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Biomedical subjects

D S Pine

Publications and source records attributed to D S Pine.

At least 19 recordsLinked to original sources
PubMed1999

Adolescent depressive symptoms as predictors of adult depression: moodiness or mood disorder?

OBJECTIVE: The authors' goal was to examine the relationship between subclinical depressive symptoms in adolescence and major depressive episodes in adulthood. METHOD: An epidemiologic sample of 776 young people received psychiatric assessments in 1983, 1985, and 1992. Among adolescents not meeting criteria for major depression, the authors estimated the magnitude of the association between subclinical adolescent depressive symptoms and adult major depression. RESULTS: Symptoms of major depression in adolescence strongly predicted an adult episode of major depression: having depressive symptoms more than two-standard-deviations above the mean in number predicted a two-fold to three-fold greater risk for an adult major depressive episode. CONCLUSIONS: Symptoms of depression in adolescence strongly predict an episode of major depression in adulthood, even among adolescents without major depression.

Adolescent↗
PubMed1998

Prospective associations between somatic illness and mental illness from childhood to adulthood.

The association between somatic illness and psychiatric illness is well established in adults but is less clear in childhood and adolescence. A cohort of over 700 randomly selected children in Upstate New York were studied from ages 1-10 years in 1975 to young adulthood in 1992. Psychiatric and physical health were assessed by means of follow-up youth and parent interviews at 8-, 2 1/2-, and 6-year intervals (in 1983, 1985-1986, and 1991-1993). Cross-sectional and longitudinal analyses investigated: 1) the consistency of the relation between physical illness and mental illness in childhood; 2) the specificity of major depressive disorder (MDD) in accounting for the relation; 3) the specificity of immunologically mediated medical disorders in this relation; and 4) whether this relation was attributable to risks associated with low socioeconomic status. Cross-sectionally, ill health was associated with increased risk of psychiatric disorders at all ages, with significant odds ratios (ORs) ranging from 1.76 to 3.26. In prospective analyses, ill health increased the risk of new-onset MDD at all ages (ORs = 2.05-4.48). MDD also predicted subsequent ill health, independent of prior health problems (ORs = 3.81 and 4.04). Relations were not attributable to familial socioeconomic status. Associations were particularly strong between MDD and medical disorders associated with alterations in immunologic factors (ORs = 1.83-6.41). Theories of common immune-mediated vulnerabilities to medical illness and depression are consistent with these associations.

Adolescent↗
PubMed1998

The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders.

BACKGROUND: Various studies find relationships among anxiety and depressive disorders of adolescence and adulthood. This study prospectively examines the magnitude of longitudinal associations between adolescent and adult anxiety or depressive disorders. METHODS: An epidemiologically selected sample of 776 young people living in upstate New York received DSM-based psychiatric assessments in 1983, 1985, and 1992 using structured interviews. The magnitude of the association between adolescent and adult anxiety or depressive disorders was quantified using odds ratios generated from logistic regression analyses and from a set of latent Markov analyses. We focus on longitudinal associations among narrowly defined DSM anxiety or depressive disorders. RESULTS: In simple logistic models, adolescent anxiety or depressive disorders predicted an approximate 2- to 3-fold increased risk for adulthood anxiety or depressive disorders. There was evidence of specificity in the course of simple and social phobia but less specificity in the course of other disorders. Results from the analyses using latent variables suggested that while most adolescent disorders were no longer present in young adulthood, most adult disorders were preceded by adolescent disorders. CONCLUSIONS: An anxiety or depressive disorder during adolescence confers a strong risk for recurrent anxiety or depressive disorders during early adulthood. Most anxiety and depressive disorders in young adults may be preceded by anxiety or depression in adolescence.

Adolescent↗
PubMed1998

Ventilatory physiology of children and adolescents with anxiety disorders.

