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Objective: To examine the clinical characteristics of adolescent girls consulting in a mood disorder clinic with a history of physical or sexual abuse. Method: A retrospective review was conducted of the charts of 55 adolescent girls consulting in a mood disorder clinic. An analysis grid was used to gather data on demographics, personal antecedents, symptoms and diagnoses. Girls with a history of physical or sexual abuse were compared with girls without such a history. Univariate analyses and a logistic regression analysis were performed. Results: Adolescent girls with a history of physical or sexual abuse did not differ statistically from those without such a history in terms of depressive symptoms or type and number of diagnoses. However, proportionally more girls with a history of physical or sexual abuse presented self-harm and relational problems with their parents and peers. Conclusion: Both history of physical or sexual abuse and self-destructive behaviors are rooted in relational problems. The results show that these are related to one another among those adolescent girls. Clinically, these findings suggest that it is important for clinicians do a thorough exploration of self-destructive behaviors and family and peer relations when assessing depressed adolescent girls. [ABSTRACT FROM AUTHOR]

Objectif: Décrire le profil clinique de jeunes déprimés selon le groupe d'âge et le sexe. Méthodologie: L'étude a été réalisée à l'aide d'une grille d'analyse sur 75 dossiers de jeunes de 6-17 ans enregistrés en pédopsychiatrie en 2002- 2003 et présentant un diagnostic de trouble dépressif. Des statistiques descriptives et des tests d'association pour comparer les garçons 6-11 ans, les garçons 12-17 ans et les filles 12-17 ans ont été complétés. Résultats: Un jeune sur deux à l'adolescence a doublé une année scolaire. Près de 60% des garçons de 6-11 ans déprimés sont dirigés en pédopsychiatrie pour des difficultés comportementales et 71% des garçons de ce groupe d'âge présentent un trouble dépressif en comorbidité avec un trouble du comportement perturbateur. Les filles et garçons à l'adolescence présentent en plus grande proportion une symptomatologie intériorisée. Les idées suicidaires sont cependant aussi présentes chez les enfants (71%) que chez les adolescents (72%) et les adolescentes (85%). Les problèmes parent-enfant se retrouvent chez la majorité des jeunes, particulièrement chez les adolescentes. Conclusion: Il est tout aussi important d'évaluer la dépression et l'idéation suicidaire chez les jeunes garçons avec troubles de comportement que chez les adolescents et les adolescentes et la dimension familiale est importante à considérer dans l'évaluation et le traitement. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical characteristics of depressed children and adolescents according to age groups and sex. Methods: A retrospective chart review study was conducted on 75 youths aged 6-17 years referred for depressive disorders to child psychiatry in 2002-2003. Descriptive statistics and tests of association were completed to compare boys aged 6-11 years, boys aged 12-17 years and girls aged 12-17 years. Results: One out of two youths has repeated a school year. About 60% of depressed boys aged 6-11 years are referred to child psychiatry services for behavioral difficulties and 71% of boys in this age group have a depressive disorder comorbid with disruptive behavior disorder. Adolescent boys and girls are more likely to present internalized symptoms than children. However, suicidal ideation is as widespread in children (71%) as in adolescent population, both boys (72%) and girls (85%). Parent-child relational problems are observed in the majority of the sample with a higher prevalence among adolescent girls. Conclusion: It is as important to assess depressive symptoms and suicidal ideation among young boys with behavioral difficulties as in adolescent boys and girls. Family functioning is important to consider in evaluating and treating youth. [ABSTRACT FROM AUTHOR]

