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Smoking is a leading cause of morbidity and premature mortality in the United States. The relationship between tobacco smoking and several forms of cancer, heart disease, stroke, chronic lung disease, and other medical diseases is well recognized and accepted. Recent epidemiological studies are now focusing on the link between tobacco use and psychiatric diseases. Experts now suggest that in the differential diagnosis of "smoker," depression, alcohol dependence, and schizophrenia are highest on the list. Studies are also focusing on the role of secondhand tobacco exposure, either in utero or during childhood, in the risk of dual disorders. Prenatal exposure may alter gene expression and change the risk for a variety of life-long psychiatric diseases, e.g., ADD/ADHD, antisocial personality disorders, substance use disorders, and major depression. Considerable time and effort have been devoted to studying the link between smoking and depression and also schizophrenia. We will focus on less well-studied areas in tobacco use and psychiatric dual disorders (including eating disorders), prenatal and early childhood secondhand smoke (SHS) exposure, and the relationship to the genesis of these dual disorders.
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PMID:Tobacco and psychiatric dual disorders. 1928 70

8.6% suicidal ideation (SI) was found among 349 urban 6-9 year olds in the top tercile of aggressive-disruptive behavior. SI was associated with more self-reported depression, ODD, conduct problems, and ADHD symptoms (ES 0.70-0.97) and 3.5-5 times more clinically significant symptoms. Parents rated more symptoms in older children associated with SI compared to parents of similar age children without SI, including greater somatic and behavior problems in 8-9 year olds with SI. Parent ratings did not differentiate SI and non-SI in 6-7 year olds. SI frequently co-occurred with thoughts about death. Children described anger, dysphoria and interpersonal conflict as motivators/triggers for SI and worries about safety/health as motivator/triggers for thoughts about death, suggesting that problems managing emotionally challenging situations are a specific factor in initiating SI. Universal and indicated interventions for children to strengthen emotional self-regulation and behavioral control are recommended to complement the current emphasis on suicide prevention among adolescents.
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PMID:Emotional triggers and psychopathology associated with suicidal ideation in urban children with elevated aggressive-disruptive behavior. 1947 70

The correlation between exposure to forms of violence and development of mental disorders in victims is well established. The purpose of this paper was to identify mental health problems in an adolescent medicine clinic population in Lexington, KY and to investigate potential correlation of mental disorders with psychosocial factors. Data were gathered from the charts of 169 adolescent clinic patients (age 10-22) seen in the clinic for mental health care and analyzed using Excel. Of the patient population, 68% were urban, whereas 32% were rural. In terms of gender, 40% of the patients were male and 60% were female, 80% were white, 13% black, and 7% had other racial background(s). The most prevalent mental disorders in this group were depression 32.12%, 13% with generalized anxiety disorder, 8.2% with an attention deficit disorder (including ADHD), and 5.76% with an adjustment disorder. The abovementioned demographic trends showed that depression continues to be the most common mental health problem in this population regardless of gender, ethnic origin, or economic status. This finding highlights the need for availability of mental health support to this patient population. Further work is needed to spotlight the most significant psychosocial factors and root causes of mental health conditions in this age group.
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PMID:Trends in mental health of an adolescent medicine clinic patient population. 1952 91

ABSTRACT The pertinent literature was reviewed on cardiovascular changes induced by psychostimulant medication treatment of hyperactive children. An assessment of 15 controlled studies using test doses of methylphenidate revealed a significant elevation of the resting heart rate in previously unmedicated children (mean + 11 beats/min) but, with continued drug treatment, only a minor insignificant increase (mean + 4 BPM) is observed. Methylphenidate resulted in no consistent or clinically meaningful blood pressure changes (8 studies) and no EKG irregularities (4 studies). Available data for dextroamphetamine and pemoline were less extensive, but showed essentially no significant cardiovascular changes in hyperactive youth. Stimulant overdoses in nonhyperactive children often led to hypertension and tachycardia, but were associated with only one cardiovascular fatality (amphetamine). Comparable studies of these stimulants in adults revealed: (1) tachycardia and hypertension following high test doses of methylphenidate, (2) hypertension but no tachycardia following high test doses of dextroamphetamine, (3) far greater cardiovascular changes following the parenteral administration of stimulants, (4) the development of a prominent degree of tolerance to the cardiovascular effects of stimulants with continued use, (5) very infrequent cardiovascular changes (3%) in medically ill, older adults following stimulant treatment for depression, and (6) infrequent cardiomyopathy and arteritis in association with amphetamine abuse, but not with pemoline or methylphenidate use. The stimulant-induced changes in children are modest in comparison with changes in cardiovascular functioning associated with normal daily activities, and are not comparable to the risks that can occur with tricyclic antidepressants. There appears to be a wide margin of cardiovascular safety when standard psychostimulants are taken orally in customary doses for long periods by hyperactive children. In view of the numerous negative studies, it probably is not essential to monitor heart rate, blood pressure, or EKG prior to or during routine psychostimulant treatment of children and adolescents with ADHD, unless there are comorbid cardiovascular abnormalities.
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PMID:Relative cardiovascular safety of psychostimulants used to treat attention-deficit hyperactivity disorder. 1963 Jun 10

