JAACAP open最新文献

{"title":"Safety and Tolerability of Brexpiprazole in Adolescents With Schizophrenia: A Long-Term, Open-Label Study","authors":"Sarah D. Atkinson MD , Alpesh Shah MD, MSc , Maria Victoria Burgess MD , Nanco Hefting MSc , Dalei Chen PhD , Caroline Ward PhD","doi":"10.1016/j.jaacop.2024.04.005","DOIUrl":"10.1016/j.jaacop.2024.04.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to characterize long-term safety and tolerability of brexpiprazole, an atypical antipsychotic, as maintenance treatment in adolescents with schizophrenia.</div></div><div><h3>Method</h3><div>This was an interim analysis of an ongoing, 24-month, multicenter, single-arm, open-label, outpatient study of oral brexpiprazole 1 to 4 mg/day (flexible dose) in adolescents aged 13 to 17 years with schizophrenia. Primary end points were incidence of treatment-emergent adverse events (TEAEs), TEAEs by severity, serious TEAEs, and adverse events leading to study discontinuation.</div></div><div><h3>Results</h3><div>At the time of interim analysis, 169 patients had entered the study, 114 (67.5%) were ongoing, 23 (13.6%) had completed the full 24 months, and 32 (18.9%) had discontinued—most commonly due to withdrawal by the patient. Study participants were 52.7% female and 79.9% White, with a mean age of 15.6 years. Overall, 95 of 167 treated patients (56.9%) reported ≥1 TEAEs, most commonly somnolence (10.2%), headache (9.0%), weight increase (9.0%), and nasopharyngitis (6.6%). Most TEAEs were mild or moderate in severity. Clinically meaningful weight gain after adjusting for natural growth occurred in 33 patients (19.8%). Five patients (3.0%) reported a serious TEAE (2 psychotic disorder; 1 each of nonfatal suicide attempt, pilonidal cyst, and psychomotor hyperactivity), all of which resolved during the study. Two patients (1.2%) discontinued the study due to adverse events: one following the serious nonfatal suicide attempt and the other due to hyperpituitarism and weight increase, which were considered stable at the time of discharge.</div></div><div><h3>Conclusion</h3><div>Brexpiprazole, when used as maintenance treatment for adolescents with schizophrenia, has a safety profile generally consistent with that observed in adult patients. Any weight gain in adolescent patients should be carefully monitored and compared against weight gain associated with normal growth.</div></div><div><h3>Plain language summary</h3><div>Long-term antipsychotic treatment is often standard of care for adolescents with schizophrenia, although side effects leading to treatment discontinuation are common. The aim of this study was to identify the frequency and severity of adverse events associated with the antipsychotic brexpiprazole in adolescents aged 13 to 17 years with schizophrenia. Among 167 treated patients, most adverse events were mild or moderate in severity, with two patients discontinuing treatment because of adverse events. One in 5 patients gained more weight than expected for growing adolescents. Overall, the long-term safety of brexpiprazole in adolescents with schizophrenia is like that in adults.</div></div><div><h3>Clinical guidance</h3><div>• This study aimed to answer the question of whether oral doses of brexpiprazole, 1-4 mg once-daily, were safe and tolerated maintenance treatment in adolescents with schizophreni","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 2","pages":"Pages 313-322"},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance and Psychometric Properties of Novel Brief Assessments for Depression in Children and Adolescents","authors":"Paul E. Croarkin DO, MS ,&nbsp;Paul A. Nakonezny PhD ,&nbsp;David W. Morris PhD ,&nbsp;A. John Rush MD ,&nbsp;Betsy D. Kennard PsyD, ABPP ,&nbsp;Graham J. Emslie MD","doi":"10.1016/j.jaacop.2024.05.002","DOIUrl":"10.1016/j.jaacop.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>Current rating scales for depressive symptom severity in pediatric patients do not meet the needs of contemporary clinical practice and research. This study sought to evaluate relative performance and psychometric properties of the 5-item Brief Children’s Depression Rating Scale—Revised (BCDRS-R5), as well as the clinician-rated and self-report versions of the 5-item Very Quick Inventory of Depressive Symptomatology (VQIDS-A5-C and VQIDS-A5-SR, respectively).</div></div><div><h3>Method</h3><div>This study examined a sample of 165 outpatients aged 8 to 17 years with major depressive disorder who were treated openly with fluoxetine for 6 weeks from a prior National Institute of Mental Health (NIMH)–funded study. We examined the internal consistency, scale dimensionality, relative performance in detecting remission and response, and sensitivity to change of each 5-item scale.