- Email: [email protected]
6.65 Association of the Kynurenine Pathway, Anhedonia, and Inflammatory Markers in Pediatric Inflammatory Bowel Disease
NEW RESEARCH POSTERS 6.64 — 6.66
Conclusions: Results support other literature suggesting that deployment has a negative effect on psychosocial outcomes of children in military families. In this study, limited by low subject number and subsequent power, number of deployments was significantly correlated with higher scores on two measures assessing a child’s functioning in multiple domains and in general. These results can serve as pilot data to support the need for further studies on the effect of deployment on the functioning of children and teenagers residing in the home of a deployed parent. In particular, further studies should focus on the effect of deployments on school functioning. If continued research confirms these clinical correlations, findings may be useful in shaping the policy on military deployment.
RF, SP, STRESS http://dx.doi.org/10.1016/j.jaac.2017.09.408
6.64 FAMILY RESPONSE STYLE IN A COHORT OF MILITARY FAMILIES AND ITS ASSOCIATION WITH PSYCHOSOCIAL FUNCTIONING Donna L. Londino, MD, Medical College of Georgia at Augusta University, [email protected]; Patrick Molitor, MD, Dwight D. Eisenhower Army Medical Center, [email protected]; Shameem Momin, Medical College of Georgia at Augusta University, smomin@ augusta.edu; Christopher F. Drescher, PhD, Medical College of Georgia at Augusta University, [email protected] Objectives: Stress and response to stress are important determinants of functioning within the family and among its members. This study sought to assess response styles in military families and to evaluate any significant correlations between response styles and child and adolescent psychosocial functioning as assessed through parent reports. Methods: Participating families completed packets consisting of a demographic form, the Pediatric Symptoms Checklist (PSC), the Weiss Functional Impairment Rating Scale (WFIRS), and the Response to Stress Questionnaire. Data were analyzed to note any clinically significant correlations between variables. Results: Thirty packets of data were obtained. Both primary (r ¼ 0.45; P < 0.01) and secondary (r ¼ 0.44; P < 0.01) controlled response styles were negatively correlated with scores on the PSC medical domain (fewer somatic complaints). Involuntary response styles either through involuntary engagement (r ¼ 0.46; P < 0.01) or involuntary disengagement (r ¼ 0.44; P ¼ 0.01) were positively associated with scores, suggesting poorer functioning (more somatic complaints). Primary (r ¼ -0.33; P < 0.05) and secondary (r ¼ -0.51; P < 0.01) controlled response styles were negatively correlated with scores on the life skills domain of the WFIRS, whereas involuntary engagement (r ¼ 0.49; P < 0.01) and involuntary disengagement (r ¼ 0.37; P < 0.03) positively correlated with scores suggestive of more dysfunction in this domain. Controlled coping responses, both primary and secondary (r ¼ -0.46; P < 0.01) negatively correlated with scores on the self-concept domain of the WFIRS (lower scores suggestive of better self-concept), whereas involuntary response styles of engagement (r ¼ 0.42; P < 0.02) and disengagement (r ¼ 0.50; P < 0.01) were positively correlated with poorer scores in this same domain. Conclusions: In several domains of functioning assessed in this study, involuntary response styles were associated with scores indicative of poorer functioning than in those families who endorsed the use of more controlled coping responses. If further research reveals similar findings, efforts can be made to teach families and family members more adaptive coping through more controlled response styles with an anticipation that implementation of this instruction would lead to more improved overall functioning.
