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| Publications of John S. March :chronological alphabetical by type listing:%% @article{fds274955, Author = {JL Podell and PC Kendall and EA Gosch and SN Compton and JS March and A-M Albano, MA Rynn and JT Walkup and JT Sherrill and GS Ginsburg and CP Keeton, B Birmaher and JC Piacentini}, Title = {Therapist Factors and Outcomes in CBT for Anxiety in Youth}, Journal = {PROFESSIONAL PSYCHOLOGY-RESEARCH AND PRACTICE}, Volume = {44}, Number = {2}, Pages = {89-98}, Year = {2013}, Month = {April}, ISSN = {0735-7028}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000318146500004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Doi = {10.1037/a0031700}, Key = {fds274955} } @article{fds274951, Author = {AK Langley and A Falk and T Peris and JF Wiley and PC Kendall and G Ginsburg, B Birmaher and J March and AM Albano and J Piacentini}, Title = {The Child Anxiety Impact Scale: Examining Parent- and Child-Reported Impairment in Child Anxiety Disorders}, Journal = {Journal of Clinical Child and Adolescent Psychology}, Year = {2013}, ISSN = {1537-4416}, url = {http://dx.doi.org/10.1080/15374416.2013.817311}, Abstract = {The purpose of the current investigation was to examine the factor structure, reliability, and construct validity of both the Child and Parent version of the Child Anxiety Impact Scale (CAIS) using data obtained from the Child/Adolescent Anxiety Multimodal Study (Walkup et al., 2008). The CAIS child and parent versions measure anxiety-related functional impairment in school, social, and family domains. Participants were 488 children ages 7 to 17 (M age = 10.7, SD = 2.8 years) enrolled as part of the CAMS study across 6 sites and their primary parent or caregiver. Families participated in a structured diagnostic interview and then completed the CAIS along with other measures. Confirmatory factor analysis revealed that the a priori three-factor structure (school, social, and home/family) for the CAIS parent- and CAIS child-report was a reasonable fit, with a comparative fit index of.88 and root mean square error of approximation of.05. Internal consistency was very good for total score and subscales of both versions of the scale (Cronbach's α =.70-.90). The CAIS total scores demonstrated good construct validity, showing predicted significant correlations with the Child Behavior Checklist (CBCL) Internalizing Scale, the Multidimensional Anxiety Scale for Children (MASC) and Screen for Child Anxiety Related Emotional Disorders (SCARED) Total Scores, the Pediatric Anxiety Rating Scale, and the Children's Global Assessment Scale. In addition, CAIS Social and School subscales were significantly related to similar subscales on the CBCL, SCARED, and MASC. The results provide support that the CAIS is a reliable and valid measure for the assessment of the impact of anxiety on child and adolescent functioning. © 2013 Copyright Taylor and Francis Group, LLC.}, Doi = {10.1080/15374416.2013.817311}, Key = {fds274951} } @article{fds274953, Author = {C Wei and A Hoff and MA Villabø and J Peterman and PC Kendall and J Piacentini, J McCracken and JT Walkup and AM Albano and M Rynn and E al}, Title = {Assessing Anxiety in Youth with the Multidimensional Anxiety Scale for Children}, Journal = {Journal of Clinical Child and Adolescent Psychology}, Year = {2013}, ISSN = {1537-4416}, url = {http://dx.doi.org/10.1080/15374416.2013.814541}, Abstract = {The present study examined the psychometric properties, including discriminant validity and clinical utility, of the youth self-report and parent-report forms of the Multidimensional Anxiety Scale for Children (MASC) among youth with anxiety disorders. The sample included parents and youth (N = 488, 49.6% male) ages 7 to 17 who participated in the Child/Adolescent Anxiety Multimodal Study. Although the typical low agreement between parent and youth self-reports was found, the MASC evidenced good internal reliability across MASC subscales and informants. The main MASC subscales (i.e., Physical Symptoms, Harm Avoidance, Social Anxiety, and Separation/Panic) were examined. The Social Anxiety and Separation/Panic subscales were found to be significantly predictive of the presence and severity of social phobia and separation anxiety disorder, respectively. Using multiple informants improved the accuracy of prediction. The MASC subscales demonstrated good psychometric properties and clinical utilities in identifying youth with anxiety disorders. © 2013 Copyright Taylor and Francis Group, LLC.}, Doi = {10.1080/15374416.2013.814541}, Key = {fds274953} } @article{fds274954, Author = {RS Beidas and O Lindhiem and DM Brodman and A Swan and M Carper and C Cummings, PC Kendall and AM Albano and M Rynn and J Piacentini and E al}, Title = {A Probabilistic and Individualized Approach for Predicting Treatment Gains: An Extension and Application to Anxiety Disordered Youth}, Journal = {Behavior Therapy}, Year = {2013}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/j.beth.2013.05.001}, Abstract = {The objective of this study was to extend the probability of treatment benefit method by adding treatment condition as a stratifying variable, and illustrate this extension of the methodology using the Child and Adolescent Anxiety Multimodal Study data. The probability of treatment benefit method produces a simple and practical way to predict individualized treatment benefit based on pretreatment patient characteristics. Two pretreatment patient characteristics were selected in the production of the probability of treatment benefit charts: baseline anxiety severity, measured by the Pediatric Anxiety Rating Scale, and treatment condition (cognitive-behavioral therapy, sertraline, their combination, and placebo). We produced two charts as exemplars which provide individualized and probabilistic information for treatment response and outcome to treatments for child anxiety. We discuss the implications of the use of the probability of treatment benefit method, particularly with regard to patient-centered outcomes and individualized decision-making in psychology and psychiatry. © 2013.}, Doi = {10.1016/j.beth.2013.05.001}, Key = {fds274954} } @article{fds274956, Author = {CP Keeton and GS Ginsburg and KL Drake and D Sakolsky and PC Kendall and B Birmaher, AM Albano and JS March and M Rynn and J Piacentini and E al}, Title = {Benefits Of Child-Focused Anxiety Treatments For Parents And Family Functioning}, Journal = {Depression and Anxiety}, Year = {2013}, ISSN = {1091-4269}, url = {http://dx.doi.org/10.1002/da.22055}, Abstract = {Background: To examine (1) changes in parent (global psychological distress, trait anxiety) and family (dysfunction, burden) functioning following 12 weeks of child-focused anxiety treatment, and (2) whether changes in these parent and family factors were associated with child's treatment condition and response. Methods: Participants were 488 youth ages 7-17 years (50% female; mean age 10.7 years) who met DSM-IV-TR criteria for social phobia, separation anxiety, and/or generalized anxiety disorder, and their parents. Youth were randomly assigned to 12 weeks of "Coping Cat" individual cognitive-behavioral therapy (CBT), medication management with sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) within the multisite Child/Adolescent Anxiety Multimodal Study (CAMS). At pre- and posttreatment, parents completed measures of trait anxiety, psychological distress, family functioning, and burden of child illness; children completed a measure of family functioning. Blinded independent evaluators rated child's response to treatment using the Clinical Global Impression-Improvement Scale at posttreatment. Results: Analyses of covariance revealed that parental psychological distress and trait anxiety, and parent-reported family dysfunction improved only for parents of children who were rated as treatment responders, and these changes were unrelated to treatment condition. Family burden and child-reported family dysfunction improved significantly from pre- to posttreatment regardless of treatment condition or response. Conclusions: Findings suggest that child-focused anxiety treatments, regardless of intervention condition, can result in improvements in nontargeted parent symptoms and family functioning particularly when children respond successfully to the treatment. © 2013 Wiley Periodicals, Inc.}, Doi = {10.1002/da.22055}, Key = {fds274956} } @article{fds274957, Author = {NE Caporino and DM Brodman and PC Kendall and AM Albano and J Sherrill and J Piacentini and D Sakolsky and B Birmaher and SN Compton and G Ginsburg and E al}, Title = {Defining treatment response and remission in child anxiety: Signal detection analysis using the pediatric anxiety rating scale}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {52}, Number = {1}, Pages = {57-67}, Year = {2013}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2012.10.006}, Abstract = {Objective: To determine optimal Pediatric Anxiety Rating Scale (PARS) percent reduction and raw score cut-offs for predicting treatment response and remission among children and adolescents with anxiety disorders. Method: Data were from a subset of youth (N = 438; 7-17 years of age) who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS), a multi-site, randomized controlled trial that examined the relative efficacy of cognitive-behavioral therapy (CBT; Coping Cat), medication (sertraline [SRT]), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The clinician-rated PARS was administered pre- and posttreatment (delivered over 12 weeks). Quality receiver operating characteristic methods assessed the performance of various PARS percent reductions and absolute cut-off scores in predicting treatment response and remission, as determined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule for DSM-IV. Corresponding change in impairment was evaluated using the Child Anxiety Impact Scale. Results: Reductions of 35% and 50% on the six-item PARS optimally predicted treatment response and remission, respectively. Post-treatment PARS raw scores of 8 to 10 optimally predicted remission. Anxiety improved as a function of PARS-defined treatment response and remission. Conclusions: Results serve as guidelines for operationalizing treatment response and remission in future research and in making cross-study comparisons. These guidelines can facilitate translation of research findings into clinical practice. © 2013 American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1016/j.jaac.2012.10.006}, Key = {fds274957} } @article{fds274958, Author = {DA Cole and S-J Cho and NC Martin and EA Youngstrom and JS March and RL Findling, BE Compas and IM Goodyer and P Rohde and M Weissman and MJ Essex, JS Hyde and JF Curry and R Forehand and MJ Slattery and JW Felton and MA Maxwell}, Title = {Are Increased Weight and Appetite Useful Indicators of Depression in Children and Adolescents?}, Journal = {JOURNAL OF ABNORMAL PSYCHOLOGY}, Volume = {121}, Number = {4}, Pages = {838-851}, Year = {2012}, Month = {November}, ISSN = {0021-843X}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000311527700005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Doi = {10.1037/a0028175}, Key = {fds274958} } @article{fds275128, Author = {A Przeworski and LA Zoellner and ME Franklin and A Garcia and J Freeman and JS March and EB Foa}, Title = {Maternal and child expressed emotion as predictors of treatment response in pediatric obsessive-compulsive disorder.}, Journal = {Child Psychiatry Hum Dev}, Volume = {43}, Number = {3}, Pages = {337-353}, Year = {2012}, Month = {June}, ISSN = {1573-3327}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22090186}, Abstract = {Expressed emotion (EE) is associated with symptoms and treatment outcome in various disorders. Few studies have examined EE in pediatric OCD and none of these has assessed the child's perspective. This study examined the relationship among maternal and child EE, child OCD severity, and OCD-related functioning pre- and post-treatment. At pre-treatment, mothers completed speech samples about the child with OCD and an unaffected sibling. Children with OCD completed speech samples about parents. There were low rates of high maternal EE (child with OCD: 16.1%; sibling: 2.6%) and high child EE about parents (mothers: 11.9%; fathers: 10.2%). High EE was primarily characterized by high criticism, not high overinvolvement. High maternal EE and child EE regarding fathers were associated with pre-treatment child OCD severity but not post-treatment severity. High child and maternal EE were predictive of post-treatment OCD-related functioning. EE may be an important child and maternal trait associated with pre-treatment OCD severity and generalization of treatment gains.}, Language = {ENG}, Doi = {10.1007/s10578-011-0268-8}, Key = {fds275128} } @article{fds275143, Author = {A Prakash and E Lobo and CJ Kratochvil and RN Tamura and BA Pangallo and KE Bullok, T Quinlan and GJ Emslie and JS March}, Title = {An open-label safety and pharmacokinetics study of duloxetine in pediatric patients with major depression.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {22}, Number = {1}, Pages = {48-55}, Year = {2012}, Month = {February}, ISSN = {1557-8992}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22251023}, Abstract = {OBJECTIVE: This preliminary, 32-week study assessed the safety, tolerability, and pharmacokinetics of duloxetine in pediatric patients (aged 7-17 years) with major depressive disorder. METHODS: Patients received flexible duloxetine doses of 20-120 mg once daily, with dose changes made based on clinical improvement and tolerability. Pharmacokinetic samples were collected across all duloxetine doses, and data were analyzed using population modeling. Primary outcome measures included treatment-emergent adverse events (TEAEs), vital signs, and Columbia-Suicide Severity Rating Scale (C-SSRS). RESULTS: Of the 72 enrolled patients, 48 (66.7%) completed acute treatment (18 weeks) and 42 (58.3%) completed extended treatment. Most patients (55/72; 76%) required doses ≥ 60 mg once daily to optimize efficacy based on investigator judgment and Clinical Global Impressions-Severity score. Body weight and age did not significantly affect duloxetine pharmacokinetic parameters. Typical duloxetine clearance in pediatric patients was ≈ 42%-60% higher than that in adults. Four patients (5.6%) discontinued due to TEAEs. Many (36/72, 50%) patients experienced potentially clinically significant (PCS) elevations in blood pressure, with most cases (21/36, 58%) being transient. As assessed via C-SSRS, one nonfatal suicidal attempt occurred, two patients (2.8%) experienced worsening of suicidal ideation, and among the 19 patients reporting suicidal ideation at baseline, 17 (90%) reported improvement in suicidal ideation. CONCLUSION: Results suggested that pediatric patients generally tolerated duloxetine doses of 30 to 120 mg once daily, although transient PCS elevations in blood pressure were observed in many patients. Pharmacokinetic results suggested that adjustment of total daily dose based on body weight or age is not warranted for pediatric patients and different total daily doses may not be warranted for pediatric patients relative to adults.}, Language = {ENG}, Doi = {10.1089/cap.2011.0072}, Key = {fds275143} } @article{fds275089, Author = {M Villabø and M Gere and S Torgersen and JS March and PC Kendall}, Title = {Diagnostic efficiency of the child and parent versions of the Multidimensional Anxiety Scale for Children.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {41}, Number = {1}, Pages = {75-85}, Year = {2012}, Month = {January}, ISSN = {1537-4424}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22233247}, Abstract = {The objective of this study is to evaluate the psychometrics and clinical efficiency of the Multidimensional Anxiety Scale for Children (MASC), which measures physical symptoms, harm avoidance, social anxiety, and separation/panic. Using a sample of 190 treatment-seeking Norwegian youth (aged 7-13 years, M (age) = 10.3 years, 62.1% male), the internal stability and ability to predict to disorder were examined for child, mother, and father reports on the MASC. Moderate to strong internal reliability was exhibited across all MASC subscales. Parent-child agreement was low, but mother-father agreement was high. MASC scores successfully distinguished between children with and without anxiety disorders and identified youth with separation anxiety disorder and social phobia, but less accurately generalized anxiety disorders. The MASC has favorable psychometric properties and is a useful screening instrument for identifying youth with anxiety disorders.}, Language = {eng}, Doi = {10.1080/15374416.2012.632350}, Key = {fds275089} } @article{fds274952, Author = {AD Simons and CN Marti and P Rohde and CC Lewis and J Curry and J March}, Title = {Does homework "matter" in cognitive behavioral therapy for adolescent depression?}, Journal = {Journal of Cognitive Psychotherapy}, Volume = {26}, Number = {4}, Pages = {390-404}, Year = {2012}, ISSN = {0889-8391}, url = {http://dx.doi.org/10.1891/0889-8391.26.4.390}, Abstract = {Objective: Examine the degree to which homework completion is associated with various indices of clinical improvement in adolescents with depression treated with cognitive behavioral therapy (CBT) either as a monotherapy and in combination with antidepressant medication. Method: This study used data from the Treatment of Adolescents with Depression Study (TADS), which compared the efficacy of CBT, fluoxetine (FLX), the combination of CBT and FLX (COMB), and a pill placebo (PBO; TADS Team, 2003, 2004, 2005). Current analyses included only TADS participants in the CBT (n 5 111) or COMB (n 5 107) conditions. Analyses focused on the relations between partial and full homework completion and a dichotomized measure of clinical response, evaluator and self-report ratings of depressive symptoms, hopelessness, and suicidality. Results: Homework completion significantly predicted clinical improvement, decrease in self-reported hopelessness, suicidality, and depression-but not in evaluator-rated depressive symptoms-in adolescents treated with CBT only. These relationships were almost completely absent in the COMB condition. The only significant COMB finding was that partially completed homework was related to decrease in hopelessness over time. Conclusions: These findings suggest that the ability of therapists and clients to collaboratively develop and complete between-session assignments is associated with response to CBT, self-report of severity of depressive symptoms, hopelessness, and suicidality and may be integral to optimizing the effects of CBT when delivered as a monotherapy. © 2012 Springer Publishing Company.}, Doi = {10.1891/0889-8391.26.4.390}, Key = {fds274952} } @article{fds275044, Author = {BS Vaughan and JS March and CJ Kratochvil}, Title = {The evidence-based pharmacological treatment of paediatric ADHD}, Journal = {International Journal of Neuropsychopharmacology}, Volume = {15}, Number = {1}, Pages = {27-39}, Year = {2012}, ISSN = {1461-1457}, url = {http://dx.doi.org/10.1017/S1461145711000095}, Abstract = {Attention deficit hyperactivity disorder (ADHD) is common in children, adolescents, and adults, with extensive research establishing it as a valid neurobiological disorder. Without intervention, ADHD can result in significant impairment throughout the lifespan for the individuals it afflicts. Fortunately, multiple evidence-based options are available for the treatment of ADHD, including several efficacious pharmacotherapies. The role of medication, including stimulants as well as non-stimulants, is well-documented by an extensive body of literature. Although there may be less enthusiasm for behavioural and other psychosocial interventions as stand-alone treatments for moderate to severe ADHD, they are recommended as first-line treatment for ADHD management in preschool-aged children, for those patients with mild symptoms, and as an adjunct to medication in patients with comorbid disorders or suboptimal responses to pharmacotherapy. When planning treatment for individuals with ADHD, the potential risks associated with the available interventions must be carefully balanced against the risks of not treating, or not treating adequately. The treatment plan must also include ongoing re-assessment of the effectiveness of and the need for continued therapy. Recent practice parameters provide further specific guidance for the evidence-based assessment and treatment of children and adolescents with ADHD. © 2011 CINP.}, Doi = {10.1017/S1461145711000095}, Key = {fds275044} } @article{fds275045, Author = {ME Franklin and JB Freeman and JS March}, Title = {Cognitive behavior therapy for pediatric obsessive-compulsive disorder - Reply}, Journal = {JAMA - Journal of the American Medical Association}, Volume = {307}, Number = {6}, Pages = {560-561}, Year = {2012}, ISSN = {0098-7484}, url = {http://dx.doi.org/10.1001/jama.2012.109}, Doi = {10.1001/jama.2012.109}, Key = {fds275045} } @article{fds275046, Author = {J Freeman and A Garcia and K Benito and C Conelea and J Sapyta and M Khanna, J March and M Franklin}, Title = {The pediatric obsessive compulsive disorder treatment study for young children (POTS Jr): Developmental considerations in the rationale, design, and methods}, Journal = {Journal of Obsessive-Compulsive and Related Disorders}, Volume = {1}, Number = {4}, Pages = {294-300}, Year = {2012}, ISSN = {2211-3649}, url = {http://dx.doi.org/10.1016/j.jocrd.2012.07.010}, Abstract = {This paper presents the rationale, design, and methods of the pediatric obsessive compulsive disorder treatment study for young children (POTS Jr). The study is a multi-site randomized controlled trial (RCT) of family-based cognitive behavioral treatment (CBT) vs. family-based relaxation therapy for young children (ages 5-8) with obsessive compulsive disorder (OCD), which examines the effect of treatment on symptom reduction, functional impairment, and quality of life. Secondary aims evaluate: potential moderators and mediators of treatment response, differences in time course of response, retention rates, and maintenance of treatment gains over one year post-treatment. The sample included 127 children (53% female) and their parents. With regard to ethnicity, 89% of the sample described themselves as non-Hispanic, 5% Hispanic/Latino, and 6% did not endorse a category. In terms of race, the sample was predominantly (91%) white. Because the rationale and methods of the multi-site RCT have been well established, we emphasize here the methodological aspects of the study that were tailored to meet the developmental needs of young children with OCD. Aspects that are highlighted include: choice of control group, inclusion/exclusion criteria, assessment/measurement issues, treatment adaptations, training, and recruitment. © 2012 Elsevier Ltd.}, Doi = {10.1016/j.jocrd.2012.07.010}, Key = {fds275046} } @article{fds275062, Author = {NE Caporino and DM Brodman and PC Kendall and AM Albano and J Sherrill and J Piacentini and D Sakolsky and B Birmaher and SN Compton and G Ginsburg and E al}, Title = {Defining Treatment Response and Remission in Child Anxiety: Signal Detection Analysis Using the Pediatric Anxiety Rating Scale}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Year = {2012}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2012.10.006}, Abstract = {Objective: To determine optimal Pediatric Anxiety Rating Scale (PARS) percent reduction and raw score cut-offs for predicting treatment response and remission among children and adolescents with anxiety disorders. Method: Data were from a subset of youth (N = 438; 7-17 years of age) who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS), a multi-site, randomized controlled trial that examined the relative efficacy of cognitive-behavioral therapy (CBT; Coping Cat), medication (sertraline [SRT]), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The clinician-rated PARS was administered pre- and posttreatment (delivered over 12 weeks). Quality receiver operating characteristic methods assessed the performance of various PARS percent reductions and absolute cut-off scores in predicting treatment response and remission, as determined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule for DSM-IV. Corresponding change in impairment was evaluated using the Child Anxiety Impact Scale. Results: Reductions of 35% and 50% on the six-item PARS optimally predicted treatment response and remission, respectively. Post-treatment PARS raw scores of 8 to 10 optimally predicted remission. Anxiety improved as a function of PARS-defined treatment response and remission. Conclusions: Results serve as guidelines for operationalizing treatment response and remission in future research and in making cross-study comparisons. These guidelines can facilitate translation of research findings into clinical practice. © 2012 American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1016/j.jaac.2012.10.006}, Key = {fds275062} } @article{fds275071, Author = {J Curry and S Silva and P Rohde and G Ginsburg and B Kennard and C Kratochvil, A Simons and J Kirchner and D May and T Mayes and N Feeny and AM Albano and S Lavanier and M Reinecke and R Jacobs and E Becker-Weidman, E Weller and G Emslie and J Walkup and E Kastelic and B Burns, K Wells and J March}, Title = {Onset of alcohol or substance use disorders following treatment for adolescent depression}, Journal = {Journal of Consulting and Clinical Psychology}, Volume = {80}, Number = {2}, Pages = {299-312}, Year = {2012}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037/a0026929}, Abstract = {Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). Method: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in the Treatment for Adolescents with Depression Study (TADS; TADS Team, 2004) and who had no prior diagnoses of AUD or SUD. TADS initial treatments were cognitive behavior therapy (CBT), fluoxetine alone (FLX), the combination of CBT and FLX (COMB), or clinical management with pill placebo (PBO). We used both the original TADS treatment response rating and a more restrictive symptom count rating. During follow-up, diagnostic interviews were completed at 6-or 12-month intervals to assess onset of AUD or SUD as well as MDD recovery and recurrence. Results: Achieving a positive response to MDD treatment was unrelated to subsequent AUD but predicted a lower rate of subsequent SUD, regardless of the measure of positive response (11.65% vs. 24.72%, or 10.0% vs. 24.5%, respectively). Type of initial MDD treatment was not related to either outcome. Prior to depression treatment, greater involvement with alcohol or drugs predicted later AUD or SUD, as did older age (for AUD) and more comorbid disorders (for SUD). Among those with recurrent MDD and AUD, AUD preceded MDD recurrence in 24 of 25 cases. Conclusion: Effective short-term adolescent depression treatment significantly reduces the rate of subsequent SUD but not AUD. Alcohol or drug use should be assessed prior to adolescent MDD treatment and monitored even after MDD recovery. © 2012 American Psychological Association.}, Doi = {10.1037/a0026929}, Key = {fds275071} } @article{fds275130, Author = {JS March and JM Fegert}, Title = {Drug development in pediatric psychiatry: current status, future trends.}, Journal = {Child Adolesc Psychiatry Ment Health}, Volume = {6}, Pages = {7}, Year = {2012}, ISSN = {1753-2000}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22313578}, Language = {eng}, Doi = {10.1186/1753-2000-6-7}, Key = {fds275130} } @article{fds275133, Author = {ME Franklin and J Sapyta and JB Freeman and M Khanna and S Compton and D Almirall, P Moore and M Choate-Summers and A Garcia and AL Edson and EB Foa and JS March}, Title = {Cognitive behavior therapy augmentation of pharmacotherapy in pediatric obsessive-compulsive disorder: the Pediatric OCD Treatment Study II (POTS II) randomized controlled trial.}, Journal = {JAMA}, Volume = {306}, Number = {11}, Pages = {1224-1232}, Year = {2011}, Month = {September}, ISSN = {1538-3598}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21934055}, Keywords = {Adolescent • Child • Cognitive Therapy* • Combined Modality Therapy • Female • Humans • Male • Obsessive-Compulsive Disorder • Serotonin Uptake Inhibitors • Severity of Illness Index • Treatment Outcome • therapeutic use* • therapy*}, Abstract = {CONTEXT: The extant literature on the treatment of pediatric obsessive-compulsive disorder (OCD) indicates that partial response to serotonin reuptake inhibitors (SRIs) is the norm and that augmentation with short-term OCD-specific cognitive behavior therapy (CBT) may provide additional benefit. OBJECTIVE: To examine the effects of augmenting SRIs with CBT or a brief form of CBT, instructions in CBT delivered in the context of medication management. DESIGN, SETTING, AND PARTICIPANTS: A 12-week randomized controlled trial conducted at 3 academic medical centers between 2004 and 2009, involving 124 pediatric outpatients between the ages of 7 and 17 years with OCD as a primary diagnosis and a Children's Yale-Brown Obsessive Compulsive Scale score of 16 or higher despite an adequate SRI trial. INTERVENTIONS: Participants were randomly assigned to 1 of 3 treatment strategies that included 7 sessions over 12 weeks: 42 in the medication management only, 42 in the medication management plus instructions in CBT, and 42 in the medication management plus CBT; the last included 14 concurrent CBT sessions. MAIN OUTCOME MEASURES: Whether patients responded positively to treatment by improving their baseline obsessive-compulsive scale score by 30% or more and demonstrating a change in their continuous scores over 12 weeks. RESULTS: The medication management plus CBT strategy was superior to the other 2 strategies on all outcome measures. In the primary intention-to-treat analysis, 68.6% (95% CI, 53.9%-83.3%) in the plus CBT group were considered responders, which was significantly better than the 34.0% (95% CI, 18.0%-50.0%) in the plus instructions in CBT group, and 30.0% (95% CI, 14.9%-45.1%) in the medication management only group. The results were similar in pairwise comparisons with the plus CBT strategy being superior to the other 2 strategies (P < .01 for both). The plus instructions in CBT strategy was not statistically superior to medication management only (P = .72). The number needed-to-treat analysis with the plus CBT vs medication management only in order to see 1 additional patient at week 12, on average, was estimated as 3; for the plus CBT vs the plus instructions in CBT strategy, the number needed to treat was also estimated as 3; for the plus instructions in CBT vs medication management only the number needed to treat was estimated as 25. CONCLUSIONS: Among patients aged 7 to 17 years with OCD and partial response to SRI use, the addition of CBT to medication management compared with medication management alone resulted in a significantly greater response rate, whereas augmentation of medication management with the addition of instructions in CBT did not. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00074815.}, Language = {eng}, Doi = {10.1001/jama.2011.1344}, Key = {fds275133} } @article{fds275139, Author = {CA Flessner and JB Freeman and J Sapyta and A Garcia and ME Franklin and JS March and E Foa}, Title = {Predictors of parental accommodation in pediatric obsessive-compulsive disorder: findings from the Pediatric Obsessive-Compulsive Disorder Treatment Study (POTS) trial.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {50}, Number = {7}, Pages = {716-725}, Year = {2011}, Month = {July}, ISSN = {1527-5418}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21703499}, Keywords = {Adolescent • Child • Cognitive Therapy • Cooperative Behavior* • Family Health* • Female • Humans • Linear Models • Male • Multivariate Analysis • Obsessive-Compulsive Disorder • Parenting* • Patient Compliance • United States • psychology • rehabilitation*}, Abstract = {OBJECTIVE: Few studies have examined predictors of parental accommodation (assessed with the Family Accommodation Scale-Parent Report) among families of children with obsessive-compulsive disorder (OCD). No studies have examined this phenomenon using empirically derived subscales of the Family Accommodation Scale-Parent Report (i.e., Caregiver Involvement, Avoidance of Triggers). METHOD: Ninety-six youths (and their families) were included in the present study. Parents were asked to complete the Family Accommodation Scale-Parent Report. Families also completed several additional measurements assessing child- and parent-level variables of interest. Regression analyses were used to examine potential predictors of accommodation. RESULTS: Results support prior research suggesting that accommodation is ubiquitous among the families of children with OCD. Analyses revealed that several child-level (i.e., compulsion severity, oppositional behavior, and frequency of washing symptoms) and one parent-level (i.e., symptoms of anxiety) predictors work jointly to provide significant predictive models of parental accommodation. CONCLUSIONS: Clinicians and researchers should be aware of the impact of specific child- and parent-level variables on family accommodation in pediatric OCD and in turn their implications for treatment compliance, adherence, and, by extension, outcome. Study limitations warrant replication and extension of these findings; in particular, researchers may seek to obtain a better understanding of how the various facets of parental accommodation may differentially affect treatment.}, Language = {eng}, Doi = {10.1016/j.jaac.2011.03.019}, Key = {fds275139} } @article{fds275107, Author = {LD Miller and A Laye-Gindhu and Y Liu and JS March and DS Thordarson and EJ Garland}, Title = {Evaluation of a preventive intervention for child anxiety in two randomized attention-control school trials.}, Journal = {Behav Res Ther}, Volume = {49}, Number = {5}, Pages = {315-323}, Year = {2011}, Month = {May}, ISSN = {1873-622X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21419391}, Keywords = {Anxiety • Attention* • Child • Cognitive Therapy* • Female • Humans • Male • Schools • Social Environment • Treatment Outcome • prevention & control* • therapy}, Abstract = {The present research examined the effectiveness of a cognitive-behavioral therapy (CBT) based intervention program, FRIENDS, for children from grades 4 to 6, using random assignment at the school-level and an attention-control design in two longitudinal studies. The first study targeted children with anxiety symptoms (N=191, mean age=10.1) as screened with self, parent, and teacher-reports; the second study took a universal approach with full classrooms of children participating (N=253, mean age=9.8). The results showed no intervention effect in both studies, with children's anxiety symptoms decreasing over time regardless of whether they were in the story-reading (attention control) or FRIENDS condition. The findings also indicated that girls reported a higher level of anxiety than boys and children in higher grades reported lower anxiety relative to younger children in both studies. In addition, similar patterns were found using a subgroup of children with high-anxiety symptoms from both studies.}, Language = {eng}, Doi = {10.1016/j.brat.2011.02.006}, Key = {fds275107} } @article{fds275108, Author = {JS March}, Title = {The preschool ADHD Treatment Study (PATS) as the culmination of twenty years of clinical trials in pediatric psychopharmacology.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {50}, Number = {5}, Pages = {427-430}, Year = {2011}, Month = {May}, ISSN = {1527-5418}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21515189}, Keywords = {Adult • Attention Deficit Disorder with Hyperactivity • Central Nervous System Stimulants • Child, Preschool • Dose-Response Relationship, Drug • Forecasting • Humans • Methylphenidate • Randomized Controlled Trials as Topic • Translational Medical Research • Treatment Outcome • United States • adverse effects • drug therapy* • therapeutic use* • trends*}, Language = {eng}, Doi = {10.1016/j.jaac.2010.09.018}, Key = {fds275108} } @article{fds275166, Author = {CU Correll and CJ Kratochvil and JS March}, Title = {Developments in pediatric psychopharmacology: focus on stimulants, antidepressants, and antipsychotics.}, Journal = {J Clin Psychiatry}, Volume = {72}, Number = {5}, Pages = {655-670}, Year = {2011}, Month = {May}, ISSN = {1555-2101}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21658348}, Keywords = {Adolescent • Age Factors • Antidepressive Agents • Antipsychotic Agents • Anxiety Disorders • Attention Deficit Disorder with Hyperactivity • Attention Deficit and Disruptive Behavior Disorders • Autistic Disorder • Bipolar Disorder • Central Nervous System Stimulants • Child • Depressive Disorder, Major • Humans • Obsessive-Compulsive Disorder • Psychotic Disorders • Schizophrenia • adverse effects • drug therapy • therapeutic use*}, Abstract = {Most major psychiatric disorders have an onset in childhood or adolescence in a sizeable proportion of patients, and earlier onset disorders often have a severe and chronic course that can seriously disrupt sensitive developmental periods, with lifelong adverse consequences. Accordingly, psychopharmacologic treatments have been increasingly utilized in severely ill youth. However, the increased use of psychopharmacologic treatments in pediatric patients has also raised concerns regarding a potential overdiagnosis and overtreatment of youth, without adequate data regarding the pediatric efficacy and safety of psychotropic agents. Over the past decade, a remarkable number of pediatric randomized controlled trials have been completed, especially with psychostimulants, antidepressants, and antipsychotics. For these frequently used agents, effect sizes against placebo have typically been at least moderate, with most numbers-needed-to-treat well below 10 for response, indicating clinical significance as well. Nevertheless, data also point to a greater and/or different profile of susceptibility to adverse effects in pediatric compared to adult patients, as well as to a role for nonpharmacologic treatments, given alone or combined with pharmacotherapy, for many of the youth. Taken together, these results highlight the need for a careful assessment of the risk-benefit relationship of psychopharmacologic treatments in patients who cannot be managed sufficiently with nonpharmacologic interventions and for routine, proactive adverse effect monitoring and management. Although considerable progress has been made, there is still enormous need for additional data and funding of pediatric psychopharmacology trials. It is hoped that the field will acquire the necessary resources to propel pediatric clinical psychopharmacology to new levels of insight by linking it with, but not replacing it by, pharmacoepidemiologic and biomarker approaches and advances.}, Language = {eng}, Doi = {10.4088/JCP.11r07064}, Key = {fds275166} } @article{fds275105, Author = {CJ Kratochvil and BS Vaughan and JA Stoner and JM Daughton and BD Lubberstedt, DW Murray and AK Chrisman and MA Faircloth and NB Itchon-Ramos, SH Kollins and LA Maayan and LL Greenhill and LA Kotler, J Fried and JS March}, Title = {A double-blind, placebo-controlled study of atomoxetine in young children with ADHD.}, Journal = {Pediatrics}, Volume = {127}, Number = {4}, Pages = {e862-e868}, Year = {2011}, Month = {April}, ISSN = {1098-4275}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21422081}, Keywords = {Age Factors • Attention Deficit Disorder with Hyperactivity • Central Nervous System Stimulants • Child • Child, Preschool • Combined Modality Therapy • Dose-Response Relationship, Drug • Double-Blind Method • Education • Female • Humans • Male • Off-Label Use • Personality Assessment • Propylamines • Psychometrics • adverse effects • diagnosis • drug therapy* • psychology • statistics & numerical data • therapeutic use*}, Abstract = {OBJECTIVE: To evaluate the efficacy and tolerability of atomoxetine for the treatment of attention-deficit/hyperactivity disorder (ADHD) in 5- and 6-year-old children. METHODS: This was an 8-week, double-blind, placebo-controlled randomized clinical trial of atomoxetine in 101 children with ADHD. Atomoxetine or placebo was flexibly titrated to a maximum dose of 1.8 mg/kg per day. The pharmacotherapist reviewed psychoeducational material on ADHD and behavioral-management strategies with parents during each study visit. RESULTS: Significant mean decreases in parent (P = .009) and teacher (P = .02) ADHD-IV Rating Scale scores were demonstrated with atomoxetine compared with placebo. A total of 40% of children treated with atomoxetine met response criteria (Clinical Global Impression-Improvement Scale indicating much or very much improved) compared with 22% of children on placebo, which was not significant (P = .1). Decreased appetite, gastrointestinal upset, and sedation were significantly more common with atomoxetine than placebo. Although some children demonstrated a robust response to atomoxetine, for others the response was more attenuated. Sixty-two percent of subjects who received atomoxetine were moderately, markedly, or severely ill according to the Clinical Global Impression-Severity Scale at study completion. CONCLUSIONS: To our knowledge, this is the first randomized controlled trial of atomoxetine in children as young as 5 years. Atomoxetine generally was well tolerated and reduced core ADHD symptoms in the children on the basis of parent and teacher reports. Reductions in the ADHD-IV Rating Scale scores, however, did not necessarily translate to overall clinical and functional improvement, as demonstrated on the Clinical Global Impression-Severity Scale and the Clinical Global Impression-Improvement Scale. Despite benefits, the children in the atomoxetine group remained, on average, significantly impaired at the end of the study.}, Language = {eng}, Doi = {10.1542/peds.2010-0825}, Key = {fds275105} } @article{fds275150, Author = {JF Leckman and JS March}, Title = {Editorial: Developmental neuroscience comes of age.}, Journal = {J Child Psychol Psychiatry}, Volume = {52}, Number = {4}, Pages = {333-338}, Year = {2011}, Month = {April}, ISSN = {1469-7610}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21410471}, Keywords = {Child • Child Psychiatry • Child Psychology • Developmental Disabilities • Forecasting • Gene Expression • Humans • Neurosciences • Social Environment • genetics • psychology • trends*}, Language = {eng}, Doi = {10.1111/j.1469-7610.2011.02378.x}, Key = {fds275150} } @article{fds275109, Author = {JS March}, Title = {Looking to the future of research in pediatric anxiety disorders.}, Journal = {Depress Anxiety}, Volume = {28}, Number = {1}, Pages = {88-98}, Year = {2011}, Month = {January}, ISSN = {1520-6394}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21162058}, Keywords = {Anxiety Disorders • Arousal • Brain • Child • Clinical Trials as Topic • Combined Modality Therapy • Evidence-Based Medicine • Fear • Forecasting • Humans • Individualized Medicine • United States • diagnosis • physiology • physiopathology • psychology • therapy*}, Abstract = {OBJECTIVE: The rapid emergence of translational developmental neuroscience as the key driver in understanding the onset of mental illness, the restructuring of academic health science centers on the NIH Roadmap, and dramatic shifts in drug, biological, device, and psychosocial intervention development all have important consequences for pediatric anxiety disorders as a field. METHOD: This article, which tracks the final presentation at a day-long symposium on pediatric anxiety disorders at the 2010 annual meeting of the Anxiety Disorders Association of America (ADAA), will try to outline where the field will head over the next decade as these forces combine to shape research and practice. RESULTS: After 20 years of large comparative treatment trials that have defined the place of current generation treatments, the field is shifting toward interventions that will emerge from the revolution in translational developmental neuroscience and that herald the dawn of stratified and ultimately personalized medicine. With a much more efficient discovery to translational continuum, intervention development and dissemination will benefit from the concurrent transformation of the clinical and clinical research enterprise. CONCLUSION: Dramatic advances in science and changes in the structure of medicine will condition the future of clinical research across every therapeutic area in medicine. For the field of pediatric anxiety disorders to thrive it will be important to embrace and actively participate in this revolution so that anxious youth are viewed as a key target population and, consequently, preemptive, preventive, and curative interventions will be developed for children by first intent.}, Language = {eng}, Doi = {10.1002/da.20754}, Key = {fds275109} } @article{fds275042, Author = {CA Flessner and J Sapyta and A Garcia and JB Freeman and ME Franklin and E Foa and J March}, Title = {Examining the psychometric properties of the family accommodation scale-parent-report (FAS-PR)}, Journal = {Journal of Psychopathology and Behavioral Assessment}, Volume = {33}, Number = {1}, Pages = {38-46}, Year = {2011}, ISSN = {0882-2689}, url = {http://dx.doi.org/10.1007/s10862-010-9196-3}, Abstract = {Growing research has examined parental accommodation among the families of children with obsessive-compulsive disorder (OCD). However, these studies have utilized a parent-report (PR) version of a measure, the Family Accommodation Scale (FAS) that has never received proper psychometric validation. In turn, previously derived subscales have been developed via clinical rather than empirical evidence. This study aims to conduct a comprehensive psychometric analysis of the FAS-PR utilizing data collected from 96 youths with OCD. Exploratory factors analysis was conducted and revealed a 12-item scale yielding two separate, yet related subscales, Avoidance of Triggers (AT) and Involvement in Compulsions (IC). Subsequent analyses revealed good internal consistency and convergent and discriminant validity. These findings suggest that future research should seek to examine factors that may impact various facets to accommodation as well as the role these facets plays in predicting treatment outcome. Limitations are discussed. © 2010 Springer Science+Business Media, LLC.}, Doi = {10.1007/s10862-010-9196-3}, Key = {fds275042} } @article{fds275043, Author = {MM Amaya and MA Reinecke and SG Silva and JS March}, Title = {Parental marital discord and treatment response in depressed adolescents}, Journal = {Journal of Abnormal Child Psychology}, Volume = {39}, Number = {3}, Pages = {401-411}, Year = {2011}, ISSN = {0091-0627}, url = {http://dx.doi.org/10.1007/s10802-010-9466-2}, Abstract = {Evidence suggests that parental marital discord contributes to the development of internalizing and externalizing symptoms in children and adolescents. Few studies, however, have examined the association between parental marital discord and youth's response to treatment. The present study examined the impact of interparental discord on treatment response in a randomized control trial of adolescents with major depression enrolled in the Treatment for Adolescents with Depression Study (TADS). Participants were 260 adolescents from two-parent households randomly assigned to one of four treatment groups: fluoxetine (FLX), cognitive behavior therapy (CBT), their combination (COMB), or placebo (PBO). Logistic regressions revealed that parental marital discord interacted with youth gender and co-morbid oppositionality symptoms to predict group differences in treatment response. © 2010 Springer Science+Business Media, LLC.}, Doi = {10.1007/s10802-010-9466-2}, Key = {fds275043} } @article{fds275061, Author = {GS Ginsburg and PC Kendall and D Sakolsky and SN Compton and J Piacentini, AM Albano and JT Walkup and J Sherrill and KA Coffey and MA Rynn and E al}, Title = {Remission after acute treatment in children and adolescents with anxiety disorders: Findings from the CAMS}, Journal = {Journal of Consulting and Clinical Psychology}, Volume = {79}, Number = {6}, Pages = {806-813}, Year = {2011}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037/a0025933}, Abstract = {Objective: To report on remission rates in anxious youth who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS). The CAMS, a multisite clinical trial, randomized 488 children and adolescents (ages 7-17 years; 79 Caucasian; 50 female) with separation, social, and/or generalized anxiety disorder to a 12-week treatment of sertraline (SRT), cognitive behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). Method: The primary definition of remission was loss of all study-entry anxiety disorder diagnoses; additional definitions of remission were used. All outcomes were rated by independent evaluators blind to treatment assignment. Predictors of remission were also examined. Results: Remission rates after 12 weeks of treatment ranged from 46 to 68 for COMB, 34 to 46 for SRT, 20 to 46 for CBT, and 15 to 27 for PBO. Rates of remission (i.e., achieving a nearly symptom-free state) were significantly lower than rates of response (i.e., achieving a clinically meaningful improvement relative to baseline) for the entire sample. Youth who received COMB had significantly higher rates of remission compared to all other treatment groups. Both monotherapies had higher remission rates compared to PBO, but rates were not different from each other. Predictors of remission were younger age, nonminority status, lower baseline anxiety severity, absence of other internalizing disorders (e.g., anxiety, depression), and absence of social phobia. Conclusions: For the majority of children, some symptoms of anxiety persisted, even among those showing improvement after 12 weeks of treatment, suggesting a need to augment or extend current treatments for some children. © 2011 American Psychological Association.}, Doi = {10.1037/a0025933}, Key = {fds275061} } @article{fds275066, Author = {J Freeman and J Sapyta and A Garcia and D Fitzgerald and M Khanna and M Choate-Summers, P Moore and A Chrisman and N Haff and A Naeem and J March and M Franklin}, Title = {Still Struggling: Characteristics of youth with OCD who are partial responders to medication treatment}, Journal = {Child Psychiatry and Human Development}, Volume = {42}, Number = {4}, Pages = {424-441}, Year = {2011}, ISSN = {0009-398X}, url = {http://dx.doi.org/10.1007/s10578-011-0227-4}, Abstract = {The primary aim of this paper is to examine the characteristics of a large sample of youth with OCD who are partial responders (i.e., still have clinically significant symptoms) to serotonin reuptake inhibitor (SRI) medication. The sample will be described with regard to: demographics, treatment history, OCD symptoms/severity, family history and parental psychopathology, comorbidity, and global and family functioning. The sample includes 124 youth with OCD ranging in age from 7 to 17 with a primary diagnosis of OCD and a partial response to an SRI medication. The youth are a predominantly older (age 12 and over), Caucasian, middle to upper income group who had received significant past treatment. Key findings include moderate to severe OCD symptoms, high ratings of global impairment, and significant comorbidity, despite partial response to an adequate medication trial. Considerations regarding generalizability of the sample and limitations of the study are discussed. © Springer Science+Business Media, LLC 2011.}, Doi = {10.1007/s10578-011-0227-4}, Key = {fds275066} } @article{fds275070, Author = {J Curry and S Silva and P Rohde and G Ginsburg and C Kratochvil and A Simons, J Kirchner and D May and B Kennard and T Mayes and N Feeny and AM Albano, S Lavanier and M Reinecke and R Jacobs and E Becker-Weidman and E Weller and G Emslie and J Walkup and E Kastelic and B Burns and K Wells and J March}, Title = {Recovery and recurrence following treatment for adolescent major depression}, Journal = {Archives of General Psychiatry}, Volume = {68}, Number = {3}, Pages = {263-270}, Year = {2011}, ISSN = {0003-990X}, url = {http://dx.doi.org/10.1001/archgenpsychiatry.2010.150}, Abstract = {Context: Major depressive disorder in adolescents is common and impairing. Efficacious treatments have been developed, but little is known about longer-term outcomes, including recurrence. Objectives: To determine whether adolescents who responded to short-term treatments or who received the most efficacious short-term treatment would have lower recurrence rates, and to identify predictors of recovery and recurrence. Design: Naturalistic follow-up study. Setting: Twelve academic sites in the United States. Participants: One hundred ninety-six adolescents (86 males and 110 females) randomized to 1 of 4 short-term interventions (fluoxetine hydrochloride treatment, cognitive behavioral therapy, their combination, or placebo) in the Treatment for Adolescents With Depression Study were followed up for 5 years after study entry (44.6% of the original Treatment for Adolescents With Depression Study sample). Main Outcome Measures: Recovery was defined as absence of clinically significant major depressive disorder symptoms on the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version interview for at least 8 weeks, and recurrence was defined as a new episode of major depressive disorder following recovery. Results: Almost all participants (96.4%) recovered from their index episode of major depressive disorder during the follow-up period. Recovery by 2 years was significantly more likely for short-term treatment responders (96.2%) than for partial responders or nonresponders (79.1%) (P<.001) but was not associated with having received the most efficacious short-term treatment (the combination of fluoxetine and cognitive behavioral therapy). Of the 189 participants who recovered, 88 (46.6%) had a recurrence. Recurrence was not predicted by full short-term treatment response or by original treatment. However, full or partial responders were less likely to have a recurrence (42.9%) than were non-responders (67.6%) (P=.03). Sex predicted recurrence (57.0% among females vs 32.9% among males; P=.02). Conclusions: Almost all depressed adolescents recovered. However, recurrence occurs in almost half of recovered adolescents, with higher probability in females in this age range. Further research should identify and address the vulnerabilities to recurrence that are more common among young women. ©2011 American Medical Association. All rights reserved.