Journal of child and adolescent psychopharmacology最新文献

{"title":"<i>Letter:</i> Seventeen-Year-Old Develops Neuroleptic Malignant Syndrome after Brief Low-Dose Exposure to Aripiprazole: A Case Report.","authors":"Ilana S Regenbogen-Li, Mark A Rapp","doi":"10.1089/cap.2025.0055","DOIUrl":"https://doi.org/10.1089/cap.2025.0055","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Search and Review: Management and Prevention of Agitation and Aggression in the Child and Adolescent Psychiatric Inpatient Setting.","authors":"Ema Saito, Rumen Nikolov, Michael T Sorter, Sarah Edwards, Jennifer L Goetz, Gabriela Iagaru, Luis C Isaza, Ehsan U Syed, Rebecca V Taylor","doi":"10.1089/cap.2025.0043","DOIUrl":"https://doi.org/10.1089/cap.2025.0043","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> The objective of this review is to review existing evidence on the management and prevention of agitation and aggression in the pediatric psychiatric inpatient setting with emphasis on general unit structure, organization, and milieu programming when discussing prevention. For management of agitation and aggression, the review focuses on de-escalation, as-needed medication, and restraint and seclusion. <b><i>Methods:</i></b> The existing literature search was conducted, yielding 1836 English language citations. An additional 109 studies were identified by citation search. Among them, 287 full-text studies were assessed for eligibility, and 107 studies were included for review. Studies were included if the contents of studies were shown to prevent agitation or aggression in pediatric psychiatric inpatient units, with focuses on staffing, staff training, milieu programming, and environmental changes. Studies were also included if the contents of studies discussed management of agitation and aggression with focuses on de-escalation, restraint and seclusion, and as-needed medication use. <b><i>Results:</i></b> We recognized multiple challenges while summarizing existing evidence in our field, including lack of definition, knowledge, and standardized measurement of agitation and aggression. Challenges further extend to heterogeneity and a constellation of small studies that are not controlled. However, existing evidence supports that management and prevention of agitation and aggression start with attention to staffing, staff training, and milieu programming. Evidence for the use of as-needed (pro re nata) medication for the management of agitation and aggression in pediatric populations is limited.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stimulants Concomitant with Other Psychotropic Classes: A Competing Risk Analysis in Medicaid-Insured Youth.","authors":"Yue Zhu, Julie M Zito, James F Gardner, Heather A Young, Scott Quinlan, Angelo Elmi","doi":"10.1089/cap.2024.0113","DOIUrl":"10.1089/cap.2024.0113","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Pharmacoepidemiologic research shows increasing use of polypharmacy to manage behavioral treatment of youth. Methods to increase precision, for example, competing risk analysis, to capture psychotropic patterns of concomitant stimulant treatment changes over time have not been explored. <b><i>Methods:</i></b> A retrospective cohort study was derived from Medicaid enrollment data, prescription drug, and clinician-reported diagnosis claims data from 2007 to 2014. Youths aged 2-17 years with 1-7.5 years of continuous enrollment who were new users of stimulants were followed. Major outcomes include detailed changes of concomitant use according to the number of psychotropic classes (NPC); competing risk assessment of patient factors according to NPC; and time factors related to changes in NPC. <b><i>Results:</i></b> Among 30,294 new stimulant users, 75.5% remained on stimulant monotherapy and 24.5% had stimulant concomitant regimens. Among the latter, great flux was observed, revealing exposure to combinations changed substantially across time. As a proportion of all changes, retention of the maximum NPC was observed for 65.3% of 2 concomitant classes, 56.2% of 3 concomitant classes, and 57.1% and 56.2% of 4 and 5 concomitant classes, respectively. Median duration according to NPC showed a linear decrease in time from 223 days for 2 classes, 172 days for 3 classes, 141 days for 4 classes, and 113 days for 5 classes combinations. By contrast, the path to maximum NPC regimens took median times of 491-833 days as NPC increased from 2 to 4 concomitant classes. Competing risk analysis demonstrated significantly increased hazard ratios according to the number of concomitant classes for 12-17-year-olds, patients with foster care or disability coverage, and those with 3-4 years of continuous enrollment. <b><i>Conclusions:</i></b> Detailed NPC changes illustrate great flux in concomitant stimulant patterns among Medicaid-insured youth. Competing risk analysis brings more precise patient characteristics risk information to assess NPC changes compared with a binary model.