Journal of child and adolescent psychopharmacology最新文献

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SYNGAP-1 Mutation And Catatonia: A Case Series and Systematic Review. SYNGAP-1 基因突变与紧张症:病例系列和系统回顾
IF 1.5 4区 医学
Journal of child and adolescent psychopharmacology Pub Date : 2024-11-01 Epub Date: 2024-09-05 DOI: 10.1089/cap.2024.0055
Isaac Baldwin, Alicia Cho, Gabe Orenstein, Natalie Wilner, Daniel Nicoli, Joshua Ryan Smith
{"title":"SYNGAP-1 Mutation And Catatonia: A Case Series and Systematic Review.","authors":"Isaac Baldwin, Alicia Cho, Gabe Orenstein, Natalie Wilner, Daniel Nicoli, Joshua Ryan Smith","doi":"10.1089/cap.2024.0055","DOIUrl":"10.1089/cap.2024.0055","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Hyperactive catatonia is often unrecognized in pediatric patients due to its clinical heterogeneity, though it is often seen in children with neurodevelopmental disabilities, especially autism spectrum disorder (ASD). Emerging evidence implicates hyperactive catatonia in more cases of self-injury and aggression in ASD than previously thought. <b><i>Objectives:</i></b> The study seeks to describe cases of hyperactive catatonia in SYNGAP-1 mutation and examine existing literature for symptomatic overlap between previously-described clinical and behavioral phenotypes of individuals with SYNGAP-1 mutations and catatonia. <b><i>Methods:</i></b> The study describes two cases of an adolescent and a young adult with SYNGAP-1 mutation and ASD presenting with hyperactive catatonia, which are the first reports of catatonia in individuals known to have a pathogenic variant in SYNGAP-1. A systematic review was undertaken during which 101 articles were screened. 13 articles were then examined for neurological and behavioral features present in participants with SYNGAP-1 mutations which are seen in catatonia. <b><i>Results:</i></b> The systematic review demonstrates that clinical features suggestive of catatonia are frequently seen among individuals with SYNGAP-1 mutations, including verbal impairment, psychomotor symptoms, aggression, oral aversion, and incontinence. These features were also present in the cases of catatonia in SYNGAP-1 mutations presented here. Both patients showed clinical improvement with use of a long-acting benzodiazepine, and one patient showed benefit from electroconvulsive therapy. <b><i>Conclusions:</i></b> This symptomatic overlap revealed in the systematic review, including symptoms seen in the reported cases, raises the possibility that diagnoses of catatonia may have been missed in the past in individuals with SYNGAP-1 mutations. Self-injurious behavior and aggression, which are hallmarks of hyperactive catatonia, are commonly part of the behavioral phenotype of SYNGAP-1-related disorders. Clinicians should consider catatonia as a cause of such symptoms in individuals with SYNGAP-1 mutations, as effective treatment can result in significant improvement in safety and quality of life.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"383-396"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132834","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}
引用次数: 0
Beyond the Off-Label: A Systematic Review of What We Know About Clozapine Use for Children. 超越标签外:关于儿童使用氯氮平的系统回顾》。
IF 1.5 4区 医学
Journal of child and adolescent psychopharmacology Pub Date : 2024-11-01 Epub Date: 2024-09-30 DOI: 10.1089/cap.2024.0070
Thales Pimenta de Figueiredo, Igor Ribeiro de Almeida, Filipe Augusto Cursino de Freitas, Caio Hage Chahine Kubrusly, Antônio Marcos Alvim-Soares Júnior, Débora Marques de Miranda
{"title":"Beyond the Off-Label: A Systematic Review of What We Know About Clozapine Use for Children.","authors":"Thales Pimenta de Figueiredo, Igor Ribeiro de Almeida, Filipe Augusto Cursino de Freitas, Caio Hage Chahine Kubrusly, Antônio Marcos Alvim-Soares Júnior, Débora Marques de Miranda","doi":"10.1089/cap.2024.0070","DOIUrl":"10.1089/cap.2024.0070","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> It is essential not to delay behavior management and control for aggression, violence, and impulsive behavior in young people. Clozapine has been widely used in adolescents and adults to manage violence and aggression in Schizophrenia. However, there are limited data on the use of clozapine in children, and no systematic review has addressed its use in this population. <b><i>Objective and