Mood Disorders In Adolescents Research Articles

Neurocognitive risk phenotyping to predict mood symptoms in adolescence.

Predicting mood disorders in adolescence is a challenge that motivates research to identify neurocognitive predictors of symptom expression and clinical profiles. This study used machine learning to test whether neurocognitive variables predicted future manic or anhedonic symptoms in two adolescent samples risk-enriched for lifetime mood disorders (Sample 1, n = 73, ages = 13-25, M [SD] = 19.22 [2.49] years, 68% lifetime mood disorder) or familial mood disorders (Sample 2, n = 154, ages = 13-21, M [SD] = 16.46 [1.95] years, 62% first-degree family history of mood disorder). Participants completed cognitive testing and functional magnetic resonance imaging at baseline, for behavioral and neural measures of reward processing and executive functioning. Next, participants completed a daily diary procedure for 8-16 weeks. Penalized mixed-effects models identified neurocognitive predictors of future mood symptoms and stress-reactive changes in mood symptoms. Results included the following. In both samples, adolescents showing ventral corticostriatal reward hyposensitivity and lower reward performance reported more severe stress-reactive anhedonia. Poorer executive functioning behavior was associated with heightened anhedonia overall in Sample 1, but lower stress-reactive anhedonia in both samples. In Sample 1, adolescents showing ventral corticostriatal reward hypersensitivity and poorer executive functioning reported more severe stress-reactive manic symptoms. Clustering analyses identified, and replicated, five neurocognitive subgroups. Adolescents characterized by neural or behavioral reward hyposensitivities together with average-to-poor executive functioning reported unipolar symptom profiles. Adolescents showing neural reward hypersensitivity together with poor behavioral executive functioning reported a bipolar symptom profile (Sample 1 only). Together, neurocognitive phenotypes may hold value for predicting symptom expression and profiles of mood pathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Polygenic risk scores and the prediction of onset of mood and psychotic disorders in adolescents and young adults.

To examine whether polygenic risk scores (PRS) for neuroticism, depression, bipolar disorder and schizophrenia are higher in individuals manifesting trans-diagnostic risk factors for the development of major mental disorders and whether PRS enhance prediction of early onset full-threshold disorders. Using data from the Brisbane Longitudinal Twin Study, we examined individual PRS for neuroticism, depression, bipolar disorder and schizophrenia, recorded evidence of subthreshold syndromes and family history of mood and/or psychotic disorders and noted progression to trans-diagnostic clinical caseness (onset of major mental disorders) at follow-up. We undertook multivariate, receiver operating curve and logistic regression analyses that were adjusted for known variables of influence (age, twin status, and so on). Of 1473 eligible participants (female = 866, 59%; mean age 26.3 years), 28% (n = 409) met caseness criteria for a mood and/or psychotic disorder. All PRS were higher in cases versus non-cases but associations with different levels of risk were inconsistent. The prediction of caseness (reported as area under the curve with 95% confidence intervals [CI]) improved from 0.68 (95% CI: 0.65, 0.71) when estimated using clinical risk factors alone up to 0.71 (95% CI: 0.69, 0.73) when PRS were added to the model. Logistic regression identified five variables that optimally classified individuals according to caseness: age, sex, individual risk characteristics, PRS for depression and mental health case status of cotwins or siblings. The findings need replication. However, this exploratory study suggests that combining PRS with other risk factors has the potential to improve outcome prediction in youth.

Mitochondrial health, NLRP3 inflammasome activation, and white matter integrity in adolescent mood disorders: A pilot study

Adolescence is a particularly important period for brain development and is also when mood disorders typically emerge. Several psychiatric illnesses exhibit mitochondrial dysfunction, elevated inflammation, and impaired white matter integrity. This study explored the intersection of mitochondrial health, NLRP3 inflammasome activation, and white matter integrity in a small cohort of 29 adolescent patients with mood disorders (bipolar disorder (BD): n = 11, major depressive disorder (MDD): n = 19) and 19 healthy controls. In this sample, adolescents with mood disorders showed lower fractional anisotropy of the ventral cingulum bundle than healthy controls. Across all adolescents, we demonstrated a significant relationship between mitochondrial electron transport chain gene expression, and NLRP3 inflammasome gene expression and activation. Furthermore, circulating cell free mitochondrial DNA was associated with lower white matter integrity in the anterior thalamic radiation. Exploratory subgroup analyses revealed that adolescents with bipolar disorder exhibited lower levels of mitochondrial gene expression and volume, along with increased sensitivity to NLRP3 inflammasome activation compared to adolescents with unipolar depression. Overall, our results reveal relationships between peripherally-measured endpoints of mitochondrial health and NLRP3 inflammasome activation, and centrally measured endpoints of white matter integrity in adolescents. Together with subtle patterns of aberrant neural and biological structure and function in association with mood disorder diagnoses, these results may shed light on the pathophysiology of disease in this early phase of illness.

