Abstract:
OBJECTIVE:Little is known about the pattern of service receipt and outcomes from clinics implementing best practice guidelines in child mental health. This study aimed to determine these variables for a clinic that implemented an attention-deficit/hyperactivity disorder (ADHD) treatment guideline proposed by the Children's Medication Algorithm Project (CMAP). METHODS:Secondary analyses of medical record extracts were conducted for children who received treatment from 2007 to 2012 in a specialty clinic linked to a public children's hospital in Canada. Patterns of medication selection and dosing were compared with CMAP guidelines. Outcomes were based on parent and teacher ratings on the ADHD portion of the Multimodal Treatment Study for ADHD (MTA)- Swanson, Nolan, and Pelham, Version IV (SNAP-IV). RESULTS:Data were available for 132 children (ages 5-14), 81.8% of whom had no previous ADHD medication exposure, and 97.0% of whom had started at least one medication. Methylphenidate was used first for 59.8% of children, whereas 33.3% started with an amphetamine product. Of the 47.0% of children who progressed to a second medication trial, 88.7% tried a stimulant from a second class. In total, 19.7% tried atomoxetine, which was typically used as a third stage choice (i.e., after two different stimulant exposures). Stage four to six medications were rarely used, rather stimulants were retried after atomoxetine and/or medication combinations were tried. Symptomatic remission at the end of treatment was achieved by 70.4% and 82.4%, according to parents and teachers respectively, for those with outcome data and who completed treatment. Outcomes for those further along the treatment algorithm were similar to discharges at the beginning of the algorithm. CONCLUSIONS:The high rates of symptomatic remission observed within this clinical service may be a function of adherence to CMAP recommendations. However, the lack of a comparison group or experimental design prevents determination of causality. Additional investigations of the impacts of implementing evidence-based guidelines are critically needed, with proposed benchmarks to inform outcome evaluations.
journal_name
J Child Adolesc Psychopharmacoljournal_title
Journal of child and adolescent psychopharmacologyauthors
Wagner DJ,Vallerand IA,McLennan JDdoi
10.1089/cap.2014.0014subject
Has Abstractpub_date
2014-11-01 00:00:00pages
472-80issue
9eissn
1044-5463issn
1557-8992journal_volume
24pub_type
杂志文章abstract:OBJECTIVE:Irritability is both a normal developmental phenomenon and a common psychiatric symptom in children. In psychiatric nosology, a distinction is made between chronic and episodic irritability. This study examines the validity of this distinction. METHODS:A sample of 776 youths received Diagnostic and Statistic...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2006.16.456
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Despite the increased recognition of attention deficit hyperactivity disorder (ADHD) in adolescents, few controlled studies have assessed treatments for this age group. Adolescent issues, such as embarrassment at receiving medication at school and experimentation with abusable substances, have accelerated ef...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1089/10445460050167313
更新日期:2000-10-01 00:00:00
abstract::The prevalence and treatment of behavioral and mental illnesses in the adolescent population are increasing, and many of the medications used are continued into adulthood. Increased vigilance is necessary when caring for this population to prevent side effects and drug interactions. In this short communication, we pre...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2005.15.693
更新日期:2005-08-01 00:00:00
abstract::Atomoxetine and stimulants have both been demonstrated effective as single agents for treatment of attention deficit hyperactivity disorder in children, adolescents, and adults. However, attention deficit hyperactivity disorder symptoms in some patients do not respond adequately to single-agent treatment with these me...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/104454604773840571
更新日期:2004-04-01 00:00:00
abstract::The study assessed competencies and practices of a large group of healthcare providers in childhood attention-deficit/hyperactivity disorder (ADHD), and identified barriers to improving care. Methods were self-assessment using an Internet questionnaire with a standardized patient case; analysis compared with professio...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2010.0029
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate clinical gains from including both dextroamphetamine and methylphenidate in stimulant trials. METHOD:Thirty-six medication-naïve children ages 9-14 years diagnosed with attention-deficit/hyperactivity disorder (ADHD) were enrolled for 6 weeks in a crossover trial,...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1089/cap.2012.0085
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:Concerns about serious cardiovascular (CV) events among stimulant-treated youth have led to clinical and policy debates. Accordingly, several population-based empirical studies have assessed the risk of CV events in children and adolescents treated with stimulants. The main objective of this review was to sum...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,评审
doi:10.1089/cap.2015.0239
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:The striatum, including the putamen and caudate, plays an important role in executive and emotional processing and may be involved in the pathophysiology of mood disorders. Few studies have examined structural abnormalities of the striatum in pediatric major depressive disorder (MDD) patients. We report stria...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2007.0026
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:Methylphenidate (MPH) is commonly used to treat attention-deficit/hyperactivity disorder (ADHD) in all children, including those with velocardiofacial syndrome (VCFS). Yet concerns have been raised regarding its safety and efficacy in VCFS. The goal of this study was to examine the safety and efficacy of MPH ...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1089/cap.2011.0042
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:Co-occurrence of substance use and bipolar disorders is both common and associated with poor treatment response and greater functional impairment than either disorder alone. The neurophysiological correlates of this co-morbidity however, remain unclear. In this pilot study, we compared brain morphometry betwe...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2008.033
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the link between the use of specific types of substances and suicidality in adolescent inpatients with schizophrenia and schizoaffective disorder. METHODS:We performed a 10-year naturalistic retrospective study of 178 adolescent inpatients diagnosed as suffering from ...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2006.16.767
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVES:To evaluate the 52-week safety/tolerability of oral olanzapine for adolescents with schizophrenia or bipolar mania and compare effectiveness of a standard versus intense behavioral weight intervention in mitigating risk of weight gain. METHODS:Patients 13-17 years old with schizophrenia (Brief Psychiatric R...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1089/cap.2016.0010
更新日期:2016-12-01 00:00:00