</div></div><div><h3>Results</h3><div>All 3 brief scales had good-to-excellent internal consistency. Cronbach coefficient α values were 0.687 to 0.795 at baseline and 0.766 to 0.844 at week 6. Principal component analysis suggested a 1-factor solution for each scale. The BCDRS-R5 demonstrated a greater degree of accuracy in identifying response and remission compared to the VQIDS-A5-C and VQIDS-A5-SR. The scales were sensitive to change in symptom severity over 6 weeks of acute treatment with fluoxetine.</div></div><div><h3>Conclusion</h3><div>Three novel, brief scales assessing depressive symptom severity in pediatric patients showed similar performance and sensitivity to change in symptom severity over 6 weeks of acute treatment when compared with longer, standard scales.</div></div><div><h3>Plain language summary</h3><div>Existing assessment tools for depressive symptom severity in children and adolescents have limitations and do not meet the needs of contemporary families, clinical practice, or research efforts. The purpose of the current study, using a sample of youth with depression, was to evaluate the psychometric properties of the 5-item Brief Children's Depression Rating Scale–Revised (BCDRS-R5) as well as the 5-item Very Quick Inventory of Depressive Symptomatology self-report and clinician-rated versions (VQIDS-A5-SR/VQIDS-A5-C), compare their relative performance, and define clinically-relevant depressive symptom severity thresholds for remission. These novel, brief scales had similar performance as longer, standard scales and show promise for future use in clinical practice and research efforts.</div></div><div><h3>Clinical trial registration information</h3><div>Sequential Treatment of Pediatric MDD to Increase Remission and Prevent Relapse; <span><span>https://clinicaltrials.gov/study/NCT00612313</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 2","pages":"Pages 335-343"},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of Prediction Models for the Diagnosis of Autism Spectrum Disorder in a Korean General Population","authors":"Hyelee Kim MD, MAS, MS ,&nbsp;Bennett L. Leventhal MD ,&nbsp;Yun-Joo Koh PhD ,&nbsp;Efstathios D. Gennatas MBBS, PhD ,&nbsp;Young Shin Kim MD, MPH, MS, PhD","doi":"10.1016/j.jaacop.2024.03.005","DOIUrl":"10.1016/j.jaacop.2024.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>Delays in autism spectrum disorder (ASD) diagnosis and treatment are significant clinical problems that can be addressed by timely, community-based assessment. This study examined tools for identifying ASD in community settings using machine learning (ML) models.</div></div><div><h3>Method</h3><div>This study analyzed population-based cross-sectional studies (2005-2017) of ASD in South Korea. A community sample of 62,083 children was screened using the Autism Spectrum Screening Questionnaire (ASSQ) and teacher/caregiver referrals. Caregivers completed the Behavior Assessment System for Children–2nd Edition (BASC-2) and the Social Responsiveness Scale (SRS). Screen positives were offered a comprehensive clinical evaluation. Among the first-graders in regular elementary schools who completed the diagnostic evaluation (N = 746), supervised ML models (generalized linear model with elastic net regularization [GLMNET], classification and regression tree, random forest, and gradient boosting [GB]) were developed and validated for classification of ASD. Models were developed in the single questionnaire and combined questionnaire datasets, using questionnaire responses and demographic and developmental information.</div></div><div><h3>Results</h3><div>ASD was diagnosed in 46.2% of children (median age, 6.8 years [interquartile range, 6.5-7.1 years]; 71.7% boys). Among single questionnaire models, the BASC GB model demonstrated the best discrimination ability (area under the curve 0.80, 95% CI 0.75-0.83). Area under the curve of the GLMNET model with combined ASSQ, BASC-2, and SRS was the highest, 0.82 (95% CI 0.77-0.89); the predicted risk of ASD by the GB model of combined questionnaires agreed the best with the observed risk of ASD compared with other ML models.</div></div><div><h3>Conclusion</h3><div>Caregiver questionnaire ML models showed future promise for identifying children with ASD in community settings.</div></div><div><h3>Plain language summary</h3><div>To tackle the problem of delayed autism diagnosis, a study in South Korea used machine learning tools to identify autism spectrum disorder (ASD) from a community sample of over 62,000 children. By analyzing questionnaire responses along with developmental data, researchers developed models to classify ASD, with the best model achieving accuracy with an area under the curve (AUC) statistic of 0.82. The findings suggest that machine learning models based on caregiver questionnaires have significant potential for early identification of ASD in community settings. This could lead to more timely interventions for affected children.