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Biomedical subjects

H H Wright

Publications and source records attributed to H H Wright.

At least 19 recordsLinked to original sources

Practice parameters for the psychiatric assessment of infants and toddlers (0-36 months). American Academy of Child and Adolescent Psychiatry.

These practice parameters describe the psychiatric assessment of infants and toddlers (0-36 months) and support the growth of infant and toddler psychiatry, a rapidly developing field. Infants and toddlers are brought to clinical attention because of concerns about emotional, behavioral, relational, or developmental difficulties. It is axiomatic that the infant or toddler must be understood, evaluated, and treated within the context of the family. A perspective that is developmental, relational, and multidimensional and that borrows from the knowledge of multiple disciplines is essential. Collaborative efforts support the urgent need and incomparable opportunity to understand and to intervene early and preventively with young children and their families.

Child Psychiatry

Case study: fluoxetine in the multimodal treatment of a preschool child with selective mutism.

Selective mutism is a rare disorder with poor treatment outcome. The current study describes the successful treatment of selective mutism in a preschool-age girl, using a comprehensive multifaceted therapeutic approach. The components of this intervention reflect a conceptualization of selective mutism that emphasizes anxiety as a core feature but also focuses on associated factors such as oppositional behaviors.

Anxiety Disorders

Measles control in institutional settings.

This paper reports on the utility of screening pediatric psychiatric admissions for the presence of antibodies to measles to determine the need for administration of MMR Vaccine to 314 children admitted over an 11-month period. Four fifths (80.6 percent) of the children had positive antibody tests when screened. No sex difference in antibody prevalence was noted but Caucasians were more likely (18.2 percent) than African American (6.2 percent) to have negative antibody tests. No relationship was noted between psychiatric diagnosis and antibody test results. A substantial proportion of adolescents have negative or equivocal measles antibody tests and interpretation of such results may be difficult. Antibody testing is cost-effective in institutional settings and, in the future, may become so in selected ambulatory settings.

Adolescent

Whole-blood serotonin and cognitive functioning in autistic individuals and their first-degree relatives.

The relationship between cognitive-intellectual abilities and whole-blood serotonin (5-hydroxytryptamine; 5-HT) in 18 autistic probands and their first-degree relatives (n = 21 parents, n = 13 siblings) was investigated. Whole-blood 5-HT was significantly negatively associated with verbal-expressive/symbolic abilities for the entire sample. The proportion of variance in cognitive-intellectual performances attributable to whole-blood 5-HT was substantial in the context of variance attributable to familial classification. The relationship between verbal-expressive abilities and whole-blood 5-HT, adjusted for race and familial classification, was noteworthy. Simple correlations between 5-HT and cognitive-intellectual performances were conducted. However, bias related to covariance attributable to race seriously limits such findings. The issue of bias and its relevance to previous research is discussed further.

Adolescent

Behavior problems in preschool children: a pilot study.

Behavior problems in 20 preschool children (13 boys, 7 girls) referred to a diagnostic nursery were assessed using parents' ratings. The patterns of behavior problems reported in 4- and 5-yr.-olds parallel those noted for older clinic-referred children (i.e., internalizing difficulties in girls, externalizing difficulties in boys). The most salient behavior problems for 3-yr.-olds involved aggression. Correlations between children's behavior problems and an index of parents' experienced stress were moderate (.44 to .64).

Child Behavior Disorders

Attention deficit hyperactivity disorder: does it affect adults too?

A review of the literature and our experience suggest that attention deficit hyperactivity disorder does not necessarily disappear in adolescence but may persist into adult life. Detection of the disorder later in life may be made more difficult when it is masked by other diagnostic labels. Once the disorder has been identified in the adult, however, proper intervention with psychotherapy and medical management can make a significant difference in the patient's life.

Adolescent

Elevated blood serotonin in autistic probands and their first-degree relatives.

Whole blood serotonin levels and platelet counts were studied in 14 families, representing 57 family members and 15 probands who met DSM III criteria for infantile autism. High serotonin appeared to segregate in families. When two parents had high serotonin, the serotonin level in their offspring was twice the parental level. When one parent had high serotonin, the serotonin level in the offspring approximated the level of serotonin in either the high serotonin parent or the low serotonin parent. For the case where both parents had low serotonin, in one family the children had low serotonin and in a second family, high serotonin levels were present in the autistic proband, and a sibling with severe mental retardation. Mean serotonin levels were higher for both male and female, autistics and family members, in the four black families than in the 10 Caucasian families.

Adolescent

Phencyclidine-induced psychosis: eight-year follow-up of ten cases.

In 1978, we identified ten patients who were hospitalized for phencyclidine-induced psychosis. Over the next eight years, we used their medical records to document their subsequent hospitalizations and psychosocial functioning. The overall outcome for this group of patients was poor, with chronic unemployment, continuing use of illicit drugs, dependence on relatives for shelter and financial support, and repeated hospitalizations being the rule.

Adolescent

Financing of child psychiatry pediatric consultation-liaison programs.

Child psychiatrists and pediatricians recognize the importance of providing psychosocial care for children and their families in medical settings. Consultation-liaison and behavioral pediatric programs provide most of the training in this area. Twenty-nine pediatric consultation-liaison program directors participated in an initial and follow-up telephone survey about their programs. In the 5 years between the surveys, there was a drastic reduction in federal funding for these programs. The findings include a change in the number and composition of both staff and trainees. There were major shifts in the financial support of the programs. The programs were involved in fewer activities and in more restricted settings at the time of the follow-up survey. Financing of pediatric consultation-liaison programs plays a major role in shaping the structure and function of the programs.

Child

Psychoactive-drug use among adolescents with psychiatric disorders.

Demographic and medical data and data on the use of prescribed and illicit psychoactive drugs were collected retrospectively from medical records of patients admitted for the first time to the adolescent unit of a psychiatric hospital between July 1974 and June 1984. The frequency with which adolescents used prescribed and illicit drugs before admission, during hospitalization, and at discharge from the facility was examined. Data were analyzed for the entire study period and for three time intervals within the 10-year period. Of 204 adolescents between the ages of 11 and 17, 52% were male and 86% were white. The percentage of patients using prescribed psychoactive agents increased during the study period, with the third time interval (1982-84) accounting for the majority of the increase. The use of antidepressants significantly increased over the 10-year period while the use of neuroleptic agents remained fairly constant. Use of at least one illicit drug before admission to the psychiatric facility was reported by 45% of the patient population studied; marijuana was the most frequently used illicit drug. The prescribing patterns reported may be related primarily to individual variation among prescribers. Other factors possibly influencing these prescribing patterns include improved history-taking over the time period studied and less resistance to taking psychoactive medications.

Adolescent