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"277-284"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication Prescribing Patterns at a Youth Mental Health Service: A Single Center Retrospective Cross-sectional Study.","authors":"Angela Dinh, Sarira El-Den, Jack C Collins, Blake Hamilton, Connie M S Janiszewski, Donna Fowler, Claire L O'Reilly","doi":"10.1089/cap.2024.0140","DOIUrl":"10.1089/cap.2024.0140","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Rates of mental illness among young people remain elevated, and the utilization of youth mental health services is expected to increase. Yet, there is limited knowledge on real-world medication usage and prescribing at these services. Hence, the aim of this study was to explore the medication prescribing patterns at a <i>headspace</i> center, an Australian youth mental health service. <b><i>Methods:</i></b> A retrospective cross-sectional study of medical records was conducted. Demographic data, clinical information, prescribed medications, and reasons for use of young people who attended an intake assessment at <i>headspace</i> Camperdown over a 13-month period, February 2021-February 2022, were analyzed. Data collection focused on medication molecule, strength, dose, prescriber designation, and indication. Data were analyzed descriptively. <b><i>Results:</i></b> Records for 608 participants were included. The median age at intake was 19.9 years old (interquartile range: 16.1-22.4), and most participants identified as female (<i>n</i> = 372, 61.2%). Anxiety (<i>n</i> = 246, 40.5%) and low mood (<i>n</i> = 95, 15.6%) were the most common presenting concerns. Almost half of participants (<i>n</i> = 291, 47.9%) reported using medication/s at intake, and almost one in five participants (<i>n</i> = 119, 19.6%) were prescribed a medication at the service. The most prescribed medications at <i>headspace</i> were melatonin (24.0%) and quetiapine (12.3%), as well as the antidepressants escitalopram (15.1%), sertraline (11.2%), and fluoxetine (7.3%). <b><i>Conclusions:</i></b> This study provides insights into the prescribing practices at a single <i>headspace</i> center. Further investigations are needed to explore the impacts of off-label prescribing for young people, particularly in relation to melatonin and quetiapine, where safety and efficacy in young people have not been well established.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"285-293"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric Polygenic Risk Scores and Week-by-Week Symptomatic Status in Youth with Bipolar Disorder: An Exploratory Study.","authors":"Xinyue Jiang, Clement C Zai, John Merranko, L Trevor Young, Boris Birmaher, Benjamin I Goldstein","doi":"10.1089/cap.2024.0130","DOIUrl":"10.1089/cap.2024.0130","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Prior studies have demonstrated that, in both adults and youth, bipolar disorder (BD) is a polygenic illness. However, no studies have examined polygenic risk scores (PRSs) in relation to the longitudinal course of mood symptoms in youth with BD. <b><i>Methods:</i></b> This study included 246 youth of European ancestry with BD (7-20 years old at intake) from the Course and Outcome of Bipolar Youth study and Centre for Youth Bipolar Disorder. Mood symptom severity was assessed at intake and, for 168 participants, prospectively for a median of 8.7 years. PRSs for BD, schizophrenia (SCZ), major depressive disorder (MDD), and attention-deficit/hyperactivity disorder (ADHD) were constructed using genome-wide summary statistics from independent adult cohorts. <b><i>Results:</i></b> Higher BD-PRS was significantly associated with lower most severe lifetime depression score at intake (<i>β</i> = -0.14, <i>p</i> = 0.03). Higher SCZ-PRS and MDD-PRS were associated with significantly less time spent in euthymia (SCZ-PRS: <i>β</i> = -0.21, <i>p</i> = 0.02; MDD-PRS: <i>β</i> = -0.22, <i>p</i> = 0.01) and more time with any subsyndromal mood symptoms (i.e., any mania, mixed, or depression symptoms; SCZ-PRS: <i>β</i> = 0.15, <i>p</i> = 0.04; MDD-PRS: <i>β</i> = 0.17, <i>p</i> = 0.01) during follow-up. PRSs for BD and ADHD were not significantly associated with any longitudinal mood variable. <b><i>Conclusions:</i></b> This exploratory analysis was the first to examine psychiatric PRSs in relation to the prospective course of mood symptoms among youth with BD. Results from the current study can serve to guide future youth BD studies with larger sample sizes on this topic.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"269-276"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Neuropsychiatric Syndromes: Updates on COVID-19 Infection and Vaccination.","authors":"Sarah O'Dor, Celia Adams, Jessica Gavin, Julia S Zagaroli, Elliott Carlisle, Olivia M Downer, Kyle A Williams, Erin E Masterson","doi":"10.1089/cap.2024.0129","DOIUrl":"10.1089/cap.2024.0129","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> SARS-CoV-2 (COVID-19) infection has been implicated in the onset of neuropsychiatric symptoms in adults and children. While outcomes of COVID-19 infection and vaccination have been tracked in the general pediatric population, little is known of their impact on children with preexisting neuropsychiatric syndromes, including pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). The aim of this study is to understand the prevalence and severity of COVID-19 symptoms and PANS/PANDAS symptoms following COVID-19 infection or vaccination in children with PANS/PANDAS. <b><i>Methods:</i></b> We analyzed retrospective COVID-19 survey