Methods:</i></b> To better understand the conditions under which clozapine is used as a therapeutic alternative for nonschizophrenic diagnoses and to assess the current evidence supporting its prescription to children, a systematic review was conducted. The review followed PRISMA guidelines and was registered in PROSPERO under the ID CRD42024537707. <b><i>Results:</i></b> The review identified that all the studies used clozapine to address externalizing behavior, particularly aggressive behavior, and found positive outcomes supporting its use for treating children with treatment-resistant aggression. The studies also found that clozapine was well-tolerated in all cases. However, the studies were limited and mainly consisted of open trials without a control group. <b><i>Conclusion:</i></b> Further high-quality research is needed to establish precise guidelines for using clozapine in children.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"e419-e426"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347410","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}
引用次数: 0
A Discrepancy in the Reports on Life Events Between Parents and Their Depressed Children Is Associated with Lower Responsiveness to SSRI Treatment. 父母与抑郁子女在生活事件报告上的差异与 SSRI 治疗反应较低有关。
IF 1.5 4区 医学
Journal of child and adolescent psychopharmacology Pub Date : 2024-11-01 Epub Date: 2024-09-25 DOI: 10.1089/cap.2024.0039
Maya Amitai, Elhai Etedgi, Tomer Mevorach, Roni Kalimi, Netta Horesh, Noga Oschry-Bernstein, Alan Apter, Noa Benaroya-Milshtein, Silvana Fennig, Abraham Weizman, Alon Chen
{"title":"A Discrepancy in the Reports on Life Events Between Parents and Their Depressed Children Is Associated with Lower Responsiveness to SSRI Treatment.","authors":"Maya Amitai, Elhai Etedgi, Tomer Mevorach, Roni Kalimi, Netta Horesh, Noga Oschry-Bernstein, Alan Apter, Noa Benaroya-Milshtein, Silvana Fennig, Abraham Weizman, Alon Chen","doi":"10.1089/cap.2024.0039","DOIUrl":"10.1089/cap.2024.0039","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Exposure to a range of stressful life events (SLE) is implicated in youth psychopathology. Previous studies point to a discrepancy between parents'/children's reports regarding stressful life events. No study systematically assessed the correlation between such discrepancies and psychopathology in depressed youth. This study was designed to assess parent-youth discrepancies regarding stressful life events and its association with severity of psychopathology at baseline and response to selective serotonin reuptake inhibitor (SSRI) treatment in depressed youth. <b><i>Methods:</i></b> Reports regarding stressful life events were assessed in children/adolescents suffering from depressive/anxiety disorders using the life events checklist (LEC), a self-report questionnaire measuring the impact of negative life events (NLE) and positive life events (PLE), as reported by the children and their parents. The severity of depression/anxiety disorders and response to antidepressant treatment were evaluated and correlated with both measures of LEC. <b><i>Results:</i></b> Participants were 96 parent-child dyads (39 boys, 57 girls) aged 6-18 years (mean = 13.90 years, SD = 2.41). Parents reported more NLE and higher severity of NLE events than their children (number of NLE: 7.51 ± 4.17 vs. 6.04 ± 5.32; Cumulative severity of NLE: 24.95 ± 14.83 vs. 17.24 ± 12.94). Discrepancy in PLE, but not NLE, was associated with more severe psychopathology and reduced response to treatment. <b><i>Discussion:</i></b> Discrepancy in informant reports regarding life events in depressed/anxious youth, especially regarding PLE, is associated with more severe psychopathology and reduced response to pharmacotherapy. It is essential to use multiple reporters in assessing stressful life events in children.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"407-413"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347409","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}
引用次数: 0
Association Between Single-Dose and Longer Term Clinical Response to Stimulants in Attention-Deficit/Hyperactivity Disorder: A Systematic Review of Randomized Controlled Trials. 注意缺陷/多动障碍患者对刺激剂的单剂量临床反应与长期临床反应之间的关系:随机对照试验的系统回顾。
IF 1.5 4区 医学
Journal of child and adolescent psychopharmacology Pub Date : 2024-10-01 Epub Date: 2024-07-19 DOI: 10.1089/cap.2024.0038
