Editors' Best of 2023.

In our inaugural year as , we are proud to support the dissemination of some of the highest quality research being conducted in our field. Choosing the "best" among stars is a tall order and most certainly misses the many ways articles make an impact: is the "best" the most interesting, most surprising, most educational, most important, most provocative, or most enjoyable? How to decide? This time around, we made some picks based on those that were methodologically rigorous and clinically salient. It is our pleasure to give a special "hats off" to the 2023 articles that we think deserve your attention or at least a second read!

Introduction to a Special Series on Aggressive Behavior as a Focus of Psychiatric Attention.

Aggressive behavior in children and adolescents is a frequent complication of numerous psychiatric, developmental, environmental, and medical factors. When present, aggression often is of paramount importance regardless of the underlying disturbances or environmental factors from which it stems. From a clinical standpoint, aggression influences important decisions about emergency service use, hospitalization, pharmacotherapy, and safety for the patient and others.

Peer Review in : Promoting Integrity While Advancing Open Science.

A critical piece in the launch of is the establishment of a high-quality and robust peer review process for incoming submissions. Indeed, peer review is the backbone of our scientific process. Here, we will discuss the importance of peer review, describe the process as we are expanding the journal family, and explain why and how you can be involved in the peer review process.

Extension and Further Replication of the Reliability, Criterion Validity, and Treatment Sensitivity of the PANSS10 and PANSS20 for Pediatric Trials.

The Positive and Negative Syndrome Scale (PANSS) is a widely accepted outcome measure for pediatric schizophrenia trials; however, it has notable limitations. Psychometric investigations have shown a multifactorial structure and some items have limited utility assessing symptom severity in children. To address these issues, we developed and evaluated optimized 10- and 20-item PANSS short-forms (PANSS10 and PANSS20) using patient-level clinical trial data.

Vortioxetine in children and adolescents with major depressive disorder: 6-month and 18-month open-label, flexible-dose, long-term extension studies.

Children and adolescents with severe or relapsing major depressive disorder (MDD) may require long-term antidepressant use, but safety and tolerability data on long-term treatment are limited. In a randomized, placebo-controlled trial in children and another in adolescents, vortioxetine and placebo groups showed improvement in MDD symptoms without statistically significant differences between groups. To gain insights on long-term safety and tolerability of vortioxetine in pediatric patients, participants from these two studies were enrolled in two long-term extension studies: 6 months (NCT02871297) followed by another 18 months (NCT03108625).

Expert consensus statement for telepsychiatry and attention-deficit hyperactivity disorder.

Changing practice patterns caused by the pandemic have created an urgent need for guidance in prescribing stimulants using telepsychiatry for attention-deficit hyperactivity disorder (ADHD). A notable spike in the prescribing of stimulants accompanied the suspension of the Ryan Haight Act, allowing the prescribing of stimulants without a face-to-face meeting. Competing forces both for and against prescribing ADHD stimulants by telepsychiatry have emerged, requiring guidelines to balance these factors.

Parental perceptions of body weight and appetite in infants and toddlers with cystic fibrosis.

Nutritional status has clinical relevance and is a target of guidance to parents of children with cystic fibrosis (CF). Growth is routinely monitored in CF clinics but there is no standardized way of assessing appetitive behaviors or parents' perceptions of their children's appetite. Greater understanding of these factors could improve clinical guidance regarding parent feeding behaviors.

Psychometric Properties and Clinical Utility of CBCL and P-GBI Sleep Items in Children and Adolescents.

Objective: Sleep is crucial to overall health, playing a complex role in a wide range of mental health concerns in children and adults. Nevertheless, clinicians may not routinely assess sleep problems due to lack of awareness or limitations such as cost or time. Scoring sleep-related items embedded on broader scales may help clinicians get more out of tools they are already using.

Randomized clinical trial of low dose suramin intravenous infusions for treatment of autism spectrum disorder.

Background: There is a critical need for effective treatment of the core symptoms of autism spectrum disorder (ASD). The purinergic antagonist suramin may improve core symptoms through restoration of normal mitochondrial function and reduction of neuro-inflammation via its known antagonism of P2X and P2Y receptors. Nonclinical studies in fragile X knockout mice and the maternal immune activation model support these hypotheses.

