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1.
PLoS One ; 11(3): e0151100, 2016.
Article in English | MEDLINE | ID: mdl-26938936

ABSTRACT

BACKGROUND: The aim of the current study was to explore the role of aromatic amino acids (AAAs) in blood in relation to attention-deficit/hyperactivity disorder (ADHD). Given their impact on the synthesis of serotonin and dopamine, decreased concentrations of the AAAs tryptophan, tyrosine and phenylalanine in blood may contribute to the expression of ADHD symptoms. Decreased AAA blood concentrations, in turn, may be related to lowered dietary protein intake or to abnormal AAA catabolism, as evidenced by increased urinary AAA concentrations. METHODS: Eighty-three children with ADHD (75% males) and 72 typically developing (TD) children (51% males), aged 6 to 13 years, participated in the study. AAA concentrations were assessed in blood spots and an 18-hour urinary sample. A nutritional diary was filled out by parents to calculate dietary protein intake. Parent and teacher questionnaires assessed symptoms of ADHD, oppositional defiant disorder, conduct disorder, and autism spectrum disorder. RESULTS: Children with ADHD showed normal AAA concentrations in blood spots and urine, as well as normal protein intake compared to controls. No associations between AAA concentrations and symptoms of ADHD or comorbid psychiatric disorders were found. CONCLUSIONS: This study is the first to explore AAA metabolism in children with ADHD using a well-defined and relatively large sample. We found that AAA deficiencies are not related to ADHD. The results do not support treatment with AAA supplements in children with ADHD. Future studies regarding the cause of serotonin and dopamine alterations in ADHD should focus on other explanations, such as effects of altered transport of AAAs.


Subject(s)
Attention Deficit Disorder with Hyperactivity/blood , Phenylalanine/blood , Tryptophan/blood , Tyrosine/blood , Adolescent , Attention Deficit Disorder with Hyperactivity/urine , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/urine , Autism Spectrum Disorder/blood , Autism Spectrum Disorder/urine , Case-Control Studies , Child , Conduct Disorder/blood , Conduct Disorder/urine , Diet , Dietary Proteins/chemistry , Female , Humans , Male , Netherlands , Phenylalanine/urine , Surveys and Questionnaires , Tryptophan/urine , Tyrosine/urine
2.
J Child Adolesc Psychopharmacol ; 24(3): 140-8, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24689967

ABSTRACT

OBJECTIVE: Epidemiological research links aggression to low serum concentrations of omega-3 fatty acids, such as those found in fish oil. However, no studies have specifically examined whether fish oil supplementation can reduce the frequency and severity of impulsive aggression in children with disruptive behavior disorders. METHODS: Children presenting with impulsive aggression and meeting research criteria for diagnosis of disruptive behavior disorders were randomized to receive either: 1) Fish oil capsules (4 g daily) for 6 weeks followed by placebo (identical-looking capsules) for 6 weeks; or 2) placebo for 6 weeks, followed by fish oil for 6 weeks, in a double-blind, crossover design. Primary outcomes were the Children's Aggression Scale and the Modified Overt Aggression Scale. Secondary outcomes included emotional and behavioral functioning (Strengths and Difficulties Questionnaire [SDQ]), hyperactivity symptoms (Attention-Deficit/Hyperactivity Disorder [ADHD] Rating Scale), family functioning (Family Assessment Device), and cognitive functioning (Stop Signal Task, Trail-Making Task, and Eriksen Flanker Task). Serum concentrations of omega-3 and omega-6 fatty acids were measured at baseline, and at 6 and 12 weeks. RESULTS: Twenty-one children participated (81% male; mean age 10.3±2.2 years; range 7-14). Fish oil treatment increased serum concentrations of eicosapentanoic acid (F=14.76, p<0.05) and total omega-3s (F=20.56, p<0.05), but did not influence primary ratings of aggression. In fact, a trend suggested that fish oil worsened a secondary measure of aggression (SDQ Conduct Subscale, F=4.34, p=0.06). Fish oil treatment was associated with an improvement in one rating of hyperactivity (SDQ Hyperactivity Subscale, F=2.22, p<0.05), but did not influence any other outcome measures. CONCLUSIONS: These findings suggest that fish oil treatment does not improve aggression in children with disruptive behavior disorders.