Valeria Parlatini, Alessio Bellato, Sulagna Roy, Declan Murphy, Samuele Cortese
{"title":"Association Between Single-Dose and Longer Term Clinical Response to Stimulants in Attention-Deficit/Hyperactivity Disorder: A Systematic Review of Randomized Controlled Trials.","authors":"Valeria Parlatini, Alessio Bellato, Sulagna Roy, Declan Murphy, Samuele Cortese","doi":"10.1089/cap.2024.0038","DOIUrl":"10.1089/cap.2024.0038","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Stimulants, such as methylphenidate (MPH) and amphetamines, represent the first-line pharmacological option for attention-deficit/hyperactivity disorder (ADHD). Randomized controlled trials (RCTs) have demonstrated beneficial effects at a group level but could not identify characteristics consistently associated with varying individual response. Thus, more individualized approaches are needed. Experimental studies have suggested that the neurobiological response to a single dose is indicative of longer term response. It is unclear whether this also applies to clinical measures. <b><i>Methods:</i></b> We carried out a systematic review of RCTs testing the association between the clinical response to a single dose of stimulants and longer term improvement. Potentially suitable single-dose RCTs were identified from the MED-ADHD data set, the European ADHD Guidelines Group RCT Data set (https://med-adhd.org/), as updated on February 1, 2024. Quality assessment was carried out using the Cochrane Risk of Bias (RoB) 2.0 tool. <b><i>Results:</i></b> A total of 63 single-dose RCTs (94% testing MPH, 85% in children) were identified. Among these, only a secondary analysis of an RCT tested the association between acute and longer term clinical response. This showed that the clinical improvement after a single dose of MPH was significantly associated with symptom improvement after a 4-week MPH treatment in 46 children (89% males) with ADHD. The risk of bias was rated as moderate. A further RCT used near-infrared spectroscopy, thus did not meet the inclusion criteria, and reported an association between brain changes under a single-dose and longer term clinical response in 22 children (82% males) with ADHD. The remaining RCTs only reported single-dose effects on neuropsychological, neuroimaging, or neurophysiological measures. <b><i>Conclusion:</i></b> This systematic review highlighted an important gap in the current knowledge. Investigating how acute and long-term response may be related can foster our understanding of stimulant mechanism of action and help develop stratification approaches for more tailored treatment strategies. Future studies need to investigate potential age- and sex-related differences.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"337-345"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723642","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}
引用次数: 0
Metabolic Monitoring for Children and Adolescents Prescribed Second-Generation Antipsychotics: A Qualitative Study with Child Psychiatrists. 对开具第二代抗精神病药物处方的儿童和青少年进行代谢监测:对儿童精神科医生的定性研究。
IF 1.5 4区 医学
Journal of child and adolescent psychopharmacology Pub Date : 2024-10-01 Epub Date: 2024-08-23 DOI: 10.1089/cap.2024.0026
Swarnava Sanyal, Paul J Rowan, Melissa Ochoa-Perez, Chadi Calarge, Rajender Aparasu, Susan Abughosh, Hua Chen
{"title":"Metabolic Monitoring for Children and Adolescents Prescribed Second-Generation Antipsychotics: A Qualitative Study with Child Psychiatrists.","authors":"Swarnava Sanyal, Paul J Rowan, Melissa Ochoa-Perez, Chadi Calarge, Rajender Aparasu, Susan Abughosh, Hua Chen","doi":"10.1089/cap.2024.0026","DOIUrl":"10.1089/cap.2024.0026","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Professional guidelines recommend that providers routinely monitor children prescribed second-generation antipsychotics (SGA) to reduce the risk of adverse metabolic events associated with the medication. Despite this guidance, many studies show low rates of monitoring compliance. In this study, we interviewed child psychiatrists for their views of possible barriers to monitoring. <b><i>Methods:</i></b> Semi-structured qualitative interviews, developed according to the Regehr model of influences upon patient-provider decision making, were conducted with child and adolescent psychiatrists in current practice and recruited by convenience and snowball sampling. Interviews were conducted