Clinical experience using intranasal ketamine in the longitudinal treatment of juvenile bipolar disorder with fear of harm phenotype.

Objectives: Fear of Harm (FOH) is a pediatric onset phenotype of bipolar disorder (BD) characterized by BD plus treatment resistance, separation anxiety, aggressive obsessions, parasomnias, and thermal dysregulation. Intranasal ketamine (InK) in 12 youths with BD-FOH produced marked improvement during a two-week trial. Here we report on the open effectiveness and safety of InK in maintenance treatment of BD-FOH from the private practice of one author.

Alterations in skin temperature and sleep in the fear of harm phenotype of pediatric bipolar disorder.

In children diagnosed with pediatric bipolar disorder (PBD), disturbances in the quality of sleep and wakefulness are prominent. A novel phenotype of PBD called Fear of Harm (FOH) associated with separation anxiety and aggressive obsessions is associated with sleep onset insomnia, parasomnias (nightmares, night-terrors, enuresis), REM sleep-related problems, and morning sleep inertia. Children with FOH often experience thermal discomfort (e.

Bipolar disorder in children: assessment in general pediatric practice.

Purpose Of Review: Pediatricians are increasingly confronted with the mental health needs of children. Given the unanticipated role, well-described diagnostic guidelines and treatment protocols are essential: but often lacking. Identification of bipolar disorder in children, a condition which lacks diagnostic criteria consensus, presents a particular challenge.

Clinical experience using intranasal ketamine in the treatment of pediatric bipolar disorder/fear of harm phenotype.

Objectives: Intravenous ketamine, a glutamate N-methyl-d-aspartate (NMDA) receptor antagonist, has been shown to exert a rapid antidepressant effect in adults with treatment resistant depression. Children with bipolar disorder (BD) often respond poorly to pharmacotherapy, including polypharmacy. A pediatric-onset Fear of Harm (FOH) phenotype has been described, and is characterized by severe clinical features and resistance to accepted treatments for BD.

Neuropsychological factors differentiating treated children with pediatric bipolar disorder from those with attention-deficit/hyperactivity disorder.

To determine the specificity of suggested endophenotypes of pediatric bipolar disorder (PBD), the performance of 15 euthymic children with PBD was contrasted with that of 20 children with attention-deficit/hyperactivity disorder (ADHD), a population with reportedly similar executive dysfunction, and 18 children with both PBD and ADHD. Children with PBD and PBD+ADHD (ages 8 to 17) demonstrated higher intraindividual variability in reaction time, slower processing speed, and more sluggish motor preparedness than did children with ADHD. The findings support the contention that processing speed, intraindividual variability, and slower and more variable reaction time as interstimulus interval lengthens are likely specific endophenotypes of PBD.