Subject(s)
Aggression/drug effects , Attention Deficit and Disruptive Behavior Disorders/diet therapy , Fish Oils/pharmacology , Fish Oils/therapeutic use , Impulsive Behavior/drug effects , Adolescent , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/complications , Child , Cognition/drug effects , Cross-Over Studies , Double-Blind Method , Fatty Acids, Omega-3/blood , Fatty Acids, Omega-6/blood , Female , Fish Oils/adverse effects , Humans , Male , Treatment Outcome
4.
Am J Psychiatry ; 170(10): 1161-8, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23846912

ABSTRACT

OBJECTIVE: Maternal depression across the postbirth period has long-term negative consequences for infant development. Little is known of the neurobiological underpinnings, but they could involve oxytocin, a neuropeptide that is dysfunctional in depression and is implicated in birth and parenting. METHOD: The authors recruited a community cohort of women with high or low depression scores 2 days after childbirth and measured depression again at 6 and 9 months. When the child was 6, the authors evaluated the families of 46 chronically depressed mothers and 103 mothers reporting no depression since childbirth. The child was assessed for psychiatric diagnoses, social engagement, and empathy. Mother, father, and child were tested for salivary oxytocin level and variation in the rs2254298 single nucleotide polymorphism on the OXTR gene. RESULTS: Of the children of the chronically depressed mothers, 61% displayed axis I disorders, mainly anxiety and oppositional defiant disorder, compared with 15% of the children of nondepressed mothers. In the depressed mothers' families, salivary oxytocin was lower in mothers, fathers, and children, and the children had lower empathy and social engagement levels. The rs2254298 GG homozygous genotype was overrepresented in depressed mothers and their families, and it correlated with lower salivary oxytocin. Presence of a single rs2254298 A allele (GA or AA genotype) in depressed mothers markedly decreased risk of child psychopathology. CONCLUSIONS: The negative effect of chronic maternal depression on child social outcomes was related to genetic and peripheral biomarkers of the oxytocin system. This suggests a potential for oxytocin-based interventions.


Subject(s)
Child of Impaired Parents/psychology , Depression, Postpartum/psychology , Empathy/physiology , Mothers/psychology , Oxytocin/blood , Social Adjustment , Social Behavior , Adult , Alleles , Anxiety Disorders/blood , Anxiety Disorders/diagnosis , Anxiety Disorders/genetics , Anxiety Disorders/psychology , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/genetics , Attention Deficit and Disruptive Behavior Disorders/psychology , Child , Child, Preschool , Cohort Studies , Depression, Postpartum/blood , Depression, Postpartum/diagnosis , Depression, Postpartum/genetics , Female , Follow-Up Studies , Genotype , Homozygote , Humans , Infant , Male , Polymorphism, Single Nucleotide/genetics , Receptors, Oxytocin/genetics
5.
Horm Res Paediatr ; 77(4): 235-40, 2012.
Article in English | MEDLINE | ID: mdl-22538969

ABSTRACT

AIMS: This cross-sectional study investigates the effect of antipsychotic (AP)-induced hyperprolactinemia on testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), inhibin B, and puberty in boys with mainly autism spectrum disorders (ASD). METHOD: One hundred and four physically healthy 10- to 19-year-old boys with ASD or disruptive behavior disorder (DBD) were recruited between October 2006 and November 2009. Fifty-six adolescents had been treated with AP for >16 months; 48 had never been exposed to AP. Morning non-fasting levels of serum prolactin, testosterone, LH, FSH and inhibin B were obtained and Tanner pubertal stage was determined. Patients with hyperprolactinemia (n = 28) were compared to those without hyperprolactinemia (n = 76) using non-parametric or parametric tests, as appropriate. RESULTS: Patients with AP-induced hyperprolactinemia had significantly lower testosterone levels with adjustment for age (p = 0.035) compared to patients without hyperprolactinemia and without AP treatment. The difference was not significant within the AP-treated group, and the level of testosterone was within the reference range compared to age- and gender-matched normative data. There was no between-group difference for LH, FSH, inhibin B or Tanner stages. CONCLUSION: AP-induced hyperprolactinemia is related to significantly lower testosterone levels in pubertal boys with ASD and DBD.


