Journal of child and adolescent psychopharmacology最新文献

{"title":"<i>Letter:</i> Restricted Access to Electroconvulsive Therapy in Pediatric and Adolescent Patients-Clinical and Familial Consequences: Case Report.","authors":"Jarod Lowe, Joshua Ryan Smith","doi":"10.1177/10445463261478543","DOIUrl":"10.1177/10445463261478543","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"10445463261478543"},"PeriodicalIF":1.8,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amantadine-Responsive, Benzodiazepine-Resistant Catatonia in an Adolescent With Autism Spectrum Disorder.","authors":"Enric Lledo-Graell, Pooja Chaudhary, Aivien Do, Kira Gomez, Sandy Juste, Mary Evans, Toju James Okotie-Eboh, Micah Knobles, Cesar A Soutullo","doi":"10.1177/10445463261477342","DOIUrl":"https://doi.org/10.1177/10445463261477342","url":null,"abstract":"<p><strong>Background: </strong>Catatonia is a severe neuropsychiatric syndrome increasingly recognized in autism spectrum disorder (ASD), where symptom overlap can delay diagnosis. In pediatric populations, it is associated with significant morbidity and requires prompt intervention. Benzodiazepines and electroconvulsive therapy (ECT) are first-line treatments; however, access to ECT may be limited due to legal or institutional constraints. Alternative pharmacological strategies, including N-methyl-D-aspartate (NMDA) receptor antagonists such as amantadine, have been proposed, although evidence remains limited.</p><p><strong>Case presentation: </strong>We report a 15-year-old male with ASD who developed progressive catatonia over 1 year, with psychomotor slowing, speech latency, staring, and functional decline requiring hospitalization. Symptoms emerged after using over-the-counter supplements and partially improved after discontinuation. Medical and neurological workup was unremarkable. A lorazepam challenge produced partial improvement, but high-dose benzodiazepines were insufficient. Due to lack of access to ECT, amantadine was initiated and titrated to 200 mg twice daily. Within days, the patient showed marked improvement, including increased speech output, improved psychomotor activity, and enhanced social engagement. Improvement was supported by clinical observations and caregiver reports.</p><p><strong>Discussion: </strong>Catatonia involves dysfunction in dopaminergic (DA), GABAergic, and glutamatergic systems within cortico-striato-thalamo-cortical circuits. In ASD, similar abnormalities in excitatory-inhibitory balance and connectivity have been reported, which may partly explain the overlap in presentation and the potential vulnerability to catatonia. Amantadine may help restore this imbalance through NMDA receptor antagonism and DA modulation.</p><p><strong>Conclusion: </strong>Amantadine may be a viable adjunctive treatment for benzodiazepine-insufficient catatonia in adolescents with ASD when lorazepam is insufficient or poorly tolerated and ECT is unavailable. Further research is needed.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"10445463261477342"},"PeriodicalIF":1.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684668","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> Outcome Measure Selection as a Source of Null Results in Autism Pharmacotherapy: The Case of Brexpiprazole and the ABC-I.","authors":"Berkan Şahin","doi":"10.1177/10445463261453242","DOIUrl":"10.1177/10445463261453242","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"382-383"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981902","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":"Manganese Exposure and Attention-Deficit/Hyperactivity Disorder-Related Neurobehavioral Outcomes in Children: A Systematic Review of Human Studies.","authors":"Enes Ogut, Sinem Ilgin, Ozlem Atli Eklioglu","doi":"10.1177/10445463261450845","DOIUrl":"10.1177/10445463261450845","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition with multifactorial etiology involving genetic, neurobiological, and environmental determinants. Emerging evidence suggests that environmental exposures may influence neurodevelopmental pathways relevant to ADHD pathophysiology. Manganese is an essential trace element required for normal brain development; however, excessive or dysregulated exposure has been associated with neurotoxic effects. This systematic review aimed to synthesize human evidence on the association between manganese exposure and ADHD or ADHD-related neurobehavioral outcomes in children.</p><p><strong>Methods: </strong>Four electronic databases were systematically searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Observational studies meeting predefined Population, Exposure, Comparison, Outcomes, and Study Design criteria were included. Methodological quality was assessed using Joanna Briggs Institute appraisal tools, and certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation framework.