Research has examined the effects of micronutrients on mood in both healthy and psychiatric populations. EMPowerplus (EMP+) is a formula containing a wide range of vitamins and minerals. It has been examined for the treatment of mood instability, anxiety, Attention Deficit Hyperactivity Disorder (ADHD) and autism. The present study trialled EMP+ with five adolescents, aged 16-21, all with Severe Mood Dysregulation (SMD) as well as co-occuring psychiatric diagnoses i.e. ADHD, anxiety and substance abuse. The sample reflects a group of adolescents with complex psychiatric presentations and therefore difficult to treat. An ABAB (off-on-off-on) research design was employed. An open-label trial (8 weeks) of the micronutrients was followed by a withdrawal phase (8 weeks) and then a reinstatement of the micronutrients for a longer period of time (up to 24 weeks). There were in-depth pre and post assessments and on-going monitoring of the participants for the duration of the study. Clinically significant improvements in symptoms and functioning were demonstrated in three/four participants. Two participants demonstrated on-off control of psychiatric symptoms, with a reversal and replication of treatment effect. Further, one participant demonstrated clinically significant improvements in mood and functioning while on the micronutrients; however, he was lost to follow up following the 7.1 earthquake, and a reversal was not obtained. One participant demonstrated a trend toward improvements in mood while on the micronutrients and subsequent deterioration during the wash-out phase. However, she decided to withdraw from the study at four weeks off to go on psychiatric medication. Further, one participant demonstrated a variable response. This study provides some further evidence that micronutrients may be an effective treatment for psychiatric symptoms, consistent with other reports. Further research, such as randomised clinical trials and studies investigating the mechanisms of action, appears warranted.

Disruptive Mood Dysregulation Disorder (DMDD) is a new addition to the DSM-5, characterized by severe persistent irritability and frequent temper tantrums. This research project aimed to answer the question, “What impacts social workers’ perspectives of DMDD?” by using a positivist approach and collecting quantitative data. Participants (n=26) were sent an electronic survey created with Google Forms. This self-administered survey asked questions regarding demographic information, and asked participants to rate seven statements regarding DMDD using a Likert-type scale. SPSS Statistics Subscription was used to analyze the data through univariate statistics, bivariate statistics in the form of a one-way ANOVA, and multiple regression. The hypothesis of the research study was that as years of clinical experience increased, social workers’ perspectives on DMDD would become increasingly negative. This hypothesis was not supported by the findings of this research study. Although the study was limited by a small sample size, some interesting data was revealed and further research is needed to investigate this topic. The majority of participants, 19 out of 26, had positive perception scores, indicating a positive perspective on DMDD. Additionally, participants unanimously agreed that prior to DMDD’s introduction, Bipolar Disorder was over-diagnosed in children. More research is needed to investigate why perspectives seem to tend towards the positive, and if this is true for the larger population of clinical social workers.

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No description available.

Le Trouble Déficit de l’Attention Hyperactivité (TDAH) est un trouble du neurodéveloppement associant des symptômes d’inattention, d’hyperactivité et/ou d’impulsivité. Fréquemment, le tableau clinique est marqué par une labilité émotionnelle pouvant se manifester sous différentes formes jusqu’à parfois s’agencer en un véritable syndrome : le Trouble Disruptif avec Dysrégulation Emotionnelle, récemment inclus dans le DSM-5. La labilité émotionnelle est-elle un symptôme du TDAH ou de troubles comorbides ? Est-elle caractéristique d’un tableau clinique du TDAH ? Ce travail de thèse propose d’étudier le profil psychopathologique associé à la labilité émotionnelle sous différentes approches, catégorielle et dimensionnelle, et à deux périodes clés du développement de l’enfant atteint de TDAH, l’âge préscolaire et l’âge scolaire. Quatre études composent ce travail de thèse : les trois premières en milieu clinique et la dernière en population générale. Les résultats ont indiqué que la labilité émotionnelle d’un point de vue dimensionnel mais également catégoriel au travers du diagnostic de Trouble Disruptif avec Dysrégulation Emotionnelle, était associée à des symptômes plus sévères et un retentissement fonctionnel plus important à l’âge préscolaire et scolaire. L’approche dimensionnelle s’est montrée plus pertinente pour identifier les enfants avec labilité émotionnelle ayant des besoins spéciaux de prises en charge au-delà de celle du TDAH. De plus, la labilité émotionnelle et l’irritabilité ont semblé être associées à des tableaux cliniques différents. Ces résultats suggèrent l’intérêt de l’évaluation de la labilité émotionnelle et des manifestations associées dans le diagnostic du TDAH chez l’enfant. Une approche clinique fine, à la fois quantitative et qualitative, semble prometteuse dans la prévention des formes prodromiques de TDAH et dans le pronostic de ce trouble afin de proposer des interventions adaptées afin d’infléchir de potentielles trajectoires développementales à risques. / Attention Deficit Hyperactivity disorder is a neurodevelopmental disorder characterized by inattentive, hyperactive and/or impulsive symptoms. Emotional lability is frequently associated with the disorder. It can cover several manifestations. These manifestations are sometimes that serious that there are parts of a disorder: the Disruptive Mood Dysregulation Disorder recently added to the DSM-5. Is emotional lability a core symptom of ADHD or one of a comorbid disorder? Is it featured with different symptoms and functional impairment in children with ADHD? This PhD work tried to provide elements to respond to these questions assessing the psychopathological profile associated with emotional lability as a categorical and dimensional feature at two crucial developmental periods: the preschool and the school aged. Four studies are part of this PhD work: three in clinical population and one in general population. Results emphasized that emotional lability is associated with more severe symptoms and functional impairment in both preschool a school aged children. Results were similar when emotional lability was assessed as a dimensional feature and as a categorical feature. Nevertheless, the dimensional approach of emotional lability seemed relevant identifying children with ADHD and emotional lability that were at special need for interventions, beyond the ADHD one. Moreover, emotional lability and irritability seemed associated with different clinical outcomes. These results suggested the value of the emotional lability assessment and of its others manifestations in the ADHD diagnosis in children. A qualitative and quantitative approach seems promising in preventing prodromal ADHD and in its prognostic. This might serve targeting adapted interventions in order to inflect potential harmful developmental trajectories.