In the Mood for Music: Listening to Music and Other Smartphone Uses Improve Adolescent Mood.

Rates of adolescent mood disorders and adolescent smartphone use have risen in parallel, leading some to suggest that smartphone use might have detrimental effects on adolescents' moods. Alternatively, it is possible that adolescents turn to smartphone use when experiencing negative mood. Past experimental study suggests that certain smartphone activities can reduce adolescents' negative moods or induce more positive moods, but little is known about the effects of real-world smartphone use, which can involve many different activities. A sample of N = 253 adolescents participated in an Ecological Momentary Assessment (EMA) procedure, which assessed which smartphone activities they were engaged in at random moments throughout the day. This procedure also prompted adolescents to rate their moods before and during smartphone use. Adolescents reported mood improvements during almost all smartphone activities and did not report that moods became more negative during any smartphone activity. Mood improvements were the largest when adolescents said they were listening to music, podcasts, or audiobooks. This may suggest some adolescent smartphone use is driven by a desire to alleviate negative mood.

High-Fat Diet Consumption Induces Neurobehavioral Abnormalities and Neuronal Morphological Alterations Accompanied by Excessive Microglial Activation in the Medial Prefrontal Cortex in Adolescent Mice.

The association between a high-fat diet (HFD) consumption and emotional/cognitive disorders is widely documented. One distinctive feature of the prefrontal cortex (PFC), a kernel emotion- and cognition-related brain region, is its protracted adolescent maturation, which makes it highly vulnerable to the detrimental effects of environmental factors during adolescence. Disruption of the PFC structure and function is linked to emotional/cognitive disorders, especially those that emerge in late adolescence. A HFD consumption is common among adolescents, yet its potential effects on PFC-related neurobehavior in late adolescence and any related underlying mechanisms are yet to be established. In the present study, adolescent (postnatal days 28-56) male C57BL/6J mice were fed a control diet (CD) or a HFD and underwent behavioral tests in addition to Golgi staining and immunofluorescence targeting of the medial PFC (mPFC). The HFD-fed adolescent mice exhibited anxiety- and depression-like behavior and abnormal mPFC pyramidal neuronal morphology accompanied by alterations in microglial morphology indicative of a heightened state of activation and increased microglial PSD95+ inclusions signifying excessive phagocytosis of the synaptic material in the mPFC. These findings offer novel insights into the neurobehavioral effects due to adolescent HFD consumption and suggest a contributing role in microglial dysfunction and prefrontal neuroplasticity deficits for HFD-associated mood disorders in adolescents.

Use of Benzodiazepines for Anxiety and Mood Disorders among High School Students with Low Academic Status: Implications for Mental Health Interventions

The prevalence of anxiety and mood disorders in adolescents is a growing public health concern worldwide. Mental disorders are a global health issue that can devastate the adolescent and family’s mental, physical, emotional, developmental health, and social life. We examined the influence of motivational interviewing (MI) on the relationship between Benzodiazepine medication Use and Anxiety disorders among adolescent university students. A random sample of 1,000 students over 18 attending a large University in southeastern Nigeria was screened (using PHQ-9 and GAD-7). Adolescents with results indicative of anxiety or depressive symptoms (n = 120) were advised to seek psychological health care. Participants who screened positive received either two sessions of MI or treatment as usual. The MI group demonstrated more willingness and confidence in treatment initiation. MI enhanced group treatment engagement in adolescents diagnosed with anxiety and mood disorders. Results indicate that Motivational interviewing mediates between benzodiazepine medication and Cognitive behavioral therapy in treating adolescent anxiety disorders.

