Prevalence, Persistence, and Severity of Psychiatric Illness in Teens

Sobering statistics reveal the necessity of investing in research today.

The diagnosis and treatment of psychiatric disorders in childhood would drastically reduce the effects of symptoms among the teenage population.  An investment in research now could save a countless number of teenagers from social impairment, behavioral issues, school/work failures and suicidal idealization.

Dr. Robert L. Findling, Director of the Division of Child and Adolescent Psychiatry at University Hospitals Case Medical Center and professor of psychiatry and pediatrics at Case Western Reserve University, presents the findings of recent studies: psychiatric disorders were found to be not only prevalent but also substantially persistent among teenagers.

For your information we have provided a link to Dr. Findling’s presentation: Prevalence, Persistence, and Severity of Psychiatric Illness in Teens.

Your investment in research could reap dividends that will improve the chances for children to beat the symptoms and effects of psychiatric disorders.

Please consider making an investment in research that is focused solely on divining the cause of bipolar disorder in children.

Your donation today may mean relief for many – and for all the generations that will follow.  It is an investment in everyone’s future.

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Sleep, Activity Patterns and Temperature Study

Sleep, Activity Patterns and Temperature Study

Physiological Marker for a Psychiatric Condition?

The findings of an NIMH funded study, Sleep, Activity Patterns, and Temperature Study conducted by JBRF researchers provides evidence for what may be the first physiological marker for a psychiatric syndrome. Why is this important to the JBRF community? Because it narrows the focus of our research to specific pathways in the brain, and may lead to novel treatment approaches.

Children who have the Fear of Harm type of bipolar disorder exhibit symptoms that reflect high levels of fear as well as defensive or reactive aggressive behaviors, and dramatic shifts in states of arousal: intense fear of harm coming to self or others, territorial aggression, carbohydrate craving/hoarding, disturbances in sleep onset and sleep offset, parasomnias (arousal disorders of sleep), as well overheating despite neutral ambient temperature.

The children who fit this phenotype share some common traits: they have difficulty settling at night and difficulty getting to sleep once in bed, they sleep fitfully and/or awaken throughout the night, and they have difficulty arising in the morning. A growing body of research has demonstrated that all of these sleep-related issues are associated with disruptions in thermoregulation. While the relationship between the ability to sleep well and body temperature has long been known, a robust series of recent research studies has shown that when temperature regulation is disrupted, problems with both sleep and arousal/wakefulness occur.

Now, for the first time, we have data showing that: thermoreguation is dysregulated in children with FOH, and sleep quality is disturbed as a result. In this study, children with the FOH phenotype were compared with healthy control children. The investigators found that an inability to dissipate heat at bedtime was strongly correlated with sleep onset latency. Skin temperature from the chest and from the lower leg were measured throughout the night, and the gradient, or difference, between these temperatures was calculated each minute. The childrens’ sleep was recorded using wrist-worn activity monitors. Typically, when a person lays down for bed, leg temperature will increase in parallel with decreases in chest temperature, as the thermoregulatory center in the brain sends a signal to the peripheral nervous system that results in vasodilation and heat dissipation. As the body’s core divests more heat, and the gradient between chest and leg temperatures approaches zero degrees, sleep onset occurs.

Researchers  found in this study, however, that in children with FOH, chest temperature remained high, sometimes throughout the entire sleep period, and leg temperature changed slowly relative to the comparison group. Whereas, the skin temperature gradient reached zero degrees an average of 9 minutes after bedtime in the comparison children, it took longer than an hour for children the FOH group to reach this thermoregulatory balance. Importantly, higher temperature gradients were significantly and strongly associated with the time it took to fall asleep.

These initial findings provide objective evidence for the link between temperature dysregulation, sleep/arousal issues, and emotion dysregulation that JBRF investigators theorize underlie the primary behavioral features of the disorder. Follow-up studies of this research will continue to examine the role of thermoregulation in the biological basis of the FOH type of juvenile bipolar disorder.

Proposed Treatment

As suggested by the physiological marker (skin temperature gradient) described above, investigators are exploring thermoregulatory approaches to treatment: melatonin, fans to enhance heat dissipation during sleep, and hypothermic agents.

Next Steps

JBRF has filed an IND application which was approved by the FDA to conduct a pharmaceutical study in 6-12 year olds with an agent that has hypothermic properties, ketamine, and which in animal studies also has been found to reduce fear sensitization.  Researchers will conduct a double blind placebo controlled study to determine the safety and efficacy of this agent in treating children with the FOH type of bipolar disorder.

The Sleep, Activity Patterns, and Temperature Study and its promising findings were made possible by JBRF, by the National Institutes of Health, and by you, our supportive community. We are so grateful for your support and we are thrilled to present to you evidenced-based research that is advancing knowledge in the field.

JBRF receives funding to do a Whole Genome Sequencing Study

JBRF receives funding to do a Whole Genome Sequencing Study

Finding the genetic basis of pediatric onset bipolar disorder has long been part of the mission of the JBRF. 

Over the past decade there have been extraordinary technological advances made in identifying genes involved in a host of neuropsychiatric disorders, including adult forms of bipolar disorder, schizophrenia, autism, and ADHD, among others.  Identifying the underlying genetic basis for such complex traits is quite difficult, and geneticists have had to rely on several different strategies, each requiring their own unique patient/family population.

Large multi-generation families with many affected members were needed for the earliest type of genetic analysis. The next strategy required affected sibling pairs, then family trios (mother, father and affected child). More recently, individual cases (thousands of them) have been needed. The newest technique – arguably the most challenging genetic strategy of all – is a very in-depth survey of the human genome that will require (going back full circle) the recruitment of families with many affected individuals. This could include multiple siblings with bipolar disorder, as well as their affected parents, grandparents, cousins, uncles and aunts.

On December 15th, the Lattner Family Foundation, Inc. granted JBRF $170,000 to undertake such a study with the goal of identifying the gene or genes suspect in early onset bipolar disorder.

This study will be undertaken in conjunction with various members of the JBRF research consortium.  The genes will be sequenced at the Laboratory of Behavioral Genetics at the Albert Einstein College of Medicine under the supervision of Dr. Herb Lachman.

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