Actigraph measures discriminate pediatric bipolar disorder from attention-deficit/hyperactivity disorder and typically developing controls / Gianni L. FAEDDA in Journal of Child Psychology and Psychiatry, 57-6 (June 2016)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 57-6 (June 2016) . - p.706-716 Titre : Actigraph measures discriminate pediatric bipolar disorder from attention-deficit/hyperactivity disorder and typically developing controls Type de document : Texte imprimé et/ou numérique Auteurs : Gianni L. FAEDDA, Auteur ; Kyoko OHASHI, Auteur ; Mariely HERNANDEZ, Auteur ; Cynthia E. MCGREENERY, Auteur ; Marie C. GRANT, Auteur ; Argelinda BARONI, Auteur ; Ann POLCARI, Auteur ; Martin H. TEICHER, Auteur Article en page(s) : p.706-716 Langues : Anglais (eng) Mots-clés : Actigraphy  ADHD  bipolar disorder  child  circadian rhythms  sleep Index. décimale : PER Périodiques Résumé : Background Distinguishing pediatric bipolar disorder (BD) from attention-deficit hyperactivity disorder (ADHD) can be challenging. Hyperactivity is a core feature of both disorders, but severely disturbed sleep and circadian dysregulation are more characteristic of BD, at least in adults. We tested the hypothesis that objective measures of activity, sleep, and circadian rhythms would help differentiate pediatric subjects with BD from ADHD and typically developing controls. Methods Unmedicated youths (N = 155, 97 males, age 5–18) were diagnosed using DSM-IV criteria with Kiddie-SADS PL/E. BD youths (n = 48) were compared to typically developing controls (n = 42) and children with ADHD (n = 44) or ADHD plus comorbid depressive disorders (n = 21). Three-to-five days of minute-to-minute belt-worn actigraph data (Ambulatory Monitoring Inc.), collected during the school week, were processed to yield 28 metrics per subject, and assessed for group differences with analysis of covariance. Cross-validated machine learning algorithms were used to determine the predictive accuracy of a four-parameter model, with measures reflecting sleep, hyperactivity, and circadian dysregulation, plus Indic's bipolar vulnerability index (VI). Results There were prominent group differences in several activity measures, notably mean 5 lowest hours of activity, skewness of diurnal activity, relative circadian amplitude, and VI. A predictive support vector machine model discriminated bipolar from non-bipolar with mean accuracy of 83.1 ± 5.4%, ROC area of 0.781 ± 0.071, kappa of 0.587 ± 0.136, specificity of 91.7 ± 5.3%, and sensitivity of 64.4 ± 13.6%. Conclusions Objective measures of sleep, circadian rhythmicity, and hyperactivity were abnormal in BD. Wearable sensor technology may provide bio-behavioral markers that can help differentiate children with BD from ADHD and healthy controls. En ligne : http://dx.doi.org/10.1111/jcpp.12520 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=289 [article] Actigraph measures discriminate pediatric bipolar disorder from attention-deficit/hyperactivity disorder and typically developing controls [Texte imprimé et/ou numérique] / Gianni L. FAEDDA, Auteur ; Kyoko OHASHI, Auteur ; Mariely HERNANDEZ, Auteur ; Cynthia E. MCGREENERY, Auteur ; Marie C. GRANT, Auteur ; Argelinda BARONI, Auteur ; Ann POLCARI, Auteur ; Martin H. TEICHER, Auteur . - p.706-716. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 57-6 (June 2016) . - p.706-716 Mots-clés : Actigraphy  ADHD  bipolar disorder  child  circadian rhythms  sleep Index. décimale : PER Périodiques Résumé : Background Distinguishing pediatric bipolar disorder (BD) from attention-deficit hyperactivity disorder (ADHD) can be challenging. Hyperactivity is a core feature of both disorders, but severely disturbed sleep and circadian dysregulation are more characteristic of BD, at least in adults. We tested the hypothesis that objective measures of activity, sleep, and circadian rhythms would help differentiate pediatric subjects with BD from ADHD and typically developing controls. Methods Unmedicated youths (N = 155, 97 males, age 5–18) were diagnosed using DSM-IV criteria with Kiddie-SADS PL/E. BD youths (n = 48) were compared to typically developing controls (n = 42) and children with ADHD (n = 44) or ADHD plus comorbid depressive disorders (n = 21). Three-to-five days of minute-to-minute belt-worn actigraph data (Ambulatory Monitoring Inc.), collected during the school week, were processed to yield 28 metrics per subject, and assessed for group differences with analysis of covariance. Cross-validated machine learning algorithms were used to determine the predictive accuracy of a four-parameter model, with measures reflecting sleep, hyperactivity, and circadian dysregulation, plus Indic's bipolar vulnerability index (VI). Results There were prominent group differences in several activity measures, notably mean 5 lowest hours of activity, skewness of diurnal activity, relative circadian amplitude, and VI. A predictive support vector machine model discriminated bipolar from non-bipolar with mean accuracy of 83.1 ± 5.4%, ROC area of 0.781 ± 0.071, kappa of 0.587 ± 0.136, specificity of 91.7 ± 5.3%, and sensitivity of 64.4 ± 13.6%. Conclusions Objective measures of sleep, circadian rhythmicity, and hyperactivity were abnormal in BD. Wearable sensor technology may provide bio-behavioral markers that can help differentiate children with BD from ADHD and healthy controls. En ligne : http://dx.doi.org/10.1111/jcpp.12520 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=289

