Journal of the American Academy of Child Psychiatry最新文献

A nonreferred elementary school population of 315 children participated in a screening for behavioral problems. The prevalence of inattentive-overactive symptoms suggestive of Attention Deficit Disorder (ADD) was determined to be 2.3%; 3.6% of the children had aggressive/oppositional symptoms suggestive of Conduct Disorder (CD). Another 3.0% showed both ADD and CD symptoms. Index children comprise 8.9% of the school population and were more likely to come from broken homes and had more remedial education. They also had higher scores on the ADD Interview (DICA) and were more impulsive and disorganized on a computerized attentional battery. There were no symptoms or characteristics that differentiated the inattentive-overactive (ADD) from the aggressive/oppositional (CD) child. Multivariate statistical techniques indicated a different relative importance of individual symptoms in the two groups. These results suggest the interdepencence of symptoms commonly associated with ADD and CD diagnoses.

Reports of eating-disordered symptoms in high risk populations suggest an increasing incidence of both anorexia nervosa and bulimia. To investigate the magnitude of this problem in a “high risk” but nonclinical population, we surveyed upper-middle-class female adolescents from two private girls' schools (one boarding, one day). Of the boarding school population, 18.1% reported at least one symptom of an eating disorder, while the figure for the day school population was 18.6%. Although clinical interviews are a prerequisite to a DSM-III diagnosis of Eating Disorder, this study indicates that many of the students are likely to have a diagnosable clinical syndrome. Discussion includes the early onset of symptoms (prepuberty) suggesting the need for educational, preventative programs.

The perceptions of anxiety and the family climate (family environment scale, FES) among 20 pairs of parents of LD boys were compared with 20 sets of parents of non-LD hoys. The LD parents were more anxious than the control group, and the LD family climate reflected greater emphasis on organization and control within the family system. More ambition and more striving for personal achievement were expected, while free expression of feelings was not encouraged by LD parents. Differences shown by non-LD parents were not found between LD fathers and mothers. Although not different from control fathers, LD fathers did not seem to play a unique male role in the family. With respect to interrelations between expressions of anxiety and FES measures, fathers were more concerned about conflicts within the family system, and this measure was related to their elevated anxiety. On the other hand, the mothers' anxiety was related to greater emphasis on achievement. The results clearly suggest the need for mental-health professionals to consider parent counseling as a significant part of LD intervention programs, with special attention given to anxiety and role definitions within the family system.

Eight children with Attention Deficit Disorder with Hyperactivity were treated with methylphenidate and promethazine in an open crossover design study. No improvement occurred with promethazine, while behavioral deterioration in four subjects necessitated discontinuation of the drug in two cases.

A 16-year-old female adolescent who met DSM-III criteria for bipolar disorder, mixed with psychotic features, showed a clinical response to lithium carbonate, but experienced repeated deterioration in function whenever she entered the premenstrual phase of her menstrual cycle. This exacerbation in her affective psychosis coincided with a progressive fall in serum lithium concentration despite a constant oral regimen with which the patient was compliant. If the oral dose was prophylactically increased during the patient's luteal phase in order to compensate for the anticipated decline in serum concentration, and if the concentration could thereby be maintained at or above 1.1 mEq/L, then the premenstrual deterioration could be prevented.