibitors (MAOIs). Seventy-four percent of this group achieved good or fa...
Desipramine 75 mg i.m. was given in the morning to 20 adolescents with major depressive disorder and 23 normal controls. Depressed adolescents secreted significantly less growth hormone (GH) over the next 2 h than did normal adolescents, although a substantial proportion of the differences were accounted for by the depressed adolescents who had a s...
Symptom frequency and severity were compared in two sequential clinically referred samples of 95 children and 92 adolescents, aged 6 to 18 years, all medically healthy, assessed with the Schedule for Affective Disorders and Schizophrenia for School Age Children, Present Episode, who met unmodified Research Diagnostic Criteria for major depressive d...
Twenty-nine adolescents with Major Depressive Disorder were treated with imipramine on a t.i.d. dosage schedule for 3 weeks titrating to a maximal 5.0 mg/kg/day as limited by side effects (X = 4.5 ± 0.7). They were then randomly divided into two groups: 16 received their total dose at 10 P.M., after standard divided doses at 7 A.M. and 3 P.M. that...
Forty-nine, mostly outpatient (86%), nonbipolar adolescents, aged Tanner stage III to 18 years, with a current diagnosis of major depressive disorder and 40 adolescents without current presence or history of psychiatric disorder were studied polysomnographically for three consecutive nights. Sleep latency was significantly longer in the depressive...
Thirty-four adolescents with mean age 14.25 years who met RDC criteria for major depressive disorder as assessed with the K-SADS, were treated for 6 weeks on a fixed schedule of imipramine hydrochloride titrated to a dosage of 5.0 mg/kg/day except as limited by side effects. Mean dose was 246 mg/day (4.5 mg/kg/day). In spite of good indications of...
Treatment-emergent symptoms and behavioral changes were assessed during an 8-week double-blind study comparing molindone and thioridazine in 31 aggressive hospitalized children (ages 6-11). Molindone was found to be as effective as thioridazine in this sample. Adverse effects differed (nonsignificantly) for the two groups, with more sedation in the...
The reliability of assessment of Research Diagnostic Criteria and DSM-III axis I affective disorders in children and adolescents was studied using a semistructured diagnostic interview. The Schedule for Affective Disorders and Schizophrenia (SADS) for School-Age Children (Kiddie SADS) Present Episode Version, an adaptation of the adult SADS for chi...
The qualitative aspects of drugs used in enuresis control or associated with enuresis or urinary incontinence and the pathological disorders associated with enuresis or urinary incontinence are reviewed. The literature to date does not clarify the factors that account for tricyclic antidepressant effectiveness in enuresis. However, it does reveal t...
This pilot study tests the hypotheses that a dopamine agonist would be beneficial in childhood enuresis. Amantadine hydrochloride, a dopamine agonist and antiviral agent, was administered openly for a 4-week period to six primary enuretic children (five boys and one girl) with a mean age of 9:1. The mean baseline wetting frequency was 0.739 (range,...
Insulin tolerance tests (ITTs) were carried out on 46 drug-free prepubertal children with severe emotional disorders. Thirteen met unmodified Research Diagnostic Criteria for major depressive disorder, definite endogenous subtype, 17 met the criteria for nonendogenous major depressive disorder, and 16 fit DSM-III criteria for nondepressed neurotic...
Insulin tolerance tests (ITTs) were performed after at least four months of sustained recovery from an episode of a major depressive disorder in 18 drug-free prepubertal children. Eleven had a definite endogenous subtype; seven did not. Sixteen children with nondepressed neurotic disorders made up a control group. The children with past endogenous...
We evaluated the Children's Global Assessment Scale (CGAS), an adaptation of the Global Assessment Scale for adults. Our findings indicate that the CGAS can be a useful measure of overall severity of disturbance. It was found to be reliable between raters and across time. Moreover, it demonstrated both discriminant and concurrent validity. Given th...
A review of the literature on the psychopathologic manifestations of myotonic dystrophy reveals that most authors consider them to be secondary aspects of the disease. The authors believe this view to be too restrictive; they offer clinical evidence that altered mental functioning is a basic feature of myotonic dystrophy. Moreover, a group of patie...
This paper presents a series of case reports making the observation of a possible association between neuroleptic drug therapy and urinary incontinence. The incontinence was limited and not of the overflow or stress variety. Anticholinergic compounds or drug action did not seem to influence or account for the findings. A central basis is postulated...
diagnostic assessment of child psychopathology is a complex undertaking / the multifaceted nature of child and adolescent assessment must take many issues into account, including developmental considerations, multiple informants, diagnostic continuity and stability, and comorbidity of disorders / addresses several of these variables as they pertain...