Predicting treatment response in adolescents and young adults with major depressive episodes from fMRI using graph isomorphism network

BackgroundMajor depressive episode (MDE) is the main clinical feature of mood disorders (major depressive disorder and bipolar disorder) in adolescents and young adults and accounts for most of the disease course. However, 30%-40% of MDE patients not responding to clinical first-line interventions. It is crucial to predict treatment response in the early stages and identify biomarkers associated with treatment response. Graph Isomorphism Network (GIN), a deep learning method, is promising for predicting treatment response for individual MDE patients with more powerful representation ability to capture the features of brain functional connectivity. MethodsIn this study, GIN was used to predict individual treatment response in 198 adolescents and young adults with MDE. The most discriminating regions were also identified for the treatment response prediction. ResultsUsing GIN approach, the baseline functional connectivity could predict 79.8% responders and 67.4% non-responders to treatment (accuracy 74.24%). Furthermore, the most discriminating brain regions were mainly involved in paralimbic and subcortical areas. ConclusionsGIN has shown potential in predicting treatment response for individual patients, which may enable personalized treatment decisions. Furthermore, targeted interventions focused on modulating the activity and connectivity within paralimbic and subcortical regions could potentially improve treatment outcomes and enable personalized interventions for adolescents and young adults with MDE.

Childhood temperamental, emotional, and behavioral characteristics associated with mood and anxiety disorders in adolescence: A prospective study.

Mood and anxiety disorders account for a large share of the global burden of disability. Some studies suggest that early signs may emerge already in childhood. However, there is a lack of well-powered, prospective studies investigating how and when childhood mental traits and trajectories relate to adolescent mood and anxiety disorders. We here examine cross-sectional and longitudinal association between maternally reported temperamental traits, emotional and behavioral problems in childhood (0.5-8 years) and clinical diagnosis of mood or anxiety ("emotional") disorders in adolescence (10-18 years), using the prospective Norwegian Mother, Father and Child Cohort Study (MoBa) of 110,367 children. Logistic regression analyses showed consistent and increasing associations between childhood negative emotionality, behavioral and emotional problems and adolescent diagnosis of emotional disorders, present from 6months of age (negative emotionality). Latent profile analysis incorporating latent growth models identified five developmental profiles of emotional and behavioral problems. A profile of early increasing behavioral and emotional problems with combined symptoms at 8 years (1.3% of sample) was the profile most strongly associated with emotional disorders in adolescence (OR vs. reference: 5.00, 95% CI: 3.70-6.30). We found a consistent and increasing association between negative emotionality, behavioral and emotional problems in early to middle childhood and mood and anxiety disorders in adolescence. A developmental profile coherent with early and increasing disruptive mood dysregulation across childhood was the profile strongest associated with adolescent emotional disorders. Our results highlight the importance of early emotional dysregulation and childhood as a formative period in the development of adolescent mood and anxiety disorders, supporting potential for prevention and early intervention initiatives.

Key factors selection on adolescents with non-suicidal self-injury: A support vector machine based approach.

Comparing a family structure to a company, one can often think of parents as leaders and adolescents as employees. Stressful family environments and anxiety levels, depression levels, personality disorders, emotional regulation difficulties, and childhood trauma may all contribute to non-suicidal self-injury (NSSI) behaviors. We presented a support vector machine (SVM) based method for discovering the key factors among mazy candidates that affected NSSI in adolescents. Using SVM as the base learner, and the binary dragonfly algorithm was used to find the feature combination that minimized the objective function, which took into account both the prediction error and the number of selected variables. Unlike univariate model analysis, we used a multivariate model to explore the risk factors, which better revealed the interactions between factors. Our research showed that adolescent education level, anxiety and depression level, borderline and avoidant personality traits, as well as emotional abuse and physical neglect in childhood, were associated with mood disorders in adolescents. Furthermore, gender, adolescent education level, physical abuse in childhood, non-acceptance of emotional responses, as well as paranoid, borderline, and histrionic personality traits, were associated with an increased risk of NSSI. These findings can help us make better use of artificial intelligence technology to extract potential factors leading to NSSI in adolescents from massive data, and provide theoretical support for the prevention and intervention of NSSI in adolescents.

Protective Effects of Resveratrol on Adolescent Social Isolation-Induced Anxiety-Like Behaviors via Modulating Nucleus Accumbens Spine Plasticity and Mitochondrial Function in Female Rats.