Assessing and Managing Suicide Risk in Autistic Youth: Findings from a Clinician Survey in a Pediatric Psychiatric Emergency Setting / Paige E. CERVANTES in Journal of Autism and Developmental Disorders, 53-5 (May 2023)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 53-5 (May 2023) . - p.1755-1763 Titre : Assessing and Managing Suicide Risk in Autistic Youth: Findings from a Clinician Survey in a Pediatric Psychiatric Emergency Setting Type de document : Texte imprimé et/ou numérique Auteurs : Paige E. CERVANTES, Auteur ; Annie LI, Auteur ; Katherine A. SULLIVAN, Auteur ; Dana E. M. SEAG, Auteur ; Argelinda BARONI, Auteur ; Sarah M. HORWITZ, Auteur Article en page(s) : p.1755-1763 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Suicidal thoughts and behaviors (STB) and emergency department (ED) utilization are prevalent in autistic youth. The current study surveyed clinicians in a pediatric psychiatric ED to examine differences in attitudes on suicide-related care for autistic and non-autistic patient populations. While clinicians rated addressing STB in ASD as important and adaptations to care as necessary, less than half identified ASD as a suicide risk factor and confidence ratings were significantly lower for autistic patients. Previous ASD training predicted confidence and accounted for approximately 25% of the variance in confidence scores. Findings highlight the urgency to develop and disseminate ED clinician training, and address the lack of validated assessment tools, adapted suicide prevention practices, and evidence-based treatments for STB in autistic youth. En ligne : https://doi.org/10.1007/s10803-022-05448-8 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=500 [article] Assessing and Managing Suicide Risk in Autistic Youth: Findings from a Clinician Survey in a Pediatric Psychiatric Emergency Setting [Texte imprimé et/ou numérique] / Paige E. CERVANTES, Auteur ; Annie LI, Auteur ; Katherine A. SULLIVAN, Auteur ; Dana E. M. SEAG, Auteur ; Argelinda BARONI, Auteur ; Sarah M. HORWITZ, Auteur . - p.1755-1763. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 53-5 (May 2023) . - p.1755-1763 Index. décimale : PER Périodiques Résumé : Suicidal thoughts and behaviors (STB) and emergency department (ED) utilization are prevalent in autistic youth. The current study surveyed clinicians in a pediatric psychiatric ED to examine differences in attitudes on suicide-related care for autistic and non-autistic patient populations. While clinicians rated addressing STB in ASD as important and adaptations to care as necessary, less than half identified ASD as a suicide risk factor and confidence ratings were significantly lower for autistic patients. Previous ASD training predicted confidence and accounted for approximately 25% of the variance in confidence scores. Findings highlight the urgency to develop and disseminate ED clinician training, and address the lack of validated assessment tools, adapted suicide prevention practices, and evidence-based treatments for STB in autistic youth. En ligne : https://doi.org/10.1007/s10803-022-05448-8 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=500

Mental health service availability for autistic youth in New York City: An examination of the developmental disability and mental health service systems / Paige E CERVANTES in Autism, 27-3 (April 2023)  

Public ISBD [article]  inAutism > 27-3 (April 2023) . - p.704-713 Titre : Mental health service availability for autistic youth in New York City: An examination of the developmental disability and mental health service systems Type de document : Texte imprimé et/ou numérique Auteurs : Paige E CERVANTES, Auteur ; Greta R CONLON, Auteur ; Dana E. M. SEAG, Auteur ; Michael FEDER, Auteur ; Qortni LANG, Auteur ; Samantha MERIL, Auteur ; Argelinda BARONI, Auteur ; Annie LI, Auteur ; Kimberly E HOAGWOOD, Auteur ; Sarah M HORWITZ, Auteur Article en page(s) : p.704-713 Langues : Anglais (eng) Mots-clés : autism spectrum disorder,community services,mental health,service systems Index. décimale : PER Périodiques Résumé : Psychiatric conditions are common in autism; however, a multitude of barriers exist in accessing community-based mental health care for autistic youth. Perhaps the first and most formidable barrier is identifying a provider that offers mental health treatment to autistic youth within the many service systems involved in supporting the autism community. These systems typically function independently of one another, contributing to the complexity of accessing services. To identify gaps caused by New York?s multisystem care model for autistic youth, and as part of a larger quality improvement initiative to advance suicide risk management in several New York City emergency departments, we conducted a telephone survey to identify outpatient mental health service availability for autistic youth with depressive symptoms or suicidal thoughts or behaviors in New York City across the state?s mental health and