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Biomedical subjects

H B Ferguson

Publications and source records attributed to H B Ferguson.

At least 19 recordsLinked to original sources
PubMed2001

Community factors in the development of resiliency: considerations and future directions.

Researchers have questioned why some children and adolescents are more resilient than others in the face of adversity and have identified several protective factors. The present paper focuses on one of these variables, namely, support from caring adults in the community. We present a brief review of this component of the resiliency literature along with a discussion of some of the issues and challenges raised by the findings. It is suggested that the evidence is substantial enough and the possible rewards associated with exploiting these findings considerable enough to warrant mounting wide-scale community-based efforts to assist vulnerable youth.

Adaptation, Psychological↗
PubMed1994

Response to desipramine treatment in adolescent depression: a fixed-dose, placebo-controlled trial.

OBJECTIVE: To determine the efficacy and tolerability of the tricyclic antidepressant desipramine (DMI) in the treatment of DSM-III-R-diagnosed major depressive disorder in adolescents. METHOD: Sixty adolescents (42 female, 18 male; aged 15 to 19 years) diagnosed with major depressive disorder using clinical interview and Schedule for Affective Disorders and Schizophrenia for School-Age Children were randomized to receive either DMI (200 mg daily in divided doses) or placebo for six consecutive weeks following a 1-week placebo period. Treatment outcome was determined using the Hamilton Depression Rating Scale and the Beck Depression Inventory. Tolerability was determined using a symptom side effects scale. In addition, a variety of laboratory and cardiovascular monitoring was performed. RESULTS: No significant differences in treatment outcome between DMI- and placebo-treated groups were determined. Neither DMI, nor its metabolite 2-hydroxy-DMI, nor their ratio, was positively correlated to treatment outcome. The DMI group endorsed more side effects but there were no significant between-group differences in any laboratory, electrocardiographic, or other cardiovascular parameters apart from heart rate, which was increased in the DMI-treated group (p = .03). CONCLUSIONS: Given the findings of this study and our review of previously published reports of tricyclic antidepressant treatment in this population, the routine use of short-term (6 weeks) DMI in the treatment of adolescent depression is not supported by the data on hand. Further investigations into what constitutes optimal psychopharmacological treatment of adolescent depression are warranted.

Adolescent↗
PubMed1992

Clinical, cognitive, and neurophysiological effects of alprazolam in children and adolescents with overanxious and avoidant disorders.

In a double-blind, placebo-controlled study, the efficacy and safety of alprazolam was investigated in childhood and adolescent anxiety disorders. Thirty patients (mean, 12.6 years) diagnosed with overanxious or avoidant disorders participated in the study. Evaluations included clinical, laboratory, cognitive, and qualitative EEG measurements. On a clinical global rating, there was no statistical difference between alprazolam and placebo. Relative to baseline EEG, acute alprazolam administration increased beta power in the right occipital lead, and chronic administration increased beta power in both leads. Alprazolam was well tolerated, and adverse effects were few, mild, and transient.

Adolescent↗
PubMed1990

Adolescent depression: a placebo-controlled fluoxetine treatment study and follow-up.

Forty patients aged 13 to 18 years participated in a placebo-controlled double-blind study of fluoxetine. Fifteen subjects in each group completed the eight week study. Approximately two-thirds of the patients showed marked or moderate clinical global improvement with both fluoxetine and placebo. Fluoxetine was superior to placebo on all clinical measures except for sleep disorder, but the differences were not statistically significant. Thirty-two of the patients and their parents were interviewed after a mean follow-up interval of 24 months (range: 8-46 months). Mean age at follow-up was 18 years (range: 15-22 years). Both groups had shown further improvement at follow-up but there were no significant group differences. Independent of the study, 19 patients (59%) had received intervening treatment following study termination and nine patients (28%) were still in treatment. Adolescent depression appears to respond to treatment but both mood disturbance and psychosocial adaptation problems persist, requiring active follow-through.

Adolescent Psychiatry↗
PubMed1989

Measurement of anxiety and depression in children and adolescents.