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 2","pages":"Pages 302-312"},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Gene–Environment Interplay Between Bereavement and Polygenic Risk for Attention-Deficit/Hyperactivity Disorder on Externalizing Behaviors During Adolescence","authors":"Ana Lucia Espinosa Dice MA ,&nbsp;Henri M. Garrison-Desany PhD ,&nbsp;Andrew Ratanatharathorn PhD ,&nbsp;Henning Tiemeier MD, PhD ,&nbsp;George Davey Smith MD, DSc ,&nbsp;Christy A. Denckla PhD","doi":"10.1016/j.jaacop.2024.04.006","DOIUrl":"10.1016/j.jaacop.2024.04.006","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The death of a close friend during adolescence may have a negative impact on one’s mental health. However, existing literature has focused primarily on internalizing disorders, leaving the domain of externalizing behaviors understudied. Furthermore, the role of genetics in shaping post-bereavement psychopathology is not understood. In response, we examine potential interplay between polygenic liability for attention-deficit/hyperactivity disorder (ADHD) and bereavement of a close friend in shaping risk of post-loss externalizing symptoms among adolescents.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;We examined self-reported loss of a close friend between ages 12 and 16 years and a polygenic risk score (PRS) for ADHD in a sample of 3,922 adolescents from the Avon Longitudinal Study of Parents and Children. Outcomes at age 16.5 included 2 subscales of the Strengths and Difficulties Questionnaire: hyperactivity/inattention symptoms and conduct problems. Zero-inflated negative binomial (ZINB) models addressed the zero-skewed outcome distribution, and likelihood ratio tests for model comparison were used to detect gene–environment interplay.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Nearly 1 in 10 adolescents reported losing a close friend. After adjusting for pre-loss psychopathology, bereavement independently predicted higher hyperactivity/inattention symptom count (bereaved vs nonbereaved: incidence rate ratio [IRR] = 1.18; 95% CI = 1.05-1.31), whereas the PRS for ADHD did not; neither were associated with the odds of zero (vs any) symptoms. Similarly, a model that included bereavement but not PRS best described the observed variation in conduct problems (bereaved vs nonbereaved: IRR = 1.40; 95% CI = 1.13-1.73).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Our findings reinforce the negative impact that losing a friend may have on an adolescent’s mental health, and suggest that externalizing symptoms among bereaved youth warrant clinical attention. Results from ZINB models reveal that bereavement may aggravate the severity or number of existing externalizing symptoms among those who would exhibit externalizing problems regardless. Genetic liability for ADHD may not augment the prediction of risk for psychopathology after bereavement, although better-powered samples are needed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;Drawing on data from a sample of 3,922 adolescents from the Avon Longitudinal Study of Parents and Children in the UK, researchers found that nearly 1 in 10 adolescents reported experiencing the death of a close friend between ages 12 and 16. Relative to those who did not experience the loss of a friend, bereaved adolescents demonstrated higher hyperactivity/inattention and conduct problems scores at age 16.5. In this study, underlying genetic liability for ADHD did not meaningfully explain externalizing behavior scores after taking bereavement into account. This study reinforces the impacts of friend bereavement ","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 2","pages":"Pages 323-334"},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Replicating and Extending the Reliability, Criterion Validity, and Treatment Sensitivity of the PANSS10 and PANSS20 for Pediatric Trials","authors":"Eric A. Youngstrom PhD ,&nbsp;Joshua A. Langfus MA ,&nbsp;David Gordon Daniel MD ,&nbsp;Joan Busner PhD ,&nbsp;Robert L. Findling MD, MBA","doi":"10.1016/j.jaacop.2024.02.010","DOIUrl":"10.1016/j.jaacop.2024.02.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Pediatric studies of schizophrenia have relied on the 30-item Positive and Negative Syndrome Scale (PANSS30) as a primary outcome measure. There have been many efforts to create shorter versions of it to reduce costs and burden. The present aim is to conduct a confirmatory investigation of the reliability and validity of 10- and 20-item abbreviated versions developed in a United States–based National Institute of Mental Health (NIMH) pediatric sample that reflects the 5-factor structure underlying the PANSS, adding more detailed examination of patient-level score reproducibility and extending the examination to a large, placebo-controlled, international pediatric trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;We applied the same psychometric and treatment sensitivity analyses as in Findling &lt;em&gt;et al.