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"Kaplan, Stuart L"
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Your child does not have bipolar disorder : how bad science and good public relations created the diagnosis
Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis examines this diagnostic fad through a variety of lenses. Author Stuart L. Kaplan, MD, draws heavily on his forty years of experience as a clinician, researcher, and professor of child psychiatry to make the argument that bipolar disorder in children and adolescents is incorrectly diagnosed and incorrectly treated.
Book
Efficacy and Safety of Atomoxetine in Adolescents with Attention-Deficit/Hyperactivity Disorder and Major Depression
This double-blind study examined efficacy and safety of atomoxetine (ATX; ≤1.8mg/kg per day) in adolescents aged 12–18 with Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnoses of both attention-deficit/hyperactivity disorder (ADHD) and co-morbid major depressive disorder (MDD). Diagnoses were confirmed by the Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children–Present and Lifetime Version and persistently elevated scores on the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV, Parent version, Investigator-administered and -scored (ADHDRS-IV-Parent:Inv, ≥1.5 standard deviations above age and gender norms) and Children's Depression Rating Scale–Revised (CDRS-R, ≥ 40). Patients were treated for approximately 9 weeks with ATX (n = 72) or placebo (n = 70). Mean decrease in ADHDRS-IV-Parent:Inv total score was significantly greater in the ATX group (−13.3 ± 10.0) compared with the placebo group (−5.1 ± 9.9; p < 0.001). Mean CDRS-R score improvement was not significantly different between groups (ATX, −14.8 ± 13.3; placebo, −12.8 ± 10.4). Rates of treatment-emergent mania did not differ between groups (ATX, 0.0%; placebo, 1.5%). ATX treatment was associated with significantly more nausea and decreased appetite (p = 0.002; p = 0.003). No spontaneously reported adverse events involving suicidal ideation or suicidal behavior occurred in either group. ATX was an effective and safe treatment for ADHD in adolescents with ADHD and MDD. However, this trial showed no evidence for ATX of efficacy in treating MDD.
Journal Article
Role of indoleacetic acid and abscisic acid in the correlative control of fruits of axillary bud development and leaf senescence Bean
When fully filled pods of bean plants were deseeded, the rate of axillary bud growth and the chlorophyll content of leaves were increased. Application of 0.1% indoleacetic acid (IAA) in lanolin on the deseeded pods caused abscission of axillary buds, inhibited growth of the remaining buds, and decreased leaf chlorophyll content. The response of bud development to fruit-applied IAA was concentration dependent between 0.001 and 0.1% IAA (representing from 2 to 200 micrograms IAA per fruit) resulting in greater growth inhibition at higher IAA concentrations. When plants were defruited so that the number of fruits per plant was adjusted to 0, 6, 12, or 18, a dosage effect of fruits on photosynthesis was observed. Removal of all fruits caused a rise in the CO2-exchange rate (CER). With increasing fruit dosage, plants showed leaf senescence of increasing intensity and a corresponding decline in CER. In contrast to the effect of fruit-applied IAA on leaves and buds, it delayed the senescence of treated fruits. When axillary buds were treated directly with aqueous solutions of IAA, no growth inhibition occurred. Abscisic acid (AbA) applied on deseeded pods, up to a concentration of 0.1% AbA in lanolin, failed to inhibit axillary bud development or to cause leaf senescence. The results support the hypothesis that the correlative control of axillary bud development and leaf senescence by fruits involves the participation of both IAA and AbA. IAA, released by the seeds, may play the role of the correlative signal that moves from the fruit to the target organ, where it stimulates the synthesis or accumulation of AbA. AbA, in turn, may be responsible for the inhibition of axillary bud development and the enhancement of leaf senescence.
Journal Article
The use of prn and stat medication in three child psychiatric inpatient settings
As part of a larger study of prescribing practices in inpatient child and adolescent settings, 1,117 stat (emergency) and pm (as needed) doses administered to 150 child and adolescent inpatients at a state hospital, a private hospital, and a county-university hospital in the New York metropolitan area during 1991 were examined. Stat dosing was most common (p < .001) at the state hospital, where 76 percent of the medicated sample received at least one stat dose of medication; prn dosing was most common (p < .001) at the county-university hospital, where 80 percent of the medicated sample received at least one prn dose. Antihistamines were the most frequently used stat and prn medications at the state hospital. Antipsychotics were the most frequently used stat and prn medications at the private hospital. At the county-university hospital, the most frequently used stat medications were the minor tranquilizers, and the most frequently used prn medications were the antipsychotics. At all three hospitals, a high proportion of patients receiving stat or prn antipsychotics were receiving standing antipsychotics. At all three hospitals agitation was the predominant indication for stat or prn medication of any type.
Journal Article
Mommy am I really bipolar?
\"Before 1995, bipolar disorder, once known as manic-depressive illness, was rarely diagnosed in children; today nearly one third of all children and adolescents discharged from child psychiatric hospitals are diagnosed with the disorder and medicated accordingly. The rise of outpatient office visits for children and adolescents with bipolar disorder increased 40-fold from 20,000 in 1994–95 to 800,000 in 2002–03.\" (Newsweek) In this article, a noted child psychiatrist argues that \"there is no scientific evidence to support the belief that bipolar disorder surfaces in childhood.\" He asserts that the consequences of wrongly diagnosing children with the \"trendy\" disorder can be devastating.
Magazine Article
MOMMY, AM I ReaLLy BiPoLar?
IN THE AUTUMN of 1994, a novel idea was afoot in my profession. At the annual conference of the American Academy of Child and Adolescent Psychiatry, I attended a workshop on bipolar disorder in children. About 10 of us attended the meeting, held in a small, poorly lit room. Only one or two doctors reported having actually seen a child with bipolar disorder, but we all agreed to keep our eyes open for other sightings. Three years later I attended another session about bipolar disorder in children at the academy's annual meeting.
Magazine Article
Mommy, Daddy, am I really bipolar?
[...] the opposite seems to be the case: In a series of studies, Luby reported that preschool children who exhibited grandiosity, elation and interest in sexual behavior were likely to have bipolar disorder.
Newspaper Article