abstract::Treatment with psychostimulant medication has been shown to improve scholastic functioning in children with attention-deficit/hyperactivity disorder (ADHD). However, the extent to which long-term academic gains are apparent in those having received such treatment remains elusive. This study examined prospectively the ...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2008.021
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Prior studies have suggested that inhibited temperament may be associated with an increased risk for developing anxiety or mood disorder, including bipolar disorder. However, the neurobiological basis for this increased risk is unknown. The aim of this study was to examine temperament in symptomatic and asym...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2016.0086
更新日期:2017-04-01 00:00:00
abstract:INTRODUCTION:The antipsychotic drugs are the best-studied agents shown to reduce symptoms in autism, including hyperactivity, aggression, self-abusive behavior, temper tantrums, lability, irritability, social withdrawal, and stereotypical behaviors. However, significant weight gain has been associated with use of many ...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2006.0126
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:Tourette syndrome (TS) is a neuropsychiatric disorder associated with motor and vocal tics. Some people with TS have reported using alternative or complementary medicine (CAM), including nutritional supplements to control their tics. In a recent national survey, approximately 40% of people reported having use...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2004.14.582
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:Few studies of psychotropic medication use among children and adolescents address the effectiveness of this medication, as it is typically used in naturalistic treatment settings. The objective of this study was to investigate psychotropic medication use among children and adolescents treated in system of car...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2012.0026
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Still little is known about neuropsychological differences between boys and girls with attention-deficit/hyperactivity disorder (ADHD) and whether there are sex-specific differences in the modulation of attentional performance by methylphenidate (MPH). METHOD:In this study, 27 males and 27 females between 8...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1089/cap.2009.0060
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the side effect risks from using one or more psychiatric medications (including antipsychotics, antidepressants, α-2 agonists, benzodiazepines, mood stabilizers, and stimulants) among a national cohort of children and adolescents. METHODS:A questionnaire survey wa...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2013.0036
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to assess long-term improvement in quality of life (QOL) in adolescents with attention-deficit/hyperactivity disorder (ADHD) treated with lisdexamfetamine dimesylate (LDX). METHODS:Adolescents with ADHD treated for ≥3 weeks in a 4 week, placebo-controlled study entered a 1 year...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1089/cap.2013.0077
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:This study examined the effects of pediatric anxiety and its interaction with gender on reward processes. Based on the purported greater sensitivity to risk in females than males and the propensity for risk aversion in anxiety, clinical anxiety and female gender were hypothesized to act synergistically in red...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2015.0008
更新日期:2016-05-01 00:00:00
abstract::In the United States, the novel compound duloxetine has been approved for the treatment of major depressive disorder (MDD) and diabetic peripheral neuropathic pain in the adult population. There are currently no published data on the use of duloxetine in children and adolescents. This report describes the successful t...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2006.0042
更新日期:2007-02-01 00:00:00
abstract::This single case reports an open trial of lamotrigine in the treatment of self-injurious behavior (SIB) and epilepsy in an 18-year-old female diagnosed with generalized seizure disorder, stereotypic movement disorder, and compulsive SIB in the context of profound mental retardation. Animal models of SIB suggest that t...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.1996.6.273
更新日期:1996-01-01 00:00:00
abstract::ABSTRACT The sudden collapse and death in three prepubertal children during routine treatment with desipramine was recently reported in brief statements. Insufficient clinical information is available to infer a cause-and-effect relationship between the therapeutic use of desipramine and sudden death in these children...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.1990.1.125
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:This study evaluates pediatric antidepressant prescribing practices of Nebraska clinicians. METHODS:Surveys were sent in July, 2005, to 1,521 prescribing clinicians throughout Nebraska to assess pediatric antidepressant use along with any practice changes following the U.S. Food and Drug Administration (FDA)...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2007.0049
更新日期:2008-02-01 00:00:00
abstract::The neuroanatomical model involved in the pathophysiology of obsessive-compulsive disorder (OCD) postulates a hyperactivation of orbitofrontal, limbic, and basal ganglia circuits. We report a case of OCD secondary to brain dysgerminoma affecting this circuit in an adolescent who responded to citalopram. The patient is...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/104454602760386950
更新日期:2002-10-01 00:00:00
abstract::This open-label study examined the potential efficacy of paroxetine in the treatment of children and adolescents diagnosed with dysthymia over a period of 3 months. Seven subjects were evaluated by the Hamilton Depression Rating Scale (HAM-D), by the Clinical Global Impression Severity of Illness Scale (CGI-S), and th...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1089/cap.2000.10.103
更新日期:2000-07-01 00:00:00
abstract::Self-report instruments commonly used to assess depression in adolescents have limited or unknown reliability and validity in this age group. We describe a new self-report scale, the Kutcher Adolescent Depression Scale (KADS), designed specifically to diagnose and assess the severity of adolescent depression. This rep...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/104454602760219153
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:Abnormal prefrontal and subcortical activity during cognitive control tasks is identified in non-depressed adolescents with bipolar disorder (BD); however, little is known about the neural correlates of bipolar adolescents in a depressed state (BDd). We aimed to investigate baseline versus after-treatment pat...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2012.0054
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To examine the persistence of three newly initiated stimulant preparations among Medicaid children and adolescents with attention-deficit/hyperactivity disorder (ADHD) diagnosis. METHODS:A retrospective longitudinal claims analysis was conducted by using Medicaid analytical eXtract data of four states. The s...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2011.0028
更新日期:2012-04-01 00:00:00