Journal of the American Academy of Child and Adolescent Psychiatry

OBJECTIVE: To compare second-generation antipsychotics (SGAs) and mood stabilizers (MSs) in youth with a bipolar disorder type-1 (BD-I) manic/mixed episode. METHOD: Systematic PubMed/Embase/PsycInfo literature search until 12/31/2023 for randomized trials of SGAs or MSs in patients aged ≤18 years with BD-I manic/mixed episode. Network meta-analysis comparing treatments regarding mania symptoms and mania response (co-primary outcomes), and secondary efficacy and tolerability outcomes...

OBJECTIVE: To examine individual and contextual characteristics associated with receipt of mental health treatment prior to youth suicide. METHOD: Data from the U.S. National Violent Death Reporting System, Area Health Resource File, and Social Vulnerability Index were used to examine characteristics associated with receipt of mental health treatment within two months before death among youth suicide decedents aged 5 to 17 years from 2013 to 2020 (N= 6,229). The association between individual (demographic, precipitating circumstances, and clinical characteristics) and contextual-level (county health resources, social vulnerability index) variables and mental health service use was modeled using logistic regression...

We currently face a national crisis in youth mental health and well-being and significant child behavioral health inequities. Addressing social determinants is a primary approach to achieving health equity. Social determinants of mental health (SDoMH) impact every child across the mental health services continuum, with inequities driven by discrimination across social class, race, gender, sexual orientation, physical ability, national origin, intellectual or mental abilities, and other group categories and combinations of group categories...

OBJECTIVE: The aim of the current study was to identify the age at which sexual orientation disparity in mental health diagnoses can be first identified, and gender and sexual identity subgroup differences in such treatment, in a population-based sample. METHOD: Individuals aged 16 to 25 (n=10,365) participating in the probability-based Swedish National Public Health Survey in 2018 were included. This sample was linked to physician-assessed mental health care treatment history data starting when all individuals in the sample were 8 years old, using national health care registries...

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OBJECTIVE: Clinically anxious youth are hypervigilant to emotional stimuli and display difficulty shifting attention from emotional to non-emotional stimuli, suggesting impairments in cognitive control over emotion. However, it is unknown whether the neural substrates of such biases vary across the clinical-to-nonclinical range of anxiety or by age. METHOD: Youth aged 7-17 years with clinical anxiety (N = 119) or without an anxiety diagnosis (N = 41) matched emotional faces or matched shapes flanked by emotional face distractors during magnetic resonance imaging, probing emotion processing and cognitive control over emotion, respectively...

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OBJECTIVE: We present results from a 2-site, randomized clinical trial to assess the efficacy of a brief intervention (As Safe As Possible [ASAP]), a safety plan phone application (BRITE), and their combination on suicide attempts, suicidal ideation, non-suicidal self-injury, re-hospitalizations. and suicidal events among adolescents. METHOD: Adolescents (n= 240; 12-17 years of age) who were hospitalized for suicidal ideation with plan and/or intent, and/or suicide attempt, were assigned to 1 of 4 treatment conditions in a 2 by 2 design: ASAP+BRITE app+treatment as usual (TAU); (2) BRITE+TAU; (3) ASAP+TAU; and (4) TAU alone...

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We read with great interest the article by Srinivasan et al.,1 and we are heartened to see a renewed focus on irritability as an important phenomenon that necessitates better understanding. In particular, the hypothesis that irritability in childhood may signal the development of psychiatric problems later in life is a persuasive concept that aligns with our thinking.

OBJECTIVE: Naturalistic developmental behavioral interventions for children with autism spectrum disorder show evidence for effectiveness for specific social communication targets such as joint attention or engagement. However, combining evidence from different studies and comparing intervention effects across those studies have not been feasible due to lack of a standardized outcome measure of broader social communication skills that can be applied uniformly across trials. This investigation examined the usefulness of the Brief Observation of Social Communication Change (BOSCC) as a common outcome measure of general social communication skills based on secondary analyses of data obtained from previously conducted randomized controlled trials of 3 intervention models, Early Social Intervention (ESI), Early Start Denver Model (ESDM) and Joint Attention Symbolic Play Engagement and Regulation (JASPER)...

OBJECTIVE: To examine longitudinal associations between early life threat and deprivation on epigenetic age acceleration at ages 9 and 15, and examine associations of age acceleration on later internalizing and externalizing symptoms. METHOD: The study examines a large (n= 2,039) and racially diverse (Black/African American = 44%, Latino = 18%, White = 5 %) sample from a national dataset. Epigenetic age acceleration was estimated using the pediatric buccal epigenetic clock...

OBJECTIVE: Children and adolescents with obsessive-compulsive disorder (OCD) are at risk of long-term adversity, but factors influencing long-term outcomes are unclear. A general factor of psychopathology, often referred to as the p factor, captures variance shared by all mental disorders and has predicted long-term outcomes in youth with anxiety and depressive disorders. The p factor has never been examined in relation to outcomes in pediatric OCD. Here, we examine whether the p factor predicts four important outcomes over both short and long durations in youth with OCD...

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Suicide is the second leading cause of death among adolescents, and rates of suicidal thoughts and behaviors (STBs) are climbing.1 Promising interventions such as dialectical behavior therapy (DBT) are available to treat suicidal youth, and new approaches may facilitate greater intervention engagement, adherence, and effectiveness.2 Digital tools (eg, personal smartphones) are a particularly promising avenue and could enhance existing, evidence-based interventions by providing new opportunities for assessment and intervention between sessions...