FAM, RF, COPI http://dx.doi.org/10.1016/j.jaac.2017.09.409
6.65 ASSOCIATION OF THE KYNURENINE PATHWAY, ANHEDONIA, AND INFLAMMATORY MARKERS IN PEDIATRIC INFLAMMATORY BOWEL DISEASE Manivel Rengasamy, MD, University of Pittsburgh, [email protected]; Meredith Spada, MD, University of
JOURNAL OF THE AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 56 NUMBER 10S OCTOBER 2017
Pittsburgh, [email protected]; Eva M. Szigethy, MD, PhD, University of Pittsburgh, [email protected]; Frank Lotrich, MD, PhD, University of Pittsburgh, lotrichfe@ upmc.edu Objectives: To our knowledge, the interaction between tryptophan, tryptophan metabolites (e.g., kynurenine), and inflammatory markers [e.g., C-reactive protein (CRP) and interleukin-6 (IL-6)] in the context of adolescent depressive symptoms has not been well described in the literature. On an exploratory basis, we sought to assess levels of these plasma metabolites in adolescent participants with inflammatory bowel disease (IBD), in whom unique gut-brain axis changes may contribute to psychiatric symptoms, such as anhedonia. Methods: We conducted a cross-sectional naturalistic assessment of plasma metabolites, depression severity, and anhedonia in pediatric participants with IBD as part of a post-hoc analysis from a larger study. Participants who were recruited from major metropolitan hospitals with gastroenterologist-diagnosed IBD comprised 27 children ages 9–17 years. Plasma kynurenine, tryptophan, CRP, and IL-6 levels were measured. We also obtained parent- and child-reported Childhood Depression Inventory (CDI) rating scores and composite anhedonia scores based on CDI subscales for anhedonia. Results: We found that plasma kynurenine/tryptophan ratio was positively correlated with IL-6 (r ¼ 0.679, P < 0.01). Anhedonia scores positively correlated with both CRP (r ¼ 0.623, P < 0.05) and kynurenine (r ¼ 0.679, P < 0.01). We did not find any correlation between plasma kynurenine, tryptophan, IL-6, and other depression severity scores. Conclusions: In this preliminary study, we found evidence that elevated inflammatory markers and tryptophan metabolites were associated with anhedonia symptoms but not with depression severity in adolescent participants. We suspect that the active inflammatory process of IBD (as evidenced by elevations of inflammatory markers such as IL-6) may lead to activation of the kynurenine pathway and, subsequently, contribute to neurobiological alterations associated with anhedonia. Thus, in adolescent patients with IBD, elevations in inflammation and kynurenine pathway activity may explain biomechanistic pathways that place these patients at greater risk of developing depressive symptomatology, particularly anhedonia.
NEURO, NI Supported by NIMH Grant R01 MH077770 and NIH Director’s Innovator Award Grant 1DP2OD001210 http://dx.doi.org/10.1016/j.jaac.2017.09.410
6.66 DIGITAL COGNITIVE-BEHAVIORAL THERAPY IN THE TREATMENT OF ADOLESCENT DEPRESSION: A RANDOMIZED CONTROLLED TRIAL Naira W. Topooco, MSC, Link€ oping University, naira. [email protected]; Gerhard Andersson, Karolinska Institute, [email protected] Objectives: Globally, depression is the primary cause of disability-adjusted life years among adolescents. Psychotherapeutic treatment capacities are recommended but are insufficient. Young individuals are under-represented in standard care settings for reasons of stigma and limited mental healthcare literacy. Digital interventions have the potential to increase availability of treatment and to reduce individual barriers. In this randomized controlled trial, we evaluated digital treatment based on CBT against a brief active control condition. Methods: Seventy adolescents (aged 15–19 years) presenting with depressive symptoms were randomly assigned to receive CBT (n ¼ 35) or active control condition (n ¼ 35). The CBT program was delivered over eight weeks and composed of text-based material and chat sessions with a psychologist. The primary outcome was self-reported depression symptoms at posttreatment, as measured with the self-reported Beck Depression Inventory (BDI-II). Assessments were made at baseline and posttreatment and are planned at 6 months and 2 years (trial currently running). Results: Preliminary results showed significant reductions in depressive symptoms after treatment, with an obtained large between-group effect [d ¼ 0.99; CI 0.48–1.51; F(1,63) ¼ 29.93, P < 0.001]. Participants indicated satisfaction with the CBT program on self-reported questionnaires and in written feedback.
