PubMed Health⌕ Search

Biomedical subjects

Jeffrey A Bridge

Publications and source records attributed to Jeffrey A Bridge.

12 recordsLinked to original sources
PubMed2006

Long-term outcome of functional childhood constipation.

We investigated whether functional childhood constipation (FCC) is an early expression in the continuum of functional disorders such as adult constipation, irritable bowel syndrome (IBS), and dyspepsia. Adults >or=18 years with a diagnosis of FCC verified by one pediatric gastroenterologist participated in the questionnaire-based study. Controls were comprised of adults who underwent tonsillectomy as otherwise healthy children during the period corresponding to the FCC diagnosis. The prevalence of constipation, IBS, and dyspepsia was determined by the Bowel Disease Questionnaire. Twenty FCC adults (8 females), median age 22 years, were compared with 17 adult controls (10 females), median age 22.9 years. The frequency of constipation in FCC adults was not different from that in controls (25% versus 23.5%). The frequency of IBS in FCC adults was higher than in controls (55% versus 23.5%; P < 0.05). Dyspepsia was reported by 25% of both groups. The median follow-up period of the FCC adults was 14 years. In a long-term follow-up of a small sample, the prevalence of constipation in FCC adults is comparable to that in controls. Childhood constipation appears to be a predictor of IBS in adulthood.

Adolescent↗
PubMed2005

The risks and benefits of antidepressant treatment for youth depression.

The U.S. Food and Drug Administration (FDA) has mandated that all antidepressants carry a 'black box' warning label indicating that antidepressants increase the risk of suicidality in youth taking these medications. In the U.K., the Medicine and Healthcare Products Regulatory Agency (MHRA) has determined that the balance of risks and benefits favors only the use of fluoxetine in the treatment of depressive illness in children and adolescents. This article reviews the FDA's analysis linking antidepressant medication use and pediatric suicidality in major depressive disorder, discusses the efficacy of antidepressants in treating depression in children and adolescents, and offers suggestions to aid clinicians, patients, and families in making clinical decisions based on an accurate assessment of the benefits and risks of medication and psychosocial treatments for pediatric depression.

Adolescent↗
PubMed2005

History of suicide attempts in pediatric bipolar disorder: factors associated with increased risk.

BACKGROUND: Despite evidence indicating high morbidity associated with pediatric bipolar disorder (BP), little is known about the prevalence and clinical correlates of suicidal behavior among this population. OBJECTIVE: To investigate the prevalence of suicidal behavior among children and adolescents with BP, and to compare subjects with a history of suicide attempt to those without on demographic, clinical, and familial risk factors. METHODS: Subjects were 405 children and adolescents aged 7-17 years, who fulfilled DSM-IV criteria for BPI (n = 236) or BPII (n = 29), or operationalized criteria for BP not otherwise specified (BP NOS; n = 140) via the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. As part of a multi-site longitudinal study of pediatric BP (Course and Outcome of Bipolar Youth), demographic, clinical, and family history variables were measured at intake via clinical interview with the subject and a parent/guardian. RESULTS: Nearly one-third of BP patients had a lifetime history of suicide attempt. Attempters, compared with non-attempters, were older, and more likely to have a lifetime history of mixed episodes, psychotic features, and BPI. Attempters were more likely to have a lifetime history of comorbid substance use disorder, panic disorder, non-suicidal self-injurious behavior, family history of suicide attempt, history of hospitalization, and history of physical and/or sexual abuse. Multivariate analysis found that the following were the most robust set of predictors for suicide attempt: mixed episodes, psychosis, hospitalization, self-injurious behavior, panic disorder, and substance use disorder. CONCLUSIONS: These findings indicate that children and adolescents with BP exhibit high rates of suicidal behavior, with more severe features of BP illness and comorbidity increasing the risk for suicide attempt. Multiple clinical factors emerged distinguishing suicide attempters from non-attempters. These clinical factors should be considered in both assessment and treatment of pediatric BP.

Adolescent↗
PubMed2005

Emergent suicidality in a clinical psychotherapy trial for adolescent depression.