Subject(s)
Antipsychotic Agents/adverse effects , Attention Deficit and Disruptive Behavior Disorders/blood , Child Development Disorders, Pervasive/blood , Hyperprolactinemia/chemically induced , Puberty , Testosterone/blood , Adolescent , Adult , Antipsychotic Agents/administration & dosage , Antipsychotic Agents/therapeutic use , Attention Deficit and Disruptive Behavior Disorders/drug therapy , Attention Deficit and Disruptive Behavior Disorders/physiopathology , Child , Child Development Disorders, Pervasive/drug therapy , Child Development Disorders, Pervasive/physiopathology , Cross-Sectional Studies , Dopamine Antagonists/administration & dosage , Dopamine Antagonists/adverse effects , Dopamine Antagonists/therapeutic use , Dopamine D2 Receptor Antagonists , Follicle Stimulating Hormone, Human/blood , Humans , Inhibins/blood , Luteinizing Hormone/blood , Male , Puberty/drug effects , Puberty, Delayed/chemically induced , Puberty, Delayed/etiology , Time Factors , Young Adult
6.
J Clin Child Adolesc Psychol ; 40(4): 562-71, 2011.
Article in English | MEDLINE | ID: mdl-21722028

ABSTRACT

The study examined whether psychosocial intervention for children diagnosed with a disruptive behavior disorder (DBD; n = 84) changed concentrations of cortisol and testosterone across a 3-year follow-up when compared to a matched, nonclinical, healthy comparison (HC; n = 69) group. Boys and girls (6-11 years) with a DBD were randomly assigned to one of two arms of a multimethod intervention. Hierarchical linear modeling revealed that children undergoing psychosocial intervention for a DBD experienced a significant decline in diurnal cortisol change over time (p < .05) when compared to the HC condition. Boys with a DBD diagnosis had significantly lower mean cortisol concentrations prior to treatment (p < .05) and showed a significantly steeper increase in mean cortisol over time (p < .05) when compared to HC boys. Treatment effects for diurnal cortisol change were replicated in the boys-only analysis. No treatment effects were noted for testosterone in either analysis.


Subject(s)
Attention Deficit and Disruptive Behavior Disorders/therapy , Hydrocortisone/analysis , Testosterone/analysis , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/physiopathology , Child , Circadian Rhythm , Cognitive Behavioral Therapy , Female , Humans , Male , Psychiatric Status Rating Scales , Saliva/chemistry , Treatment Outcome
8.
Acta Paediatr ; 98(4): 731-6, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19133873

ABSTRACT

OBJECTIVE: To determine the effect of zinc supplementation on behaviour in low-income school aged children. DESIGN: Double-blind randomized, placebo controlled trial. SETTING: Low-income district primary school in Turkey. PARTICIPANTS: Third grade students in the school. Among 252 students, 226 participated and 218 completed the study. INTERVENTION: Children in each class were randomized either to the study group to receive 15 mg/day elemental zinc syrup or to placebo group to receive the syrup without zinc for 10 weeks. MAIN OUTCOME MEASURES: The change in Conner's Rating Scales for Teachers and Parents scores after supplementation. RESULTS: The mean Conner's Rating Scale for Parents scores on attention deficit, hyperactivity, oppositional behaviour and conduct disorder decreased significantly in the study and placebo groups after supplementation (p < 0.01). The prevalence of children with clinically significant parent ratings on attention deficit (p = 0.01) and hyperactivity (p = 0.004) decreased in the study group while prevalence of oppositional behaviour (p = 0.007) decreased in the placebo group. In children of mothers with low education all mean Parents' scores decreased significantly (p < 0.01) in the study group while only hyperactivity scores decreased in the placebo group (p < 0.01). In this subgroup the prevalence of children with clinically significant scores for attention deficit, hyperactivity and oppositional behaviour decreased only in the study group (p < 0.05). There was no change in mean Teachers' scores. CONCLUSION: In our study zinc supplementation decreased the prevalence of children with clinically significant scores for attention deficit and hyperactivity. The affect on behaviour was more evident in the children of low educated mothers.