developmental disability systems. Results demonstrated that while a greater proportion of clinics in the mental health system compared with agencies in the developmental disability system offered outpatient mental health services to autistic youth (47.1% vs 25.0%), there is remarkably limited service availability overall. Efforts to reduce these care inequities through policy reform and improving workforce capacity are urgently needed.Lay abstractAutistic children and adolescents experience high rates of co-occurring mental health conditions, including depression and suicidality, which are frequently identified by stakeholders as treatment priorities. Unfortunately, accessing community-based mental health care is often difficult for autistic youth and their families. The first obstacle families confront is finding a provider that offers mental health treatment to autistic youth within the many service systems involved in supporting the autism community. The mental health and developmental disability systems are two of the most commonly accessed, and previous work has shown there is often confusion over which of these systems is responsible for providing mental health care to autistic individuals. In this study, we conducted a telephone survey to determine the availability of outpatient mental health services for autistic youth with depressive symptoms or suicidal thoughts or behaviors in New York City across the state?s mental health and developmental disability systems. Results showed that while a greater percentage of clinics in the mental health system compared with in the developmental disability system offered outpatient mental health services to autistic youth (47.1% vs 25.0%), many more did not offer care to autistic youth and there were very few options overall. Therefore, it is important that changes to policy are made to increase the availability of services and that mental health care providers' knowledge and confidence in working with autistic youth are improved. En ligne : https://doi.org/10.1177/13623613221112202 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499 [article] Mental health service availability for autistic youth in New York City: An examination of the developmental disability and mental health service systems [Texte imprimé et/ou numérique] / Paige E CERVANTES, Auteur ; Greta R CONLON, Auteur ; Dana E. M. SEAG, Auteur ; Michael FEDER, Auteur ; Qortni LANG, Auteur ; Samantha MERIL, Auteur ; Argelinda BARONI, Auteur ; Annie LI, Auteur ; Kimberly E HOAGWOOD, Auteur ; Sarah M HORWITZ, Auteur . - p.704-713. Langues : Anglais (eng) in Autism > 27-3 (April 2023) . - p.704-713 Mots-clés : autism spectrum disorder,community services,mental health,service systems Index. décimale : PER Périodiques Résumé : Psychiatric conditions are common in autism; however, a multitude of barriers exist in accessing community-based mental health care for autistic youth. Perhaps the first and most formidable barrier is identifying a provider that offers mental health treatment to autistic youth within the many service systems involved in supporting the autism community. These systems typically function independently of one another, contributing to the complexity of accessing services. To identify gaps caused by New York?s multisystem care model for autistic youth, and as part of a larger quality improvement initiative to advance suicide risk management in several New York City emergency departments, we conducted a telephone survey to identify outpatient mental health service availability for autistic youth with depressive symptoms or suicidal thoughts or behaviors in New York City across the state?s mental health and developmental disability systems. Results demonstrated that while a greater proportion of clinics in the mental health system compared with agencies in the developmental disability system offered outpatient mental health services to autistic youth (47.1% vs 25.0%), there is remarkably limited service availability overall. Efforts to reduce these care inequities through policy reform and improving workforce capacity are urgently needed.Lay abstractAutistic children and adolescents experience high rates of co-occurring mental health conditions, including depression and suicidality, which are frequently identified by stakeholders as treatment priorities. Unfortunately, accessing community-based mental health care is often difficult for autistic youth and their families. The first obstacle families confront is finding a provider that offers mental health treatment to autistic youth within the many service systems involved in supporting the autism community. The mental health and developmental disability systems are two of the most commonly accessed, and previous work has shown there is often confusion over which of these systems is responsible for providing mental health care to autistic individuals. In this study, we conducted a telephone survey to determine the availability of outpatient mental health services for autistic youth with depressive symptoms or suicidal thoughts or behaviors in New York City across the state?s mental health and developmental disability systems. Results showed that while a greater percentage of clinics in the mental health system compared with in the developmental disability system offered outpatient mental health services to autistic youth (47.1% vs 25.0%), many more did not offer care to autistic youth and there were very few options overall. Therefore, it is important that changes to policy are made to increase the availability of services and that mental health care providers' knowledge and confidence in working with autistic youth are improved. En ligne : https://doi.org/10.1177/13623613221112202 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499