BACKGROUND: Abnormalities in ventilatory physiology have been noted in adults with panic disorder. We tested the hypothesis that abnormalities in ventilatory physiology differentiate children and adolescents with anxiety disorders from psychiatrically healthy children. METHODS: Ventilatory physiology was monitored with a canopy apparatus during room-air breathing and 15 minutes of carbon dioxide exposure in 33 children and adolescents comprising 18 probands with an anxiety disorder and 15 psychiatrically healthy children. RESULTS: During room-air breathing, probands had significantly larger minute ventilation, larger tidal volumes, and more variable breathing patterns than healthy comparisons, but the groups did not differ in end-tidal carbon dioxide or respiratory rate. During carbon dioxide challenge, probands exhibited larger minute ventilation and respiratory rate responses relative to comparisons. CONCLUSION: These findings on the association between ventilatory physiology and anxiety disorders in children and adolescents are consistent with results from studies of adults with panic disorder.

Adolescent↗
PubMed1998

Heart period variability and psychopathology in urban boys at risk for delinquency.

To examine associations between heart period variability (HPV) and psychopathology in young urban boys at risk for delinquency, a series of 697-11-year-old younger brothers of adjudicated delinquents received a standardized psychiatric evaluation and an assessment of heart period variability (HPV). Psychiatric symptoms were rated in two domains: externalizing and internalizing psychopathology. Continuous measures of both externalizing and internalizing psychopathology were associated with reductions in HPV components related to parasympathetic activity. These associations could not be explained by a number of potentially confounding variables, such as age, ethnicity, social class, body size, or family history of hypertension. Although familial hypertension predicted reduced HPV and externalizing psychopathology, associations between externalizing psychopathology and HPV were independent of familial hypertension. Psychiatric symptoms are associated with reduced HPV in young urban boys at risk for delinquency.

Blood Pressure↗
PubMed1997

Neuroendocrine response to fenfluramine challenge in boys. Associations with aggressive behavior and adverse rearing.

BACKGROUND: There is evidence of relationships among serotonin, aggressive behavior, and a childhood history of socially adverse-rearing conditions. This study examines the prolactin response to fenfluramine hydrochloride challenge in young boys who show clinically significant aggressive behavior or who are raised in a social environment that is conducive to the development of chronic aggression. METHODS: A series of 34 younger brothers of convicted delinquents underwent standardized psychiatric and observation-based assessments of their social-rearing environments that were conducted during home visits. Approximately 2 years later, these boys underwent a reassessment of psychiatric status and an assessment of central serotonergic activity using the fenfluramine challenge procedure. RESULTS: Increasing degrees of aggressive behavior at either assessment were positively correlated with the prolactin response to fenfluramine challenge. Furthermore, adverse-rearing circumstances that were conducive to the development of aggressive behavior also exhibited positive correlations with the prolactin response. This association between adverse rearing and the prolactin response was statistically independent of that between aggression and the prolactin response. CONCLUSION: In young boys, aggressive behavior and social circumstances that are conducive to the development of aggressive behavior are positively correlated with a marker of central serotonergic activity.

Aggression↗
PubMed1997

Neurological soft signs: one-year stability and relationship to psychiatric symptoms in boys.

OBJECTIVE: This study had two main objectives: (1) to examine the 1-year stability of neurological soft signs and (2) to examine the longitudinal relationship between soft signs and psychiatric symptoms in young boys. METHOD: A consecutive series of 56 boys from a high-risk sample received standardized psychiatric and soft sign assessments at study intake. Approximately 1 year later, 48 (86%) of these boys received a reassessment of their psychiatric and soft sign status. RESULTS: Soft signs exhibited marked stability across the 1-year period (intraclass correlation = .70, p < .001). Symptoms of both internalizing and externalizing disorders correlated with poor performance on the soft sign examination. For both internalizing and externalizing symptoms, the association with soft signs occurred primarily among individuals with persistently high scores on symptom scales across the two assessments. CONCLUSIONS: Performance on a standardized neurological soft sign examination is stable over a 1-year period. Soft signs measured with this examination relate to both internalizing and externalizing symptoms in young boys, particularly when symptoms are relatively stable over time. Further research should consider the clinical significance of childhood soft signs.

Affective Symptoms↗
PubMed1997

Open fluoxetine treatment of mixed anxiety disorders in children and adolescents.