Subject(s)
Behavior/drug effects , Zinc/administration & dosage , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/drug therapy , Child , Dietary Supplements , Double-Blind Method , Educational Status , Faculty , Female , Humans , Male , Mothers , Personality Assessment , Poverty Areas , Psychomotor Agitation/blood , Psychomotor Agitation/drug therapy , Schools , Turkey , Zinc/blood , Zinc/deficiency
9.
J Clin Psychopharmacol ; 27(6): 590-4, 2007 Dec.
Article in English | MEDLINE | ID: mdl-18004125

ABSTRACT

We investigated ghrelin, leptin, glucose, and insulin response to an oral glucose tolerance test among children receiving antipsychotics. Hormone concentrations were assayed at fasting, 30, 60, and 120 minutes. The sample was composed of 9 obese (defined as at or above the 95th percentile for age) and 10 overweight/normal children (defined as less than the 95th percentile in weight) based on National Institutes of Health criteria. Ages of the obese (10.7 +/- 3.4 years) and the overweight/normal (13.1 +/- 1.6 years) did not differ. Leptin was significantly higher among the obese group and did not change consequent to glucose. Ghrelin did not differ between the groups, and when the values were combined, ghrelin decreased at 30 minutes and approached fasting concentrations at 120 minutes. To further explore our data, we constituted separate groups based upon z score changes. When weight gain defined as an increase in z score (X = 0.4), the nongainers showed leptin concentrations to decrease over time. Findings encourage further oral glucose tolerance test studies to explain the leptin response to weight gain seen among children receiving antipsychotic medication.


Subject(s)
Antipsychotic Agents/therapeutic use , Attention Deficit and Disruptive Behavior Disorders/drug therapy , Ghrelin/blood , Glucose/administration & dosage , Leptin/blood , Administration, Oral , Adolescent , Age Factors , Analysis of Variance , Antipsychotic Agents/administration & dosage , Aripiprazole , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/physiopathology , Blood Glucose/metabolism , Body Mass Index , Child , Chlorpromazine/administration & dosage , Chlorpromazine/therapeutic use , Fasting/blood , Female , Glucose/pharmacokinetics , Glucose Tolerance Test/methods , Humans , Insulin/blood , Male , Piperazines/administration & dosage , Piperazines/therapeutic use , Quinolones/administration & dosage , Quinolones/therapeutic use , Risperidone/administration & dosage , Risperidone/therapeutic use , Sex Factors , Time Factors , Weight Gain/drug effects
10.
J Child Adolesc Psychopharmacol ; 16(3): 252-9, 2006 Jun.
Article in English | MEDLINE | ID: mdl-16768633

ABSTRACT

INTRODUCTION: The psychopharmacology of aggression in youth is relatively unexplored, even though such maladaptive aggression manifests across many different diagnoses. METHODS: This study was a 12-week, open-label trial with divalproex sodium (DVPX) in 24 bipolar offspring 6-18 years of age (mean age = 11.3 years; 17 boys) with mixed diagnoses of major depression, cyclothymia, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD). The Overt Aggression Scale (OAS) was used to measure aggression in 4-week intervals. We measured serum gamma-butyric acid (GABA) and glutamate levels at baseline and week 12. RESULTS: Seventy-one percent of evaluable subjects were considered responders to DVPX treatment by the OAS. There was a significant correlation between the Young Mania Rating Scale (YMRS) and OAS scores at week 0 (p = 0.036) and week 12 (p = 0.025). Serum DVPX level did not correlate with treatment response. CONCLUSIONS: These youths who are at high risk for bipolar disorder experienced an overall decrease in aggressive behavior in response to DVPX. Age or gender did not predict a positive response to DVPX. This study is the first report of treatment efficacy of a mood stabilizer for aggression in youth at high risk for bipolar disorder.


