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J Am Acad Child Adolesc Psychiatry [journal]
- Dr. Kaliebe replies. [Comment, Letter]
- J Am Acad Child Adolesc Psychiatry 2014 Oct; 53(10):1135.
- Dr. Harper et al. reply. [Comment, Letter]
- J Am Acad Child Adolesc Psychiatry 2014 Oct; 53(10):1133.
- Rethinking the "complex problem of obesity". [Comment, Letter]
- J Am Acad Child Adolesc Psychiatry 2014 Oct; 53(10):1133-4.
- Children's mental health: let's build bridges, not admire the divides. [Comment, Letter]
- J Am Acad Child Adolesc Psychiatry 2014 Oct; 53(10):1131-3.
- Drs. Ozonoff and Miller reply. [Comment, Letter]
- J Am Acad Child Adolesc Psychiatry 2014 Oct; 53(10):1130-1.
- The relationship between social communication disorder (SCD) and broad autism phenotype (BAP). [Comment, Letter]
- J Am Acad Child Adolesc Psychiatry 2014 Oct; 53(10):1130.
- Attention-deficit/hyperactivity disorder polygenic risk scores predict attention problems in a population-based sample of children. [Journal Article]
- J Am Acad Child Adolesc Psychiatry 2014 Oct; 53(10):1123-1129.e6.
Clinically, attention-deficit/hyperactivity disorder (ADHD) is characterized by hyperactivity, impulsivity, and inattention and is among the most common childhood disorders. These same traits that define ADHD are variable in the general population, and the clinical diagnosis may represent the extreme end of a continuous distribution of inattentive and hyperactive behaviors. This hypothesis can be tested by assessing the predictive value of polygenic risk scores derived from a discovery sample of ADHD patients in a target sample from the general population with continuous scores of inattention and hyperactivity. In addition, the genetic overlap between ADHD and continuous ADHD scores can be tested across rater and age.The Psychiatric Genomics Consortium has performed the largest genome-wide analysis (GWA) study of ADHD so far, including 5,621 clinical patients and 13,589 controls. The effects sizes of single nucleotide polymorphisms (SNPs) estimated in this meta-analysis were used to obtain individual polygenic risk scores in an independent population-based cohort of 2,437 children from the Netherlands Twin Register. The variance explained in Attention Problems (AP) scale scores by the polygenic risk scores was estimated by linear mixed modeling.The ADHD polygenic risk scores significantly predicted both parent and teacher ratings of AP in preschool- and school-aged children.These results indicate genetic overlap between a diagnosis of ADHD and AP scale scores across raters and age groups and provides evidence for a dimensional model of ADHD. Future GWA studies on ADHD can likely benefit from the inclusion of population-based cohorts and the analysis of continuous scores.
- The effects of parental mood on reports of their children's psychopathology. [Journal Article]
- J Am Acad Child Adolesc Psychiatry 2014 Oct; 53(10):1111-22.e5.
In this study, we aimed to assess whether current mood state (depressed or manic/hypomanic) among parents with a mood disorder would affect their reports of their offspring's psychopathology.Sixty-five parents with current depression, 42 parents with current mania/hypomania, 181 parents with mood disorder in remission, and their offspring (n = 479, aged 6-18 years) completed assessments of offspring psychopathology as part of the Pittsburgh Bipolar Offspring Study (BIOS). We compared rates of offspring psychopathology assessed using the following: a clinician-administered semi-structured interview with parent and child using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS); parent-reported Child Behavior Checklist (CBCL); offspring self-reported Youth Self Reports (YSR) for those 11 years and older (n = 250); and teachers' reports when available (n = 209).There were no between-group differences in rates of psychopathology yielded from the K-SADS, except for more depressive disorders in offspring of parents with current mania/hypomania compared to offspring of parents in remission. Conversely, using the CBCL and comparing with parents who were in remission, parents with current depression reported significantly more externalizing psychopathology in offspring, whereas parents with current mania/hypomania reported more externalizing and internalizing psychopathology in their offspring. On the YSR, offspring of parents with current mania/hypomania had more internalizing psychopathology compared to offspring of parents in remission. Teacher's reports showed no between-group differences in rates of any psychopathology.Parental active mood symptomatology, especially during a manic/hypomanic episode, significantly affects their reports of their offspring's psychopathology. Trained interviewers reduce potential report bias. Clinicians and studies assessing children's psychopathology should take into account parental current mood state.