through internet video meetings and were recorded. Interview data were analyzed following Framework Analysis qualitative methods. <b><i>Results:</i></b> We recruited and completed interviews with 17 psychiatrists. Patient-level barriers included travel difficulties, limited family time for health care appointments, patient fear of blood draws, and more. Provider-level barriers included professional judgment versus guideline guidance, perceived family burden, assumption of low-risk, short-term SGA use, and more. Organizational level barriers included lack of organizational mandates or incentives, limited appointment time per patient, lack of care coordination, lack of co-located labs, personnel turnover, and more. Barriers at the social and cultural level include stigma and low health literacy. <b><i>Conclusion:</i></b> These practicing prescribers provided a wide range of possible barriers to metabolic monitoring in children and adolescents prescribed SGAs. The next step is to explore which may be present in certain settings, and to pilot quality improvement interventions. Addressing barriers can reduce risk of metabolic disorders arising from long-term use of SGAs in children and adolescents.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"359-365"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142043955","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}
引用次数: 0
Pharmacological Treatment of Tourette Disorder in Children. 儿童抽动症的药物治疗。
IF 1.5 4区 医学
Journal of child and adolescent psychopharmacology Pub Date : 2024-10-01 Epub Date: 2024-08-30 DOI: 10.1089/cap.2023.0026
Afra Can, Jennifer Vermilion, Jonathan W Mink, Peter Morrison
{"title":"Pharmacological Treatment of Tourette Disorder in Children.","authors":"Afra Can, Jennifer Vermilion, Jonathan W Mink, Peter Morrison","doi":"10.1089/cap.2023.0026","DOIUrl":"10.1089/cap.2023.0026","url":null,"abstract":"<p><p><i><b>Background:</b></i> Tourette disorder (TD) is a neurodevelopmental disorder characterized by childhood onset of tics lasting more than one year, with multiple motor tics and at least one phonic tic at some point during the course of the symptoms. Treatment of tics may include psychoeducation, non-pharmacologic treatment, or pharmacologic treatment. We review pharmacologic treatment here. <i><b>Methods:</b></i> We performed a literature review on pharmacologic treatments for TD. <i><b>Results:</b></i> There is no current evidence to suggest that medications impact the prognosis of tic disorders, so current clinical guidelines recommend reassurance of the patient and family and monitoring if there is no change in function or quality of life due to tics. If treatment is indicated, it must be chosen based on the needs of each individual patient. Comprehensive behavioral intervention for tics (CBIT) is considered first-line management for most individuals with bothersome tics, especially if they are mild to moderate in severity. Pharmacotherapy should be considered when tics are impairing daily functioning, causing social problems, accompanied by other neuropsychiatric symptoms, or when the patient is not likely to benefit from CBIT. Current recommended pharmacotherapy options include alpha-2 adrenergic agonists, dopamine modulators, GABAergic medications, dopamine depleters, and botulinum toxin injections. Additionally, there are other novel medications that are being studied in ongoing clinical trials. <i><b>Conclusions:</b></i> This review summarizes available pharmacotherapy options for TD in children. It provides an overview of new medications and offers guidance to physicians when selecting appropriate treatments. If medications are indicated for tic management, treatment should be chosen based on the needs of the individual patient.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"346-352"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107856","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}
引用次数: 0
From the Editor-in-Chief's Desk: Maximizing Adherence, Digital Platforms, and Early Response for Precision Pediatric Psychopharmacology. 来自主编的信息:最大化依从性、数字平台和早期响应,实现精准儿科精神药理学。
IF 1.5 4区 医学
Journal of child and adolescent psychopharmacology Pub Date : 2024-10-01 Epub Date: 2024-10-08 DOI: 10.1089/cap.2024.0097
Paul E Croarkin