&lt;/em&gt; (2023) to an adolescent schizophrenia paliperidone randomized placebo-controlled trial (RCT), accessed via the Yale Open Data Access (YODA) secure data environment (described in Singh &lt;em&gt;et al.&lt;/em&gt;, 2011). Analyses included confirmatory factor analyses, graded response models, ω reliability coefficients, tests of convergent criterion validity, sensitivity to change, and Bland–Altman plots to evaluate score reproducibility.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Using the paliperidone RCT dataset, with N = 201 participants between the ages of 12 and 17 years (mean age = 15.40, SD = 1.53 years; 59% male), the PANSS 10- or 20-item vs 30-item versions had similar average interitem correlations (0.11-0.15); ω&lt;sup&gt;Total&lt;/sup&gt; reliabilities of 0.78 to 0.89 with reliability &gt;0.80 across patient presentations from mild residual symptoms to severe pathology; correlations of 0.92 and 0.98 with the 30-item total; partial eta-squared (η&lt;sup&gt;2&lt;/sup&gt;) values for time, treatment, and time by treatment; and also correlations with Clinical Global Impression (CGI) severity and Children’s Global Assessment Scale (CGAS) ratings. Per-item scores differed by 0.04 points on average on the PANSS10 and by 0.01 points for the PANSS20 vs the PANSS30, all not significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Results replicated reliability and validity findings for the PANSS10 and PANSS20 short forms in an international pediatric randomized placebo-controlled trial. Findings extend prior work by being the first to apply modern reliability models (ω) for multi-factor composites, also using Bland–Altman methods to evaluate patient-level score reproducibility. Scores based on the PANSS10 or PANSS20 reproduce traditional scores with high fidelity and low bias, offering substantial savings in terms of time, cost, and burden, especially when used for tracking progress or outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;A secondary analysis of data from a global clinical trial involving 201 young patients with schizophrenia found that shorter, 10 and 20-item versions of the standard 30-item schizophrenia assessment tool (PANSS) are equall","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 2","pages":"Pages 257-267"},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141145185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Cardiovascular Disease Risk Endotypes of Adolescent Major Depressive Disorder Using Exploratory Unsupervised Machine Learning","authors":"Anisa F. Khalfan BSc ,&nbsp;Susan C. Campisi PhD ,&nbsp;Ronda F. Lo PhD ,&nbsp;Brian W. McCrindle MD, MPH ,&nbsp;Daphne J. Korczak MD, MSc","doi":"10.1016/j.jaacop.2024.04.004","DOIUrl":"10.1016/j.jaacop.2024.04.004","url":null,"abstract":"<div><h3>Objective</h3><div>Adolescents with major depressive disorder (MDD) are at increased risk of premature atherosclerosis and cardiovascular disease (CVD). The ability to identify adolescents with MDD who are at increased CVD risk would facilitate personalized interventions and advance knowledge regarding the MDD–CVD association. This study aimed to identify adolescent MDD endotypes of increased CVD risk.</div></div><div><h3>Method</h3><div>Youth with MDD (n = 189; 74% female; mean [SD] age 15.03 [1.85] years) were recruited through an outpatient psychiatry program in a large urban hospital. Individual and family (demographics, depression, anxiety symptoms, family conflict), physical examination (vital signs, body mass index), and laboratory (lipid profile, glucose, C-reactive protein) data were collected. Using demographic, clinical, and laboratory data, k-means clustering was performed; a subsequent model included only lipids. Continuous and categorical measures were compared between clusters.</div></div><div><h3>Results</h3><div>The model containing all variables yielded 1 high and 1 low CVD risk cluster, which differed significantly in ethnicity, anthropometrics, laboratory data, and family conflict, but not in depression or anxiety severity. The lipid-only model yielded 2 high and 2 low CVD risk clusters that differed significantly in sex, ethnicity, body mass index, lipids, depression, and anxiety severity. Of the 2 CVD risk clusters, one was indicative of increased cardiometabolic risk, while the other comprised adolescents with MDD who had high low-density lipoprotein and no other cardiovascular risk factors.