}, Doi = {10.1001/archgenpsychiatry.2010.150}, Key = {fds275070} } @article{fds275090, Author = {LD Miller and A Laye-Gindhu and JL Bennett and Y Liu and S Gold and JS March, BF Olson and VE Waechtler}, Title = {An effectiveness study of a culturally enriched school-based CBT anxiety prevention program.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {40}, Number = {4}, Pages = {618-629}, Year = {2011}, ISSN = {1537-4424}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21722033}, Keywords = {Anxiety • Canada • Child • Cognitive Therapy* • Culture • Female • Humans • Indians, North American • Male • School Health Services • Sex Factors • Treatment Outcome • ethnology • prevention & control* • psychology*}, Abstract = {Anxiety disorders are prevalent in the school-aged population and are present across cultural groups. Scant research exists on culturally relevant prevention and intervention programs for mental health problems in the Aboriginal populations. An established cognitive behavioral program, FRIENDS for Life, was enriched to include content that was culturally relevant to Aboriginal students. Students (N = 533), including 192 students of Aboriginal background, participated in the cluster randomized control study. Data were collected three times over 1 year. A series of multilevel models were conducted to examine the effect of the culturally enriched FRIENDS program on anxiety. These analyses revealed that the FRIENDS program did not effectively reduce anxiety for the total sample or for Aboriginal children specifically. However, all students, regardless of intervention condition, Aboriginal status, or gender, reported a consistent decrease in feelings of anxiety over the 6-month study period.}, Language = {eng}, Doi = {10.1080/15374416.2011.581619}, Key = {fds275090} } @article{fds275117, Author = {JS March}, Title = {Attention bias modification training and the new interventions research.}, Journal = {Biol Psychiatry}, Volume = {68}, Number = {11}, Pages = {978-979}, Year = {2010}, Month = {December}, ISSN = {1873-2402}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21075226}, Keywords = {Anxiety Disorders • Attention* • Behavior Therapy* • Humans • therapy*}, Language = {eng}, Doi = {10.1016/j.biopsych.2010.10.007}, Key = {fds275117} } @article{fds275122, Author = {AM Garcia and JJ Sapyta and PS Moore and JB Freeman and ME Franklin and JS March and EB Foa}, Title = {Predictors and moderators of treatment outcome in the Pediatric Obsessive Compulsive Treatment Study (POTS I).}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {49}, Number = {10}, Pages = {1024-1033}, Year = {2010}, Month = {October}, ISSN = {1527-5418}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20855047}, Keywords = {Adolescent • Awareness • Child • Codependency (Psychology) • Cognitive Therapy* • Combined Modality Therapy • Comorbidity • Disability Evaluation • Female • Humans • Internal-External Control • Linear Models • Male • Obsessive-Compulsive Disorder • Parent-Child Relations • Prognosis • Serotonin Uptake Inhibitors • Sertraline • diagnosis • genetics • psychology • therapeutic use* • therapy*}, Abstract = {OBJECTIVE: To identify predictors and moderators of outcome in the first Pediatric OCD Treatment Study (POTS I) among youth (N = 112) randomly assigned to sertraline, cognitive behavioral therapy (CBT), both sertraline and CBT (COMB), or a pill placebo. METHOD: Potential baseline predictors and moderators were identified by literature review. The outcome measure was an adjusted week 12 predicted score for the Children's Yale Brown Obsessive Compulsive Scale (CY-BOCS). Main and interactive effects of treatment condition and each candidate predictor or moderator variable were examined using a general linear model on the adjusted predicted week 12 CY-BOCS scores. RESULTS: Youth with lower obsessive-compulsive disorder (OCD) severity, less OCD-related functional impairment, greater insight, fewer comorbid externalizing symptoms, and lower levels of family accommodation showed greater improvement across treatment conditions than their counterparts after acute POTS treatment. Those with a family history of OCD had more than a sixfold decrease in effect size in CBT monotherapy relative to their counterparts in CBT without a family history of OCD. CONCLUSIONS: Greater attention is needed to build optimized intervention strategies for more complex youth with OCD. Youth with a family history of OCD are not likely to benefit from CBT unless offered in combination with an SSRI. CLINICAL TRIALS REGISTRATION INFORMATION: Treatment of Obsessive Compulsive Disorder (OCD) in Children, http://www.clinicaltrials.gov, NCT00000384.}, Language = {eng}, Doi = {10.1016/j.jaac.2010.06.013}, Key = {fds275122} } @article{fds275157, Author = {GL Stein and JF Curry and J Hersh and A Breland-Noble and J March and SG Silva, MA Reinecke and R Jacobs}, Title = {Ethnic differences among adolescents beginning treatment for depression.}, Journal = {Cultur Divers Ethnic Minor Psychol}, Volume = {16}, Number = {2}, Pages = {152-158}, Year = {2010}, Month = {April}, ISSN = {1099-9809}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20438153}, Abstract = {This study examines ethnic/racial differences at the start of treatment among participants in the Treatment for Adolescents with Depression Study (TADS). African American and Latino youth were compared to Caucasian youth on symptom presentation and cognitive variables associated with depression. Contrary to hypothesis, there were no significant differences in symptom presentation as measured by the interview-based items of the Children's Depression Rating Scale--Revised (CDRS-R). However, African American and Latino youth were both rated as demonstrating more severe symptoms on the observational items of the CDRS-R compared to Caucasian youth. In terms of cognitive variables associated with depression, African Americans reported fewer negative cognitive biases compared to Caucasians, but cognitive biases were significantly correlated with depression severity across ethnic groups.}, Doi = {10.1037/a0018666}, Key = {fds275157} } @article{fds275091, Author = {CC Lewis and AD Simons and LJ Nguyen and JL Murakami and MW Reid and SG Silva and JS March}, Title = {Impact of childhood trauma on treatment outcome in the Treatment for Adolescents with Depression Study (TADS).}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {49}, Number = {2}, Pages = {132-140}, Year = {2010}, Month = {February}, ISSN = {1527-5418}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20215935}, Keywords = {Adolescent • Antidepressive Agents, Second-Generation • Child • Child Abuse • Child Abuse, Sexual • Cognitive Therapy* • Combined Modality Therapy • Depressive Disorder, Major • Double-Blind Method • Female • Fluoxetine • Humans • Life Change Events* • Longitudinal Studies • Male • Personality Inventory • Psychometrics • Stress Disorders, Post-Traumatic • Treatment Outcome • blood* • diagnosis • psychology* • statistics & numerical data • therapeutic use* • therapy}, Abstract = {OBJECTIVE: The impact of childhood trauma was examined in 427 adolescents (54% girls, 74% Caucasian, mean = 14.6, SD = 1.5) with major depressive disorder participating in the Treatment for Adolescents with Depression Study (TADS). METHOD: TADS compared the efficacy of cognitive behavioral therapy (CBT), fluoxetine (FLX), their combination (COMB), and placebo (PBO). Teens were separated into four trauma history groups: (1) no trauma; (2) trauma, no abuse; (3) physical abuse; (4), and sexual abuse. The effects of treatment and trauma history on depression severity across 12 weeks of acute treatment, as measured by the Children's Depression Rating Scale-Revised (CDRS-R), were examined. RESULTS: A significant trauma-by-treatment-by-time interaction indicated that trauma history moderated treatment. The Week 12 primary efficacy findings previously reported by TADS were replicated in the no trauma group (n = 201): COMB = FLX > CBT = PBO. No significant differences in treatment arms were observed among the trauma, no abuse, or physical abuse group. Teens with a history of sexual abuse treated with COMB, FLX, and PBO showed significant and equivalent improvement on the CDRS-R (mean <45), whereas the mean CDRS-R for the CBT group tended to remain in the depressed range (mean >45). Baseline suicidality and self-reported depression were significantly related to a history of sexual abuse. CONCLUSIONS: The study was limited by the level of detail regarding childhood traumatic experiences. Results are discussed in terms of the implications for treating depressed adolescents with traumatic backgrounds.Clinical Trials Registry Information: Treatment for Adolescents with Depression Study; http://www.clinicaltrials.gov, NCT00006286.}, Language = {eng}, Key = {fds275091} } @article{fds275167, Author = {JS March}, Title = {Commentary on 'Forum: use of antidepressants in children and adolescents'.}, Journal = {Curr Opin Psychiatry}, Volume = {23}, Number = {1}, Pages = {63-65}, Year = {2010}, Month = {January}, ISSN = {1473-6578}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19952557}, Keywords = {Adolescent • Behavior Therapy • Child • Depressive Disorder • Humans • Meta-Analysis as Topic • Serotonin Uptake Inhibitors • Suicide, Attempted* • drug therapy* • psychology • therapeutic use*}, Language = {eng}, Doi = {10.1097/01.yco.0000365437.88103.9d}, Key = {fds275167} } @article{fds275035, Author = {EG Becker-Weidman and RH Jacobs and MA Reinecke and SG Silva and JS March}, Title = {Social problem-solving among adolescents treated for depression}, Journal = {Behaviour Research and Therapy}, Volume = {48}, Number = {1}, Pages = {11-18}, Year = {2010}, ISSN = {0005-7967}, url = {http://dx.doi.org/10.1016/j.brat.2009.08.006}, Abstract = {Studies suggest that deficits in social problem-solving may be associated with increased risk of depression and suicidality in children and adolescents. It is unclear, however, which specific dimensions of social problem-solving are related to depression and suicidality among youth. Moreover, rational problem-solving strategies and problem-solving motivation may moderate or predict change in depression and suicidality among children and adolescents receiving treatment. The effect of social problem-solving on acute treatment outcomes were explored in a randomized controlled trial of 439 clinically depressed adolescents enrolled in the Treatment for Adolescents with Depression Study (TADS). Measures included the Children's Depression Rating Scale-Revised (CDRS-R), the Suicidal Ideation Questionnaire - Grades 7-9 (SIQ-Jr), and the Social Problem-Solving Inventory-Revised (SPSI-R). A random coefficients regression model was conducted to examine main and interaction effects of treatment and SPSI-R subscale scores on outcomes during the 12-week acute treatment stage. Negative problem orientation, positive problem orientation, and avoidant problem-solving style were non-specific predictors of depression severity. In terms of suicidality, avoidant problem-solving style and impulsiveness/carelessness style were predictors, whereas negative problem orientation and positive problem orientation were moderators of treatment outcome. Implications of these findings, limitations, and directions for future research are discussed. © 2009 Elsevier Ltd. All rights reserved.}, Doi = {10.1016/j.brat.2009.08.006}, Key = {fds275035} } @article{fds275036, Author = {RH Jacobs and EG Becker-Weidman and MA Reinecke and N Jordan and SG Silva, P Rohde and JS March}, Title = {Treating depression and oppositional behavior in adolescents}, Journal = {Journal of Clinical Child and Adolescent Psychology}, Volume = {39}, Number = {4}, Pages = {559-567}, Year = {2010}, ISSN = {1537-4416}, url = {http://dx.doi.org/10.1080/15374416.2010.486318}, Abstract = {Adolescents with depression and high levels of oppositionality often are particularly difficult to treat. Few studies, however, have examined treatment outcomes among youth with both externalizing and internalizing problems. This study examines the effect of fluoxetine, cognitive behavior therapy (CBT), the combination of fluoxetine and CBT, and placebo on co-occurring oppositionality within a sample of depressed adolescents. All treatments resulted in decreased oppositionality at 12 weeks. Adolescents receiving fluoxetine, either alone or in combination with CBT, experienced greater reductions in oppositionality than adolescents not receiving antidepressant medication. These results suggest that treatments designed to alleviate depression can reduce oppositionality among youth with a primary diagnosis of depression. © Taylor & Francis Group, LLC.}, Doi = {10.1080/15374416.2010.486318}, Key = {fds275036} } @article{fds275037, Author = {EB Foa and M Coles and JD Huppert and RV Pasupuleti and ME Franklin and J March}, Title = {Development and Validation of a Child Version of the Obsessive Compulsive Inventory}, Journal = {Behavior Therapy}, Volume = {41}, Number = {1}, Pages = {121-132}, Year = {2010}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/j.beth.2009.02.001}, Abstract = {Surprisingly, only 3 self-report measures that directly assess pediatric obsessive-compulsive disorder (OCD) have been developed. In addition, these scales have typically been developed in small samples and fail to provide a quick assessment of symptoms across multiple domains. Therefore, the current paper presents initial psychometric data for a quick assessment of pediatric OCD across multiple symptom domains, a child version of the Obsessive Compulsive Inventory (the OCI-CV). Data from a sample of over 100 youth ages 7 to 17 with a primary DSM-IV diagnosis of OCD support the use of the 21-item OCI-CV. Results support the use of the OCI-CV as a general index of OCD symptom severity and in 6 symptom domains parallel to those assessed by the revised adult version of the scale (OCI-R). The OCI-CV showed strong retest reliability after approximately 1.5 weeks in a subsample of 64 participants and was significantly correlated with clinician-rated OCD symptom severity and parent and child reports of dysfunction related to OCD. Significantly stronger correlations with self-reported anxiety than with depressive symptoms provide initial support for the divergent validity of the measure. Finally, preliminary data with 88 treatment completers suggest that the OCI-CV is sensitive to change. © 2009.}, Doi = {10.1016/j.beth.2009.02.001}, Key = {fds275037} } @article{fds275038, Author = {JS March and DL Evans}, Title = {In Memoriam: Elizabeth Weller, M.D.}, Journal = {Biological Psychiatry}, Volume = {67}, Number = {7}, Pages = {e49}, Year = {2010}, ISSN = {0006-3223}, url = {http://dx.doi.org/10.1016/j.biopsych.2010.01.031}, Doi = {10.1016/j.biopsych.2010.01.031}, Key = {fds275038} } @article{fds275039, Author = {CA Flessner and A Allgair and A Garcia and J Freeman and J Sapyta and ME Franklin, E Foa and J March}, Title = {The impact of neuropsychological functioning on treatment outcome in pediatric obsessive-compulsive disorder}, Journal = {Depression and Anxiety}, Volume = {27}, Number = {4}, Pages = {365-371}, Year = {2010}, ISSN = {1091-4269}, url = {http://dx.doi.org/10.1002/da.20626}, Abstract = {Background: Scant research has examined the effect of neuropsychological (NP) functioning on treatment outcome in pediatric obsessive-compulsive disorder (OCD). This study sought to address this gap in existing research. Methods: A total of 63 youths were included in this study and asked to complete the Rey- Osterrieth Complex Figure (ROCF) and specific subtests of theWechsler Intelligence Scale for Children, Third Edition (WISC-III). Results: Analyses suggest that 5min recall accuracy (raw score) and percent recall from the ROCF, assessed before treatment may be predictors of treatment response among children with OCD. What is more, exploratory post hoc analyses indicated that performance on these ROCF tasks is particularly relevant among youths receiving cognitive-behavior therapy (CBT) alone. These results may be driven by executive functioning ability. Additional analyses suggest a relationship between age, symptom severity, and NP functioning on select tasks from both the ROCF and WISC-III. Conclusions: Although alternative explanations exist, these findings suggest that poorer performance on the ROCF and, in turn, poorer response to treatment, particularly among those youths receiving CBT alone, may be due to executive functioning difficulties. Clinicians and researchers should be sensitive to this fact and may warrant modification(s) to existing treatment protocols. Limitations to this study, however, suggest the need for replication and extension of these findings in the future. © 2009 Wiley-Liss, Inc.}, Doi = {10.1002/da.20626}, Key = {fds275039} } @article{fds275040, Author = {RH Jacobs and MA Reinecke and JK Gollan and N Jordan and SG Silva and JS March}, Title = {Extreme thinking in clinically depressed adolescents: Results from the Treatment for Adolescents with Depression Study (TADS)}, Journal = {Behaviour Research and Therapy}, Volume = {48}, Number = {11}, Pages = {1155-1159}, Year = {2010}, ISSN = {0005-7967}, url = {http://dx.doi.org/10.1016/j.brat.2010.08.001}, Abstract = {The purpose of this report is to examine relations between extreme thinking, as measured by the Dysfunctional Attitudes Scale, and the maintenance of gains among adolescents who participated in the Treatment for Adolescents with Depression Study (TADS). We examine extreme thinking among 327 adolescents (mean age. = 14.56, 57% female, 75% White) who received cognitive behavior therapy (CBT), fluoxetine (FLX), or a combination of CBT and FLX (COMB). Among those who met remission status on the Children's Depression Rating Scale - Revised (CDRS-R ≤ 28; 56 at week 12, 79 at week 18) extreme thinking did not predict failure to maintain remission. This is in contrast to findings with depressed adults. Treatment influenced level of extreme thinking, and this appeared to be driven by greater endorsement of positively valenced beliefs as opposed to a decrease in negatively valenced beliefs. Developmental or investigation characteristics may account for the discrepancy in findings. © 2010 Elsevier Ltd.}, Doi = {10.1016/j.brat.2010.08.001}, Key = {fds275040} } @article{fds275041, Author = {J March and HC Kraemer and M Trivedi and J Csernansky and J Davis and TA Ketter and ID Glick}, Title = {What have we learned about trial design from NIMH-funded pragmatic trials}, Journal = {Neuropsychopharmacology}, Volume = {35}, Number = {13}, Pages = {2491-2501}, Year = {2010}, ISSN = {0893-133X}, url = {http://dx.doi.org/10.1038/npp.2010.115}, Abstract = {At the 2008 annual meeting of the American College of Neuropsychopharmacology (ACNP), a symposium was devoted to the following question: what have we learned about the design of pragmatic clinical trials (PCTs) from the recent costly long-term, large-scale trials of psychiatric treatments? in order to inform the design of future trials. In all, 10 recommendations were generated placing emphasis on (1) appropriate conduct of pragmatic trials; (2) clinical, rather than, merely statistical significance; (3) sampling from the population clinicians are called upon to treat; (4) clinical outcomes of patients, rather than, on outcome measures; (5) use of stratification, controlling, or adjusting when necessary and not otherwise; (6) appropriate consideration of site differences in multisite studies; (7) encouragement of post hoc exploration to generate (not test) hypotheses; (8) precise articulation of the treatment strategy to be tested and use of the corresponding appropriate design; (9) expanded opportunity for training of researchers and reviewers in RCT principles; and (10) greater emphasis on data sharing. © 2010 Nature Publishing Group All rights reserved.}, Doi = {10.1038/npp.2010.115}, Key = {fds275041} } @article{fds275060, Author = {PC Kendall and SN Compton and JT Walkup and B Birmaher and AM Albano and J Sherrill, G Ginsburg and M Rynn and J McCracken and E Gosch and E al}, Title = {Clinical characteristics of anxiety disordered youth}, Journal = {Journal of Anxiety Disorders}, Volume = {24}, Number = {3}, Pages = {360-365}, Year = {2010}, ISSN = {0887-6185}, url = {http://dx.doi.org/10.1016/j.janxdis.2010.01.009}, Abstract = {Reports the characteristics of a large, representative sample of treatment-seeking anxious youth (N=488). Participants, aged 7-17 years (mean 10.7 years), had a principal DSM-IV diagnosis of separation anxiety disorder (SAD), generalized anxiety disorder (GAD), or social phobia (SP). Although youth with a co-primary diagnosis for which a different disorder-specific treatment would be indicated (e.g., major depressive disorder, substance abuse) were not included, there were few other exclusion criteria. Participants and their parent/guardian underwent an extensive baseline assessment using a broad array of measures capturing diagnostic status, anxiety symptoms and severity, and areas of functional impairment. Means and standard deviations of the measures of psychopathology and data on diagnostic status are provided. The sample had moderate to severe anxiety disorder and was highly comorbid, with 55.3% of participants meeting criteria for at least one non-targeted DSM-IV disorder. Anxiety disorders in youth often do not present as a single/focused disorder: such disorders in youth overlap in symptoms and are highly comorbid among themselves. © 2010 Elsevier Ltd.}, Doi = {10.1016/j.janxdis.2010.01.009}, Key = {fds275060} } @article{fds275171, Author = {SN Compton and JT Walkup and AM Albano and JC Piacentini and B Birmaher and JT Sherrill and GS Ginsburg and MA Rynn and JT McCracken and BD Waslick and S Iyengar and PC Kendall and JS March}, Title = {Child/Adolescent Anxiety Multimodal Study (CAMS): rationale, design, and methods.}, Journal = {Child Adolesc Psychiatry Ment Health}, Volume = {4}, Pages = {1}, Year = {2010}, ISSN = {1753-2000}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20051130}, Abstract = {OBJECTIVE: To present the design, methods, and rationale of the Child/Adolescent Anxiety Multimodal Study (CAMS), a recently completed federally-funded, multi-site, randomized placebo-controlled trial that examined the relative efficacy of cognitive-behavior therapy (CBT), sertraline (SRT), and their combination (COMB) against pill placebo (PBO) for the treatment of separation anxiety disorder (SAD), generalized anxiety disorder (GAD) and social phobia (SoP) in children and adolescents. METHODS: Following a brief review of the acute outcomes of the CAMS trial, as well as the psychosocial and pharmacologic treatment literature for pediatric anxiety disorders, the design and methods of the CAMS trial are described. RESULTS: CAMS was a six-year, six-site, randomized controlled trial. Four hundred eighty-eight (N = 488) children and adolescents (ages 7-17 years) with DSM-IV-TR diagnoses of SAD, GAD, or SoP were randomly assigned to one of four treatment conditions: CBT, SRT, COMB, or PBO. Assessments of anxiety symptoms, safety, and functional outcomes, as well as putative mediators and moderators of treatment response were completed in a multi-measure, multi-informant fashion. Manual-based therapies, trained clinicians and independent evaluators were used to ensure treatment and assessment fidelity. A multi-layered administrative structure with representation from all sites facilitated cross-site coordination of the entire trial, study protocols and quality assurance. CONCLUSIONS: CAMS offers a model for clinical trials methods applicable to psychosocial and psychopharmacological comparative treatment trials by using state-of-the-art methods and rigorous cross-site quality controls. CAMS also provided a large-scale examination of the relative and combined efficacy and safety of the best evidenced-based psychosocial (CBT) and pharmacologic (SSRI) treatments to date for the most commonly occurring pediatric anxiety disorders. Primary and secondary results of CAMS will hold important implications for informing practice-relevant decisions regarding the initial treatment of youth with anxiety disorders. TRIAL REGISTRATION: ClinicalTrials.gov NCT00052078.}, Language = {eng}, Doi = {10.1186/1753-2000-4-1}, Key = {fds275171} } @article{fds275092, Author = {RH Jacobs and SG Silva and MA Reinecke and JF Curry and GS Ginsburg and CJ Kratochvil and JS March}, Title = {Dysfunctional attitudes scale perfectionism: a predictor and partial mediator of acute treatment outcome among clinically depressed adolescents.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {38}, Number = {6}, Pages = {803-813}, Year = {2009}, Month = {November}, ISSN = {1537-4424}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20183664}, Keywords = {Adolescent • Attitude* • Child • Cognitive Therapy • Depressive Disorder, Major • Diagnostic and Statistical Manual of Mental Disorders • Female • Humans • Male • Personality* • Predictive Value of Tests • Questionnaires* • Self Concept • Treatment Outcome • diagnosis • methods* • psychology • therapy*}, Abstract = {The effect of perfectionism on acute treatment outcomes was explored in a randomized controlled trial of 439 clinically depressed adolescents (12-17 years of age) enrolled in the Treatment for Adolescents with Depression Study (TADS) who received cognitive behavior therapy (CBT), fluoxetine, a combination of CBT and FLX, or pill placebo. Measures included the Children's Depression Rating Scale-Revised, the Suicidal Ideation Questionnaire-Grades 7-9, and the perfectionism subscale from the Dysfunctional Attitudes Scale (DAS). Predictor results indicate that adolescents with higher versus lower DAS perfectionism scores at baseline, regardless of treatment, continued to demonstrate elevated depression scores across the acute treatment period. In the case of suicidality, DAS perfectionism impeded improvement. Treatment outcomes were partially mediated by the change in DAS perfectionism across the 12-week period.}, Language = {eng}, Doi = {10.1080/15374410903259031}, Key = {fds275092} } @article{fds275093, Author = {NC Feeny and SG Silva and MA Reinecke and S McNulty and RL Findling and P Rohde, JF Curry and GS Ginsburg and CJ Kratochvil and SM Pathak and DE May, BD Kennard and AD Simons and KC Wells and M Robins and D Rosenberg and JS March}, Title = {An exploratory analysis of the impact of family functioning on treatment for depression in adolescents.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {38}, Number = {6}, Pages = {814-825}, Year = {2009}, Month = {November}, ISSN = {1537-4424}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20183665}, Keywords = {Adolescent • Child • Cognitive Therapy • Depressive Disorder, Major • Double-Blind Method • Family • Female • Fluoxetine • Humans • Male • Research Design • Serotonin Uptake Inhibitors • Single-Blind Method • Social Environment • Treatment Outcome • diagnosis • methods* • psychology* • therapeutic use* • therapy*}, Abstract = {This article explores aspects of family environment and parent-child conflict that may predict or moderate response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive behavioral therapy, their combination, or placebo. Outcomes were Week 12 scores on measures of depression and global impairment. Of 20 candidate variables, one predictor emerged: Across treatments, adolescents with mothers who reported less parent-child conflict were more likely to benefit than their counterparts. When family functioning moderated outcome, adolescents who endorsed more negative environments were more likely to benefit from fluoxetine. Similarly, when moderating effects were seen on cognitive behavioral therapy conditions, they were in the direction of being less effective among teens reporting poorer family environments.}, Language = {eng}, Doi = {10.1080/15374410903297148}, Key = {fds275093} } @article{fds275094, Author = {GS Ginsburg and SG Silva and RH Jacobs and S Tonev and RH Hoyle and JN Kingery, MA Reinecke and JF Curry and JS March}, Title = {Cognitive measures of adolescent depression: unique or unitary constructs?}, Journal = {J Clin Child Adolesc Psychol}, Volume = {38}, Number = {6}, Pages = {790-802}, Year = {2009}, Month = {November}, ISSN = {1537-4424}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20183663}, Keywords = {Adolescent • Child • Cognition Disorders • Cognitive Therapy • Culture • Depressive Disorder, Major • Female • Fluoxetine • Humans • Male • Neuropsychological Tests • Personality Disorders • Questionnaires • Self Concept • Serotonin Uptake Inhibitors • Treatment Outcome • diagnosis • diagnosis* • epidemiology • epidemiology* • methods* • psychology • therapeutic use* • therapy*}, Abstract = {The factor structure of several self-report questionnaires assessing depression-relevant cognitions frequently employed in clinical research was examined in a sample of 390 adolescents (M age = 14.54; 216 girls; 74% Caucasian) with current major depressive disorder enrolled in the Treatment of Adolescents with Depression Study. A four-factor solution resulted, accounting for 65% of the total variance. The factors were labeled (a) Cognitive Distortions and Maladaptive Beliefs, (b) Cognitive Avoidance, (c) Positive Outlook, and (d) Solution-Focused Thinking. Internal consistencies for the factor-based composite scores were .83, .85, .84, and .82, respectively. Girls endorsed more negative cognitions than boys on three of the four factors. Maladaptive cognitions were positively related to severity of depression and predicted treatment response. Taken together, findings indicated that there are four distinct domains of cognitions that are present among adolescents with depression that are tapped by several widely used self-report measures of cognitions.}, Language = {eng}, Doi = {10.1080/15374410903259015}, Key = {fds275094} } @article{fds275095, Author = {GM Rogers and JH Park and MJ Essex and MH Klein and SG Silva and RH Hoyle and JF Curry and NC Feeny and B Kennard and CJ Kratochvil and S Pathak and MA Reinecke, DR Rosenberg and EB Weller and JS March}, Title = {The dysfunctional attitudes scale: psychometric properties in depressed adolescents.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {38}, Number = {6}, Pages = {781-789}, Year = {2009}, Month = {November}, ISSN = {1537-4424}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20183662}, Keywords = {Adolescent • Anxiety Disorders • Attitude* • Child • Depressive Disorder, Major • Factor Analysis, Statistical • Female • Humans • Male • Psychological Theory • Questionnaires* • Self Concept • diagnosis • diagnosis* • epidemiology • psychology • psychology*}, Abstract = {The psychometric properties and factor structure of the Dysfunctional Attitudes Scale were examined in a sample of 422 male and female adolescents (ages 12-17) with current major depressive disorder. The scale demonstrated high internal consistency (alpha = .93) and correlated significantly with self-report and interview-based measures of depression. Confirmatory factor analysis indicated that a correlated 2-factor model, with scales corresponding to perfectionism and need for social approval, provided a satisfactory fit to the data. The goodness-of-fit was equivalent across sexes and age groups. The findings support the use of the Dysfunctional Attitudes Scale and its subscales in the assessment of clinically depressed adolescents.}, Language = {eng}, Doi = {10.1080/15374410903259007}, Key = {fds275095} } @article{fds275096, Author = {MA Reinecke and JF Curry and JS March}, Title = {Findings from the Treatment for Adolescents with Depression Study (TADS): what have we learned? What do we need to know?}, Journal = {J Clin Child Adolesc Psychol}, Volume = {38}, Number = {6}, Pages = {761-767}, Year = {2009}, Month = {November}, ISSN = {1537-4424}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20183660}, Keywords = {Adolescent • Clinical Competence* • Depressive Disorder • Health Knowledge, Attitudes, Practice* • Humans • Recurrence • Suicide, Attempted • drug therapy* • epidemiology • prevention & control • psychology • statistics & numerical data}, Abstract = {This introduction to the special section on findings from the Treatment for Adolescents with Depression Study provides a review of the rationale for the study, its design, and principal findings to date. Findings with regard to acute effectiveness of alternative treatments, relapse, recurrence, maintenance of gains, and the effects of treatment on suicidal ideations and suicidal behavior are reviewed. We conclude with a brief discussion of unresolved clinical issues, including treatment resistance, management of partial response, moderators and predictors of long-term response, and mediators of clinical change. The articles of the special section address a range of issues including relations between cognitive factors associated with depression, relations between maladaptive beliefs and treatment response, cognitive mediators of therapeutic improvement, relations between family conflict and treatment response, and the economic costs of adolescent depression.}, Language = {eng}, Doi = {10.1080/15374410903258991}, Key = {fds275096} } @article{fds275097, Author = {JN Kingery and HO Kepley and GS Ginsburg and JT Walkup and SG Silva and RH Hoyle, MA Reinecke and JS March}, Title = {Factor structure and psychometric properties of the Children's Negative Cognitive Error Questionnaire with a clinically depressed adolescent sample.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {38}, Number = {6}, Pages = {768-780}, Year = {2009}, Month = {November}, ISSN = {1537-4424}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20183661}, Keywords = {Adolescent • Affect* • Child • Cognition* • Cognitive Therapy • Depressive Disorder, Major • Factor Analysis, Statistical • Female • Fluoxetine • Humans • Male • Observer Variation • Psychometrics • Questionnaires* • Serotonin Uptake Inhibitors • diagnosis* • epidemiology • methods* • therapeutic use* • therapy*}, Abstract = {The factor structure and psychometric properties of the Children's Negative Cognitive Error Questionnaire (CNCEQ) were examined with 427 adolescents ages 12 to 18 (193 boys) with current major depressive disorder. Results of confirmatory factor analysis supported a four-factor model comprised of three content area factors (i.e., social, academic, athletic) and a general factor. Internal consistencies ranged between .84 and .94 for the total and three content area scores. Girls scored significantly higher than boys on all factors, but no age differences on the factors were found. Convergent and discriminant validity of the CNCEQ were supported. Results did not support the original subscales organized by type of cognitive distortion (e.g., catastrophizing, overgeneralizing). Findings indicated that the CNCEQ would be a useful clinical tool for assessing cognitive symptoms within relevant domains of functioning (e.g., social, academic) of depressed youth.}, Language = {eng}, Doi = {10.1080/15374410903297130}, Key = {fds275097} } @article{fds275099, Author = {ME Domino and BJ Burns and J Mario and MA Reinecke and B Vitiello and EB Weller, CJ Kratochvil and DE May and NC Feeny and M Robins and MJ Hallin, SG Silva and JS March}, Title = {Service use and costs of care for depressed adolescents: who uses and who pays?}, Journal = {J Clin Child Adolesc Psychol}, Volume = {38}, Number = {6}, Pages = {826-836}, Year = {2009}, Month = {November}, ISSN = {1537-4424}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20183666}, Keywords = {Adolescent • Child • Depressive Disorder, Major • Female • Humans • Male • Mental Health Services • drug therapy* • economics* • utilization*}, Abstract = {Major depressive disorder is common in adolescence and is associated with significant morbidity and family burden. Little is known about service use by depressed adolescents. The purpose of this article is to report the patterns of services use and costs for participants in the Treatment for Adolescents with Depression Study sample during the 3 months before randomization. Costs were assigned across three categories of payors: families, private insurance, and the public sector. We examined whether costs from payors varied by baseline covariates, such as age, gender, insurance status, and family income. The majority (71%) of depressed youth sought services during the 3-month period. Slightly more than one-fifth had contact with a behavioral health specialist. The average participant had just under $300 (SD = $437.67, range = $0-$3,747.71) in treatment-related costs, with most of these costs borne by families and private insurers.}, Language = {eng}, Doi = {10.1080/15374410903259023}, Key = {fds275099} } @article{fds275069, Author = { Treatment for Adolescents With Depression Study (TADS) Team and J March and S Silva and J Curry and K Wells and J Fairbank and B Burns, M Domino and B Vitiello and J Severe and K Riedal and M Goldman and N Feeny and R Findling and S Stull and S Baab and EB Weller and M Robbins and RA Weller and N Jessani and B Waslick and M Sweeney and R Dublin and J Walkup, G Ginsburg and E Kastelic and H Koo and C Kratochvil and D May and R LaGrone and B Vaughan and AM Albano and GS Hirsch and E Podniesinki and A Chu, M Reincecke and B Leventhal and G Rogers and R Jacobs and S Pathak and J Wells and SA Lavanier and A Danielyan and P Rohde and A Simons and J Grimm, S Frank and G Emslie and B Kennard and C Hughes and TL Mayes and D Rosenberg, N Benazon and M Butkus and M Bartoi}, Title = {The Treatment for Adolescents With Depression Study (TADS): outcomes over 1 year of naturalistic follow-up.}, Journal = {Am J Psychiatry}, Volume = {166}, Number = {10}, Pages = {1141-1149}, Year = {2009}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19723787}, Abstract = {OBJECTIVE: The Treatment for Adolescents With Depression Study (TADS) evaluates the effectiveness of fluoxetine, cognitive-behavioral therapy (CBT), and their combination in adolescents with major depressive disorder. The authors report effectiveness outcomes across a 1-year naturalistic follow-up period. METHOD: The randomized, controlled trial was conducted in 13 academic and community sites in the United States. Stages I, II, and III consisted of 12, 6, and 18 weeks of acute, consolidation, and continuation treatment, respectively. Following discontinuation of TADS treatments at the end of stage III, stage IV consisted of 1 year of naturalistic follow-up. The participants were 327 subjects between the ages of 12 and 17 with a primary DSM-IV diagnosis of major depressive disorder. No TADS treatment was provided during the follow-up period; treatment was available in the community. The primary dependent measures, rated by an independent evaluator blind to treatment status, were the total score on the Children's Depression Rating Scale-Revised and the rate of response, defined as a rating of much or very much improved on the Clinical Global Impressions improvement measure. RESULTS: Sixty-six percent of the eligible subjects participated in at least one stage IV assessment. The benefits seen at the end of active treatment (week 36) persisted during follow-up on all measures of depression and suicidality. CONCLUSIONS: In contrast to earlier reports on short-term treatments, in which worsening after treatment is the rule, the longer treatment in the TADS was associated with persistent benefits over 1 year of naturalistic follow-up.}, Doi = {10.1176/appi.ajp.2009.08111620}, Key = {fds275069} } @article{fds275103, Author = {DA Brent and LL Greenhill and S Compton and G Emslie and K Wells and JT Walkup, B Vitiello and O Bukstein and B Stanley and K Posner and BD Kennard, MF Cwik and A Wagner and B Coffey and JS March and M Riddle and T Goldstein, J Curry and S Barnett and L Capasso and J Zelazny and J Hughes, S Shen and SS Gugga and JB Turner}, Title = {The Treatment of Adolescent Suicide Attempters study (TASA): predictors of suicidal events in an open treatment trial.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {48}, Number = {10}, Pages = {987-996}, Year = {2009}, Month = {October}, ISSN = {1527-5418}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19730274}, Keywords = {Adolescent • Algorithms • Antidepressive Agents • Child • Cognitive Therapy* • Combined Modality Therapy • Depressive Disorder, Major • Dysthymic Disorder • Female • Humans • Interview, Psychological • Male • Personality Inventory • Recurrence • Suicide, Attempted • diagnosis • epidemiology • prevention & control • prevention & control* • psychology • psychology* • statistics & numerical data • therapeutic use* • therapy*}, Abstract = {OBJECTIVE: To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial. METHOD: Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two participants withdrew before treatment assignment. The remaining 124 youths received a specialized psychotherapy for suicide attempting adolescents (n = 17), a medication algorithm (n = 14), or the combination (n = 93). The participants were followed up 6 months after intake with respect to rate, timing, and predictors of a suicidal event (attempt or acute suicidal ideation necessitating emergency referral). RESULTS: The morbid risks of suicidal events and attempts on 6-month follow-up were 0.19 and 0.12, respectively, with a median time to event of 44 days. Higher self-rated depression, suicidal ideation, family income, greater number of previous suicide attempts, lower maximum lethality of previous attempt, history of sexual abuse, and lower family cohesion predicted the occurrence, and earlier time to event, with similar findings for the outcome of attempts. A slower decline in suicidal ideation was associated with the occurrence of a suicidal event. CONCLUSIONS: In this open trial, the 6-month morbid risks for suicidal events and for reattempts were lower than those in other comparable samples, suggesting that this intervention should be studied further. Important treatment targets include suicidal ideation, family cohesion, and sequelae of previous abuse. Because 40% of events occurred with 4 weeks of intake, an emphasis on safety planning and increased therapeutic contact early in treatment may be warranted.}, Language = {eng}, Doi = {10.1097/CHI.0b013e3181b5dbe4}, Key = {fds275103} } @article{fds275106, Author = {CJ Kratochvil and DE May and SG Silva and V Madaan and SE Puumala and JF Curry, J Walkup and H Kepley and B Vitiello and JS March}, Title = {Treatment response in depressed adolescents with and without co-morbid attention-deficit/hyperactivity disorder in the Treatment for Adolescents with Depression Study.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {19}, Number = {5}, Pages = {519-527}, Year = {2009}, Month = {October}, ISSN = {1557-8992}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19877976}, Keywords = {Adolescent • Attention Deficit Disorder with Hyperactivity • Child • Cognitive Therapy • Combined Modality Therapy • Depressive Disorder, Major • Female • Fluoxetine • Humans • Male • Randomized Controlled Trials as Topic • Regression Analysis • Serotonin Uptake Inhibitors • Treatment Outcome • complications • complications* • methods* • therapeutic use* • therapy*}, Abstract = {OBJECTIVE: In the Treatment for Adolescents with Depression Study (TADS), fluoxetine (FLX) and the combination of fluoxetine with cognitive-behavioral therapy (COMB) had superior improvement trajectories compared to pill placebo (PBO), whereas cognitive-behavioral therapy (CBT) was not significantly different from PBO. Because attention-deficit/hyperactivity disorder (ADHD) and major depressive disorder (MDD) frequently co-exist, we examined whether ADHD moderated these outcomes in TADS. METHOD: A total of 439 adolescents with MDD, 12-17 years old, were randomized to FLX, CBT, COMB, or PBO. Random coefficients regression models examined depression improvement in 377 depressed youths without ADHD and 62 with ADHD, including 20 who were treated with a psychostimulant. RESULTS: Within the ADHD group, the improvement trajectories of the three active treatments were similar, all with rates of improvement greater than PBO. For those without ADHD, only COMB had a rate of improvement that was superior to PBO. CONCLUSIONS: Co-morbid ADHD moderated treatment of MDD. CBT alone or FLX alone may offer benefits similar to COMB in the treatment of MDD in youths with co-morbid MDD and ADHD, whereas monotherapy may not match the benefits of COMB for those without ADHD. The ADHD subgroup analysis presented in this paper is exploratory in nature because of the small number of youths with ADHD in the sample. CLINICAL TRIAL REGISTRY: www.clinicaltrials.gov Identifier: NCT00006286. The TADS protocol and all of the TADS manuals are available on the Internet at https://trialweb.dcri.duke.edu/tads/index.html .}, Language = {eng}, Doi = {10.1089/cap.2008.0143}, Key = {fds275106} } @article{fds275110, Author = {RA Shelby and TJ Somers and FJ Keefe and SG Silva and DC McKee and L She and SJ Waters and I Varia and YB Riordan and VM Knowles and M Blazing and JA Blumenthal and P Johnson}, Title = {Pain catastrophizing in patients with noncardiac chest pain: relationships with pain, anxiety, and disability.}, Journal = {Psychosom Med}, Volume = {71}, Number = {8}, Pages = {861-868}, Year = {2009}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19737857}, Abstract = {OBJECTIVE: To examine the contributions of chest pain, anxiety, and pain catastrophizing to disability in 97 patients with noncardiac chest pain (NCCP) and to test whether chest pain and anxiety were related indirectly to greater disability via pain catastrophizing. METHODS: Participants completed daily diaries measuring chest pain for 7 days before completing measures of pain catastrophizing, trait anxiety, and disability. Linear path model analyses examined the contributions of chest pain, trait anxiety, and catastrophizing to physical disability, psychosocial disability, and disability in work, home, and recreational activities. RESULTS: Path models accounted for a significant amount of the variability in disability scales (R(2) = 0.35 to 0.52). Chest pain and anxiety accounted for 46% of the variance in pain catastrophizing. Both chest pain (beta = 0.18, Sobel test Z = 2.58, p < .01) and trait anxiety (beta = 0.14, Sobel test Z = 2.11, p < .05) demonstrated significant indirect relationships with physical disability via pain catastrophizing. Chest pain demonstrated a significant indirect relationship with psychosocial disability via pain catastrophizing (beta = 0.12, Sobel test Z = 1.96, p = .05). After controlling for the effects of chest pain and anxiety, pain catastrophizing was no longer related to disability in work, home, and recreational activities. CONCLUSIONS: Chest pain and anxiety were directly related to greater disability and indirectly related to physical and psychosocial disability via pain catastrophizing. Efforts to improve functioning in patients with NCCP should consider addressing pain catastrophizing.}, Doi = {10.1097/PSY.0b013e3181b49584}, Key = {fds275110} } @article{fds275131, Author = {JS March and B Vitiello}, Title = {Benefits exceed risks of newer antidepressant medications in youth--maybe.}, Journal = {Clin Pharmacol Ther}, Volume = {86}, Number = {4}, Pages = {355-357}, Year = {2009}, Month = {October}, ISSN = {1532-6535}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19763113}, Keywords = {Adolescent • Antidepressive Agents, Second-Generation • Behavior Therapy • Child • Clinical Trials as Topic • Humans • Mental Disorders • Placebo Effect • Risk Assessment • Serotonin Uptake Inhibitors • Suicide • adverse effects* • drug therapy* • therapeutic use • therapy}, Language = {eng}, Doi = {10.1038/clpt.2009.172}, Key = {fds275131} } @article{fds275153, Author = {B Vitiello and DA Brent and LL Greenhill and G Emslie and K Wells and JT Walkup, B Stanley and O Bukstein and BD Kennard and S Compton and B Coffey, MF Cwik and K Posner and A Wagner and JS March and M Riddle and T Goldstein, J Curry and L Capasso and T Mayes and S Shen and SS Gugga and JB Turner, S Barnett and J Zelazny}, Title = {Depressive symptoms and clinical status during the Treatment of Adolescent Suicide Attempters (TASA) Study.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {48}, Number = {10}, Pages = {997-1004}, Year = {2009}, Month = {October}, ISSN = {1527-5418}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20854770}, Keywords = {Adolescent • Antidepressive Agents • Child • Cognitive Therapy* • Combined Modality Therapy • Depressive Disorder, Major • Drug Resistance • Drug Therapy, Combination • Dysthymic Disorder • Female • Follow-Up Studies • Humans • Interview, Psychological • Male • Recurrence • Suicide, Attempted • diagnosis • epidemiology • prevention & control • prevention & control* • psychology • psychology* • statistics & numerical data • therapeutic use* • therapy*}, 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 Children's Depression Rating Scale-Revised (CDRS-R) score of 36 or higher, entered a 6-month treatment with antidepressant medication, cognitive-behavioral therapy focused on suicide prevention, or their combination (Comb), at five academic sites. Treatment assignment could be either random or chosen by study participants. Intent-to-treat, mixed effects regression models of depression and other relevant ratings were estimated. Improvement and remission rates were computed with the last observation carried forward. RESULTS: Most patients (n = 104 or 84%) chose treatment assignment, and overall, three fourths (n = 93) received Comb. In Comb, CDRS-R declined from a baseline adjusted mean of 49.6 (SD 12.3) to 38.3 (8.0) at week 12 and to 27.0 (10.1) at week 24 (p < .0001), with a Clinical Global Impression -defined improvement rate of 58.0% at week 12 and 72.2% at week 24 and a remission (CDRS-R ≤ 28) rate of 32.5% at week 12 and 50.0% at week 24. The CDRS-R and the Scale for Suicidal Ideation scores were correlated at baseline (r = 0.43, p < .0001) and declined in parallel. CONCLUSIONS: When vigorously treated with a combination of medication and psychotherapy, adolescents with depression who have recently attempted suicide show rates of improvement and remission of depression that seem comparable to those observed in nonsuicidal adolescents with depression.}, Language = {eng}, Doi = {10.1097/CHI.0b013e3181b5db66}, Key = {fds275153} } @article{fds275161, Author = {JS March and B Vitiello}, Title = {Clinical messages from the Treatment for Adolescents With Depression Study (TADS).}, Journal = {Am J Psychiatry}, Volume = {166}, Number = {10}, Pages = {1118-1123}, Year = {2009}, Month = {October}, ISSN = {1535-7228}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19723786}, Keywords = {Adolescent • Adolescent Behavior • Cognitive Therapy* • Combined Modality Therapy • Depressive Disorder, Major • Double-Blind Method • Female • Fluoxetine • Great Britain • Harm Reduction • Humans • Male • Multicenter Studies as Topic • Placebos • Randomized Controlled Trials as Topic • Research Design • Serotonin Uptake Inhibitors • Suicide • Treatment Outcome • adverse effects • drug effects • drug therapy • methods • prevention & control • psychology • statistics & numerical data* • therapeutic use* • therapy}, Abstract = {OBJECTIVE: The purpose of this report was to summarize the key clinical messages from the Treatment for Adolescents with Depression Study (TADS). METHODS: TADS is a National Institute of Mental Health (NIMH)-funded randomized controlled trial designed to evaluate the relative effectiveness of fluoxetine, cognitive-behavioral therapy (CBT), and the combination of fluoxetine plus CBT across acute treatment, maintenance treatment, and naturalistic follow-up periods among adolescents with major depressive disorder. RESULTS: Findings revealed that 6 to 9 months of combined fluoxetine plus CBT should be the modal treatment from a public health perspective as well as to maximize benefits and minimize harms for individual patients. CONCLUSION: The combination of fluoxetine and CBT appears to be superior to both CBT monotherapy and fluoxetine monotherapy as a treatment for moderate to severe major depressive disorder in adolescents.