- Age 31 mental health outcomes of childhood language and speech disorders. [Journal Article]
- J Am Acad Child Adolesc Psychiatry 2014 Oct; 53(10):1102-1110.e8.
Language disorders are associated with emotional and behavioral problems in childhood and adolescence. Although clinical studies with small samples suggest that psychosocial difficulties continue into adulthood, adult mental health outcomes of childhood language disorders are not well known. The objective of this prospective longitudinal study is to determine whether the age 31 mental health outcomes of individuals who had childhood language disorders differ from the outcomes of typically developing controls.A 26-year cohort study followed up children with language or speech disorders from age 5 to age 31. The children were selected from a 1-in-3 random sample of 5-year-olds using a 3-stage screening and assessment process. A control group matched by sex, age, and classroom or school was also selected. Diagnoses were assigned with the Composite International Diagnostic Interview with the additional criterion that Global Assessment of Functioning scores indicated at least mild impairment. Dimensional psychosocial self-report measures were also administered.Rates of diagnosis at age 31 years were equivalent between participants who had childhood language disorders and controls, with and without multiple imputation to estimate missing outcomes. Differences in rates of affective and substance use disorders could not be ruled out because of attrition in the cohort with language disorders, who were less likely to participate at age 31. Psychosocial scores for both cohorts were in the normal range. The cohort with language disorders had poorer self-rated physical health than controls.Mild/moderate language disorders may not have significant long-term mental health consequences in early adulthood.
- Response/Remission With Guanfacine Extended-Release and Psychostimulants in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder. [Journal Article]
- J Am Acad Child Adolesc Psychiatry 2014 Oct; 53(10):1092-101.
In this post hoc analysis, we assessed whether guanfacine extended-release (GXR) adjunctive to a psychostimulant resulted in greater response and remission rates than placebo + psychostimulant in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).In this 9-week, double-blind, placebo-controlled dose-optimization study, participants (N = 461) aged 6 to 17 years with suboptimal response to psychostimulants were randomized to GXR on awakening (AM) + psychostimulant, GXR at bedtime (PM) + psychostimulant, or placebo + psychostimulant.At the final on-treatment assessment, more participants in both GXR + psychostimulant groups versus the placebo + psychostimulant group achieved response as assessed by 2 criteria: reduction from baseline in ADHD Rating Scale IV (ADHD-RS-IV) total score (1) ≥40% (GXR AM + psychostimulant = 69.8%, GXR PM + psychostimulant = 70.3%, versus placebo + psychostimulant = 57.9%; p = .032 and p = .026, respectively), or (2) ≥50% (63.1%, 64.9%, versus 43.4%; p <.001 for both). Results were similar for symptomatic remission (ADHD-RS-IV total score ≤18; 61.1%, 62.2%, versus 46.1%; p = .010 and p = .005, respectively) and syndromal remission (symptomatic remission plus Clinical Global Impressions of Severity of Illness score ≤2). The most common treatment-emergent adverse events in participants receiving GXR + psychostimulant were headache (21.2%) and somnolence (13.6%).GXR + psychostimulant treatment resulted in a greater percentage of participants meeting stringent criteria for response and remission compared with placebo + psychostimulant. The adverse event profile of adjunctive therapy was consistent with known effects of either treatment alone. Clinical trial registration information-Efficacy and Safety of SPD503 in Combination With Psychostimulants; http://clinicaltrials.gov/; NCT00734578.