Subject(s)
Aggression/drug effects , Antimanic Agents/therapeutic use , GABA Agents/therapeutic use , Valproic Acid/therapeutic use , Adolescent , Affect/drug effects , Attention Deficit Disorder with Hyperactivity/blood , Attention Deficit Disorder with Hyperactivity/drug therapy , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/drug therapy , Bipolar Disorder , Child , Cyclothymic Disorder/blood , Cyclothymic Disorder/drug therapy , Depressive Disorder, Major/blood , Depressive Disorder, Major/drug therapy , Dysthymic Disorder/blood , Dysthymic Disorder/drug therapy , Female , Glutamic Acid/blood , Humans , Male , Risk Factors , gamma-Aminobutyric Acid/blood
11.
Psychiatry Res ; 134(1): 1-10, 2005 Mar 30.
Article in English | MEDLINE | ID: mdl-15808285

ABSTRACT

Cortisol has been implicated in psychobiological explanations of antisocial behavior. This study measured basal salivary cortisol in a sample of 25 children (age range 6 to 12 years) selected to vary in levels of antisocial behavior. Regression analyses were used to predict cortisol concentrations from parent- and teacher-reported symptoms. Parent-reported symptoms did not predict basal cortisol. Teacher-reported conduct disorder (CD) symptoms explained 38% of the variance in the cortisol concentrations, with high symptom severity associated with low cortisol. When a distinction was made between aggressive and non-aggressive CD symptoms, aggressive CD symptoms were more clearly related to low cortisol than non-aggressive CD symptoms. In contrast to previous research, no evidence was found for a mediating role of anxiety symptoms in the relationship between CD and cortisol. The results support biologically based models of antisocial behavior in children that involve reduced autonomic activity.


Subject(s)
Antisocial Personality Disorder/diagnosis , Child Behavior Disorders/diagnosis , Hydrocortisone/blood , Personality Assessment/statistics & numerical data , Adolescent , Aggression/physiology , Antisocial Personality Disorder/blood , Antisocial Personality Disorder/psychology , Anxiety/blood , Anxiety/diagnosis , Anxiety/psychology , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/psychology , Child , Child Behavior Disorders/blood , Child Behavior Disorders/psychology , Female , Humans , Male , Predictive Value of Tests , Psychometrics/statistics & numerical data , Regression Analysis , Saliva/metabolism , Statistics as Topic
13.
J Am Acad Child Adolesc Psychiatry ; 43(8): 1011-8, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15266196

ABSTRACT

OBJECTIVE: Basal cortisol and cortisol stress responsivity are valuable biological characteristics of children with disruptive behavior disorder (DBD). In this study, the predictive value of cortisol to outcome of intervention was investigated. METHOD: Basal cortisol levels and cortisol levels under stress were studied in 22 children with DBD before the start of a psychotherapeutic treatment. The disruptive behavior of the child was assessed before treatment and after cessation (9 months later). RESULTS: Children with DBD with relatively high and low basal cortisol levels differed in the severity of problem behavior at pretreatment, with the low basal cortisol group having more severe problems. During stress, children with DBD showed either increasing or decreasing cortisol values. Although these cortisol responsivity groups were similar in the severity of behavioral problems at pretreatment, the behavioral problems of the group with high cortisol stress responsivity were significantly lower after the intervention than the behavioral problems of the group with low cortisol stress responsivity. CONCLUSIONS: In children with DBD, the basal cortisol level was related to the severity of behavioral problems at pretreatment but not to the severity of behavioral problems after treatment. The cortisol response pattern during stress was related to treatment outcome.


Subject(s)
Aggression/physiology , Attention Deficit and Disruptive Behavior Disorders/therapy , Behavior Therapy , Cognitive Behavioral Therapy , Family Therapy , Hydrocortisone/blood , Adolescent , Attention Deficit Disorder with Hyperactivity/blood , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/therapy , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Child , Comorbidity , Female , Follow-Up Studies , Humans , Male , Outcome Assessment, Health Care , Personality Assessment , Psychotherapy, Group
14.
Am J Psychiatry ; 161(5): 918-20, 2004 May.
Article in English | MEDLINE | ID: mdl-15121661