}, Language = {eng}, Doi = {10.1176/appi.ajp.2009.08101606}, Key = {fds275161} } @article{fds275123, Author = {ME Domino and EM Foster and B Vitiello and CJ Kratochvil and BJ Burns and SG Silva and MA Reinecke and JS March}, Title = {Relative cost-effectiveness of treatments for adolescent depression: 36-week results from the TADS randomized trial.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {48}, Number = {7}, Pages = {711-720}, Year = {2009}, Month = {July}, ISSN = {1527-5418}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19465880}, Keywords = {Adolescent • Antidepressive Agents, Second-Generation • Child • Cognitive Therapy • Combined Modality Therapy • Cost-Benefit Analysis • Depressive Disorder, Major • Double-Blind Method • Drug Costs • Female • Fluoxetine • Follow-Up Studies • Hospitalization • Humans • Male • Personality Assessment • Psychometrics • economics • economics* • statistics & numerical data • therapeutic use* • therapy*}, Abstract = {OBJECTIVE: The cost-effectiveness of three active interventions for major depression in adolescents was compared after 36 weeks of treatment in the Treatment of Adolescents with Depression Study. METHOD: Outpatients aged 12 to 18 years with a primary diagnosis of major depression participated in a randomized controlled trial conducted at 13 U.S. academic and community clinics from 2000 to 2004. Three hundred twenty-seven participants randomized to 1 of 3 active treatment arms, fluoxetine alone (n = 109), cognitive-behavioral therapy (n = 111) alone, or their combination (n = 107), were evaluated for a 3-month acute treatment and a 6-month continuation/maintenance treatment period. Costs of services received for the 36 weeks were estimated and examined in relation to the number of depression-free days and quality-adjusted life-years. Cost-effectiveness acceptability curves were also generated. Sensitivity analyses were conducted to assess treatment differences on the quality-adjusted life-years and cost-effectiveness measures. RESULTS: Cognitive-behavioral therapy was the most costly treatment component (mean $1,787 [in monotherapy] and $1,833 [in combination therapy], median $1,923 [for both]). Reflecting higher direct and indirect costs associated with psychiatric hospital use, the costs of services received outside Treatment of Adolescents with Depression Study in fluoxetine-treated patients (mean $5,382, median $2,341) were significantly higher than those in participants treated with cognitive-behavioral therapy (mean $3,102, median $1,373) or combination (mean $2,705, median $927). Accordingly, cost-effectiveness acceptability curves indicate that combination treatment is highly likely (>90%) to be more cost-effective than fluoxetine alone at 36 weeks. Cognitive-behavioral therapy is not likely to be more cost-effective than fluoxetine. CONCLUSIONS: These findings support the use of combination treatment in adolescents with depression over monotherapy.}, Language = {eng}, Doi = {10.1097/CHI.0b013e3181a2b319}, Key = {fds275123} } @article{fds275111, Author = {CC Lewis and AD Simons and SG Silva and P Rohde and DM Small and JL Murakami, RR High and JS March}, Title = {The role of readiness to change in response to treatment of adolescent depression.}, Journal = {J Consult Clin Psychol}, Volume = {77}, Number = {3}, Pages = {422-428}, Year = {2009}, Month = {June}, ISSN = {1939-2117}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19485584}, Keywords = {Adolescent • Antidepressive Agents, Second-Generation • Child • Cognitive Therapy* • Combined Modality Therapy • Depressive Disorder • Depressive Disorder, Major • Dysthymic Disorder • Female • Fluoxetine • Follow-Up Studies • Humans • Male • Motivation* • Personality Inventory • Psychometrics • diagnosis • psychology • statistics & numerical data • therapeutic use* • therapy • therapy*}, Abstract = {The effect of readiness to change on treatment outcome was examined among 332 adolescents (46% male, 74% Caucasian), ages 12 through 17 years (M = 14.6, SD = 1.5), with major depressive disorder who were participating in the Treatment for Adolescents With Depression Study (TADS). TADS is a randomized clinical trial comparing the effectiveness of fluoxetine (an antidepressant medication), cognitive-behavioral therapy, their combination, and a pill placebo. An abbreviated Stages of Change Questionnaire was used to obtain 4 readiness to change scores: precontemplation, contemplation, action, and maintenance. The association between each readiness score and depression severity across 12 weeks of acute treatment for depression, as measured by the Children's Depression Rating Scale--Revised, was examined. Although treatment response was not moderated by any of the readiness scores, baseline action scores predicted outcome: Higher action scores were associated with better outcome regardless of treatment modality. Furthermore, treatment effects were mediated by change in action scores during the first 6 weeks of treatment, with increases in action scores related to greater improvement in depression. Assessing readiness to change may have implications for tailoring treatments for depressed adolescents.}, Language = {eng}, Doi = {10.1037/a0014154}, Key = {fds275111} } @article{fds275098, Author = {B Vitiello and SG Silva and P Rohde and CJ Kratochvil and BD Kennard and MA Reinecke, TL Mayes and K Posner and DE May and JS March}, Title = {Suicidal events in the Treatment for Adolescents With Depression Study (TADS).}, Journal = {J Clin Psychiatry}, Volume = {70}, Number = {5}, Pages = {741-747}, Year = {2009}, Month = {May}, ISSN = {1555-2101}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19552869}, Keywords = {Adolescent • Child • Cognitive Therapy • Depressive Disorder, Major • Diagnostic and Statistical Manual of Mental Disorders • Female • Fluoxetine • Humans • Irritable Mood • Male • Psychomotor Agitation • Questionnaires • Serotonin Uptake Inhibitors • Sleep Disorders • Suicide • diagnosis • epidemiology • epidemiology* • methods • psychology • psychology* • statistics & numerical data* • therapeutic use* • therapy}, Abstract = {OBJECTIVE: The Treatment for Adolescents with Depression Study (TADS) database was analyzed to determine whether suicidal events (attempts and ideation) occurred early in treatment, could be predicted by severity of depression or other clinical characteristics, and were preceded by clinical deterioration or symptoms of increased irritability, akathisia, sleep disruption, or mania. METHOD: TADS was a 36-week randomized, controlled clinical trial of pharmacologic and psychotherapeutic treatments involving 439 youths with major depressive disorder (DSM-IV criteria). Suicidal events were defined according to the Columbia Classification Algorithm of Suicidal Assessment. Patients were randomly assigned into the study between spring 2000 and summer 2003. RESULTS: Forty-four patients (10.0%) had at least 1 suicidal event (no suicide occurred). Events occurred 0.4 to 31.1 weeks (mean +/- SD = 11.9 +/- 8.2) after starting TADS treatment, with no difference in event timing for patients receiving medication versus those not receiving medication. Severity of self-rated pretreatment suicidal ideation (Suicidal Ideation Questionnaire adapted for adolescents score > or = 31) and depressive symptoms (Reynolds Adolescent Depression Scale score > or = 91) predicted occurrence of suicidal events during treatment (P < .05). Patients with suicidal events were on average still moderately ill prior to the event (mean +/- SD Clinical Global Impressions-Severity of Illness scale score = 4.0 +/- 1.3) and only minimally improved (mean +/- SD Clinical Global Impressions-Improvement scale score = 3.2 +/- 1.1). Events were not preceded by increased irritability, akathisia, sleep disturbance, or manic signs. Specific interpersonal stressors were identified in 73% of cases (N = 44). Of the events, 55% (N = 24) resulted in overnight hospitalization. CONCLUSIONS: Most suicidal events occurred in the context of persistent depression and insufficient improvement without evidence of medication-induced behavioral activation as a precursor. Severity of self-rated suicidal ideation and depressive symptoms predicted emergence of suicidality during treatment. Risk for suicidal events did not decrease after the first month of treatment, suggesting the need for careful clinical monitoring for several months after starting treatment.}, Language = {eng}, Key = {fds275098} } @article{fds275115, Author = {BD Kennard and SG Silva and TL Mayes and P Rohde and JL Hughes and B Vitiello, CJ Kratochvil and JF Curry and GJ Emslie and MA Reinecke and JS March and TADS}, Title = {Assessment of safety and long-term outcomes of initial treatment with placebo in TADS.}, Journal = {Am J Psychiatry}, Volume = {166}, Number = {3}, Pages = {337-344}, Year = {2009}, Month = {March}, ISSN = {1535-7228}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19147693}, Keywords = {Adolescent • Child • Cognitive Therapy • Combined Modality Therapy • Depressive Disorder, Major • Drug Toxicity* • Female • Fluoxetine • Humans • Male • Serotonin Uptake Inhibitors • Time Factors • Treatment Outcome • drug therapy • methods* • therapeutic use* • therapy*}, Abstract = {OBJECTIVE: The authors examined whether initial assignment to receive placebo for 12 weeks followed by open active treatment as clinically indicated was associated with different levels of benefit and risk of harm across 36 weeks as compared with initial assignment to receive active treatments. METHOD: Adolescents with major depressive disorder (N=439) were randomly assigned to receive an initial 12 weeks of treatment with fluoxetine, cognitive-behavioral therapy (CBT), combination treatment with fluoxetine and CBT, or clinical management with placebo; those assigned to placebo received open active treatment as clinically indicated after 12 weeks of placebo. Assessments were conducted every 6 weeks for 36 weeks. The primary outcome measures were response and remission based on scores on the Children's Depression Rating Scale-Revised and the Clinical Global Impression improvement subscale. RESULTS: At week 36, the response rate was 82% in the placebo/open group and 83% in the active treatment groups. The remission rate was 48% in the placebo/open group and 59% in the active treatment groups, a difference that approached statistical significance. Patients who responded to placebo generally retained their response. Those who did not respond to placebo subsequently responded to active treatment at the same rate as those initially assigned to active treatments. There were no differences between groups in rates of suicidal events, study retention, or symptom worsening. CONCLUSIONS: Remission rates at 9 months were lower in patients treated initially with placebo, but 3 months of placebo treatment was not associated with any harm or diminished response to subsequent treatment.}, Language = {eng}, Doi = {10.1176/appi.ajp.2008.08040487}, Key = {fds275115} } @article{fds275118, Author = {JS March}, Title = {The future of psychotherapy for mentally ill children and adolescents.}, Journal = {J Child Psychol Psychiatry}, Volume = {50}, Number = {1-2}, Pages = {170-179}, Year = {2009}, Month = {January}, ISSN = {1469-7610}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19220600}, Keywords = {Adolescent • Child • Cognitive Therapy • Forecasting • Humans • Mental Disorders • Patient-Centered Care • Psychology • Psychotherapy • methods • methods* • standards • therapy* • trends • trends*}, Abstract = {OBJECTIVE: Given striking advances in translational developmental neuroscience and its convergence with developmental psychopathology and developmental epidemiology, it is now clear that mental illnesses are best thought of as neurodevelopmental disorders. This simple fact has enormous implications for the nature and organization of psychotherapy for mentally ill children, adolescents and adults. METHOD: This article reviews the 'trajectory' of psychosocial interventions in pediatric psychiatry, and makes some general predictions about where this field is heading over the next several decades. RESULTS: Driven largely by scientific advances in molecular, cellular and systems neuroscience, psychotherapy in the future will focus less on personal narratives and more on the developing brain. In place of disorders as intervention targets, modularized psychosocial treatment components derived from current cognitive-behavior therapies will target corresponding central nervous system (CNS) information processes and their functional behavioral consequences. Either preventive or rehabilitative, the goal of psychotherapy will be to promote development along typical developmental trajectories. In place of guilds, psychotherapy will be organized professionally much as physical therapy is organized today. As with other forms of increasingly personalized health care, internet-based delivery of psychotherapy will become commonplace. CONCLUSION: Informed by the new field of translational developmental neuroscience, psychotherapy in the future will take aim at the developing brain in a service delivery model that closely resembles the place and role of psychosocial interventions in the rest of medicine. Getting there will be, as they say, interesting.}, Language = {eng}, Doi = {10.1111/j.1469-7610.2008.02034.x}, Key = {fds275118} } @article{fds275034, Author = {EG Becker-Weidman and MA Reinecke and RH Jacobs and Z Martinovich and SG Silva and JS March}, Title = {Predictors of hopelessness among clinically depressed youth}, Journal = {Behavioural and Cognitive Psychotherapy}, Volume = {37}, Number = {3}, Pages = {267-291}, Year = {2009}, ISSN = {1352-4658}, url = {http://dx.doi.org/10.1017/S1352465809005207}, Abstract = {Background: Factors that distinguish depressed individuals who become hopeless from those who do not are poorly understood. Method: In this study, predictors of hopelessness were examined in a sample of 439 clinically depressed adolescents participating in the Treatment for Adolescents with Depression Study (TADS). The total score of the Beck Hopelessness Scale (BHS) was used to assess hopelessness at baseline. Multiple regression and logistic regression analyses were conducted to evaluate the extent to which variables were associated with hopelessness and determine which cluster of measures best predicted clinically significantly hopelessness. Results: Hopelessness was associated with greater depression severity, poor social problem-solving, cognitive distortions, and family conflict. View of self, view of the world, internal attributional style, need for social approval, positive problem-solving orientation, and family problems consistently emerged as the best predictors of hopelessness in depressed youth. Conclusions: Cognitive and familial factors predict those depressed youth who have high levels of hopelessness. © 2009 British Association for Behavioural and Cognitive Psychotherapies.}, Doi = {10.1017/S1352465809005207}, Key = {fds275034} } @article{fds275054, Author = {BD Kennard and SG Silva and S Tonev and P Rohde and JL Hughes and B Vitiello, CJ Kratochvil and JF Curry and GJ Emslie and M Reinecke and J March}, Title = {Remission and recovery in the treatment for adolescents with depression study (TADS): Acute and long-term outcomes}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {48}, Number = {2}, Pages = {186-195}, Year = {2009}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/CHI.0b013e31819176f9}, Abstract = {Objective: We examine remission rate probabilities, recovery rates, and residual symptoms across 36 weeks in the Treatment for Adolescents with Depression Study (TADS). Method: The TADS, a multisite clinical trial, randomized 439 adolescents with major depressive disorder to 12 weeks of treatment with fluoxetine, cognitive-behavioral therapy, their combination, or pill placebo. The pill placebo group, treated openly after week 12, was not included in the subsequent analyses. Treatment differences in remission rates and probabilities of remission over time are compared. Recovery rates in remitters at weeks 12 (acute phase remitters) and 18 (continuation phase remitters) are summarized. We also examined whether residual symptoms at the end of 12 weeks of acute treatment predicted later remission. Results: At week 36, the estimated remission rates for intention-to-treat cases were as follows: combination, 60%; fluoxetine, 55%; cognitive-behavioral therapy, 64%; and overall, 60%. Paired comparisons reveal that, at week 24, all active treatments converge on remission outcomes. The recovery rate at week 36 was 65% for acute phase remitters and 71% for continuation phase remitters, with no significant between-treatment differences in recovery rates. Residual symptoms at the end of acute treatment predicted failure to achieve remission at weeks 18 and 36. Conclusions: Most depressed adolescents in all three treatment modalities achieved remission at the end of 9 months of treatment. ©2009 by the American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/CHI.0b013e31819176f9}, Key = {fds275054} } @article{fds275119, Author = {M Shapiro and SG Silva and S Compton and A Chrisman and J DeVeaugh-Geiss, A Breland-Noble and D Kondo and J Kirchner and JS March}, Title = {The child and adolescent psychiatry trials network (CAPTN): infrastructure development and lessons learned.}, Journal = {Child Adolesc Psychiatry Ment Health}, Volume = {3}, Number = {1}, Pages = {12}, Year = {2009}, ISSN = {1753-2000}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19320979}, Abstract = {BACKGROUND: In 2003, the National Institute of Mental Health funded the Child and Adolescent Psychiatry Trials Network (CAPTN) under the Advanced Center for Services and Intervention Research (ACSIR) mechanism. At the time, CAPTN was believed to be both a highly innovative undertaking and a highly speculative one. One reviewer even suggested that CAPTN was "unlikely to succeed, but would be a valuable learning experience for the field." OBJECTIVE: To describe valuable lessons learned in building a clinical research network in pediatric psychiatry, including innovations intended to decrease barriers to research participation. METHODS: The CAPTN Team has completed construction of the CAPTN network infrastructure, conducted a large, multi-center psychometric study of a novel adverse event reporting tool, and initiated a large antidepressant safety registry and linked pharmacogenomic study focused on severe adverse events. Specific challenges overcome included establishing structures for network organization and governance; recruiting over 150 active CAPTN participants and 15 child psychiatry training programs; developing and implementing procedures for site contracts, regulatory compliance, indemnification and malpractice coverage, human subjects protection training and IRB approval; and constructing an innovative electronic casa report form (eCRF) running on a web-based electronic data capture system; and, finally, establishing procedures for audit trail oversight requirements put forward by, among others, the Food and Drug Administration (FDA). CONCLUSION: Given stable funding for network construction and maintenance, our experience demonstrates that judicious use of web-based technologies for profiling investigators, investigator training, and capturing clinical trials data, when coupled to innovative approaches to network governance, data management and site management, can reduce the costs and burden and improve the feasibility of incorporating clinical research into routine clinical practice. Having successfully achieved its initial aim of constructing a network infrastructure, CAPTN is now a capable platform for large safety registries, pharmacogenetic studies, and randomized practical clinical trials in pediatric psychiatry.}, Language = {eng}, Doi = {10.1186/1753-2000-3-12}, Key = {fds275119} } @article{fds275120, Author = {JB Freeman and ML Choate-Summers and AM Garcia and PS Moore and JJ Sapyta, MS Khanna and JS March and EB Foa and ME Franklin}, Title = {The Pediatric Obsessive-Compulsive Disorder Treatment Study II: rationale, design and methods.}, Journal = {Child Adolesc Psychiatry Ment Health}, Volume = {3}, Number = {1}, Pages = {4}, Year = {2009}, ISSN = {1753-2000}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19183470}, Abstract = {UNLABELLED: This paper presents the rationale, design, and methods of the Pediatric Obsessive-Compulsive Disorder Treatment Study II (POTS II), which investigates two different cognitive-behavior therapy (CBT) augmentation approaches in children and adolescents who have experienced a partial response to pharmacotherapy with a serotonin reuptake inhibitor for OCD. The two CBT approaches test a "single doctor" versus "dual doctor" model of service delivery. A specific goal was to develop and test an easily disseminated protocol whereby child psychiatrists would provide instructions in core CBT procedures recommended for pediatric OCD (e.g., hierarchy development, in vivo exposure homework) during routine medical management of OCD (I-CBT). The conventional "dual doctor" CBT protocol consists of 14 visits over 12 weeks involving: (1) psychoeducation, (2), cognitive training, (3) mapping OCD, and (4) exposure with response prevention (EX/RP). I-CBT is a 7-session version of CBT that does not include imaginal exposure or therapist-assisted EX/RP. In this study, we compared 12 weeks of medication management (MM) provided by a study psychiatrist (MM only) with two types of CBT augmentation: (1) the dual doctor model (MM+CBT); and (2) the single doctor model (MM+I-CBT). The design balanced elements of an efficacy study (e.g., random assignment, independent ratings) with effectiveness research aims (e.g., differences in specific SRI medications, dosages, treatment providers). The study is wrapping up recruitment of 140 youth ages 7-17 with a primary diagnosis of OCD. Independent evaluators (IEs) rated participants at weeks 0,4,8, and 12 during acute treatment and at 3,6, and 12 month follow-up visits. TRIAL REGISTRATION: NCT00074815.}, Language = {eng}, Doi = {10.1186/1753-2000-3-4}, Key = {fds275120} } @article{fds275151, Author = {AB Lewin and J Piacentini and CA Flessner and DW Woods and ME Franklin and NJ Keuthen and P Moore and M Khanna and JS March and DJ Stein and TLC-SAB}, Title = {Depression, anxiety, and functional impairment in children with trichotillomania.}, Journal = {Depress Anxiety}, Volume = {26}, Number = {6}, Pages = {521-527}, Year = {2009}, ISSN = {1520-6394}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19016486}, Keywords = {Achievement • Adolescent • Anxiety Disorders • Child • Comorbidity • Cross-Sectional Studies • Defense Mechanisms • Depressive Disorder • Female • Friends • Health Surveys • Humans • Internal-External Control* • Internet • Male • Personality Inventory • Self Concept • Social Adjustment* • Trichotillomania • diagnosis • epidemiology* • psychology}, Abstract = {BACKGROUND: Trichotillomania (TTM) remains understudied in children. Adult research suggests that TTM is accompanied by significant depression, anxiety, and functional impairment. The purpose of this study is to examine the occurrence of depression and anxiety in a relatively large sample of youth with TTM and the extent to which these symptoms mediate the relationship between TTM severity and associated impairment. METHODS: The study utilized data from the Child and Adolescent Trichotillomania Impact Project (CA-TIP), an internet-based sample of 133 youth aged 10-17 (inclusive) with TTM. RESULTS: Over 45% of children with TTM endorsed depressive symptoms and 40% endorsed anxiety symptoms in excess of one standard deviation (SD) above published community norms. More remarkably, 25% of our sample reported depressive and 20% reported anxiety symptoms in excess of 2 SD above these norms. Older participants reported more symptoms of depression and anxiety than younger ones; age of onset (children with later onset), but not duration of illness, was predictive of higher reports of both depressive and anxiety symptoms. Neither depressive nor anxiety symptoms were related to pulling site. Depressive symptoms partially mediated the relationship between TTM severity and functional impairment. CONCLUSIONS: Based on an internet sample recruited from the homepage of the Trichotillomania Learning Center, data from this study suggests that symptoms of depression and anxiety may be pervasive among youth with TTM and likely impact functional impairment. Longitudinal studies using directly assessed samples are needed to replicate and extend these findings.}, Language = {eng}, Doi = {10.1002/da.20537}, Key = {fds275151} } @article{fds275100, Author = {JT Walkup and AM Albano and J Piacentini and B Birmaher and SN Compton and JT Sherrill and GS Ginsburg and MA Rynn and J McCracken and B Waslick and S Iyengar, JS March and PC Kendall}, Title = {Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety.}, Journal = {N Engl J Med}, Volume = {359}, Number = {26}, Pages = {2753-2766}, Year = {2008}, Month = {December}, ISSN = {1533-4406}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18974308}, Keywords = {Adolescent • Anxiety Disorders • Child • Cognitive Therapy* • Combined Modality Therapy • Female • Humans • Male • Serotonin Uptake Inhibitors • Sertraline • Treatment Outcome • therapeutic use* • therapy*}, Abstract = {BACKGROUND: Anxiety disorders are common psychiatric conditions affecting children and adolescents. Although cognitive behavioral therapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders, little is known about their relative or combined efficacy. METHODS: In this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioral therapy, sertraline (at a dose of up to 200 mg per day), a combination of sertraline and cognitive behavioral therapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4, 8, and 12. RESULTS: The percentages of children who were rated as very much or much improved on the Clinician Global Impression-Improvement scale were 80.7% for combination therapy (P<0.001), 59.7% for cognitive behavioral therapy (P<0.001), and 54.9% for sertraline (P<0.001); all therapies were superior to placebo (23.7%). Combination therapy was superior to both monotherapies (P<0.001). Results on the Pediatric Anxiety Rating Scale documented a similar magnitude and pattern of response; combination therapy had a greater response than cognitive behavioral therapy, which was equivalent to sertraline, and all therapies were superior to placebo. Adverse events, including suicidal and homicidal ideation, were no more frequent in the sertraline group than in the placebo group. No child attempted suicide. There was less insomnia, fatigue, sedation, and restlessness associated with cognitive behavioral therapy than with sertraline. CONCLUSIONS: Both cognitive behavioral therapy and sertraline reduced the severity of anxiety in children with anxiety disorders; a combination of the two therapies had a superior response rate. (ClinicalTrials.gov number, NCT00052078.)}, Language = {eng}, Doi = {10.1056/NEJMoa0804633}, Key = {fds275100} } @article{fds275141, Author = {RH Jacobs and JB Klein and MA Reinecke and SG Silva and S Tonev and A Breland-Noble, Z Martinovich and CJ Kratochvil and AJ Rezac and J Jones and JS March}, Title = {Ethnic Differences in Attributions and Treatment Expectancies for Adolescent Depression.}, Journal = {Int J Cogn Ther}, Volume = {1}, Number = {2}, Pages = {163-178}, Year = {2008}, Month = {June}, ISSN = {1937-1209}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19169367}, Abstract = {Studies suggest that ethnicity and socioeconomic factors may relate to differences in treatment expectancies and the attributions made for emotional or behavioral problems. We examined ethnic differences in (1) parents' attributions about the causes of adolescent behavioral and emotional problems and (2) treatment expectancies among 236 adolescent participants who enrolled in a 36-week randomized controlled trial for depression. Controlling for education and income, European American parents were more likely to endorse beliefs reflecting physical causes of depression than African American parents. There were no ethnic differences for beliefs reflecting external, familial, or community factors. Ethnic differences were observed in the treatment expectancies reported by parents, but not adolescents, with African American parents more likely than European Americans and Other minorities to endorse positive expectations for CBT. These findings may have implications for understanding discrepancies in mental health service use.}, Language = {ENG}, Doi = {10.1680/ijct.2008.1.2.163}, Key = {fds275141} } @article{fds275116, Author = {ME Domino and BJ Burns and SG Silva and CJ Kratochvil and B Vitiello and MA Reinecke, J Mario and JS March}, Title = {Cost-effectiveness of treatments for adolescent depression: results from TADS.}, Journal = {Am J Psychiatry}, Volume = {165}, Number = {5}, Pages = {588-596}, Year = {2008}, Month = {May}, ISSN = {1535-7228}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18413703}, Keywords = {Adolescent • Child • Combined Modality Therapy • Cost-Benefit Analysis • Depressive Disorder, Major • Drug Therapy • Female • Fluoxetine • Humans • Male • Primary Health Care • Psychotherapy • Serotonin Uptake Inhibitors • Treatment Outcome • drug therapy • economics • economics* • methods • methods* • therapeutic use* • therapy*}, Abstract = {OBJECTIVE: While the evidence base for treatments for adolescent depression is building, little is known about the relative efficiency of such treatments. Treatment costs are a relevant concern given the competing demands on family and health care budgets. The authors evaluated the cost-effectiveness of three active treatments among adolescents with major depressive disorder. METHOD: Volunteers (N=439) ages 12 to 18 with a primary diagnosis of major depressive disorder participated in a randomized, controlled trial conducted at 13 U.S. academic and community clinics from 2000 to 2004. Subjects included those participants who did not drop out and had evaluable outcome and cost data at 12 weeks (N=369). Subjects were randomly assigned to 12 weeks of either fluoxetine alone (10-40 mg/day), CBT alone, CBT combined with fluoxetine (10-40 mg/day), or placebo (equivalent to 10-40 mg/day). Both placebo and fluoxetine were administered double-blind; CBT alone and CBT in combination with fluoxetine were administered unblinded. Societal cost per unit of improvement on the Children's Depression Rating Scale-Revised and cost per quality-adjusted life year (QALY) were compared. RESULTS: Results ranged from an incremental cost over placebo of $24,000 per QALY for treatment with fluoxetine to $123,000 per QALY for combination therapy treatment. The cost-effectiveness ratio for CBT treatment was not evaluable due to negative clinical effects. The models were robust on a variety of assumptions. CONCLUSIONS: Both fluoxetine and combination therapy are at least as cost-effective in the short-term as other treatments commonly used in primary care (using a threshold of $125,000/QALY). Fluoxetine is more cost-effective than combination therapy after 12 weeks of treatment.}, Language = {eng}, Doi = {10.1176/appi.ajp.2008.07101610}, Key = {fds275116} } @article{fds275101, Author = {JH Krystal and CS Carter and D Geschwind and HK Manji and JS March and EJ Nestler, JK Zubieta and DS Charney and D Goldman and RE Gur and JA Lieberman, P Roy-Byrne and DR Rubinow and SA Anderson and S Barondes and KF Berman and J Blair and DL Braff and ES Brown, JR Calabrese and WA Carlezon, EH Cook and RJ Davidson and M Davis and R Desimone and WC Drevets, RS Duman and SM Essock and SV Faraone and R Freedman and KJ Friston, J Gelernter and B Geller and M Gill and E Gould and AA Grace and C Grillon, R Gueorguieva and AR Hariri and RB Innis and EG Jones and JE Kleinman, GF Koob and AD Krystal and E Leibenluft and DF Levinson and PR Levitt, DA Lewis and I Liberzon and BK Lipska, SR Marder and A Markou, GF Mason and CJ McDougle and BS McEwen and FJ McMahon and MJ Meaney, HY Meltzer and KR Merikangas and A Meyer-Lindenberg and K Mirnics, LM Monteggia and A Neumeister and CP O'Brien and MJ Owen and DS Pine, JL Rapoport and SL Rauch and TW Robbins and JF Rosenbaum and DR Rosenberg, CA Ross and AJ Rush and HA Sackeim and G Sanacora and AF Schatzberg, Y Shaham and LJ Siever and T Sunderland and LH Tecott and ME Thase, RD Todd and MM Weissman and R Yehuda and T Yoshikawa and EA Young and R McCandless}, Title = {It is time to take a stand for medical research and against terrorism targeting medical scientists.}, Journal = {Biol Psychiatry}, Volume = {63}, Number = {8}, Pages = {725-727}, Year = {2008}, Month = {April}, ISSN = {1873-2402}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18371494}, Keywords = {Animal Experimentation* • Animal Rights • Animals • Attitude of Health Personnel* • Biomedical Research* • Crime • Ethics, Research • Humans • Primates • Research Personnel* • Terrorism • United States • prevention & control • prevention & control*}, Language = {eng}, Doi = {10.1016/j.biopsych.2008.03.005}, Key = {fds275101} } @article{fds275102, Author = {P Rohde and SG Silva and ST Tonev and BD Kennard and B Vitiello and CJ Kratochvil, MA Reinecke and JF Curry and AD Simons and JS March}, Title = {Achievement and maintenance of sustained response during the Treatment for Adolescents With Depression Study continuation and maintenance therapy.}, Journal = {Arch Gen Psychiatry}, Volume = {65}, Number = {4}, Pages = {447-455}, Year = {2008}, Month = {April}, ISSN = {1538-3636}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18391133}, Keywords = {Achievement* • Adolescent • Antidepressive Agents, Second-Generation • Child • Cognitive Therapy* • Combined Modality Therapy • Depressive Disorder, Major • Female • Fluoxetine • Humans • Male • Patient Compliance • Prevalence • Single-Blind Method • Treatment Outcome • epidemiology • psychology • therapeutic use* • therapy*}, Abstract = {CONTEXT: The Treatment for Adolescents With Depression Study evaluated fluoxetine (FLX), cognitive behavioral therapy (CBT), and FLX/CBT combination (COMB) vs pill placebo in 439 adolescents with major depressive disorder. Treatment consisted of 3 stages: (1) acute (12 weeks), (2) continuation (6 weeks), and (3) maintenance (18 weeks). OBJECTIVE: To examine rates of achieving and maintaining sustained response during continuation and maintenance treatments. DESIGN: Randomized controlled trial. Response was determined by blinded independent evaluators. SETTING: Thirteen US sites. PATIENTS: Two hundred forty-two FLX, CBT, and COMB patients in their assigned treatment at the end of stage 1. INTERVENTIONS: Stage 2 treatment varied based on stage 1 response. Stage 3 consisted of 3 CBT and/or pharmacotherapy sessions and, if applicable, continued medication. MAIN OUTCOME MEASURES: Sustained response was defined as 2 consecutive Clinical Global Impression-Improvement ratings of 1 or 2 ("full response"). Patients achieving sustained response were classified on subsequent nonresponse status. RESULTS: Among 95 patients (39.3%) who had not achieved sustained response by week 12 (29.1% COMB, 32.5% FLX, and 57.9% CBT), sustained response rates during stages 2 and 3 were 80.0% COMB, 61.5% FLX, and 77.3% CBT (difference not significant). Among the remaining 147 patients (60.7%) who achieved sustained response by week 12, CBT patients were more likely than FLX patients to maintain sustained response through week 36 (96.9% vs 74.1%; P = .007; 88.5% of COMB patients maintained sustained response through week 36). Total rates of sustained response by week 36 were 88.4% COMB, 82.5% FLX, and 75.0% CBT. CONCLUSIONS: Most adolescents with depression who had not achieved sustained response during acute treatment did achieve that level of improvement during continuation and maintenance therapies. The possibility that CBT may help the subset of adolescents with depression who achieve early sustained response maintain their response warrants further investigation. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00006286.}, Language = {eng}, Doi = {10.1001/archpsyc.65.4.447}, Key = {fds275102} } @article{fds275031, Author = {JS March}, Title = {In reply}, Journal = {Archives of General Psychiatry}, Volume = {65}, Number = {6}, Pages = {723-724}, Year = {2008}, ISSN = {0003-990X}, Key = {fds275031} } @article{fds275032, Author = {DM Small and AD Simons and P Yovanoff and SG Silva and CC Lewis and JL Murakami and J March}, Title = {Depressed adolescents and comorbid psychiatric disorders: Are there differences in the presentation of depression?}, Journal = {Journal of Abnormal Child Psychology}, Volume = {36}, Number = {7}, Pages = {1015-1028}, Year = {2008}, ISSN = {0091-0627}, url = {http://dx.doi.org/10.1007/s10802-008-9237-5}, Abstract = {Patterns and correlates of comorbidity, as well as differences in manifest depressive profiles were investigated in a sample of depressed adolescents. A sub-sample of the youth were characterized as belonging to either a Pure depression group, an Internalizing group (depression and co-occurring internalizing disorders), or an Externalizing group (depression and co-occurring externalizing disorders). Item response theory (IRT) and differential item functioning (DIF) were used to assess whether the depressed adolescents from the different comorbidity groups presented with different depressive symptoms. Results indicated that the comorbidity groups were meaningfully distinct in terms of psychosocial correlates as well as showed differences in depressive symptom profiles as informed by DIF analyses. In particular, the comorbidity groups differed in terms of presentation of psychomotor changes and cognitive impairments. Implications for assessment are discussed. © 2008 Springer Science+Business Media, LLC.}, Doi = {10.1007/s10802-008-9237-5}, Key = {fds275032} } @article{fds275033, Author = {J March}, Title = {In Memory of Richard Todd}, Journal = {Biological Psychiatry}, Volume = {64}, Number = {10}, Pages = {e9}, Year = {2008}, ISSN = {0006-3223}, url = {http://dx.doi.org/10.1016/j.biopsych.2008.09.018}, Doi = {10.1016/j.biopsych.2008.09.018}, Key = {fds275033} } @article{fds275059, Author = {AK Roy and RA Vasa and M Bruck and K Mogg and BP Bradley and M Sweeney and RL Bergman, EB McClure-Tone and DS Pine and JT Walkup and E al}, Title = {Attention bias toward threat in pediatric anxiety disorders}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {47}, Number = {10}, Pages = {1189-1196}, Year = {2008}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/CHI.0b013e3181825ace}, Abstract = {Objective: To examine attention bias toward threat faces in a large sample of anxiety-disordered youths using a well-established visual probe task. Method: Study participants included 101 children and adolescents (ages 7-18 years) with generalized anxiety disorder, social phobia, and/or separation anxiety disorder enrolled in a multisite anxiety treatment study. Nonanxious youths (n = 51; ages 9-18 years) were recruited separately. Participants were administered a computerized visual probe task that presents pairs of faces portraying threat (angry), positive (happy), and neutral expressions. They pressed a response key to indicate the spatial location of a probe that replaced one of the faces on each trial. Attention bias scores were calculated from response times to probes for each emotional face type. Results: Compared to healthy youths, anxious participants demonstrated a greater attention bias toward threat faces. This threat bias in anxious patients did not significantly vary across the anxiety disorders. There was no group difference in attention bias toward happy faces. Conclusions: These results suggest that pediatric anxiety disorders are associated with an attention bias toward threat. Future research may examine the manner in which cognitive bias in anxious youths changes with treatment. ©2008 by the American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/CHI.0b013e3181825ace}, Key = {fds275059} } @article{fds275149, Author = {PM Wehmeier and A Schacht and M Lehmann and RW Dittmann and SG Silva and JS March}, Title = {Emotional well-being in children and adolescents treated with atomoxetine for attention-deficit/hyperactivity disorder: findings from a patient, parent and physician perspective using items from the pediatric adverse event rating scale (PAERS).}, Journal = {Child Adolesc Psychiatry Ment Health}, Volume = {2}, Number = {1}, Pages = {11}, Year = {2008}, ISSN = {1753-2000}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18507848}, Abstract = {BACKGROUND: The objective of this analysis was to measure changes in items on the Pediatric Adverse Event Rating Scale (PAERS) that relate to emotional well-being of children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) during treatment with atomoxetine for up to 24 weeks from the perspective of the patient, the parent, and the physician. METHODS: Patients aged 6-17 years with ADHD were treated with atomoxetine (target dose 1.2 mg/kg/day). In the two studies on which this secondary analysis is based the PAERS was used to assess the tolerability of atomoxetine in children and adolescents. This scale has a total of 48 items. The ten items that reflect emotional well-being were selected to measure changes over time from a patient, parent, and physician perspective. RESULTS: 421 patients were treated with atomoxetine. 355 patients completed the 8-week treatment period, and 260 patients completed the 24-week treatment period. The ten items that reflect emotional well-being were grouped in five dimensions: depressed mood, self-harm, irritability/agitation, drowsiness, and euphoria. The scores of these dimensions decreased over time, both from a patient as well as from a parent and physician perspective. Only the dimension self-harm was extremely low at baseline and stayed low over time. The mean scores for the ten items depended on the rater perspective. CONCLUSION: The emotional well-being of children and adolescents with ADHD improved in terms of depressed mood, irritability/agitation, drowsiness, and euphoria during treatment with atomoxetine for up to 24 weeks.}, Language = {eng}, Doi = {10.1186/1753-2000-2-11}, Key = {fds275149} } @article{fds275138, Author = {B Vitiello and CJ Kratochvil and S Silva and J Curry and M Reinecke and S Pathak, B Waslick and CW Hughes and ED Prentice and DE May and JS March}, Title = {Research knowledge among the participants in the Treatment for Adolescents With Depression Study (TADS).}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {46}, Number = {12}, Pages = {1642-1650}, Year = {2007}, Month = {December}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18030086}, Keywords = {Adolescent • Cognitive Therapy • Depressive Disorder, Major • Diagnostic and Statistical Manual of Mental Disorders • Female • Fluoxetine • Humans • Male • Questionnaires • Serotonin Uptake Inhibitors • diagnosis • drug therapy • methods* • therapeutic use* • therapy*}, Abstract = {OBJECTIVE: We examined the extent to which parents and adolescents participating in the Treatment for Adolescents With Depression Study (TADS) understood key aspects of the study. METHOD: TADS was a clinical trial comparing the effectiveness of fluoxetine, cognitive-behavioral therapy (CBT), their combination, and placebo in 439 adolescents (12-17 years old) with major depressive disorder. Six weeks after starting treatment, adolescents and their parents were asked to complete a questionnaire about critical elements of the trial. RESULTS: Completion rate was 67.2% for adolescents (N = 295) and 73.6% for parents (N = 323). More than 90% of the completers knew of the main purpose of the trial, possible assignment to placebo, and their right to withdraw participation at any time. However, about one third overall (and 49% in the CBT group) described TADS as "education" rather than "research." Of 12 questions, the mean number of correct answers was 10.3 (SD 1.7) among adolescents and 11.2 (SD 1.2) among parents (p <.0001). The most frequently stated reason for TADS participation was the pursuit of high-quality care. CONCLUSIONS: Most parents and adolescents were well-informed research participants. Difficulties in appreciating the research nature of the trial, however, emerged, especially among participants assigned to psychotherapy. Parents were overall better informed than adolescents.}, Language = {eng}, Doi = {10.1097/chi.0b013e318153f8c7}, Key = {fds275138} } @article{fds275155, Author = {JS March and AR Entusah and M Rynn and AM Albano and KA Tourian}, Title = {A Randomized controlled trial of venlafaxine ER versus placebo in pediatric social anxiety disorder.}, Journal = {Biol Psychiatry}, Volume = {62}, Number = {10}, Pages = {1149-1154}, Year = {2007}, Month = {November}, ISSN = {0006-3223}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17553467}, Keywords = {Adolescent • Antidepressive Agents, Second-Generation • Anxiety Disorders • Child • Confidence Intervals • Cyclohexanols • Double-Blind Method • Female • Humans • Male • Pediatrics* • Psychiatric Status Rating Scales • Regression Analysis • Treatment Outcome • drug therapy* • therapeutic use*}, Abstract = {BACKGROUND: Social anxiety disorder, which occurs in 2% to 5% of children and adolescents, is associated with significant distress and functional impairment. METHODS: The objective of the randomized, masked controlled trial conducted in 48 academic and community centers in the United States was to evaluate the efficacy of venlafaxine ER in children and adolescents with generalized social anxiety disorder. A volunteer sample of 293 outpatients, age 8 to 17, who met diagnostic criteria for social anxiety disorder and were enrolled between February 2000 and March 2003 participated. Venlafaxine ER or placebo was titrated from a starting dose of 37.5 mg to a maximum dose of 225 mg over 16 weeks. The primary dependent measures were the Social Anxiety Scale, child or adolescent version (SAS-CA) and for responder analysis, a (dichotomized) Clinical Global Impressions-Improvement (CGI-I) score. RESULTS: Compared with placebo, intent-to-treat random regression analyses indicated a statistically significant advantage for venlafaxine ER (p = .001) on the SAS-CA. On the CGI-I responder analysis, 56% (95% confidence interval [CI], 47%-64%) of venlafaxine ER treated subjects responded, which was statistically superior to placebo (37% [95% CI, 29%-45%]). Three venlafaxine ER and no placebo patients developed treatment-emergent suicidality; there were no completed suicides. CONCLUSIONS: Venlafaxine ER is an effective and reasonably well-tolerated treatment for generalized social anxiety disorder in children and adolescents. As with other antidepressants, careful clinical monitoring for adverse events, including treatment-emergent suicidality, is essential.}, Language = {eng}, Doi = {10.1016/j.biopsych.2007.02.025}, Key = {fds275155} } @article{fds275172, Author = {SH Kollins and JS March}, Title = {Advances in the pharmacotherapy of attention-deficit/hyperactivity disorder.}, Journal = {Biol Psychiatry}, Volume = {62}, Number = {9}, Pages = {951-953}, Year = {2007}, Month = {November}, ISSN = {0006-3223}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17950067}, Keywords = {Attention Deficit Disorder with Hyperactivity • Central Nervous System Stimulants • Humans • drug therapy* • therapeutic use*}, Language = {eng}, Doi = {10.1016/j.biopsych.2007.08.009}, Key = {fds275172} } @article{fds275140, Author = {KC Herman and R Ostrander and JT Walkup and SG Silva and JS March}, Title = {Empirically derived subtypes of adolescent depression: latent profile analysis of co-occurring symptoms in the Treatment for Adolescents with Depression Study (TADS).}, Journal = {J Consult Clin Psychol}, Volume = {75}, Number = {5}, Pages = {716-728}, Year = {2007}, Month = {October}, ISSN = {0022-006X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17907854}, Keywords = {Adolescent • Antidepressive Agents, Second-Generation • Attention Deficit Disorder with Hyperactivity • Cognitive Therapy* • Combined Modality Therapy • Comorbidity • Depressive Disorder, Major • Fluoxetine • Follow-Up Studies • Humans • Internal-External Control • Personality Assessment • diagnosis • psychology • statistics & numerical data* • therapeutic use* • therapy • therapy*}, Abstract = {A latent profile analysis was conducted on the co-occurring symptoms of 423 adolescents diagnosed with major depressive disorder as part of the Treatment for Adolescents with Depression Study (TADS), a multisite, randomized treatment trial. The participants had a mean (SD) age of 14.6 (1.5) years; of the sample, 45.6% was male and 73.8% was white. Scores on the primary subscales of Conners' Parent Rating Scale--Revised were used as indicators in the analysis. Five classes of symptoms best described the clinical presentation of adolescents enrolled in the TADS. Of the adolescents in the sample, 80% were assigned to classes with clinically significant elevations on 1 or more subscales of the Children's Depression Rating Scale--Revised. The 5 classes met empirical criteria for distinctiveness and were validated against clinical diagnoses, child-rated symptoms, and clinician-rated functional impairment. The findings are consistent with prior studies that showed a high rate of co-occurring symptoms among depressed adolescents. The discussion focuses on understanding subtypes and comorbidity in adolescent depression as well as the implications for treatment and for prevention.}, Language = {eng}, Doi = {10.1037/0022-006X.75.5.716}, Key = {fds275140} } @article{fds275170, Author = {JS March and S Silva and S Petrycki and J Curry and K Wells and J Fairbank and B Burns and M Domino and S McNulty and B Vitiello and J Severe}, Title = {The Treatment for Adolescents With Depression Study (TADS): long-term effectiveness and safety outcomes.}, Journal = {Arch Gen Psychiatry}, Volume = {64}, Number = {10}, Pages = {1132-1143}, Year = {2007}, Month = {October}, ISSN = {0003-990X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17909125}, Keywords = {Adolescent • Clinical Protocols • Cognitive Therapy* • Combined Modality Therapy • Depressive Disorder, Major • Diagnostic and Statistical Manual of Mental Disorders • Double-Blind Method • Female • Fluoxetine • Humans • Male • Placebos • Psychiatric Status Rating Scales • Serotonin Uptake Inhibitors • Severity of Illness Index • Suicide • Time Factors • Treatment Outcome • United States • adverse effects • diagnosis • drug therapy • prevention & control • psychology • statistics & numerical data • therapeutic use* • therapy*}, Abstract = {CONTEXT: The Treatment for Adolescents With Depression Study evaluates the effectiveness of fluoxetine hydrochloride therapy, cognitive behavior therapy (CBT), and their combination in adolescents with major depressive disorder. OBJECTIVE: To report effectiveness outcomes across 36 weeks of randomized treatment. DESIGN AND SETTING: Randomized, controlled trial conducted in 13 academic and community sites in the United States. Cognitive behavior and combination therapies were not masked, whereas administration of placebo and fluoxetine was double-blind through 12 weeks, after which treatments were unblinded. Patients assigned to placebo were treated openly after week 12, and the placebo group is not included in these analyses by design. PARTICIPANTS: Three hundred twenty-seven patients aged 12 to 17 years with a primary DSM-IV diagnosis of major depressive disorder. INTERVENTIONS: All treatments were administered per protocol. MAIN OUTCOME MEASURES: The primary dependent measures rated blind to treatment status by an independent evaluator were the Children's Depression Rating Scale-Revised total score and the response rate, defined as a Clinical Global Impressions-Improvement score of much or very much improved. RESULTS: Intention-to-treat analyses on the Children's Depression Rating Scale-Revised identified a significant time x treatment interaction (P < .001). Rates of response were 73% for combination therapy, 62% for fluoxetine therapy, and 48% for CBT at week 12; 85% for combination therapy, 69% for fluoxetine therapy, and 65% for CBT at week 18; and 86% for combination therapy, 81% for fluoxetine therapy, and 81% for CBT at week 36. Suicidal ideation decreased with treatment, but less so with fluoxetine therapy than with combination therapy or CBT. Suicidal events were more common in patients receiving fluoxetine therapy (14.7%) than combination therapy (8.4%) or CBT (6.3%). CONCLUSIONS: In adolescents with moderate to severe depression, treatment with fluoxetine alone or in combination with CBT accelerates the response. Adding CBT to medication enhances the safety of medication. Taking benefits and harms into account, combined treatment appears superior to either monotherapy as a treatment for major depression in adolescents.