青少年重症抑郁症患儿执行功能的特点

目的探讨青少年重症抑郁症(MDD)患儿执行功能的特点。方法采用学龄儿童情感障碍和精神分裂症问卷-目前及终生版,儿童抑郁量表,中国韦氏智力测试中的数字广度分测验,Stroop色词关联测验以及剑桥神经心理自动化成套测试(CANTAB)中的空间工作记忆(SWM)测验、剑桥袜(SOC)测验、目标内外注意转换(IED)测验分别对36例首发未服药青少年MDD患儿(抑郁症组)和40例健康对照儿童的当前和既往精神疾病发作情况进行筛查,评估抑郁严重程度和执行功能,比较二组执行功能的区别。结果在数字广度分测验和Stroop色词关联测验中,抑郁症组与健康对照组比较差异均无统计学意义(Pa>0.05);在SWM测验中,抑郁症组的8个格子间隔错误数(20.27±12.51 vs 13.91±9.72)、策略分(34.79±3.35 vs 32.14±4.25)多于健康对照组,二组比较差异均有统计学意义(Pa<0.05);在SOC测验中,抑郁症组的4步平均移动步数(5.98±1.25 vs 5.33±0.96)多于健康对照组,二组比较差异有统计学意义(P<0.05);在IED测验中,抑郁症组的总尝试次数(60.74±37.45 vs 35.44±27.40)明显多于健康对照组,二组比较差异有统计学意义(P<0.05)。结论青少年MDD患者存在空间工作记忆、认知灵活性和计划等多个执行功能成分的损害,而语音工作记忆和抑制控制等执行功能成分的损害不突出。     

Effects of induced rumination and distraction on mood and overgeneral autobiographical memory in adolescent Major Depressive Disorder and controls

BACKGROUND: In adults there is evidence that the affective-cognitive processes of rumination and overgeneral autobiographical memory retrieval may play a part in maintaining depression. This study investigated the effects of induced rumination as compared to distraction on mood and categoric overgeneral memory in adolescents with first episode Major Depressive Disorder (MDD), and the specificity of any effects to MDD. METHOD: Three subject groups; adolescents with first episode MDD (N = 75), non-depressed psychiatric participants (N = 26) and community controls (N = 33) were recruited. An experimental design was used, with repeated measures of 'in the moment' depressed mood and categoric overgeneral memory before and after rumination and distraction, induced on separate occasions and counterbalanced in order across participants. RESULTS: In adolescents with MDD, induced rumination as compared to distraction differentially increased depressed mood. There were no significant differences in this effect between full current MDD participants and those in partial remission. This differential effect was also seen in community controls but was absent in non-MDD psychiatric participants. In addition, rumination as compared to distraction increased overgeneral memories to negative cues in MDD participants, but this increase was not significantly related to mood change, and was specific to MDD, being absent in non-MDD psychiatric and community control groups. CONCLUSIONS: Experimentally induced rumination as compared to distraction increases depressed mood and negative categoric memories in adolescents with first episode MDD. These results suggest that rumination has a deleterious effect on mood and memory retrieval processes in adolescents with first episode MDD. Increased negative overgeneral memories with rumination may be a process of particular importance for adolescents with MDD rather than psychiatric disorder in general. The findings imply that strategies to interrupt ruminative processes may be helpful in minimising persistence of first episode MDD in adolescence.     

青少年抑郁症患者性激素受体基因微卫星多态性与功能失调性认知的关系

目的探讨青春期首发的青少年抑郁症患者性激素受体基因微卫星多态性是否与功能失调性认知存在联系。方法采用聚合酶链式反应（PcR）结合毛细管电泳和基因扫描技术。检测青春期首发的青少年抑郁症患者雄激素受体（AR）、雌激素受体α（ERα）、雌激素受体β（ERβ）基因重复序列多态性的重复片段长度。应用《功能失调性态度问卷》（DAS）对青少年抑郁症患者进行评估，并把评估结果和微卫星多态片段长度进行相关性和对照性分析。结果1．女性患者ERβ基因微卫星多态性与DAS总分呈显著仉相关；2．对各位点等位基因分长短片段作组间比较。发现ERα短片段组DAS总分显著高于长片段组。男性患者不存在这种差异性。3．AR受体与功能失调性认知不存在这种联系。结论女性青少年ERα、ERβ受体基因微卫星多态可能与功能失调性认知存在联系，而男性青年抑郁症患者可能不存在这种联系。     

Controlled Trial of a Brief Cognitive–Behavioural Intervention in Adolescent Patients with Depressive Disorders

Fifty-three child and adolescent psychiatric patients with depressive disorders were randomly allocated to brief cognitive-behaviour therapy (CBT) or to a control treatment, relaxation training. Forty-eight patients completed the treatment phase of the trial, which comprised 5–8 treatment sessions. Post-treatment assessments showed a clear advantage of CBT over relaxation on measures of both depression and overall outcome. However, there were no significant differences between the treatments on comorbid anxiety and conduct symptoms. At follow-up, the differences between the groups were reduced, partly because of a high relapse rate in the DTP group and partly because subjects in the relaxation group continued to recover.     

