Abstract:
:How should treatment be initiated for children with obsessive-compulsive disorder (OCD)? This editorial comments on an article by Melin and colleagues,1 published in this issue, from the NordLOTS study, which reports excellent outcomes from cognitive behavior therapy (CBT) for children with OCD. Children continued to improve after CBT was discontinued; at 3 year follow-up, they enjoyed a 90% response rate. Such continuing improvement contrasts markedly with other studies finding, among patients treated with selective serotonin reuptake inhibitors (SSRIs), high relapse rates upon discontinuation. Evidence has accumulated that upon discontinuation of SSRIs, there is often not simply a return to baseline, but a withdrawal state for which opposites of the therapeutic effects can be prominent symptoms-these may include anxiety, dysphoria, irritability, and insomnia. The duration of such symptoms is highly variable, and the possibility of permanent deleterious effects has not been ruled out. Embarking upon lifelong treatment with medication, especially with children, is not a good solution to the withdrawal problem, given findings of antidepressant tachyphylaxis after chronic administration. The long-term dependency and tolerance risks to children started on serotonin reuptake inhibitors are largely unquantified. The NordLOTS study strengthens prior conclusions that cognitive behavior therapy without medication should usually be the initial treatment for children with OCD. Nonetheless, economic influences, which have spurred an exodus of psychiatrists from the psychotherapy workforce, continue to foster treatment with medication alone rather than with cognitive behavior therapy alone.
journal_name
J Am Acad Child Adolesc Psychiatryauthors
Strayhorn J Jrdoi
10.1016/j.jaac.2019.03.015subject
Has Abstractpub_date
2020-02-01 00:00:00pages
219-221issue
2eissn
0890-8567issn
1527-5418pii
S0890-8567(19)30201-1journal_volume
59pub_type
评论,社论abstract:OBJECTIVE:Both the diagnosis and treatment of bipolar disorder in youth remain the subject of debate. In the Treatment of Early Age Mania (TEAM) study, risperidone was more effective than lithium or divalproex in children diagnosed with bipolar mania and highly comorbid with attention-deficit/hyperactivity disorder (AD...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jaac.2012.07.001
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:This study examined the relationship between parental expressed emotion (EE) and adolescent self-injurious thoughts and behaviors (SITB), as well as potential mediators and moderators of this relationship. METHOD:Thirty-six adolescents ages 12 to 17 years recruited from the community (2004-2005) provided dat...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/chi.0b013e3180ca9aaf
更新日期:2007-09-01 00:00:00
abstract::Japanese society strongly influences the mode of presentation of child mental health problems, both in terms of protective factors and pressures inherent in Japanese child-rearing practices. Recent changes in society associated with Japan's rapid economic development are affecting the mental health of children and fam...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,评审
doi:10.1097/00004583-198907000-00003
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the hypothesis of stimulant medication effect on physical growth in the follow-up phase of the Multimodal Treatment Study of Children With ADHD. METHOD:Naturalistic subgroups were established based on patterns of treatment with stimulant medication at baseline, 14-, 24-, and 36-month assessments:...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1097/chi.0b013e3180686d7e
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:To determine whether preadolescent physical abuse raises the risk of adolescent suicidal behavior, to examine potential mediators and moderators of the relationship between preadolescent abuse and adolescent suicidality, and to examine whether distal (preadolescent) risk factors add to proximal (adolescent) ...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/chi.0b013e318054e702
更新日期:2007-07-01 00:00:00
abstract::In keeping with the Journal's policies,1 we provide a listing of disclosures for all members of the editorial masthead and the ad hoc and guest editors (marked with an asterisk) as of October 3, 2019. This list, based on annually updated signed statements on file in the editorial office, includes all biomedical financ...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 社论
doi:10.1016/j.jaac.2019.10.002
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To determine demographic and school-related risk factors for psychiatric emergencies presented by children in a hospital emergency room serving the majority of an urban community. METHOD:1,436 consecutive psychiatric emergency room visits for children younger than 16 years of age seen over a 10-year period w...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199609000-00014
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:Parental psychiatric symptoms can negatively affect the outcome of children's psychopathology. Studies thus far have mainly shown a negative effect of maternal depression. This study examined the associations between a broad range of psychiatric symptoms in mothers and fathers and the child's outcome. METHOD...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2018.05.017
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:To compare the longitudinal course of family functioning in offspring of parents with bipolar disorder (BD), offspring of parents with non-BD psychopathology, and offspring of healthy control (HC) parents. METHOD:Offspring of parents with BD (256 parents and 481 offspring), parents without BD (82 parents and...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2018.10.011
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:This longitudinal study examined whether responsiveness of the neurotransmitter serotonin (5-HT) in childhood predicts adolescent aggression. METHOD:Boys (N = 33) with disruptive behavior disorders who received assessments of central 5-HT function via the prolactin response to fenfluramine between 1990 and 1...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/01.chi.0000220855.79144.ae
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:To examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide. METHOD:Adolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0% had major depressive disorder), and a Chil...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/CHI.0b013e3181b5db66
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of Safe Thinking and Affect Regulation (STAR), a 14-session HIV-prevention program for adolescents at alternative/therapeutic schools. Because these youth frequently have difficulties with emotions and cognitions, it was designed to improve sexuality-specific affect management an...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jaac.2011.06.018
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To determine what clinical symptoms clinicians have been using to distinguish between Asperger's disorder (AsD) and autistic disorder (AD). METHOD:Parents of children and adolescents with high-functioning AD (n = 48) and AsD (n = 69) were given a structured interview based on DSM-III-R and ICD-10 diagnostic ...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199611000-00022