}, Language = {eng}, Doi = {10.1001/archpsyc.64.10.1132}, Key = {fds275170} } @article{fds275126, Author = {JS March and P Szatmari and O Bukstein and A Chrisman and D Kondo and JD Hamilton, CM Kremer and CJ Kratochvil}, Title = {AACAP 2005 Research Forum: speeding the adoption of evidence-based practice in pediatric psychiatry.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {46}, Number = {9}, Pages = {1098-1110}, Year = {2007}, Month = {September}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17712233}, Keywords = {Child • Child Psychiatry • Education • Evidence-Based Medicine* • Humans • Practice Guidelines as Topic* • Research* • education • methods* • organization & administration • standards*}, Abstract = {OBJECTIVES: At the 2005 Annual Meeting of the American Academy of Child and Adolescent Psychiatry (AACAP), the Academy's Workgroup on Research conducted a Research Forum entitled "Increasing Research Literacy Through the Adoption of Evidence-Based Practice (EBP) in Pediatric Psychiatry." METHOD: Forum participants focused on speeding the adoption of EBP across five areas: EBP as the preferred heuristic for teaching research literacy, use of EBP in training programs, dissemination of EBP in clinical practice, EBP in partnership with industry, and EBP as a framework for developing practice guidelines. RESULTS: EBP provides an easy-to-understand method for accessing and evaluating the research literature and then applying this information to decisions about patient care. Although EBP has been gaining greater visibility in pediatric psychiatry, it is far from the preferred heuristic. To move the field toward fully embracing EBP will require greater understanding of what EBP is (and is not), educating mental health professionals in EBP skills, access to EBP resources, and a commitment to apply EBP to the conceptualization and design of research protocols and practice guidelines. CONCLUSIONS: Pediatric psychiatry would benefit from a principled commitment to follow other areas of medicine in adopting EBP.}, Language = {eng}, Doi = {10.1097/chi.0b013e318074eb48}, Key = {fds275126} } @article{fds275145, Author = {SN Compton and CJ Kratochvil and JS March}, Title = {Pharmacotherapy for anxiety disorders in children and adolescents: an evidence-based medicine review.}, Journal = {Pediatr Ann}, Volume = {36}, Number = {9}, Pages = {586-598}, Year = {2007}, Month = {September}, ISSN = {0090-4481}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17910206}, Keywords = {Adolescent • Anxiety Disorders • Child • Drug Therapy* • Evidence-Based Medicine* • Humans • United States • drug therapy*}, Abstract = {These studies generally support the use of the SSRIs fluvoxamine, sertraline, and fluoxetine in the acute treatment of pediatric non-OCD anxiety disorders. Two large multicenter studies suggest a favorable outcome for paroxetine in the treatment of pediatric social anxiety disorder. Mixed results currently exist for the use of extended-release venlafaxine in the treatment of pediatric generalized anxiety disorder. In both of these latter studies, concerns with safety were present.}, Language = {eng}, Key = {fds275145} } @article{fds275158, Author = {JN Epstein and D Rabiner and DE Johnson and DP Fitzgerald and A Chrisman, A Erkanli and KK Sullivan and JS March and P Margolis and EC Norton and CK Conners}, Title = {Improving attention-deficit/hyperactivity disorder treatment outcomes through use of a collaborative consultation treatment service by community-based pediatricians: a cluster randomized trial.}, Journal = {Arch Pediatr Adolesc Med}, Volume = {161}, Number = {9}, Pages = {835-840}, Year = {2007}, Month = {September}, ISSN = {1072-4710}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17768282}, Keywords = {Attention Deficit Disorder with Hyperactivity • Child • Child Health Services • Cooperative Behavior • Female • Health Services Research • Humans • Male • Outcome Assessment (Health Care)* • Physician's Practice Patterns • Primary Health Care • Referral and Consultation • drug therapy • organization & administration • organization & administration* • standards* • therapy*}, Abstract = {OBJECTIVE: To test whether adoption of a collaborative consultative service model results in improved patient outcomes. DESIGN: Twelve pediatric practices were randomly assigned to receive access to collaborative consultative services or to a control group. SETTING: Community-based pediatric offices. PARTICIPANTS: Fifty-two pediatricians and their 377 patients with attention-deficit/hyperactivity disorder (ADHD). Intervention A collaborative consultative service promoting the use of titration trials and periodic monitoring during medication maintenance. Main Outcome Measure Physician practice behaviors and child ADHD symptomatology. RESULTS: Using self-report of pediatricians, the collaborative consultative service increased the use of evidence-based practices by pediatricians, but no difference in children's ADHD symptomatology was observed between the groups. However, many pediatricians did not fully use the collaborative consultative services. Those children who actually received collaborative consultative services showed significant behavioral improvement compared with children not receiving these services. CONCLUSIONS: When actually implemented by pediatricians, the collaborative consultative service appears to be an effective method for facilitating evidence-based treatment procedures for ADHD and use of these procedures appear to improve children's outcomes. Barriers to implementation of collaborative consultative service in pediatric practice need to be further understood.}, Language = {eng}, Doi = {10.1001/archpedi.161.9.835}, Key = {fds275158} } @article{fds275129, Author = {BS Molina and K Flory and SP Hinshaw and AR Greiner and LE Arnold and JM Swanson, L Hechtman and PS Jensen and B Vitiello and B Hoza and WE Pelham, GR Elliott and KC Wells and HB Abikoff and RD Gibbons and S Marcus, CK Conners and JN Epstein and LL Greenhill and JS March and JH Newcorn, JB Severe and T Wigal}, Title = {Delinquent behavior and emerging substance use in the MTA at 36 months: prevalence, course, and treatment effects.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {46}, Number = {8}, Pages = {1028-1040}, Year = {2007}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17667481}, Keywords = {Adolescent • Behavior Therapy • Child • Cognition Disorders • Combined Modality Therapy • Disease Progression • Female • Follow-Up Studies • Humans • Juvenile Delinquency • Male • Prevalence • Questionnaires • Substance-Related Disorders • Treatment Outcome • diagnosis • drug therapy • epidemiology • epidemiology* • methods* • statistics & numerical data* • therapy*}, Abstract = {OBJECTIVE: To compare delinquent behavior and early substance use between the children in the Multimodal Treatment Study of Children With ADHD (MTA; N = 487) and those in a local normative comparison group (n = 272) at 24 and 36 months postrandomization and to test whether these outcomes were predicted by the randomly assigned treatments and subsequent self-selected prescribed medications. METHOD: Most MTA children were 11 to 13 years old by 36 months. Delinquency seriousness was coded ordinally from multiple measures/reporters; child-reported substance use was binary. RESULTS: Relative to local normative comparison group, MTA children had significantly higher rates of delinquency (e.g., 27.1% vs. 7.4% at 36 months; p = .000) and substance use (e.g., 17.4% vs. 7.8% at 36 months; p = .001). Children randomized to intensive behavior therapy reported less 24-month substance use than other MTA children (p = .02). Random effects ordinal growth models revealed no other effects of initial treatment assignment on delinquency seriousness or substance use. By 24 and 36 months, more days of prescribed medication were associated with more serious delinquency but not substance use. CONCLUSIONS: Cause-and-effect relationships between medication treatment and delinquency are unclear; the absence of associations between medication treatment and substance use needs to be re-evaluated at older ages. Findings underscore the need for continuous monitoring of these outcomes as children with attention-deficit/hyperactivity disorder enter adolescence.}, Language = {eng}, Doi = {10.1097/chi.0b013e3180686d96}, Key = {fds275129} } @article{fds275132, Author = {PS Jensen and LE Arnold and JM Swanson and B Vitiello and HB Abikoff and LL Greenhill, L Hechtman and SP Hinshaw and WE Pelham and KC Wells and CK Conners, GR Elliott and JN Epstein and B Hoza and JS March and BS Molina, JH Newcorn and JB Severe and T Wigal and RD Gibbons and K Hur}, Title = {3-year follow-up of the NIMH MTA study.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {46}, Number = {8}, Pages = {989-1002}, Year = {2007}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17667478}, Keywords = {Algorithms • Attention Deficit Disorder with Hyperactivity • Attention Deficit and Disruptive Behavior Disorders • Central Nervous System Stimulants • Child • Cognitive Therapy • Combined Modality Therapy • Female • Follow-Up Studies • Humans • Male • National Institute of Mental Health (U.S.) • United States • diagnosis • drug therapy • epidemiology • methods* • psychology • therapeutic use* • therapy*}, Abstract = {OBJECTIVE: In the intent-to-treat analysis of the Multimodal Treatment Study of Children With ADHD (MTA), the effects of medication management (MedMgt), behavior therapy (Beh), their combination (Comb), and usual community care (CC) differed at 14 and 24 months due to superiority of treatments that used the MTA medication algorithm (Comb+MedMgt) over those that did not (Beh+CC). This report examines 36-month outcomes, 2 years after treatment by the study ended. METHOD: For primary outcome measures (attention-deficit/hyperactivity disorder [ADHD] and oppositional defiant disorder [ODD] symptoms, social skills, reading scores, impairment, and diagnostic status), mixed-effects regression models and orthogonal contrasts examined 36-month outcomes. RESULTS: At 3 years, 485 of the original 579 subjects (83.8%) participated in the follow-up, now at ages 10 to 13 years, (mean 11.9 years). In contrast to the significant advantage of MedMgt+Comb over Beh+CC for ADHD symptoms at 14 and 24 months, treatment groups did not differ significantly on any measure at 36 months. The percentage of children taking medication >50% of the time changed between 14 and 36 months across the initial treatment groups: Beh significantly increased (14% to 45%), MedMed+Comb significantly decreased (91% to 71%), and CC remained constant (60%-62%). Regardless of their treatment use changes, all of the groups showed symptom improvement over baseline. Notably, initial symptom severity, sex (male), comorbidity, public assistance, and parental psychopathology (ADHD) did not moderate children's 36-month treatment responses, but these factors predicted worse outcomes over 36 months, regardless of original treatment assignment. CONCLUSIONS: By 36 months, the earlier advantage of having had 14 months of the medication algorithm was no longer apparent, possibly due to age-related decline in ADHD symptoms, changes in medication management intensity, starting or stopping medications altogether, or other factors not yet evaluated.}, Language = {eng}, Doi = {10.1097/CHI.0b013e3180686d48}, Key = {fds275132} } @article{fds275142, Author = {P Szatmari and JS March}, Title = {Clinical practice guidelines.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {46}, Number = {8}, Pages = {939-940}, Year = {2007}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17667469}, Keywords = {Humans • Mental Disorders • Mental Health Services • Practice Guidelines as Topic* • diagnosis • standards • therapy*}, Language = {eng}, Doi = {10.1097/chi.0b013e318068fbdd}, Key = {fds275142} } @article{fds275164, Author = {JM Swanson and SP Hinshaw and LE Arnold and RD Gibbons and S Marcus and K Hur, PS Jensen and B Vitiello and HB Abikoff and LL Greenhill and L Hechtman, WE Pelham and KC Wells and CK Conners and JS March and GR Elliott, JN Epstein and K Hoagwood and B Hoza and BS Molina and JH Newcorn, JB Severe and T Wigal}, Title = {Secondary evaluations of MTA 36-month outcomes: propensity score and growth mixture model analyses.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {46}, Number = {8}, Pages = {1003-1014}, Year = {2007}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17667479}, Keywords = {Algorithms • Attention Deficit Disorder with Hyperactivity • Behavior Therapy • Central Nervous System Stimulants • Child • Combined Modality Therapy • Follow-Up Studies • Humans • Psychology • Severity of Illness Index • Time Factors • Treatment Outcome • diagnosis* • drug therapy • methods* • therapeutic use* • therapy*}, Abstract = {OBJECTIVE: To evaluate two hypotheses: that self-selection bias contributed to lack of medication advantage at the 36-month assessment of the Multimodal Treatment Study of Children With ADHD (MTA) and that overall improvement over time obscured treatment effects in subgroups with different outcome trajectories. METHOD: Propensity score analyses, using baseline characteristics and severity of attention-deficit/hyperactivity disorder symptoms at follow-up, established five subgroups (quintiles) based on tendency to take medication at the 36-month assessment. Growth mixture model (GMM) analyses were performed to identify subgroups (classes) with different patterns of outcome over time. RESULTS: All five propensity subgroups showed initial advantage of medication that disappeared by the 36-month assessment. GMM analyses identified heterogeneity of trajectories over time and three classes: class 1 (34% of the MTA sample) with initial small improvement followed by gradual improvement that produced significant medication effects; class 2 (52%) with initial large improvement maintained for 3 years and overrepresentation of cases treated with the MTA Medication Algorithm; and class 3 (14%) with initial large improvement followed by deterioration. CONCLUSIONS: We failed to confirm the self-selection hypothesis. We found suggestive evidence of residual but not current benefits of assigned medication in class 2 and small current benefits of actual treatment with medication in class 1.}, Language = {eng}, Doi = {10.1097/CHI.0b013e3180686d63}, Key = {fds275164} } @article{fds275174, Author = {JM Swanson and GR Elliott and LL Greenhill and T Wigal and LE Arnold and B Vitiello, L Hechtman and JN Epstein and WE Pelham and HB Abikoff and JH Newcorn, BS Molina and SP Hinshaw and KC Wells and B Hoza and PS Jensen and RD Gibbons and K Hur and A Stehli and M Davies and JS March and CK Conners and M Caron and ND Volkow}, Title = {Effects of stimulant medication on growth rates across 3 years in the MTA follow-up.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {46}, Number = {8}, Pages = {1015-1027}, Year = {2007}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17667480}, Keywords = {Attention Deficit Disorder with Hyperactivity • Behavior Therapy • Central Nervous System Stimulants • Child • Combined Modality Therapy • Female • Follow-Up Studies • Humans • Male • Severity of Illness Index • Time Factors • diagnosis • drug therapy • methods* • therapeutic use* • therapy*}, 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: not medicated (n = 65), newly medicated (n = 88), consistently medicated (n = 70), and inconsistently medicated (n = 147). Analysis of variance was used to evaluate effects of subgroup and assessment time on measures of relative size (z scores) obtained from growth norms. RESULTS: The subgroup x assessment time interaction was significant for z height (p <.005) and z weight (p <.0001), due primarily to divergence of the newly medicated and the not medicated subgroups. These initially stimulant-naïve subgroups had z scores significantly >0 at baseline. The newly medicated subgroup showed decreases in relative size that reached asymptotes by the 36-month assessment, when this group showed average growth of 2.0 cm and 2.7 kg less than the not medicated subgroup, which showed slight increases in relative size. CONCLUSIONS: Stimulant-naïve school-age children with Combined type attention-deficit/hyperactivity disorder were, as a group, larger than expected from norms before treatment but show stimulant-related decreases in growth rates after initiation of treatment, which appeared to reach asymptotes within 3 years without evidence of growth rebound.}, Language = {eng}, Doi = {10.1097/chi.0b013e3180686d7e}, Key = {fds275174} } @article{fds275159, Author = {DE May and MJ Hallin and CJ Kratochvil and SE Puumala and LS Smith and MA Reinecke, SG Silva and EB Weller and B Vitiello and A Breland-Noble and JS March}, Title = {Factors associated with recruitment and screening in the Treatment for Adolescents With Depression Study (TADS).}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {46}, Number = {7}, Pages = {801-810}, Year = {2007}, Month = {July}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17581444}, Keywords = {Adolescent • Child • Depressive Disorder • Female • Humans • Interviews as Topic • Male • Mass Screening* • Odds Ratio • Patient Selection* • Randomized Controlled Trials as Topic • Research Design • diagnosis* • methods • psychology • therapy*}, Abstract = {OBJECTIVE: To examine factors associated with eligibility and randomization and consider the efficiency of recruitment methods. METHOD: Adolescents, ages 12 to 17 years, were telephone screened (N = 2,804) followed by in-person evaluation (N = 1,088) for the Treatment for Adolescents With Depression Study. Separate logistic regression models, controlling for site, examined whether sex, age, race, or source of recruitment was associated with eligibility, providing written consent, or randomization. Efficiency was calculated from the number of completed telephone screens per each enrolled participant. RESULTS: Older adolescents were less likely to be eligible at telephone screening (odds ratio [OR] 0.81). Regardless of race, eligible adolescents who were referred by a professional had higher odds of presenting in-person for consent (OR 1.56). African Americans had statistically lower odds of providing consent (OR 0.67), particularly if recruited by advertisement (OR 0.54). Females were more likely to be diagnosed with major depressive disorder (OR 1.69). No significant differences were found between randomized participants and eligible adolescents who withdrew from the study before randomization. CONCLUSIONS: These findings underscore the importance of using multiple strategies to recruit adolescents for clinical trial participation and enhancing sensitivity to cultural variations, especially when reaching out to depressed African Americans.}, Language = {eng}, Doi = {10.1097/CHI.0b013e3180582019}, Key = {fds275159} } @article{fds275114, Author = {DE May and CJ Kratochvil and SE Puumala and SG Silva and AJ Rezac and MJ Hallin, MA Reinecke and B Vitiello and EB Weller and S Pathak and AD Simons and JS March}, Title = {A manual-based intervention to address clinical crises and retain patients in the Treatment of Adolescents With Depression Study (TADS).}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {46}, Number = {5}, Pages = {573-581}, Year = {2007}, Month = {May}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17450048}, Keywords = {Adolescent • Child • Crisis Intervention • Dangerous Behavior • Depressive Disorder, Major • Emergency Services, Psychiatric* • Female • Health Promotion* • Humans • Male • Manuals as Topic* • Patient Compliance* • Questionnaires • methods* • psychology* • therapy*}, Abstract = {OBJECTIVE: To describe a manual-based intervention to address clinical crises and retain participants in the Treatment for Adolescents With Depression Study (TADS). METHOD: The use of adjunct services for attrition prevention (ASAP) is described for adolescents (ages 12-17 years) during the 12-week acute treatment in TADS, from 2000 to 2003. Logistic regression, controlling for site, was used to predict use. RESULTS: Of 439 enrolled participants, 17.8% (n = 78) used ASAP primarily for suicidality or worsening of depression. Of these, 46.2% continued in their assigned treatment through week 12, 47.4% received out-of-protocol treatment but continued participating in assessments, and 10.3% withdrew consent, including 3 who terminated treatment and withdrew consent on the same date. ASAP use did not differ between treatments (p =.97) and typically occurred early in treatment. At the end of the 12 weeks, 37.2% of participants using ASAP remained in their assigned treatment, although 80.8% continued participating in assessments. ASAP was associated with, at baseline, a higher severity of depression (p <.01), substance use (p <.01), and precontemplation level of change (p <.02). CONCLUSIONS: ASAP may be useful to retain adolescent participants and as a safety intervention in placebo-controlled trials. In clinical practice ASAP-like procedures may be useful to encourage adherence in patients engaging in long-term treatment. Clinical trial registration information-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00006286.}, Language = {eng}, Doi = {10.1097/chi.0b013e3180323342}, Key = {fds275114} } @article{fds275169, Author = {CJ Kratochvil and BS Vaughan and ML Mayfield-Jorgensen and JS March and SH Kollins and DW Murray and H Ravi and LL Greenhill and LA Kotler and N Paykina, P Biggins and J Stoner}, Title = {A pilot study of atomoxetine in young children with attention-deficit/hyperactivity disorder.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {17}, Number = {2}, Pages = {175-185}, Year = {2007}, Month = {April}, ISSN = {1044-5463}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17489712}, Keywords = {Adrenergic Uptake Inhibitors • Age Factors • Attention Deficit Disorder with Hyperactivity • Child • Child, Preschool • Feasibility Studies • Female • Humans • Male • Pilot Projects • Propylamines • Severity of Illness Index • Treatment Outcome • adverse effects • drug therapy* • therapeutic use*}, Abstract = {OBJECTIVE: The purpose of this study was to assess the effectiveness and tolerability of atomoxetine during acute treatment of attention-deficit/hyperactivity disorder (ADHD) in 5 and 6 year olds. METHOD: Twenty two children (male n = 19, 86%) with ADHD were treated with atomoxetine for 8 weeks in a three-site, open-label pilot study. Dosing was flexible, with titration to a maximum of 1.8 mg/kg per day. Parent education on behavior management was provided as part of each pharmacotherapy visit. RESULTS: Subjects demonstrated a mean decrease of 20.68 points (SD = 12.80, p < 0.001)) on the ADHD Rating Scale-IV (ADHD-IV-RS) total score, 10.18 (SD = 7.48, p < 0.001) on the inattentive subscale and 10.50 (SD = 7.04, p < 0.001) on the hyperactive/impulsive subscale. Clinical Global Impression-Severity (CGI-S) was improved in 82% of the children (95% CI, 66-98%) and Children's Global Assessment (CGAS) scores improved 18.91 points on average (SD = 12.20, p < 0.001). The mean final dose of atomoxetine was 1.25 mg/kg per day (SD = 0.35 mg/kg per day). Mood lability was the most commonly reported adverse event (n = 12, 54.5%). Eleven subjects (50%) reported decreased appetite and a mean weight loss of 1.04 kg (SD = 0.80 kg) (p < 0.001) was observed for the group. Vital sign changes were mild and not clinically significant. There were no discontinuations due to adverse events or lack of efficacy. CONCLUSION: Atomoxetine was generally effective for reducing core ADHD symptoms in the 5 and 6 year olds in this open-label study.}, Language = {eng}, Doi = {10.1089/cap.2007.0143}, Key = {fds275169} } @article{fds275165, Author = {JS March and ME Franklin and H Leonard and A Garcia and P Moore and J Freeman and E Foa}, Title = {Tics moderate treatment outcome with sertraline but not cognitive-behavior therapy in pediatric obsessive-compulsive disorder.}, Journal = {Biol Psychiatry}, Volume = {61}, Number = {3}, Pages = {344-347}, Year = {2007}, Month = {February}, ISSN = {0006-3223}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17241830}, Keywords = {Acute Disease • Adolescent • Child • Cognitive Therapy* • Combined Modality Therapy • Female • Humans • Male • Obsessive-Compulsive Disorder • Psychiatric Status Rating Scales • Serotonin Uptake Inhibitors • Sertraline • Tic Disorders • Tourette Syndrome • drug therapy • drug therapy* • psychology • therapeutic use* • therapy*}, Abstract = {BACKGROUND: The presence of a comorbid tic disorder may predict a poorer outcome in the acute treatment of pediatric obsessive-compulsive disorder (OCD). METHODS: Using data from the National Institute of Mental Health (NIMH)-funded Pediatric OCD Treatment Study (POTS) that compared cognitive-behavior therapy (CBT), medical management with sertraline (SER), and the combination of CBT and SER (COMB), to pill placebo (PBO) in children and adolescents with OCD, we asked whether the presence of a comorbid tic disorder influenced symptom reduction on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) after 12 weeks of treatment. RESULTS: Fifteen percent (17 of 112) of patients exhibited a comorbid tic disorder. In patients without tics, results replicated previously published intent-to-treat outcomes: COMB > CBT > SER > PBO. In patients with a comorbid tic disorder, SER did not differ from PBO, while COMB remained superior to CBT and CBT remained superior to PBO. CONCLUSIONS: In contrast to CBT outcomes, which are not differentially impacted, tic disorders appear to adversely impact the outcome of medication management of pediatric OCD. Children and adolescents with obsessive-compulsive disorder and a comorbid tic disorder should begin treatment with cognitive-behavior therapy alone or the combination of cognitive-behavior therapy plus a serotonin reuptake inhibitor.}, Language = {eng}, Doi = {10.1016/j.biopsych.2006.09.035}, Key = {fds275165} } @article{fds275072, Author = {K Gersing and B Burchett and J March and T Ostbye and KR Krishnan}, Title = {Predicting antipsychotic use in children.}, Journal = {Psychopharmacol Bull}, Volume = {40}, Number = {3}, Pages = {116-124}, Year = {2007}, ISSN = {0048-5764}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18007573}, Abstract = {UNLABELLED: Psychotropic medications are increasingly being used by children and adolescents. In an earlier report, we noted that boys were receiving atypical antipsychotics more frequently than were girls, (70% of the claims). Since diagnosis was not available in the data, we were unable to ascertain the reasons for this. In the present analysis, we examined a large clinical mental health database to ascertain the reason for antipsychotic use.We evaluated the extent to which race, gender, age and type of diagnosis accounted for atypical antipsychotic use in children. METHODS: The authors used an anonymous clinical database created at Duke University Medical Center. The database is based on the clinical document of care in the Department of Psychiatry. The data are de-identified per HIPAA guidelines and has an IRB exemption for use in clinical research. Patients analyzed were seen from 1999 to 2005 and were below the age of 18 at the time of clinical care. A total 3,268 patients, with a total of 7,701 visits comprise the analysis sample. Age, gender, race, and diagnosis were extracted as predictors of use of atypical antipsychotics. RESULTS: Males and older children were also more likely to use an atypical. African Americans were slightly more likely to use an atypical than whites. Patients whose diagnoses were classified as either psychotic or internalizing were also more likely to use an antipsychotic. CONCLUSION: The underlying reasons for the high level of use of atypicals in boys and in African Americans need to be investigated further.}, Key = {fds275072} } @article{fds275027, Author = {KC Wells and TC Chi and SP Hinshaw and JN Epstein and L Pfiffner and M Nebel-Schwalm, EB Owens and LE Arnold and HB Abikoff and CK Conners and GR Elliott and LL Greenhill and L Hechtman and B Hoza and PS Jensen and J March, JH Newcorn and WE Pelham and JB Severe and J Swanson and B Vitiello and T Wigal}, Title = {Treatment-related changes in objectively measured parenting behaviors in the multimodal treatment study of children with attention-deficit/hyperactivity disorder.}, Journal = {J Consult Clin Psychol}, Volume = {74}, Number = {4}, Pages = {649-657}, Year = {2006}, Month = {August}, ISSN = {0022-006X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16881772}, Abstract = {The present study examined treatment outcomes for objectively measured parenting behavior in the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD). Five hundred seventy-nine ethnically and socioeconomically diverse children with ADHD-combined type (ages 7.0-9.9 years) and their parent(s) were recruited at 6 sites in the United States and Canada and randomly assigned to 1 of 4 treatment groups for 14 months of active intervention: medication management (MedMgt), intensive behavior therapy, combination of the 2 (Comb), or a community-treated comparison (CC). Baseline and posttreatment laboratory observations of parent-child interactions were coded by observers blind to treatment condition. Comb produced significantly greater improvements in constructive parenting than did MedMgt or CC, with effect sizes approaching medium for these contrasts. Treatment effects on child behaviors were not significant. The authors discuss the importance of changes in parenting behavior for families of children with ADHD and the need for reliable and objective measures in evaluating treatment outcome.}, Doi = {10.1037/0022-006X.74.4.649}, Key = {fds275027} } @article{fds275026, Author = {JN Epstein and CK Conners and AS Hervey and ST Tonev and LE Arnold and HB Abikoff, G Elliott and LL Greenhill and L Hechtman and K Hoagwood and SP Hinshaw, B Hoza and PS Jensen and JS March and JH Newcorn and WE Pelham and JB Severe and JM Swanson and K Wells and B Vitiello and T Wigal and MTA Cooperative Study Group}, Title = {Assessing medication effects in the MTA study using neuropsychological outcomes.}, Journal = {J Child Psychol Psychiatry}, Volume = {47}, Number = {5}, Pages = {446-456}, Year = {2006}, Month = {May}, ISSN = {0021-9630}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16671928}, Abstract = {BACKGROUND: While studies have increasingly investigated deficits in reaction time (RT) and RT variability in children with attention deficit/hyperactivity disorder (ADHD), few studies have examined the effects of stimulant medication on these important neuropsychological outcome measures. METHODS: 316 children who participated in the Multimodal Treatment Study of Children with ADHD (MTA) completed the Conners' Continuous Performance Test (CPT) at the 24-month assessment point. Outcome measures included standard CPT outcomes (e.g., errors of commission, mean hit reaction time (RT)) and RT indicators derived from an Ex-Gaussian distributional model (i.e., mu, sigma, and tau). RESULTS: Analyses revealed significant effects of medication across all neuropsychological outcome measures. Results on the Ex-Gaussian outcome measures revealed that stimulant medication slows RT and reduces RT variability. CONCLUSIONS: This demonstrates the importance of including analytic strategies that can accurately model the actual distributional pattern, including the positive skew. Further, the results of the study relate to several theoretical models of ADHD.}, Doi = {10.1111/j.1469-7610.2005.01469.x}, Key = {fds275026} } @article{fds275047, Author = {J DeVeaugh-Geiss and J March and M Shapiro and PJ Andreason and G Emslie, LM Ford and L Greenhill and D Murphy and E Prentice and R Roberts, S Silva and JM Swanson and B van Zwieten-Boot and B Vitiello, KD Wagner and B Mangum}, Title = {Child and adolescent psychopharmacology in the new millennium: a workshop for academia, industry, and government.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {45}, Number = {3}, Pages = {261-270}, Year = {2006}, Month = {March}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16540810}, Abstract = {OBJECTIVE: To give academic researchers, government officials, and industry scientists an opportunity to assess the state of pediatric psychopharmacology and identify challenges facing professionals in the field. METHOD: Increased federal spending and the introduction of pediatric exclusivity led to large increases in pediatric psychopharmacology research in the 1990s. Despite the increase in research, concerns exist about methods and incentives for making new medications available for use in pediatric psychiatric disorders. In recognition of these concerns, the Duke Clinical Research Institute held a roundtable in September 2004. Participants from the National Institutes of Health, regulatory agencies, academia, and the pharmaceutical industry spoke about the effects of government regulations such as the U.S. Food and Drug Administration Modernization Act and the Pediatric Research Equity Act on pediatric research from academic, clinical, and industry perspectives, and bioethical considerations of such research. CONCLUSIONS: To ensure development of new drugs for treating psychiatric disorders in children and adolescents, we must address the challenges posed by the regulatory environment governing pediatric psychopharmacology research. Strategies were identified for improving the evidence base for psychopharmacologic interventions in youth before widespread use and for more effectively defining a research agenda for the future.}, Doi = {10.1097/01.chi.0000194568.70912.ee}, Key = {fds275047} } @article{fds275162, Author = {JS March and BJ Klee and CM Kremer}, Title = {Treatment benefit and the risk of suicidality in multicenter, randomized, controlled trials of sertraline in children and adolescents.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {16}, Number = {1-2}, Pages = {91-102}, Year = {2006}, Month = {February}, ISSN = {1044-5463}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16553531}, Keywords = {Adolescent • Child • Double-Blind Method • Humans • Mental Disorders • Multicenter Studies as Topic* • Randomized Controlled Trials as Topic* • Risk Factors • Sertraline • Suicide* • Treatment Outcome • adverse effects • drug therapy • epidemiology • therapeutic use*}, Abstract = {OBJECTIVE: The aim of this study was to examine the balance between the benefits of treatment and the risk of suicidality in children and adolescents in multicenter, randomized, controlled trials of sertraline versus placebo. METHOD: The published literature was searched for multicenter, randomized, placebo-controlled trials of sertraline for pediatric mental disorders. Four trials were identified: Two (pooled) in pediatric major depressive disorder (MDD; Wagner 2003) and two in obsessive-compulsive disorder (OCD; March et al. 1998; POTS Team 2004). Using intent-to-treat (ITT) analysis populations, the authors calculated the number needed to treat (NNT) for response and remission and the number needed to harm (NNH) for suicidality, and their ratio, for each clinical trial. RESULTS: NNTs ranged from 2 to 10, indicating clinically meaningful benefits. Benefit was greater for OCD than for MDD, and for adolescents as compared with children in MDD. No age effect was apparent for OCD. Suicidality was reported in 8 patients (5 assigned to sertraline and 3 assigned to placebo). All but 1 (a placebo-treated patient in the Pfizer OCD trial) were enrolled in the sertraline MDD trial. The NNH for suicidality in MDD was 64. Treatment emergent suicidality was more common in children (NNH 28.7) than in adolescents (NNH 706.3). Because no patient developed suicidality in sertraline-treated OCD patients, the NNH for sertraline in OCD approaches infinity. CONCLUSIONS: With the stipulation that doctor and patient preferences necessarily play a critical role in the choice of treatment, NNT to NNH ratios indicate a positive benefit-to-risk ratio for sertraline in adolescents with MDD and in patients of all ages with OCD.}, Language = {eng}, Doi = {10.1089/cap.2006.16.91}, Key = {fds275162} } @article{fds275023, Author = {CJ Kratochvil and B Vitiello and J Walkup and G Emslie and BD Waslick and EB Weller and WJ Burke and JS March}, Title = {Selective serotonin reuptake inhibitors in pediatric depression: Is the balance between benefits and risks favorable?}, Journal = {Journal of Child and Adolescent Psychopharmacology}, Volume = {16}, Number = {1-2}, Pages = {11-24}, Year = {2006}, ISSN = {1044-5463}, url = {http://dx.doi.org/10.1089/cap.2006.16.11}, Abstract = {Recent controversies surrounding the use of selective serotonin reuptake inhibitors (SSRIs) have highlighted the need to reassess potential benefits, as well as potential risks of this class of medications in the treatment of pediatric depression. The recent availability of data from meta-analyses of published and unpublished antidepressant trials, epidemiological studies, and the Treatment for Adolescents with Depression Study (TADS) has facilitated a reanalysis of this risk/benefit relationship. Despite reviewing similar data, various regulatory agencies have arrived at rather disparate conclusions regarding the data, resulting in continued controversy. Although all groups appear to agree that careful assessment, education regarding risks, and closer monitoring are essential for SSRIs, only the U.S. Food and Drug Administration (FDA) and the U.K. Medicine and Health Care Products Regulatory Agency maintain that an acceptable risk/benefit relationship exists for fluoxetine. The European Medicines Agency concluded that the SSRIs should not be used in the treatment of depression in children and adolescents. The authors of this review have taken into consideration many of these same data and offer a critical discussion of the pros and cons of SSRIs in pediatric depression. The authors have concluded that SSRIs-in particular, fluoxetine-do have a role in the treatment of pediatric depression.}, Doi = {10.1089/cap.2006.16.11}, Key = {fds275023} } @article{fds275024, Author = {JS March}, Title = {Dr. March replies [2]}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {45}, Number = {4}, Pages = {383-384}, Year = {2006}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.chi.0000207317.69141.58}, Doi = {10.1097/01.chi.0000207317.69141.58}, Key = {fds275024} } @article{fds275025, Author = {AE Layne and GA Bernstein and JS March}, Title = {Teacher awareness of anxiety symptoms in children}, Journal = {Child Psychiatry and Human Development}, Volume = {36}, Number = {4}, Pages = {383-392}, Year = {2006}, ISSN = {0009-398X}, url = {http://dx.doi.org/10.1007/s10578-006-0009-6}, Abstract = {The present study aimed to determine which anxiety symptoms in children are associated with teacher awareness and whether teacher awareness differs according to student age and gender. The Multidimensional Anxiety Scale for Children (MASC) was completed by 453 second through fifth grade students and teachers nominated the three most anxious students in their classrooms. A multivariate analysis of variance was conducted with MASC scale scores as the dependent variables. Children identified by teachers as anxious had significantly higher levels of overall anxiety, physiological anxiety, social anxiety, and separation anxiety. Overall, teacher awareness did not differ based on student age or gender. © Springer Science+Business Media, Inc. 2006.}, Doi = {10.1007/s10578-006-0009-6}, Key = {fds275025} } @article{fds275028, Author = {J March and S Silva and B Vitiello}, Title = {The Treatment for Adolescents with Depression Study (TADS): Methods and message at 12 weeks}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {45}, Number = {12}, Pages = {1393-1403}, Year = {2006}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.chi.0000237709.35637.c0}, Abstract = {Funded by the National Institute of Mental Health, the Treatment for Adolescents With Depression Study (TADS) is intended to evaluate the short-term (12 weeks) and longer-term (36 weeks) effectiveness of four treatments for adolescents with DSM-IV major depressive disorder: clinical management with fluoxetine (FLX), cognitive-behavioral therapy (CBT), FLX and CBT combined (COMB), and clinical management with placebo (PBO). We previously reported that COMB and FLX were more effective in reducing depression than CBT or PBO after 12 weeks of acute treatment. In this special section of the Journal, separate articles extend these findings to the impact of TADS treatments on remission, speed of response, function and quality of life, predictors of outcome, and safety during the first 12 weeks of treatment. To set the stage for the special section, we briefly review the rationale, design, and methods of the TADS; describe the TADS sample to which the TADS findings generalize; using all of the currently available data, summarize the intent-to-treat outcomes across multiple endpoints at 12 weeks; and consider the public health value of the TADS findings in the context of design decisions and methodological limitations of the TADS, including some that may have advantaged the combined treatment condition. Reflecting the ordering of effect sizes at week 12-COMB (0.98) > FLX (0.68) > CBT (-0.03)-combined treatment proved superior to PBO on 15 of 16 endpoints, to CBT on 14 of 16 endpoints, and to FLX on 8 of 16 endpoints, whereas FLX was superior to CBT on 8 of 14 and to PBO on 7 of 16 measures. CBT did not differ from PBO on any measure. Despite the fact that suicidality improved markedly across all of the treatment conditions, suicidal events were twice as common in patients treated with FLX alone than with COMB or CBT alone, perhaps indicating that CBT protects against suicidal events. Thus, combined treatment appears to accelerate recovery relative to CBT and, for some outcomes, FLX alone, while minimizing the risk of suicidality relative to FLX alone. Taking benefit and risk into account, we conclude that the combination of FLX and CBT appears superior to either monotherapy as a treatment for moderate to severe major depressive disorder in adolescents. Copyright 2006 © American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/01.chi.0000237709.35637.c0}, Key = {fds275028} } @article{fds275029, Author = {B Vitiello and P Rohde and S Silva and K Wells and C Casat and B Waslick and A Simons, M Reinecke and E Weller and C Kratochvil and E al}, Title = {Functioning and quality of life in the Treatment for Adolescents with Depression Study (TADS)}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {45}, Number = {12}, Pages = {1419-1426}, Year = {2006}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.chi.0000242229.52646.6e}, Abstract = {OBJECTIVE: To test whether 12-week treatment of major depression improved the level of functioning, global health, and quality of life of adolescents. METHOD: The Treatment for Adolescents With Depression Study was a multisite, randomized clinical trial of fluoxetine, cognitive-behavioral therapy (CBT), their combination (COMB), or clinical management with placebo in 439 adolescents with major depression. Functioning was measured with the Children's Global Assessment Scale (CGAS), global health with the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), and quality of life with the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Random-effects regression models were applied to the data. RESULTS: Compared with placebo, COMB was effective on the CGAS (p < .0001), HoNOSCA (p < .05), and PQ-LES-Q (p < .001), whereas fluoxetine was superior to placebo on the CGAS only (p < .05). COMB was superior to fluoxetine on the CGAS (p < .05) and PQ-LES-Q (p = .001). Fluoxetine was superior to CBT on the CGAS (p < .01). CBT monotherapy was not statistically different from the placebo group on any of the measures assessed. Treatment effects were mediated by improvement in depressive symptoms measured on the Child Depression Rating Scale-Revised. CONCLUSIONS: The combination of fluoxetine and CBT was effective in improving functioning, global health, and quality of life in depressed adolescents. Fluoxetine monotherapy improved functioning. Copyright 2006 © American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/01.chi.0000242229.52646.6e}, Key = {fds275029} } @article{fds275030, Author = {G Emslie and C Kratochvil and B Vitiello and S Silva and T Mayes and S McNulty, E Weller and B Waslick and C Casat and J Walkup and E al}, Title = {Treatment for Adolescents with Depression Study (TADS): Safety results}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {45}, Number = {12}, Pages = {1440-1455}, Year = {2006}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.chi.0000240840.63737.1d}, Abstract = {OBJECTIVE: To compare the rates of physical, psychiatric, and suicide-related events in adolescents with MDD treated with fluoxetine alone (FLX), cognitive-behavioral therapy (CBT), combination treatment (COMB), or placebo (PBO). METHOD: Safety assessments included adverse events (AEs) collected by spontaneous report, as well as systematic measures for specific physical and psychiatric symptoms. Suicidal ideation and suicidal behavior were systematically assessed by self- and clinician reports. Suicidal events were also reanalyzed by the Columbia Group and expert raters using the Columbia-Classification Algorithm for Suicidal Assessment used in the U.S. Food and Drug Administration reclassification effort. RESULTS: Depressed adolescents reported high rates of physical symptoms at baseline, which improved as depression improved. Sedation, insomnia, vomiting, and upper abdominal pain occurred in at least 2% of those treated with FLX and/or COMB and at twice the rate of placebo. The rate of psychiatric AEs was 11% in FLX, 5.6% in COMB, 4.5% in PBO, and 0.9% in CBT. Suicidal ideation improved overall, with greatest improvement in COMB. Twenty-four suicide-related events occurred during the 12-week period: 5 patients (4.7%) in COMB, 10 (9.2%) in FLX, 5 (4.5%) in CBT, and 3 (2.7%) in placebo. Statistically, only FLX had more suicide-related events than PBO (p =.0402, odds ratio (OR) = 3.7, 95% CI 1.00-63.7). Only five actual attempts occurred (2 COMB, 2 FLX, 1 CBT, 0 PBO). There were no suicide completions. CONCLUSIONS: Different methods for eliciting AEs produce different results. In general, as depression improves, physical complaints and suicidal ideation decrease in proportion to treatment benefit. In this study, psychiatric AEs and suicide-related events are more common in FLX-treated patients. COMB treatment may offer a more favorable safety profile than medication alone in adolescent depression. Copyright 2006 © American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/01.chi.0000240840.63737.1d}, Key = {fds275030} } @article{fds275051, Author = {C Kratochvil and G Emslie and S Silva and S McNulty and J Walkup and J Curry, M Reinecke and B Vitiello and P Rohde and N Feeny and C Casat and S Pathak, E Weller and D May and T Mayes and M Robins and J March}, Title = {Acute time to response in the Treatment for Adolescents with Depression Study (TADS)}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {45}, Number = {12}, Pages = {1412-1418}, Year = {2006}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.chi.0000237710.73755.14}, Abstract = {OBJECTIVE: To examine the time to response for both pharmacotherapy and psychotherapy in the Treatment for Adolescents with Depression Study (TADS). METHOD: Adolescents (N = 439, ages 12 to 17 years) with major depressive disorder were randomized to fluoxetine (FLX), cognitive-behavioral therapy (CBT), their combination (COMB), or pill placebo (PBO). Defining response as very much improved or much improved on the Clinical Global Impression- Improvement Scale (CGI-I), survival analyses using Cox proportional hazards models, and Kaplan-Meier curves were conducted to evaluate time to first response and time to stable response for subjects receiving pharmacotherapy (COMB, FLX, PBO) as well as for subjects receiving CBT (COMB, CBT). Direct comparisons between pharmacotherapy and CBT were not made because of differences in visit schedules. RESULTS: Based on pharmacotherapist CGI-I scores, COMB and FLX showed faster onset of benefit than PBO on time to response and time to stable response (p < .001), and COMB was faster than FLX on time to stable response (p = .034). The probability of sustained early response was approximately threefold greater for COMB than PBO, twofold greater for FLX than PBO, and 1.5-fold greater for COMB than FLX. On the psychotherapist CGI-I scores, both first response and stable response occurred faster in COMB than CBT (p < .001), with a probability of sustained early response approximately threefold greater for COMB than CBT. CONCLUSIONS: In the acute treatment of depressed adolescents, FLX and COMB accelerate response relative to PBO, and COMB accelerates response relative to CBT alone. Copyright 2006 © American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/01.chi.0000237710.73755.14}, Key = {fds275051} } @article{fds275052, Author = {J Curry and P Rohde and A Simons and S Silva and B Vitiello and C Kratochvil, M Reinecke and N Feeny and K Wells and S Pathak and E Weller, D Rosenberg and B Kennard and M Robins and G Ginsburg and J March}, Title = {Predictors and moderators of acute outcome in the Treatment for Adolescents with Depression Study (TADS)}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {45}, Number = {12}, Pages = {1427-1439}, Year = {2006}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.chi.0000240838.78984.e2}, Abstract = {OBJECTIVE: To identify predictors and moderators of response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive-behavioral therapy (CBT), both fluoxetine and CBT, or clinical management with pill placebo in the Treatment for Adolescents With Depression Study (TADS). METHOD: Potential baseline predictors and moderators were identified by a literature review. The outcome measure was a week 12 predicted score derived from the Children's Depression Rating Scale-Revised (CDRS-R). For each candidate moderator or predictor, a general linear model was conducted to examine main and interactive effects of treatment and the candidate variable on the CDRS-R predicted scores. RESULTS: Adolescents who were younger, less chronically depressed, higher functioning, and less hopeless with less suicidal ideation, fewer melancholic features or comorbid diagnoses, and greater expectations for improvement were more likely to benefit acutely than their counterparts. Combined treatment, under no condition less effective than monotherapy, was more effective than fluoxetine for mild to moderate depression and for depression with high levels of cognitive distortion, but not for severe depression or depression with low levels of cognitive distortion. Adolescents from high-income families were as likely to benefit from CBT alone as from combined treatment. CONCLUSIONS: Younger and less severely impaired adolescents are likely to respond better to acute treatment than older, more impaired, or multiply comorbid adolescents. Family income level, cognitive distortions, and severity of depression may help clinicians to choose among acute interventions, but combined treatment proved robust in the presence of moderators. Copyright 2006 © American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/01.chi.0000240838.78984.e2}, Key = {fds275052} } @article{fds275053, Author = {B Kennard and S Silva and B Vitiello and J Curry and C Kratochvil and A Simons, J Hughes and N Feeny and E Weller and M Sweeney and M Reinecke and S Pathak and G Ginsburg and G Emslie and J March}, Title = {Remission and residual symptoms after short-term treatment in the Treatment of Adolescents with Depression Study (TADS)}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {45}, Number = {12}, Pages = {1404-1411}, Year = {2006}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.chi.0000242228.75516.21}, Abstract = {OBJECTIVE: To ascertain remission rates in depressed youth participating in the Treatment for Adolescents With Depression Study (TADS), a multisite clinical trial that randomized 439 adolescents with major depressive disorder (MDD) to a 12-week treatment of fluoxetine (FLX), cognitive-behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). METHOD: Using an end-of-treatment Children's Depression Rating Scale-Revised (CDRS-R) total score of 28 or below as the criterion for remission, rates of remission were examined with logistic regression, controlling for site. Loss of MDD diagnosis and residual symptoms in responders (defined as Clinical Global Impressions-Improvement (CGI-I) score of 1 (very much improved) or 2 (much improved) were also examined across treatment groups. RESULTS: After 12 weeks of treatment, 102 (23%) of 439 youths had reached remission. The remission rate was significantly higher in the COMB group (37%) relative to the other treatment groups (FLX, 23%; CBT, 16%; PBO, 17%), with odds ratios of 2.1 for COMB versus FLX, 3.3 for COMB versus CBT, and 3.0 for COMB versus PBO. In addition, 71% of subjects across treatment groups no longer met criteria for MDD at the end of acute treatment. Fifty percent of the youths who responded by CGI-I criteria continued to have residual symptoms, such as sleep or mood disturbances, fatigue, and poor concentration. CONCLUSIONS: The combination of FLX and CBT was superior to both monotherapy and PBO in terms of remission rates, but overall rates of remission remain low and residual symptoms are common at the end of 12 weeks of treatment. Copyright 2006 © American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/01.chi.0000242228.75516.21}, Key = {fds275053} } @article{fds275121, Author = {JS March and SG Silva and S Compton and M Shapiro and R Califf and R Krishnan}, Title = {The case for practical clinical trials in psychiatry.