</div></div><div><h3>Conclusion</h3><div>Endotypes of adolescent MDD associated with varying levels of CVD risk were identified. Results highlight the heterogeneity of adolescent MDD and the need for precision medicine approaches in management of MDD to improve both CVD and depression outcomes.</div></div><div><h3>Plain language summary</h3><div>This study examined cardiovascular risk factors among adolescents with major depressive disorder (MDD) at the Hospital for Sick Children in Toronto, Canada. Cluster analysis using fasting serum lipid concentrations yielded 4 endotypes of adolescent depression with respect to youth demographic, clinical, and cardiometabolic factors and highlighted different potential mechanisms of increased cardiovascular disease (CVD) risk. Results underscore the heterogeneity of adolescent MDD and the need for precision medicine approaches to improve both CVD and depression outcomes.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 2","pages":"Pages 291-301"},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative Review: A Neurobiological Perspective on Resilience in Youth","authors":"Kiran Khalid MBBS ,&nbsp;Huma Baqir MD ,&nbsp;Hanna E. Stevens MD, PhD","doi":"10.1016/j.jaacop.2024.05.001","DOIUrl":"10.1016/j.jaacop.2024.05.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Children and adolescents are faced with multiple factors that may pose risks for development of psychiatric morbidity. These include both inherited and environmental factors such as a family history of depression or experiencing adversity. However, not all individuals who have such risks develop illness, due to resilience factors that effectively provide protection from risk. The topic of resilience has received much attention in research in recent years. Its importance lies in improving our theoretical understanding of protection from illness and may also pave the way for psychoeducation to families and intervention for youth.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Understanding the neurobiology underlying resilience may reveal brain-based methods to protect mental health. Relevant literature from 2008 to 2023 was searched for neuroimaging studies that demonstrated youth outcomes linked with fewer psychiatric symptoms or better functioning in the face of psychiatric risks.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;This narrative review summarizes current evidence pertaining to the neurobiological underpinnings of resilience, including anatomical, functional, and genetic perspectives of the hippocampus, amygdala, prefrontal and cingulate cortices, white matter tracts, and related networks in youth with environmental or inherited psychiatric risks. In addition, a functional and developmental overview of the involved regions is provided for a comprehensive understanding. Avenues for further research are also discussed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Psychiatric resilience in youth is linked with multiple neurobiological and genetic features. This evidence could be leveraged toward identification and intervention development to protect mental health in the face of risks.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;This narrative review explores structural, functional, and genetic aspects of the brain that are associated with the resilience of youth to psychiatric risks. Multiple brain features (eg, greater prefrontal cortex volume and activity, less default mode connectivity) are linked to children and adolescents having fewer psychiatric symptoms or better functioning in the presence of risk factors such as family mood disorder risk or community adversity. These findings have implications for research and for prevention which could be leveraged to develop interventions for youth who are at-risk for developing psychiatric illness.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Clinical guidance&lt;/h3&gt;&lt;div&gt;• When constructing clinical case formulations, it is important to include both risk and resilience factors, to reflect parallels in the structure and function of the brain.&lt;/div&gt;&lt;div&gt;• In psychoeducation with youth and families, consider inclusion of evidence indicating neurobiological strengths to promote better outcomes.&lt;/div&gt;&lt;div&gt;• Functional aspects of the brain, including neurobiology underlying resilience needs to be studied and targ","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 2","pages":"Pages 171-191"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141026448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent/Guardian- and Self-Report Versions of the Irritability Domain of the Concise Associated Symptom Tracking Scale: Evaluation of Psychometric Properties and Potential Clinical Utility in the Texas Youth Depression and Suicide Research Network","authors":"Manish K. Jha MD ,&nbsp;Abu Minhajuddin PhD ,&nbsp;Regina Baronia MD, MEd ,&nbsp;Joseph C. Blader PhD ,&nbsp;Taryn L. Mayes MS ,&nbsp;Michaella A. Petrosky MS ,&nbsp;Holli Slater PhD ,&nbsp;Sarah M. Wakefield MD ,&nbsp;Madhukar H. Trivedi MD","doi":"10.1016/j.jaacop.2024.04.002","DOIUrl":"10.1016/j.jaacop.2024.