Social isolation (SI) is a major risk factor for mood disorders in adolescents. The nucleus accumbens (NAc) is an important reward center implicated in psychiatric disorders. Resveratrol (RSV) is one of the most effective natural polyphenols with anti-anxiety and depression effects. However, little is known about the therapeutic effects and mechanisms of RSV on behavioral abnormality of adolescent social stress. Therefore, this study aimed to investigate the underlying mechanism of RSV on the amelioration of SI-induced behavioral abnormality. We found that SI induced anxiety-like behavior and social dysfunction in isolated female rats. Moreover, SI reduced mitochondrial number and ATP levels and increased thin spine density in the NAc. RNA sequencing results showed that SI changed the transcription pattern in the NAc, including 519 upregulated genes and 610 downregulated genes, especially those related to mitochondrial function. Importantly, RSV ameliorated behavioral and spine abnormalities induced by SI and increased NAc ATP levels and mitochondria number. Furthermore, RSV increased the activity of cytochrome C oxidase (COX) and upregulated mRNA levels of Cox5a, Cox6a1 and Cox7c. These results demonstrate that the modulation of spine plasticity and mitochondrial function in the NAc by RSV has a therapeutic effect on mood disorders induced by social isolation.

The Mediterranean Diet and the Western Diet in Adolescent Depression-Current Reports.

Depression is one of the most common mental disorders in the world and a current and growing social and health problem. The growing scale of the problem not only concerns adults, but now it particularly affects children and adolescents. Prevention, early diagnosis and treatment of mood disorders in adolescence is crucial because adolescent depression is a risk factor for recurrence of depression later in life, as well as many other mental health disorders in adulthood. The purpose of this study was to analyze data on the dietary patterns and composition of the Mediterranean diet as a modifiable risk factor for depression, which would be a viable prevention strategy and a good target for early intervention and supportive treatment of depression. Research shows that the Mediterranean diet pattern can reduce the risk and symptoms of depression, while western eating styles can increase the risk and severity of depression in adolescents. The number of studies in adolescent populations continues to increase, but most longitudinal and clinical studies are still insufficient. Modification of the diet can be a helpful strategy for the prevention and treatment of depression in adolescents; therefore, the diet of young people should be considered a key and modifiable goal in the prevention of mental disorders.

The Association Between Racial Attitudes, Alcohol Use and Mood Disorders Among Black Adolescents.

Alcohol is the most widely used substance among adolescents. Although Black adolescents use alcohol at lower rates than White adolescents, Black adolescents tend to have worse outcomes. This includes higher rates of mood disorders and criminal justice involvement associated with alcohol use and misuse compared to any other racial group. Black adolescents are also more likely to experience racial discrimination and be exposed to traumatic events within their communities, which may increase their chances of using substances. Understanding the relationship between racial attitudes (towards one's own group and others) and substance use and mental health can provide unique and meaningful insight into prevention programming for Black adolescents. Yet, these concepts have been understudied. To fill this gap, we examined the association between racial attitudes and alcohol use and mood disorders in Black adolescents in Philadelphia, PA (N = 154). We used the revised Adolescent Survey of Black Life to measure pro-Black (positive attitudes toward being Black and factors related to Black people), anti-White (negative attitudes toward White people due to experiences of racism and discrimination) and racism awareness (recognition of racism) domains. Logistic regression analyses were conducted to test the associations. Results showed that: higher pro-Black attitudes were associated with a lower odds of mood disorder (odds ratio [OR] = 0.72, 95% CI = 0.55, 0.89); and higher racism awareness was associated with an increased odds of alcohol use (OR = 1.18, 95% confidence interval [CI] = 1.06, 1.29). Findings provide preliminary support for interventions and policies for Black adolescents that bolster positive racial identity and eliminate experiences of racism as alcohol use and mood disorder prevention strategies.

Prevalence and Socio-Demographic Factors of Bipolar Mood Disorders in Children and Adolescents: Identifying the Principal Predictors