In summary, symptom checklists and rating scales are a cost-effective means of deriving an extensive amount of clinical information in a relatively short period of time. Measures designed to assess affect in children have primarily been self-report inventories owing to the subjective nature of the constructs being assessed. However, subscales for the assessment of anxiety and depression by significant others (parent, teacher, clinician) can be found on more general measures of behavior such as the Conners' Parent and Teacher Rating Scales, the Achenbach Parent and Teacher Forms of the Child Behavior Checklist, and the Brief Psychiatric Rating Scale for Children. In choosing from the array of available measures, emphasis should be placed on an examination of the psychometric properties of the scales. Inventories with demonstrated reliability and validity will provide the clinician with a much more useful profile of a patient's symptoms than will instruments with undocumented or poor psychometric properties. A major concern for all structured interviews is the relative lack of detailed reliability or validity studies. In addition, there are important caveats for such research. A high internal reliability may only demonstrate that one narrow aspect of depression has been measured or a high test-retest reliability may indicate that the interview is measuring a stable trait rather than a current state. Research on the validity and efficiency of the interviews requires careful consideration and consensus regarding acceptable comparison standards. At this time, variants of the "best estimate diagnosis" methodology appear to have gained widest acceptance. In general, there remains much work to be done before the distinct capabilities of the structured interviews are established. It should be noted that in all cases these interviews are evolving instruments and continue to undergo revision and refinement. However, one difference has evolved and may be relevant to the choice of instrument in specific studies. The highly structured interviews, such as the DICA and the DISC, are amenable to epidemiologic screening. They cover a wide range of disorders and have a relatively low threshold for disorder or high sensitivity. In application, these instruments will tend to overdiagnose. It will be necessary to use good clinical judgment in ruling out those disorders that do not apply. In contrast the semistructured interviews, such as the K-SADS and the ISC, have a relatively high diagnostic threshold or relatively high specificity for a few disorders. These instruments are probably best used for the purpose for which they were designed; that is, the selection of depressed and or anxious subjects for research studies.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1987

Alprazolam effects in children with anxiety disorders.

Children with overanxious and/or avoidant disorder (DSM-III) were treated with alprazolam (Xanax, Upjohn) to determine its safety, clinical and cognitive effects. Ten male and two female patients (age range 8.8 to 16.5 years; mean 11.5) participated in an open clinical trial consisting of a baseline placebo period (1 week), alprazolam therapy (4 weeks), a drug-tapering period (1 week), and a post-drug placebo period (1 week). There was a drug-free follow-up approximately 4 weeks after termination of the study. Dosages were individually adjusted and the daily maximum ranged from 0.50 mg to 1.5 mg. Evaluations included clinical assessments, parent, teacher and self ratings, and cognitive tests. Clinical global improvement with alprazolam therapy was marked in 1 patient, moderate in 6, minimal in 4, and none in 1. Clinician ratings indicated significant improvements of anxiety, depression, and psychomotor excitation. Parent questionnaires indicated significant improvements of anxiety and hyperactivity while teacher questionnaires showed significant improvement of an anxious-passive factor. Significant improvements in the paired associate learning tasks, maze task and the block design tasks were maintained after drug withdrawal suggesting a practice effect. Adverse effects were infrequent, mild and transient. There were no clinically significant changes of laboratory values, blood pressure, pulse or respiration during the 4 weeks of alprazolam administration. Body weight increased significantly (mean increase was 0.87 kg). Double-blind trials with alprazolam are recommended in child psychiatry disorders.

Adolescent↗
PubMed1986

Catecholamine response of children in a naturally occurring stressor situation.

The present study examined the response of children to a stressor condition. Urine samples were collected from 38 children between ages 10 and 12 preceding a class presentation and again one week later, when no unusual event was occurring. Cognitive tasks and a state anxiety inventory were administered on both occasions. Personality and stressor situation inventories (hypothesized antecedent factors) were completed. Bidirectional changes in catecholamine levels were demonstrated (adrenalin: 55% of the children showed an increase, 29% a decrease; noradrenalin: 47% increase, 40% decrease; 3-methoxy-4-hydroxyphenethylene glycol: 40% increase, 42% decrease). Distinct differences in gender distribution and cognitive performance were demonstrated for the increase and decrease subgroups. It was suggested that both increases and decreases in catecholamine levels represent responses to the stressor situation, with an increase representing an adaptive response and a decrease representing a less adaptive response.

Arousal↗
PubMed1986

Bupropion effects in attention deficit and conduct disorders.