ABSTRACT

OBJECTIVE: This study assessed the impact of risperidone on growth and sexual maturation. METHOD: The pooled database of five studies included 700 children ages 5-15 years with disruptive behavior disorders. All evaluable patients had received risperidone for 11 or 12 months. Those evaluable for growth also had baseline and 11- or 12-month height measurements (N=350); girls >/=9 years and boys >/=10 years who were evaluable for sexual maturation also had baseline and 11- or 12-month Tanner staging (N=222). RESULTS: Risperidone-treated children had a mean increase in height 1.2 cm greater than the reference population, and they experienced no delay in progression through Tanner staging. Transient increases in prolactin did not correlate with growth or sexual maturation. CONCLUSIONS: In this retrospective analysis, there was no evidence of statistically or clinically significant growth failure or delay in pubertal onset or progression in children treated for up to 1 year with risperidone.


Subject(s)
Antipsychotic Agents/therapeutic use , Attention Deficit and Disruptive Behavior Disorders/drug therapy , Growth/drug effects , Risperidone/therapeutic use , Sexual Maturation/drug effects , Adolescent , Antipsychotic Agents/pharmacology , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/psychology , Child , Child, Preschool , Clinical Trials as Topic , Drug Administration Schedule , Growth/physiology , Humans , Longitudinal Studies , Prolactin/blood , Prolactin/drug effects , Retrospective Studies , Risperidone/pharmacology , Sexual Maturation/physiology , Treatment Outcome
15.
Arch Gen Psychiatry ; 60(12): 1248-55, 2003 Dec.
Article in English | MEDLINE | ID: mdl-14662557

ABSTRACT

BACKGROUND: Despite the robust and widely replicated finding of elevated hypothalamic-pituitary-adrenal (HPA) axis reactivity in depressed adults, studies of depressed children have yielded ambiguous findings. Animal models of early depression and studies of children experiencing early psychosocial deprivation have suggested that alterations in HPA axis reactivity are evident in early "depressive-like" conditions. The current study is, to our knowledge, the first investigation of HPA axis reactivity in very young children with a clinical depressive syndrome for which content validity has been established. METHODS: Depressed, psychiatric, and no-disorder comparison children aged 3 through 5.6 years were studied for HPA axis reactivity in response to experimental psychosocial stressors. The children were diagnosed using a developmentally appropriate, structured psychiatric interview. Salivary cortisol was obtained at 3 time points during a laboratory assessment before and after stressors involving separation from the parent and frustrating tasks. RESULTS: Repeated measures of multivariate analysis of variance revealed a significant interaction between the diagnostic group and 2 cortisol percent change scores. Depressed preschoolers displayed a pattern of increasing cortisol levels throughout the assessment in response to both separation and frustration stressors. In contrast, both comparison groups showed decreasing cortisol levels in response to the separation stressor. All groups displayed increasing cortisol levels in response to frustrating tasks. Preschoolers with a presumptive melancholic depressive subtype displayed these alterations at a greater magnitude relative to comparison groups. CONCLUSIONS: To our knowledge, these findings are the first to demonstrate altered HPA axis reactivity in depressed preschoolers. These alterations are consistent with those described in depressed adults and in animal models of early depression. These findings provide evidence for possible continuity of HPA axis alterations in depressive disorders across the lifespan and are discussed in the context of prior studies of HPA axis reactivity in clinically depressed children and adolescents, suggesting that younger age and inpatient status are features associated with altered HPA axis reactivity.


Subject(s)
Depressive Disorder, Major/blood , Stress, Psychological/complications , Arousal/physiology , Attention Deficit Disorder with Hyperactivity/blood , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/psychology , Child, Preschool , Depressive Disorder, Major/psychology , Female , Frustration , Humans , Hypothalamo-Hypophyseal System/physiopathology , Male , Personality Assessment , Pituitary-Adrenal System/physiopathology , Reference Values , Saliva/metabolism , Stress, Psychological/blood
16.
Lipids ; 38(10): 1007-21, 2003 Oct.
Article in English | MEDLINE | ID: mdl-14669965