www.jaacap.org
S299
Conclusions: Results support other literature suggesting that deployment has a negative effect on psychosocial outcomes of children in military families. In this study, limited by low subject number and subsequent power, number of deployments was significantly correlated with higher scores on two measures assessing a child’s functioning in multiple domains and in general. These results can serve as pilot data to support the need for further studies on the effect of deployment on the functioning of children and teenagers residing in the home of a deployed parent. In particular, further studies should focus on the effect of deployments on school functioning. If continued research confirms these clinical correlations, findings may be useful in shaping the policy on military deployment.
RF, SP, STRESS http://dx.doi.org/10.1016/j.jaac.2017.09.408
6.64 FAMILY RESPONSE STYLE IN A COHORT OF MILITARY FAMILIES AND ITS ASSOCIATION WITH PSYCHOSOCIAL FUNCTIONING Donna L. Londino, MD, Medical College of Georgia at Augusta University, [email protected]; Patrick Molitor, MD, Dwight D. Eisenhower Army Medical Center, [email protected]; Shameem Momin, Medical College of Georgia at Augusta University, smomin@ augusta.edu; Christopher F. Drescher, PhD, Medical College of Georgia at Augusta University, [email protected] Objectives: Stress and response to stress are important determinants of functioning within the family and among its members. This study sought to assess response styles in military families and to evaluate any significant correlations between response styles and child and adolescent psychosocial functioning as assessed through parent reports. Methods: Participating families completed packets consisting of a demographic form, the Pediatric Symptoms Checklist (PSC), the Weiss Functional Impairment Rating Scale (WFIRS), and the Response to Stress Questionnaire. Data were analyzed to note any clinically significant correlations between variables. Results: Thirty packets of data were obtained. Both primary (r ¼ 0.45; P < 0.01) and secondary (r ¼ 0.44; P < 0.01) controlled response styles were negatively correlated with scores on the PSC medical domain (fewer somatic complaints). Involuntary response styles either through involuntary engagement (r ¼ 0.46; P < 0.01) or involuntary disengagement (r ¼ 0.44; P ¼ 0.01) were positively associated with scores, suggesting poorer functioning (more somatic complaints). Primary (r ¼ -0.33; P < 0.05) and secondary (r ¼ -0.51; P < 0.01) controlled response styles were negatively correlated with scores on the life skills domain of the WFIRS, whereas involuntary engagement (r ¼ 0.49; P < 0.01) and involuntary disengagement (r ¼ 0.37; P < 0.03) positively correlated with scores suggestive of more dysfunction in this domain. Controlled coping responses, both primary and secondary (r ¼ -0.46; P < 0.01) negatively correlated with scores on the self-concept domain of the WFIRS (lower scores suggestive of better self-concept), whereas involuntary response styles of engagement (r ¼ 0.42; P < 0.02) and disengagement (r ¼ 0.50; P < 0.01) were positively correlated with poorer scores in this same domain. Conclusions: In several domains of functioning assessed in this study, involuntary response styles were associated with scores indicative of poorer functioning than in those families who endorsed the use of more controlled coping responses. If further research reveals similar findings, efforts can be made to teach families and family members more adaptive coping through more controlled response styles with an anticipation that implementation of this instruction would lead to more improved overall functioning.