An open-label pilot study examined fluoxetine treatment in 16 outpatients (9-18 years old) with mixed anxiety disorders. Following nonresponse to psychotherapy, fluoxetine monotherapy was started at 5 mg daily and was increased weekly by 5 or 10 mg daily for 6-9 weeks until improvement occurred or to a maximum of 40 mg (children under 12) or 80 mg (adolescents). Among patients on fluoxetine, severity of illness ratings were "much improved" (mean final Clinical Global Impression scale score 2.8 +/- 0.7). Clinical improvement occurred in 10 of 10 patients with current separation anxiety disorder, 8 of 10 with social phobia, 4 of 6 with specific phobia, 3 of 5 with panic disorder, and 1 of 7 with generalized anxiety disorder. Mean time to improvement was 5 weeks. Mean doses were 24 mg (0.7 mg/kg) for children and 40 mg (0.71 mg/kg) for adolescents. Side effects were transient and included drowsiness (31% of patients), sleep problems (19%), decreased appetite (13%), nausea (13%), abdominal pain (13%), and excitement (13%). No patient developed disinhibition, akathisia, or suicidality. These preliminary findings suggest fluoxetine effectiveness in separation anxiety disorder and social phobia. Youths with only one anxiety disorder appeared to respond to lower doses of fluoxetine than patients with multiple anxiety disorders (0.49 +/- 0.14 versus 0.80 +/- 0.28 mg/kg, p < 0.05).

Adolescent↗
PubMed1997

Minor physical anomalies: modifiers of environmental risks for psychiatric impairment?

OBJECTIVE: To test the hypothesis that minor physical anomalies (MPAs) modify an adolescent's vulnerability to environmental risk factors for psychopathology. METHOD: One hundred eighteen unreferred male adolescents who had been evaluated as 7-year-olds received a comprehensive neuropsychiatric evaluation. The evaluation included standardized assessments of environmental risk factors for psychiatric impairment, neurological signs, IQ, MPAs, and psychiatric impairment. The relationship between psychiatric status and environmental risk was examined as a function of the MPA profile. RESULTS: There was a significant interaction between MPAs and environmental risk in predicting psychiatric status. Environmental risk was more predictive of psychiatric impairment at age 17 in subjects with high scores on the MPA scale than in subjects with low scores on the scale. This relationship was particularly apparent in subjects with conduct disorder. MPAs also exhibited relationships with two childhood factors, neurological soft signs and Verbal IQ, that had been shown to predict adolescent psychopathology in prior reports on this cohort. CONCLUSIONS: MPAs may contribute to psychiatric impairment by influencing an individual's vulnerability to environmental risk factors for psychopathology. These suggestive findings are consistent with an emerging body of literature examining the role of biopsychosocial interactions in psychiatric disorders.

Adolescent↗
PubMed1997

Verbal dichotic listening in boys at risk for behavior disorders.

OBJECTIVE: The association between deficits in verbal processing skills and disruptive psychopathology remains one of the most frequently replicated findings in all of child psychiatry. This study uses a dichotic consonant-vowel listening test to examine the potential neural basis for this association. METHOD: A series of 87 young boys recruited from a sample at risk for disruptive disorders received standardized psychiatric, neuropsychological, and language skills assessments. Approximately 1 year later, these boys received a reassessment of their psychiatric status and a test that assesses the neural basis of language-processing ability, a dichotic consonant-vowel listening test. RESULTS: Disruptive psychopathology predicted reduced right ear accuracy for dichotic syllables, indicative of a deficit in left hemisphere processing ability. Deficits in reading and language ability also correlated with right ear accuracy for dichotic syllables. CONCLUSIONS: Boys with disruptive behavior disorders, relative to at-risk but nondisruptive boys, exhibit a deficit in verbal processing abilities on dichotic listening tasks. This deficit in verbal processing ability is also manifested as low scores on standardized tests of reading achievement and language comprehension.

Brain↗
PubMed1997

Childhood anxiety disorders.

Although anxiety is among the most common psychiatric problems faced by children and adolescents, anxiety disorders have been a relatively neglected research topic in comparison to childhood disruptive behavior and depressive disorders. Recent epidemiologic data have brought increasing attention to these impairing disorders. A review of these data is provided, and results from recent studies on the genetics, biology, and treatment of childhood anxiety disorders are integrated with a discussion of directions for future research. The data reviewed here point both to our growing understanding of childhood anxiety and to the need for continued research to address significant shortcomings in our knowledge base.