ABSTRACT

This pilot study evaluated the effects of supplementation with PUFA on blood FA composition and behavior in children with Attention-Deficit/Hyperactivity Disorder (AD/HD)-like symptoms also reporting thirst and skin problems. Fifty children were randomized to treatment groups receiving either a PUFA supplement providing a daily dose of 480 mg DHA, 80 mg EPA, 40 mg arachidonic acid (AA), 96 mg GLA, and 24 mg alpha-tocopheryl acetate, or an olive oil placebo for 4 mon of double-blind parallel treatment. Supplementation with the PUFA led to a substantial increase in the proportions of EPA, DHA, and alpha-tocopherol in the plasma phospholipids and red blood cell (RBC) total lipids, but an increase was noted in the plasma phospholipid proportions of 18:3n-3 with olive oil as well. Significant improvements in multiple outcomes (as rated by parents) were noted in both groups, but a clear benefit from PUFA supplementation for all behaviors characteristic of AD/HD was not observed. For most outcomes, improvement of the PUFA group was consistently nominally better than that of the olive oil group; but the treatment difference was significant, by secondary intent-to-treat analysis, on only 2 out of 16 outcome measures: conduct problems rated by parents (-42.7 vs. -9.9%, n = 47, P = 0.05), and attention symptoms rated by teachers (-14.8 vs. +3.4%, n = 47, P = 0.03). PUFA supplementation led to a greater number of participants showing improvement in oppositional defiant behavior from a clinical to a nonclinical range compared with olive oil supplementation (8 out of 12 vs. 3 out of 11, n = 33, P = 0.02). Also, significant correlations were observed when comparing the magnitude of change between increasing proportions of EPA in the RBC and decreasing disruptive behavior as assessed by the Abbreviated Symptom Questionnaire (ASQ) for parents (r = -0.38, n = 31, P < 0.05), and for EPA and DHA in the RBC and the teachers' Disruptive Behavior Disorders (DBD) Rating Scale for Attention (r = -0.49, n = 24, P < 0.05). Interestingly, significant correlations were observed between the magnitude of increase in alpha-tocopherol concentrations in the RBC and a decrease in scores for all four subscales of the teachers' DBD (Hyperactivity, r = -0.45; Attention, r= -0.60; Conduct, r = -0.41; Oppositional/Defiant Disorder, r = -0.54; n = 24, P < 0.05) as well as the ASQ for teachers (r = -0.51, n = 24, P < 0.05). Thus, the results of this pilot study suggest the need for further research with both n-3 FA and vitamin E in children with behavioral disorders.


Subject(s)
Attention Deficit Disorder with Hyperactivity/drug therapy , Dietary Supplements , Fatty Acids, Unsaturated/therapeutic use , Adolescent , Attention Deficit Disorder with Hyperactivity/blood , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/drug therapy , Attention Deficit and Disruptive Behavior Disorders/psychology , Child , Double-Blind Method , Fatty Acids, Unsaturated/pharmacology , Female , Humans , Male , Olive Oil , Pilot Projects , Plant Oils/pharmacology , Plant Oils/therapeutic use , Skin Diseases/blood , Skin Diseases/drug therapy , Thirst/drug effects , Thirst/physiology
17.
J Am Acad Child Adolesc Psychiatry ; 39(11): 1446-51, 2000 Nov.
Article in English | MEDLINE | ID: mdl-11068901

ABSTRACT

OBJECTIVE: To examine the relationship between adrenal androgens and aggression in children with oppositional and antisocial behavior and to compare their levels with those of psychiatric and normal controls. METHOD: Dehydroepiandrosterone sulfate (DHEAS) was measured in 24 children with oppositional defiant disorder (ODD), 42 psychiatric controls (including 20 children with attention-deficit/hyperactivity disorder [ADHD]), and 30 normal controls. The children's parents filled out the Child Behavior Checklist (CBCL). RESULTS: Children with ODD had higher DHEAS levels than either the psychiatric control or normal control groups; DHEAS levels of the latter groups did not differ. Moreover, it was possible to classify children as having either ODD or ADHD on the basis of their DHEAS levels, whereas this was not the case on the basis of the CBCL data. CONCLUSIONS: The results indicate that adrenal androgen functioning is specifically elevated in children with ODD. It is speculated that the mechanism could be a shift in balance of ACTH-beta-endorphin functioning in the hypothalamic-pituitary-adrenal axis due to early stress or genetic factors.