FAM, RF, COPI http://dx.doi.org/10.1016/j.jaac.2017.09.409
6.65 ASSOCIATION OF THE KYNURENINE PATHWAY, ANHEDONIA, AND INFLAMMATORY MARKERS IN PEDIATRIC INFLAMMATORY BOWEL DISEASE Manivel Rengasamy, MD, University of Pittsburgh, [email protected]; Meredith Spada, MD, University of
JOURNAL OF THE AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 56 NUMBER 10S OCTOBER 2017
Pittsburgh, [email protected]; Eva M. Szigethy, MD, PhD, University of Pittsburgh, [email protected]; Frank Lotrich, MD, PhD, University of Pittsburgh, lotrichfe@ upmc.edu Objectives: To our knowledge, the interaction between tryptophan, tryptophan metabolites (e.g., kynurenine), and inflammatory markers [e.g., C-reactive protein (CRP) and interleukin-6 (IL-6)] in the context of adolescent depressive symptoms has not been well described in the literature. On an exploratory basis, we sought to assess levels of these plasma metabolites in adolescent participants with inflammatory bowel disease (IBD), in whom unique gut-brain axis changes may contribute to psychiatric symptoms, such as anhedonia. Methods: We conducted a cross-sectional naturalistic assessment of plasma metabolites, depression severity, and anhedonia in pediatric participants with IBD as part of a post-hoc analysis from a larger study. Participants who were recruited from major metropolitan hospitals with gastroenterologist-diagnosed IBD comprised 27 children ages 9–17 years. Plasma kynurenine, tryptophan, CRP, and IL-6 levels were measured. We also obtained parent- and child-reported Childhood Depression Inventory (CDI) rating scores and composite anhedonia scores based on CDI subscales for anhedonia. Results: We found that plasma kynurenine/tryptophan ratio was positively correlated with IL-6 (r ¼ 0.679, P < 0.01). Anhedonia scores positively correlated with both CRP (r ¼ 0.623, P < 0.05) and kynurenine (r ¼ 0.679, P < 0.01). We did not find any correlation between plasma kynurenine, tryptophan, IL-6, and other depression severity scores. Conclusions: In this preliminary study, we found evidence that elevated inflammatory markers and tryptophan metabolites were associated with anhedonia symptoms but not with depression severity in adolescent participants. We suspect that the active inflammatory process of IBD (as evidenced by elevations of inflammatory markers such as IL-6) may lead to activation of the kynurenine pathway and, subsequently, contribute to neurobiological alterations associated with anhedonia. Thus, in adolescent patients with IBD, elevations in inflammation and kynurenine pathway activity may explain biomechanistic pathways that place these patients at greater risk of developing depressive symptomatology, particularly anhedonia.
NEURO, NI Supported by NIMH Grant R01 MH077770 and NIH Director’s Innovator Award Grant 1DP2OD001210 http://dx.doi.org/10.1016/j.jaac.2017.09.410
6.66 DIGITAL COGNITIVE-BEHAVIORAL THERAPY IN THE TREATMENT OF ADOLESCENT DEPRESSION: A RANDOMIZED CONTROLLED TRIAL Naira W. Topooco, MSC, Link€ oping University, naira. [email protected]; Gerhard Andersson, Karolinska Institute, [email protected] Objectives: Globally, depression is the primary cause of disability-adjusted life years among adolescents. Psychotherapeutic treatment capacities are recommended but are insufficient. Young individuals are under-represented in standard care settings for reasons of stigma and limited mental healthcare literacy. Digital interventions have the potential to increase availability of treatment and to reduce individual barriers. In this randomized controlled trial, we evaluated digital treatment based on CBT against a brief active control condition. Methods: Seventy adolescents (aged 15–19 years) presenting with depressive symptoms were randomly assigned to receive CBT (n ¼ 35) or active control condition (n ¼ 35). The CBT program was delivered over eight weeks and composed of text-based material and chat sessions with a psychologist. The primary outcome was self-reported depression symptoms at posttreatment, as measured with the self-reported Beck Depression Inventory (BDI-II). Assessments were made at baseline and posttreatment and are planned at 6 months and 2 years (trial currently running). Results: Preliminary results showed significant reductions in depressive symptoms after treatment, with an obtained large between-group effect [d ¼ 0.99; CI 0.48–1.51; F(1,63) ¼ 29.93, P < 0.001]. Participants indicated satisfaction with the CBT program on self-reported questionnaires and in written feedback.
www.jaacap.org
S299