Much of the research examining intergenerational continuity of problems from mother to offspring has focused on homotypic continuity (e.g., depression), despite the fact that different types of mental health problems tend to cluster in both adults and children. It remains unclear whether mothers with multiple mental health problems compared to mothers with fewer or no problems are more likely to have daughters with multiple mental health problems during middle childhood (ages 7 to 11). Six waves of maternal and child data from the Pittsburgh Girls Study (n = 2,451) were used to examine the specificity of effects of maternal psychopathology on child adjustment. Child multiple mental health problems comprised disruptive behavior, ADHD symptoms, depressed mood, anxiety symptoms and somatic complaints, while maternal multiple mental health problems consisted of depression, prior conduct problems and somatic complaints. Generalized Estimating Equations (GEE) was used to examine the prospective relationships between mother's single and multiple mental health problems and their daughter's single and multiple mental health problems across the elementary school-aged period (ages 7-11 years). The results show that multiple mental health problems in the mothers predicted multiple mental health problems in the daughters even when earlier mental health problem of the daughters, demographic factors, and childrearing practices were controlled. Maternal low parental warmth and harsh punishment independently contributed to the prediction of multiple mental health problems in their daughter, but mediation analyses showed that the contribution of parenting behaviors to the explanation of girls' mental health problems was small.
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PMID:Intergenerational transmission of multiple problem behaviors: prospective relationships between mothers and daughters. 1963 6

Serotonin (5-HT) is involved in many developmental processes and influences behaviors including anxiety, aggression, and cognition. Disruption of the serotonergic system has been implicated in human disorders including autism, depression, schizophrenia, and ADHD. Although pharmacological, neurotoxin, and dietary manipulation of 5-HT and tryptophan hydroxylase has added to our understanding of the serotonergic system, the results are complicated by multiple factors. A newly identified ETS domain transcription factor, Pet-1, has direct control of major aspects of 5-HT neuronal development. Pet-1 is the only known factor that is restricted in the brain to 5-HT neurons during development and adulthood and exerts dominant control over 5-HT neuronal phenotype. Disruption of Pet-1 produces an approximately 80% loss of 5-HT neurons and content and results in increased aggression in male Pet-1(-/-) mice [Hendricks TJ, Fyodorov DV, Wegman LJ, Lelutiu NB, Pehek EA, Yamamoto B, Silver J, Weeber EJ, Sweatt JD, Deneris ES (2003) Neuron 37:233-247]. We hypothesized that Pet-1(-/-) mice would also exhibit changes in anxiety and cognition. Pet-1(-/-) mice were hypoactive which may have affected the observed lack of anxious behavior in the elevated zero maze and light-dark test. Pet-1(-/-) mice, however, were more defensive during marble burying and showed acoustic startle hyper-reactivity. No deficits in spatial, egocentric, or novel object recognition learning were found in Pet-1(-/-) mice. These findings were unexpected given that 5-HT depleting drugs given to adult or developing animals result in learning deficits [Mazer C, Muneyyirci J, Taheny K, Raio N, Borella A, Whitaker-Azmitia P (1997) Brain Res 760:68-73; Morford LL, Inman-Wood SL, Gudelsky GA, Williams MT, Vorhees CV (2002) Eur J Neurosci 16:491-500; Vorhees CV, Schaefer TL, Williams MT (2007) Synapse 61:488-499]. Lack of differences may be the result of compensatory mechanisms in reaction to a constitutive knock out of Pet-1 or 5-HT may not be as important in learning and memory as previously suspected.
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PMID:Mouse plasmacytoma-expressed transcript 1 knock out induced 5-HT disruption results in a lack of cognitive deficits and an anxiety phenotype complicated by hypoactivity and defensiveness. 1978 75

