Journal of the American Academy of Child and Adolescent Psychiatry最新文献

{"title":"Editorial: Structural Determinants of School Discipline: A Call to Action.","authors":"Brittany E Bryant","doi":"10.1016/j.jaac.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.02.014","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Esketamine on Depressive Symptoms in Adolescents with Major Depressive Disorder at Imminent Suicide Risk: A Randomized Psychoactive-Controlled Study.","authors":"Colette Kosik-Gonzalez, Dong-Jing Fu, Li Nancy Chen, Rosanne Lane, Michael H Bloch, Melissa DelBello, Carmen Moreno, Wayne C Drevets, Carla M Canuso","doi":"10.1016/j.jaac.2025.02.015","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.02.015","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy, safety, and tolerability of esketamine nasal spray versus psychoactive placebo (oral midazolam) in rapidly reducing depressive symptoms in adolescents with major depressive disorder at imminent risk for suicide.</p><p><strong>Method: </strong>This double-blind, double-dummy, phase 2b study randomized (1:1:1:2) 147 adolescents (12 to <18 years old) to esketamine (28, 56, or 84 mg) or midazolam twice-weekly for 4 weeks. Participants concomitantly received comprehensive standard-of-care (SOC), including initial hospitalization, oral antidepressant, and evidenced-based psychotherapy. The primary efficacy endpoint - change in Children's Depression Rating Scale-Revised (CDRS-R) total score from baseline to 24 hours post-first dose was analyzed using ANCOVA, according to a pooled sequential multiple-testing procedure.</p><p><strong>Results: </strong>All participants were moderately-to-severely depressed at enrollment; approximately 95% were moderately-to-extremely suicidal. Pooled esketamine doses (56 and 84 mg) showed superiority over midazolam in reducing CDRS-R total score at 24 hours post-first dose (between-group difference of LS means [95% CI]: -5.8 [-11.19, -0.35]; p=0.037). The between-group differences for individual 84 mg and 56 mg esketamine doses versus midazolam were -5.7 ([-12.91, 1.55], p=0.123) and -5.9 ([-12.25, 0.53], p=0.072), respectively. Severity of suicidality, per Clinical Global Impression-Severity of Suicidality Revised, improved in all 4 groups (between-group difference of LS means [95% CI]: -0.2 [-0.90, 0.41], -0.3 [-0.93, 0.31], 0.0 [-0.69, 0.72] for esketamine 28, 56, and 84 mg, respectively, at 24 hours post-first dose). Common adverse events (incidence ≥20%) reported for esketamine were dizziness, nausea, dissociation, headache, dysgeusia, somnolence, vomiting, hypoesthesia, and intentional self-injury.</p><p><strong>Conclusion: </strong>The primary efficacy endpoint of the study was met for the pooled esketamine doses (56 and 84 mg): Esketamine in conjunction with comprehensive SOC rapidly improved depressive symptoms among adolescents at imminent risk for suicide.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: The Power of Racial-Ethnic Socialization in Promoting Adolescent Resilience.","authors":"Amanda E Baker","doi":"10.1016/j.jaac.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.02.016","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Bridging Generations: The Role of Executive Function in Intergenerational Transmission of Depression.","authors":"Eric A Youngstrom","doi":"10.1016/j.jaac.2025.02.011","DOIUrl":"10.1016/j.jaac.2025.02.011","url":null,"abstract":"<p><p>Maternal depression casts long shadows across generations, influencing cognitive, emotional, and behavioral outcomes in children. Yet, understanding the precise pathways of intergenerational transmission remains a challenge for researchers and clinicians alike. In their recent study, Han et al.¹ offer valuable insights into one such pathway: the mediating role of executive function (EF) deficits in the relationship between maternal depressive symptoms and childhood depression. This investigation not only advances the field's understanding of EF but also suggests a role for interventions targeting EF to mitigate the transmission of depressive symptoms.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Historical Trauma and Resilience: The Importance of Narrative Change.","authors":"John T Walkup","doi":"10.1016/j.jaac.2025.02.010","DOIUrl":"10.1016/j.jaac.2025.02.010","url":null,"abstract":"<p><p>Understanding the disparate outcomes of those who have experienced historical trauma is critical to developing interventions for individuals, families, and communities. The authors¹ suggest that population health approaches that incorporate traditional knowledge and practices is one powerful approach for Indigenous communities. Efforts at narrative change at the population level will be key to understanding the impact of the past, dealing with current realities, and empowering for the future. There is much to learn from Indigenous peoples about not only the impact of historical trauma, but the response to that and current traumas, as well as the role of empowering narratives of resilience to offset the demoralization of Indigenous peoples and to address health disparities.