Journal of child and adolescent psychopharmacology最新文献

{"title":"Placebo Response on Attention-Deficit/Hyperactivity Disorder Ratings: Application to Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder 3-Month Outcomes.","authors":"L Eugene Arnold, Hernan Bozzolo, Lindsay Crowl, Michael Yao, Ashley Jones Reno, Neha Dudipala, Antonino Amato, Lily Hechtman, Jeffrey Newcorn","doi":"10.1177/10445463251360685","DOIUrl":"https://doi.org/10.1177/10445463251360685","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To characterize the size and course of placebo response in attention-deficit/hyperactivity disorder (ADHD), with informant and moderator effects, and illustrate its importance by comparison to Multimodal Treatment Study of ADHD (MTA) 3-month data. <b><i>Methods:</i></b> In two randomized clinical trials parents and teachers rated DSM-IV ADHD symptoms (Sx) on pill placebo at baseline (BL), 8, 12, and 16 weeks for 57 children age 5-12 with ADHD (25 inattentive, 32 combined type) and on an intense 12-week nonmedical control condition (NMCC) for 27 children age 6-12. <b><i>Results:</i></b> Parent- and teacher-rated placebo effects peaked at 12 and 8 weeks, respectively. Changes from BL are significant (<i>p</i> = 0.001) by parent and teacher on inattentive Sx (<i>d</i> = .60, .56 for pill placebo; <i>d</i> = 1.48, .51 for NMCC) and on hyperactive/impulsive Sx by parent (<i>d</i> = 0.48 pill; <i>d</i> = 1.26 NMCC). Teacher-rated hyperactive/impulsive show greater placebo effect September-January than February-May (<i>p</i> = 0.017). Teacher-rated inattentive Sx shows a significant (<i>p</i> = 0.033) interaction of season*subtype. Compared to placebo data, MTA treatments show significant benefit (<i>p</i> = 0.000) at 3 months on both inattentive and HYP/IMP symptoms for medication management and combination groups but not for behavioral treatment (Beh) or community comparison groups, except for teacher-rated HYP/IMP for Beh (<i>p</i> = 0.002). <b><i>Conclusions:</i></b> Parent/teacher ratings show a medium placebo effect for pill placebo and a large effect (<i>d</i> > 1.2) by parent for intense, complex NMCC, suggesting that parent-rated placebo response depends on the complexity/intensity of the control condition. Raters agree on inattentive but diverge on HYP/IMP Sx. Teachers' perceptions of HYP/IMP severity change by season. Pill placebo data indirectly support the 3-month efficacy of two MTA treatments, combination and medication management.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717987","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: Improving the Health of Children with Greater Rigor in the Clinical Science of Psychopharmacology.","authors":"Paul E Croarkin","doi":"10.1177/10445463251361069","DOIUrl":"https://doi.org/10.1177/10445463251361069","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642648","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":"Severe Early-Onset Conduct Disorder and Pervasive Violence in a Patient with Comorbid Neurodevelopmental Disorders.","authors":"Jeremy Hsiang, Fayeza Malik, Anthony Maristany, Alina Kang, Cylena Stewart, Suchitra Joshi, Barbara J Coffey","doi":"10.1177/10445463251358892","DOIUrl":"https://doi.org/10.1177/10445463251358892","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626494","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":"Examining Antidepressant Side Effect Burden in Youth: The FIBSER-C Scale in the Texas Youth Depression and Suicide Research Network Study.","authors":"Fatma Ozlem Hokelekli, Emine Rabia Ayvaci, Abu Minhajuddin, Rachel A Walker, Lynnel C Goodman, Jair C Soares, Eric A Storch, Sarah M Wakefield, Madhukar H Trivedi","doi":"10.1089/cap.2025.0018","DOIUrl":"https://doi.org/10.1089/cap.2025.0018","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Evaluating antidepressant side effects in children and adolescents is important, as side effects can significantly impact treatment adherence and outcomes. While there are tools to assess side effects globally encompassing various body systems, their administration time can be substantial, limiting their practical use in clinical settings. This is especially challenging in pediatric practice, where providers need to collect information from both patients and guardians. The Frequency, Intensity, Burden of Side Effects Rating-Child (FIBSER-C) was developed to address this need and assesses side effect frequency, intensity, and burden; however, its psychometric properties have not been examined in pediatric samples. <b><i>Methods:</i></b> The analytic sample included <i>n</i> = 746 youth among the first 1000 participants who completed FIBSER-C and were taking antidepressant medication(s). The construct validity of FIBSER-C was examined by confirmatory factor analysis; internal consistency was evaluated using Cronbach's alpha (α); convergent and divergent validity were assessed by examining its association with depression severity and functioning measures. <b><i>Results:</i></b> FIBSER-C showed a single-factor structure, with standardized item loadings of 0.73, 0.83, and 0.89. The scale showed good internal consistency (Cronbach's α = 0.85). The FIBSER-C total score was weakly and positively associated with total PHQ-A, Patient-Reported Outcomes Measurement Information System (PROMIS)-Pain, PROMIS-Pain Severity, and PROMIS-Fatigue and was weakly and inversely associated with PROMIS-Physical Function. <b><i>Conclusions:</i></b> The FIBSER-C had has good internal consistency and a single-factor solution. The associations between side effect burden and depression severity, as well as functioning domains, were weak. Further research should explore the consistency and stability of the scale over time.