}, Journal = {Am J Psychiatry}, Volume = {162}, Number = {5}, Pages = {836-846}, Year = {2005}, Month = {May}, ISSN = {0002-953X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15863782}, Keywords = {Adolescent • Adult • Bias (Epidemiology) • Child • Clinical Protocols • Clinical Trials as Topic • Evidence-Based Medicine • Humans • Mental Disorders • Outcome Assessment (Health Care) • Patient Selection • Psychiatry • Quality Assurance, Health Care • Randomized Controlled Trials as Topic • Reproducibility of Results • Research Design • Research Support as Topic • economics • methods* • standards • therapy}, Abstract = {OBJECTIVE: Clinical trials in psychiatry frequently fail to maximize clinical utility for practicing clinicians, or, stated differently, available evidence is not perceived by clinicians (and other decision makers) as sufficiently relevant to clinical practice, thereby diluting its impact. To attain maximum clinical relevance and acceptability, researchers must conduct clinical trials designed to meet the needs of clinicians and others who are making decisions about patients' care. The authors present the case for psychiatry's adoption of the practical clinical trials model, which is widely used in research in other areas of medicine. METHOD: The authors outline the characteristics and scope of practical clinical trials, give examples of practical clinical trials, and discuss the challenges of using the practical clinical trials model in psychiatry, including issues of funding. RESULTS: Practical clinical trials, which are intended to provide generalizable answers to important clinical questions without bias, are characterized by eight key features: a straightforward clinically relevant question, a representative sample of patients and practice settings, sufficient power to identify modest clinically relevant effects, randomization to protect against bias, clinical uncertainty regarding the outcome of treatment at the patient level, assessment and treatment protocols that enact best clinical practices, simple and clinically relevant outcomes, and limited subject and investigator burden. CONCLUSIONS: To implement the practical clinical trials model in psychiatry will require stable funding for network construction and maintenance plus methodological innovation in governance and trial selection, assessment, treatment, data management, site management, and data analytic procedures.}, Language = {eng}, Doi = {10.1176/appi.ajp.162.5.836}, Key = {fds275121} } @article{fds275136, Author = {JS March and A Chrisman and A Breland-Noble and K Clouse and R D'Alli and H Egger, P Gammon and M Gazzola and A Lin and C Mauro and A Rana and H Ravi and M Srirama and H Su and G Thrall and P van de Velde and Duke Pediatric Psychiatry EBM Seminar Team}, Title = {Using and teaching evidence-based medicine: the Duke University child and adolescent psychiatry model.}, Journal = {Child Adolesc Psychiatr Clin N Am}, Volume = {14}, Number = {2}, Pages = {273-ix}, Year = {2005}, Month = {April}, ISSN = {1056-4993}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15694786}, Keywords = {Academic Medical Centers • Adolescent • Adolescent Health Services • Adolescent Psychiatry • Child • Child Health Services • Child Psychiatry • Evidence-Based Medicine • Humans • Mental Health Services • Teaching • United States • education* • methods • methods* • organization & administration • organization & administration*}, Abstract = {Evidence-based medicine (EBM) is defined as a set of processes that facilitate the conscientious, explicit, and judicious integration of individual clinical expertise with the best available external clinical evidence from systematic research in making decisions about the care of individual patients. EBM focuses not only on grading the strength of the evidence but also on the processes and tools that are necessary for clinicians to continually upgrade their knowledge and skills for those problems encountered in daily practice. This article, authored by members of the Duke Pediatric Psychiatry EBM Seminar Team, (1) describes EBM as applied to the training of child and adolescent psychiatrists in the Division of Child and Adolescent Psychiatry, Department of Psychiatry at Duke University Medical Center; (2) presents a simplified discussion of EBM as a technology for training and patient care; (3) discusses the basic principles and procedures for teaching EBM in the setting of a multidisciplinary training program; and (4) briefly mentions two training and research initiatives that are furthered by incorporating EBM.}, Language = {eng}, Doi = {10.1016/j.chc.2004.05.001}, Key = {fds275136} } @article{fds275015, Author = {JS March}, Title = {Review: a pooled long term persistence rate of 40% for childhood OCD is lower than previously expected.}, Journal = {Evid Based Ment Health}, Volume = {8}, Number = {1}, Pages = {6}, Year = {2005}, Month = {February}, ISSN = {1362-0347}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15671497}, Key = {fds275015} } @article{fds275012, Author = {B Hoza and AC Gerdes and S Mrug and SP Hinshaw and WM Bukowski and JA Gold and LE Arnold and HB Abikoff and CK Conners and GR Elliott and E al}, Title = {Peer-assessed outcomes in the multimodal treatment study of children with attention deficit hyperactivity disorder}, Journal = {Journal of Clinical Child and Adolescent Psychology}, Volume = {34}, Number = {1}, Pages = {74-86}, Year = {2005}, ISSN = {1537-4416}, Abstract = {Peer-assessed outcomes were examined at the end of treatment (14 months after study entry) for 285 children (226 boys, 59 girls) with attention deficit hyperactivity disorder (ADHD) who were rated by their classmates (2,232 classmates total) using peer sociometric procedures. All children with ADHD were participants in the Multimodal Treatment Study of Children with ADHD (MTA). Treatment groups were compared using the orthogonal treatment contrasts that accounted for the largest amount of variance in prior MTA outcome analyses: Medication Management + Combined Treatment versus Behavior Therapy + Community Care; Medication Management versus Combined Treatment; Behavior Therapy versus Community Care. There was little evidence of superiority of any of the treatments for the peer-assessed outcomes studied, although the limited evidence that emerged favored treatments involving medication management. Post hoc analyses were used to examine whether any of the four treatment groups yielded normalized peer relationships relative to randomly selected-classmates. Results indicated that children from all groups remained significantly impaired in their peer relationships.}, Key = {fds275012} } @article{fds275014, Author = {CJ Kratochvil and A Simons and B Vitiello and J Walkup and G Emslie and D Rosenberg and JS March}, Title = {A multisite psychotherapy and medication trial for depressed adolescents: Background and benefits}, Journal = {Cognitive and Behavioral Practice}, Volume = {12}, Number = {2}, Pages = {159-165}, Year = {2005}, ISSN = {1077-7229}, url = {http://dx.doi.org/10.1016/S1077-7229(05)80021-5}, Abstract = {The Treatment for Adolescents With Depression Study (TADS) is an NIMH-supported multisite clinical trial that compares the. effectiveness of a depression-specific cognitive behavioral therapy (CBT), medication management with fluoxetine (FLX), the combination of CBT and FLX (COMB), and medical management with pill placebo (PBO). TADS was specifically designed as a comprehensive effectiveness study, able to answer clinically meaningful questions by including a broad and representative sample of depressed teens, delivering treatment at both tertiary medical centers and community clinics, and assessing functional as well as symptomatic outcomes. This report supports the importance of conducting clinical trials in youth with depression to bridge the gap between science and practice. Copyright © 2005 by Association for Advancement of Behavior Therapy. All rights of reproduction in any form reserved.}, Doi = {10.1016/S1077-7229(05)80021-5}, Key = {fds275014} } @article{fds275016, Author = {CJ Kratochvil and KD Wagner and G Emslie and J March}, Title = {Pharmacological management of treatment-resistant pediatric depression}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {44}, Number = {2}, Pages = {198-200}, Year = {2005}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/00004583-200502000-00013}, Doi = {10.1097/00004583-200502000-00013}, Key = {fds275016} } @article{fds275017, Author = {JS March}, Title = {Authors of TADS study reply to letter raising concerns [2]}, Journal = {British Medical Journal}, Volume = {330}, Number = {7493}, Pages = {730-731}, Year = {2005}, url = {http://dx.doi.org/10.1136/bmj.330.7493.730-b}, Doi = {10.1136/bmj.330.7493.730-b}, Key = {fds275017} } @article{fds275018, Author = {JS March and S Silva and S Petrycki and B Dubicka and P Ramchandani}, Title = {Fluoxetine plus cognitive behavioural therapy was most effective for adolescents with major depressive disorder}, Journal = {Evidence-Based Medicine}, Volume = {10}, Number = {2}, Pages = {46-}, Year = {2005}, url = {http://dx.doi.org/10.1136/ebm.10.2.46}, Doi = {10.1136/ebm.10.2.46}, Key = {fds275018} } @article{fds275019, Author = {H Abikoff and J McGough and B Vitiello and J McCracken and M Davies and J Walkup, M Riddle and M Oatis and L Greenhill and A Skrobala and E al}, Title = {Sequential pharmacotherapy for children with comorbid attention-deficit/ hyperactivity and anxiety disorders}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {44}, Number = {5}, Pages = {418-427}, Year = {2005}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.chi.0000155320.52322.37}, Abstract = {Objective: Attention-deficit/hyperactivity disorder (ADHD) is often accompanied by clinically significant anxiety, but few empirical data guide treatment of children meeting full DSM-IV criteria for ADHD and anxiety disorders (ADHD/ANX). This study examined the efficacy of sequential pharmacotherapy for ADHD/ANX children. Method: Children, age 6 to 17 years, with ADHD/ANX were titrated to optimal methylphenidate dose and assessed along with children who entered the study on a previously optimized stimulant. Children with improved ADHD who remained anxious were randomly assigned to 8 weeks of double-blind stimulant + fluvoxamine (STIM/FLV) or stimulant + placebo (STIM/PL). Primary efficacy measures were the Swanson, Nolan, Atkins, and Pelham IV Parent and Teacher Rating Scale ADHD score and the Pediatric Anxiety Rating Scale total score. ADHD, ANX, and overall Clinical Global Impressions- Improvement scores were also obtained. Results: Of the 32 medication-naïve children openly treated with methylphenidate, 26 (81%) improved as to ADHD. Twenty-five children entered the randomized trial. Intent-to-treat analysis indicated no differences between the STIM/FLV (n = 15) and STIM/PL groups on the Pediatric Anxiety Rating Scale or Clinical Global impressions-improvement- defined responder rate. Medications in both arms were well tolerated. Conclusions: Children with ADHD/ANX have a response rate to stimulants for ADHD that is comparable with that of children with general ADHD. The benefit of adding FLV to stimulants for ANX remains unproven. ©2005 by the American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/01.chi.0000155320.52322.37}, Key = {fds275019} } @article{fds275020, Author = {A Weintrob and JS March}, Title = {Placebo use [2] (multiple letters)}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {44}, Number = {7}, Pages = {624-625}, Year = {2005}, url = {http://dx.doi.org/10.1097/01.chi.0000162578.07277.9f}, Doi = {10.1097/01.chi.0000162578.07277.9f}, Key = {fds275020} } @article{fds275021, Author = {L Hechtman and J Etcovitch and R Platt and LE Arnold and HB Abikoff and JH Newcorn, B Hoza and SP Hinshaw and HC Kraemer and E al}, Title = {Does multimodal treatment of ADHD decrease other diagnoses?}, Journal = {Clinical Neuroscience Research}, Volume = {5}, Number = {5-6}, Pages = {273-282}, Year = {2005}, ISSN = {1566-2772}, url = {http://dx.doi.org/10.1016/j.cnr.2005.09.007}, Abstract = {Comorbid conditions in children with attention deficit hyperactivity disorder (ADHD) are frequent and can affect treatment response and life course. From the multimodal treatment study of ADHD (MTA), we examined the persistence or development of conditions other than ADHD, e.g. oppositional defiant disorder (ODD), conduct disorder (CD), anxiety, depression, and learning disorder (LD) in 576 children, age 7-9 years, diagnosed rigorously with ADHD, who were randomly assigned to four different treatments for 14 months. The treatment groups were medication management alone (MedMgt), behavioral treatment alone (Beh), the combination (Comb), and community comparison routine care (CC). For the sample as a whole, we found significant decreases from baseline to 14 months in diagnoses of ODD, CD, and anxiety disorder but not LD or mood disorder. The CC group developed significantly more new ODD and retained more baseline ODD than the Comb or MedMgt groups. There were no significant treatment group differences for specific other conditions. Only the Comb group was significantly better than the CC group in reducing total number of disorders and impairment at 14 months in subjects with multiple conditions at baseline. Well-titrated and monitored stimulant medication can decrease ODD and possibly prevent future CD. Combined treatment may be required for the most disturbed children with ADHD who have multiple disorders and severe impairment. © 2005 Association for Research in Nervous and Mental Disease. Published by Elsevier B.V. All rights reserved.}, Doi = {10.1016/j.cnr.2005.09.007}, Key = {fds275021} } @article{fds275022, Author = {S Pathak and CJ Kratochvil and GM Rogers and S Silva and B Vitiello and EB Weller and JS March}, Title = {Comparative efficacy of cognitive behavioral therapy, fluoxetine, and their combination in depressed adolescents: Initial lessons from the treatment for adolescents with depression study}, Journal = {Current Psychiatry Reports}, Volume = {7}, Number = {6}, Pages = {429-434}, Year = {2005}, ISSN = {1523-3812}, url = {http://dx.doi.org/10.1007/s11920-005-0063-y}, Abstract = {Adolescents with major depressive disorder (MDD), their families and clinicians experience significant challenges when weighing the potential risks versus benefits of available choices in the treatment of MDD. Although MDD is highly prevalent in adolescents and is associated with marked suffering, impairment and risk of suicide, the scientific data regarding the safety and efficacy of treatments for pediatric depression are limited. Controlled clinical trials have provided support for the use of psychotherapy and fluoxetine for the treatment of pediatric depression, but until recently no information on the comparative efficacy of these recommended interventions alone or in combination was available. The Treatment for Adolescents with Depression Study provides a very important therapeutic advance in the field by convincingly showing that combination treatment with cognitive behavioral therapy and fluoxetine has the best benefit to risk ratio for adolescents with moderate to severe depression, and is superior to monotherapy. Moreover, the study results confirm that fluoxetine alone is effective in the treatment of depressed adolescents. Copyright © 2005 by Current Science Inc.}, Doi = {10.1007/s11920-005-0063-y}, Key = {fds275022} } @article{fds275057, Author = {H Chabrol and DA Brent and J Curry and SN Compton and JS March}, Title = {CBT versus supportive therapy for depression [1] (multiple letters)}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {44}, Number = {9}, Pages = {841-843}, Year = {2005}, url = {http://dx.doi.org/10.1097/01.chi.0000170555.00551.37}, Doi = {10.1097/01.chi.0000170555.00551.37}, Key = {fds275057} } @article{fds275068, Author = {J March and S Silva and S Petrycki and J Curry and K Wells and J Fairbank and B Burns and M Domino and S McNulty and B Vitiello and J Severe and C Casat and J Kolker and K Riedal and M Goldman and N Feeny and R Findling and S Stull and N McNamara and E Weller and M Robins and R Weller and N Jessani and B Waslick, M Sweeney and R Kandel and D Schoenholz and J Walkup and G Ginsburg, E Kastelic and H Koo and C Kratochvil and D May and R LaGrone and M Harrington and AM Albano and G Hirsch and T Knibbs and E Capili and M Reinecke, B Leventhal and C Nageotte and G Rogers and S Pathak and J Wells, S Arszman and A Danielyan and A Simons and P Rohde and J Grimm and L Nguyen, G Emslie and B Kennard and C Hughes and M Ruberu and D Rosenberg, N Benazon and M Butkus and M Bartoi and G Clarke and D Brent and G Koch}, Title = {The Treatment for Adolescents with Depression Study (TADS): Demographic and clinical characteristics}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {44}, Number = {1}, Pages = {28-40}, Year = {2005}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.chi.0000145807.09027.82}, Abstract = {Objective: The Treatment for Adolescents With Depression Study is a multicenter, randomized clinical trial sponsored by the NIMH. This study is designed to evaluate the short- and long-term effectiveness of four treatments for adolescents with major depressive disorder: fluoxetine, cognitive-behavioral therapy, their combination, and, acutely, pill placebo. This report describes the demographic and clinical characteristics of the sample and addresses external validity. Method: Participants are 439 adolescents, aged 12-17 years inclusively, with a primary DSM-IV diagnosis of current major depressive disorder. Baseline data are summarized and compared with those from national samples and previous trials. Results: The sample composition is 54.4% girls, 73.8% white, 12.5% African American, and 8.9% Hispanic. The mean Child Depression Rating Scale-Revised total score is 60.1 (SD = 10.4, range 45-98) with 86.0% experiencing their first major depressive episode. The most common concurrent diagnoses are generalized anxiety disorder (15.3%), attention-deficit/hyperactivity disorder (13.7%), oppositional defiant disorder (13.2%), social phobia (10.7%), and dysthymia (10.5%). Demographic results are consistent with data from national samples and large psychopharmacology trials involving depressed adolescents. Conclusions: The Treatment for Adolescents With Depression Study provides a large, diverse, and representative sample of depressed adolescents that highlights the complexity of major depressive disorder in adolescents and provides a rich source for explicating the effects of moderator and mediator variables on baseline psychopathology and treatment outcome.}, Doi = {10.1097/01.chi.0000145807.09027.82}, Key = {fds275068} } @article{fds275173, Author = {JS March}, Title = {Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection (PANDAS): implications for clinical practice.}, Journal = {Arch Pediatr Adolesc Med}, Volume = {158}, Number = {9}, Pages = {927-929}, Year = {2004}, Month = {September}, ISSN = {1072-4710}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15351762}, Keywords = {Autoimmune Diseases of the Nervous System • Behavioral Symptoms • Child • Child Welfare • Child, Preschool • Cognition Disorders • Humans • Physician's Practice Patterns • Polysaccharides, Bacterial* • Psychomotor Performance • Streptococcal Infections* • complications • epidemiology* • microbiology* • physiology • psychology}, Language = {eng}, Doi = {10.1001/archpedi.158.9.927}, Key = {fds275173} } @article{fds275009, Author = {J March and S Silva and S Petrycki and J Curry and K Wells and J Fairbank and B Burns and M Domino and S McNulty and B Vitiello and J Severe and Treatment for Adolescents With Depression Study (TADS) Team}, Title = {Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial.}, Journal = {JAMA}, Volume = {292}, Number = {7}, Pages = {807-820}, Year = {2004}, Month = {August}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15315995}, Abstract = {CONTEXT: Initial treatment of major depressive disorder in adolescents may include cognitive-behavioral therapy (CBT) or a selective serotonin reuptake inhibitor (SSRI). However, little is known about their relative or combined effectiveness. OBJECTIVE: To evaluate the effectiveness of 4 treatments among adolescents with major depressive disorder. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial of a volunteer sample of 439 patients between the ages of 12 to 17 years with a primary Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of major depressive disorder. The trial was conducted at 13 US academic and community clinics between spring 2000 and summer 2003. INTERVENTIONS: Twelve weeks of (1) fluoxetine alone (10 to 40 mg/d), (2) CBT alone, (3) CBT with fluoxetine (10 to 40 mg/d), or (4) placebo (equivalent to 10 to 40 mg/d). Placebo and fluoxetine alone were administered double-blind; CBT alone and CBT with fluoxetine were administered unblinded. MAIN OUTCOME MEASURES: Children's Depression Rating Scale-Revised total score and, for responder analysis, a (dichotomized) Clinical Global Impressions improvement score. RESULTS: Compared with placebo, the combination of fluoxetine with CBT was statistically significant (P =.001) on the Children's Depression Rating Scale-Revised. Compared with fluoxetine alone (P =.02) and CBT alone (P =.01), treatment of fluoxetine with CBT was superior. Fluoxetine alone is a superior treatment to CBT alone (P =.01). Rates of response for fluoxetine with CBT were 71.0% (95% confidence interval [CI], 62%-80%); fluoxetine alone, 60.6% (95% CI, 51%-70%); CBT alone, 43.2% (95% CI, 34%-52%); and placebo, 34.8% (95% CI, 26%-44%). On the Clinical Global Impressions improvement responder analysis, the 2 fluoxetine-containing conditions were statistically superior to CBT and to placebo. Clinically significant suicidal thinking, which was present in 29% of the sample at baseline, improved significantly in all 4 treatment groups. Fluoxetine with CBT showed the greatest reduction (P =.02). Seven (1.6%) of 439 patients attempted suicide; there were no completed suicides. CONCLUSION: The combination of fluoxetine with CBT offered the most favorable tradeoff between benefit and risk for adolescents with major depressive disorder.}, Doi = {10.1001/jama.292.7.807}, Key = {fds275009} } @article{fds275008, Author = {J March and C Kratochvil and G Clarke and W Beardslee and A Derivan and G Emslie, EP Green and J Heiligenstein and S Hinshaw and K Hoagwood and P Jensen, P Lavori and H Leonard and J McNulty and MA Michaels and A Mossholder, T Osher and T Petti and E Prentice and B Vitiello and K Wells}, Title = {AACAP 2002 research forum: placebo and alternatives to placebo in randomized controlled trials in pediatric psychopharmacology.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {43}, Number = {8}, Pages = {1046-1056}, Year = {2004}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15266201}, Abstract = {OBJECTIVE: The use of placebo in the pediatric age group has come under increasing scrutiny. At the 2002 Annual Meeting of the American Academy of Child and Adolescent Psychiatry, the Academy's Workgroup on Research conducted a research forum. The purpose was to identify challenges and their solutions regarding the use of placebo in randomized controlled trials in pediatric psychopharmacology. METHOD: Workgroups focused on problems and solutions in five areas: ethics and human subjects, research design and statistics, partnering with consumers, U.S. Food and Drug Administration and pharmaceutical industry perspectives, and psychosocial treatments. RESULTS: In many but not all circumstances, inclusion of a placebo control is essential to meet the scientific goals of treatment outcome research. Innovative research designs; involvement of consumers in planning and implementing research; flexibility by industry, academia, the National Institutes of Health, and regulatory agencies acting in partnership; and concomitant use of evidence-based psychosocial services can and should assist in making placebo-controlled trials acceptable. CONCLUSIONS: Properly designed placebo-controlled trials remain necessary, ethical, and feasible.}, Doi = {10.1097/01.chi.0000129606.83206.77}, Key = {fds275008} } @article{fds275125, Author = {SN Compton and JS March and D Brent and AM Albano and R Weersing and J Curry}, Title = {Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: an evidence-based medicine review.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {43}, Number = {8}, Pages = {930-959}, Year = {2004}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15266189}, Keywords = {Adolescent • Anxiety Disorders • Child • Cognitive Therapy* • Controlled Clinical Trials as Topic • Depressive Disorder • Evidence-Based Medicine* • Humans • diagnosis • psychology • therapy*}, Abstract = {OBJECTIVE: To review the literature on the cognitive-behavioral treatment of children and adolescents with anxiety and depressive disorders within the conceptual framework of evidence-based medicine. METHOD: The psychiatric and psychological literature was systematically searched for controlled trials applying cognitive-behavioral treatment to pediatric anxiety and depressive disorders. RESULTS: For both anxiety and depression, substantial evidence supports the efficacy of problem-specific cognitive-behavioral interventions. Comparisons with wait-list, inactive control, and active control conditions suggest medium to large effects for symptom reduction in primary outcome domains. CONCLUSIONS: From an evidence-based perspective, cognitive-behavioral therapy is currently the treatment of choice for anxiety and depressive disorders in children and adolescents. Future research in this area will need to focus on comparing cognitive-behavioral psychotherapy with other treatments, component analyses, and the application of exportable protocol-driven treatments to divergent settings and patient populations.}, Language = {eng}, Key = {fds275125} } @article{fds275006, Author = {JS March}, Title = {Review: clomipramine is more effective than SSRIs for paediatric obsessive compulsive disorder.}, Journal = {Evid Based Ment Health}, Volume = {7}, Number = {2}, Pages = {50}, Year = {2004}, Month = {May}, ISSN = {1362-0347}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15107346}, Key = {fds275006} } @article{fds275152, Author = {JS March and SG Silva and S Compton and G Anthony and J DeVeaugh-Geiss and R Califf and R Krishnan}, Title = {The Child and Adolescent Psychiatry Trials Network (CAPTN).}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {43}, Number = {5}, Pages = {515-518}, Year = {2004}, Month = {May}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15100557}, Keywords = {Adolescent • Adolescent Psychiatry* • Child • Child Psychiatry* • Clinical Trials as Topic* • Cooperative Behavior • Evidence-Based Medicine • Humans • Information Services* • Mental Disorders • Psychotropic Drugs • drug therapy}, Abstract = {OBJECTIVE: The current generation of clinical trials in pediatric psychiatry often fails to maximize clinical utility for practicing clinicians, thereby diluting its impact. METHOD: To attain maximum clinical relevance and acceptability, the Child and Adolescent Psychiatry Trials Network (CAPTN) will transport to pediatric psychiatry the practical clinical trials model widely used in other areas of medicine. RESULTS: CAPTN, a collaborative effort of the Duke Clinical Research Institute and the American Academy of Child and Adolescent Psychiatry, will conduct large, simple "practical" trials that provide generalizable answers to important clinical questions without bias. "Large" in this case means the random allocation of thousands of patients in hundreds of clinical centers to different treatments as they are delivered in community settings. "Simple" means that the number and type of data elements (and, hence, subject and investigator burden) is small and straightforward so as not to discourage provider or patient participation and to maximize the number of subjects per dollar spent. CONCLUSION: With 200 to 400 child and adolescent psychiatrists each participating in two or three practical clinical trials over 4 years, CAPTN promises to advance both the evidence base and research capacity in child and adolescent psychiatry.}, Language = {eng}, Doi = {10.1097/00004583-200405000-00004}, Key = {fds275152} } @article{fds275002, Author = {P Barrett and L Healy-Farrell and JS March}, Title = {Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: A controlled trial}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {43}, Number = {1}, Pages = {46-62}, Year = {2004}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/00004583-200401000-00014}, Abstract = {Objective: To evaluate the relative efficacy of (1) individual cognitive-behavioral family-based therapy (CBFT); (2) group CBFT; and (3) a waitlist control group in the treatment of childhood obsessive-compulsive disorder (OCD). Method: This study, conducted at a university clinic in Brisbane, Australia, involved 77 children and adolescents with OCD who were randomized to individual CBFT, group CBFT, or a 4- to 6-week waitlist control condition. Children were assessed before and after treatment and at 3 months and 6 months following the completion of treatment using diagnostic interviews, symptom severity interviews, and self-report measures. Parental distress, family functioning, sibling distress, and levels of accommodation to OCD demands were also assessed. Active treatment involved a manualized 14-week cognitive-behavioral protocol, with parental and sibling components. Results: By an evaluable patient analysis, statistically and clinically significant pretreatment-to-posttreatment change occurred in OCD diagnostic status and severity across both individual and group CBFT, with no significant differences in improvement ratings between these conditions. There were no significant changes across measures for the waitlist condition. Treatment gains were maintained up to 6 months of follow-up. Conclusions: Contrary to previous findings and expectations, group CBFT is as effective in reducing OCD symptoms for children and adolescents as individual treatment. Findings support the efficacy and durability of CBFT in treating childhood OCD. ©2003 by the American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/00004583-200401000-00014}, Key = {fds275002} } @article{fds275004, Author = {KD Wagner and P Ambrosini and M Rynn and J March}, Title = {Sertraline reduced the severity of patients' depressive symptoms in major depressive disorder}, Journal = {Evidence-Based Medicine}, Volume = {9}, Number = {2}, Pages = {46-}, Year = {2004}, url = {http://dx.doi.org/10.1136/ebm.9.2.46}, Doi = {10.1136/ebm.9.2.46}, Key = {fds275004} } @article{fds275005, Author = {LE Arnold and S Chuang and M Davies and HB Abikoff and CK Conners and GR Elliott, LL Greenhill and L Hechtman and SP Hinshaw and E al}, Title = {Nine Months of Multicomponent Behavioral Treatment for ADHD and Effectiveness of MTA Fading Procedures}, Journal = {Journal of Abnormal Child Psychology}, Volume = {32}, Number = {1}, Pages = {39-51}, Year = {2004}, url = {http://dx.doi.org/10.1023/B:JACP.0000007579.61289.31}, Abstract = {We examined 9-month data from the 14-month NIMH Multimodal Treatment Study of Children with ADHD (the MTA) as a further check on the relative effect of medication (MedMgt) and behavioral treatment (Beh) for attention-deficit/hyperactivity disorder (ADHD) while Beh was still being delivered at greater intensity than at 14-month endpoint, and conversely as a check on the efficacy of the MTA behavioral generalization/maintenance procedures. Intention-to-treat analysis at 9 months showed essentially the same results as at 14 months, after Beh had been completely faded; MedMgt and the combination (Comb) of medication and Beh were significantly superior to Beh and community care (CC) for ADHD and oppositional-defiant (ODD) symptoms, with mixed results for social skills and internalizing symptoms. All treatment-group differences examined as changes in slopes from 9 to 14 months were nonsignificant (we found general improvement for all groups). Slopes from baseline to 9 months correlated highly (r > .74, p < .0001) with slopes from baseline to 14 months for all groups. The time function from baseline to 14 months showed a significant linear, but not quadratic, trend for the main outcome measure (a composite of parent- and teacher-rated ADHD and ODD symptoms) for all groups. Findings suggest that in contrast to the hypothesized deterioration in the relative benefit of Beh between 9 and 14 months (after completion of fading), the MTA Beh generalization and maintenance procedures implemented through 9 months apparently yielded continuing improvement through 14 months, with preservation of the relative position of Beh compared to other treatment strategies.}, Doi = {10.1023/B:JACP.0000007579.61289.31}, Key = {fds275005} } @article{fds275007, Author = {AT Derivan and BL Leventhal and J March and M Wolraich and JM Zito}, Title = {The ethical use of placebo in clinical trials involving children}, Journal = {Journal of Child and Adolescent Psychopharmacology}, Volume = {14}, Number = {2}, Pages = {169-174}, Year = {2004}, ISSN = {1044-5463}, url = {http://dx.doi.org/10.1089/1044546041649057}, Abstract = {The authors reviewed various statements describing the ethical use of placebo-controls in clinical trials involving minors. Attention was focused upon the Guidelines for the Ethical Conduct of Studies to Evaluate Drugs in Pediatric Populations, published by the American Academy of Pediatrics (AAP) (Kaufman et al. 1995). A brief review of certain key documents and a possible expansion of the guidelines are presented. Specifically, it is recommended that a review and update of guidelines for the use of placebo-controlled trials in children be undertaken by a working group comprised of stakeholders, including academic clinical and research professionals, bioethicists, consumers, members of key government agencies, and the pharmaceutical industry.}, Doi = {10.1089/1044546041649057}, Key = {fds275007} } @article{fds275010, Author = {NC Feeny and EB Foa and KRH Treadwell and J March}, Title = {Posttraumatic stress disorder in youth: A critical review of the cognitive and behavioral treatment outcome literature}, Journal = {Professional Psychology: Research and Practice}, Volume = {35}, Number = {5}, Pages = {466-476}, Year = {2004}, ISSN = {0735-7028}, url = {http://dx.doi.org/10.1037/0735-7028.35.5.466}, Abstract = {What treatments work for children who have posttraumatic stress disorder (PTSD)? Perhaps more important, what else do clinicians need to learn? In this article, the authors focus on treatment research in the area of trauma and PTSD in youth, in an attempt to highlight the clinical implications of such work and to identify the areas in which additional research is needed. Overall, there is emerging evidence that a variety of cognitive and behavioral programs are effective in treating youth with PTSD. In spite of such evidence, additional research is needed to shore up the scientific base for effective clinical practice with these youth. Psychologists working with traumatized youth will find this article a useful update on the state of evidence for cognitive-behavioral interventions in the treatment of PTSD.}, Doi = {10.1037/0735-7028.35.5.466}, Key = {fds275010} } @article{fds275011, Author = {JS March}, Title = {Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: The pediatric OCD treatment study (POTS) randomized controlled trial}, Journal = {Journal of the American Medical Association}, Volume = {292}, Number = {16}, Pages = {1969-1976}, Year = {2004}, url = {http://dx.doi.org/10.1001/jama.292.16.1969}, Abstract = {Content: The empirical literature on treatment of obsessive-compulsive disorder (OCD) in children and adolescents supports the efficacy of short-term OCD-specific cognitive-behavior therapy (CBT) or medical management with selective serotonin reuptake inhibitors. However, little is known about their relative and combined efficacy. Objective: To evaluate the efficacy of CBT alone and medical management with the selective serotonin reuptake inhibitor sertraline alone, or CBT and sertraline combined, as initial treatment for children and adolescents with OCD. Design, Setting, and Participants: The Pediatric OCD Treatment Study, a balanced, masked randomized controlled trial conducted in 3 academic centers in the United States and enrolling a volunteer outpatient sample of 112 patients aged 7 through 17 years with a primary Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of OCD and a Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score of 16 or higher. Patients were recruited between September 1997 and December 2002. Interventions: Participants were randomly assigned to receive CBT alone, sertraline alone, combined CBT and sertraline, or pill placebo for 12 weeks. Main Outcome Measures: Change in CY-BOCS score over 12 weeks as rated by an independent evaluator masked to treatment status; rate of clinical remission defined as a CY-BOCS score less than or equal to 10. Results: Ninety-seven of 112 patients (87%) completed the full 12 weeks of treatment. Intent-to-treat random regression analyses indicated a statistically significant advantage for CBT alone (P=.003), sertraline alone (P=.007), and combined treatment (P=.001) compared with placebo. Combined treatment also proved superior to CBT alone (P=.008) and to sertraline alone (P=.006), which did not differ from each other. Site differences emerged for CBT and sertraline but not for combined treatment, suggesting that combined treatment is less susceptible to setting-specific variations. The rate of clinical remission for combined treatment was 53.6% (95% confidence interval [CI], 36%-70%); for CBT alone, 39.3% (95% CI, 24%-58%); for sertraline alone, 21.4% (95% CI, 10%-40%); and for placebo, 3.6% (95% CI, 0%-19%). The remission rate for combined treatment did not differ from that for CBT alone (P=.42) but did differ from sertraline alone (P=.03) and from placebo (P<.001). CBT alone did not differ from sertraline alone (P=.24) but did differ from placebo (P=.002), whereas sertraline alone did not (P=.10). The 3 active treatments proved acceptable and well tolerated, with no evidence of treatment-emergent harm to self or to others. Conclusion: Children and adolescents with OCD should begin treatment with the combination of CBT plus a selective serotonin reuptake inhibitor or CBT alone.}, Doi = {10.1001/jama.292.16.1969}, Key = {fds275011} } @article{fds275013, Author = {D Antonuccio and D Burns and A Rifkin and W Rifkin and BJ Carroll and JA Bridge, DA Brent and JS March}, Title = {Adolescents with depression [1] (multiple letters)}, Journal = {Journal of the American Medical Association}, Volume = {292}, Number = {21}, Pages = {2577-2579}, Year = {2004}, Key = {fds275013} } @article{fds275065, Author = {LL Greenhill and B Vitiello and P Fisher and J Levine and M Davies and H Abikoff, AK Chrisman and S Chuang and RL Findling and J March and L Scahill, J Walkup and MA Riddle}, Title = {Comparison of increasingly detailed elicitation methods for the assessment of adverse events in pediatric psychopharmacology}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {43}, Number = {12}, Pages = {1488-1496}, Year = {2004}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.chi.0000142668.29191.13}, Abstract = {Objective: To improve the gathering of adverse events (AEs) in pediatric psychopharmacology by examining the value and acceptability of increasingly detailed elicitation methods. Method: Trained clinicians administered the Safety Monitoring Uniform Report Form (SMURF) to 59 parents and outpatients (mean age ± SD = 11.9 ± 3.2 years) in treatment, with 36% on stimulants, 29% on selective serotonin reuptake inhibitor drugs, 10% on both, and 25% on other drug combinations. The SMURF included a brief general inquiry, a drug-specific inquiry, and a comprehensive body system review (BSR). Results: SMURF administration took 24.6 ± 13.9 minutes (median, 21). The BSR took 15.5 ± 8.1 minutes (median, 14) longer (p < .0001) than the general inquiry (4.3 ± 5.4 minutes) and the drug-specific inquiry (4.2 ± 2.9 minutes). The general inquiry elicited 48 AEs, the drug-specific inquiry elicited 16 additional AEs, and the BSR 129 additional AEs. Of all the clinically relevant AEs elicited by the SMURF (n = 36), 19 (53%) were elicited by the BSR. The BSR length and detail were acceptable to parents but not to clinicians. Conclusions: The BSR elicited additional clinically significant AEs that had been missed with less detailed methods. Parents, but not clinicians, rated satisfaction and acceptability of the BSR as good. © 2004 by the American Academy of Child and Adolescent Psychiatry.}, Doi = {10.1097/01.chi.0000142668.29191.13}, Key = {fds275065} } @article{fds275137, Author = {CJ Kratochvil and LL Greenhill and JS March and WJ Burke and BS Vaughan}, Title = {The role of stimulants in the treatment of preschool children with attention-deficit hyperactivity disorder.}, Journal = {CNS Drugs}, Volume = {18}, Number = {14}, Pages = {957-966}, Year = {2004}, ISSN = {1172-7047}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15584766}, Keywords = {Attention Deficit Disorder with Hyperactivity • Central Nervous System Stimulants • Child, Preschool • Clinical Trials as Topic • Humans • Practice Guidelines as Topic • diagnosis • drug therapy* • psychology • therapeutic use*}, Abstract = {The symptoms of attention-deficit hyperactivity disorder (ADHD) can have an early onset, beginning before the age of 6 years. Despite the significant number of preschool-aged children that can be diagnosed with ADHD, there are limited controlled data available on the pharmacological interventions being increasingly used in this population. A 1990 review showed that 34% of paediatricians and 15% of family physicians had prescribed psychostimulant medications to preschoolers with ADHD, and pharmacoepidemiological studies indicate growing use of stimulants in preschoolers during the 1990s. Unfortunately, only six controlled trials, with a total enrollment of less than 200 children, have been conducted using these drugs in preschoolers. While these small studies provide some evidence of benefit from the use of methylphenidate in preschoolers with ADHD, more data are critically needed. Practice parameters developed by the American Academy of Child & Adolescent Psychiatry and the American Academy of Pediatrics provide some guidance regarding the diagnosis and treatment of young children with ADHD, but are mainly based upon research in children of primary-school age. The ongoing PATS (Preschool ADHD Treatment Study), funded by the National Institute of Mental Health, will provide important clinical guidance for diagnostic considerations and intervention strategies for children with ADHD aged 3-5 years. Pending the release of data from the PATS study, clinicians must rely on developmental assessment skills, available standardised rating instruments, reports about the child from multiple informants, and knowledge of the risks and benefits of available pharmacological and behavioural treatments, in order to treat preschool children with ADHD effectively.}, Language = {eng}, Key = {fds275137} } @article{fds275113, Author = {LL Greenhill and B Vitiello and MA Riddle and P Fisher and E Shockey and JS March, J Levine and J Fried and H Abikoff and JM Zito and JT McCracken and RL Findling and J Robinson and TB Cooper and M Davies and E Varipatis and MJ Labellarte and L Scahill and JT Walkup and L Capasso and J Rosengarten}, Title = {Review of safety assessment methods used in pediatric psychopharmacology.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {42}, Number = {6}, Pages = {627-633}, Year = {2003}, Month = {June}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12921469}, Keywords = {Adolescent • Adverse Drug Reaction Reporting Systems • Child • Child, Preschool • Clinical Trials as Topic* • Drug Therapy • Female • Humans • Male • Pediatrics* • Psychopharmacology* • Psychotropic Drugs • Quality Assurance, Health Care • Safety • adverse effects* • methods}, Abstract = {OBJECTIVE: Elicitation is an essential and critical step in ascertaining adverse events (AEs). This report reviews elicitation methods used in published clinical trials of psychopharmacological agents in children. METHOD: Pediatric psychopharmacology reports were reviewed for safety methods in the Medline database. Studies were included if they were published 1980 or later, provided data on AEs, and described the ascertainment methodology used for determining them. RESULTS: A review of 196 pediatric psychopharmacology articles depicting safety assessments in clinical studies over the past 22 years revealed that there was no common method used for eliciting or reporting AE data. CONCLUSION: The current inconsistency in safety data ascertainment is a major limitation that likely impairs the ability to promptly and accurately identify drug-induced AEs. Research on how best to standardize safety methods should be considered a priority in pediatric psychopharmacology.}, Language = {eng}, Doi = {10.1097/01.CHI.0000046841.56865.37}, Key = {fds275113} } @article{fds275124, Author = {B Vitiello and MA Riddle and LL Greenhill and JS March and J Levine and RJ Schachar, H Abikoff and JM Zito and JT McCracken and JT Walkup and RL Findling, J Robinson and TB Cooper and M Davies and E Varipatis and MJ Labellarte, L Scahill and L Capasso}, Title = {How can we improve the assessment of safety in child and adolescent psychopharmacology?}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {42}, Number = {6}, Pages = {634-641}, Year = {2003}, Month = {June}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12921470}, Keywords = {Adolescent • Adverse Drug Reaction Reporting Systems • Child • Child, Preschool • Female • Humans • Male • Psychopharmacology* • Psychotropic Drugs • Randomized Controlled Trials as Topic • adverse effects • standards*}, Abstract = {OBJECTIVE: To identify approaches to improving methods for assessing tolerability and safety of psychotropic medications in children and adolescents. METHOD: Strengths and limitations of current methodology were reviewed and possible alternatives examined. RESULTS: Research on the validity of safety evaluation has been extremely limited. No evidence-based "gold standard" exists. Clinical trials remain the best design to establish causality, but sample size limitations prevent the detection of infrequent, though serious, adverse events. Other designs, such as cohort and case-control studies, and approaches, such as mining of large databases, must be considered. CONCLUSION: The current lack of methodological standardization across studies prevents generalizations and meta-analyses. Because the issues relevant to drug safety are diverse, a variety of methodological approaches and instruments are needed. It is, however, possible to adopt standard basic definitions of adverse events, degree of severity, ascertainment methods, and recording procedures, as a common "core," to which more specific assessment instruments can be added. Systematic empirical testing and validation of safety methodology is needed.}, Language = {eng}, Doi = {10.1097/01.CHI.0000046840.90931.36}, Key = {fds275124} } @article{fds275135, Author = {LL Greenhill and B Vitiello and H Abikoff and J Levine and JS March and MA Riddle, L Capasso and TB Cooper and M Davies and P Fisher and RL Findling, J Fried and MJ Labellarte and JT McCracken and D McMahon and J Robinson, A Skrobala and L Scahill and E Varipatis and JT Walkup and JM Zito}, Title = {Developing methodologies for monitoring long-term safety of psychotropic medications in children: report on the NIMH conference, September 25, 2000.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {42}, Number = {6}, Pages = {651-655}, Year = {2003}, Month = {June}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12921472}, Keywords = {Adolescent • Child • Child, Preschool • Clinical Trials as Topic • Congresses as Topic* • Female • Humans • Long-Term Care* • Male • National Institute of Mental Health (U.S.) • Psychopharmacology • Psychotropic Drugs • Research Design* • Safety • United States • adverse effects • methods • methods*}, Abstract = {OBJECTIVE: To improve the methods for long-term assessment of drug-associated side effects and advance knowledge of the safety profile of psychotropic medications in children and adolescents. METHOD: A multidisciplinary, interactive workshop was hosted by the National Institute of Mental Health (NIMH) and the Research Units on Pediatric Psychopharmacology network. Participants were experts in child and adolescent psychiatry, psychopharmacology, pharmacoepidemiology, and statistics from academia, the pharmaceutical industry, the Food and Drug Administration (FDA), and the NIMH. Evaluation of drug safety was examined from five perspectives: research design and methods, industry, regulatory requirements, bioethics, and practice settings. For each of these areas, special emphasis was placed on identifying barriers and generating solutions. RESULTS: A major obstacle is the lack of standardization of the methods used for collecting safety data. The limitations of both randomized clinical trials and passive postmarketing surveillance in assessing long-term safety were recognized. The need to consider alternative approaches, such as registries and trend analysis of population-based databases, was highlighted. Recommendations were proposed together with possible approaches to implementation. CONCLUSIONS: A concerted effort by academic researchers, industry, FDA, practitioners, and NIMH is needed to standardize methods and lay the foundations for systematic research on the long-term safety of psychotropic medications in children.}, Language = {eng}, Doi = {10.1097/01.CHI.0000046842.56865.EC}, Key = {fds275135} } @article{fds275134, Author = {JS March}, Title = {Acute stress disorder in youth: a multivariate prediction model.}, Journal = {Biol Psychiatry}, Volume = {53}, Number = {9}, Pages = {809-816}, Year = {2003}, Month = {May}, ISSN = {0006-3223}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12725973}, Keywords = {Adolescent • Child • Child, Preschool • Humans • Models, Psychological* • Multivariate Analysis • Predictive Value of Tests • Risk Factors • Stress Disorders, Traumatic, Acute • psychology*}, Abstract = {There is little empirical support for the diagnosis of acute stress disorder (ASD) in children and adolescents. Most reports treat ASD as "provisional posttraumatic stress disorder (PTSD)" (meaning that children evidence ASD on the way to a formal diagnosis of PTSD), while speculating on factors that might moderate or mediate the transformation of ASD into PTSD. This report briefly reviews the literature on ASD in the context of presenting a testable, multivariate model for understanding acute stress responses in youth.}, Language = {eng}, Key = {fds275134} } @article{fds275000, Author = {EB Owens and SP Hinshaw and LE Arnold and DP Cantwell and G Elliott and L Hechtman, PS Jensen and JH Newcorn and JB Severe and B Vitiello and E al}, Title = {Which treatment for whom for ADHD? Moderators of treatment response in the MTA}, Journal = {Journal of Consulting and Clinical Psychology}, Volume = {71}, Number = {3}, Pages = {540-552}, Year = {2003}, url = {http://dx.doi.org/10.1037/0022-006X.71.3.540}, Abstract = {Using receiver operating characteristics, the authors examined outcome predictors (variables associated with outcome regardless of treatment) and moderators (variables identifying subgroups with differential treatment effectiveness) in the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD; MTA). Treatment response was determined using parent- and teacher-reported ADHD and oppositional defiant symptoms, with levels near or within the normal range indicating excellent response. Among 9 baseline child and family characteristics, none predicted but 3 moderated treatment response. In medication management and combined treatments, parental depressive symptoms and severity of child ADHD were associated with decreased rates of excellent response; when these 2 characteristics were present, below-average child IQ was an additional moderator. No predictors or moderators emerged for behavioral and community comparison treatments. The authors discuss conceptual and clinical implications of research on treatment moderators.