Single-micronutrient and broad-spectrum micronutrient approaches for treating mood disorders in youth and adults.

Several different vitamins and minerals appear to be effective augmenting agents for mood-modifying drugs, but are not potent monotherapies in themselves for treating psychiatric disorders. In contrast, broad-spectrum micronutrient interventions appear in early trials to be as effective as psychiatric medications with fewer adverse effects for treating mood disorders, ADHD, aggressivity, and misconduct in youth and adults. Broad-spectrum treatments also may improve stress responses, cognition, and sense of well-being in healthy adults, but have been less well studied in youth. Current clinical data justify an extensive expansion of research on micronutrient mechanisms and treatments in psychiatry.

Overview of integrative medicine in child and adolescent psychiatry.

Complementary and alternative medicine (CAM) defies simple definition, because the distinction between CAM and conventional medicine is largely arbitrary and fluid. Despite inconclusive data on the efficacy and safety of many CAM treatments in child and adolescent psychiatry, there are enough data on certain treatments to provide guidance to clinicians and researchers. CAM treatments, as adjunctive therapy or monotherapy, can be clinically beneficial and sensible. The low stigma and cost-competitiveness of many CAM psychiatric treatments are highly attractive to children and parents. Physicians need to be knowledgeable about CAM treatments to provide clinically valid informed consent for some conventional treatments.

Mood disorders in youth: exercise, light therapy, and pharmacologic complementary and integrative approaches.

The therapeutic value of physical exercise, bright light therapy and dawn simulation, and several pharmacologic treatments, including hypericum (St. John's wort), S-adenosylmethionine, and 5-hydroxytryptophan, are reviewed, with a focus on their use for treating major depressive disorder in children and adolescents and also for alleviating depressed mood in the general (nonclinical) population of youth. For each treatment discussed, all published randomized, double-blind, placebo-controlled trials are summarized, along with some additional selected studies. Nutritional psychopharmacology and several other approaches to treating depression will be presented in an upcoming volume in the Child and Adolescent Psychiatric Clinics of North America.

The MAVRIC-C and MAVRIC-P: a preliminary reliability and validity study.

We administered the Measure of Aggression, Violence, and Rage in Children (MAVRIC; Bass, Geenens, & Popper, 1993a, 1993b), a questionnaire assessing the severity of reactive, impulsive aggression, to 28 prepubertal psychiatrically hospitalized children and 54 prepubertal lowrisk nonpatients and their mothers. Cross-informant reliability was supported between the MAVRIC-Child Version (MAVRIC-C; Bass et al., 1993a) and MAVRIC-Parent Version (MAVRIC-P; Bass et al., 1993b), r = .62, p < .001. Convergent validity was supported with the Aggressive Behavior factor of the Child Behavior Checklist (Achenbach, 1991a) for the MAVRIC-C, r = .62, p < .001, and MAVRIC-P, r = .74, p < .001. Both versions were also associated with disruptive behavior disorders, inpatient status, and assaultive behavior. We discuss the differences in the perception of aggression as a function of informant.