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>This report evaluated how self- vs parent/guardian-report of irritability, a common transdiagnostic feature of mental illness in children and adolescents, relate to each other, and whether there are any differences based on sex.</div></div><div><h3>Method</h3><div>Individuals (aged 8-17 years) from the ongoing Texas Youth Depression and Suicide Research Network (TX-YDSRN) with data available for self- and parent/guardian-versions of the 5-item irritability domain of Concise Associated Symptom Tracking (CAST-IRR) as a measure were included (N=658). Confirmatory factor analyses (CFAs) and item response theory (IRT) analyses evaluated psychometric properties for the full sample and for male and female participants separately. Weighted kappa statistics evaluated the agreement, and bifactor analysis evaluated shared vs unique components of the 2 versions.</div></div><div><h3>Results</h3><div>Both self- and parent/guardian-report versions of CAST-IRR had similar psychometric properties in the full sample as well as in male and female participants separately. The slope of each item exceeded 1.0 on IRT analyses, suggesting adequate discrimination for each item. There was poor agreement for items of self- and parent/guardian versions (weighted kappa range, 0.07-0.21). Self- and parent/guardian-report versions were significantly correlated with other self- and parent/guardian-report measures of depression and anxiety, respectively. A bifactor model supported the presence of a shared factor as well as unique self- and parent/guardian-specific factors that explained 40.8%, 14.2%, and 45.0% variance, respectively.</div></div><div><h3>Conclusion</h3><div>Self- and parent/guardian-report versions of CAST-IRR have similar psychometric properties in both male and female participants, and measure distinct aspects of irritability in youths. Clinicians may consider using both versions in their practice to comprehensively assess irritability.</div></div><div><h3>Plain language summary</h3><div>This study from the Texas Youth Depression and Suicide Research Network evaluated the psychometric properties and agreement between youth-report and parent/guardian-report versions of an irritability questionnaire for youth, the Concise Associated Symptom Tracking-Irritability scale (CAST-IRR). The psychometric properties of both scales were similar, though agreement between youth and parents/guardians was low. CAST-IRR measured both a shared factor of irritability between youth and parents/guardians, as well as unique factors of irritability for the youth and the parents/guardians. Given the importance of irritability in youth psychopathology, further work is needed to determine the value of considering both self- and parent/guardian reports.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 2","pages":"Pages 279-290"},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Depression Increases the Risk of Autism Diagnosis in the Offspring","authors":"Morgan R. Peltier PhD ,&nbsp;Michael J. Fassett MD ,&nbsp;Nana A. Mensah PhD, MPH ,&nbsp;Nehaa Khadka PhD, MPH ,&nbsp;Meiyu Yeh MS ,&nbsp;Vicki Y. Chiu MS ,&nbsp;Yinka Oyelese MD ,&nbsp;Darios Getahun MD, PhD, MPH","doi":"10.1016/j.jaacop.2024.02.008","DOIUrl":"10.1016/j.jaacop.2024.02.008","url":null,"abstract":"<div><h3>Objective</h3><div>Although maternal psychopathology has long been suggested to increase the risk of neurodevelopmental disorders, whether or not postpartum depression (PPD), a condition diagnosed after delivery, is associated with increased risk of diagnosis of autism spectrum disorders (ASDs) in the offspring, is unclear. Therefore, we tested the hypothesis that PPD diagnosis in the mother would increase the risk of ASD diagnosis in her offspring, and that the association would be independent of gestational age at birth, child’s sex, or race/ethnicity.</div></div><div><h3>Method</h3><div>We conducted a retrospective cohort study among children born between 2010 and 2021 by examination of individual patient maternal–child linked electronic health records (EHRs) (N = 297,720) from Kaiser Permanente Southern California hospitals. <em>International Classification of Diseases codes</em> listed in the EHR were used to identify diagnosed PPD and ASD cases. Marginal Cox proportional hazard models were fit to evaluate the potential association between maternal PPD diagnosis and the diagnosis of ASD in the offspring. Results are reported as incidence rates and adjusted hazard ratios (HRs) with 95% CIs.