}, Doi = {10.1037/0022-006X.71.3.540}, Key = {fds275000} } @article{fds275001, Author = {CA Galanter and GA Carlson and PS Jensen and LL Greenhill and M Davies and W Li and SZ Chuang and GR Elliott and LE Arnold and JS March and E al}, Title = {Response to Methylphenidate in Children with Attention Deficit Hyperactivity Disorder and Manic Symptoms in the Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder Titration Trial}, Journal = {Journal of Child and Adolescent Psychopharmacology}, Volume = {13}, Number = {2}, Pages = {123-136}, Year = {2003}, ISSN = {1044-5463}, Abstract = {Objective: Recent reports raise concern that children with attention deficit hyperactivity disorder (ADHD) and some manic symptoms may worsen with stimulant treatment. This study examines the response to methylphenidate in such children. Methods: Data from children participating in the 1-month methylphenidate titration trial of the Multimodal Treatment Study of Children with ADHD were reanalyzed by dividing the sample into children with and without some manic symptoms. Two "mania proxies" were constructed using items from the Diagnostic Interview Schedule for Children (DISC) or the Child Behavior Checklist (CBCL). Treatment response and side effects are compared between participants with and without proxies. Results: Thirty-two (11%) and 29 (10%) participants fulfilled criteria for the CBCL mania proxy and DISC mania proxy, respectively. Presence or absence of either proxy did not predict a greater or lesser response or side effects. Conclusion: Findings suggest that children with ADHD and manic symptoms respond robustly to methylphenidate during the first month of treatment and that these children are not more likely to have an adverse response to methylphenidate. Further research is needed to explore how such children will respond during long-term treatment. Clinicians should not a priori avoid stimulants in children with ADHD and some manic symptoms.}, Key = {fds275001} } @article{fds275003, Author = {LE Arnold and M Elliott and L Sachs and HC Kraemer and HB Abikoff and CK Conners, LL Greenhill and SP Hinshaw and PS Jensen and E al}, Title = {Effects of ethnicity on treatment attendance, stimulant response/dose, and 14-month outcome in ADHD}, Journal = {Journal of Consulting and Clinical Psychology}, Volume = {71}, Number = {4}, Pages = {713-727}, Year = {2003}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037/0022-006X.71.4.713}, Abstract = {From the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder - a randomized clinical trial of 579 children ages 7-9 years receiving 14 months of medication management, behavioral treatment, combination, or community care - the authors matched each African American and Latino participant with randomly selected Caucasian participants of same sex, treatment group, and site. Although Caucasian children were significantly less symptomatic than African American and Latino children on some ratings, response to treatment did not differ significantly by ethnicity after controlling for public assistance. Ethnic minority families cooperated with and benefited significantly from combination (multimodal) treatment (d = 0.36. compared with medication). This incremental gain withstood statistical control for mother's education, single-parent status, and public assistance. Treatment for lower socioeconomic status minority children, especially if comorbid, should combine medication and behavioral treatment.}, Doi = {10.1037/0022-006X.71.4.713}, Key = {fds275003} } @article{fds275063, Author = {DG Kondo and AK Chrisman and JS March}, Title = {An evidence-based medicine approach to combined treatment for ADHD in children and adolescents.}, Journal = {Psychopharmacol Bull}, Volume = {37}, Number = {3}, Pages = {7-23}, Year = {2003}, ISSN = {0048-5764}, url = {http://www.ncbi.nlm.nih.gov/pubmed/14608237}, Abstract = {Psychiatrists need to update their skills to incorporate advances in psychiatric practice and to do so "at the bedside."To this end, evidence-based medicine (EBM), which is widely used as an educational heuristic in other areas medicine and has begun to make inroad in psychiatry training programs, provides practical methods to access, evaluate, and interpret the medical literature regarding disease causation, prognosis, diagnostic tests, and treatment strategies.With respect to treatment, EBM asserts the primacy of randomized, controlled trials for demonstrating efficacy, and, in some cases, the use of meta-analytic or systematic literature reviews conducted according to pre-specified criteria. Using the common clinical problem of when and how to combine drug and psychosocial interventions at the level of the individual patient, this article illustrates the principles of EBM as they pertain to how best to combine drug and psychosocial treatments for children and adolescents with ADHD.}, Key = {fds275063} } @article{fds275067, Author = {J March and S Silva and S Petrycki and J Curry and K Wells and J Fairbank and B Burns and M Domino and B Vitiello and J Severe and C Casat and J Kolker and N Feeny and R Findling and S Stull and S Baab and B Waslick and M Sweeney and L Kentgen and R Kandel and J Walkup and G Ginsburg and E Kastelik and H Koo, C Kratochvil and D May and R LaGrone and M Harrington and AM Albano, G Hirsch and T Knibbs and E Capili and M Reinecke and B Leventhal, C Nageotte and G Rogers and S Pathak and F Sallee and E Cottingham, J Wells and P Rohde and A Simons and J Grimm and K Hadjiyannakis, E Weller and M Robins and R Weller and N Jessani and G Emslie, B Kennard and C Hughes and M Ruberu and N Benazon and D Rosenberg, M Butkus and M Bartoi and G Clarke and D Brent and G Koch}, Title = {Treatment for Adolescents with Depression Study (TADS): Rationale, design, and methods}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {42}, Number = {5}, Pages = {531-542}, Year = {2003}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.CHI.0000046839.90931.0D}, Abstract = {Objectives: A rapidly growing empirical literature on the treatment of major depressive disorder (MDD) in youth supports the efficacy of short-term treatment with depression-specific cognitive-behavioral therapy or medication management with a selective serotonin reuptake inhibitor. These studies also identify a substantial probability of partial response and of relapse, which might be addressed by more intensive, longer-term treatments. Method: Funded by the National Institute of Mental Health, the Treatment for Adolescents With Depression Study (TADS) is a multicenter, randomized, masked effectiveness trial designed to evaluate the short-term (12-week) and long-term (36-week) effectiveness of four treatments for adolescents with MDD: fluoxetine, cognitive-behavioral therapy, their combination, and, acutely, pill placebo. A volunteer sample of 432 subjects aged 12-17 years (inclusive) with a primary DSM-IV diagnosis of MDD who are broadly representative of patients seen in clinical practice will enter the study. The primary dependent measures rated blindly by an independent evaluator are the Children's Depression Rating Scale and, for responder analysis, a dichotomized Clinical Global Impressions- Improvement score. Consistent with an intent-to-treat analysis, all patients, regardless of treatment status, return for all scheduled assessments. Results: This report describes the design of the trial, the rationale for the design choices made, and the methods used to carry out the trial. Conclusion: When completed, TADS will improve our understanding of how best to initiate treatment for adolescents with MDD.}, Doi = {10.1097/01.CHI.0000046839.90931.0D}, Key = {fds275067} } @article{fds275076, Author = {L Amaya-Jackson and V Reynolds and MC Murray and G McCarthy and A Nelson, MS Cherney and R Lee and E Foa and JS March}, Title = {Cognitive-Behavioral Treatment for Pediatric Posttraumatic Stress Disorder: Protocol and Application in School and Community Settings}, Journal = {Cognitive and Behavioral Practice}, Volume = {10}, Number = {3}, Pages = {204-213}, Year = {2003}, url = {http://dx.doi.org/10.1016/S1077-7229(03)80032-9}, Abstract = {This paper describes a multimodality trauma treatment protocol (MMTT) for children and adolescents with PTSD. Based upon empirically validated cognitive-behavioral methods of treating PTSD in adults and anxiety and aggression in children, MMTT was developed as a group intervention administered in schools to treat children and adolescents exposed to single-incident trauma resulting in PTSD. In this paper, the protocol development and outcome data are described, followed by a detailed overview of the protocol. Attention is given to clinical implications for both school and community mental health center application of the protocol.}, Doi = {10.1016/S1077-7229(03)80032-9}, Key = {fds275076} } @article{fds275087, Author = {P Barrett and L Healy and JS March}, Title = {Behavioral avoidance test for childhood obsessive-compulsive disorder: A home-based observation}, Journal = {American Journal of Psychotherapy}, Volume = {57}, Number = {1}, Pages = {80-100}, Year = {2003}, Abstract = {Obsessive-compulsive disorder (OCD) is one of the most debilitating of the anxiety disorders. As our knowledge about this childhood condition continues to grow, there is a need for controlled treatment-outcome trials with precise assessments that are sensitive to treatment change, to guide the development of effective interventions. To evaluate the efficacy of a treatment protocol, it is necessary to have reliable and sensitive measures of OCD symptoms, including measures of obsessions, compulsions, and related levels of distress and avoidance. Whilst structured diagnostic interviews, semistructured clinical interviews, and self-report measures have been widely used in the assessment of childhood OCD, related levels of behavioral distress and avoidance have not been measured in treatment-outcome trials. This study investigated the sensitivity of a behavioral avoidance test (BAT), conducted in the home environment, in assessing treatment-outcome effects for children and adolescents with OCD following a 14-week cognitive-behavioral therapy (CBT) family intervention, in comparison to children in an 8-week "waitlist" control group. The results of the current study strongly support the sensitivity of a standardized BAT in assessing treatment-related changes in children and adolescents with OCD. Implications and future directions for research are discussed.}, Key = {fds275087} } @article{fds275127, Author = {M Franklin and E Foa and JS March}, Title = {The pediatric obsessive-compulsive disorder treatment study: rationale, design, and methods.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {13 Suppl 1}, Pages = {S39-S51}, Year = {2003}, ISSN = {1044-5463}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12880499}, Keywords = {Adolescent • Child • Data Interpretation, Statistical • Humans • Multicenter Studies as Topic • Obsessive-Compulsive Disorder • Psychiatric Status Rating Scales • Quality Assurance, Health Care • Randomized Controlled Trials as Topic • Research Design • drug therapy • psychology • therapy*}, Abstract = {Obsessive-compulsive disorder (OCD), which has a prevalence of 1 in 200 in children and adolescents, carries with it significant functional morbidity. A growing empirical literature supports the efficacy of short-term treatment with OCD-specific cognitive-behavior therapy (CBT) or medication management with a selective serotonin reuptake inhibitor. These and other studies also identify a substantial probability of partial response and, possibly, differences in durability when treatment is discontinued between medication and CBT. The Pediatric OCD Treatment Study is a multicenter, randomized, masked clinical trial designed to evaluate the relative benefit and durability of four treatments for children and adolescents with OCD: sertraline, CBT, combination of sertraline and CBT, and pill placebo. Stage 1 (12 weeks) is a balanced randomized comparison of these four treatments. Responders at the end of stage 1 advance to 4 months of open follow-up in their assigned arm during which all treatment is discontinued. At the end of stage 2 (if not before), nonresponders to any treatment at the end of stage 1, any patient relapsing in stage 2, and all stage 1 placebo patients receive open treatment that is tailored to the patient's needs. A volunteer sample of 120 subjects between the ages of 7 and 17 inclusive with a primary Diagnostic and Statistical Manual of Mental Disorders (fourth edition) diagnosis of OCD enters the study. All patients, regardless of responder status, return for all scheduled assessments. This report describes the design of the trial, the rationale for the design choices made, and the methods used to carry out the trial.}, Language = {eng}, Doi = {10.1089/104454603322126331}, Key = {fds275127} } @article{fds275154, Author = {EJ Costello and DS Pine and C Hammen and JS March and PM Plotsky and MM Weissman, J Biederman and HH Goldsmith and J Kaufman and PM Lewinsohn, M Hellander and K Hoagwood and DS Koretz and CA Nelson and JF Leckman}, Title = {Development and natural history of mood disorders.}, Journal = {Biol Psychiatry}, Volume = {52}, Number = {6}, Pages = {529-542}, Year = {2002}, Month = {September}, ISSN = {0006-3223}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12361667}, Keywords = {Adolescent • Age Factors • Child • Evidence-Based Medicine • Humans • Mood Disorders • National Institute of Mental Health (U.S.) • Practice Guidelines as Topic • Research • Treatment Outcome • United States • diagnosis • economics • education • epidemiology* • therapy • trends*}, Abstract = {To expand and accelerate research on mood disorders, the National Institute of Mental Health (NIMH) developed a project to formulate a strategic research plan for mood disorder research. One of the areas selected for review concerns the development and natural history of these disorders. The NIMH convened a multidisciplinary Workgroup of scientists to review the field and the NIMH portfolio and to generate specific recommendations. To encourage a balanced and creative set of proposals, experts were included within and outside this area of research, as well as public stakeholders. The Workgroup identified the need for expanded knowledge of mood disorders in children and adolescents, noting important gaps in understanding the onset, course, and recurrence of early-onset unipolar and bipolar disorder. Recommendations included the need for a multidisciplinary research initiative on the pathogenesis of unipolar depression encompassing genetic and environmental risk and protective factors. Specifically, we encourage the NIMH to convene a panel of experts and advocates to review the findings concerning children at high risk for unipolar depression. Joint analyses of existing data sets should examine specific risk factors to refine models of pathogenesis in preparation for the next era of multidisciplinary research. Other priority areas include the need to assess the long-term impact of successful treatment of juvenile depression and known precursors of depression, in particular, childhood anxiety disorders. Expanded knowledge of pediatric-onset bipolar disorder was identified as a particularly pressing issue because of the severity of the disorder, the controversies surrounding its diagnosis and treatment, and the possibility that widespread use of psychotropic medications in vulnerable children may precipitate the condition. The Workgroup recommends that the NIMH establish a collaborative multisite multidisciplinary Network of Research Programs on Pediatric-Onset Bipolar Disorder to achieve a better understanding of its causes, course, treatment, and prevention. The NIMH should develop a capacity-building plan to ensure the availability of trained investigators in the child and adolescent field. Mood disorders are among the most prevalent, recurrent, and disabling of all illnesses. They are often disorders of early onset. Although the NIMH has made important strides in mood disorders research, more data, beginning with at-risk infants, children, and adolescents, are needed concerning the etiology and developmental course of these disorders. A diverse program of multidisciplinary research is recommended to reduce the burden on children and families affected with these conditions.}, Language = {eng}, Key = {fds275154} } @article{fds275104, Author = {H Abikoff and LE Arnold and JH Newcorn and GR Elliott and L Hechtman and JB Severe, T Wigal and C Shapiro and DP Cantwell and CK Conners and LL Greenhill, SP Hinshaw and B Hoza and PS Jensen and HC Kraemer and JS March, WE Pelham and JM Swanson and B Vitiello and KC Wells}, Title = {Emergency/Adjunct services and attrition prevention for randomized clinical trials in children: the MTA manual-based solution.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {41}, Number = {5}, Pages = {498-504}, Year = {2002}, Month = {May}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12014781}, Keywords = {Attention Deficit Disorder with Hyperactivity • Behavior Therapy • Bias (Epidemiology) • Central Nervous System Stimulants • Child • Combined Modality Therapy • Emergency Services, Psychiatric* • Female • Guidelines as Topic* • Humans • Male • Multicenter Studies as Topic • Outcome and Process Assessment (Health Care) • Patient Dropouts • Randomized Controlled Trials as Topic • Referral and Consultation* • statistics & numerical data* • therapeutic use • therapy*}, Abstract = {Treatment studies in child and adolescent psychiatry are increasingly characterized by long-term, multisite, randomized clinical trials (RCTs). During the course of these RCTs it is common for clinical exigencies to emerge that require rapid, direct intervention. The challenge is to provide clinically appropriate responses that do not contaminate the delivery, distinctness, and interpretation of the treatments under investigation. In multisite studies, the problem is compounded by the need to minimize cross-site differences in the delivery of adjunct treatments. Such minimization requires fully operationalized and manual-based procedures for clinically mandated intervention. The NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (ADHD)--"the MTA"--is a long-term multisite collaborative study in which children with ADHD were randomly assigned to either medication management, behavioral treatment, the combination, or community-comparison assessment and referral. In designing its study, the MTA developed a manual-based set of procedures (the MTA Adjunct Services and Attrition Prevention [ASAP] Manual) for situations not covered by the protocol treatments. The majority of cases requiring adjunct services fell into two major categories: (1) crisis/emergent situations and (2) imminent risk of attrition. This report describes the ASAP guidelines for dealing with cases that required adjunct services that the MTA Steering Committee adopted before initiating the trial. Although the manual-based guidelines are especially applicable to multisite RCTs, many of the procedures in the ASAP Manual can apply to any treatment study in children.}, Language = {eng}, Doi = {10.1097/00004583-200205000-00006}, Key = {fds275104} } @article{fds274997, Author = {R Rieppi and LL Greenhill and RE Ford and S Chuang and M Wu and M Davies and HB Abikoff and LE Arnold and CK Conners and GR Elliott and E al}, Title = {Socioeconomic Status as a Moderator of ADHD Treatment Outcomes}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {41}, Number = {3}, Pages = {269-277}, Year = {2002}, url = {http://dx.doi.org/10.1097/00004583-200203000-00006}, Abstract = {Objective: To explore whether socioeconomic status (SES) variables moderate treatment response of attention-deficit/hyperactivity disorder (ADHD) to medication management (MedMgt), behavioral treatment (Beh), combined intervention (Comb), and routine community care (CC). Method: The MTA Cooperative Group's intent-to-treat (ITT) analyses were repeated, covarying for composite Hollingshead SES, education, occupation, income, and marital status. Results: Individual SES variables were more informative than the composite Hollingshead Index. Treatment response of children from less educated households paralleled ITT outcomes: no significant difference was found between Comb and MedMgt (both better than Beh and CC) for core ADHD symptoms. However, children from more educated families showed superior reduction of ADHD symptoms with Comb. For oppositional-aggressive symptoms, children from blue-collar, lower SES households benefited most from Comb, whereas those from white-collar, higher SES homes generally showed no differential treatment response. Household income and marital status failed to influence outcomes. Controlling for treatment attendance attenuated the moderating effects of the SES variables only for MedMgt. Conclusions: Investigators are encouraged to use independent SES variables for maximal explanation of SES effects. Clinicians should prioritize target symptoms and consider the mediating role of treatment adherence when determining an ADHD patient's optimal intervention plan.}, Doi = {10.1097/00004583-200203000-00006}, Key = {fds274997} } @article{fds274998, Author = {HB Abikoff and PS Jensen and LLE Arnold and B Hoza and L Hechtman and S Pollack, D Martin and J Alvir and JS March and S Hinshaw and E al}, Title = {Observed classroom behavior of children with ADHD: Relationship to gender and comorbidity}, Journal = {Journal of Abnormal Child Psychology}, Volume = {30}, Number = {4}, Pages = {349-359}, Year = {2002}, url = {http://dx.doi.org/10.1023/A:1015713807297}, Abstract = {Examined hypothesized gender and comorbidity differences in the observed classroom behavior of children with attention deficit hyperactivity disorder (ADHD). The behavior of 403 boys and 99 girls with ADHD, ages 7-10, was compared (a) to observed, sex-specific classroom behavior norms, (b) by sex, and (c) by comorbid subgroups. Boys and girls with ADHD deviated significantly from classroom norms on 15/16 and 13/16 categories, respectively. Compared to comparison girls, girls with ADHD had relatively high rates of verbal aggression to children. Boys with ADHD engaged in more rule-breaking and externalizing behaviors than did girls with ADHD, but the sexes did not differ on more "neutral," unobtrusive behaviors. The sex differences are consistent with notions of why girls with ADHD are identified and referred later than boys. Contrary to hypothesis, the presence of comorbid anxiety disorder (ANX) was not associated with behavioral suppression; yet, as hypothesized, children with a comorbid disruptive behavior disorder (DBD) had higher rates of rule-breaking, and impulsive and aggressive behavior, than did children with ADHD alone and those with ADHD+ANX. Elevated rates of ADHD behaviors were also observed in children with comorbid DBD, indicating that these behaviors are truly present and suggesting that reports of higher ADHD ratings in this subgroup are not simply a consequence of negative halo effects and rater biases.}, Doi = {10.1023/A:1015713807297}, Key = {fds274998} } @article{fds274999, Author = {JM Swanson and LE Arnold and B Vitiello and HB Abikoff and KC Wells and WE Pelham, JS March and SP Hinshaw and B Hoza and JN Epstein and E al}, Title = {Response to commentary on the multimodal treatment study of ADHD (MTA): Mining the meaning of the MTA}, Journal = {Journal of Abnormal Child Psychology}, Volume = {30}, Number = {4}, Pages = {327-332}, Year = {2002}, ISSN = {0091-0627}, url = {http://dx.doi.org/10.1023/A:1015709706388}, Abstract = {In the December 2000 issue of the Journal of Abnormal Child Psychology, we published a set of papers presenting secondary analyses of the Multimodal Treatment Study of ADHD (MTA), and R. A. Barkley (2000) provided a commentary. A critique of the design of the study (MTA Cooperative Group, 1999) was presented based on a theoretical perspective of a "behavioral inhibition" deficit that has been hypothesized as the core deficit of ADHD (R. A. Barkley, 1997). The commentary questioned the design and analysis of the MTA in terms of (1) the empirical criteria for selection of components of behavioral (Beh) intervention, (2) the effectiveness of the Beh intervention, (3) the methods for analyses at the group and individual level, (4) implications of the MTA findings for clinical practice, (5) the role of genetics in response to treatment, and (6) the lack of a nontreatment control group. In this response, we relate the content of the papers to the commentary, (1) by reviewing the selection criteria for the Beh treatment, as outlined by K. C. Wells, W. E. Pelham, et al. (2000), (2) by addressing the myth that the MTA Beh treatment was ineffective (Pelham, 1999), (3) by describing the use of analyses at the level of the individual participant, as presented by J. S. March et al. (2000) and W. E. Pelham et al. (2000) as well as elsewhere by J. M. Swanson et al. (2001) and C. K. Conners et al. (2001), (4) by relating some of the suggestions from the secondary analyses about clinically relevant factors such as comorbidity (as presented by J. S. March et al., 2000) and family and parental characteristics (as presented by B. Hoza et al., 2000, S. P. Hinshaw et al., 2000, and K. C. Wells, J. N. Epstein, et al., 2000), (5) by discussing the statistical concept of heritability and the lack of a significant difference in the presence of ADHD symptoms in parents of the MTA families compared to parents in the classmate-control families (as presented by J. N. Epstein, et al., 2000), and (6) by acknowledging that an ethically necessary weakness of the MTA design is that it did not include a no-treatment control group. We discuss the use of secondary analyses to suggest how, when, and for what subgroups effectiveness of the Beh treatment may have been manifested. Finally, we invite others to use the large and rich data set that will soon be available in the public domain, to perform secondary analyses to mine the meaning of the MTA and to evaluate theories of ADHD and response to treatments.}, Doi = {10.1023/A:1015709706388}, Key = {fds274999} } @article{fds275084, Author = {JS March}, Title = {Combining medication and psychosocial treatments: An evidence-based medicine approach}, Journal = {International Review of Psychiatry}, Volume = {14}, Number = {2}, Pages = {155-163}, Year = {2002}, url = {http://dx.doi.org/10.1080/09540260220132671}, Abstract = {In a perfectly evidence-based world, selecting an appropriate treatment regimen for the anxious child from among the many possible options would be reasonably straightforward. In the complex world of clinical practice, choices are rarely so clear-cut. Many experts recommend the combination of medication and psychosocial treatment as offering the best chance of normalization. Despite a lack of supporting evidence, valid reasons for combining treatment include the presence of comorbidity and the propensity of single treatments to yield partial response. Within the conceptual framework of evidence-based medicine (EBM), this article provides a conceptual framework for how to combine drug and psychosocial treatments at the level of the individual patient.}, Doi = {10.1080/09540260220132671}, Key = {fds275084} } @article{fds275085, Author = {CJ Kratochvil and MJ Harrington and WJ Burke and JS March}, Title = {Pharmacotherapy of childhood anxiety disorders.}, Journal = {Current psychiatry reports}, Volume = {4}, Number = {4}, Pages = {264-269}, Year = {2002}, Abstract = {Anxiety disorders are among the most common psychiatric disorders of childhood, yet limited data is available regarding the use of psychotropic medications for these conditions. Until recently, much of the data on the pharmacologic treatment of pediatric anxiety disorders has consisted of case reports and small open-label studies, with the exception of pediatric obsessive-compulsive disorder (OCD), which has had a comparatively rich literature consisting of several double blind trials. This void has been lessening, however, with four double blind, placebo-controlled studies published in the past year alone. Although the majority of pharmacologic studies of pediatric anxiety continue to focus on the treatment of OCD, additional reports on treatment of generalized anxiety disorder, panic disorder, social anxiety disorder, and separation anxiety disorder have recently been published. This article will review significant pharmacologic studies published in the prior year, and the role of pharmacotherapy in the treatment of pediatric anxiety disorders.}, Key = {fds275085} } @article{fds275086, Author = {J Walkup and H Abikoff and S Hack and B Klee and RL Bergman and D Lynn and J McCracken, J March and P Gammon and J Robinson and E al}, Title = {Treatment of pediatric anxiety disorders: An open-label extension of the research units on pediatric psychopharmacology anxiety study}, Journal = {Journal of Child and Adolescent Psychopharmacology}, Volume = {12}, Number = {3}, Pages = {175-188}, Year = {2002}, ISSN = {1044-5463}, Abstract = {Background: An 8-week placebo-controlled study, the Research Units on Pediatric Psychopharmacology Anxiety Study, documented beneficial effects of fluvoxamine in the treatment of pediatric social anxiety, separation anxiety, or generalized anxiety disorders. Following completion of this study, participants were invited to enter a 6-month open-label treatment phase designed to examine three issues: (a) long-term maintenance of response in fluvoxamine responders, (b) acute response to fluoxetine in fluvoxamine nonresponders, and (c) acute response to fluvoxamine in placebo nonresponders. Methods: Participants aged 6-17 years meeting criteria for social anxiety, separation anxiety, or generalized anxiety disorders previously treated in an 8-week placebo-controlled trial (n = 128) were offered open treatment. Changes in symptoms of anxiety during open treatment were assessed in three groups: (a) fluvoxamine responders maintained on fluvoxamine, (b) fluvoxamine nonresponders changed to fluoxetine, and (c) placebo nonresponders changed to fluvoxamine. Response was defined based on Clinical Global Impression criteria. Results: During 6 months of continued open treatment, anxiety symptoms remained low in 33 of 35 (94%) subjects who initially responded to fluvoxamine. Among 14 fluvoxamine nonresponders switched to fluoxetine, anxiety symptoms appeared significantly improved in 10 (71%) subjects. Finally, among 48 placebo nonresponders, 27 (56%) showed clinically significant improvement in anxiety on fluvoxamine. Conclusion: The current findings concerning extended treatment of pediatric anxiety disorders are only preliminary, because treatment was uncontrolled. Results suggest that an initial fluvoxamine response is likely to be retained with continued treatment, that some fluvoxamine nonresponders may respond to fluoxetine, and that some placebo nonresponders may respond to fluvoxamine.}, Key = {fds275086} } @article{fds275163, Author = {L Giulino and P Gammon and K Sullivan and M Franklin and E Foa and R Maid and JS March}, Title = {Is parental report of upper respiratory infection at the onset of obsessive-compulsive disorder suggestive of pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection?}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {12}, Number = {2}, Pages = {157-164}, Year = {2002}, ISSN = {1044-5463}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12188984}, Keywords = {Adolescent • Autoimmune Diseases • Caregivers* • Chi-Square Distribution • Child • Female • Humans • Male • Obsessive-Compulsive Disorder • Parents • Respiratory Tract Infections • Retrospective Studies • Streptococcal Infections • Streptococcus pyogenes* • complications* • diagnosis}, Abstract = {The diagnosis of pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) requires a prospectively determined association between group A beta-hemolytic streptococcal (GABHS) infection and obsessive-compulsive disorder (OCD) or tic disorder. Screening for GABHS infection imposes a significant burden on both patient and clinician. To heighten the index of suspicion for PANDAS, it would be useful to know if parent-reported upper respiratory infection (URI) is associated with PANDAS symptoms or associated characteristics. Eighty-three consecutive, clinically referred patients aged 6 to 17 years with a primary diagnosis of OCD and their primary caregivers were asked about URI signs and symptoms at the time of OCD onset, PANDAS symptoms, OCD and tic symptoms, comorbidity, and putative PANDAS risk factors. Specific inquiry regarding URI symptoms proved more informative than general inquiry. In the URI present versus URI absent group, more patients experienced a sudden rather than insidious onset of symptoms. Additionally, more patients with a URI plus sudden onset exhibited a comorbid tic disorder. Until validated biomarkers permit retrospective diagnosis, a history that OCD began around the time of a URI should clue the clinician to look prospectively for PANDAS. Additional research is required to define the boundaries of PANDAS and to develop psychometrically reliable and valid diagnostic strategies.}, Language = {eng}, Doi = {10.1089/104454602760219199}, Key = {fds275163} } @article{fds275146, Author = {JS March and B Vitiello}, Title = {Advances in paediatric neuropsychopharmacology: an overview.}, Journal = {Int J Neuropsychopharmacol}, Volume = {4}, Number = {2}, Pages = {141-147}, Year = {2001}, Month = {June}, ISSN = {1461-1457}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11466164}, Keywords = {Adolescent • Autoimmunity • Child • Depressive Disorder, Major • Humans • Mental Disorders • National Institutes of Health (U.S.) • Neuropharmacology • Obsessive-Compulsive Disorder • Panic Disorder • Pediatrics • Psychopharmacology • Psychotropic Drugs • Sleep Disorders • Streptococcal Infections • United States • drug therapy • drug therapy* • immunology • microbiology • psychology • therapeutic use* • trends*}, Abstract = {This Special Section of Int J Neuropsychopharmacol highlights current progress in paediatric neuropsychopharmacology. Combining critical reviews and, in some cases, new data, specific topics include: biological findings in major depression, sleep dysregulation in depressed youth, cardiovascular and ventilatory dysregulation in panic disorder, paediatric autoimmune neuropsychiatric disorder associated with strep (PANDAS), age of onset as a subtype marker in tic and obsessive--compulsive disorders (OCD), functional and pharmaconeuroanatomy of OCD and the behavioural pharmacokinetics of methylphenidate. In this introductory section, these articles are placed in the context of the state-of-the field and, more specifically, within the framework of recent NIMH initiatives in paediatric neuropsychopharmacology.}, Language = {eng}, Doi = {10.1017/S1461145701002346}, Key = {fds275146} } @article{fds275064, Author = {SN Compton and PJ Grant and AK Chrisman and PJ Gammon and VL Brown and JS March}, Title = {Sertraline in children and adolescents with social anxiety disorder: an open trial.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {40}, Number = {5}, Pages = {564-571}, Year = {2001}, Month = {May}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11349701}, Abstract = {OBJECTIVE: The aim of this open-label study was to assess the therapeutic benefits, response pattern, and safety of sertraline in children with social anxiety disorder. METHOD: Fourteen outpatient subjects with a primary Axis I diagnosis of social anxiety disorder were treated in an 8-week open trial of sertraline. Diagnostic and primary outcome measures included the Anxiety Disorders Interview Schedule for Children, Clinical Global Impressions scale (CGI), Social Phobia and Anxiety Inventory for Children, and a standardized behavioral avoidance test. RESULTS: As measured by the CGI (Improvement subscale), 36% (5/14) of subjects were classified as treatment responders and 29% (4/14) as partial responders by the end of the 8-week trial. A significant clinical response appeared by week 6. Self-report and behavioral measures showed significant clinical improvement into normal range across all domains measured. The mean dose of sertraline was 123.21+/-37.29 mg per day. Sertraline was generally well tolerated. CONCLUSION: In open treatment, sertraline resulted in significant improvement in symptoms of childhood social anxiety disorder. Absolute response rates varied depending on rating scales used. Findings from this study are sufficiently strong to warrant a future multisite, randomized, double-blind, placebo-controlled trial of sertraline for treatment of childhood social anxiety disorder.}, Doi = {10.1097/00004583-200105000-00016}, Key = {fds275064} } @article{fds275168, Author = {JS March and M Franklin and A Nelson and E Foa}, Title = {Cognitive-behavioral psychotherapy for pediatric obsessive-compulsive disorder.}, Journal = {J Clin Child Psychol}, Volume = {30}, Number = {1}, Pages = {8-18}, Year = {2001}, Month = {March}, ISSN = {0047-228X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11294080}, Keywords = {Adolescent • Behavior Therapy • Child • Cognitive Therapy • Conditioning, Operant • Extinction, Psychological • Humans • Obsessive-Compulsive Disorder • Prognosis • Risk Factors • Treatment Outcome • diagnosis • methods* • psychology • therapy*}, Abstract = {Discusses the cognitive-behavioral psychotherapy for pediatric obsessive-compulsive disorder (OCD). Over the past 15 years, cognitive-behavioral psychotherapy has emerged as the psychosocial treatment of choice for OCD across lifespan. Unlike other psychotherapies that have been applied usually unsuccessfully to OCD, cognitive-behavioral treatment (CBT) presents a logically consistent and compelling relationship between the disorder, the treatment, and the specified outcome. Nevertheless, despite a consensus that CBT is usually helpful, clinicians routinely complain that patients will not comply with behavioral treatments and parents routinely complain that clinicians are poorly trained in CBT, with the result that many if not most children and adolescents are denied access to effective psychosocial treatment. This unfortunate situation may be avoidable, given an increased understanding regarding the implementation of CBT in children and adolescents with OCD. To this end, we review the principles and the practical aspects of the cognitive-behavioral treatment of OCD in youth, move on to discuss empirical studies supporting the use of CBT in the pediatric age group, and conclude by discussing directions for future research.}, Language = {eng}, Doi = {10.1207/S15374424JCCP3001_3}, Key = {fds275168} } @article{fds275074, Author = {CK Conners and JN Epstein and JS March and A Angold and KC Wells and J Klaric, JM Swanson and LE Arnold and HB Abikoff and GR Elliott and LL Greenhill, L Hechtman and SP Hinshaw and B Hoza and PS Jensen and HC Kraemer, JH Newcorn and WE Pelham and JB Severe and B Vitiello and T Wigal}, Title = {Multimodal treatment of ADHD in the MTA: an alternative outcome analysis.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {40}, Number = {2}, Pages = {159-167}, Year = {2001}, Month = {February}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11211364}, Abstract = {OBJECTIVE: To conduct a post hoc investigation of the utility of a single composite measure of treatment outcome for the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) at 14 months postbaseline. BACKGROUND: Examination of multiple measures one at a time in the main MTA intent-to-treat outcome analyses failed to detect a statistically significant advantage of combined treatment (Comb) over medication management (MedMgt). A measure that increases power and precision using a single outcome score may be a useful alternative to multiple outcome measures. METHOD: Factor analysis of baseline scores yielded two "source factors" (parent and teacher) and one "instrument factor" (parent-child interactions). A composite score was created from the average of standardized parent and teacher measures. RESULTS: The composite was internally consistent (alpha = .83), reliable (test-retest over 3 months = 0.86), and correlated 0.61 with clinician global judgments. In an intent-to-treat analysis, Comb was statistically significantly better than all other treatments, with effect sizes ranging from small (0.28) versus MedMgt, to moderately large (0.70) versus a community comparison group. CONCLUSIONS: A composite of ADHD variables may be an important tool in future treatment trials with ADHD and may avoid some of the statistical limitations of multiple measures.}, Doi = {10.1097/00004583-200102000-00010}, Key = {fds275074} } @article{fds275088, Author = {ED Levin and CK Conners and D Silva and W Canu and J March}, Title = {Effects of chronic nicotine and methylphenidate in adults with attention deficit/hyperactivity disorder.}, Journal = {Exp Clin Psychopharmacol}, Volume = {9}, Number = {1}, Pages = {83-90}, Year = {2001}, Month = {February}, ISSN = {1064-1297}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11519638}, Abstract = {Acute nicotine treatment has been found to reduce symptoms of attention deficit/hyperactivity disorder in adults (E. D. Levin, C. K. Conners, et al., 1996). In this study, chronic nicotine effects were compared with placebo and methylphenidate. Acute and chronic nicotine treatment significantly attenuated the rise in hit reaction time standard error over session blocks on the Conners Continuous Performance Test (C. K. Conners et al., 1996). Acute nicotine significantly reduced severity of clinical symptoms on the Clinical Global Impressions scale (National Institute of Mental Health, 1985). Nicotine caused a significant decrease in self-report of depressive mood as measured by the Profile of Mood States test (D. M. McNair, M. Lorr, & L. F. Droppleman, 1981). This small study (40 participants) provided evidence that nicotine treatment can reduce severity of attentional deficit symptoms and produce improvement on an objective computerized attention task.}, Key = {fds275088} } @article{fds138665, Author = {J.S. March}, Title = {Sahoo T, Goenaga-Diaz E, Serebreiiskii IG, Thomas JW, Kotova E, Cuellar JG, Peloquin JM, Golemis E, Beitinjaneh F, Green ED, Johnson EW, and Marchuk DA. Computational and experimental analyses reveal previously undetected coding exons of the KRIT1 (CCM1) gene. Genomics, 71:123-126, 2001.}, Year = {2001}, Key = {fds138665} } @article{fds274990, Author = {ME Franklin and DF Tolin and JS March and EB Foa}, Title = {Treatment of pediatric obsessive-compulsive disorder: A case example of intensive cognitive-behavioral therapy involving exposure and ritual prevention}, Journal = {Cognitive and Behavioral Practice}, Volume = {8}, Number = {4}, Pages = {297-304}, Year = {2001}, Abstract = {The development of effective pharmacotherapies for pediatric obsessive-compulsive disorder (OCD) has improved the clinical prognosis for children and adolescents who suffer from the disorder. Recent pilot work has also suggested that cognitive-behavioral therapy (CBT) involving exposure and ritual prevention (EX/RP) may prove particularly helpful in ameliorating OCD symptoms in children and adolescents. The application of intensive CBT of a 12-year-old boy with severe and unusual OCD symptoms is illustrated here. Case material is presented, illustrating the design and implementation of CBT involving EX/RP; recommendations to guide clinical decision making regarding session frequency, concomitant medication use, and maintenance of treatment gains are provided. Copyright © 2001 by Association for Advancement of Behavior.}, Key = {fds274990} } @article{fds274991, Author = {PS Jensen and SP Hinshaw and JM Swanson and LL Greenhill and CK Conners and LE Arnold and HB Abikoff and G Elliott and L Hechtman and E al}, Title = {Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): Implications and applications for primary care providers}, Journal = {Journal of Developmental and Behavioral Pediatrics}, Volume = {22}, Number = {1}, Pages = {60-73}, Year = {2001}, ISSN = {0196-206X}, Abstract = {In 1992, the National Institute of Mental Health and 6 teams of investigators began a multisite clinical trial, the Multimodal Treatment of Attention-Deficit Hyperactivity Disorder (MTA) study. Five hundred seventy-nine children were randomly assigned to either routine community care (CC) or one of three study-delivered treatments, all lasting 14 months. The three MTA treatments-monthly medication management (usually methylphenidate) following weekly titration (MedMgt), intensive behavioral treatment (Beh), and the combination (Comb)-were designed to reflect known best practices within each treatment approach. Children were assessed at four time points in multiple outcome. Results indicated that Comb and MedMgt interventions were substantially superior to Beh and CC interventions for attention-deficit hyperactivity disorder symptoms. For other functioning domains (social skills, academics, parent-child relations, oppositional behavior, anxiety/depression), results suggested slight advantages of Comb over single treatments (MedMgt, Beh) and community care. High quality medication treatment characterized by careful yet adequate dosing, three times daily methylphenidate administration, monthly follow-up visits, and communication with schools conveyed substantial benefits to those children that received it. In contrast to the overall study findings that showed the largest benefits for high quality medication management (regardless of whether given in the MedMgt or Comb group), secondary analyses revealed that Comb had a significant incremental effect over MedMgt (with a small effect size for this comparison) when categorical indicators of excellent response and when composite outcome measures were used. In addition, children with parent-defined comorbid anxiety disorders, particularly those with overlapping disruptive disorder comorbidities, showed preferential benefits to the Beh and Comb interventions. Parental attitudes and disciplinary practices appeared to mediate improved response to the Beh and Comb interventions.}, Key = {fds274991} } @article{fds274992, Author = {LL Greenhill and JM Swanson and B Vitiello and M Davies and W Clevenger and M Wu and LE Arnold and HB Abikoff and OG Bukstein and CK Conners and E al}, Title = {Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {40}, Number = {2}, Pages = {180-187}, Year = {2001}, ISSN = {0890-8567}, Abstract = {Objective: Results of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention- Deficit/Hyperactivity Disorder (MTA) were analyzed to determine whether a double-blind, placebo-controlled methylphenidate (MPH) titration trial identified the best MPH dose for each child with attention-deficit/hyperactivity disorder (ADHD). Method: Children with ADHD assigned to MTA medication treatment groups (n = 289) underwent a controlled 28-day titration protocol that administered different MPH doses (placebo, low, middle, and high) on successive days. Results: A repeated-measures analysis of variance revealed main effects for MPH dose with greater effects on teacher ratings of impairment and deportment (F 3 = 100.6, n = 223, p = .0001; effect sizes 0.8-1.3) than on parent ratings of similar endpoints (F 3 = 55.61, n = 253, p = .00001; effect sizes 0.4-0.6). Dose did not interact with period, dose order, comorbid diagnosis, site, or treatment group. Conclusions: The MTA titration protocol validated the efficacy of weekend MPH dosing and established a total daily dose limit of 35 mg of MPH for children weighing less than 25 kg. It replicated previously reported MPH response rates (77%), distribution of best doses (10-50 mg/day) across subjects, effect sizes on impairment and deportment, as well as dose-related adverse events.}, Key = {fds274992} } @article{fds274993, Author = {B Vitiello and JB Severe and LL Greenhill and LE Arnold and HB Abikoff and OG Bukstein and GR Elliott and L Hechtman and PS Jensen and E al}, Title = {Methylphenidate dosage for children with ADHD over time under controlled conditions: Lessons from the MTA}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {40}, Number = {2}, Pages = {188-196}, Year = {2001}, ISSN = {0890-8567}, Abstract = {Objectives: To examine the trajectory of methylphenidate (MPH) dosage over time, following a controlled titration, and to ascertain how accurately the titration was able to predict effective long-term treatment in children with attention-deficit/hyperactivity disorder (ADHD). Method: Using the 14-month-treatment database of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA), the outcome of the initial placebo-controlled, double-blind, randomized daily switch titration of MPH was compared with the subsequent maintenance pharmacotherapy. Children received monthly monitoring visits and, when needed, medication adjustments. Results: Of the 198 children for whom MPH was the optimal treatment at titration (mean ± SD dose: 30.5 ± 14.2 mg/day), 88% were still taking MPH at the end of maintenance (mean dose 34.4 ± 13.3 mg/day), Titration-determined dose and end-of-maintenance dose were significantly correlated (r = 0.52-0.68). Children receiving combined pharmacotherapy and behavioral treatment ended maintenance on a lower dose (31.1 ± 11.7 mg/day) than did children receiving pharmacotherapy only (38,1 ± 14.2 mg/day). Of the 230 children for whom titration identified an optimal treatment, 17% continued both the assigned medication and dosage throughout maintenance. The mean number of pharmacological changes per child was 2.8 ± 1.8 (SD), and time to first change was 4.7 months ± 0.3 (SE). Conclusions: For most children, initial titration found a dose of MPH in the general range of the effective maintenance dose, but did not prevent the need for subsequent maintenance adjustments. For optimal pharmacological treatment of ADHD, both careful initial titration and ongoing medication management are needed.}, Key = {fds274993} } @article{fds274994, Author = {JM Swanson and HC Kraemer and SP Hinshaw and LE Arnold and CK Conners and HB Abikoff and W Clevenger and M Davies and GR Elliott and LL Greenhill and E al}, Title = {Clinical relevance of the primary findings of the MTA: Success rates based on severity of ADHD and ODD symptoms at the end of treatment}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {40}, Number = {2}, Pages = {168-179}, Year = {2001}, ISSN = {0890-8567}, Abstract = {Objectives: To develop a categorical outcome measure related to clinical decisions and to perform secondary analyses to supplement the primary analyses of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA). Method: End-of-treatment status was summarized by averaging the parent and teacher ratings of attention-deficit/hyperactivity disorder and oppositional defiant disorder symptoms on the Swanson, Nolan, and Pelham, version IV (SNAP-IV) scale, and low symptom-severity ("Just a Little") on this continuous measure was set as a clinical cutoff to form a categorical outcome measure reflecting successful treatment. Three orthogonal comparisons of the treatment groups (combined treatment [Comb], medication management [MedMgt], behavioral treatment [Beh], and community comparison [CC]) evaluated hypotheses about the MTA medication algorithm ("Comb + MedMgt versus Beh + CC"), multimodality superiority ("Comb versus MedMgt"), and psychosocial substitution ("Beh versus CC"). Results: The summary of SNAP-IV ratings across sources and domains increased the precision of measurement by 30%. The secondary analyses of group differences in success rates (Comb = 68%; MedMgt = 56%; Beh = 34%; CC = 25%) confirmed the large effect of the MTA medication algorithm and a smaller effect of multimodality superiority, which was now statistically significant (p < .05). The psychosocial substitution effect remained negligible and nonsignificant. Conclusion: These secondary analyses confirm the primary findings and clarify clinical decisions about the choice between multimodal and unimodal treatment with medication.