The prevalence of overweight and obesity is approximately 32% among children and adolescents in the United States. Comorbid conditions associated with pediatric overweight and obesity include psychiatric conditions. The purpose of this study was to determine the prevalence of overweight and obesity among children and adolescents presenting for consultation from rural communities to the UC Davis Telemedicine Program (UCDTP), as well as to collect preliminary data to design an integrated disease management program for children and adolescents with obesity and mental illness. Patients aged 21 and under seen for psychiatric consultation at the UCDTP between 2004 and 2006 were included. Retrospective medical record review was conducted to determine the major psychiatric diagnoses, height, weight, body-mass index, and weight status (underweight/at risk for underweight, normal weight, overweight, or obese) for each patient. Of the 230 patients referred, a total of 121 patients had both height and weight values documented. Three patients were underweight; 51 were normal weight; 28 were overweight; 39 were obese. The most common psychiatric diagnoses in the 121 patients were attention deficit/hyperactivity disorder (ADHD; n = 40), bipolar disorder (n = 36), and depression (n = 31). The most common psychiatric diagnoses in patients with available weight and height data who were overweight and obese were bipolar disorder (n = 20), depression (n = 18), and ADHD (n = 17). Approximately 55% of child and adolescent patients seen for telepsychiatry consultation whose charts documented height and weight measurements were overweight or obese. Psychiatric diagnoses in overweight youngsters need to be researched further to determine whether the weight change is primary or secondary to mood and/or to treatments, such as medication. At such a high rate of comorbidity, monitoring the weight status of young psychiatric patients in this population is indicated.
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PMID:Weight status of children and adolescents in a telepsychiatry clinic. 2002 89

Preclinical studies suggest that compounds with dual norepinephrine reuptake inhibitor (NRI) and 5-HT(1A) partial agonist properties may provide an important new therapeutic approach to ADHD, depression, and anxiety. Reported herein is the discovery of a novel chemical series with a favorable NRI and 5-HT(1A) partial agonist pharmacological profile as well as excellent selectivity for the norepinephrine transporter over the dopamine transporter.
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PMID:Design, synthesis, and pharmacological evaluation of phenoxy pyridyl derivatives as dual norepinephrine reuptake inhibitors and 5-HT1A partial agonists. 2003 10

The aims of this study were to examine a non-English (Hebrew) version of a scale that measures the premonitory urge in children suffering from tic disorder, as well as examine the correlations of the urge with demographic and clinical aspects of Tourette Syndrome. Forty children and adolescents, suffering from tics participated in this study. They were assessed with the Premonitory Urge for Tics Scale (PUTS); the Yale Global Tic Severity Scale (YGTSS); the Childhood Version of the Yale Brown Obsessive Compulsive Scale (CYBOCS); the ADHD Rating Scale IV (Conners) Scale; the Screen for Child Anxiety Related Emotional Disorders (SCARED); and the Child Depression Inventory (CDI). The mean PUTS score was 20.15 (SD = 5.89). For the entire sample the PUTS was found to be internally consistent at a = 0.79. Youths older than 10 years had higher consistency (a = 0.83) than youths younger than 10 (a = 0.69). Premonitory urge was not correlated with tic severity in the entire sample. In youths older than 10, as opposed to youths younger than 10, premonitory urge did correlate with obsessions, compulsions and depression, but not with anxiety or with ADHD. The premonitory urge can be measured reliably and the PUTS is a useful instrument for measuring this important phenomena. Premonitory urges seems to be related to obsessions, compulsions, and depression in older children and this may have implications for the developmental psychopatholgy of these symptoms.
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PMID:Tic disorders and the premonitory urge. 2003 36

The histamine H(3) receptor is involved in the central and peripheral regulation of levels of histamine and other neurotransmitters (e.g., acetylcholine, noradrenaline, dopamine, serotonin and GABA), which sets it up as a target in the treatment of various CNS (e.g., depression, schizophrenia, ADHD, dementia, neuropathic pain and sleep disorders), metabolic syndrome (e.g., obesity) and allergic disorders. Novel chemical series from the most recent 2 years of patent literature have been reviewed. While overall structural diversity is moderate, these represent or relate to some of the compounds progressing through clinical trials (e.g., GSK-189254). However, an H(3) receptor drug still has yet to reach the market. Patenting activity is likely to remain high in the near future, bolstered by the commercial promise of potential H(3) receptor drugs.
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PMID:Recent advances in the development of histamine H3 antagonists. 2014 64


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