Practitioner Review: The assessment of bipolar disorder in children and adolescents / Argelinda BARONI in Journal of Child Psychology and Psychiatry, 50-3 (March 2009)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 50-3 (March 2009) . - p.203-215 Titre : Practitioner Review: The assessment of bipolar disorder in children and adolescents Type de document : Texte imprimé et/ou numérique Auteurs : Argelinda BARONI, Auteur ; Ellen LEIBENLUFT, Auteur ; Kenneth E. TOWBIN, Auteur ; Jessica R. LUNSFORD, Auteur ; David A. LUCKENBAUGH, Auteur Année de publication : 2009 Article en page(s) : p.203-215 Langues : Anglais (eng) Mots-clés : Bipolar-disorder severe-mood-dysregulation mania diagnosis-assessment Index. décimale : PER Périodiques Résumé : Background: An increasing number of youth are being diagnosed with, and treated for, bipolar disorder (BD). Controversy exists about whether youth with non-episodic irritability and symptoms of attention deficit hyperactivity disorder (ADHD) should be considered to have a developmental presentation of mania. Method: A selective review of the literature related to this question, along with recommendations to guide clinical assessment. Results: Data indicate differences between youth with episodic mania and those with non-episodic irritability in longitudinal diagnostic associations, family history, and pathophysiology. In youth with episodic mania, elation and irritability are both common during manic episodes. Conclusions: In diagnosing mania in youth, clinicians should focus on the presence of episodes that consist of a distinct change in mood accompanied by concurrent changes in cognition and behavior. BD should not be diagnosed in the absence of such episodes. In youth with ADHD, symptoms such as distractibility and agitation should be counted as manic symptoms only if they are markedly increased over the youth's baseline symptoms at the same time that there is a distinct change in mood and the occurrence of other associated symptoms of mania. Although different techniques for diagnosing comorbid illnesses have not been compared systematically, it appears most rational to diagnose co-occurring illnesses such as ADHD only if the symptoms of the co-occurring illness are present when the youth is euthymic. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2008.01953.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=718 [article] Practitioner Review: The assessment of bipolar disorder in children and adolescents [Texte imprimé et/ou numérique] / Argelinda BARONI, Auteur ; Ellen LEIBENLUFT, Auteur ; Kenneth E. TOWBIN, Auteur ; Jessica R. LUNSFORD, Auteur ; David A. LUCKENBAUGH, Auteur . - 2009 . - p.203-215. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 50-3 (March 2009) . - p.203-215 Mots-clés : Bipolar-disorder severe-mood-dysregulation mania diagnosis-assessment Index. décimale : PER Périodiques Résumé : Background: An increasing number of youth are being diagnosed with, and treated for, bipolar disorder (BD). Controversy exists about whether youth with non-episodic irritability and symptoms of attention deficit hyperactivity disorder (ADHD) should be considered to have a developmental presentation of mania. Method: A selective review of the literature related to this question, along with recommendations to guide clinical assessment. Results: Data indicate differences between youth with episodic mania and those with non-episodic irritability in longitudinal diagnostic associations, family history, and pathophysiology. In youth with episodic mania, elation and irritability are both common during manic episodes. Conclusions: In diagnosing mania in youth, clinicians should focus on the presence of episodes that consist of a distinct change in mood accompanied by concurrent changes in cognition and behavior. BD should not be diagnosed in the absence of such episodes. In youth with ADHD, symptoms such as distractibility and agitation should be counted as manic symptoms only if they are markedly increased over the youth's baseline symptoms at the same time that there is a distinct change in mood and the occurrence of other associated symptoms of mania. Although different techniques for diagnosing comorbid illnesses have not been compared systematically, it appears most rational to diagnose co-occurring illnesses such as ADHD only if the symptoms of the co-occurring illness are present when the youth is euthymic. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2008.01953.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=718

Trauma diagnoses during emergency psychiatric evaluation among youth with and without autism spectrum disorder / Sakshi DHIR ; Fei GUO ; Yuxiao SONG ; Cheryl R. STEIN ; Argelinda BARONI in Autism, 28-12 (December 2024)  