data from caregivers of youth with PANS/PANDAS at Massachusetts General Hospital (MGH; <i>n</i> = 57) and the International PANS Registry (IPR; <i>n</i> = 478). Surveys were conducted online between late 2021 and early 2022 to collect COVID-19 infection and vaccination histories, side effects, and changes in PANS/PANDAS symptoms. Descriptive results are reported, stratified by case and sibling groups within the IPR sample. <b><i>Results:</i></b> Among patients with test-confirmed COVID-19 (MGH: <i>n</i> = 20, IPR: <i>n</i> = 65 cases, <i>n</i> = 16 siblings), mild/minor COVID-19 symptoms were common (62-75%). All patients with preexisting PANS/PANDAS-related symptoms at the time of COVID-19 infection experienced an exacerbation of PANS/PANDAS symptoms, while remitted patients did not report any PANS/PANDAS symptoms. Following the first COVID-19 vaccine dose (MGH: <i>n</i> = 45, IPR: <i>n</i> = 150 cases, <i>n</i> = 44 siblings), fatigue was the predominant side effect (30-56%). Most patients did not report new (59-81%) or worsened (71-82%) PANS symptoms post-vaccination, irrespective of symptomatic status at vaccination. Vaccine hesitancy often stemmed from concerns that the vaccination would cause an exacerbation of PANS/PANDAS symptoms. <b><i>Conclusions:</i></b> In two samples of children with PANS/PANDAS, symptoms of COVID-19 following infection and vaccination were common and generally mild to moderate. Children experiencing PANS/PANDAS symptoms at the time of COVID-19 infection experienced an increase in PANS/PANDAS symptom severity.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"294-303"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biofeedback-Based Videogame May Improve Rage Attacks in Tourette Syndrome.","authors":"Jennifer Vermilion, Nicole Walsh, Matthew Tae, Alyssa Peechatka, Jason Kahn, Jessica Ragnio, Emily Stone, Jonathan W Mink","doi":"10.1089/cap.2024.0084","DOIUrl":"10.1089/cap.2024.0084","url":null,"abstract":"<p><p><b><i>Background:</i></b> Approximately 20%-40% of individuals with Tourette syndrome (TS) have rage attacks (RAs), which are recurrent, explosive behavioral outbursts that can cause significant functional impairment. Despite the impact of RA in TS, there has been limited research on treatment, and most studies have focused on pharmacologic interventions. Nonpharmacologic interventions have the potential to improve symptoms with fewer side effects. <i>Mightier,</i> a video game-based biofeedback therapy, may help teach emotional regulation through heart rate control and has the potential to improve RA in youth with TS. <b><i>Objective:</i></b> To evaluate the feasibility and acceptability of <i>Mightier</i> as a therapeutic intervention for RA in youth with TS. <b><i>Methods:</i></b> Subjects aged 6-12 years old with a diagnosis of TS and RA were enrolled between October 2021 and May 2022 into a 20-week single-arm trial. Feasibility was assessed by the rate of enrollment, screen failures, and retention and device engagement. We also evaluated efficacy by assessing rage severity (Clinical Global Impressions of Rage), Rage Outbursts and Anger Rating Scale (ROARS) and overall aggression severity (Modified Overt Aggression Scale [MOAS]) pre- and postintervention. CGI-Improvement (CGI-I) was completed postintervention. <b><i>Results:</i></b> We enrolled 11 participants. The study was feasible based on enrollment rate (one participant every 2.5 months), screen failures (<i>n</i> = 1), and retention rate (91%). Mean weekly play time was 38 (SD 18) minutes/week. No adverse effects were reported. Median rage severity scores improved across all assessment measures. All participants reported overall improvement on the post-intervention CGI-I. <b><i>Conclusions:</i></b> This <i>Mightier</i> study was feasible in terms of recruitment and retention. Participants with TS and RA used the device often and engaged with the device throughout the 12-week intervention period. Rage severity overall improved across the various outcome measures, and all participants had at least some improvement by parent report. Mightier may be a helpful tool for reducing rage severity in children with RA and TS.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"304-311"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Editor-in-Chief's Desk: Navigating Flawed Dogma in Child and Adolescent Psychopharmacology.","authors":"Paul E Croarkin","doi":"10.1089/cap.2025.0048","DOIUrl":"10.1089/cap.2025.0048","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"261-262"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myths of Randomized Controlled Trial Analysis in Pediatric Psychopharmacology.","authors":"Jeffrey A Mills, Jeffrey R Strawn","doi":"10.1089/cap.2025.0005","DOIUrl":"10.1089/cap.2025.0005","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"263-268"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response: Can Epileptic Seizures Explain Hyperactive Catatonia in Patients with Autism and Intellectual Disability?","authors":"Aparna Srinivasan, James Luccarelli, Rafael Tamargo, Timothy Adegoke, Joshua R Smith","doi":"10.1089/cap.2025.0037","DOIUrl":"10.1089/cap.2025.0037","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"317-318"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}