Attention deficit disorder in children at risk for anxiety and depression.

The comorbidity between attention deficit disorder (ADD) and anxiety and/or depressive disorders was examined in the children of parents with panic disorder, major depressive disorder, or with no diagnosis. A child received a diagnosis by a self-report, parent report, and by consensus, using a best estimate procedure. The prevalence rates of ADD were significantly greater in offspring of parents with depressive and panic disorder by the parents' report and in children of depressed parents by consensus. A significant relationship between ADD and anxiety and/or depression was found for parent, child, and consensus diagnoses. Higher rates of ADD were reported by children (1% versus 13%), parents (8% versus 31%), and in the consensus diagnoses (13% versus 29%) when anxiety and/or depression was present. These results suggest that in children referred for evaluation of ADD, the possibility of a primary anxiety or depressive disorder should be considered.

Children's concepts of the family.

The past decade has witnessed increased research emphasis on children's developing conceptions of their social environment. In the present study, 64 children in grades 1 through 6 were interviewed to examine age-related changes in their understanding of the concept of family. The study also explored whether children's developing conceptions of the family were mediated by their own family structures. Results indicated five levels of family concept understanding that reflected a growing (i.e., age-related) facility in children's application of kinship criteria across traditional and nontraditional family groupings. However, the sophistication of children's understanding of the family was not related to the structure of their own families. These findings suggest that children's level of cognitive development is more important for their comprehension of the family than the specific experiences derived from living within their own unique family. Implications of these findings for mental health professionals who work with families in transition are discussed.

Does "physiologic" mitral valve prolapse occur with acute blood loss?

Intravascular volume changes are reported to affect the clinical and echocardiographic spectrum of patients with known mitral valve prolapse syndrome (MVPS). We tested whether acute blood loss can produce MVP in normal adults. Twenty-one subjects were studied with Doppler echocardiography before and after donating 550 ml whole blood. Two subjects demonstrated minimal (1+) prolapse postphlebotomy, but in only one echocardiographic view, and without mitral regurgitation by Doppler. Three subjects demonstrated slight, early (not late or pansystolic) mitral regurgitation after phlebotomy, but without prolapse. Left atrial dimensions decreased significantly after the blood donation but the left ventricular size was not significantly smaller. The 1+ MVP is within the range of superior systolic motion found in 35% of a normal population, free of heart disease, and without intervention. We find no evidence in our study or in the literature that pathologic degrees of MVP can be produced in normal subjects by physiologic alteration in blood volume.

Manic psychosis in childhood. Report of two cases.

Two cases of acute manic psychosis in prepubertal children are described. Mania in adolescence has been described with increasing frequency, but the existence of childhood-onset mania remains controversial. That may be attributed to the presence of schizophreniform features in mania in young individuals. The management and prognosis of juvenile-onset mania are discussed.