OBJECTIVE: The authors' goal was to examine the incidence and predictors of emergent suicidality that occurred during a clinical trial of psychotherapy for adolescent depression. METHOD: The rates and predictors of emergent suicidality in 88 medication-free depressed adolescent outpatients who reported no current suicidality during an intake interview were assessed over 12 to 16 weeks of psychotherapy treatment. RESULTS: The incidence of emergent suicidality was 12.5% (11 of 88 subjects). Self-reported suicidal thoughts at intake were a significant predictor of emergent suicidality, even when suicidality was denied at intake interview. CONCLUSIONS: Emergent suicidality is a common occurrence in psychosocial treatment of adolescent depression, with rates similar to those reported recently in antidepressant trials. To evaluate accurately the role of treatment in emergent suicidality, it is important to assess self-reported suicidality at intake and to balance treatment groups on this key predictor of emergent suicidality.

Adolescent↗
PubMed2005

Clinical differences between suicidal and nonsuicidal depressed children and adolescents.

OBJECTIVE: To examine the clinical symptoms and comorbid psychiatric disorders of depressed children and adolescents with and without clinically significant suicidal ideation. METHOD: Children and adolescents aged 7 to 17 years with current DSM-III-R major depressive disorder (MDD) (N = 135) were recruited between January 1987 and April 2002. Current MDD symptoms and lifetime comorbid psychiatric disorders were assessed using either a combination of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Epidemiologic and -Present Episode versions or the -Present Lifetime version. Thirty-two percent (N = 43) of the depressed subjects were classified as suicidal (at least suicidal ideation with a plan). RESULTS: Depressed suicidal youth presented with a more severe episode (p = .001) and a poorer functional status (p = .019), were more hopeless (p = .001), and presented more frequently with insomnia (p = .011). There was an interaction between suicide x sex x pubertal status for severity of MDD (p = .013), the presence of hopelessness (p < .001), poor functional status (p = .023), and comorbidity with a lifetime history of any disruptive behavior (p = .019). Among pre-pubertal depressed males, suicidal boys had significantly increased severity of MDD (p = .025) and poorer functional status (p = .044) than non-suicidal boys. Among postpubertal depressed females, suicidal girls were more frequently hopeless (p = .008) and presented an increased severity of MDD (p = .022) and more frequent lifetime history of any disruptive behavior (p = .03) when compared with nonsuicidal girls. CONCLUSION: There appears to be a sex difference for some clinical features, particularly hopelessness, among depressed suicidal children and adolescents. Whether hopelessness is a sex-specific characteristic of depressed suicidal children and adolescents requires further study.

Adolescent↗
PubMed2004

Psychosocial functioning in youths at high risk to develop major depressive disorder.

OBJECTIVE: To compare the psychosocial functioning of children and adolescents at high risk of major depressive disorder with youths with acute major depressive disorder and healthy controls. METHOD: High-risk (n = 57), major depressive disorder (n = 71), and healthy control (n = 48) youths and their families were recruited from 1987 to 1996 and assessed for psychopathology using standardized instruments. Except for 16 children who had disruptive disorders, the high-risk children were free of psychopathology. A parent completed the Psychosocial Schedule to evaluate the mother-child, father-child, marital relationships, and child-friend relationships and the child's school performance. RESULTS: Overall, high-risk and healthy controls had similar psychosocial functioning. Marital relationships were worse in the high-risk children with psychopathology. Youths with major depressive disorder had significantly more psychosocial problems and school difficulties than those at high risk and healthy controls in most domains measured. Controlling for age, pubertal stage, race, sex, family composition, current and lifetime parental depression, and current and lifetime parental nonmood psychopathology yielded similar results. CONCLUSIONS: The family and peer interactions of high-risk youths were similar to the interactions of healthy controls. Although family dysfunctional patterns seem to mainly depend on the child's depressive symptoms, longitudinal studies are needed to establish causality.

Acute Disease↗
PubMed2004

Screening for childhood anxiety symptoms in primary care: integrating child and parent reports.