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626493","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":"Reducing Psychotropic Medication Use in Foster-Care Children with a Personalized Medication Review.","authors":"M Christopher Newland, Erica S Ramey, John T Rapp","doi":"10.1089/cap.2025.0022","DOIUrl":"https://doi.org/10.1089/cap.2025.0022","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Investigators and government agencies have expressed concern about the high percentage of foster youth who receive psychotropic medication, the number of psychotropic medications prescribed, and the extended duration for which many foster youth receive psychotropic medication. One contributor to the duration of medication use is the absence of clear guidelines for de-prescribing in pediatric psychiatry. The present study evaluated whether medication review letters crafted by medical professionals and sent to caregivers prompted a reduction in psychotropic medication in foster youth. <b><i>Methods:</i></b> The caretaker or caseworker of 52 foster children, 38 males, under 16 years of age, who received medication through Medicaid, was sent a letter assessing the use of psychotropic medication and identifying areas of concern. Recipients were encouraged to discuss the letter with the child's prescriber. These children had been referred to a university-affiliated organization that provided behavioral interventions to other children, but the children in the present study did not receive behavioral interventions from the organization. The use of psychotropic medication was assessed for 18 months before and 24 months after the letter was sent. The control group had comparable demographics and medication-use parameters. The trajectories of medication count before and after a letter (for cases) or a \"phantom\" letter (for controls) was sent were compared. <b><i>Results:</i></b> The medication review letter precipitated a decrease in medication count over the year after the letter was sent for 9- to 12-year-olds. For 13- to 16-year-olds, an increasing trend in medication use was halted. No effect was seen for 5- to 8-year-olds. No such changes occurred in the control groups. <b><i>Conclusions:</i></b> A single personalized letter, tailored to a child's medication list, was provided to caregivers to share with prescribers. This decreased or halted an increase in the use of psychotropic medications for children in foster care who were 9 years old or older.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540365","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":"Utility of Aripiprazole in the Treatment of Anorexia Nervosa in Children and Adolescents: A Retrospective, Descriptive, Matched Cohort Study.","authors":"Isabelle Bindseil, Danielle L Stutzman, Marissa A Schiel, Kimberly Sheffield, Jennifer Hagman","doi":"10.1089/cap.2025.0013","DOIUrl":"https://doi.org/10.1089/cap.2025.0013","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Current standards for treatment of anorexia nervosa (AN) in children and adolescents include Family-Based Treatment and nutrition restoration. The use of aripiprazole for AN has been detailed through case series and one retrospective review analyzing the change in outcomes on body mass index and weight restoration. The goal of this descriptive study was to evaluate the impact of aripiprazole on food avoidant behaviors (FABs) and to describe prescribing patterns, including dosing and tolerability. <b><i>Methods:</i></b> This was a retrospective, descriptive, matched, cohort study of pediatric patients with AN admitted to an eating disorders program (EDP) between January 1, 2018, and December 31, 2023. Patients were included in this study if they had a diagnosis of AN and were started on aripiprazole for eating disorder cognitions. Patients were matched 1:2 to a control group based on age, sex, and length of stay. <b><i>Results:</i></b> A total of 42 patients on aripiprazole were analyzed and matched to 84 controls. Aripiprazole was associated with a reduction in FABs with a mean change over the evaluated time period of 3.5 versus 0.9 (<i>p</i> = 0.026). The mean starting dose of aripiprazole was 1.9 mg/day, with a mean discharge dose of 2.8 mg/day. Aripiprazole was overall well-tolerated. <b><i>Conclusion:</i></b> Aripiprazole was associated with an improvement in FABs among children and adolescents admitted to an EDP. Additionally, low-dose aripiprazole improved weight, likelihood of achieving target weight, and was well-tolerated.