</p><p><strong>Results: </strong>Thirty studies met the inclusion criteria. Elevated manganese exposure was more frequently associated with increased risk or severity of ADHD or ADHD-related neurobehavioral symptoms, although inverse and nonlinear (U-shaped) associations were also reported.</p><p><strong>Conclusions: </strong>The available evidence indicates a complex and potentially nonlinear relationship between manganese exposure and child neurobehavioral outcomes. These findings identify manganese exposure as a potentially modifiable environmental factor influencing neurodevelopmental mechanisms relevant to ADHD and highlight the need for longitudinal studies integrating exposure biomarkers with neurobiological and clinical outcomes to clarify causal pathways and therapeutic implications.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"325-336"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930032","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> Clonidine Hydrochloride Extended-Release Oral Suspension for Pediatric Attention-Deficit/Hyperactivity Disorder: A Meaningful Addition to Clinical Practice?","authors":"Maryam Tariq, Ann Genovese","doi":"10.1177/10445463261454151","DOIUrl":"10.1177/10445463261454151","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"384-385"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981948","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":"Bidirectional Associations Between Screen Time and Irritability in Preadolescence: A Temporal Network Analysis.","authors":"Lanting Zhang, Nellia Bellaert, Haoran Zhuo, Zeyan Liew, Wan-Ling Tseng","doi":"10.1177/10445463251415497","DOIUrl":"10.1177/10445463251415497","url":null,"abstract":"<p><strong>Introduction: </strong>Irritability, a form of emotion dysregulation, is a transdiagnostic symptom cutting across internalizing and externalizing problems. Clinical practitioners and parents have expressed concerns about the potential negative impact of screen use on irritability in youth. Despite the significant concerns, no studies have examined the association between screen usage and irritability and its directionality. Using a novel temporal network approach, this study investigated bidirectional associations between irritability and screen time across different activities in preadolescents.</p><p><strong>Materials and methods: </strong>We used data from the Adolescent Brain and Cognitive Development (ABCD) study. Data from baseline, 1-year, and 2-year follow-ups were included (<i>N</i> = 8979, baseline mean age = 9.5 years, 49.1% females). All data used in the study were collected from 2016 to 2019. At each timepoint, time spent on different screen activities was self-reported by youth using the ABCD Youth Screen Time Survey, and irritability was measured using parent-rated Child Behavior Checklist.</p><p><strong>Results: </strong>The cross-sectional Gaussian Graphical Model showed that irritability was negatively associated with time spent on video streaming at Year 2. The temporal network, estimated by Graphical Vector Autoregressive Model, revealed bidirectional associations between irritability online chatting. Specifically, online chatting predicted decreases in irritability over time, whereas irritability predicted increased time spent on online chatting. Additionally, watching TV and using social media were both associated with subsequent increases in irritability. Results controlled for co-occurring attention-deficit/hyperactivity disorder, anxiety, and depressive symptoms.</p><p><strong>Conclusions: </strong>These findings suggest a bidirectional association between irritability and online chatting. TV watching and social media unidirectionally predicted increased irritability. These associations highlighted the importance of monitoring screen use patterns as both potential behavioral symptoms and modifiable risk factors in interventions targeting emotion dysregulation. More research is needed to better understand how various screen activities and contents and adolescents' motives to use them are linked to irritability.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"359-368"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213325","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":"Symptoms Improve for Inpatient Adolescents According to Measurement-Based Care.","authors":"Alison A Tebbett-Mock, Shannon Gasparro, William Chaplin, Ema Saito","doi":"10.1177/10445463261453495","DOIUrl":"10.1177/10445463261453495","url":null,"abstract":"<p><strong>Objective: </strong>Use measurement-based care to assess symptom change across diagnostic categories for adolescents receiving acute-care psychiatric inpatient treatment including both psychopharmacology and dialectical behavior therapy.