}, Key = {fds274994} } @article{fds274995, Author = {PS Jensen and SP Hinshaw and HC Kraemer and N Lenora and JH Newcorn and HB Abikoff, JS March and LE Arnold and DP Cantwell and E al}, Title = {ADHD comorbidity findings from the MTA study: Comparing comorbid subgroups}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {40}, Number = {2}, Pages = {147-158}, Year = {2001}, ISSN = {0890-8567}, Abstract = {Objectives: Previous research has been inconclusive whether attention-deficit/hyperactivity disorder (ADHD), when comorbid with disruptive disorders (oppositional defiant disorder [ODD] or conduct disorder [CD]), with the internalizing disorders (anxiety and/or depression), or with both, should constitute separate clinical entities. Determination of the clinical significance of potential ADHD + internalizing disorder or ADHD + ODD/CD syndromes could yield better diagnostic decision-making, treatment planning, and treatment outcomes. Method: Drawing upon cross-sectional and longitudinal information from 579 children (aged 7-9.9 years) with ADHD participating in the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA), investigators applied validational criteria to compare ADHD subjects with and without comorbid internalizing disorders and ODD/CD. Results: Substantial evidence of main effects of internalizing and externalizing comorbid disorders was found. Moderate evidence of interactions of parent-reported anxiety and ODD/CD status were noted on response to treatment, indicating that children with ADHD and anxiety disorders (but no ODD/CD) were likely to respond equally well to the MTA behavioral and medication treatments. Children with ADHD-only or ADHD with ODD/CD (but without anxiety disorders) responded best to MTA medication treatments (with or without behavioral treatments), while children with multiple comorbid disorders (anxiety and ODD/CD) responded optimally to combined (medication and behavioral) treatments. Conclusions: Findings indicate that three clinical profiles, ADHD co-occurring with internalizing disorders (principally parent-reported anxiety disorders) absent any concurrent disruptive disorder (ADHD + ANX), ADHD co-occurring with ODD/CD but no anxiety (ADHD + ODD/CD), and ADHD with both anxiety and ODD/CD (ADHD + ANX + ODD/CD) may be sufficiently distinct to warrant classification as ADHD subtypes different from "pure" ADHD with neither comorbidity. Future clinical, etiological, and genetics research should explore the merits of these three ADHD classification options.}, Key = {fds274995} } @article{fds274996, Author = {LL Greenhill and B Vitiello and H Abikoff and J Levine and JS March and MA Riddle, L Capasso and T Cooper and M Davies and P Fisher and E al}, Title = {Improving the methods for evaluating the safety of psychotropic medications in children and adolescents}, Journal = {Current Therapeutic Research - Clinical and Experimental}, Volume = {62}, Number = {12}, Pages = {873-884}, Year = {2001}, ISSN = {0011-393X}, url = {http://dx.doi.org/10.1016/S0011-393X(01)80092-8}, Abstract = {Background: Given the considerable importance of drug safety in children and adolescents and the potential effects of psychotropic medications on growth rates and developing central neurotransmitter systems, there is a need for valid methods for detecting possible drug-induced adverse events during prolonged exposure. Objectives: The aims of this study were to discuss challenges involved in the collection of safety information on psychotropic medications when administered to children and adolescents and suggest methods for improving existing approaches. Methods: Current methods for collecting and assessing safety data during pediatric psychopharmacological trials are critiqued and possible alternatives reviewed. Results: Methods used for collecting and assessing drug safety data remain less sophisticated than efficacy evaluations. Multisite trials, although demonstrating statistical power to detect placebo/active drug differences, remain too small to detect infrequent but serious drug-related adverse events. Other active surveillance approaches, such as long-duration follow-up studies and clinical epidemiological studies, using case-control, cohort designs, or trend analysis of population-based treatment data must be used. Conclusions: Research is needed to standardize the basic ascertainment approaches, definitions of adverse events, lists of preferred terms, and recording procedures to a common core battery. A possible approach to developing and testing these procedures is proposed. Then more detailed lists of drug-related adverse events can be added, which can be study specific. The increasing use of psychotropic medications in youths should be accompanied by increased efforts to standardize the ascertainment of drug-related adverse events.}, Doi = {10.1016/S0011-393X(01)80092-8}, Key = {fds274996} } @article{fds275056, Author = {DS Pine and JT Walkup and MJ Labellarte and MA Riddle and L Greenhill and R Klein, M Davies and M Sweeney and H Abikoff and S Hack and E al}, Title = {Fluvoxamine for the treatment of anxiety disorders in children and adolescents}, Journal = {New England Journal of Medicine}, Volume = {344}, Number = {17}, Pages = {1279-1285}, Year = {2001}, ISSN = {0028-4793}, url = {http://dx.doi.org/10.1056/NEJM200104263441703}, Abstract = {Background: Drugs that selectively inhibit serotonin reuptake are effective treatments for adults with mood and anxiety disorders, but limited data are available on the safety and efficacy of serotonin-reuptake inhibitors in children with anxiety disorders. Methods: We studied 128 children who were 6 to 17 years of age; who met the criteria for social phobia, separation anxiety disorder, or generalized anxiety disorder; and who had received psychological treatment for three weeks without improvement. The children were randomly assigned to receive fluvoxamine (at a maximum of 300 mg per day) or placebo for eight weeks and were evaluated with rating scales designed to assess the degree of anxiety and impairment. Results: Children in the fluvoxamine group had a mean (±SD) decrease of 9.7±6.9 points in symp toms of anxiety on the Pediatric Anxiety Rating Scale (range of possible scores, 0 to 25, with higher scores indicating greater anxiety), as compared with a decrease of 3.1±4.8 points among children in the placebo group (P<0.001). On the Clinical Global Impressions-Improvement scale, 48 of 63 children in the fluvoxamine group (76 percent) had a response to the treatment, as indicated by a score of less than 4, as compared with 19 of 65 children in the placebo group (29 percent, P±0.001). Five children in the fluvoxamine group (8 percent) discontinued treatment because of adverse events, as compared with one child in the placebo group (2 percent). Conclusions: Fluvoxamine is an effective treatment for children and adolescents with social phobia, separation anxiety disorder, or generalized anxiety disorder. Copyright © 2001 Massachusetts Medical Society.}, Doi = {10.1056/NEJM200104263441703}, Key = {fds275056} } @article{fds275082, Author = {TL Waters and PM Barrett and JS March}, Title = {Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: Preliminary findings}, Journal = {American Journal of Psychotherapy}, Volume = {55}, Number = {3}, Pages = {372-387}, Year = {2001}, Abstract = {The effectiveness of a 14-week cognitive-behavioral family treatment protocol for childhood obsessive-compulsive disorder (OCD) was piloted using a volunteer sample of seven children aged 10-14 years. The primary outcome measures were diagnostic status, symptom severity, and global functioning which were assessed at pre- and post-treatment, and at three-month followup. A series of self-report measures assessing obsessive-compulsive symptomatology, depression, and family factors were also completed at pre- and post-treatment. The results indicated that six participants no longer met criteria for OCD at post-treatment, with a mean reduction of 60% in symptom severity. Self-reported obsessive-compulsive symptomatology and family involvement in the disorder also significantly decreased across time. The findings support the efficacy of cognitive-behavioral treatment with a structured family component for childhood OCD. Further research investigating the comparative efficacy of treatment with and without family involvement is warranted.}, Key = {fds275082} } @article{fds275083, Author = {EH Cook and KD Wagner and JS March and J Biederman and P Landau and R Wolkow and M Messig}, Title = {Long-term sertraline treatment of children and adolescents with obsessive-compulsive disorder}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {40}, Number = {10}, Pages = {1175-1181}, Year = {2001}, ISSN = {0890-8567}, Abstract = {Objective: To evaluate the safety and effectiveness of sertraline in the long-term treatment of pediatric obsessive-compulsive disorder (OCD). Method: Children (6-12 years; n=72) and adolescents (13-18 years; n=65) with DSM-III-R-defined OCD who had completed a 12-week, double-blind, placebo-controlled sertraline study were given open-label sertraline 50 to 200 mg/day in this 52-week extension study. Concomitant psychotherapy was allowed during the extension study. Outcome was evaluated by the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), National Institute of Mental Health Global Obsessive-Compulsive Scale, and Clinical Global Impression Severity (CGI-S) and Improvement (CGI-I) scores. Results: Significant improvement (p<.0001) was demonstrated on all four outcome parameters on an intent-to-treat analysis for the overall study population (n=132), as well as the child and the adolescent samples. At endpoint, 72% of children and 61% of adolescents met response criteria (>25% decrease in CY-BOCS and a CGI-I score of 1 or 2). Significant (p<.05) improvements were also demonstrated from the extension study baseline to endpoint on all outcome parameters in those patients who received sertraline during the 12-week, double-blind acute study. Long-term sertraline treatment was well tolerated, and there were no discontinuations due to changes in vital signs, laboratory values, or electrocardiograms. Conclusion: Sertraline (50-200 mg/day) was effective and generally well tolerated in the treatment of childhood and adolescent OCD for up to 52 weeks. Improvement was seen with continued treatment.}, Key = {fds275083} } @article{fds274986, Author = {KC Wells and JN Epstein and SP Hinshaw and CK Conners and J Klaric and HB Abikoff, A Abramowitz and LE Arnold and G Elliott and LL Greenhill and L Hechtman, B Hoza and PS Jensen and JS March and W Pelham and L Pfiffner and J Severe and JM Swanson and B Vitiello and T Wigal}, Title = {Parenting and family stress treatment outcomes in attention deficit hyperactivity disorder (ADHD): an empirical analysis in the MTA study.}, Journal = {J Abnorm Child Psychol}, Volume = {28}, Number = {6}, Pages = {543-553}, Year = {2000}, Month = {December}, ISSN = {0091-0627}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11104316}, Abstract = {Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7-9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD.}, Key = {fds274986} } @article{fds274988, Author = {KC Wells and WE Pelham and RA Kotkin and B Hoza and HB Abikoff and A Abramowitz, LE Arnold and DP Cantwell and CK Conners and R Del Carmen and G Elliott and LL Greenhill and L Hechtman and E Hibbs and SP Hinshaw, PS Jensen and JS March and JM Swanson and E Schiller}, Title = {Psychosocial treatment strategies in the MTA study: rationale, methods, and critical issues in design and implementation.}, Journal = {J Abnorm Child Psychol}, Volume = {28}, Number = {6}, Pages = {483-505}, Year = {2000}, Month = {December}, ISSN = {0091-0627}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11104313}, Abstract = {The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7-9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.}, Key = {fds274988} } @article{fds275147, Author = {JS March and JM Swanson and LE Arnold and B Hoza and CK Conners and SP Hinshaw, L Hechtman and HC Kraemer and LL Greenhill and HB Abikoff and LG Elliott and PS Jensen and JH Newcorn and B Vitiello and J Severe and KC Wells and WE Pelham}, Title = {Anxiety as a predictor and outcome variable in the multimodal treatment study of children with ADHD (MTA).}, Journal = {J Abnorm Child Psychol}, Volume = {28}, Number = {6}, Pages = {527-541}, Year = {2000}, Month = {December}, ISSN = {0091-0627}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11104315}, Keywords = {Anxiety • Attention Deficit Disorder with Hyperactivity • Central Nervous System Stimulants • Child • Combined Modality Therapy • Comorbidity • Conduct Disorder • Confounding Factors (Epidemiology) • Diagnosis, Differential • Female • Humans • Male • Negativism • Odds Ratio • Predictive Value of Tests • Prognosis • Psychiatric Status Rating Scales • Socioenvironmental Therapy* • Treatment Outcome • drug therapy • epidemiology • psychology • psychology* • therapeutic use* • therapy*}, Abstract = {Initial moderator analyses in the Multimodal Treatment Study of Children with ADHD (MTA) suggested that child anxiety ascertained by parent report on the Diagnostic Interview Schedule for Children 2.3 (DISC Anxiety) differentially moderated the outcome of treatment. Left unanswered were questions regarding the nature of DISC Anxiety, the impact of comorbid conduct problems on the moderating effect of DISC Anxiety, and the clinical significance of DISC Anxiety as a moderator of treatment outcome. Thirty-three percent of MTA subjects met DSM-III-R criteria for an anxiety disorder excluding simple phobias. Of these, two-thirds also met DSM-III-R criteria for comorbid oppositional-defiant or conduct disorder whereas one-third did not, yielding an odds ratio of approximately two for DISC Anxiety, given conduct problems. In this context, exploratory analyses of baseline data suggest that DISC Anxiety may reflect parental attributions regarding child negative affectivity and associated behavior problems (unlike fearfulness), particularly in the area of social interactions, another core component of anxiety that is more typically associated with phobic symptoms. Analyses using hierarchical linear modeling (HLM) indicate that the moderating effect of DISC Anxiety continues to favor the inclusion of psychosocial treatment for anxious ADHD children irrespective of the presence or absence of comorbid conduct problems. This effect, which is clinically meaningful, is confined primarily to parent-reported outcomes involving disruptive behavior, internalizing symptoms, and inattention; and is generally stronger for combined than unimodal treatment. Contravening earlier studies, no adverse effect of anxiety on medication response for core ADHD or other outcomes in anxious or nonanxious ADHD children was demonstrated. When treating ADHD, it is important to search for comorbid anxiety and negative affectivity and to adjust treatment strategies accordingly.}, Language = {eng}, Key = {fds275147} } @article{fds275055, Author = {SN Compton and AH Nelson and JS March}, Title = {Social phobia and separation anxiety symptoms in community and clinical samples of children and adolescents.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {39}, Number = {8}, Pages = {1040-1046}, Year = {2000}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10939233}, Abstract = {OBJECTIVE: To examine the developmental progression and pattern of self-reported symptoms of social phobia (SP) and separation anxiety (SA) in community (n = 2,384) and clinical (n = 217) samples of children and adolescents, using a cross-sectional method. METHOD: Subjects were cross-classified by age, gender, and race. Using mean scores on the SP and SA subscales of the Multidimensional Anxiety Scale for Children, 4 categories of children were established: HighSP/HighSA, HighSP/LowSA, LowSP/HighSA, and LowSP/LowSA. Data were analyzed using a generalized logit model. RESULTS: Community sample: Preadolescents and females reported more symptoms of HighSP/HighSA and LowSP/HighSA than adolescents and males. White children reported more symptoms of HighSP/LowSA, while the opposite pattern was found among African-American children. Clinical sample: Similar to the community sample, preadolescents reported more symptoms of HighSP/HighSA. However, clinical males reported more symptoms of LowSP/HighSA than clinical females. CONCLUSIONS: In general, adolescents endorsed more symptoms of SP and fewer symptoms of SA than preadolescent children. Irrespective of age, white children endorsed more symptoms of SP and fewer symptoms of SA than African-American children. In the community sample, preadolescent boys endorsed more symptoms of SA and fewer symptoms of SP, suggesting a possible referral bias.}, Doi = {10.1097/00004583-200008000-00020}, Key = {fds275055} } @article{fds274987, Author = {SP Hinshaw and EB Owens and KC Wells and HC Kraemer and HB Abikoff and LE Arnold, CK Conners and G Elliott and LL Greenhill and E al}, Title = {Family processes and treatment outcome in the MTA: Negative/ineffective parenting practices in relation to multimodal treatment}, Journal = {Journal of Abnormal Child Psychology}, Volume = {28}, Number = {6}, Pages = {555-568}, Year = {2000}, ISSN = {0091-0627}, url = {http://dx.doi.org/10.1023/A:1005183115230}, Abstract = {To elucidate processes underlying therapeutic change in a large-scale randomized clinical trial, we examined whether alterations in self-reported parenting practices were associated with the effects of behavioral, medication, or combination treatments on teacher-reported outcomes (disruptive behavior, social skills, internalizing symptoms) in children with attention-deficit hyperactivity disorder (ADHD). Participants were 579 children with Combined-type ADHD, aged 7-9.9 years, in the Multimodal Treatment Study of Children with ADHD (MTA). We uncovered 2 second-order factors of parenting practices, entitled Positive Involvement and Negative/Ineffective Discipline. Although Positive Involvement was not associated with amelioration of the school-based outcome measures, reductions in Negative/Ineffective Discipline mediated improvement in children's social skills at school. For families showing the greatest reductions in Negative/Ineffective Discipline, effects of combined medication plus behavioral treatment were pronounced in relation to regular community care. Furthermore, only in combination treatment (and not in behavioral treatment alone) was decreased Negative/Ineffective Discipline associated with reduction in children's disruptive behavior at school. Here, children in families receiving combination treatment who showed the greatest reductions in Negative/Ineffective Discipline had teacher-reported disruptive behavior that was essentially normalized. Overall, the success of combination treatment for important school-related outcomes appears related to reductions in negative and ineffective parenting practices at home; we discuss problems in interpreting the temporal sequencing of such process-outcome linkages and the means by which multimodal treatment may be mediated by psychosocial processes related to parenting.}, Doi = {10.1023/A:1005183115230}, Key = {fds274987} } @article{fds274989, Author = {JS March}, Title = {Imipramine plus cognitive behavioural therapy (CBT) was more effective than placebo plus CBT in adolescents with comorbid anxiety and depression who refused to attend school: Commentary}, Journal = {Evidence-Based Mental Health}, Volume = {3}, Number = {4}, Pages = {107-}, Year = {2000}, ISSN = {1362-0347}, url = {http://dx.doi.org/10.1136/ebmh.3.4.107}, Doi = {10.1136/ebmh.3.4.107}, Key = {fds274989} } @article{fds275160, Author = {JS March and K Sullivan}, Title = {Test-retest reliability of the Multidimensional Anxiety Scale for Children.}, Journal = {J Anxiety Disord}, Volume = {13}, Number = {4}, Pages = {349-358}, Year = {1999}, Month = {July}, ISSN = {0887-6185}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10504106}, Keywords = {Adolescent • African Americans • Age Factors • Anxiety Disorders • Child • Child Psychology • European Continental Ancestry Group • Female • Humans • Male • Psychiatric Status Rating Scales • Psychometrics • Reproducibility of Results • Sex Factors • diagnosis* • ethnology • methods* • psychology* • standards*}, Abstract = {We examined the test-retest reliability of the Multidimensional Anxiety Scale for Children (MASC) in a school-based sample of children and adolescents. One classroom at each grade from 3 to 12 was randomly selected to participate. Teachers were trained to administer the MASC at baseline and again 3 weeks later. The intraclass correlation coefficient (ICC) was used to estimate stability of the MASC over time. For both single case and mean ICCs, the MASC exhibited satisfactory to excellent stability across all factors and subfactors. Stability was unaffected by age or gender, but was lower for African American than Caucasian subjects. Satisfactory test-retest reliability also was demonstrated for two empirically derived subscales, the MASC-10 and Anxiety Index.}, Language = {eng}, Key = {fds275160} } @article{fds274981, Author = {TE Wilens and J Biederman and JS March and R Wolkow and CS Fine and RB Millstein, SV Faraone and D Geller and TJ Spencer}, Title = {Absence of cardiovascular adverse effects of sertraline in children and adolescents}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {38}, Number = {5}, Pages = {573-577}, Year = {1999}, ISSN = {0890-8567}, Abstract = {Objective: In a 12 week, placebo-controlled, parallel-design, multicenter study of sertraline for obsessive-compulsive disorder in 107 children and 80 adolescents, the authors prospectively assessed cardiovascular effects to doses of sertraline of ≤200 mg/day. Method: Vital signs (blood pressure and heart rate) and electrocardiograph parameters (ECGs) were systematically evaluated at baseline and again throughout treatment. Results: There were no clinically significant cardiovascular adverse events in any of the subjects enrolled in the study. Moreover, compared with baseline and placebo, sertraline treatment at an average dose of 167 mg did not result in any clinically meaningful changes in any ECG indices (PR, QRS, and QTc intervals), cardiac rhythm, blood pressure, or heart rate. Conclusions: These prospectively derived results support the cardiovascular safety of sertraline at doses up to 200 mg in children and adolescents.}, Key = {fds274981} } @article{fds274982, Author = {MA Riddle and GA Bernstein and EH Cook and HL Leonard and JS March and JM Swanson}, Title = {Anxiolytics, adrenergic agents, and naltrexone}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {38}, Number = {5}, Pages = {546-556}, Year = {1999}, ISSN = {0890-8567}, Abstract = {Objective: To review extant data on the efficacy and safety of anxiolytic medications (benzodiazepines, buspirone, and other serotonin 1A agonists), adrenergic agents (β-blockers and α 2-adrenergic agonists clonidine and guanfacine), and the opiate antagonist naltrexone that have been used to treat various psychopathologies in children and adolescents. To identify critical gaps in our current knowledge about these agents and needs for further research. Method: All available controlled trials of these medications in children and adolescents published in English through 1997 were reviewed. In addition, selected uncontrolled studies are included. Results: The major finding, that there are virtually no controlled data that support the efficacy of most of these drugs for the treatment of psychiatric disorders in children and adolescents, is both surprising and unfortunate. For some drugs, e.g., buspirone and guanfacine, this is because no controlled studies have been carried out in children and/or adolescents. For other drugs, e.g., clonidine and naltrexone, most of the placebo-controlled studies have failed to demonstrate efficacy. Conclusions: The strongest recommendations for controlled studies of safety and efficacy in children and adolescents can be given for the following drugs: benzodiazepines for acute anxiety; buspirone (and newer serotonin 1A agonists as they become available) for anxiety and depression; β-blockers for aggressive dyscontrol; guanfacine for attention-deficit/hyperactivity disorder; and naltrexone for hyperactivity, inattention and aggression in autistic disorder.}, Key = {fds274982} } @article{fds274983, Author = {J Swanson and M Lerner and J March and FM Gresham}, Title = {Assessment and intervention for attention-deficit/hyperactivity disorder in the schools: Lessons from the MTA study}, Journal = {Pediatric Clinics of North America}, Volume = {46}, Number = {5}, Pages = {993-1009}, Year = {1999}, ISSN = {0031-3955}, url = {http://dx.doi.org/10.1016/S0031-3955(05)70168-1}, Abstract = {The MTA experience provides several lessons that may have clinical relevance. First, the MTA study identified six key instruments (see Table 1) that clinicians may want to use, but even on these instruments discrepancies in parent and teacher sources should be expected. We believe that unnoticed or unresolved discrepancies may be important factors contributing to the 'disconnect' identified by the Consensus Conference Panel. Based on the MTA experience, we recommend a telephone call to the child's teacher, specifically to inquire about any discrepancy in the 'source by domain' summary, as an efficient way to make a meaningful connection '... between developmental or educational (school-based) assessments and health-related (medical practice-based) services' for children with ADHD. Second, evaluation of pharmacologic intervention in the MTA study confirmed that teachers' reports are crucial for documenting efficacy, whereas parent reports are crucial for documenting side effects. Based on the MTA experience, we recommend frequent telephone contact with the teacher specifically to inquire about the peak effects and dissipation of effects of medication that are expected to occur during the school hours as a way to improve'... communication between diagnosticians and those who implement and monitor treatment in the schools'.}, Doi = {10.1016/S0031-3955(05)70168-1}, Key = {fds274983} } @article{fds274984, Author = {JS March and C Conners and G Arnold and J Epstein and J Parker and S Hinshaw, H Abikoff and B Molina and K Wells and J Newcorn and E al}, Title = {The Multidimensional Anxiety Scale for Children (MASC): Confirmatory factor analysis in a pediatric ADHD sample}, Journal = {Journal of Attention Disorders}, Volume = {3}, Number = {2}, Pages = {85-89}, Year = {1999}, ISSN = {1087-0547}, Abstract = {While considerable attention has been paid to discriminating attention-deficit/hyperactivity and anxiety disorders, there are as yet no published confirmatory factor analytic studies of any self-report anxiety scale in ADHD youth. The Multidimensional Anxiety Scale for Children (MASC) is a 39-item, 4-point Likert self-report scale that robustly represents the factor structure of anxiety in children aged 8 to 18 years. Using confirmatory factor analytic methods, the present paper reports a replication of the four-factor measurement model for the MASC in a large sample of ADHD youth aged 7 to 10 years. The fit indices proved to be comparable to those obtained in the MASC clinical and non-clinical (normative) samples. Clinically, therefore, this report strengthens confidence that the MASC is a valid measure of anxiety in diverse populations. With respect to research, it provides supporting evidence that results obtained using the MASC in the MTA and other research studies reflect valid estimates of anxiety in those samples. Copyright © Multi-Health Systems Inc., 1999.}, Key = {fds274984} } @article{fds274985, Author = {J March}, Title = {CBT plus parental anxiety management was more effective when the child and parent(s) were anxious: Commentary}, Journal = {Evidence-Based Mental Health}, Volume = {2}, Number = {3}, Pages = {76-}, Year = {1999}, ISSN = {1362-0347}, url = {http://dx.doi.org/10.1136/ebmh.2.3.76}, Doi = {10.1136/ebmh.2.3.76}, Key = {fds274985} } @article{fds275075, Author = {CL Donnelly and L Amaya-Jackson and JS March}, Title = {Psychopharmacology of pediatric posttraumatic stress disorder}, Journal = {Journal of Child and Adolescent Psychopharmacology}, Volume = {9}, Number = {3}, Pages = {203-220}, Year = {1999}, ISSN = {1044-5463}, Abstract = {Objective: To review the current knowledge of pharmacotherapy in the treatment of Posttraumatic Stress Disorder (PTSD) as it applies to children and adolescents and to provide a rational approach to medication use in Pediatric PTSD. Method: The literature on the psychopharmacology of Pediatric PTSD is reviewed. Additionally, literature is reviewed on the neurobiological systems presumptively involved in trauma as well as studies in the pharmacology of adult PTSD, as they pertain to the treatment of Pediatric PTSD. Results: There are too few studies in the current Pediatric PTSD literature to confirm treatment recommendations. Downward extrapolation from the adult literature combined with an understanding of the neurobiology of PTSD and its comorbid conditions may serve as the basis for a rational pharmacotherapy of PTSD in childhood. The effectiveness of targeting pharmacological agents at PTSD symptom clusters and associated comorbid conditions remains to be verified in controlled clinical trials. Conclusions: The state of psychopharmacology for Pediatric PTSD is in its earliest stages. While there are insufficient numbers of controlled pharmacological trials to make firm recommendations, the field requires a starting point for a rational psychopharmacological approach. Pharmacotherapy may provide symptom relief of both the debilitating primary symptoms and the comorbid conditions in children suffering from PTSD.}, Key = {fds275075} } @article{fds275144, Author = {JS March and J Biederman and R Wolkow and A Safferman and J Mardekian and EH Cook and NR Cutler and R Dominguez and J Ferguson and B Muller and R Riesenberg, M Rosenthal and FR Sallee and KD Wagner and H Steiner}, Title = {Sertraline in children and adolescents with obsessive-compulsive disorder: a multicenter randomized controlled trial.}, Journal = {JAMA}, Volume = {280}, Number = {20}, Pages = {1752-1756}, Year = {1998}, Month = {November}, ISSN = {0098-7484}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9842950}, Keywords = {Adolescent • Antidepressive Agents • Child • Double-Blind Method • Female • Humans • Male • Obsessive-Compulsive Disorder • Psychological Tests • Serotonin Uptake Inhibitors • Sertraline • Treatment Outcome • drug therapy* • therapeutic use*}, Abstract = {CONTEXT: The serotonin reuptake inhibitors are the treatment of choice for patients with obsessive-compulsive disorder; however, empirical support for this assertion has been weaker for children and adolescents than for adults. OBJECTIVE: To evaluate the safety and efficacy of the selective serotonin reuptake inhibitor sertraline hydrochloride in children and adolescents with obsessive-compulsive disorder. DESIGN: Randomized, double-blind, placebo-controlled trial. PATIENTS: One hundred eighty-seven patients: 107 children aged 6 to 12 years and 80 adolescents aged 13 to 17 years randomized to receive either sertraline (53 children, 39 adolescents) or placebo (54 children, 41 adolescents). SETTING: Twelve US academic and community clinics with experience conducting randomized controlled trials. INTERVENTION: Sertraline hydrochloride was titrated to a maximum of 200 mg/d during the first 4 weeks of double-blind therapy, after which patients continued to receive this dosage of medication for 8 more weeks. Control patients received placebo. MAIN OUTCOME MEASURES: The Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the National Institute of Mental Health Global Obsessive Compulsive Scale (NIMH GOCS), and the NIMH Clinical Global Impressions of Severity of Illness (CGI-S) and Improvement (CGI-I) rating scales. RESULTS: In intent-to-treat analyses, patients treated with sertraline showed significantly greater improvement than did placebo-treated patients on the CY-BOCS (adjusted mean, -6.8vs -3.4, respectively; P=.005), the NIMH GOCS (-2.2 vs -1.3, respectively; P=.02), and the CGI-I (2.7 vs 3.3, respectively; P=.002) scales. Significant differences in efficacy between sertraline and placebo emerged at week 3 and persisted for the duration of the study. Based on CGI-I ratings at end point, 42% of patients receiving sertraline and 26% of patients receiving placebo were very much or much improved. Neither age nor sex predicted response to treatment. The incidence of insomnia, nausea, agitation, and tremor were significantly greater in patients receiving sertraline; 12 (13%) of 92 sertraline-treated patients and 3 (3.2%) of 95 placebo-treated patients discontinued prematurely because of adverse medical events (P=.02). No clinically meaningful abnormalities were apparent on vital sign determinations, laboratory findings, or electrocardiographic measurements. CONCLUSION: Sertraline appears to be a safe and effective short-term treatment for children and adolescents with obsessive-compulsive disorder.}, Language = {eng}, Key = {fds275144} } @article{fds275050, Author = {ED Levin and CK Conners and D Silva and SC Hinton and WH Meck and J March and JE Rose}, Title = {Transdermal nicotine effects on attention.}, Journal = {Psychopharmacology (Berl)}, Volume = {140}, Number = {2}, Pages = {135-141}, Year = {1998}, Month = {November}, ISSN = {0033-3158}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9860103}, Abstract = {Nicotine has been shown to improve attentiveness in smokers and attenuate attentional deficits in Alzheimer's disease patients, schizophrenics and adults with attention-deficit/hyperactivity disorder (ADHD). The current study was conducted to determine whether nicotine administered via transdermal patches would improve attentiveness in non-smoking adults without attentional deficits. The subjects underwent the nicotine and placebo exposure in a counterbalanced double-blind manner. Measures of treatment effect included the Profile of Mood States (POMS), Conners' computerized Continuous Performance Test (CPT) of attentiveness and a computerized interval-timing task. The subjects were administered a 7 mg/day nicotine transdermal patch for 4.5 h during a morning session. Nicotine significantly increased self-perceived vigor as measured by the POMS test. On the CPT, nicotine significantly decreased the number of errors of omission without causing increases in either errors of commission or correct hit reaction time. Nicotine also significantly decreased the variance of hit reaction time and the composite measure of attentiveness. This study shows that, in addition to reducing attentional impairment, nicotine administered via transdermal patches can improve attentiveness in normal adult non-smokers.}, Key = {fds275050} } @article{fds275073, Author = {EJ Costello and A Angold and J March and J Fairbank}, Title = {Life events and post-traumatic stress: the development of a new measure for children and adolescents.}, Journal = {Psychol Med}, Volume = {28}, Number = {6}, Pages = {1275-1288}, Year = {1998}, Month = {November}, ISSN = {0033-2917}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9854269}, Abstract = {BACKGROUND: A new interview measure of life events and post-traumatic stress disorder (PTSD) has been developed for children and adolescents aged 9 through 17, for use in both epidemiological and clinical studies. It includes 'high magnitude' events associated with PTSD as well as other 'low magnitude' events. METHOD: The interview is designed as a module of the Child and Adolescent Psychiatric Assessment, an interviewer-based interview conducted with parent and child separately by trained lay interviewers. The module includes: (1) questions about a wide range of events; (2) a screen for key PTSD symptoms (painful recall, avoidance, hypervigilance); and (3) a detailed interview on all PTSD symptoms, including onset, duration, severity and co-morbidity. A test-retest reliability study was conducted with 58 parents and children, who were interviewed twice by different interviewers. RESULTS: Intraclass correlations were 0.72 (child) and 0.83 (parent) for high magnitude events, and 0.62 (child) and 0.58 (parent) for low magnitude events. Kappa coefficients ranged from high for violence and sexual abuse to low for child reports of serious accidents and natural disasters. The reliability of the PTSD screen symptoms was fair to excellent (kappa = 0.40-0.79), and reliability of PTSD symptoms in those who passed the screen was excellent (ICC = 0.94-0.99). Compared with a general population sample (N = 1015), the clinic-referred subjects and their parents were twice as likely to report a traumatic event and, depending on the event, up to 25 times as likely to report symptoms of PTSD. CONCLUSIONS: The results support the reliability and discriminant validity of the measure.}, Key = {fds275073} } @article{fds275112, Author = {JS March and L Amaya-Jackson and MC Murray and A Schulte}, Title = {Cognitive-behavioral psychotherapy for children and adolescents with posttraumatic stress disorder after a single-incident stressor.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {37}, Number = {6}, Pages = {585-593}, Year = {1998}, Month = {June}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9628078}, Keywords = {Adolescent • Analysis of Variance • Behavior Therapy • Child • Cognitive Therapy • Female • Humans • Internal-External Control • Male • Psychotherapy, Brief • Stress Disorders, Post-Traumatic • methods • methods* • therapy*}, Abstract = {OBJECTIVE: To test the efficacy of a group-administered cognitive-behavioral psychotherapy (CBT) protocol for pediatric posttraumatic stress disorder (PTSD) after a single-incident stressor. METHOD: After a school-wide selection-to-treatment procedure conducted in two elementary and two junior high schools, children and adolescents with DSM-IV PTSD by structured interview were entered into an 18-week, group-administered CBT protocol using a single case across time and setting experimental design. Assessments of PTSD, anxiety, depression, trait anger, locus of control, and disruptive behavior were conducted at baseline, posttreatment, and at 6-month follow-up. RESULTS: Experimental control across time (staggered start date) and setting (school and age) was demonstrated. Fourteen of 17 subjects completed treatment. Of these, 8 (57%) no longer met DSM-IV criteria for PTSD immediately after treatment; 12 (86%) of 14 were free of PTSD at 6-month follow-up. On intent-to-treat analyses, treatment produced a robust beneficial effect posttreatment on the Clinician-Administered PTSD Scale-Child and Adolescent Version, with additional improvement accruing at follow-up (p < .001). Improvements of a similar magnitude were seen for depression (p < .001), anxiety (p < .001), and anger (p < .005). Locus of control remained external from pre- to posttreatment but became strongly internal at follow-up (p < .001). CONCLUSION: More clinical trials are required to confirm that CBT is a safe, acceptable, and effective treatment for PTSD in children and adolescents.}, Language = {eng}, Doi = {10.1097/00004583-199806000-00008}, Key = {fds275112} } @article{fds274978, Author = {JN Epstein and JS March and CK Conners and DL Jackson}, Title = {Racial differences on the Conners Teacher Rating Scale.}, Journal = {J Abnorm Child Psychol}, Volume = {26}, Number = {2}, Pages = {109-118}, Year = {1998}, Month = {April}, ISSN = {0091-0627}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9634133}, Abstract = {Factor congruence and mean differences on the Conners Teacher Rating Scale were assessed across African-American and Caucasian school children. Factor analyses conducted separately by gender revealed similar factors across races for males and females. The main differences in factor structure within gender were the presence of an Antisocial factor in black males and an Inattention factor in white females. Across both males and females, teachers tended to rate black children higher than white children on factors relating to externalizing behaviors. Whether mean differences are a result of teacher bias or actual behavioral differences in the classroom needs further research.}, Key = {fds274978} } @article{fds275156, Author = {JS March and JF Curry}, Title = {Predicting the outcome of treatment.}, Journal = {J Abnorm Child Psychol}, Volume = {26}, Number = {1}, Pages = {39-51}, Year = {1998}, Month = {February}, ISSN = {0091-0627}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9566545}, Keywords = {Adolescent • Adolescent Psychiatry* • Anxiety Disorders • Child • Child Psychiatry* • Decision Making • Forecasting • Humans • Models, Statistical • Psychotherapy • Research Design • Treatment Outcome • therapy* • trends • trends*}, Abstract = {The clinical question--"Which treatment(s) for which patients with what set of subgrouping characteristics working by what mechanism(s)?"--rests at the heart of differential therapeutics. Experimentally, this question reduces to a test of how well we can predict the outcome of treatment using the treatment conditions plus other moderating and mediating variables. Reflecting the discussions held at a recent National Institute of Mental Health (NIMH) conference on psychosocial treatments, and using pediatric anxiety disorders as a case in point, we discuss the problem of prediction in treatment outcome studies from the standpoint of definition of terms, using the general linear model of prediction. We also outline types of studies that may be useful in testing potential predictors, and put forward a possible matrix of predictor variables as currently implemented in an NIMH-funded treatment outcome study of pediatric obsessive-compulsive disorder (OCD). We conclude by making specific suggestions for implementing a broader approach to the study of predictors.}, Language = {eng}, Key = {fds275156} } @article{fds274977, Author = {LL Greenhill and D Pine and J March and B Birmaher and M Riddle}, Title = {Assessment issues in treatment research of pediatric anxiety disorders: What is working, what is not working, what is missing, and what needs improvement}, Journal = {Psychopharmacology Bulletin}, Volume = {34}, Number = {2}, Pages = {155-164}, Year = {1998}, ISSN = {0048-5764}, Abstract = {Reviewing the strengths and weaknesses of the rating scales for anxiety disorders makes it possible to select appropriate measures for use in a multisite treatment study of children and adolescents with DSM-IV-diagnosed anxiety disorders. Categorical diagnosis for study inclusion is provided by the K-SADS-PL, which has strong published psychometrics for anxiety disorders. Broadband symptom ratings of diverse pediatric psychiatric disorder can be obtained at baseline by the parent-scored Child Behavior Checklist. Anxiety symptom monitoring may be provided by the use of two psychometrically strong self-report measures, the MASC and the SCARED. Weekly global ratings are provided by the CGI whose scale points have been enhanced by detailed anchors; in addition, the raters all trained on practice vignettes to calibrate their scoring. Clinician-based ratings of the patient's anxiety symptoms can be carded out in adolescent patients using the HAM-A. The newly developed Children's Anxiety Rating Scale promises to cover the full pediatric age range as a clinician-based anxiety rating instrument, but must first be subjected to formal psychometric and treatment sensitivity evaluation.}, Key = {fds274977} } @article{fds274979, Author = {RA King and H Leonard and J March and W Bernet and JE Dunne and M Adair and V Arnold, RS Benson and O Bukstein and J Kinlan and E al}, Title = {Practice parameters for the assessment and treatment of children and adolescents with obsessive-compulsive disorder}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {37}, Number = {10 SUPPL.}, Pages = {27S-45S}, Year = {1998}, ISSN = {0890-8567}, Abstract = {These practice parameters describe the assessment and treatment of obsessive-compulsive disorder based on a detailed literature review and expert consultation. Obsessive-compulsive disorder is a disorder of heterogeneous origin characterized by intrusive thoughts or compulsive urges or behaviors that are distressing, time-consuming, or functionally impairing. In children and adolescents, the disorder often is accompanied by a wide range of comorbidity, including mood, anxiety, attentional, and learning difficulties, and/or tic disorder. These parameters describe the relevant areas of assessment, especially symptomatology, onset, and course, other associated psychopathology, and developmental, family, and medical history (including postinfectious onset or exacerbations). Two modalities have been systematically assessed and empirically shown to ameliorate core symptoms: cognitive-behavioral therapy (primarily exposure/response prevention) and serotonin reuptake inhibitor medication. Data regarding the indications, efficacy, and implementation of these modalities are reviewed. Because OCD frequently occurs in the context of other psychopathology and adaptive difficulties, additional individual and family psychotherapeutic, pharmacological, and educational interventions often are necessary. Treatment planning guidelines are provided.}, Key = {fds274979} } @article{fds274980, Author = {RA King and H Leonard and J March and W Bernet and JE Dunne and M Adair and V Arnold, RS Benson and O Bukstein and J Kinlan and E al}, Title = {Summary of the practice parameters for the assessment and treatment of children and adolescents with obsessive-compulsive disorder}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {37}, Number = {10}, Pages = {1110-1116}, Year = {1998}, ISSN = {0890-8567}, Abstract = {This summary provides an overview of the assessment, differential diagnosis, and treatment recommendations contained in the Practice Parameters for the Assessment and Treatment of Children and Adolescents with Obsessive- Compulsive Disorder. OCD is a disorder of heterogeneous origin characterized by intrusive thoughts or compulsive urges or behaviors that are distressing, time-consuming, or functionally impairing. In children and adolescents, the disorder often is accompanied by a wide range of comorbidity. Two modalities have been systematically assessed and empirically shown to ameliorate the core symptoms of OCD: cognitive-behavioral therapy (primarily exposure/response prevention) and serotonin reuptake inhibitor medication. Additional individual and family psychotherapeutic, pharmacological, and educational interventions often are necessary.}, Key = {fds274980} } @article{fds275081, Author = {JN Epstein and CK Conners and D Erhardt and JS March and JM Swanson}, Title = {Asymmetrical hemispheric control of visual-spatial attention in adults with attention deficit hyperactivity disorder.}, Journal = {Neuropsychology}, Volume = {11}, Number = {4}, Pages = {467-473}, Year = {1997}, Month = {October}, ISSN = {0894-4105}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9345690}, Abstract = {As neuropsychological mechanisms for attention have been hypothesized to be located in the right hemisphere of the brain, several investigators have begun to conceptualize attention deficit hyperactivity disorder (ADHD)-related attentional deficits as involving right-hemispheric abnormalities. The authors evaluated and compared adult patients diagnosed with ADHD with a non-ADHD group of patients using a chronometric visual-spatial attention task that is sensitive to hemispheric differences in efficiency of information processing. Reaction times across different cuing conditions, cue-target delays, and visual fields were assessed. When participants' attention was misdirected with cues in the right visual field and attention had to be switched to a target on the left visual field, there was a longer delay among ADHD adults than non-ADHD adults, specifically when the interval between the cue and target was 800 ms as compared with 100 ms. This specific pattern of dysfunction was interpreted as a difficulty with maintaining attention possibly associated with anterior attention mechanisms in the right hemisphere.}, Key = {fds275081} } @article{fds203048, Author = {JS March and L Amaya-Jackson and R Terry and P Costanzo}, Title = {Posttraumatic symptomatology in children and adolescents after an industrial fire.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {36}, Number = {8}, Pages = {1080-8}, Year = {1997}, Month = {August}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/00004583-199708000-00015}, Keywords = {Adolescent • Analysis of Variance • Chi-Square Distribution • Child • Comorbidity • Factor Analysis, Statistical • Female • Fires* • Health Surveys • Humans • Male • North Carolina • Regression Analysis • Sampling Studies • Stress Disorders, Post-Traumatic • epidemiology • etiology • psychology*}, Abstract = {OBJECTIVE: This investigation evaluated the extent and nature of posttraumatic symptomatology (PTS) in children and adolescents 9 months after an industrial fire at the imperial Foods chicken-processing plant in Hamlet, North Carolina, caused extensive loss of life. METHODS: Using a PTS self-report measure plus self- and teacher reports of comorbid symptoms the authors surveyed 1,019 fourth- to ninth-grade students in the community where the fire occurred. RESULTS: Three factors comprising PTS were identified: reexperiencing, avoidance and hyperarousal. Reexperiencing and avoidance were positively correlated; hyperarousal proved weakly correlated with reexperiencing, perhaps because exposure was largely indirect. Using a T score cutoff of 65 on the reexperiencing factor as indicative of PTS 9.7% of subjects met criteria for PTS; 11.9% met criteria for posttraumatic stress disorder (PTSD) using DSM-III-R PTSD criteria. Degree of exposure was the most powerful predictor of PTS. Race (African-American) and gender (female) posed significant risk factors for PTS. Self-reported internalizing symptoms and teacher-reported externalizing symptoms were positively predicted by intercurrent PTS, and independently of PTS, by degree of exposure. Comorbid symptoms showed interesting interactions with exposure, race, and gender. Lack of self-attributed personal efficacy predicted PTS but did not moderate the effects of race or gender on PTS risk. CONCLUSIONS: This study, which used a population-based sampling strategy, strengthens and extends findings from earlier literature on pediatric PTSD in showing that (1) PTS and comorbid internalizing and externalizing symptoms rise in direct proportion to degree of exposure; (2) gender and race show variable effects on risk for PTS and comorbid symptoms; and (3) comorbid symptoms are positively correlated with PTS and may represent primary outcomes of traumatic exposure in their own right.}, Language = {eng}, Doi = {10.1097/00004583-199708000-00015}, Key = {fds203048} } @article{fds275176, Author = {JS March and L Amaya-Jackson and R Terry and P Costanzo}, Title = {Posttraumatic symptomatology in children and adolescents after an industrial fire.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {36}, Number = {8}, Pages = {1080-1088}, Year = {1997}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9256587}, Abstract = {OBJECTIVE: This investigation evaluated the extent and nature of posttraumatic symptomatology (PTS) in children and adolescents 9 months after an industrial fire at the imperial Foods chicken-processing plant in Hamlet, North Carolina, caused extensive loss of life. METHOD: Using a PTS self-report measure plus self- and teacher reports of comorbid symptoms the authors surveyed 1,019 fourth- to ninth-grade students in the community where the fire occurred. RESULTS: Three factors comprising PTS were identified: reexperiencing, avoidance and hyperarousal. Reexperiencing and avoidance were positively correlated; hyperarousal proved weakly correlated with reexperiencing, perhaps because exposure was largely indirect. Using a T score cutoff of 65 on the reexperiencing factor as indicative of PTS 9.7% of subjects met criteria for PTS; 11.9% met criteria for posttraumatic stress disorder (PTSD) using DSM-III-R PTSD criteria. Degree of exposure was the most powerful predictor of PTS. Race (African-American) and gender (female) posed significant risk factors for PTS. Self-reported internalizing symptoms and teacher-reported externalizing symptoms were positively predicted by intercurrent PTS, and independently of PTS, by degree of exposure. Comorbid symptoms showed interesting interactions with exposure, race, and gender. Lack of self-attributed personal efficacy predicted PTS but did not moderate the effects of race or gender on PTS risk. CONCLUSIONS: This study, which used a population-based sampling strategy, strengthens and extends findings from earlier literature on pediatric PTSD in showing that (1) PTS and comorbid internalizing and externalizing symptoms rise in direct proportion to degree of exposure; (2) gender and race show variable effects on risk for PTS and comorbid symptoms; and (3) comorbid symptoms are positively correlated with PTS and may represent primary outcomes of traumatic exposure in their own right.