Subject(s)
Adrenal Glands/metabolism , Aggression , Androgens/metabolism , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/psychology , Dehydroepiandrosterone Sulfate/blood , Analysis of Variance , Attention Deficit and Disruptive Behavior Disorders/physiopathology , Case-Control Studies , Child , Conduct Disorder/complications , Dehydroepiandrosterone Sulfate/metabolism , Female , Humans , Hypothalamo-Hypophyseal System , Male , Mental Disorders/blood , Mental Disorders/physiopathology , Mental Disorders/psychology , Pituitary-Adrenal System , Psychiatric Status Rating Scales
18.
Eur Neuropsychopharmacol ; 9(1-2): 141-7, 1999 Jan.
Article in English | MEDLINE | ID: mdl-10082240

ABSTRACT

In two studies the relationship between plasma monoamine metabolites and different parameters of aggression were examined in children suffering from severe aggression and antisocial behavior. No prior studies have related measures of serotonergic function to experimentally elicited aggression and only a few included healthy comparison groups. Plasma 5-HIAA, HVA and MHPG were measured in 15 boys with a oppositional defiant disorder (ODD) and 25 normal controls (NC) (study 1), and 22 ODD and 25 NC children (study 2). On a separate occasion each subject had the opportunity to behave aggressively towards an opponent. 5-HIAA and HVA were significantly lower in the ODD than NC group and both parameters were significantly inversely correlated with aggression and delinquency. These findings were replicated in the second study: The results of the study support a role for serotonergic functioning in persistent antisocial and aggressive behavior in young children.


Subject(s)
Aggression/physiology , Attention Deficit and Disruptive Behavior Disorders/blood , Biogenic Monoamines/blood , Child , Homovanillic Acid/blood , Humans , Hydroxyindoleacetic Acid/blood , Intelligence Tests , Male , Methoxyhydroxyphenylglycol/blood
19.
Biol Psychiatry ; 44(7): 568-77, 1998 Oct 01.
Article in English | MEDLINE | ID: mdl-9787881

ABSTRACT

BACKGROUND: This study reports relationships between suicidal behavior and its risk factors in prepubertal children and whole blood and platelet serotonin-related measures. METHODS: Seventy-five prepubertal psychiatric inpatients including 23 (30.7%) nonsuicidal, 32 (42.7%) with suicidal ideation, and 20 (26.6%) with a suicide attempt were compared to 35 normal prepubertal controls with regard to platelet serotonin content, serotonin-amplified platelet aggregation, and whole blood tryptophan. RESULTS: Mean whole blood tryptophan content was significantly lower among inpatient children with a recent suicide attempt than among normal controls or inpatients with suicidal ideation (F = 3.94, df = 3.54, p < or = .01). Inpatient children with a mood disorder had significantly higher platelet serotonin content than inpatients without a mood disorder (F = 3.86, df = 2.80, p < or = .03). Racial/ethnic differences were also observed for inpatients and normal controls, with whites having significantly lower levels of platelet serotonin (expressed as ng/mL blood or ng/10(9) platelets) than blacks or Latinos. Blacks had significantly higher levels of whole blood tryptophan than other racial/ethnic groups. CONCLUSIONS: The results suggest that whole blood tryptophan and platelet serotonin content should be studied for their predictive validity as risk factors for suicidal behavior in youth while controlling for racial/ethnic differences.


Subject(s)
Mental Disorders/metabolism , Serotonin/metabolism , Suicide/psychology , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/psychology , Blood Platelets/metabolism , Child , Female , Humans , Inpatients , Male , Mental Disorders/blood , Mood Disorders/blood , Mood Disorders/psychology , Platelet Aggregation/drug effects , Psychiatric Status Rating Scales , Receptors, Serotonin/blood , Risk Factors , Serotonin/blood , Suicide, Attempted , Tryptophan/blood
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