OBJECTIVE: Parents' concerns typically determine the focus of a primary care visit. This study examined which information is lost if child reports are excluded from screening for anxiety. It also explores the use in primary care of the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Pediatric Symptom Checklist (PSC-17). METHOD: Two hundred thirty-six children (8-12 years 11 months) and their parents completed SCARED and PSC-17 before a primary care visit occurring during discrete periods between June 1999 and March 2001. RESULTS: Child reports yielded higher SCARED scores than parent reports (mean=18.12, SD=12.14 versus 14.43, SD=10.34, p <.001). Somatic/panic and separation anxiety accounted for 73.8% of the excess score from children's reports. The level of parent-reported symptoms did not vary with demographics. Female gender and younger age predicted greater excess reporting by children. Parent and child scores were moderately to highly correlated (R=0.55 total score; 0.40-0.58 subfactors). CONCLUSIONS: There are discrete anxiety domains in which children's reports are likely to yield more information than that of parents. This phenomenon is almost entirely attributable to variations in the level of symptoms reported by children. Studies are needed to design brief screening procedures that integrate parent and child reports and carry age- and gender-adjusted thresholds.

Age Factors↗
PubMed2004

Lifetime history of sexual abuse, clinical presentation, and outcome in a clinical trial for adolescent depression.

OBJECTIVE: To investigate the impact of sexual abuse on clinical presentation and treatment outcome in depressed adolescents. METHOD: 107 adolescent outpatients, 13 to 18 years old, with DSM-III-R major depression were randomly assigned to cognitive-behavioral therapy (CBT), systemic behavioral family therapy (SBFT), or nondirective supportive therapy (NST) from Oct. 1, 1991 through May 31, 1995. Subjects were classified on the basis of the presence or absence of lifetime history of sexual abuse. Since only 1 subject assigned to SBFT had a history of sexual abuse, we restricted our analyses to those 72 subjects assigned to either CBT or NST. The impact of lifetime history of sexual abuse on service use, depression, and treatment outcome was examined. RESULTS: Depressed adolescents with a past history of sexual abuse were more likely, at 2-year follow-up, to have had a psychiatric hospitalization and have a depressive relapse, even controlling for maternal depression, source of referral, race, and treatment assignment. CBT was more efficacious than NST in absence of sexual abuse but was not better than NST in those with a history of sexual abuse. CONCLUSION: Sexual abuse is a negative predictor of long-term outcome in adolescent depression. CBT for depression may not be as efficacious for those depressed adolescents with a history of sexual abuse. These findings suggest that a history of sexual abuse should be assessed not only in clinical practice, but also in research studies of depressive outcome. Further work is indicated to understand the relationship between sexual abuse and poor outcome in order to help restore these high-risk youths to an optimal developmental trajectory.

Adolescent↗
PubMed2003

Major depressive disorder in adolescents exposed to a friend's suicide.

OBJECTIVE: To evaluate whether the risk of DSM-III major depressive disorder (MDD) is uniform across the 6 months after adolescent exposure to a friend's suicide, and to examine potential moderating or mediating processes that may influence the risk of new-onset MDD. METHOD: One-month incidence rates of MDD were compared between 129 adolescents who were exposed to a friend's suicide between December 1988 and March 1991 and 145 similar-aged, unexposed community controls participating in the Youth Exposed to Suicide study. Clinical, family, and social factors that antedated the exposure were examined as predictors of new-onset MDD within 1 month of the suicide. RESULTS: Exposed adolescents had a markedly increased risk of developing new-onset MDD that was restricted to a narrow period of time, within 1 month after exposure. In contrast, there were no differences in the incidence of MDD between the groups in months 2 to 6. Past history of alcohol abuse increased the risk of exposure to suicide, which subsequently increased the risk of new-onset MDD within 1 month of exposure. Exposed youths who had both a family history of MDD and feelings of accountability for the death were at considerably increased risk of new-onset MDD. CONCLUSIONS: For adolescents exposed to a friend's suicide, events surrounding the death interact with family history of MDD to greatly increase the risk for new-onset MDD.

Adolescent↗
PubMedDate not supplied

Adolescent suicide and suicidal behavior.

This review examines the descriptive epidemiology, and risk and protective factors for youth suicide and suicidal behavior. A model of youth suicidal behavior is articulated, whereby suicidal behavior ensues as a result of an interaction of socio-cultural, developmental, psychiatric, psychological, and family-environmental factors. On the basis of this review, clinical and public health approaches to the reduction in youth suicide and recommendations for further research will be discussed.

Adolescent↗