Public ISBD [article]  inAutism > 28-12 (December 2024) . - p.3201-3207 Titre : Trauma diagnoses during emergency psychiatric evaluation among youth with and without autism spectrum disorder Type de document : Texte imprimé et/ou numérique Auteurs : Sakshi DHIR, Auteur ; Fei GUO, Auteur ; Yuxiao SONG, Auteur ; Cheryl R. STEIN, Auteur ; Argelinda BARONI, Auteur Article en page(s) : p.3201-3207 Langues : Anglais (eng) Mots-clés : autism  trauma  psychiatric co-morbidity Index. décimale : PER Périodiques Résumé : Autistic youth are more likely to experience traumatic events and may be more likely to develop trauma-related symptoms. However, accurately identifying trauma-related symptoms in autistic youth can be challenging. We examined post-traumatic stress disorder (PTSD) and other trauma-related diagnoses in youth with and without autism spectrum disorder (ASD) in a large, pediatric psychiatric emergency department (ED) in a diverse urban setting. Between March 2019 and November 2021, 2728 patients presented at our emergency psychiatric ED. Youth with ASD were 42% less likely to receive trauma-related diagnoses (prevalence ratio 0.58, 95% CI 0.41, 0.80) compared with youth without ASD. One possible explanation for this finding is that trauma-related symptoms are under-detected in youth with ASD during emergency psychiatric evaluations. There is a need for trauma screening and diagnostic instruments specifically tailored to the unique needs of youth with ASD to ensure optimal assessment and care. Lay abstract Autistic youth are more likely to experience maltreatment, victimization, and other traumatic events. However, it can be difficult to identify trauma-related symptoms in autistic youth, especially in those with limited verbal communication. In this study, we compared the prevalence of trauma-related diagnoses given to youth with autism spectrum disorder (ASD) to those given to youth without ASD who presented to a specialized pediatric psychiatric emergency department. We found that youth with ASD were 42% less likely to receive trauma-related diagnoses than youth without ASD. As there is evidence that youth with ASD are no less likely to experience traumatic events compared with youth without ASD, one possible explanation for this result is that trauma-related symptoms are missed during emergency psychiatric evaluations. Developing trauma screening instruments specifically designed for the needs of youth with ASD is an outstanding need. En ligne : https://dx.doi.org/10.1177/13623613241274832 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=543 [article] Trauma diagnoses during emergency psychiatric evaluation among youth with and without autism spectrum disorder [Texte imprimé et/ou numérique] / Sakshi DHIR, Auteur ; Fei GUO, Auteur ; Yuxiao SONG, Auteur ; Cheryl R. STEIN, Auteur ; Argelinda BARONI, Auteur . - p.3201-3207. Langues : Anglais (eng) in Autism > 28-12 (December 2024) . - p.3201-3207 Mots-clés : autism  trauma  psychiatric co-morbidity Index. décimale : PER Périodiques Résumé : Autistic youth are more likely to experience traumatic events and may be more likely to develop trauma-related symptoms. However, accurately identifying trauma-related symptoms in autistic youth can be challenging. We examined post-traumatic stress disorder (PTSD) and other trauma-related diagnoses in youth with and without autism spectrum disorder (ASD) in a large, pediatric psychiatric emergency department (ED) in a diverse urban setting. Between March 2019 and November 2021, 2728 patients presented at our emergency psychiatric ED. Youth with ASD were 42% less likely to receive trauma-related diagnoses (prevalence ratio 0.58, 95% CI 0.41, 0.80) compared with youth without ASD. One possible explanation for this finding is that trauma-related symptoms are under-detected in youth with ASD during emergency psychiatric evaluations. There is a need for trauma screening and diagnostic instruments specifically tailored to the unique needs of youth with ASD to ensure optimal assessment and care. Lay abstract Autistic youth are more likely to experience maltreatment, victimization, and other traumatic events. However, it can be difficult to identify trauma-related symptoms in autistic youth, especially in those with limited verbal communication. In this study, we compared the prevalence of trauma-related diagnoses given to youth with autism spectrum disorder (ASD) to those given to youth without ASD who presented to a specialized pediatric psychiatric emergency department. We found that youth with ASD were 42% less likely to receive trauma-related diagnoses than youth without ASD. As there is evidence that youth with ASD are no less likely to experience traumatic events compared with youth without ASD, one possible explanation for this result is that trauma-related symptoms are missed during emergency psychiatric evaluations. Developing trauma screening instruments specifically designed for the needs of youth with ASD is an outstanding need. En ligne : https://dx.doi.org/10.1177/13623613241274832 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=543

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