Children with Attention Deficit and/or Conduct Disorders were treated with bupropion, a new antidepressant, to determine its clinical, cognitive, and EEG effects. Seventeen male patients (age range 7 to 13.4 years; mean 10.4) participated in an open clinical trial consisting of a baseline placebo period (4 weeks), bupropion therapy (8 weeks), and post-drug placebo (2 weeks). Evaluations included clinical assessments, parents, teachers, and self-ratings; cognitive tests and blood level measurements of bupropion. Fifteen patients received a daily maximum of 150 mg, one received 100 mg and one 50 mg. Clinical global improvement with bupropion therapy was marked in 5 patients, moderate in 7, mild in 2, and none in 3. The Children's Psychiatric Rating Scale indicated improvements of hyperactivity, withdrawal, anxiety, hostility/uncooperativeness, sleep disorder, antisocial behaviour, neuroticism, depression and eating disturbance. Parents' Questionnaires indicated significant improvements of conduct disorder, anxiety, hyperactivity, muscle tension and psychosomaticism. While no single cognitive test showed significant improvement, all nine tests changed in the positive direction. Adverse effects were infrequent, transient and mild. There were no clinically significant changes of the laboratory values and vital signs. Two weeks following bupropion discontinuation, clinical global improvement was maintained in 8 patients, 7 showed relapses, while 2 remained unimproved. Analyses of computerized EEG revealed that degree of clinical improvement was indexed by baseline EEG parameters and that there were significant bupropion effects on EEG measures. Double-blind trials of bupropion are recommended in child psychiatry disorders.

Adolescent↗
PubMed1985

Recent developments in the use of antidepressant and anxiolytic medications.

In this article the authors review recent research contributions to the knowledge regarding the role of antidepressant and anxiolytic medications in the treatment of child psychiatry disorders. For each of the two classes of drug, recent data regarding a range of indications are evaluated. In addition, general methodologic issues and future research priorities are discussed.

Anti-Anxiety Agents↗
PubMed1985

Learning disabilities. Etiology, diagnosis, and management.

The common co-occurrence of psychiatric disorders and academic problems makes it important for child psychiatrists to have a general understanding of learning disabilities. The authors review past and present conceptual models of learning disabilities and set out brief guidelines for comprehensive evaluation and diagnosis of learning problems. In addition, general issues of remediation, educational placement, and future research priorities are discussed.

Achievement↗
PubMed1984

Evaluating drug effects on children's cognitive functioning.

In our studies of drug therapy in child psychiatry disorders, we have been using a battery of tests to monitor any effects of medication on the various components of cognitive processing. Our intention was to measure skills required by the children for successful classroom performance. We have used this test battery approach in open clinical trials of bupropion (Wellbutrin) and of alprazolam (Xanax) with child psychiatry patients. On no single test was the effect of bupropion vs placebo significant; however, there was no indication of any cognitive deterioration with bupropion. Group performance with alprazolam was more variable, and again no individual test showed significant changes with medication. These initial applications of the cognitive battery indicate that bupropion, a new antidepressant and alprazolam, an anxiolytic have no adverse effects on cognition at therapeutically effective doses.

Alprazolam↗
PubMed1981

Biological validation of the hyperkinetic syndrome.

Biological evidence for the hyperkinetic syndrome is reviewed and evaluated. Research data from anatomical, genetic, physiological and pharmacological studies consistently yield weak or non-specific relationships between biological factors and hyperactivity. While such findings suggest an organic basis for at least some subgroups of hyperactive children, criteria for selection of subjects in past research have not been sufficiently well-established to allow such biological factors to be linked with specific behavioral symptoms. Thus there is no compelling evidence for the existence of the syndrome; there is merely an array of general correlations between biological alteration and non-specific deviant behavior. Alternative interpretations of this situation are presented.

Adolescent↗
PubMed1981

Plasma free and total tryptophan, blood serotonin, and the hyperactivity syndrome: no evidence for the serotonin deficiency hypothesis.

Total and free plasma tryptophan and plasma cortisol levels were determined for children diagnosed as hyperactive or learning disabled and in normal siblings of these subjects. No differences were observed among the groups on any of the dependent variables related to a number of parameters measured for the hyperactive children such as degree of hyperactivity, presence of food allergies, favorable response to methylphenidate, and brain dysfunction. Moreover, in further comparisons no differences were found between hyperactive and age-matched controls on these variables as well as blood serotonin, nor were any differences found for a group of hyperactive children between placebo and methylphenidate trials. These data do not support earlier suggestions of a serotonin deficiency in hyperactive children.

Attention Deficit Disorder with Hyperactivity↗