Objectives: Our objective is to measure the prevalence of bipolar mood disorder (BMD) in Iranian children and adolescents and its comorbidity with psychiatric disorders. Also, the main purpose of this study is to characterize the main risk factors for BMD in children and adolescents. Methods: This is an analytical cross-sectional study. In a community-based study, we sampled 1000 children and adolescents from the age of 6 to 18 years in each province via the multistage cluster sampling method. The total valid sample size reached 29 812 cases. The instructed clinical psychologists completed the Persian version of the kiddie schedule for affective disorders and schizophrenia present and lifetime version (K-SADS-PL). Furthermore, the demographic data were obtained. To analyze the data, descriptive statistics, multinomial, and multiple logistic regressions were utilized to evaluate the relationships. Results: The total prevalence rates for BMD were 0.29%; it was 0.26% in males and 0.29% in females. BMD rates were larger in children and adolescents whose mothers had an occupation. Also, after controlling the effective variables (sex and age), location (rural or urban), the father’s education, and the psychiatric hospitalization of the mother or the father, none predicted BMD significantly. Moreover, patients with comorbidities showed a superior prevalence compared to those without comorbidities, ranging from 1.96% for posttraumatic stress disorder to 39.22% for the oppositional defiant disorder. Conclusion: BMD was more prevalent among women. The gender or the father’s education level was not the risk factor for BMD symptoms. Several factors, such as maternal education and maternal job were also important for the prevalence of BMD symptoms.

EDUCATION AND TRAINING REGARDING MENSTRUAL HYGIENE MANAGEMENT (MHM) AS AN EFFORT TO CARE REPRODUCTIVE ORGANS IN ADOLESCENT

Introduction: According to the Indonesian Demographic and Health Survey (IDHS) in 2017, young women (63.9%) in maintaining cleanliness during menstruation are still lacking due to low knowledge and information about personal hygiene during menstruation. SMP Negeri 1 Sampit is located in Central Kalimantan where most of the students do not have knowledge about menstrual hygiene management. Methods: The activities used in this community service program were in the form of health education to 120 students of 7th and 8th grades. The community service events carried out through this webinar include opening, pretest, giving material, and closing with a post test. The pretest was carried out before giving the material to determine the participant's initial understanding of menstrual hygine management. Results: Knowledge related to adolescent growth and development scored well as many as 19 people (15.83%) then during the good posttest it became 63 people (52.50%). Knowledge related to menstrual hygiene management during the pretest who got a good score was only 20 people (16.67%) and 72 people (60%) good in posttest. While the knowledge related to mood disorders in adolescents who got a good score at the pretest was 21 (17.5%) and 70 people (58.3%) had a good score in posttest. Conclusion: Community service activities conducted in the form of online webinars to provide health education and modules to teachers can improve knowledge and practice of menstrual hygiene management as an early effort in maintaining and caring for the health of the female reproductive organs.

The Association Between Binge-Watching Behavior and Psychological Problems Among Adolescents.

This study aims to investigate the relationship between binge-watching addiction and family, emotional, conduct, cognitive and anger control problems, hyperactivity, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV)-ADHD Index, DSM-IV-Inattention, and DSM-IV-Hyperactivity Impulsivity in a large sample of healthy Turkish adolescents. The association between binge-watching behavior addiction and mood disorders in healthy adolescents was examined in this cross-sectional study conducted in Turkey. Participants completed both measures, The Binge-Watching Addiction Questionnaire and The Conners-Wells' Adolescent Self-Report Scale. An online survey of 189 adolescents was conducted. One hundred fourteen subjects (60.3%) were categorized into the binge-watcher group. Results showed important positive associations between binge-watching behavior and emotional, conduct, cognitive problems, and DSM-IV-Inattention. The conducted analysis showed an important association between high frequency of binge-watching and emotional problems (p < 0.001), conduct problems (p = 0.012), cognitive problems (p = 0.001), and inattention (p < 0.001). These findings contributed to our comprehension of adolescents' psychological correlates of television viewing behavior. Further researches on the relationship between extreme binge-watching and psychiatric disorders of adolescents are recommended.

Temperament and character dimensions as psychological markers of mood disorders in Polish adolescents and young adults-A prospective study.

An increasing incidence of mood disorders in adolescents and young adults is being observed. The assessment of personality traits seems to be an interesting tool in identifying early markers of major depression (MD) or bipolar disorder (BD) as well as predictors of the course of the disease. The aim of this study was to compare the personality profiles in young patients with MD and BD in acute and remitted mood states. Seventy-nine adolescents and young adults with mood disorder diagnoses (MD or BD) were included in the study. The participants were assessed based on structured diagnostic interviews and completed the Temperament and Character Inventory (TCI). The clinical evaluation was conducted during the acute episodes and after reaching the stabilized mood in the course of follow-up visits in a 2-year study observation. At baseline, MD patients had higher scores on the harm avoidance (HA) with more pronounced anticipatory worry and fatigability subscale than BD patients. Conversely, BD patients reached higher scores in the total self-directedness (SD) character dimension and its sub-dimensions. MD patients with acute depressive symptoms had higher scores in the HA dimension and its subscale: anticipatory worry, shyness, and fatigability compared with their euthymic states. No significant differences in TCI dimensions between baseline and euthymia in the BD subgroup were found, and no differences between euthymic MD and BD patients. Higher ST and SD sub-dimensions may constitute a personality profile specific to BD, while high HA seems to be related to major depression in both acute and remitted states in young patients.