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333231","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":"Characteristics and Predictors of Patient and Parent Satisfaction in the Treatment of Youth Anxiety Disorders.","authors":"Galen D McNeil, Ruben G Martinez, John C Piacentini, Jeffrey R Strawn, Philip C Kendall, Scott N Compton, James T McCracken, John T Walkup, Tara S Peris","doi":"10.1089/cap.2025.0010","DOIUrl":"https://doi.org/10.1089/cap.2025.0010","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To describe the rates and predictors of youth and parent satisfaction following engagement in one of three evidence-based treatments or a placebo control for youth anxiety. <b><i>Method:</i></b> In a multisite randomized controlled trial (RCT) of youth ages 7-17 (<i>n</i> = 426) and parents (<i>n</i> = 429) comparing cognitive behavioral therapy (CBT), sertraline (SRT), the combination of the two (COMB), and placebo (PBO), we examined satisfaction at the end of acute treatment and assessed predictors including clinical change, pretreatment expectations, reactions to treatment assignment, and therapeutic relationship using multiple hierarchical linear regressions. <b><i>Results:</i></b> Satisfaction was high across all treatments. Both parents and youth reported the highest satisfaction with COMB, followed by CBT and SRT, and the least satisfaction with PBO. Parents were more satisfied than youth, and remitters were more satisfied than nonremitters. In CBT-containing arms, a stronger child-therapist relationship at week 6 predicted greater parent and youth satisfaction. Higher expectations of improvement at pretreatment predicted greater youth, but not parent, satisfaction in CBT and SRT. <b><i>Discussion:</i></b> Posttreatment, youth and parents report greater satisfaction with combination therapy over the monotherapies and PBO. Satisfaction patterns largely mirror clinical outcomes. An early strong youth-reported therapeutic alliance is key to satisfaction in CBT, highlighting the importance of child-therapist alignment when selecting anxiety treatments.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248098","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":"National Trends in Pediatric Obsessive compulsive disorder Management: Insights from a Retrospective Cohort Study.","authors":"Raman Baweja, Daniel A Waschbusch, Aarya K Rajalakshmi, Lidija Petrovic-Dovat, James G Waxmonsky","doi":"10.1089/cap.2025.0049","DOIUrl":"https://doi.org/10.1089/cap.2025.0049","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Obsessive compulsive disorder (OCD) is a chronic psychiatric condition that significantly impairs various domains, including social, academic, and overall functioning. While antidepressants and psychotherapy-specifically cognitive behavioral therapy-are the standard first-line treatments, there is considerable variability in the use of augmenting agents, particularly antipsychotics. This study examines treatment patterns in children and adolescents with OCD. <b><i>Methods:</i></b> This population-based retrospective cohort study utilized the TriNetX research network to identify patients aged 6-18 with an OCD diagnosis (F42, <i>N</i> = 37,355). Treatment patterns were analyzed based on sociodemographic factors (age, gender, and race/ethnicity) and clinical settings (inpatient vs. outpatient). Odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated, with Cox proportional hazards models used to adjust for potential confounders. <b><i>Results:</i></b> The average age of OCD diagnosis in youth was 10.9 years, with a balanced gender distribution. Psychiatric comorbidities were common, particularly anxiety disorders (53%), attention-deficit hyperactivity disorder (47%), and mood disorders (37%). Antidepressants were prescribed to 55% of patients, with sertraline and fluoxetine being the most common, while 22% were prescribed antipsychotics, primarily aripiprazole and risperidone. In addition, 31% had billable therapy codes. Racial and ethnic minority groups received less treatment overall, with lower odds of receiving antidepressants (OR 0.51-0.74) and therapy (OR 0.75) among Black youth. In contrast, Black youth were more likely to be prescribed antipsychotics (OR 1.18). Among those prescribed antipsychotics, 47% had prior antidepressant use, 22% had billed psychotherapy, and only one-sixth had both before starting antipsychotics. Inpatient hospitalization, as an indicator of symptom severity, was strongly associated with antipsychotic prescriptions (adjusted HR: 3.03, 95% CI: 2.85, 3.21). <b><i>Conclusions:</i></b> There is considerable variability in the pharmacological management of pediatric OCD, with frequent use of antipsychotics even before first-line treatments. The low utilization of psychotherapy suggests gaps in adherence to evidence-based care. These findings highlight the need for improved adherence to OCD treatment guidelines, with a focus on increasing access to psychotherapy.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248099","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":"<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}