Subgenual prefrontal cortex of child and adolescent bipolar patients: a morphometric magnetic resonance imaging study.

The subgenual prefrontal cortex (SGPFC) plays an important role in emotional processing. We carried out a magnetic resonance imaging (MRI) study comparing the volume of the SGPFC in child and adolescent bipolar patients and healthy controls. The sample consisted of 15 children and adolescents who met DSM-IV criteria for bipolar disorder (mean age +/- S.

Normal pituitary volumes in children and adolescents with bipolar disorder: a magnetic resonance imaging study.

The volume of the pituitary gland in adults with bipolar disorder has previously been reported to be smaller than that of healthy controls. Such abnormalities would be consistent with the HPA dysfunction reported in this illness. We conducted a study of children and adolescents with bipolar disorder to determine whether size abnormalities in the pituitary gland are already present early in illness course.

Clinical characteristics of depressive symptoms in children and adolescents with major depressive disorder.

Objective: Very few studies have compared the symptoms of major depressive disorder (MDD) and rates of comorbid psychiatric disorders between depressed children and adolescents. The aim of this study was to reproduce and extend these findings.

Method: The Kiddie Schedule for Affective Disorders and Schizophrenia, present version (KSADS-P) was administered to parents (about their children) and in face-to-face interviews with 916 subjects aged 5.

Use of medical and behavioral health services by adolescents with bipolar disorder.

Objective: This study compared use of medical and behavioral health care by adolescents with bipolar disorder and other adolescents and identified areas in need of more clinical attention.

Methods: Medical and behavioral health insurance claims from 1996 for 100,880 adolescents were examined and categorized. Differences between and among various categories of disease were explored by using multivariate analyses.

Family-focused treatment for adolescents with bipolar disorder.

Background: Research has begun to elucidate the optimal pharmacological treatments for pediatric-onset bipolar patients, but few studies have examined the role of psychosocial interventions as adjuncts to pharmacotherapy in maintenance treatment. This article describes an adjunctive family-focused psychoeducational treatment for bipolar adolescents (FFT-A). The adult version of FFT has been shown to be effective in forestalling relapses in two randomized clinical trials involving bipolar adults.

Citalopram treatment of pediatric recurrent abdominal pain and comorbid internalizing disorders: an exploratory study.

Objective: To assess the potential efficacy, tolerability, and safety of citalopram in the treatment of functional pediatric recurrent abdominal pain and comorbid internalizing disorders.

Method: Twenty-five clinically referred children and adolescents with recurrent abdominal pain aged 7 to 18 years, inclusive, participated in a 12-week, flexible-dose, open-label trial of citalopram. Primary outcome measure was the Clinical Global Impression Scale-Improvement, with responders defined by ratings of 1 (very much improved) or 2 (much improved).

Phenomenology of panic disorder in youth.

We compared the demographic and clinical characteristics of youth with panic disorder (PD) (n=42), non-panic anxiety (n=407), and non-anxiety psychiatric disorders (n=1,576). Subjects were recruited from a mood and anxiety disorders clinic and assessed with the KSADS-P. In this large clinical sample, approximately 2% of the patients had PD.

Cross-sectional study of abnormal amygdala development in adolescents and young adults with bipolar disorder.

Background: In vivo imaging studies in adult bipolar patients have suggested enlargement of the amygdala. It is not known whether this abnormality is already present early in the illness course or whether it develops later in life. We conducted a morphometric MRI study to examine the size of specific temporal lobe structures in adolescents and young adults with bipolar disorder and healthy control subjects, as well as their relationship with age, to examine possible neurodevelopmental abnormalities.

Psychosocial functioning in youths at high risk to develop major depressive disorder.

Objective: To compare the psychosocial functioning of children and adolescents at high risk of major depressive disorder with youths with acute major depressive disorder and healthy controls.

Method: High-risk (n = 57), major depressive disorder (n = 71), and healthy control (n = 48) youths and their families were recruited from 1987 to 1996 and assessed for psychopathology using standardized instruments. Except for 16 children who had disruptive disorders, the high-risk children were free of psychopathology.

Abnormal left superior temporal gyrus volumes in children and adolescents with bipolar disorder: a magnetic resonance imaging study.

Abnormalities in left superior temporal gyrus (STG) have been reported in adult bipolar patients. However, it is not known whether such abnormalities are already present early in the course of this illness. Magnetic resonance imaging (MRI) morphometric analysis of STG was performed in 16 DSM-IV children and adolescents with bipolar disorder (mean age+/-SD 15.

First episode of depression in children at low and high familial risk for depression.

Objective: To examine the development of first-onset major depressive disorder (MDD) in children at high and low familial risk for depression in a prospective study.

Method: High-risk children (n = 76) who were free of any lifetime affective disorder and had at least one first-degree and one second-degree relative with a lifetime history of childhood-onset, recurrent, bipolar, or psychotic depression were included. Low-risk children (n = 63) were included if they were free of any lifetime psychiatric disorder and had no first-degree relatives and fewer than 20% of their second-degree relatives with a lifetime affective disorder.

A preliminary study of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children mania rating scale for children and adolescents.

Objective: To construct a mania rating scale designed for children and adolescents.

Methods: Fourteen questions from the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode (K-SADS-P) 1986 version plus a new item assessing mood lability were used to construct a clinician-rated mania rating scale (K-SADS-MRS). Interrater reliability was determined prospectively with 22 patients from a bipolar outpatient clinic.

Clinical presentation and course of depression in youth: does onset in childhood differ from onset in adolescence?

Objective: To simultaneously and prospectively compare the clinical presentation, course, and parental psychiatric history between children and adolescents with major depressive disorder.