Review finds positives and few negatives for ECT in children and adolescents

Treating mood disorders in children and adolescents with electroconvulsive therapy (ECT) should be considered in severe cases which do not respond to other treatments, researchers have found in a literature review. There are mostly case studies, but many are moderate‐sized and across different settings, with an alignment of findings, according to the research.

Systematic review: Electroconvulsive therapy for treatment-resistant mood disorders in children and adolescents.

Electroconvulsive therapy (ECT) is a well-established treatment for adults with mood disorders. However, its use in child and adolescent populations is less common. At the same time, approximately 60% of child and adolescent patients do not respond satisfactorily to first-line treatments for mood disorders. Given the need for effective treatments for severe mood disorders in adolescents and the low use rate of ECT, this systematic review examines the existing literature on the effectiveness and adverse effect profile of ECT when used for treatment-resistant mood disorders in children and adolescents. Searches were conducted in Medline, Embase, and PsycInfo using search terms related to (1) children and adolescents, (2) mood disorders, and (3) ECT. Searches identified 1715 unique articles. The full text of 71 selected articles were reviewed, leading to 41 studies included in the study. A standardized data extraction tool was used to collect key information from each study (i.e. author and publication year, objectives, participants and setting, design, measures, clinical outcomes, and side effects). As most of the studies found were case series, the Joanna Briggs Institute Case Series Critical Appraisal tool was used to assess quality. Studies were summarized qualitatively by comparing findings across key study parameters. Our review identified 41 studies for inclusion. Twenty were case series, two were case-control studies, and nineteen were case reports. Overall treatment response rates ranged from 51 to 92%, with patients receiving an average of 12 treatments. Among studies with n > 30, response rates were largely 70-82% for depression and 87-90% for mania. Seven studies used the Mini-Mental State Exam and found no evidence of significant post-treatment cognitive impairment. The majority of side effects were minor and transient. Tardive seizure was reported in 4 (0.6%) patients. ECT was discontinued early due to side effects in 11 (1.5%) cases. No fatalities were reported. Our data suggest that ECT is safe and effective for the treatment of mood disorders in child and adolescent populations, and should be considered in severe and treatment-refractory cases. Controlled studies with objective measures and long-term follow-up are needed to advance the evidence base.

Parental Attitudes Toward Use of Ketamine in Adolescent Mood Disorders and Suicidality.

Objectives: Investigation into parental decision-making processes involving ketamine is of high priority, given the necessary role of parents in consenting to treatment. In this study, we examined parental attitudes toward the emerging use of ketamine in adolescent mood disorders and suicidality. Methods: Two hundred eighty-three English-speaking parents completed an online survey using Amazon Mechanical Turk on psychiatric use of ketamine, acceptability of treatment, and their perceptions of ketamine treatment. Data quality control measures were used to mitigate invalid reporting. Results: Parents reported high acceptability toward use of ketamine for suicidality, major depressive disorder, and bipolar disorder in adolescents. Primary concerns around ketamine involved its potential side effects and lack of United States Food and Drug Administration (FDA) approval. Responses indicated a preference for short-term applications and less invasive routes of administration for ketamine. Parent history of mental illness, familiarity with psychological treatments, and comfort using other mental health interventions in their children predicted greater acceptability of ketamine. Conclusion: Although ketamine is not currently approved by the FDA for psychiatric use in children nor recommended outside of research protocols, these findings suggest that parents have interest in the application of ketamine as a treatment for pediatric mood disorders and point to future directions for research and clinical orientation.

39.1 Narcolepsy Comorbid With Mood Disorders in Adolescents: Clinical Correlates and Their Impact on Hospital Outcomes in the United States

39.1 Narcolepsy Comorbid With Mood Disorders in Adolescents: Clinical Correlates and Their Impact on Hospital Outcomes in the United States