Objective: DSM-5 has added a new developmentally appropriate child and adolescent mood disorder subtype called disruptive mood dysregulation disorder (DMDD). The core features of DMDD are temper outbursts (manifested by either verbal rages and/or physical aggression) and unrelenting irritability or anger. Currently, the literature is lacking a thorough review of the possible treatment options for the cardinal symptoms constituting DMDD. The objective of this article is to provide a thorough review of peer-reviewed studies on the subject of pharmacological treatment options for children and adolescents with the cardinal symptoms of DMDD. Methods: Relevant articles for this study were obtained through Pubmed, Medline, PsychINFO and PsychINDEXplus using the key words: "adolescents," "children," "paediatric," "youth," "irritability," "temper outbursts," "aggression," "rage," "disruptive behaviour," "treatment," "dysphoria," "autism," "mental retardation/intellectual disability," "impulsivity," "ADHD," "oppositional defiant disorder," and "conduct disorder." A total of 823 studies were generated; only English studies focusing on pharmacological treatment were retained. Results: Currently there are no established guidelines or thorough reviews summarizing the treatment of DMDD. Pharmacotherapeutic treatment options of both aggression and chronic irritability include: antidepressants/selective norepinephrine reuptake inhibitors, mood stabilizers, psychostimulants, antipsychotics, and alpha-2 agonists. Conclusion: Treatment options of severe, persistent irritability in youth are numerous, and a consensual treatment algorithm has not yet emerged from the literature. Further studies and clinical trials are warranted to determine efficacious and safe treatment modalities. [ABSTRACT FROM AUTHOR]

Objective: to study the reliability of a self-questionnaire on adolescent affective instability, within a francophone clinical population. Method: After reviewing the literature and consulting experts, the Affective Lability Scale (ALS), developed by Harvey and collaborators (1989), was selected. An anglophone and francophone version, adapted for the adolescent population, was developed. The final version includes 54 questions, divided into six sections, which examine the affective variations between euthymia, on the one hand, and depression, elation, and anxiety, on the other, and also examine the affective variations between anxiety and depression, and between depression and elation. The francophone version was the subject of a reliability study. A total of 43 francophone adolescents (48.8% male, 51.2% female; median age=14.86 years) took part in the comprehension and reliability study. Results: All questions were assigned a comprehension rate per item (CRI)>0.60 as evaluated by inter-rater agreement (median kappa=0.85). The median CRI is very satisfactory (0.88, SD=0.14). The internal consistency, determined by Cronbach coefficients, is elevated for each section and for the entire instrument (0.87 to 0.95). The temporal stability at three weeks is satisfactory, with an intraclass correlation coefficient (ICC) for the entire scale of 0.89 (confidence interval of 95%=0.75 to 0.95) and section's ICCs ranging between 0.72 and 0.89. Conclusion: This initial reliability data supports interest in the ALS as a means to evaluate a global level of affective lability, during the euthymic phase, among francophone adolescents in an in-patient psychiatric unit. A future study with a larger sample will make it possible to confirm these initial results and examine the factorial structure of the instrument. [ABSTRACT FROM AUTHOR]

Objectif: étudier la fiabilité en population clinique francophone d'un auto-questionnaire portant sur l'instabilité émotionnelle des adolescents. Méthode: Après recension des écrits et consultation d'experts, l'Échelle de Labilité Émotionnelle (Affective Lability Scale) développée par Harvey et collaborateurs (1989) a été choisie. Une version anglophone et francophone adaptée à la population adolescente a été élaborée. La version finale comprend 54 questions réparties en six sections examinant les variations émotionnelles entre euthymie d'une part, et dépression, élation, colère et anxiété d'autre part, ainsi qu'entre anxiété et dépression, et enfin entre dépression et élation. La version francophone a fait l'objet d'une étude de fiabilité. Au total 43 adolescents francophones (48,8% garçons, 51,2% filles d'âge moyen=14,86 ans) ont participé à l'étude de compréhension et de fiabilité. Résultats: Toutes les questions ont un taux de compréhension par item (TCI)>0,60 tel qu'évalué par accord interjuge (Kappa-moyen=0,85). Le TCI-moyen est très satisfaisant (0,88, SD=0,14). La consistance interne appréciée par les coefficients de Cronbach est élevée pour chaque section et pour l'ensemble de l'instrument (0,87 à 0,95). La stabilité temporelle à trois semaines est satisfaisante avec un coefficient de corrélation-intraclasse (CIC) pour l'ensemble de l'échelle de 0,89 (intervalle de confiance à 95%=0,75 et 0,95) et des CIC de section s'échelonnant entre 0,72 et 0,89. Conclusion: Ces premières données de fiabilité soutiennent l'intérêt de l'ALS pour évaluer, en période euthymique chez des adolescents francophones en unité interne psychiatrique, un niveau global de labilité émotionnelle. Une étude future sur un plus grand échantillon permettra de confirmer ces premiers résultats et d'étudier la structure factorielle de l'instrument. [ABSTRACT FROM AUTHOR]