Archive | December, 2019

John Hopkins Medicine study: Early-life exposure to dogs may lessen risk of developing schizophrenia

27 Dec

The American Psychiatric Association wrote in What Is Schizophrenia?

What Is Schizophrenia?
Schizophrenia is a chronic brain disorder that affects less than one percent of the U.S. population. When schizophrenia is active, symptoms can include delusions, hallucinations, trouble with thinking and concentration, and lack of motivation. However, with treatment, most symptoms of schizophrenia will greatly improve.
While there is no cure for schizophrenia, research is leading to new, safer treatments. Experts also are unraveling the causes of the disease by studying genetics, conducting behavioral research, and using advanced imaging to look at the brain’s structure and function. These approaches hold the promise of new, more effective therapies.
The complexity of schizophrenia may help explain why there are misconceptions about the disease. Schizophrenia does not mean split personality or multiple-personality. Most people with schizophrenia are not dangerous or violent. They also are not homeless nor do they live in hospitals. Most people with schizophrenia live with family, in group homes or on their own.
Research has shown that schizophrenia affects men and women about equally but may have an earlier onset in males. Rates are similar around the world. People with schizophrenia are more likely to die younger than the general population, in part because of high rates of co-occurring medical conditions, such as heart disease and diabetes…. https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia

WebMD wrote a concise description of schizophrenia in Schizophrenia: An Overview:

Schizophrenia is a chronic, severe mental disorder that affects the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. Though schizophrenia isn’t as common as other major mental illnesses, it can be the most chronic and disabling.
People with schizophrenia often have problems doing well in society, at work, at school, and in relationships. They might feel frightened and withdrawn, and could appear to have lost touch with reality. This lifelong disease can’t be cured but can be controlled with proper treatment.
Contrary to popular belief, schizophrenia is not a split or multiple personality. Schizophrenia involves a psychosis, a type of mental illness in which a person can’t tell what’s real from what’s imagined. At times, people with psychotic disorders lose touch with reality. The world may seem like a jumble of confusing thoughts, images, and sounds. Their behavior may be very strange and even shocking. A sudden change in personality and behavior, which happens when people who have it lose touch with reality, is called a psychotic episode.
How severe schizophrenia is varies from person to person. Some people have only one psychotic episode, while others have many episodes during a lifetime but lead relatively normal lives in between. Still others may have more trouble functioning over time, with little improvement between full-blown psychotic episodes. Schizophrenia symptoms seem to worsen and improve in cycles known as relapses and remissions.
What Are the Early Symptoms of Schizophrenia?
The condition usually shows its first signs in men in their late teens or early 20s. It mostly affects women in their early 20s and 30s. The period when symptoms first start and before full psychosis is called the prodromal period. It can last days, weeks, or even years. It can be hard to spot because there’s usually no specific trigger. You might only notice subtle behavioral changes, especially in teens. This includes:
• A change in grades
• Social withdrawal
• Trouble concentrating
• Temper flares
• Difficulty sleeping
https://www.webmd.com/schizophrenia/mental-health-schizophrenia#1

Johns Hopkins Medicine reported that exposure to dogs may lessen the risk of developing schizophrenia.

Science Daily reported in Early-life exposure to dogs may lessen risk of developing schizophrenia