Maternal Depressive Symptoms and Ratings of Emotional Disorder Symptoms in Children and Adolescents

This study uses information collected on two occasions from a probability sample of families with 8- to 12-year-old children ( N = 718) participating in a general population study in 1983 and follow-up in 1987. It focuses on the association between maternal depressive symptoms and emotional disorder in children and adolescents, taking into consideration the influences of informant rating errors, contextual variables (economic disadvantage and family dysfunction), and child gender. Covariance structure analysis revealed a strong association between maternal depressive symptoms in girls (β= .59 in 1983 and β= .39 in 1987) but not in boys. This association is independent of the impact of contextual variables and the treatment of teacher rating errors. Among adolescent boys, maternal depressive symptoms are correlated with mother rating errors, suggesting the possible presence of maternal bias.     

Facebook as a Recruitment Tool for Adolescent Health Research: A Systematic Review

BackgroundResearchers are increasingly using social media to recruit participants to surveys and clinical studies. However, the evidence of the efficacy and validity of adolescent recruitment through Facebook is yet to be established.ObjectiveTo conduct a systematic review of the literature on the use of Facebook to recruit adolescents for health research.Data SourcesNine electronic databases and reference lists were searched for articles published between 2004 and 2013.Study Eligibility CriteriaStudies were included in the review if: 1) participants were aged ≥10 to ≤18 years, 2) studies addressed a physical or mental health issue, 3) Facebook was identified as a recruitment tool, 4) recruitment details using Facebook were outlined in the methods section and considered in the discussion, or information was obtained by contacting the authors, 5) results revealed how many participants were recruited using Facebook, and 6) studies addressed how adolescent consent and/or parental consent was obtained.Study Appraisals and Synthesis MethodsTitles, abstracts, and keywords were scanned and duplicates removed by 2 reviewers. Full text was evaluated for inclusion criteria, and 2 reviewers independently extracted data.ResultsThe search resulted in 587 publications, of which 25 full-text papers were analyzed. Six studies met all the criteria for inclusion in the review. Three recruitment methods using Facebook was identified: 1) paid Facebook advertising, 2) use of the Facebook search tool, and 3) creation and use of a Facebook Page.ConclusionsEligible studies described the use of paid Facebook advertising and Facebook as a search tool as methods to successfully recruit adolescent participants. Online and verbal consent was obtained from participants recruited from Facebook.     

The Adolescent Outcome of Hyperactive Children Diagnosed By Research Criteria—III. Mother–Child Interactions, Family Conflicts and Maternal Psychopathology

The present study reports the results of a prospective, 8-year follow-up study of 100 hyperactive and 60 normal children followed from childhood into adolescence. Ratings of child behavior problems and family conflicts as well as direct observations of mother-child interactions were taken in childhood and again at adolescent follow-up. At outcome, hyperactives continued to have more conduct and learning problems and to be more hyperactive, inattentive, and impulsive than controls. Hyperactives were also rated by their mothers as having more numerous and intense family conflicts than the normal controls, although the adolescents in both groups did not differ in their own ratings of these conflicts. Observations of mother-adolescent interactions at outcome found the hyperactive dyads displaying more negative and controlling behaviors and less positive and facilitating behaviors towards each other than in the normal dyads. These interaction patterns were significantly related to similar patterns in mother-child interactions observed 8 years earlier. Mothers of hyperactives also reported more personal psychological distress than normal mothers at outcome. Further analyses of subgroups of hyperactives at outcome, formed on the presence or absence of ADHD and oppositional defiant disorder (ODD), indicated that the presence of ODD accounted for most of the differences between hyperactives and normals on the interaction measures, ratings of home conflicts, and ratings of maternal psychological distress. Results suggest that the development and maintenance of ODD into adolescence in hyperactive children is strongly associated with aggression and negative parent-child interactions in childhood.     

Subtypes of Suicidal and Assaultive Behaviors in Adolescent Psychiatric Inpatients: A Research Note

Among 129 adolescent psychiatric inpatients, four subgroups of suicidal and/or assaultive behaviors were identified. A suicidal-only subgroup with no evidence of assaultive behavior was characterized by depression, drug abuse and environmental stresses. An assaultive-only subgroup with no evidence of suicidal behavior exhibited aggressive symptoms and violence at home. A subgroup with both suicidal and assaultive behaviors experienced accidents and family violence. A fourth subgroup had neither suicidal nor assaultive behavior. This subgroup showed eating disorders, depression, minimal assaultiveness and few peer friendships.     

Movement Assessment of Infants as a Predictor of One Year Neuromotor Outcome in Very Low Birth Weight Infants

Objective  

To predict neuromotor outcome in Very Low Birth Weight infants at 1 year using Movement Assessment of Infants scale at 4 and 8 months of corrected age.     