{"title":"From the Editor-in-Chief's Desk: Maximizing Adherence, Digital Platforms, and Early Response for Precision Pediatric Psychopharmacology.","authors":"Paul E Croarkin","doi":"10.1089/cap.2024.0097","DOIUrl":"10.1089/cap.2024.0097","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"329-330"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390837","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}
引用次数: 0
Electronic Health Records for Research on Attention-Deficit/Hyperactivity Disorder Pharmacotherapy: A Comprehensive Review. 用于注意缺陷/多动障碍药物疗法研究的电子健康记录:全面回顾。
IF 1.5 4区 医学
Journal of child and adolescent psychopharmacology Pub Date : 2024-10-01 Epub Date: 2024-09-05 DOI: 10.1089/cap.2024.0066
Sulagna Roy, Lucrezia Arturi, Valeria Parlatini, Samuele Cortese
{"title":"Electronic Health Records for Research on Attention-Deficit/Hyperactivity Disorder Pharmacotherapy: A Comprehensive Review.","authors":"Sulagna Roy, Lucrezia Arturi, Valeria Parlatini, Samuele Cortese","doi":"10.1089/cap.2024.0066","DOIUrl":"10.1089/cap.2024.0066","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Randomized controlled trials (RCTs) have shown that attention-deficit/hyperactivity disorder (ADHD) medications significantly reduce symptomatology at a group level, but individual response to ADHD medication is variable. Thus, developing prediction models to stratify treatment according to individual baseline clinicodemographic characteristics is crucial to support clinical practice. A potential valuable source of data to develop accurate prediction models is real-world clinical data extracted from electronic healthcare records (EHRs). Yet, systematic information regarding EHR data on ADHD is lacking. <b><i>Methods:</i></b> We conducted a comprehensive review of studies that included EHR reporting data regarding individuals with ADHD, with a specific focus on treatment-related data. Relevant studies were identified from PubMed, Ovid, and Web of Science databases up to February 24, 2024. <b><i>Results:</i></b> We identified 103 studies reporting EHR data for individuals with ADHD. Among these, 83 studies provided information on the type of prescribed medication. However, dosage, duration of treatment, and ADHD symptom ratings before and after treatment initiation were only reported by a minority of studies. <b><i>Conclusion:</i></b> This review supports the potential use of EHRs to develop treatment response prediction models but emphasizes the need for more comprehensive reporting of treatment-related data, such as changes in ADHD symptom ratings and other possible baseline clinical predictors of treatment response.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"331-336"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132876","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}
引用次数: 0
Adherence Rates and Barriers to Second-Generation Antipsychotic Medication Use in Youth with Bipolar Spectrum Disorders Who Have Overweight/Obesity. 体重超重/肥胖的双相情感障碍青少年服用第二代抗精神病药物的依从率和障碍。
IF 1.5 4区 医学
Journal of child and adolescent psychopharmacology Pub Date : 2024-10-01 Epub Date: 2024-05-21 DOI: 10.1089/cap.2024.0011
Christina C Klein, Avani C Modi, Jeffrey A Welge, Victor M Fornari, Brian Kurtz, Thomas J Blom, Claudine Higdon, Christoph U Correll, Melissa P DelBello
{"title":"Adherence Rates and Barriers to Second-Generation Antipsychotic Medication Use in Youth with Bipolar Spectrum Disorders Who Have Overweight/Obesity.","authors":"Christina C Klein, Avani C Modi, Jeffrey A Welge, Victor M Fornari, Brian Kurtz, Thomas J Blom, Claudine Higdon, Christoph U Correll, Melissa P DelBello","doi":"10.1089/cap.2024.0011","DOIUrl":"10.1089/cap.2024.0011","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Youth with bipolar spectrum disorders (BSD) are frequently prescribed second-generation antipsychotics (SGAs). Nonadherence to treatment often results in increased mood symptoms and diminished quality of life. We examined SGA adherence rates and adherence barriers among youth who have overweight/obesity and are diagnosed with BSD enrolled in a multisite pragmatic clinical trial. <b><i>Methods:</i></b> SGA adherence and adherence barriers at baseline via patient- and caregiver report was assessed. Adherence was defined as taking ≥70% of prescribed SGA doses in the past week. The weighted Kappa statistic was used to measure child-caregiver agreement about adherence rates, barriers, and caregiver assistance. Regression analyses were used to