ISSN:1044-5463    

DOI:10.1089/cap.1992.2.1

年代:1992

数据来源: MAL

ISSN:1044-5463    

DOI:10.1089/cap.1992.2.5

年代:1992

数据来源: MAL

ISSN:1044-5463    

DOI:10.1089/cap.1992.2.7

年代:1992

数据来源: MAL

摘要:

ABSTRACTDespite the sophistication of the currently available studies on antidepressant treatment of adolescent depression, various methodological problems limit the conclusions that can be drawn. It is difficult to evaluate trends across the available studies because of differences in definitions of treatment response, therapeutic response and placebo response rates, symptomatic subtypes of depression, comorbidity, drugs studied, and study designs that limit the statistical power to detect treatment effects. Some fundamental issues concern the sample selection and reliability of the measurement instruments, as well as the assumption that efficacy of antidepressants in adults is easy to demonstrate. None of the studies now available carefully examine behavioral, social, or academic variables that clinicians commonly use to assess antidepressant effects in adolescents. Before concluding that antidepressants are less effective in treating depression in adolescents than in adults, these methodological issues need further study. The main problem is not merely the small number of studies or low number of subjects. Until the validity of the diagnostic construct of depression in adolescents is better developed, or until more homogeneous samples of patients can be defined, it is pointless to encourage further attempts to assess antidepressant efficacy using the past methodologies.

ISSN:1044-5463    

DOI:10.1089/cap.1992.2.11

年代:1992

数据来源: MAL

摘要:

ABSTRACTIn current pharmacological treatment studies, diagnostic subgroups vary appreciably in phenomenological characteristics, biological dysfunctions, and illness severity. In adults, a variety of diagnostic conditions as well as concurrent psychological and social features, medical disorders, and personality disorders have been proposed to be predictors of weak responsivity to tricyclic antidepressants. Such clinical and diagnostic predictors of treatment response in adults may be applied heuristically in adolescents; however, whether or not these features have the same predictive significance in adolescents is not known. Further, the onset, course, and treatment responsivity of depressive disorders may be more intimately affected by naturally occurring maturational processes in adolescents than in adults. Until pharmacological studies in adolescents address these conceptual and diagnostic problems, we cannot reasonably infer any firm knowledge about the alleged inefficacy of tricyclic antidepressants in adolescents. Without adequate inclusionary and exclusionary criteria, developed in adolescent populations, samples may be studied (and patients may be treated) who have a high likelihood of placebo response or refractoriness to antidepressant treatment.

ISSN:1044-5463    

DOI:10.1089/cap.1992.2.23

年代:1992

数据来源: MAL

摘要:

ABSTRACTCurrent concerns about antidepressant efficacy in children and adolescents are reminiscent of the history of adult studies. Such awareness should temper these concerns, especially in view of the enormous progress in the last two decades of studies of adult depression. A number of methodologie, nosologie, developmental, and validity considerations may have hampered the child and adolescent studies to date; thus, with more careful consideration of past problem areas, future studies may yield more promising results. The next generation of treatment research in child and adolescent depression may require innovative, multisite, longitudinal treatment designs which allow the simultaneous possibility for the continuing clarification and validation of depressive syndromes and treatment-responsive subgroups.

ISSN:1044-5463    

DOI:10.1089/cap.1992.2.31

年代:1992

数据来源: MAL

ISSN:1044-5463    

DOI:10.1089/cap.1992.2.47

年代:1992

数据来源: MAL

摘要:

ABSTRACTThe present study examines the indirect "spillover" effects of methylphenidate on the behavior of the classmates of drug-treated children in public school settings, and it measures the extent to which medication normalizes hyperactive and noncompliant–aggressive behaviors. Eleven aggressive hyperactive boys, who metDSM-IIIdiagnostic criteria for attention deficit disorder, received placebo and methylphenidate in a double-blind crossover design. Medication effects were assessed by conducting observations of the drug-treated boy and his peers in the classroom and lunchroom settings. In most classrooms, a spillover effect did not occur for most of the behaviors assessed, but there was a decrease in the rate of nonphysical aggression exhibited by peers as a function of the hyperactive child's methylphenidate dose. Peers were generally less aggressive when the hyperactive boys were receiving methylphenidate than when they received placebo. In the lunchroom, in contrast, peers appeared slightly more noncompliant and aggressive when the aggressive hyperactive boys were receiving medication compared with placebo, but these differences did not attain statistical significance. Methylphenidate effectively normalized the negativistic behaviors of the aggressive hyperactive boys in the classroom. In some cases, the frequency of occurrence of certain behaviors dropped significantly below the level of the hyperactive child's peers. This "supranormalization" may reflect behavioral toxicity of the psychostimulan

ISSN:1044-5463    

DOI:10.1089/cap.1992.2.49

年代:1992

数据来源: MAL

摘要:

ABSTRACTMany people with autistic disorder have problems with oversensitivity to both touch and sound. The author (an autistic person) developed a device that delivers deep touch pressure to help her learn to tolerate touching and to reduce anxiety and nervousness. The "squeeze machine" applies lateral, inwardly directed pressure to both lateral aspects of a person's entire body, by compressing the user between two foam-padded panels. Clinical observations and several studies suggest that deep touch pressure is therapeutically beneficial for both children with autistic disorder and probably children with attention-deficit hyperactivity disorder. Only minor and occasional adverse effects have been noted. Data are reported that show a similar calming effect in nonreferred college students. A review of the animal literature reveals that animals have similar calming reactions, and also suggests possible additional physiological effects of deep touch pressure. At present, there are increasing anecdotal reports of the clinical value of the squeeze machine, including suggestions that it can be used to reduce required doses of psychostimulant medications. More clinical studies are needed to evaluate the potential role of this seemingly beneficial form of "physiological" stimulation.

ISSN:1044-5463    

DOI:10.1089/cap.1992.2.63

年代:1992

数据来源: MAL

ISSN:1044-5463    

DOI:10.1089/cap.1992.2.73

年代:1992

数据来源: MAL