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Council Page","authors":"","doi":"10.1016/S0890-8567(24)02040-9","DOIUrl":"10.1016/S0890-8567(24)02040-9","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"64 3","pages":"Page A2"},"PeriodicalIF":9.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review and Meta-Analysis: Imputing Response Rates for First-Line Psychological Treatments for Posttraumatic Stress Disorder in Youth.","authors":"Katie Lofthouse, Alana Davies, Joanne Hodgekins, Richard Meiser-Stedman","doi":"10.1016/j.jaac.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.jaac.2024.12.014","url":null,"abstract":"<p><strong>Objective: </strong>Meta-analyses assessing psychological therapies for posttraumatic stress disorder (PTSD) in youth have demonstrated their effectiveness using standardised mean differences. Imputation of response rates (i.e. 50% or greater reduction in symptoms) may facilitate easier interpretation for clinicians.</p><p><strong>Method: </strong>We searched four databases (MEDLINE, PsycINFO, PTSDPubs, and Web of Science) and screened 1,654 records to include 60 randomized controlled trials (52 Trauma-focused cognitive-behavioral therapy [TF-CBT], 8 Eye movement desensitization [EMDR]) with a total of 5,113 participants comparing psychological therapies for PTSD against control conditions in youth. Data from randomized controlled trials of EMDR and TF-CBT for PTSD were used to impute response rates, establishing how many patients display 50% reduction, 20% reduction, and reliable improvement and deterioration (using reliable change indices) in PTSD and depression.</p><p><strong>Results: </strong>The proportion of youth exhibiting a 50% reduction in PTSD symptoms was .48 (95% CI: .41-.55) for TF-CBT, .30 (.24-.37) for EMDR, and .46 (.39-.52) for all psychological therapies, compared to 0.20 (0.16-0.24) for youth in control conditions. Reliable improvement was displayed by 0.53 (0.45-0.61; TF-CBT .55 [.46-.64], EMDR .42[.30-.55]) of youth receiving psychological therapies, compared to .25 (.20-.30) of youth in control conditions. Reliable deterioration was seen in .01 (.01-.02) of youth receiving psychological therapies, compared to .13 (.08-.20) of youth in control conditions. There was a high degree of heterogeneity in the included studies.</p><p><strong>Conclusion: </strong>Psychological therapies, in particular TF-CBT, for young people with PTSD are effective and unlikely to cause deterioration, with around half of youth receiving TF-CBT exhibiting 50% symptom reduction.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Reciprocal Causality in Parent-Child Relationships.","authors":"David J Miklowitz","doi":"10.1016/j.jaac.2025.02.009","DOIUrl":"10.1016/j.jaac.2025.02.009","url":null,"abstract":"<p><p>The question of whether family dysfunction predates or is a consequence of individual psychopathology is almost as old as the mind-body problem. In traditional family systems views, individual psychopathology emerges from pathology in the family as a whole and is best alleviated by treating the familial context. Medical models view family system disturbances as reflecting caregiver distress in managing the psychiatric symptoms of another family member. In transactional developmental psychopathology models, dynamic processes within the family interact with the psychological and biological vulnerabilities of high-risk individuals, interactions that change at different points of cognitive, social, or emotional development.¹ Transactional models are recursive: psychiatric symptoms or behaviors in an ill family member affect the psychological health and relationships of other family members, and the reactions of these family members affect the functioning of the ill person.².</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board Page","authors":"","doi":"10.1016/S0890-8567(24)02039-2","DOIUrl":"10.1016/S0890-8567(24)02039-2","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"64 3","pages":"Page A1"},"PeriodicalIF":9.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Broadening the Assessment and Intervention Paradigms for Anxious Children.","authors":"Stuart Goldman","doi":"10.1016/j.jaac.2025.02.008","DOIUrl":"10.1016/j.jaac.2025.02.008","url":null,"abstract":"<p><p>Anxiety is a normal and even protective part of everyday life. At the same time, anxiety disorders (AD) are among the most common disorders of childhood and adolescence, with a point prevalence of approximately 7%¹ and a childhood/adolescent lifetime prevalence approaching 25% to 30%.²^,³ Ideally, parents and professionals would be able to identify children with early or modest forms of AD, and then provide interventions that treat as well as prevent the disorders' progression to more serious forms (secondary prevention). Early identification of AD is particularly challenging because some anxiety is normal and, as an internalizing disorder, the early manifestations of AD often go unseen by those around the child. Even if we were able to identify these at-risk children, providing effective evidence-based care is problematic. Although cognitive-behavioral therapy (CBT) and medications have evidence-based support, the evidence is at times modest,⁴ and there are not enough mental health professionals to meet the clinical need.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}