Journal of the American Academy of Child and Adolescent Psychiatry
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J Am Acad Child Adolesc Psychiatry · Mar 2012
Autism spectrum disorder and autistic traits in the Avon Longitudinal Study of Parents and Children: precursors and early signs.
To chart the emergence of precursors and early signs of autism spectrum disorder (ASD) and autistic traits in the Avon Longitudinal Study of Parents and Children, a prospective longitudinal cohort study of the surviving offspring of 14,541 pregnant women from southwestern England with an expected delivery date between April 1991 and December 1992. ⋯ Precursors, early signs, and other developmental differences were reported in the first year of development among children from the general population who later developed autism spectrum disorder and subtler autistic traits. Other differences emerged and unfolded as development progressed. The findings confirm the long-held suspicion that early differences underscore the multifaceted nature of autism spectrum disorder and the broader autism phenotype, and highlight the centrality of impairments in social communication skills.
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J Am Acad Child Adolesc Psychiatry · Mar 2012
Aftercare, emergency department visits, and readmission in adolescents.
U.S. and Canadian data demonstrate decreasing inpatient days, increasing nonurgent emergency department (ED) visits, and short supply of child psychiatrists. Our study aims to determine whether aftercare reduces ED visits and/or readmission in adolescents with first psychiatric hospitalization. ⋯ Our results are provocative: we found that aftercare in the month post-discharge increased the likelihood of readmission but not ED visit. Over and above confounding by severity and Canadian/U.S. systems differences, our results may indicate a relative lack of psychiatric services for youth. Our results point to the need for improved data capture of pediatric mental health service use.
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J Am Acad Child Adolesc Psychiatry · Mar 2012
Mental health in low-to-moderate risk preterm, low birth weight, and small for gestational age children at 4 to 5 years: the role of early maternal parenting.
The majority of children born preterm, with low birth weight, or small for gestational age are born with low-to-moderate risk (LTM), yet most research focuses on the high-risk group. Little is known about whether children with LTM perinatal risk are at greater risk for mental health problems, or what the role of early maternal parenting is in determining these outcomes. ⋯ Children with LTM perinatal risk were at a small increased risk for emotional difficulties but did not differ significantly from other children of similar social backgrounds in their risk for generalized mental health problems. These findings support a biological and socio-economic, rather than parenting, pathway to psychological risk in children born with LTM perinatal risk.
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J Am Acad Child Adolesc Psychiatry · Feb 2012
Outpatient care of young people after emergency treatment of deliberate self-harm.
Little is known about the mental health care received by young people after an episode of deliberate self-harm. This study examined predictors of emergency department (ED) discharge, mental health assessments in the ED, and follow-up outpatient mental health care for Medicaid-covered youth with deliberate self-harm. ⋯ A substantial proportion of young Medicaid beneficiaries who present to EDs with deliberate self-harm are discharged to the community and do not receive emergency mental health assessments or follow-up outpatient mental health care.
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J Am Acad Child Adolesc Psychiatry · Jan 2012
Randomized Controlled Trial Multicenter Study Comparative StudyA controlled trial of extended-release guanfacine and psychostimulants for attention-deficit/hyperactivity disorder.
To examine efficacy, tolerability, and safety of guanfacine extended release (GXR; ≤4 mg/d) adjunctive to a long-acting psychostimulant for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents 6 to 17 years of age with suboptimal, but partial, response to psychostimulant alone. ⋯ Morning or evening GXR administered adjunctively to a psychostimulant showed significantly greater improvement over placebo plus psychostimulant in ADHD symptoms and generated no new safety signals. Clinical trial registration information-Efficacy and Safety of SPD503 in Combination With Psychostimulants; http://www.clinicaltrials.gov; NCT00734578.