Quantifying the PBAC in a Pediatric and Adolescent Gynecology Population

Study objective: To determine the usefulness of the pictorial blood assessment chart (PBAC) for use as a valid screening tool for menorrhagia in adolescents. Study design: To conduct a prospective survey paired with retrospective chart review. Main outcome measures: To determine mean PBAC scores among adolescents presenting with menorrhagia versus normal or infrequent cycles. To determine the PBAC scores among adolescents self-identifying as having heavy, normal, or light menses. Results: Seventy-three subjects met criteria. Teens self-identified as having “light,” “medium,” or “heavy” cycles. Groups were then subdivided: Group 1 “heavy menses,” Group 2 “normal menses,” and Group 3 “light menses.” The mean age of menarche was similar in all groups: 11.59 ± 1.56 years, 11.41 ± 1.51 years, 11.78 ± .83 years in Groups 1, 2, and 3, respectively. The mean PBAC score for the cohort was 195, while the mean PBAC in Group 1 was 362, compared to 136 and 44 for Groups 2 and 3, respectively (?p < .002). Conclusions: This is the first study to address the use of the PBAC in an adolescent population. In addition, this study evaluates mean PBAC scores among teens who self-identify as having heavy, normal, or light periods. The incidence of bleeding disorders among those with menorrhagia was 20%, consistent with previously published studies.     

Adolescent and young adult health in a children's hospital: Everybody's business

Background: To guide the development of adolescent health training and the planning of future services, accurate data describing health service use by adolescents and young adults are needed. Aim: To describe admission rates for adolescents (12–17 years) and young adults (age 18 years and over) attending a specialist children's hospital over an 8‐year period. Specific objectives were to describe the (i) proportion of adolescents and young adults admitted under different specialties; (ii) age range, with emphasis on those 18 years and over; and (iii) proportion of patients admitted to the general adolescent ward. Methods: Data on adolescent and young adult admissions to Princess Margaret Hospital (PMH) were collected prospectively from July 2000 to June 2008. Results: Adolescents and young adults accounted for one fifth (range 18–22%) of all admissions to PMH. Over the 8‐year period, the number of adolescent and young adult admissions increased from 3935 (54% males) to 4967 (56% males) per year. The proportion admitted to the general adolescent ward ranged from 22% to 36%. The three specialties admitting the most adolescents and young adults were General Surgery (11–13%), Orthopaedics (11–13%) and Oncology/Haematology (10–14%). The age range was: 12–14 years (57–67%); 15–17 (30–39%); 18+ (2–5%). At least 15 patients aged 20 or over were admitted each year, mostly for Dental or Plastic Surgery. Conclusions: Adolescent and young adult health is part of the core business of paediatrics. This should be reflected in the planning of future paediatric services. All trainees require some basic training, regardless of heir specialty area.     

Children with a Pervasive Developmental Disorder, Children with a Language Disorder and Normally Developing Children in Situations with High- and Low-level Involvement of the Caregiver

The social behaviour of tow-functioning children with a Pervasive Developmental Disorder (PDD). high-functioning children with a PDD, children with a Language Disorder (LD) and normally developing children (ND| was investigated in a playroom session while they were iteracting with one of their parents. High-functioning children with a PDD were found to differ from the other groups in social responsivity. Low-functioning children with a PDD differed from high-functioning children with a PDD in the total number of social bids, type of social bids, number of looks at parent and social responsivity. When parents structured the behaviour of their children, this resulted in an increase in number of social bids and looks in the low-functioning children with PDD.     

An Adoption Study of Depressive Symptoms in Middle Childhood

Several twin studies of children and adolescents have found significant heritability of depressive symptoms. In contrast, the sole adoption study of biologically related and biologically unrelated adopted siblings found no evidence for genetic influence. The present study attempts to confirm these results in middle childhood using two adoption designs. The sample, from the Colorado Adoption Project, included 180 adopted children (77 with adoptive siblings) and their biological and adoptive mothers, and 227 nonadopted children (93 with biological siblings) and their mothers. Mothers reported their own neuroticism, and children's depressive symptoms were reported by the parents and by the children themselves. For both the sibling adoption and the parent-offspring designs heritability was negligible, shared environment modest, and nonshared environment substantial, irrespective of child gender. Although the power of the sibling data is low, the combined findings from the two designs suggest that genetic effects on depressive symptoms in childhood may be somewhat smaller than previously estimated in twin studies.     

Patterns of Psychiatric Disorder in Adopted Girls: a Research Note

Over a 15-year period adopted children were overrepresented in a psychiatric clinic population. The excess was seen in all age groups and there was no rise of referrals of adoptees during adolescence. Adopted boys showed the same range of disorder as all referred boys. Adopted girls were more likely than other girls to have conduct disorders. Those with conduct disorders were more likely than non-adopted girls with the same disorder to be taken into care and to be given inpatient treatment. Differences in family structure and relationships were found both between conduct disordered girls of different adoptive status and between adopted girls with conduct and other disorders.