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AbstractObjective:We compared temperament and character traits in children and adolescents with bipolar disorder (BP) and healthy control (HC) subjects.Method:Sixty nine subjects (38 BP and 31 HC), 8–17 years old, were assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia–Present and Lifetime. Temperament and character traits were measured with parent and child versions of the Junior Temperament and Character Inventory.Results:BP subjects scored higher on novelty seeking, harm avoidance, and fantasy subscales, and lower on reward dependence, persistence, self-directedness, and cooperativeness compared to HC (all p< 0.007), by child and parent reports. These findings were consistent in both children and adolescents. Higher parent-rated novelty seeking, lower self-directedness, and lower cooperativeness were associated with co-morbid attention-deficit/hyperactivity disorder (ADHD). Lower parent-rated reward dependence was associated with co-morbid conduct disorder, and higher child-rated persistence was associated with co-morbid anxiety.Conclusions:These findings support previous reports of differences in temperament in BP children and adolescents and may assist in a greater understating of BP children and adolescents beyond mood symptomatology. [ABSTRACT FROM AUTHOR]

AbstractBipolar disorder (BD) is an increasingly prevalent diagnosis in youth. As a result, there has been a corresponding increase in interest about neuropsychological and cognitive profiles in children and adolescents diagnosed with BD. Meta-analysis of the existing literature comparing individuals with BD to healthy controls indicated that the largest differences are observed for measures of verbal memory (d 0.77). Moderate differences were found in the areas of attention (d 0.62), executive functioning (d 0.62), working memory (d 0.60), visual memory (d 0.51), visual perceptual skills (d 0.48), and verbal fluency (d 0.45). Small differences were found for measures of reading (d 0.40), motor speed (d 0.33), and full-scale intelligence quotient (IQ) (d 0.32). Often, few studies have provided relevant information for a particular neurocognitive domain. Despite this, several domains displayed heterogeneity of effect sizes across studies. Methodological factors explained the variance in effect sizes to different extents depending upon the cognitive domain. The changing influence of method artifacts is likely due to variable coverage of cognitive domains across studies and the use of different measures across studies. Findings are consistent with previous meta-analyses of the adult BD neurocognitive literature, suggesting that many of the deficits observed in adults are present earlier in the course of the illness. Study reporting guidelines are offered that may help clarify the impact of illness definitions, mood state, medication status, and other methodological variables on neurocognition in pediatric BD. [ABSTRACT FROM AUTHOR]

Objectives: Adults with major depressive disorder (MDD) are reported to have reduced orbitofrontal cortex (OFC) volumes, which could be related to decreased neuronal density. We conducted a study on medication naïve children with MDD to determine whether abnormalities of OFC are present early in the illness course.Methods: Twenty seven medication naïve pediatric Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition (DSM-IV) MDD patients (mean age +/- SD = 14.4 +/- 2.2 years; 10 males) and 26 healthy controls (mean age +/- SD = 14.4 +/- 2.4 years; 12 males) underwent a 1.5T magnetic resonance imaging (MRI) with 3D spoiled gradient recalled acquisition. The OFC volumes were compared using analysis of covariance with age, gender, and total brain volume as covariates.Results: There was no significant difference in either total OFC volume or total gray matter OFC volume between MDD patients and healthy controls. Exploratory analysis revealed that patients had unexpectedly larger total right lateral (F = 4.2, df = 1, 48, p = 0.05) and right lateral gray matter (F = 4.6, df = 1, 48, p = 0.04) OFC volumes compared to healthy controls, but this finding was not significant following statistical correction for multiple comparisons. No other OFC subregions showed a significant difference.Conclusions: The lack of OFC volume abnormalities in pediatric MDD patients suggests the abnormalities previously reported for adults may develop later in life as a result of neural cell loss. [ABSTRACT FROM AUTHOR]