Adolescent↗
PubMed1997

Psychiatric symptoms in adolescence as predictors of obesity in early adulthood: a longitudinal study.

OBJECTIVES: This study examined the longitudinal relationship between psychopathology and obesity in young adulthood. METHODS: More than 700 youth in a population-based sample were psychiatrically assessed in 1983 (mean age = 14 years) and 1992 (mean age = 22 years). Self-reported body mass index (BMI) in 1992 was regressed on measures of depression and conduct disorder as well as a set of covariates including indices of physical health, social class, intelligence, and cigarette and alcohol use. Associations were examined with BMI treated as a continuous variable and with a binary index of obesity derived from the BMI distribution in each gender. RESULTS: BMI in young adults was positively related to a number of covariates. With all covariates controlled, BMI was inversely related to adult depressive symptoms in males but not females. BMI was positively related to adolescent symptoms of conduct disorder in both sexes. Similar associations were found between psychiatric symptoms and obesity. CONCLUSIONS: Conduct disorder symptoms in adolescence predicted BMI and obesity in early adulthood. These associations remained after controlling for factors that can affect the association between psychopathology and obesity.

Adolescent↗
PubMed1996

Discriminating depression and anxiety in youth: a role for diagnostic criteria.

OBJECTIVE: To test the hypothesis that anxiety and depression in youth, as in adults, become increasingly discriminable when youth meet criteria for an emotional disorder. METHOD: The study uses cross-sectional data at two points in time from a large (n = 776) community sample of youths, aged eight to twenty. Associations between major depression and five anxiety disorders (overanxious, obsessive compulsive and separation anxiety disorders, and social and simple phobias) are examined by symptom scale and diagnosis. RESULTS: Anxiety and depression are moderately correlated, and substantially comorbid by diagnostic category. Symptoms are more discriminable among youths with diagnoses of at least one emotional disorder than among those without. A single factor accounts for symptoms among the non-diagnosed but multiple factors are required for the diagnosed group. CONCLUSIONS: Anxiety and depression are discriminable among youth who meet criteria for a specific emotional disorder but more highly associated among youths without such a diagnosis. This suggests that in youth, as has been shown in adults, depression and anxiety become increasingly discriminable as emotional psychopathology becomes more severe.

Adolescent↗
PubMed1996

The association between major depression and headache: results of a longitudinal epidemiologic study in youth.

Retrospective epidemiologic research in adults suggests that a long-term association between major depression and headache arises during childhood or adolescence. This study uses data from a prospective epidemiologic study to examine the association between major depression and headache from late childhood into early adulthood. An epidemiologically selected sample of 776 youth, aged 9-18, was assessed psychiatrically in 1983 using DISC interviews with both youth and parent informants. Reassessments were conducted in 1985-1986 and 1992. Current and past histories of functionally impairing migraine or chronic headache were elicited in both 1985-1986 and 1992. Regression analyses examined the relationships between major depression and headache status. The prevalence of current functionally impairing headache was approximately 10% in both 1985-1986 and 1992. There were lifetime and cross-sectional associations between headache and major depression. Headache was approximately twice as common in depressed adolescents compared with nondepressed adolescents. Major depression in adolescents, without current or past headache, prospectively predicted the new onset of headaches in young adulthood. Among adolescents who had no history of chronic impairing headache in 1985-1986, those with current major depression faced a nearly tenfold increased risk of developing such headaches at some time during the next 7 years. Consistent with findings of retrospective studies among adults, a longitudinal/ developmental relationship between major depression and functionally impairing headache was found in this prospective epidemiologic study of youth. These findings suggest that (1) neurochemical and pharmacologic commonalities between depression and headache should receive further investigation and that (2) it may be clinically useful to inquire about family history of headache syndromes in adolescents with major depression because such questioning may provide insight about the risk of subsequent functionally impairing headache in a depressed adolescent.

Adolescent↗