</div></div><div><h3>Results</h3><div>Children of mothers diagnosed with PPD had higher rates of ASD diagnosis than children of mothers without the diagnosis of PPD (9.11 vs 5.48 per 1000 person-years, HR =1.57, CI = 1.49, 1.65). PPD diagnosis in mothers was associated with ASD diagnosis in the offspring for both preterm and term-born children, boys as well as girls, and no strong racial/ethnic heterogeneity in the association was detected.</div></div><div><h3>Conclusion</h3><div>Postpartum depression in the mother is associated with an increased risk of ASD diagnosis in her child, independent of gestational age at birth, child sex, and race/ethnicity.</div></div><div><h3>Plain language summary</h3><div>This study examines whether a diagnosis of postpartum depression (PPD) in a mother is associated with an increased risk of autism spectrum disorder (ASD) being later diagnosed in her children, based on data derived from electronic health records of Kaiser Permanente Southern California hospitals. Findings from the sample studied suggest that maternal diagnosis of PPD is significantly associated with an increased risk of ASD diagnosis in her child. This association was observed for both preterm and term-born infants, regardless of gender or race/ethnicity. These findings need to be verified in independent samples.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 2","pages":"Pages 232-244"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Pandemic Impacts on Behavioral and Emotional Health of Young Children With Autism","authors":"Olivia M. Pokoski MPH ,&nbsp;Hayley M. Crain PsyD ,&nbsp;Sarah M. Furnier MS ,&nbsp;Ronald E. Gangnon PhD ,&nbsp;Cy Nadler PhD ,&nbsp;Eric J. Moody PhD ,&nbsp;Karen Pazol PhD, MPH ,&nbsp;Maria A. Stanley MD ,&nbsp;Lisa D. Wiggins PhD, MPH ,&nbsp;Maureen S. Durkin PhD, DrPH","doi":"10.1016/j.jaacop.2024.02.006","DOIUrl":"10.1016/j.jaacop.2024.02.006","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To test initial hypotheses that the coronavirus disease 2019 (COVID-19) pandemic was associated with decreases in adaptive behavior and increases in behavioral and emotional problems of children with autism; greater impacts for children who lost specialty services; and greater behavioral and emotional problems for children with autism vs control participants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Eligible participants (N = 1,158) enrolled in phase 3 of the multisite, case-control Study to Explore Early Development (SEED) before March 31, 2020, were between 2 and 5 years old, and completed follow-up assessments between January and July 2021. Caregivers completed a COVID-19 Impact Assessment Questionnaire, Vineland Adaptive Behavior Scales (VABS), and Child Behavior Checklist (CBCL) for 274 children with autism and 385 control participants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Mean VABS communication scores of children with autism decreased significantly (mean difference [SD] = −4.2 [10.5]) between prepandemic and pandemic periods, while VABS composite (+2.0 [9.0]), daily living (+5.5 [11.4]), socialization (+2.3 [10.0]), and CBCL (−3.2 [8.4]) scores improved. In contrast, CBCL scores worsened in population control participants (+3.4 [8.8]). Children with autism who missed specialty appointments scored significantly lower on VABS during the pandemic vs children who did not miss appointments (VABS Composite 70.6; 95% CI 68.8-72.4 vs 74.5; 95% CI 71.8-77.2).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;While stay-at-home policies of the COVID-19 pandemic may have beneficially impacted daily living skills, socialization, and behavioral and emotional well-being of children with autism, benefits may have occurred at the cost of communication skills. These findings indicate the need for strategies to maintain therapeutic services in future emergency settings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;In this study of 274 children with autism, measures of daily living, socialization, and behavioral and emotional wellbeing improved following the COVID-19 pandemic, whereas a measure of communication skills worsened. Findings emphasize the nuanced impact of the COVID-19 pandemic and resultant policies on the behavioral and emotional health of children with autism. Children with autism who missed specialty appointments scored worse on follow-up measures of communication skills, highlighting the importance of maintaining therapeutic services during emergency situations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Diversity &amp; Inclusion Statement&lt;/h3&gt;&lt;div&gt;We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 2","pages":"Pages 268-278"},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}