</p><p><strong>Methods: </strong>Adolescents were aged 12-17 and hospitalized on a coeducational, acute-care inpatient unit within a psychiatric hospital in New York City. We conducted a retrospective chart review to analyze symptoms across two or more timepoints from the first 15 days of admission using mixed effects regression models to estimate linear change on five outcome measures including Generalized Anxiety Disorder-7 (GAD-7), General Behavior Inventory-Mania subscale (GBI-10M), Patient Health Questionnaire-9 (PHQ-9), Prodromal Questionnaire Brief-21 (PQB-21), and Schwartz Outcome Scale-10 (SOS-10).</p><p><strong>Results: </strong>There were improvements on all five measures. For the GAD-7, GBI-10M, PHQ-9, and PQB-21, the change is negative, indicating a decrease in symptoms. For the SOS-10, the change is positive, suggesting an increase in well-being. The covariance parameters indicate that there is generally significant individual variation around the adolescent's initial assessment as well as significant individual variation around the slope, suggesting that patients change at different rates. The Days <i>×</i> Intercept covariance parameter is generally negative, indicating that adolescents who started with higher symptom severity showed greater symptom reduction. For well-being, the negative change indicates that adolescents with higher well-being on the first assessment showed smaller increases in well-being over time.</p><p><strong>Conclusion: </strong>Adolescents experienced improvements in their symptoms of anxiety, mania, depression, psychosis, and well-being during acute psychiatric inpatient treatment. These are notable findings, particularly for demonstrating the impact of psychiatric inpatient treatment on improving symptoms/diagnoses.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"369-376"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030774","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":"Cardiac Biomarkers as Potential Indicators of Neuroimaging Brain Changes in Children and Young Adults with Psychiatric Disorders: A Systematic Review.","authors":"Lucero Sangster-Carrasco, Irem Azamet, Cicek N Bakir, Karina Delaney, Dana Gerberi, Magdalena Romanowicz, Arjun P Athreya, Paul E Croarkin","doi":"10.1177/10445463261448801","DOIUrl":"10.1177/10445463261448801","url":null,"abstract":"<p><strong>Background: </strong>Cardiac biomarkers are recognized as potential indicators for brain function, emotion regulation, and psychiatric risk. While research in adults has suggested associations between cardiac variables of autonomic function and neural changes, little is known about these relationships in children and young adults with psychiatric conditions. This systematic review aimed to examine the evidence linking cardiac biomarkers with structural, functional, and connectivity-based brain changes in this population.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Multiple databases were searched for studies examining associations between any cardiac biomarker and neuroimaging findings in individuals under 21 years old with psychiatric diagnoses. After screening and full-text review, 11 eligible studies were included.</p><p><strong>Results: </strong>The included studies investigating a range of psychiatric conditions and cardiac biomarkers were associated with brain changes across three domains: structure, connectivity, and neural responses. Associations were most consistent between higher vagal tone and structural and functional integrity of emotion-regulating regions such as the prefrontal cortex, amygdala, and insula. However, findings were heterogeneous and potentially moderated by symptom severity or environmental stressors.</p><p><strong>Conclusions: </strong>This review supports the potential of cardiac biomarkers, particularly high-frequency heart rate variability and root mean square of the successive differences, as proxies of brain changes in youth with psychiatric disorders. While promising, current evidence is too limited and variable for clinical applications. Future research should prioritize large-scale, longitudinal studies using harmonized protocols and wearable technologies to validate these indices as translational tools in child and adolescent psychiatry.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"337-349"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838493","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":"Effectiveness and Safety of Selective Serotonin Reuptake Inhibitors in Individuals with Williams Syndrome.","authors":"Liron Snapir, Maya Elazar, Tal Cohen, Ronnie Weinberger, Maya Schwartz-Lifshitz, Michal Taler, Doron Gothelf","doi":"10.1177/10445463261451798","DOIUrl":"10.1177/10445463261451798","url":null,"abstract":"<p><strong>Objective: </strong>Anxiety and depressive disorders are common in individuals with Williams syndrome (WS), yet data regarding pharmacologic treatment in this population are limited. This study aimed to evaluate the effectiveness and safety of selective serotonin reuptake inhibitors (SSRIs) in individuals with WS treated for anxiety and/or depressive disorders.