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:The authors examined the applicability of personality disorder criteria to adolescent inpatients by evaluating internal consistency and criterion overlap. METHOD:Thirty-eight adolescents and 28 adults were assessed with the Personality Disorder Examination. Within-category cohesiveness (internal consistency)...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 临床试验,杂志文章
doi:10.1097/00004583-199902000-00020
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the co-occurrence of posttraumatic stress disorder (PTSD) and dissociation in a clinical sample of trauma-exposed adolescents by evaluating evidence for the depersonalization/derealization dissociative subtype of PTSD as defined by the DSM-5 and then examining a broade...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2017.09.425
更新日期:2017-12-01 00:00:00
abstract::This article addresses the unique ethical conflicts that are encountered in forensic psychiatry. Special issues for the forensic child and adolescent psychiatrist in the areas of custody, sexual abuse, termination of parental rights and adoption, evaluation of juvenile offenders, and maternal-fetal conflicts are addre...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199205000-00004
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVE:To examine the startle reflex as a possible vulnerability marker among offspring of parents with anxiety disorders and/or alcoholism. METHOD:The subjects were 66 male and female offspring (aged 10 to 17 years) of proband who participated in a family study of comorbidity of alcoholism and anxiety disorders. T...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199707000-00014
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:Symptoms of depression and anxiety are commonly comorbid with attention-deficit/hyperactivity disorder (ADHD). The authors assessed the safety and effectiveness of atomoxetine monotherapy compared with combined atomoxetine/fluoxetine therapy in a population of children and adolescents with ADHD and concurrent...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.chi.0000169012.81536.38
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:To identify trajectories of substance use disorders (SUDs) in youth during the 12 years after detention and how gender, race/ethnicity, and age at baseline predict trajectories. METHOD:As part of the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2016.10.018
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:To assess critically the short-term efficacy and safety of carbamazepine in the reduction of aggressiveness in children with diagnosed conduct disorder. METHOD:Subjects were children aged 5 to 12 years who were hospitalized for treatment-resistant aggressiveness and explosiveness and who had diagnosed conduc...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004583-199604000-00014
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:Because ADHD is heterogeneous with respect to psychiatric comorbidity, familiality, and learning disabilities, it was hypothesized that such features might influence the severity and pattern of neuropsychological function in ADHD. METHOD:Subjects were 9- to 20-year-old males with DSM-III-R ADHD (n = 65) and ...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199508000-00011
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. METHOD:Male and female former child soldiers (N = 260, age...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2010.03.008
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:The current trial examined whether a specific cognitive-behavioral treatment package was more efficacious in treating childhood anxiety disorders than a nonspecific support package. METHOD:One hundred twelve children (aged 7-16 years) with a principal anxiety disorder were randomly allocated to either a grou...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1097/CHI.0b013e31819c2401
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:Changes in autism diagnostic criteria found in DSM-5 may affect autism spectrum disorder (ASD) prevalence, research findings, diagnostic processes, and eligibility for clinical and other services. Using our published, total-population Korean prevalence data, we compute DSM-5 ASD and social communication disor...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2013.12.021
更新日期:2014-05-01 00:00:00
abstract::This study examined the prevalence of depressive disorders in a sample of 56 7- to 12-year-old maltreated children. Overall, 18% of the sample met the diagnostic criteria for major depression, and 25% met the criteria for dysthymia, with the majority of the children who met the criteria for major depression also meeti...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199103000-00014
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:Functional magnetic resonance imaging (fMRI) studies have repeatedly shown alterations in patients with anorexia nervosa (AN). These alterations might be driven by baseline signal characteristics such as the (fractional) amplitude of low frequency fluctuations (fALFF/ALFF), as well as regional signal consiste...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2019.01.011
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of an intervention designed to improve outcomes for infants and toddlers in foster care. METHOD:Records were reviewed for all children who were adjudicated as in need of care in a specific parish in Louisiana between 1991 and 1998. This period included 4 years before and 4 year...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 临床试验,杂志文章
doi:10.1097/00004583-200102000-00016
更新日期:2001-02-01 00:00:00
abstract::We appreciate the thoughtful and supportive comments from Dr. Masters1 and agree that coercive parent-child relationships were often what was addressed and modified during hospitalization. Lowering seclusion and restraint rates by prohibiting them, without lowering rates of aggression, is not the desired outcome. As w...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 评论,信件
doi:10.1016/j.jaac.2020.01.020
更新日期:2020-06-01 00:00:00
abstract::Akathesia is a common side effect of neuroleptic medication and has been reported to occur in patients with Tourette's Syndrome (TS). In TS, the differentiation between untreated hyperactivity and akathesia can be difficult. A case of neuroleptic treated TS with hyperactivity versus akathesia is presented in which pro...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199005000-00024
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVE:To review evidence for the neurodevelopmental effects of in utero exposure to nicotine. Concerns about long-term cognitive and behavioral effects of prenatal exposure to nicotine arise from reports of increased rates of disruptive behavioral disorders in children whose mothers smoked during pregnancy. The rel...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,评审
doi:10.1097/00004583-200106000-00007
更新日期:2001-06-01 00:00:00