ABSTRACTObjective: The striatum, including the putamen and caudate, plays an important role in executive and emotional processing and may be involved in the pathophysiology of mood disorders. Few studies have examined structural abnormalities of the striatum in pediatric major depressive disorder (MDD) patients. We report striatal volume abnormalities in medication-naïve pediatric MDD compared to healthy comparison subjects.Method: Twenty seven medication-naïve pediatric Diagnostic and Statistical Manual of Mental Disorders, 4thedition (DSM-IV) MDD and 26 healthy comparison subjects underwent volumetric magnetic resonance imaging (MRI). The putamen and caudate volumes were traced manually by a blinded rater, and the patient and control groups were compared using analysis of covariance adjusting for age, sex, intelligence quotient, and total brain volumes.Results: MDD patients had significantly smaller right striatum (6.0 smaller) and right caudate volumes (7.4 smaller) compared to the healthy subjects. Left caudate volumes were inversely correlated with severity of depression in MDD subjects. Age was inversely correlated with left and right putamen volumes in MDD patients but not in the healthy subjects.Conclusions: These findings provide fresh evidence for abnormalities in the striatum of medication-naïve pediatric MDD patients and suggest the possible involvement of the striatum in the pathophysiology of MDD. [ABSTRACT FROM AUTHOR]

BackgroundIncreasing evidence suggests abnormalities in the structure, function, and neurochemistry of the frontal cortex in pediatric bipolar (BP) patients. We conducted a single-voxel proton magnetic resonance spectroscopy (1H MRS) of the left dorsolateral prefrontal cortex (DLPFC) of pediatric BP patients, expecting lower N-acetyl-aspartate (NAA) levels within that brain region compared to healthy comparison subjects.MethodsWe studied 35 pediatric BP (23 BP type I, 12 BP type II; mean age ± SD 13.2 ± 2.9 years; 18 females) and 36 healthy controls (mean age ± SD 13.7 ± 2.6 years, 17 females). A short echo time, single-voxel 1H spectroscopy approach point-resolved spectroscopy (PRESS) sequence, measurements of metabolites was performed on a 1.5T Philips MR system.ResultsBP subjects had significantly lower NAA levels in the left DLPFC compared to healthy controls (F 4.21, df 1, 68, p 0.04). There was not a significant difference between groups for phosphocreatine creatine (PCrCr), glycerolphosphocholine phosphocholine (GPC PC), myo-inositol (mI), or glutamate. Further analyses revealed a significant reduction of NAA in our early puberty group compared to controls (Mann-Whitney U-test statistic 52.00, p 0.014), but not for BP versus controls in other pubertal groups.Conclusions BP subjects have lower NAA levels in the left DLPFC compared to healthy subjects, suggesting neuronal dysfunction in this region. [ABSTRACT FROM AUTHOR]

Background. Although memory deficits are consistently reported in schizophrenia and bipolar disorder, the mechanisms underlying these impairments are poorly understood. Clarifying the nature and degree of overlap in memory deficits between the two illnesses could help to distinguish brain systems disrupted in these illnesses, and indicate cognitive remediation strategies to improve patient outcomes.Method. We examined performance on a non-verbal memory task in clinically stable out-patients with bipolar disorder (n=40), schizophrenia (n=40), and healthy comparison subjects (n=40). This task includes conditions in which distinct mnemonic strategies – namely, using context to organize familiar stimuli or using holistic representation of novel stimuli – facilitate performance.Result. When compared to a reference condition, bipolar patients had deficits consistent with organizational dysfunction and poor detection of novel information. Although patients with schizophrenia performed worse than the other groups, they were only differentially impaired when organizational demands were significant. Task performance was not correlated with severity of clinical symptomatology.Conclusions. This pattern of distinct memory impairments implies disturbances in partially overlapping neural systems in bipolar disorder and schizophrenia. Evidence of impairment in detection of novel stimuli that is unique to bipolar disorder suggests that, while the absolute level of cognitive dysfunction is less severe in bipolar disorder as compared to schizophrenia, subtle disruptions in memory are present. These findings can be used to plan targeted cognitive remediation programs by helping patients to capitalize on intact functions and to learn new strategies that they do not employ without training. [ABSTRACT FROM AUTHOR]

Although the pathogenesis of bipolar disorder is still not completely understood, there is evidence from imaging studies that abnormalities in inter-hemispheric communication may play a major role in the pathophysiology of bipolar disorder. In the present review, we discuss the most consistent findings from diffusion imaging studies exploring corpus callosum integrity in bipolar disorder. [ABSTRACT FROM AUTHOR]