examine associations of caregiver assistance, age, sex, race, insurance status, dosing frequency, and number of concomitant medications with adherence. Barriers to adherence were analyzed separately for youth and their caregivers, using logistic regression to assess associations between informant-reported barriers and informant-reported adherence. <b><i>Results:</i></b> Participants included 1485 patients and/or caregivers. At baseline, 88.6% of patients self-reported as adherent; 92.0% of caregivers reported their child was adherent. Concordance between patients and caregivers was moderate (<i>k</i> = 0.42). Approximately, 50% of the sample reported no adherence barriers. Frequently endorsed barriers included forgetting, side effects, being embarrassed to take medications, and preferring to do something else. Concordance between informants regarding adherence barriers was weak (<i>k</i> = 0.05-0.36). Patients and caregivers who did not endorse adherence barriers reported higher adherence than those who endorsed barriers. Male sex and having once daily dosing of medications were associated with lower adherence. <b><i>Discussion:</i></b> One-week patient- and caregiver-reported adherence was high in this sample. Half of the sample reported adherence barriers. Most commonly endorsed barriers were forgetting, side effects, being embarrassed, and preferring to do something else. Caregivers and patients have unique perspectives regarding adherence barriers. Understanding and addressing treatment barriers in clinical practice may facilitate adherence.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"353-358"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071300","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}
引用次数: 0
Description, Implementation, and Efficacy of the Comprehensive Behavioral Intervention for Tics as First-Line Treatment for Tourette and Other Tic Disorders. 将抽动综合行为干预作为图雷特和其他抽动障碍的一线治疗方法的说明、实施和疗效。
IF 1.5 4区 医学
Journal of child and adolescent psychopharmacology Pub Date : 2024-09-23 DOI: 10.1089/cap.2024.0023
Kelly Kohler, Nicole Rosen, John Piacentini
{"title":"Description, Implementation, and Efficacy of the Comprehensive Behavioral Intervention for Tics as First-Line Treatment for Tourette and Other Tic Disorders.","authors":"Kelly Kohler, Nicole Rosen, John Piacentini","doi":"10.1089/cap.2024.0023","DOIUrl":"https://doi.org/10.1089/cap.2024.0023","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To provide an evidence-based review of the Comprehensive Behavioral Intervention for Tic (CBIT) disorders. <b><i>Results:</i></b> For close to a century, behavioral interventions for managing tics associated with Tourette and other tic disorders (TDs) were incorrectly considered ineffective and dangerous by the professional community, due, in large part, to unfounded fears that efforts to suppress tics would lead to a host of negative psychological, and even physical, outcomes (e.g., symptom substitution, tic rebound). Spurred by a growing body of research to the contrary, the Comprehensive Behavioral Treatment for Tics (CBIT) was developed to provide a tolerable and effective nonpharmacological treatment option, alone or in combination with medication, for youth and adults with tics associated with Tourette or other TDs. CBIT combines two evidence-based practices, habit reversal training (HRT) to address the urge-tic relationship and a functional intervention to identify and neutralize tic-related environmental factors. Based on positive findings from two large-scale randomized controlled trials that involved a total of 248 8-69-year olds with Tourette or chronic TD, CBIT has been designated as a first-line treatment, when available, for treating tics by the American Academy of Neurology and the European and Canadian medical academies. <b><i>Conclusions:</i></b> CBIT has demonstrated acute and durable efficacy when delivered alone or in combination with medication, in person, or via telehealth, and in the presence or absence of common comorbid conditions. Additional research is needed to develop and test treatment guidelines for the use of CBIT in combination with pharmacologic, neuromodulatory, and other intervention modalities.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288142","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}
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