Graham A. Rogeness

Differences in heart rate and blood pressure in children with conduct disorder, major depression, and separation anxiety

Heart rate and blood pressure of children and adolescents admitted to a psychiatric hospital were compared among those diagnosed conduct disorder, major depressive disorder, and separation anxiety disorder. Subjects with conduct disorder had a lower heart rate compared to subjects without a conduct disorder diagnosis; and subjects with separation anxiety disorder had higher heart rate and systolic blood pressure compared to subjects without an anxiety disorder diagnosis. Subjects with major depressive disorder had higher systolic blood pressure than subjects with conduct disorder but no difference in heart rate. The findings are consistent with conduct disorder being associated with decreased noradrenergic function and anxiety/depressive disorder being associated with increased noradrenergic function.

Psychopathology in Abused or Neglected Children

This study compares 539 emotionally disturbed children with a history of abuse only, neglect, or no abuse or neglect who have been hospitalized at a childrens psychiatric hospital. Neglected boys have lower verbal IQs and more impaired relatedness than abused boys or boys with no history of abuse or neglect. Abused boys and neglected boys have an increased frequency of conduct disorder diagnoses. Abused girls have an increase in conduct disorder diagnoses but the neglected girls do not. In contrast to the boys, verbal and performance IQ were lower for both abused and neglected girls.

Classical conditioning in children with attention deficit hyperactivity disorder (ADHD) and anxiety disorders: A test of Quay's model

Quay (1988) put forward a model of childhood mental disorders based on Grays (1982) theory that there exists within the brain a behavioral inhibition system (BIS), which processes signals related to aversive or punishing stimuli. According to this model, children with attention deficit hyperactivity disorder (ADHD) show lower than optimal levels of activity in this system, which leads to less responsiveness at a physiological level to signals related to punishment. Children with ADHD and controls were compared on a classical conditioning paradigm. Skin conductance and cardiac responses were measured in response to a conditioned stimulus that had been paired with an aversive unconditioned stimulus. There were no differences between the groups, suggesting that, in terms of classical conditioning, ADHD children are equally responsive to signals related to punishment as controls.

Urinary Catecholamines in Attention-Deficit Hyperactivity Disorder with and without Comorbid Anxiety

OBJECTIVE To determine whether there are differences in noradrenergic or adrenergic functioning in children with attention-deficit hyperactivity disorder (ADHD) with and without anxiety. METHOD ADHD children with and without a comorbid overanxious (ANX) disorder were compared to each other and to normal controls in terms of 2-hour urinary excretion of norepinephrine (NE), epinephrine (EPI), and their metabolites. All subjects performed a fixed series of mentally stressful tasks during the collection period. RESULTS Children with ADHD, regardless of comorbid anxiety, excreted more normetanephrine (NMN), the chief extracellular metabolite of NE, than controls, as well as more vanillylmandelic acid. Children with ADHD alone had lower NE/NMN and EPI/metanephrine ratios compared to controls. Children with ADHD/ANX excreted more EPI than ADHD children without anxiety. CONCLUSIONS Children with ADHD may have a higher tonic activity of the noradrenergic system than controls, while children with comorbid ADHD/ANX may be differentiated from those with ADHD alone by higher adrenergic activity.

Psychopathology in Hospitalized, Adopted Children

Abstract Of 763 consecutive admissions to a childrens psychiatric hospital, 66 (8.7%) were adopted. The adopted subjects had a higher frequency of personality disorder diagnosis, a difference accounted for by an increased frequency of personality disorder diagnosis in the girls. The not-adopted subjects had more frequent diagnoses of separation anxiety disorder and major depressive disorder. Adopted boys had more concentration symptoms and hyperactivity symptoms than not-adopted boys and adopted girls had fewer anxiety symptoms than not-adopted girls.