}, Doi = {10.1097/00004583-199708000-00015}, Key = {fds275176} } @article{fds203079, Author = {JS March and JD Parker and K Sullivan and P Stallings and CK Conners}, Title = {The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {36}, Number = {4}, Pages = {554-65}, Year = {1997}, Month = {April}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/00004583-199704000-00019}, Keywords = {Adolescent • Analysis of Variance • Anxiety • Child • Cross-Sectional Studies • Factor Analysis, Statistical • Female • Humans • Male • North Carolina • Psychiatric Status Rating Scales • Psychometrics • Reproducibility of Results • Sex Factors • diagnosis* • methods* • psychology* • standards • standards*}, Abstract = {OBJECTIVE: To describe the history, factor structure, reliability, and validity of the Multidimensional Anxiety Scale for Children (MASC). METHODS: In two separate school-based population studies, principal-components factor analysis was used, first, to test a theory-driven factor structure, and second, to develop an empirically derived factor structure for the MASC. In a separate study using a clinical population, test-retest reliability at 3 weeks and 3 months, interrater concordance, and convergent and divergent validity were examined. RESULTS: The final version of the MASC consists of 39 items distributed across four major factors, three of which can be parsed into two subfactors each. Main and subfactors include (1) physical symptoms (tense/restless and somatic/autonomic), (2) social anxiety (humiliation/rejection and public performance fears), (3) harm avoidance (perfectionism and anxious coping), and (4) separation anxiety. The MASC factor structure, which presumably reflects the in the vivo structure of pediatric anxiety symptoms, is invariant across gender and age and shows excellent internal reliability. As expected, females show greater anxiety on all factors and subfactors than males. Three-week and 3-month test-retest reliability was satisfactory to excellent. Parent-child agreement was poor to fair. Concordance was greatest for easily observable symptom clusters and for mother-child over father-child or father-mother pairs. Shared variance with scales sampling symptom domains of interest was highest for anxiety, intermediate for depression, and lowest for externalizing symptoms, indicating adequate convergent and divergent validity. CONCLUSIONS: The MASC is a promising self-report scale for assessing anxiety in children and adolescents.}, Language = {eng}, Doi = {10.1097/00004583-199704000-00019}, Key = {fds203079} } @article{fds275175, Author = {JS March and JD Parker and K Sullivan and P Stallings and CK Conners}, Title = {The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {36}, Number = {4}, Pages = {554-565}, Year = {1997}, Month = {April}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9100431}, Abstract = {OBJECTIVE: To describe the history, factor structure, reliability, and validity of the Multidimensional Anxiety Scale for Children (MASC). METHOD: In two separate school-based population studies, principal-components factor analysis was used, first, to test a theory-driven factor structure, and second, to develop an empirically derived factor structure for the MASC. In a separate study using a clinical population, test-retest reliability at 3 weeks and 3 months, interrater concordance, and convergent and divergent validity were examined. RESULTS: The final version of the MASC consists of 39 items distributed across four major factors, three of which can be parsed into two subfactors each. Main and subfactors include (1) physical symptoms (tense/restless and somatic/autonomic), (2) social anxiety (humiliation/rejection and public performance fears), (3) harm avoidance (perfectionism and anxious coping), and (4) separation anxiety. The MASC factor structure, which presumably reflects the in the vivo structure of pediatric anxiety symptoms, is invariant across gender and age and shows excellent internal reliability. As expected, females show greater anxiety on all factors and subfactors than males. Three-week and 3-month test-retest reliability was satisfactory to excellent. Parent-child agreement was poor to fair. Concordance was greatest for easily observable symptom clusters and for mother-child over father-child or father-mother pairs. Shared variance with scales sampling symptom domains of interest was highest for anxiety, intermediate for depression, and lowest for externalizing symptoms, indicating adequate convergent and divergent validity. CONCLUSION: The MASC is a promising self-report scale for assessing anxiety in children and adolescents.}, Doi = {10.1097/00004583-199704000-00019}, Key = {fds275175} } @article{fds138630, Author = {J.S. March}, Title = {March J, Amaya-Jackson L and Pyoos R (in press): Pediatric post-traumatic stress disorder, in Weiner J (ed): Textbook of Child and Adolescent Psychiatry. Washington,DC:American Psychiatric Press}, Year = {1997}, Key = {fds138630} } @article{fds138631, Author = {J.S. March}, Title = {Penn JV, March JS and Leonard, HL (in press). Obsessive-compulsive disorder in children and adolescents. In Dickstein L: Annual Review of Psychiatry: OCD Accross the Lifecycle, M. Pato (ed), 16: APA Press, Washington, DC}, Year = {1997}, Key = {fds138631} } @article{fds138661, Author = {J.S. March}, Title = {Davidson, J., & March, J. (in press). Traumatic stress disorders. In A. Tasman, J. Kay, & J. Lieberman (Eds.), Psychiatry . Philadelphia: Saunders. March, J., & Mulle, K. (in press). Cognitive-behavioral psychotherapy for obsessive-compulsive disorder. In E. Hibbs & P. Jensen (Eds.), Psychosocial Treatments for Child and Adolescent Disorders: Empirically Based Approaches . Washington: American Psychological Press.}, Year = {1997}, Key = {fds138661} } @article{fds138662, Author = {J.S. March}, Title = {March, J., Leonard, H., & Swedo, S. (in press). Neuropsychiatry of pediatric obsessive compulsive disorder. In E. Coffey & R. Brumback (Eds.), Textbook of Pediatric Neuropsychiatry . Washington: APA Press.}, Year = {1997}, Key = {fds138662} } @article{fds138663, Author = {J.S. March}, Title = {March, J., & Albano, A. (in press). Assessment of anxiety in children and adolescents. In T. Olendick (Ed.), Annual Review of Psychology. Washington: American Pychological Association Press.}, Year = {1997}, Key = {fds138663} } @article{fds274970, Author = {SP Hinshaw and JS March and H Abikoff and LE Arnold and DP Cantwell and CK Conners, GR Elliott and J Halperin and LL Greenhill and LT Hechtman and E al}, Title = {Comprehensive assessment of childhood attention-deficit hyperactivity disorder in the context of a multisite, multimodal clinical trial}, Journal = {Journal of Attention Disorders}, Volume = {1}, Number = {4}, Pages = {217-234}, Year = {1997}, ISSN = {1087-0547}, Abstract = {As the largest randomized clinical trial conducted by the National Institute of Mental Health, the Multimodal Treatment Study of Children with ADHD (MTA) will yield data on a diverse sample of 576 7.0- to 9.9-year-old children with attention-deficit hyperactivity disorder (ADHD), Combined type, regarding the relative and combined effectiveness of psychosocial and pharmacologic interventions. After delineating key challenges posed by such a multisite investigation, we describe the MTA's multiple-gating procedures for recruitment, screening, and diagnosis of a diverse sample. We then discuss the cross-domain assessment battery for tracking the sample before, during, and after 14 months of active intervention. Throughout, we emphasize the guiding principles that shaped pertinent decision making. Highlighted are issues of psychometric adequacy; dimensional vs. categorical measurement; multi-method, multi-agent, and multi-domain coverage; plotting of individual trajectories of development and change; respondent bias and burden; appraisal of treatment processes as well as outcomes; and construction of composite indices. Copyright © Multi-Health Systems Inc., 1997.}, Key = {fds274970} } @article{fds274972, Author = {JN Epstein and NA Goldberg and CK Conners and JS March}, Title = {The effects of anxiety on continuous performance test functioning in an ADHD clinic sample}, Journal = {Journal of Attention Disorders}, Volume = {2}, Number = {1}, Pages = {45-52}, Year = {1997}, ISSN = {1087-0547}, Abstract = {Several research studies have reported that the performance of children with attention deficit hyperactivity disorder (ADHD) on continuous performance tests (CPTs) is affected by comorbid anxiety. However, the specific anxiety domains/symptoms that affect CPT performance as well as the particular CPT performance measures have been inconsistent across studies. The present study examines CPT performance in 158 ADHD clinic-referred children using measures derived from signal detection theory. Regression analyses are conducted to examine whether any of the anxiety domains from the Revised Children's Manifest Anxiety Scale (RCMAS) account for variance on CPT performance measures. The main finding of these analyses is that physiological anxiety appears to increase response inhibition, whereas cognitive anxiety appears to decrease response inhibition. This finding suggests that physiological anxiety alone may be responsible for increased response inhibition/decreased impulsivity in children with comorbid anxiety. These results are interpreted in the context of Gray's model of a behavioral inhibition system. Copyright © Multi-Health Systems Inc., 1997.}, Key = {fds274972} } @article{fds274973, Author = {HL Leonard and J March and KC Rickler and AJ Allen}, Title = {Pharmacology of the selective serotonin reuptake inhibitors in children and adolescents}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {36}, Number = {6}, Pages = {725-736}, Year = {1997}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/00004583-199706000-00008}, Abstract = {Objective: To review the pharmacology of a new class of medications, the potent selective serotonin reuptake inhibitors (SSRIs), what is known about their metabolism in children and adolescents, and the practical clinical implications of such. Method: Articles were retrieved through Index Medicus searches for articles published during the past 10 years on the SSRIs and on pediatric pharmacology. Results: More than 300 articles were reviewed. Pharmacological data, derived from relevant adult literature, were summarized and extrapolated to children and from the limited pediatric literature. The SSRIs represent a new class of antidepressants with distinct advantages in their side effect profile and their broad therapeutic index over that seen with the tricyclic antidepressants. Their advantage of few anticholinergic side effects and limited cardiovascular toxicities are particularly relevant for the pediatric population. The SSRIs are metabolized via the hepatic cytochrome isoenzyme P450 system, and potential drug-drug interactions are reviewed. Conclusions: The SSRIs appear to offer advantages over the tricyclic antidepressants. Unfortunately, pharmacokinetic data are tacking, and systematic studies of safety and efficacy in the pediatric age group are limited. Preliminary reports are encouraging, but further study is required.}, Doi = {10.1097/00004583-199706000-00008}, Key = {fds274973} } @article{fds274974, Author = {R Frost and G Steketee and N Amir and M Bouvard and C Carmin and DA Clark and J Cottraux and J Eisen and P Emmelkamp and E Foa and E al}, Title = {Cognitive assessment of obsessive-compulsive disorder}, Journal = {Behaviour Research and Therapy}, Volume = {35}, Number = {7}, Pages = {667-681}, Year = {1997}, ISSN = {0005-7967}, url = {http://dx.doi.org/10.1016/S0005-7967(97)00017-X}, Abstract = {Recent theories of obsessive-compulsive disorder (OCD) emphasize the importance of cognitive contents (beliefs and appraisals) and cognitive processes in the etiology and maintenance of OCD. In order to evaluate these theories and to assess the mechanisms of treatment-related change, it is necessary to develop measures of the relevant cognitive contents and processes. Several scales have been developed, although many are unpublished and there is a great deal of overlap among measures. The purpose of the present article is to describe the progress of an international group of investigators who have commenced a coordinated effort to develop a standardized set of cognitive measures. This article describes the theoretical bases and clinical importance of such an endeavor, and the proceedings of the working group meetings are summarized. Several methods of assessment are reviewed, including idiographic methods, information processing paradigms, and self-report measures. The working group is currently developing and evaluating self-report measures of appraisals about intrusions, and self-report measures of OC-related beliefs. Consensus ratings indicated that 6 belief domains are likely to be important in OCD. These are beliefs pertaining to: (1) inflated responsibility; (2) overimportance of thoughts; (3) excessive concern about the importance of controlling one's thoughts; (4) overestimation of threat; (5) intolerance of uncertainty; and (6) perfectionism.}, Doi = {10.1016/S0005-7967(97)00017-X}, Key = {fds274974} } @article{fds274975, Author = {LE Arnold and HB Abikoff and DP Cantwell and CK Conners and GR Elliott and LL Greenhill and L Hechtman and SP Hinshaw and B Hoza and PS Jensen and E al}, Title = {NIMH collaborative multimodal treatment study of children with ADHD (MTA): Design, methodology, and protocol evolution}, Journal = {Journal of Attention Disorders}, Volume = {2}, Number = {3}, Pages = {141-158}, Year = {1997}, ISSN = {1087-0547}, Abstract = {The steering committee of the collaborative six-site Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (the MTA) had to develop a common protocol consistent with public health goals and with scientific and clinical state of the art. With the aid of statistical, educational, and public health consultation, the steering committee balanced the stated objectives of the RFA against budgetary, clinical, ethical, and logistical practicalities. Two primary questions will be addressed: (1) What is the relative long-term effectiveness of excellent medication vs. excellent behavioral treatment vs. the combination? (2) What is the relative long-term effectiveness of each of these state-of-the art intense treatments vs. routine community care? In a parallel-group design, 576 children (96 at each site) age 7-9 in grades 1-4 are thoroughly assessed in multiple domains from multiple informants and randomized to 4 treatment conditions: a medication-alone strategy, a psychosocial-treatment-alone strategy, a combination strategy, and community comparison (assessment and referral). The first three groups are treated for 14 months and all are re-assessed periodically for 24 months. Each treatment strategy is multi-component, with compromises between clinical flexibility and cross-site uniformity supported by a multi-tiered supervisory/fidelity structure, including 10 manuals, weekly teleconference panels, site visits, circuit-riding consultants, and feedback loops from therapists and supervisors to the steering committee about clinical realities. The resulting data should not only answer the primary questions above, but also support secondary data analyses about the effect of comorbidity, sex, SES, and other subject characteristics on treatment outcome. The MTA should both provide conclusions useful to the practicing clinician and define questions for the next generation of investigations. Copyright © Multi-Health Systems Inc., 1997.}, Key = {fds274975} } @article{fds274976, Author = {LE Arnold and HB Abikoff and DP Cantwell and CK Conners and G Elliott and LL Greenhill and L Hechtman and SP Hinshaw and B Hoza and E al}, Title = {National Institute of Mental Health Collaborative Multimodal Treatment Study of Children With ADHD (the MTA): Design challenges and choices}, Journal = {Archives of General Psychiatry}, Volume = {54}, Number = {9}, Pages = {865-870}, Year = {1997}, ISSN = {0003-990X}, Abstract = {The Collaborative Multimodal Treatment Study of Children With Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first child multisite cooperative agreement treatment study of children conducted by the National Institute of Mental Health. Rockville, Md. It examines the long-term effectiveness of medication vs behavioral treatment vs both for treatment of ADHD and compares state-of-the-art treatment with routine community care. In a parallel-groups design, 576 children (age, 7-9 years) with ADHD (96 at each site) are thoroughly assessed and randomized to 4 conditions: (1) medication alone, (2) psychosocial treatment alone. (3) the combination of both, (4) or community comparison. The first 3 groups are treated for 14 months and all are reassessed periodically for 24 months. Designers met the following challenges: framing clinically relevant primary questions; defining the target population; choice, intensity, and integration and combination of treatments for fair comparisons; combining scientific controls and standardization with clinical flexibility; and implementing a controlled clinical trial in a nonclinical setting (school) controlled by others. Innovative solutions included extensive decision algorithms and manualized adaptations of treatments to speCifiC needs.}, Key = {fds274976} } @article{fds275148, Author = {JS March and HL Leonard}, Title = {Obsessive-compulsive disorder in children and adolescents: a review of the past 10 years.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {35}, Number = {10}, Pages = {1265-1273}, Year = {1996}, Month = {October}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8885580}, Keywords = {Adolescent • Autoimmune Diseases • Child • Cognitive Therapy • Combined Modality Therapy • Comorbidity • Delirium, Dementia, Amnestic, Cognitive Disorders • Humans • Obsessive-Compulsive Disorder • Serotonin Uptake Inhibitors • Streptococcal Infections • Streptococcus pyogenes • complications • diagnosis • diagnosis* • epidemiology • therapeutic use • therapy}, Abstract = {OBJECTIVE: To review the literature on pediatric obsessive-compulsive disorder (OCD) from the perspective of information relevant to American Board of Psychiatry and Neurology recertification in child and adolescent psychiatry. METHOD: The clinical and research literatures were systematically searched or articles that address the diagnosis and treatment of pediatric OCD. RESULTS: Drawing from the literature and their own clinical experience, the authors note that (1) OCD is a common neuropsychiatric disorder; (2) comorbidity is common, especially with tic, attention-deficit, anxiety, and affective disorders; (3) OCD following group A beta-hemolytic streptococcal infection may define an autoimmune sub-grouping calling for immunomodulatory treatments; and (4) OCD-specific cognitive-behavioral psychotherapy and pharmacotherapy with a serotonin reuptake inhibitor define the psychotherapeutic and pharmacotherapeutic treatments of choice, respectively. CONCLUSION: Child psychiatrists should be familiar with the differential diagnosis and treatment of OCD.}, Language = {eng}, Doi = {10.1097/00004583-199610000-00012}, Key = {fds275148} } @article{fds275049, Author = {ED Levin and CK Conners and E Sparrow and SC Hinton and D Erhardt and WH Meck, JE Rose and J March}, Title = {Nicotine effects on adults with attention-deficit/hyperactivity disorder.}, Journal = {Psychopharmacology (Berl)}, Volume = {123}, Number = {1}, Pages = {55-63}, Year = {1996}, Month = {January}, ISSN = {0033-3158}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8741955}, Abstract = {Several lines of evidence suggest that nicotine may be useful in treating the symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). The current study was an acute, placebo-controlled double-blind experiment to determine whether nicotine might be useful as an alternative treatment of adults with ADHD symptomatology. Six smokers and 11 nonsmokers who were outpatient referrals for ADHD were diagnosed by DSM-IV criteria. Measures of treatment effect included the Clinical Global Impressions (CGI) scale, Hopkins' symptom check list (SCL-90-R), the Profile of Mood States (POMS), Conners' computerized Continuous Performance Test (CPT), the Stroop test, and an interval-timing task. The smokers underwent overnight deprivation from smoking and were given a 21 mg/day nicotine skin patch for 4.5 h during a morning session. The nonsmokers were given a 7 mg/day nicotine skin patch for 4.5 h during a morning session. Active and placebo patches were given in a counter-balanced order approximately 1 week apart. Nicotine caused a significant overall nicotine-induced improvement on the CGI. This effect was significant when only the nonsmokers were considered, which indicated that it was not due merely to withdrawal relief. Nicotine caused significantly increased vigor as measured by the POMS test. Nicotine caused an overall significant reduction in reaction time (RT) on the CPT, as well as, with the smokers, a significant reduction in another index of inattention, variability in reaction time over trial blocks. Nicotine improved accuracy of time estimation and lowered variability of time-estimation response curves. Because improvements occurred among nonsmokers, the nicotine effect appears not to be merely a relief of withdrawal symptoms. It is concluded that nicotine deserves further clinical trials with ADHD.}, Key = {fds275049} } @article{fds138628, Author = {J.S. March}, Title = {Levin, E., Conners, C., Sparrow, E., Hinton, S., Erhardt, D., Meck, W., Rose, J., & March, J. (1996). Nicotine effects on adults with attention-deficit/hyperactivity disorder. Psychopharmacology, 123, 55-63.}, Year = {1996}, Key = {fds138628} } @article{fds138629, Author = {J.S. March}, Title = {March J, Parker J, Sullivan K, Stallings S, Conners CK (in press). The Multidimensional Anxiety Scale for Children (MASC): Factor structure, reliability and validity. J Amer Acad of Ch Adolesc Psychiatry}, Year = {1996}, Key = {fds138629} } @article{fds138652, Author = {J.S. March}, Title = {March, J., Wells, K., & Conners, C. (1996). Attention-Deficit/Hyperactivity Disorder: Part II. Treatment. Journal of practical psychiatry and behavioral health, 1, 219-228.}, Year = {1996}, Key = {fds138652} } @article{fds138653, Author = {J.S. March}, Title = {Conners, C., Levin, E., Sparrow, E., Hinton, S., Erhardt, D., Meck, W., Rose, J., & March, J. (1996). Nicotine and attention in adult ADHD. Psychopharmacology Bulletin, 32, 67-73.}, Year = {1996}, Key = {fds138653} } @article{fds138654, Author = {J.S. March}, Title = {Conners, C., March, J., Erhardt, D., & Butcher, T. (1996). Assessment of attention-deficit disorders. Journal of Psychoeducational Assessment, 32:186-205. Leonard H, March J, Allen A and Swedo S (in press): Serotonin reuptake inhibitors I: Pharmacology, Journal of the American Academy of Child and Adolescent Psychiatry}, Year = {1996}, Key = {fds138654} } @article{fds138655, Author = {J.S. March}, Title = {Greenhill, L., Abikoff, H., Arnold, L., Cantwell, D., Conners, C., Wells, K., Elliott, G., Hechtman, L., Hinshaw, S., Hoza , B., Jensen, P., March, J., Newcorn, J., Pelham, W., Severe, J., Swanson, J., & Vitiello, B. (in press). Medication treatment strategies in the MTA study: relevance to clinicians and researchers. Journal of the American Academy of Child and Adolescent Psychiatry.}, Year = {1996}, Key = {fds138655} } @article{fds138656, Author = {J.S. March}, Title = {March J & Leonard H (in press): Obsessive-compulsive disorder in children and adolescents: a review of the past ten years, Journal of the American Academy of Child and Adolescent Psychiatry}, Year = {1996}, Key = {fds138656} } @article{fds138657, Author = {J.S. March}, Title = {March J, Amaya-Jackson L, Terry R, Costanzo P(in press): Post-traumatic stress symptomatology in children and adolescents after an industrial fire, J Amer Acad of Ch Adolesc Psychiatry}, Year = {1996}, Key = {fds138657} } @article{fds138658, Author = {J.S. March}, Title = {March J & Mulle K (publication expected, Spring, 1996): A Guide to Cognitive- Behavioral Psychotherapy for Children and Adolescents with Obsessive- Compulsive Disorder, New York: Guilford Press}, Year = {1996}, Key = {fds138658} } @article{fds138659, Author = {J.S. March}, Title = {March, J., & Albano, A. (1996). Assessment of anxiety in children and adolescents. In M. Oldham (Ed.), Annual Review of Psychiatry (Vol. XVI, pp. 35-88). Washington: American Psychiatric Press.}, Year = {1996}, Key = {fds138659} } @article{fds138660, Author = {J.S. March}, Title = {Davidson, J., Foa, E., Blank, A., Brett, E., Fairbank, J., Green, B., Herman, J., Keane, T., Kilpartick, D., March, J., McNally, R., Pitman, R., Resnick, H., & Rothbaum, B. (1996). Posttraumatic stress disorder. In T. Widiger, A. Frances, H. Pincus, M. Ross, M. First, & W. Davis (Eds.), DSM-IV Sourcebook (Vol. 2, pp. 577-605). Washington: APA Press.}, Year = {1996}, Key = {fds138660} } @article{fds274969, Author = {JS March and K Wells and CK Conners}, Title = {Attention-deficit/hyperactivity disorder: Part II. Treatment strategies}, Journal = {Journal of Practical Psychiatry and Behavioral Health}, Volume = {2}, Number = {1}, Pages = {23-32}, Year = {1996}, ISSN = {1076-5417}, Abstract = {In the second half of this two-part article, the authors review the current state of knowledge about the treatment of attention-deficit/hyperactivity disorder (ADHD) across the lifespan. They first discuss general principles of pharmacotherapy for ADHD and then review the use of the psychostimulants, as well as nonstimulant medications, for ADHD. A strong case is made for including psychosocial interventions in any treatment plan in order to address the complex set of treatment targets that characterize the typical patient with ADHD. The authors review the types of psychosocial interventions that have been found most effective in ADHD, focusing especially on parent training and pedagogical/behavioral school interventions. The article concludes with a discussion of how to combine psychopharmacological treatments and psychosocial interventions most effectively and how to treat ADHD patients whose conditions are complicated by comorbid disorders. Copyright ©Williams & Wilkins, Waverly Inc.,.}, Key = {fds274969} } @article{fds274971, Author = {LL Greenhill and HB Abikoff and LE Arnold and DP Cantwell and CK Conners, G Elliott and L Hechtman and SP Hinshaw and B Hoza and PS Jensen and E al}, Title = {Medication treatment strategies in the MTA study: Relevance to clinicians and researchers}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {35}, Number = {10}, Pages = {1304-1313}, Year = {1996}, ISSN = {0890-8567}, Abstract = {Objective: Clinicians have difficulty applying drug research findings to clinical practice, because research protocols use methods different from those used in daily office practice settings. Method: To design a medication protocol for a multisite clinical trial involving 576 children with attention-deficit hyperactivity disorder (ADHD) while maintaining relevance to clinical practice, investigators from the NIMH Collaborative Multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA study) developed novel medication strategies. These were designed to work either in a monomodal or multimodal format and to ensure standard approaches are used across diverse sites. Each child randomized to medication (projected N = 288) is individually titrated to his or her 'best' methylphenidate dose and has individual ADHD symptoms monitored. Decision rules were developed to guide 'best dose' selection, dose changes, medication changes, the management of side effects, and integration with psychosocial treatments. Conclusions: The MTA study uses a controlled method to standardize the identification of each child's 'best' methylphenidate dose in a national, multisite cooperative treatment program. Although the titration protocol is complex, the study's individual dosing approach and algorithms for openly managing ADHD children's medication over time will be of interest to clinicians in office practice.}, Key = {fds274971} } @article{fds275048, Author = {CK Conners and ED Levin and E Sparrow and SC Hinton and D Erhardt and WH Meck, JE Rose and J March}, Title = {Nicotine and attention in adult attention deficit hyperactivity disorder (ADHD).}, Journal = {Psychopharmacol Bull}, Volume = {32}, Number = {1}, Pages = {67-73}, Year = {1996}, ISSN = {0048-5764}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8927677}, Abstract = {Nicotine, like the psychostimulants methylphenidate and dextroamphetamine, acts as an indirect dopamine agonist and improves attention and arousal. Adults and adolescents with attention deficit hyperactivity disorder (ADHD) smoke much more frequently than normal individuals or those with other psychiatric conditions, perhaps as a form of self-medication for ADHD symptoms. Nicotine might therefore have some value as a treatment for ADHD. The present study is an acute double-blind crossover administration of nicotine and placebo with smokers (n = 6) and nonsmokers (n = 11) diagnosed with adult ADHD. The drug was delivered via a transdermal patch at a dosage of 7 mg/day for nonsmokers and 21 mg/day for smokers. Results indicate significant clinician-rated global improvement, self-rated vigor and concentration, and improved performance on chronometric measures of attention and timing accuracy. Side effects were minimal. These acute results indicate the need for a longer clinical trial and a comparison with other stimulants in adult ADHD treatment.}, Key = {fds275048} } @article{fds275080, Author = {SW Heimann and JS March}, Title = {SSRI-induced mania [3]}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {35}, Number = {1}, Pages = {4-}, Year = {1996}, ISSN = {0890-8567}, Key = {fds275080} } @article{fds274968, Author = {JS March and HL Leonard and SE Swedo}, Title = {Neuropsychiatry of obsessive-compulsive disorder in children and adolescents.}, Journal = {Compr Ther}, Volume = {21}, Number = {9}, Pages = {507-512}, Year = {1995}, Month = {September}, ISSN = {0098-8243}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8565438}, Abstract = {Physicians understanding of the pathobiobiology, diagnosis, and treatment of OCD in children and adolescents closely resembles that for OCD in adults. Moreover, it is now clear that OCD is a neurobehavioral disorder involving dysregulation in links between cortical and subcortical circuitry that is substantially influenced by serotonergic neurotransmission. Although current treatments are not generally curative, given a correct diagnosis and the skillful combination of pharmacotherapy with a serotonin reuptake inhibitor and focused cognitive-behavioral psychotherapy, most children can be helped to resume a normal developmental trajectory.}, Key = {fds274968} } @article{fds275079, Author = {JS March}, Title = {Cognitive-behavioral psychotherapy for children and adolescents with OCD: a review and recommendations for treatment.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {34}, Number = {1}, Pages = {7-18}, Year = {1995}, Month = {January}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7860461}, Abstract = {OBJECTIVE: To critically review the published literature on cognitive-behavioral psychotherapy for obsessive-compulsive disorder (OCD) in children and adolescents. METHOD: The psychiatric and psychological literature was systematically searched for "studies" applying cognitive-behavioral principles to children and adolescents with OCD. RESULTS: Thirty-two investigations, most of them single case reports, were identified. Despite manifold differences in terminology and theoretical framework, all but one showed some benefit for cognitive-behavioral interventions. Graded exposure and response prevention form the core of treatment; anxiety management training and OCD-specific family interventions may play an adjunctive role. Poor compliance, inadequately documented and inconsistently applied treatment, and lack of exportability were recurrent problems. CONCLUSIONS: Abundant clinical and emerging empirical evidence suggest that cognitive-behavioral psychotherapy, alone or in combination with pharmacotherapy, is an effective treatment for OCD in children and adolescents. Future research in this area will need to focus on comparisons of cognitive-behavioral psychotherapy to other treatments, on component analyses, and on the application of exportable protocol-driven treatments to divergent patient populations.}, Doi = {10.1097/00004583-199501000-00008}, Key = {fds275079} } @article{fds138623, Author = {J.S. March}, Title = {March, J., & Mulle, K. (1995). Manualized cognitive-behavioral psychotherapy for obsessive-compulsive disorder in childhood: a preliminary single case study. Journal of Anxiety Disorders, 9(2), 175-184.}, Year = {1995}, Key = {fds138623} } @article{fds138624, Author = {J.S. March}, Title = {March, J., Leonard, H., & Swedo, S. (1995). Neuropsychiatry of obsessive- compulsive disorder in children and adolescents. Comprehensive Therapy, 21(9), 507-512.}, Year = {1995}, Key = {fds138624} } @article{fds138625, Author = {J.S. March}, Title = {March, J., Wells, K., & Conners, C. (1995). Attention-Deficit/Hyperactivity Disorder: Part I. Assessment and diagnosis. Journal of Practical Psychiatry and Behavioral Health, 2, 23-32.}, Year = {1995}, Key = {fds138625} } @article{fds138626, Author = {J.S. March}, Title = {Amaya-Jackson, L., & March, J. (1995). Posttraumatic stress disorder. In J. March (Ed.), Anxiety Disorders in Children and Adolescents (pp. 276-300). New York: Guilford.}, Year = {1995}, Key = {fds138626} } @article{fds138627, Author = {J.S. March}, Title = {Stallings, P., & March, J. (1995). Assessment of Anxiety in Children and Adolescents. In J. March (Ed.), Anxiety Disorders in Children and Adolescents (pp. 125-147). New York: Guilford.}, Year = {1995}, Key = {fds138627} } @article{fds138632, Author = {J.S. March}, Title = {March, J. (1995). Anxiety Disorders in Children and Adolescents. New York: Guilford Press March, J., Leonard, H. (in press), Obsessive-compulsive disorder: a review of the past ten years. Journal of the American Academy of Child and Adolescent Psychiatry}, Year = {1995}, Key = {fds138632} } @article{fds138633, Author = {J.S. March}, Title = {March, J., Mulle, K. (1995), Manualized cognitive-behavioral psychotherapy for obsessive-compulsive disorder in childhood: a preliminary single case study. Journal of Anxiety Disorders. 9(2): 175-184}, Year = {1995}, Key = {fds138633} } @article{fds138644, Author = {J.S. March}, Title = {March, J. S. (1995). Cognitive-behavioral psychotherapy for children and adolescents with OCD: A review and recommendations for treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 34(1), 7-18.}, Year = {1995}, Key = {fds138644} } @article{fds138645, Author = {J.S. March}, Title = {Amaya-Jackson, L. (1995). Post-traumatic stress disorder in adolescents. Adolescent Medicine, 6(2), 251-270.}, Year = {1995}, Key = {fds138645} } @article{fds138646, Author = {J.S. March}, Title = {March, J., Conners, C., Erhardt, D., & Johnston, H. (1995). Pharmacotherapy of Attention-Deficit Hyperactivity Disorder. In J. Jefferson & J. Greist (Eds.), Psychiatric Clinics of North America: Annual of Drug Therapy (Vol. 2, pp. 187-213). Philadelphia: Saunders.}, Year = {1995}, Key = {fds138646} } @article{fds138647, Author = {J.S. March}, Title = {Leonard, H., Swedo, S., March, J., & Rapoport, J. (1995). Obsessive-compulsive disorder. In G. Gabbard (Ed.), Treatments of Psychiatric Disorders (Vol. 1, pp. 301-314). Washington: American Psychiatric Press.}, Year = {1995}, Key = {fds138647} } @article{fds138648, Author = {J.S. March}, Title = {March, J., Leonard, H., & Swedo, S. (1995). Pharmacotherapy of Obsessive- Compulsive Disorder. In M. Riddle (Ed.), Child Psychiatric Clinics of North America: Pharmacotherapy (pp. 217-236). New York: Saunders.}, Year = {1995}, Key = {fds138648} } @article{fds138649, Author = {J.S. March}, Title = {Hooper, S. R., & March, J. S. (1995). Neuropsychology. In J. March (Ed.), Anxiety Disorders in Children and Adolescents (pp. 35-60). New York: Guilford Press.}, Year = {1995}, Key = {fds138649} } @article{fds138650, Author = {J.S. March}, Title = {March, J. S., Leonard, H. L., & Swedo, S. E. (1995). Obsessive-compulsive disorder. In J. March (Ed.), Anxiety Disorders in Children and Adolescents (pp. 251-275). New York: Guilford Press.}, Year = {1995}, Key = {fds138650} } @article{fds138651, Author = {J.S. March}, Title = {March, J. S., Mulle, K., Stallings, P., Erhardt, D., & Conners, C. K. (1995). Organizing an anxiety disorders clinic. In J. March (Ed.), Anxiety Disorders in Children and Adolescents (pp. 420-435). New York: Guildord Press.}, Year = {1995}, Key = {fds138651} } @article{fds138664, Author = {J.S. March}, Title = {March, J., Leonard, H., Swedo, S. (1995). Pharmacotherapy of Obsessive-Compulsive Disorder. In M. Riddle (Ed.), Child Psychiatric Clinics of North America: Pharmacotherapy (pp. 217-236). New York: Saunders}, Year = {1995}, Key = {fds138664} } @article{fds39072, Author = {March, J}, Title = {Anxiety Disorders in Children and Adolescents}, Series = {Journal of the American Academy of Child and Adolescent Psychiatry}, Booktitle = {Obsessive-compulsive disorder: a review of the past ten years}, Publisher = {New York: Guilford Press}, Editor = {J. March and H. Leonard}, Year = {1995}, Key = {fds39072} } @article{fds274967, Author = {JS March and HL Leonard and SE Swedo}, Title = {Pharmacotherapy of obsessive-compulsive disorder}, Journal = {Child and Adolescent Psychiatric Clinics of North America}, Volume = {4}, Number = {1}, Pages = {217-236}, Booktitle = {Child Psychiatric Clinics of North America: Pharmacotherapy}, Publisher = {New York: Saunders}, Editor = {M. Riddle}, Year = {1995}, Abstract = {The diagnosis and treatment of OCD in children and adolescents strongly resemble the diagnosis and treatment of OCD in adults. Differences derive largely from developmental considerations, especially limitations in insight with younger age and family dynamics and pattern of comorbidity. Ideally, children with OCD should first receive cognitive-behavioral psychotherapy tailored to OCD and, if not rapidly responsive to behavior therapy, a SRI. Some physicians and patients may choose medication first, trying to avoid the time, effort, and anxiety associated with behavior therapy. Others prefer to begin with behavior therapy in hopes of avoiding the need for medication and accompanying side effects. Most prefer to combine the two approaches, especially in severely ill patients. In all cases, the decision to begin with pharmacotherapy versus CBT or their combination depends on the clinician and the individual patient and his or her family. Because there are little empiric data favoring one SRI over another, choice of agent depends largely on side-effect profile, accumulated clinical experience, clinician and patient preference, and ultimately new evidence from controlled studies comparing SRIs. Supportive psychotherapy is useful in every case; family therapy is useful when family problems interfere with the implementation of OCD-specific interventions. Although current treatments are not curative in the majority of patients, given a correct diagnosis and the skillful combination of pharmacotherapy and CBT, most children can be helped to resume a normal developmental trajectory.}, Key = {fds274967} } @article{fds275178, Author = {JS March and K Mulle}, Title = {Manualized cognitive-behavioral psychotherapy for obsessive-compulsive disorder in childhood: A preliminary single case study}, Journal = {Journal of Anxiety Disorders}, Volume = {9}, Number = {2}, Pages = {175-184}, Year = {1995}, url = {http://dx.doi.org/10.1016/0887-6185(94)00038-7}, Abstract = {Using a within-subject multiple baseline design plus global ratings across treatment weeks, the authors conducted a preliminary evaluation of the effectiveness of manualized cognitive-behavioral psychotherapy in an eight-year-old girl with obsessive-compulsive disorder (OCD). Eleven weeks of treatment produced complete resolution in OCD symptoms; treatment gains were maintained at six-month follow-up. Symptom reduction within each baseline was specific to the exposure and/or response prevention targets for that baseline; generalization across baselines appeared late in treatment.}, Doi = {10.1016/0887-6185(94)00038-7}, Key = {fds275178} } @article{fds275177, Author = {JS March and K Mulle and B Herbel}, Title = {Behavioral psychotherapy for children and adolescents with obsessive-compulsive disorder: an open trial of a new protocol-driven treatment package.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {33}, Number = {3}, Pages = {333-341}, Year = {1994}, Month = {March}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8169177}, Abstract = {OBJECTIVE: The authors present an open trial of cognitive-behavioral psychotherapy for children and adolescents with obsessive-compulsive disorder. METHOD: The authors developed a treatment manual explicitly designed to facilitate (1) patient and parental compliance, (2) exportability, and (3) empirical evaluation. Successive versions of the manual were used to treat 15 consecutive child and adolescent patients with obsessive-compulsive disorder, most of whom were also treated with medications. RESULTS: Statistical analyses showed a significant benefit for treatment immediately posttreatment and at follow-up. Nine patients experienced at least a 50% reduction in symptoms on the Yale-Brown Obsessive-Compulsive Scale at posttreatment; 6 were asymptomatic on the National Institute of Mental Health Global Obsessive-Compulsive Scale. No patients relapsed at follow-up intervals as long as 18 months. Booster behavioral treatment allowed medication discontinuation in 6 patients. No patient refused treatment; 2 discontinued prematurely. CONCLUSIONS: Cognitive-behavioral psychotherapy, alone or in combination with pharmacotherapy, appears to be a safe, acceptable, and effective treatment for obsessive-compulsive disorder in children and adolescents.}, Doi = {10.1097/00004583-199403000-00006}, Key = {fds275177} } @article{fds138621, Author = {J.S. March}, Title = {Adams, G. B., Waas, G. A., March, J. S., & Smith, M. C. (1994). Obsessive compulsive disorder in children and adolescents: The role of the school psychologist in identification, assessment, and treatment. School Psychology Quarterly, 9(4), 274-294.}, Year = {1994}, Key = {fds138621} } @article{fds138622, Author = {J.S. March}, Title = {March J (ed) (1994): Anxiety Disorders in Children and Adolescents, New York: Guilford Press}, Year = {1994}, Key = {fds138622} } @article{fds138634, Author = {J.S. March}, Title = {March, J., Mulle, K., Herbel, B. (1994), Behavioral Psychotherapy for Children and Adolescents With Obsessive-Compulsive Disorder: An Open Trial of a New Protocol Driven Treatment Package. Journal of the American Academy of Child and Adolescent Psychiatry. 33(3): 333-341}, Year = {1994}, Key = {fds138634} } @article{fds138639, Author = {J.S. March}, Title = {Maletic, V., March, J., & Johnston, H. (1994). Child and Adolescent Psychopharmacology. In J. Jefferson & J. Greist (Eds.), Psychiatric Clinics of North America: Annual of Drug Therapy (Vol. 1, pp. 101-124). Philadelphia: Saunders.}, Year = {1994}, Key = {fds138639} } @article{fds138640, Author = {J.S. March}, Title = {March, J., Mulle, K., & Herbel, B. (1994). Behavioral Psychotherapy for Children and Adolescents With Obsessive-Compulsive Disorder: An Open Trial of a New Protocol Driven Treatment Package. Journal of the American Academy of Child and Adolescent Psychiatry, 33(3), 333-341.}, Year = {1994}, Key = {fds138640} } @article{fds138641, Author = {J.S. March}, Title = {March, J., & Amaya-Jackson, L. (1994). Post-traumatic stress disorder in children and adolescents. PTSD Research Quarterly, 4(4), 1-7.}, Year = {1994}, Key = {fds138641} } @article{fds138642, Author = {J.S. March}, Title = {March, J., & Mulle, K. (1994). How I Ran OCD Off My Land: A Guide to Cognitive-Behavioral Psychotherapy for Children and Adolescents with Obsessive-Compulsive Disorder, Currently distributed by the OC Foundation March, J. (1996). Manual for the Multidimensional Anxiety Scale for Children (MASC). Toronto: MultiHealth Systems.}, Year = {1994}, Key = {fds138642} } @article{fds138643, Author = {J.S. March}, Title = {Conners, C., Wells, K., March, J., & Fiore, C. (1994). Methodological issues in the multimodal treatment of the disruptive behavior disorders. In L. Greenhill (Ed.), Psychiatric Clinics of North America: Disruptive Behavior Disorders (pp. 361-378). Philadelphia: Saunders.}, Year = {1994}, Key = {fds138643} } @article{fds138618, Author = {J.S. March}, Title = {March, J. (1993). What Constitutes a Stressor? The \"Criterion A\" Issue. In J. Davidson & E. Foa (Eds.), Posttraumatic Stress Disorder: DSM-IV and Beyond (pp. 37-54). Wasington DC: American Psychiaric Press, Inc}, Year = {1993}, Key = {fds138618} } @article{fds138620, Author = {J.S. March}, Title = {Foa E, March J: Behavioral psychotherapy for OCD. In (ed Greist J, Jefferson J): Diagnosis and treatment of OCD. Ciba-Geigy, 1993.}, Year = {1993}, Key = {fds138620} } @article{fds138636, Author = {J.S. March}, Title = {Johnston H, Swift W, March J: High dose tricyclic therapy in children: A case report and commentary. Journal of Child and Adolescent Psychopharamcology 3: 115-125, 1993.}, Year = {1993}, Key = {fds138636} } @article{fds138637, Author = {J.S. March}, Title = {Amaya-Jackson L, March J: Post-traumatic stress disorder in children and adolescents. In (ed Leonard H): Anxiety Disorders. Philadelphia, Sanders, 1993.}, Year = {1993}, Key = {fds138637} } @article{fds138638, Author = {J.S. March}, Title = {March J, Amaya-Jackson L: Post-traumatic stress disorder in children and adolescents, PTSD Research Quarterly, National Center for PTSD Research Quarterly, National Center for PTSD, White River Junction VT: Veterans Admnistration 4 (4): 1-7, 1993.}, Year = {1993}, Key = {fds138638} } @article{fds39070, Author = {March, J.}, Title = {What Constitutes a Stressor? The "Criterion A" Issue}, Pages = {37-54}, Booktitle = {Posttraumatic Stress Disorder: DSM-IV and Beyond}, Publisher = {Washington, DC: American Psychiatric Press, Inc}, Editor = {J. Davidson and E. Foa}, Year = {1993}, Key = {fds39070} } @article{fds274966, Author = {JS March}, Title = {Fluoxetine and fluvoxamine in PTSD [7]}, Journal = {American Journal of Psychiatry}, Volume = {149}, Number = {3}, Pages = {413-}, Year = {1992}, Key = {fds274966} } @article{fds274965, Author = {JS March}, Title = {Posttraumatic stress in the emergency setting}, Journal = {Emergency Care Quarterly}, Volume = {7}, Number = {1}, Pages = {74-81}, Year = {1991}, Abstract = {In summary, extremely violent events, whether natural or human in origin, are unfortunately all too common. EMS workers encounter persons potentially traumatized by such events in the course of their normal duties. EMS personnel are thus in an excellent position to minimize psychologic morbidity following exposure to extreme stressors by implementing an early intervention strategy. Early intervention depends on an understaning of the trauma response, accurate differential diagnosis, careful risk assessment prior to triage, brief psychotherapeutic interventions in the EMS setting, and psychiatric consultation or follow-up when indicated. Skillful intercession by knowledgeable EMS personnel can substantially minimize posttraumatic psychiatric morbidity.}, Key = {fds274965} } @article{fds274962, Author = {JS March}, Title = {The nosology of Posttraumatic Stress Disorder}, Journal = {Journal of Anxiety Disorders}, Volume = {4}, Number = {1}, Pages = {61-82}, Year = {1990}, url = {http://dx.doi.org/10.1016/0887-6185(90)90024-4}, Abstract = {Since its introduction as a diagnostic category in DSM-III, Posttraumatic Stress Disorder has been the subject of continuing nosologic disagreement. Two theoretical perspectives-one emphasizing traumatic imagery, the other conditioned anxiety-subtly permeate the field. A sizable empirical database has also accrued. These contributions are discussed in the context of nosologic arguments endorsing the theoretical construct and the applicability of the DSM-III-R criteria set.}, Doi = {10.1016/0887-6185(90)90024-4}, Key = {fds274962} } @article{fds274963, Author = {JS March and KA Kobak and JW Jefferson and J Mazza and JH Greist}, Title = {A double-blind, placebo-controlled trial of fluvoxamine versus imipramine in outpatients with major depression}, Journal = {Journal of Clinical Psychiatry}, Volume = {51}, Number = {5}, Pages = {200-202}, Year = {1990}, Abstract = {The authors employed a double-blind, placebo-controlled design to investigate the effectiveness of fluvoxamine versus imipramine in 54 outpatients with moderate major depression. Fluvoxamine proved superior to placebo but not to imipramine on the Hamilton Rating Scale for Depression and the Montgomery and Asberg Depression Rating Scale. Nausea and hyperarousal were the most common side effects in the fluvoxamine-treated patients.}, Key = {fds274963} } @article{fds274964, Author = {JH Greist and JW Jefferson and R Rosenfeld and LD Gutzmann and JS March and NE Barklage}, Title = {Clomipramine and obsessive compulsive disorder: A placebo-controlled double-blind study of 32 patients}, Journal = {Journal of Clinical Psychiatry}, Volume = {51}, Number = {7}, Pages = {292-297}, Year = {1990}, Abstract = {Thirty-two nondepressed patients with obsessive impulsive disorder were randomly assigned to treatment with clomipramine (N=16) or placebo (N=16) in a 10 week double-blind study. Of the 15 patients who received at least 3 weeks of clomipramine treatment, 11 (73%) improved, 5 (33%) improved by more than 50%, and none worsened. Clomipramine treatment was associated with statistically significant improvement on several measures of obsessive compulsive symptoms. Side effects were more frequent and severe with clomipramine than with placebo. Although most patients tolerated clomipramine well, 3 discontinued treatment because of side effects.}, Key = {fds274964} } @article{fds275077, Author = {JS March and RL Moon and H Johnston}, Title = {Fluoxetine-TCA interaction}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {29}, Number = {6}, Pages = {985-986}, Year = {1990}, Key = {fds275077} } @article{fds275078, Author = {JS March}, Title = {Sleep disturbance in PTSD}, Journal = {American Journal of Psychiatry}, Volume = {147}, Number = {12}, Pages = {1697-}, Year = {1990}, Key = {fds275078} } @article{fds274960, Author = {JS March and LD Gutzman and JW Jefferson and JH Greist}, Title = {Serotonin and treatment in obsessive-complusive disorder}, Journal = {Psychiatric Developments}, Volume = {7}, Number = {1}, Pages = {1-18}, Year = {1989}, Abstract = {Recognized since the Middle Ages, and clearly described for more than 100 years, obsessive-compulsive disorder (OCD) continues to intrigue and challenge mental health professionals. Recent evidence has implicated dysfunctional serotonergic neurotransmission in OCD. This review summarizes the evidence favoring a serotonergic hypothesis for OCD followed by a more detailed discussion of the implications the hypothesis holds for treatment.}, Key = {fds274960} } @article{fds274961, Author = {JS March and H Johnston and JH greist}, Title = {Obsessive-compulsive disorder}, Journal = {American Family Physician}, Volume = {39}, Number = {5}, Pages = {175-182}, Year = {1989}, Abstract = {Patients with obsessive-compulsive disorder complain of anxiety-producing intrusive thoughts and/or perform repetitive, anxiety-reducing rituals. A combination of behavior therapy and drug therapy is generally beneficial in this relatively common disorder. Behavior therapy consists of exposing patients to anxiety-provoking situations and helping them avoid ritualistic responses. Drug therapy appears to work by blocking serotonin reuptake in the brain.}, Key = {fds274961} } @article{fds274959, Author = {CH Avery and J March and RH Brook}, Title = {An assessment of the adequacy of self-care by adult asthmatics}, Journal = {Journal of Community Health}, Volume = {5}, Number = {3}, Pages = {167-180}, Year = {1980}, ISSN = {0094-5145}, url = {http://dx.doi.org/10.1007/BF01323989}, Abstract = {Little is known about how individuals who have chronic disease actually manage their symptoms. This study involving a community-based population of 157 adult asthmatics assesses their ability to take care of their disease and to alter their behavior following a change in symptoms. Multiple techniques (interview, direct observation, and diary) were used to determine their behavior with respect to medications and physician use; these were then compared with criteria defining the requisite level of a behavior to reduce symptoms. Of the population assessed, 66% had no bronchodilator medication at home, 24% used an inhaler ineffectively, and 68% did not see a physician regularly. When faced with increasing symptoms, at least 40% of the asthmatics did not perform three basic and appropriate behaviors in medication use and physician contact. If physicians and other health care providers could decrease the frequency of these inappropriate self-care behaviors, it could result in improved health. © 1980 Human Sciences Press.}, Doi = {10.1007/BF01323989}, Key = {fds274959} } @article{fds138619, Author = {J.S. March}, Title = {March, J., Parker, J., Sullivan, K., Stallings, P., Conners, C. (in press), The Multidimensional Anxiety Scale for Children (MASC): Factor structure, reliability and validity. J Am Acad Child Adolesc Psychiatry}, Key = {fds138619} } @article{fds138635, Author = {J.S. March}, Title = {March, J., Amaya-Jackson, L., Costanzo, P., Terry, R. (in press), Post-traumatic stress in children and adolescents after an industrial fire. Journal of the American Academy of Child and Adolescent Psychiatry}, Key = {fds138635} } | |
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