Scoping Review: Evidence-Based Assessment of Reactive Aggression in Children.

Objective: Severe reactive aggression poses a major mental health challenge for many families. A lack of validated instrumentation for assessing young children may present a barrier to more effective clinical assessment and treatment. This scoping review evaluates tools currently used in clinical research to assess aggressive behavior, and identifies gaps in the evidence base for their use in children under the age of 12 years.

Examining Behavioral Approach and Inhibition to Further Characterize Youth With Impulsive Aggression.

Objective: Impulsive aggression in youth is a significant clinical and public health concern, spanning multiple diagnostic categories and causing significant psychosocial impairment. To advance its assessment and treatment, recent research has focused on developing an empirically derived nosology that can distinguish impulsive aggression from other common childhood problems. The current study is a secondary analysis examining the associations between this empirically defined form of impulsive aggression, other psychiatric symptom dimensions, and behavioral approach and inhibition motivation of youth.

Our Hopes for .

With the launch of , we are thrilled to join the JAACAP family of journals and to facilitate expanded access to science generated in our field. We hope you are enjoying freely accessing, reading, and sharing the articles that we have published in thus far. Our journal family aims to promote the well-being of children and families globally by publishing original research and papers of theoretical, scientific, and clinical relevance to the field of child and adolescent mental health that are openly available for broad readership.

Cariprazine in Pediatric Patients with Autism Spectrum Disorder: Results of a Pharmacokinetic, Safety and Tolerability Study.

Cariprazine is a dopamine D-preferring D/D and serotonin 5-HT receptor partial agonist approved to treat adults with schizophrenia and manic/mixed or depressive episodes associated with bipolar I disorder. This study, which is the first to evaluate cariprazine in pediatric patients with autism spectrum disorder (ASD) (including children 5-9 years of age) using an oral solution formulation, evaluated the safety, tolerability, pharmacokinetics (PK), and exploratory efficacy of cariprazine and its two major active metabolites, desmethyl cariprazine (DCAR) and didesmethyl cariprazine (DDCAR). This clinical pharmacology, open-label, multiple-dose study enrolled 25 pediatric patients from 5 to 17 years of age, who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for ASD.

Adequacy of Children's Psychopharmacology Services: Variations by Race and Clinical Characteristics.

Objective: An expert consensus approach was used to determine the adequacy of children's psychopharmacology and to examine whether adequacy varied by demographic or clinical characteristics.

Methods: Data were from the baseline interview of 601 children, ages 6-12 years, who had visited one of nine outpatient mental health clinics and participated in the Longitudinal Assessment of Manic Symptoms study. Children and parents were interviewed with the Kiddie Schedule for Affective Disorders and Schizophrenia and the Service Assessment for Children and Adolescents to assess the child's psychiatric symptoms and lifetime mental health services use, respectively.

The stability and persistence of symptoms in childhood-onset ADHD.

The course of childhood-onset attention deficit hyperactivity disorder (ADHD) varies across individuals; some will experience persistent symptoms while others' symptoms fluctuate or remit. We describe the longitudinal course of ADHD symptoms and associated clinical characteristics in adolescents with childhood-onset ADHD. Participants (aged 6-12 at baseline) from the Longitudinal Assessment of Manic Symptoms (LAMS) study who met DSM criteria for ADHD prior to age 12 were evaluated annually with the Kiddie Schedule for Affective Disorders and Schizophrenia for eight years.

Reorienting Latent Variable Modeling for Supervised Learning.

Despite its potentials benefits, using prediction targets generated based on latent variable (LV) modeling is not a common practice in supervised learning, a dominating framework for developing prediction models. In supervised learning, it is typically assumed that the outcome to be predicted is clear and readily available, and therefore validating outcomes before predicting them is a foreign concept and an unnecessary step. The usual goal of LV modeling is inference, and therefore using it in supervised learning and in the prediction context requires a major conceptual shift.

Comparing self-reported quality of life in youth with bipolar versus other disorders.