Clinical Characteristics of Emotionally Disturbed Boys with Very Low Activities of Dopamine-β-hydroxylase

Twenty boys with very low levels of plasma dopamine-β-hydroxylase (DβH) are compared to 20 boys with plasma DβH greater than 15μ/min/L. All 40 had been hospitalized in a childrens psychiatric hospital. We report an association between zero DβH and a cluster of symptoms, and the diagnoses of conduct disorder, undersocialized, and borderline personality disorder. The association between zero DβH and the group of symptoms is strong enough to suggest a direct relationship between the clinical picture and very low activities of DβH. The triad of firesetting, enuresis, and cruelty to animals frequently appears to be associated with zero DβH. Interestingly, there were significantly more cases of neglect or abuse in the zero DβH group.

Catecholamines and diagnoses in children

Theoretically, noradrenergic (NA) function may be lower in subjects with undersocialized conduct disorder (CDU) and higher in subjects with anxiety/depressive disorder. To test this hypothesis, diagnostic and 24-hour urine catecholamine measures were compared between subjects with plasma dopamine-beta-hydroxylase (D beta H) activities less than 6 mumoles/min/L (low D beta H group) and greater than 15 mumoles/min/L (high D beta H group). Several measures relating to norepinephrine metabolism were lower in the low D beta H group, and the low D beta H group had more diagnoses of CDU and fewer anxiety and depressive disorder diagnoses. Comparisons between clinical and biological measures within each of the D beta H groups were also consistent with the hypothesized relationship between NA function, CDU, and anxiety/depressive disorder.

Near-Zero Plasma Dopamine-β-Hydroxylase and Conduct Disorder in Emotionally Disturbed Boys

Plasma dopamine-β-hydroxylase (DβH) was measured on 420 boys and 128 girls admitted to a childrens psychiatric hospital. Children with plasma DβH activities ≥ 6 μM/min/L, the near-zero DβH group, were compared to children with DβH activities > 6 μM/min/L, the comparison group. Fifty-four percent of the boys with near-zero DβH were diagnosed conduct disorder, undersocialized and 24% were diagnosed borderline personality compared to 21% and 10% for the comparison group. Symptomatically the near-zero group had more conduct symptoms, concentration symptoms, impaired relationships, and fewer anxiety and depressive symptoms than the comparison group. Significantly more boys in the near-zero group were discharged on medication and on methylphenidate. Girls did not show these differences. The results show a relationship between near-zero plasma DβH and conduct disorder symptomatology in emotionally disturbed boys.

Diagnoses, Catecholamine Metabolism, and Plasma Dopamine-β-Hydroxylase

ABSTRACT From a group of 80 hospitalized boys, 41 with plasma dopamine-β-hydroxylase (DβH)ss ≤ 6 µM/ min/L were compared with 39 boys with plasma (DβH ≥ 15 µM/min/L. The low group had more diagnoses of Conduct Disorder, undersocialized, as determined by the diagnosing child psychiatrist. On a structured diagnostic instrument, the DISC/DISC-P, the high group had more diagnoses of Dysthymic Disorder and Separation Anxiety Disorder. Twenty-four-hour urine cathecholamines and their metabolites were obtained on 50 subjects. The results show differences in norephinephrine metabolism in the low group.

Influence of depression on cognitive functioning in Fragile X females

We sought to determine the frequency of a history of major depression in women with Fragile X syndrome. In addition, we attempted to disentangle the cognitive effects of major depression from those of Fragile X syndrome. Thirty-seven mothers of developmentally delayed children (Fragile X syndrome: n = 18; comparison group n = 19), matched for age, educational level, and socioeconomic status, were administered psychiatric and neuropsychological measures. Women with Fragile X syndrome had a higher frequency of lifetime diagnosis of major depressive disorder (78%) than the comparison group (37%). Mild impairment was seen on visuospatial construction and memory tasks in women with Fragile X syndrome, while women with depression showed subtle deficits in several aspects of visuospatial perception and learning. There was no interaction of Fragile X syndrome and depression in their influence on cognition. The results underscore the importance of considering the influence of depression on cognitive performance in studies of genetic disorders.