Method: A group of prepubertal children (n = 46) and postpubertal adolescents (n = 22) were assessed with structured interviews for psychopathology and parental psychiatric history and followed once every 2 years for approximately 5 years.

Results: With the exception of more depressive melancholic symptoms in the adolescents, both groups had similar depressive symptomatology, duration (average 17 months), severity of the index episode, rates of recovery (85%) and recurrence (40%), comorbid disorders, and parental psychiatric history.

Measuring mood and complex behavior in natural environments: use of ecological momentary assessment in pediatric affective disorders.

This article describes the theoretical background and methodology of ecological momentary assessment (EMA) and reports results from a pilot study using EMA techniques in 16 children and adolescents with affective disorders and 5 subjects who were healthy and at low risk to develop future affective disorders. Multiple daily assessments of the subjects' mood, thoughts, and behaviors were performed in their natural environments using brief interviews on cellular phone calls by the study staff and by wrist actigraphy. The pilot results demonstrated that the EMA methodology is feasible in this population, as 17 of 21 subjects were able to complete the entire 8-week protocol.

Fluoxetine for the treatment of childhood anxiety disorders.

Objective: To assess the efficacy and tolerability of fluoxetine for the acute treatment of children and adolescents with generalized anxiety disorder, separation anxiety disorder, and/or social phobia.

Method: Anxious youths (7-17 years old) who had significant functional impairment were randomized to fluoxetine (20 mg/day) (n = 37) or placebo (n = 37) for 12 weeks.

Results: Fluoxetine was effective in reducing the anxiety symptoms and improving functioning in all measures.

Sertraline pharmacokinetics and dynamics in adolescents.

Objective: To determine the pharmacokinetics of sertraline in adolescents and assess its effect on a surrogate marker of serotonin transport.

Method: Pharmacokinetic parameters of a single 50-mg dose of sertraline were determined in 10 adolescents. Steady-state withdrawal kinetics were determined in 12 adolescents taking 50 mg/day and in 6 adolescents taking 100 to 150 mg/day.

Applications of neural network analyses to in vivo 1H magnetic resonance spectroscopy of Parkinson disease patients.

Purpose: To apply neural network analyses to in vivo magnetic resonance spectra of controls and Parkinson disease (PD) patients for the purpose of classification.

Materials And Methods: Ninety-seven in vivo proton magnetic resonance spectra of the basal ganglia were recorded from 31 patients with (PD) and 14 age-matched healthy volunteers on a 1.5-T imager.

Is bipolar disorder specifically associated with panic disorder in youths?

Objective: To replicate previous findings of high rates of bipolar disorder (BPD) in patients with panic disorder (PD) and determine if youths with both PD and BPD have more severe illness.

Method: 2025 youths aged 5 to 19 years seen at a mood and anxiety specialty clinic were assessed using the Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present Episode, 4th Revision. Diagnoses were made using DSM-III and DSM-III-R criteria and then updated to conform to DSM-IV criteria.

Superior temporal gyrus volumes in pediatric generalized anxiety disorder.

Background: The essential symptoms of generalized anxiety disorder (GAD) are intrusive worry about everyday life circumstances and social competence, and associated autonomic hyperarousal. The amygdala, a brain region involved in fear and fear-related behaviors in animals, and its projections to the superior temporal gyrus (STG), thalamus, and to the prefrontal cortex are thought to comprise the neural basis of our abilities to interpret social behaviors. Larger amygdala volumes were previously reported in pediatric GAD; however, the brain regions involved in social intelligence were not examined in this pilot study.

Feature extraction and classification of dynamic contrast-enhanced T2*-weighted breast image data.

Unlabelled: The relatively low specificity of dynamic contrast-enhanced T1-weighted magnetic resonance imaging (MR) imaging of breast cancer has lead several groups to investigate different approaches to data acquisition, one of them being the use of rapid T2*-weighted imaging. Analyses of such data are difficult due to susceptibility artifacts and breathing motion.

Materials And Methods: One-hundred-twenty-seven patients with breast tumors underwent MR examination with rapid, single-slice T2*-weighted imaging of the tumor.

Amygdala response to fearful faces in anxious and depressed children.

Background: Alterations in amygdala function have been implicated in the pathophysiological characteristics of adult anxiety and depressive disorders. Studies with healthy adults and children, as well as with adults who have amygdala lesions, have found facial expressions of emotion to be useful probes of amygdala activity. Our study examined the amygdala response to fearful and neutral facial expressions in healthy, anxious, and depressed children.

Relation between anxiety and depressive disorders in childhood and adolescence.

Current research indicates that there is a strong relationship between pediatric anxiety disorders and depression. Assessment measures show high rates of correlation between depression and anxiety and much of the overlap may be related to a common domain of negative affectivity. Anxious youth and depressed youth share a cognitive style marked by a negative bias in information processing.

Classification of in vivo 1H MR spectra from breast tissue using artificial neural networks.

Background: The study was designed in order to investigate whether artificial neural networks could be used for analysis of in vivo magnetic resonance (MR) spectra from breast cancer patients.

Materials And Methods: In vivo 1H MR spectra with three different echo times (TE 135, 350 and 450 msec) were acquired from patients with benign and malignant breast lesions and from healthy volunteers, of whom some were breast-feeding. A spectral region (4.

Low growth hormone response to growth hormone-releasing hormone in child depression.

Background: This study examined growth hormone (GH) response to growth hormone-releasing hormone (GHRH) in a large sample of depressed children compared with normal control children. Within-subject comparisons were also performed in control subjects to examine test-retest reliability and in depressed children comparing episode versus clinical recovery.

Methods: The sample included depressed children (n = 82) and normal control children (n = 55) group-matched for age, gender, and pubertal status; the mean ages were 11.