Objectives: This study benchmarks quality of life (QoL) of youth with bipolar disorder (BD) against healthy youth, youth with chronic medical conditions, and youth with other psychiatric disorders. The relative impacts of depressive, (hypo)manic, mixed, and externalizing symptoms on QoL are tested for youth with BD.

Method: In total, 657 youth completed the Schedule for Affective Disorders and Schizophrenia for Children (KSADS), the KSADS depression and mania scales, the Parent General Behavior Inventory (PGBI), and the Child Behavior Checklist (CBCL).

Finding a Needed Diagnostic Home for Children with Impulsive Aggression.

Aggressive behavior is one of the most common reasons for referrals of youth to mental health treatment. While there are multiple publications describing different types of aggression in children, it remains challenging for clinicians to diagnose and treat aggressive youth, especially those with impulsively aggressive behaviors. The reason for this dilemma is that currently several psychiatric diagnoses include only some of the common symptoms of aggression in their criteria.

An Optimized Version of the Positive and Negative Symptoms Scale (PANSS) for Pediatric Trials.

Objective: The accepted primary outcome measure for evaluating psychotic symptoms is decades old, long, and initially designed for adults. Surprisingly, the psychometric properties of primary outcome measures have never been reported for a pediatric sample using modern methods. The present study's aim is to use a pediatric sample to evaluate the psychometrics of the most used primary outcome measure in pediatric schizophrenia trials, the Positive and Negative Syndrome Scale (PANSS).

Diagnostic accuracy of the Child and Adolescent Symptom Inventory (CASI-4R) substance use subscale in detecting substance use disorders in youth.

Identifying substance use disorders (SUDs) early and accurately improves case formulation and treatment. Previous studies have investigated validity and reliability of the Child and Adolescent Symptom Inventory (CASI) for anxiety, mood, and behavior problems. The present study's aim was to test if the embedded CASI Substance Use (SU) subscale can discriminate adolescents and young adults (AYA) with and without a SUD diagnosis accurately enough to justify clinical application within an evidence-based assessment framework.

26-Week Open-Label Extension Study Evaluating the Safety and Tolerability of Flexible Doses of Oral Ziprasidone in Children and Adolescents with Bipolar I Disorder (Most Recent Episode Manic).

To describe the longer-term effectiveness, safety, and tolerability of open-label ziprasidone in children and adolescents with bipolar I disorder (BD-I). A subset of 23 participants aged 10-17 years, who were previously treated in a multi-site, 4-week randomized controlled trial received open-label ziprasidone (20-80 mg twice a day) for up to 26 weeks. The most common adverse events (AEs) were fatigue (30%), somnolence (17%), and nausea (13%).

Efficacy and Safety of Lisdexamfetamine in Preschool Children With Attention-Deficit/Hyperactivity Disorder.

Objective: To evaluate the acute efficacy, safety, and tolerability of lisdexamfetamine dimesylate (LDX) vs placebo (PBO) in preschool-aged children with attention-deficit/hyperactivity disorder (ADHD).

Method: This phase 3, double-blind, fixed-dose study randomly assigned children (aged 4-5 years) with ADHD to 6 weeks of LDX (5, 10, 20, 30 mg) or PBO. The prespecified primary (change from baseline at week 6 in ADHD Rating Scale IV, Preschool version, total score [ADHD-RS-IV-PS-TS]) and key secondary (Clinical Global Impression-Improvement [CGI-I] score at week 6) efficacy endpoints were assessed using linear mixed-effects models for repeated measures.

Efficacy, Safety, and Tolerability of Flexibly Dosed Ziprasidone in Children and Adolescents with Mania in Bipolar I Disorder: A Randomized Placebo-Controlled Replication Study.

To evaluate the acute efficacy, safety, and tolerability of flexibly dosed ziprasidone in children and adolescents with Bipolar I Disorder (BD-I). Participants, 10-17 years of age, meeting The criteria, were randomized 1:1 in a 4-week double-blind (DB) study, to receive ziprasidone (20-80 mg/twice a day) or placebo. Some were then enrolled in a 26-week open-label extension (OLE) study.