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of patients with a genetically confirmed diagnosis of WS treated with SSRIs between 2010 and 2025 at a clinic for individuals with WS. Fourteen children and adults (5 males and 9 females; mean age: 23.2 ± 11.9 years) met inclusion criteria, contributing 16 distinct SSRI treatment trials. Illness severity was assessed using the Clinical Global Impressions-Severity (CGI-S) scale at baseline and last follow-up and the Clinical Global Impressions-Improvement (CGI-I) scale.</p><p><strong>Results: </strong>The CGI-S score decreased significantly from 4.62 ± 0.81 at baseline to 3.06 ± 1.12 at last follow-up (<i>t</i>(15) = 3.83, <i>p</i> = 0.002). Nine of 16 trials (56.2%) were rated as much or very much improved (CGI-I = 1 or 2). The mean duration of SSRI treatment was 3.95 ± 3.91 years (range: 0.75-16). Adverse events were documented in two trials (12.5%), and no treatment discontinuations due to adverse events occurred.</p><p><strong>Conclusions: </strong>SSRI treatment was effective and well tolerated in individuals with WS. Prospective controlled studies are required.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"377-381"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147929989","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":"A Phase-2 Open-Label Trial of Cannabidiol to Treat Core and Associated Symptoms of Autism in Children and Adolescents Without Intellectual Disability.","authors":"Jacqueline Lawson, Lauren Robinson, Greta R Conlon, Rebecca A Shalev, Paige E Cervantes, Yuliya Yoncheva, Glenn S Hirsch, Andrea B Troxel, Daniel Friedman, Orrin Devinsky, Francisco Xavier Castellanos","doi":"10.1177/10445463261452514","DOIUrl":"10.1177/10445463261452514","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate cannabidiol (CBD) in pediatric patients with autism spectrum disorder (ASD), fluent verbal language and an estimated full-scale IQ of 80 or above.</p><p><strong>Background: </strong>Preliminary evidence suggests CBD may ameliorate challenges associated with ASD. Whether CBD benefits pediatric ASD without accompanying intellectual or language impairment remains unknown.</p><p><strong>Methods: </strong>We enrolled 23 participants, ages 7.8-17.8 (Mean [M] = 11.3 ± 2.8) with ASD and IQ ≥ 80 in a 6-week Phase-2 open-label trial of ≥98% CBD (Epidiolex^®, 100 mg/mL) at 3, 6, or 9 mg/kg/day using a Bayesian optimal interval dosing design. The primary endpoint was the CBD dose associated with the highest response rate (i.e., Clinical Global Impression Scale-Improvement [CGI-I] score = 1 or 2) on a target symptom domain designated individually based on informant report, standardized scales, and clinical observation. Secondary endpoints were effect sizes of changes from baseline in measures assessing ASD core and associated symptoms, and global functioning. Adverse events (AEs) were assessed weekly. Plasma CBD levels and clinical labs were obtained at the final visit.</p><p><strong>Results: </strong>All 23 enrolled participants completed the trial. The highest response (62%) was observed at 9 mg/kg/day (<i>N</i> = 8). Overall, 10 of 23 patients (44%) were responders. Response varied across domains: Irritability/Tantrums (<i>N</i> = 5, 60%), Social (<i>N</i> = 8, 50%), Anxiety (<i>N</i> = 5, 40%), Restricted, Repetitive Behaviors (<i>N</i> = 4, 25%), and Sleep Problems (<i>N</i> = 1, 0%). Dose correlated with individualized CGI-I (r = -0.42, <i>N</i> = 23, <i>p</i> = 0.04).Individualized domain CGI-Severity scores improved from pre-(M = 4.6 ± 0.5) to post-(M = 3.9 ± 0.8) treatment, t₍₂₂₎ = -4.36, <i>p</i> ≤ 0.001; <i>d</i> = 0.91; 95%CI [0.37,1.03]. Social Responsiveness Scale-2 Total-Score (SRS2-T) had the largest effect size (<i>p</i> ≤ 0.001; <i>d</i> = 1.36, 95% CI [0.78-1.93]).Of 222 reported AEs, 27 unique AEs were considered treatment-related. Most AEs (93%) were mild and expected (82%); none was severe. The most frequent related AEs were increased salivation (30%), increased sleep duration (39%), sleepiness/sedation (26%), increased dream activity (35%), and polyuria (22%). Vital signs, physical exams, weight, liver function tests, and complete blood counts were unaffected. CBD plasma levels did not correlate with response.</p><p><strong>Conclusions: </strong>In this preliminary study, CBD was well tolerated; AEs were mild-moderate. Mean SRS2-T and subscores decreased significantly with large effect sizes, shifting from the severe to the moderate range.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov Identifier NCT03900923.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"350-358"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042181","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}