Ever since humans domesticated the dog, the faithful, obedient and protective animal has provided its owner with companionship and emotional well-being. Now, a study from Johns Hopkins Medicine suggests that being around “man’s best friend” from an early age may have a health benefit as well — lessening the chance of developing schizophrenia as an adult.
And while Fido may help prevent that condition, the jury is still out on whether or not there’s any link, positive or negative, between being raised with Fluffy the cat and later developing either schizophrenia or bipolar disorder.
“Serious psychiatric disorders have been associated with alterations in the immune system linked to environmental exposures in early life, and since household pets are often among the first things with which children have close contact, it was logical for us to explore the possibilities of a connection between the two,” says Robert Yolken, M.D., chair of the Stanley Division of Pediatric Neurovirology and professor of neurovirology in pediatrics at the Johns Hopkins Children’s Center, and lead author of a research paper recently posted online in the journal PLOS One.
In the study, Yolken and colleagues at Sheppard Pratt Health System in Baltimore investigated the relationship between exposure to a household pet cat or dog during the first 12 years of life and a later diagnosis of schizophrenia or bipolar disorder. For schizophrenia, the researchers were surprised to see a statistically significant decrease in the risk of a person developing the disorder if exposed to a dog early in life. Across the entire age range studied, there was no significant link between dogs and bipolar disorder, or between cats and either psychiatric disorder.
The researchers caution that more studies are needed to confirm these findings, to search for the factors behind any strongly supported links, and to more precisely define the actual risks of developing psychiatric disorders from exposing infants and children under age 13 to pet cats and dogs.
According to the American Pet Products Association’s most recent National Pet Owners Survey, there are 94 million pet cats and 90 million pet dogs in the United States. Previous studies have identified early life exposures to pet cats and dogs as environmental factors that may alter the immune system through various means, including allergic responses, contact with zoonotic (animal) bacteria and viruses, changes in a home’s microbiome, and pet-induced stress reduction effects on human brain chemistry.
Some investigators, Yolken notes, suspect that this “immune modulation” may alter the risk of developing psychiatric disorders to which a person is genetically or otherwise predisposed.
In their current study, Yolken and colleagues looked at a population of 1,371 men and women between the ages of 18 and 65 that consisted of 396 people with schizophrenia, 381 with bipolar disorder and 594 controls. Information documented about each person included age, gender, race/ethnicity, place of birth and highest level of parental education (as a measure of socioeconomic status). Patients with schizophrenia and bipolar disorder were recruited from inpatient, day hospital and rehabilitation programs of Sheppard Pratt Health System. Control group members were recruited from the Baltimore area and were screened to rule out any current or past psychiatric disorders.
All study participants were asked if they had a household pet cat or dog or both during their first 12 years of life. Those who reported that a pet cat or dog was in their house when they were born were considered to be exposed to that animal since birth.
The relationship between the age of first household pet exposure and psychiatric diagnosis was defined using a statistical model that produces a hazard ratio — a measure over time of how often specific events (in this case, exposure to a household pet and development of a psychiatric disorder) happen in a study group compared to their frequency in a control group. A hazard ratio of 1 suggests no difference between groups, while a ratio greater than 1 indicates an increased likelihood of developing schizophrenia or bipolar disorder. Likewise, a ratio less than 1 shows a decreased chance.
Analyses were conducted for four age ranges: birth to 3, 4 to 5, 6 to 8 and 9 to 12.
Surprisingly, Yolken says, the findings suggests that people who are exposed to a pet dog before their 13th birthday are significantly less likely — as much as 24% — to be diagnosed later with schizophrenia.
“The largest apparent protective effect was found for children who had a household pet dog at birth or were first exposed after birth but before age 3,” he says…. https://www.sciencedaily.com/releases/2019/12/191218153448.htm

Citation:

Early-life exposure to dogs may lessen risk of developing schizophrenia
Findings do not link similar contact with cats to either schizophrenia or bipolar disorder

Date: December 18, 2019
Source: Johns Hopkins Medicine
Summary:
Ever since humans domesticated the dog, the faithful, obedient and protective animal has provided its owner with companionship and emotional well-being. Now, a study suggests that being around ‘man’s best friend’ from an early age may have a health benefit as well — lessening the chance of developing schizophrenia as an adult.

Journal Reference:
Robert Yolken, Cassie Stallings, Andrea Origoni, Emily Katsafanas, Kevin Sweeney, Amalia Squire, Faith Dickerson. Exposure to household pet cats and dogs in childhood and risk of subsequent diagnosis of schizophrenia or bipolar disorder. PLOS ONE, 2019; 14 (12): e0225320 DOI: 10.1371/journal.pone.0225320

Here is the press release from Johns Hopkins Medicine:

Study suggests early-life exposure to dogs may lessen risk of developing schizophrenia
by Johns Hopkins University School of Medicine
Ever since humans domesticated the dog, the faithful, obedient and protective animal has provided its owner with companionship and emotional well-being. Now, a study from Johns Hopkins Medicine suggests that being around “man’s best friend” from an early age may have a health benefit as well—lessening the chance of developing schizophrenia as an adult.
And while Fido may help prevent that condition, the jury is still out on whether or not there’s any link, positive or negative, between being raised with Fluffy the cat and later developing either schizophrenia or bipolar disorder.
“Serious psychiatric disorders have been associated with alterations in the immune system linked to environmental exposures in early life, and since household pets are often among the first things with which children have close contact, it was logical for us to explore the possibilities of a connection between the two,” says Robert Yolken, M.D., chair of the Stanley Division of Pediatric Neurovirology and professor of neurovirology in pediatrics at the Johns Hopkins Children’s Center, and lead author of a research paper recently posted online in the journal PLOS One.
In the study, Yolken and colleagues at Sheppard Pratt Health System in Baltimore investigated the relationship between exposure to a household pet cat or dog during the first 12 years of life and a later diagnosis of schizophrenia or bipolar disorder. For schizophrenia, the researchers were surprised to see a statistically significant decrease in the risk of a person developing the disorder if exposed to a dog early in life. Across the entire age range studied, there was no significant link between dogs and bipolar disorder, or between cats and either psychiatric disorder.
The researchers caution that more studies are needed to confirm these findings, to search for the factors behind any strongly supported links, and to more precisely define the actual risks of developing psychiatric disorders from exposing infants and children under age 13 to pet cats and dogs.
According to the American Pet Products Association’s most recent National Pet Owners Survey, there are 94 million pet cats and 90 million pet dogs in the United States. Previous studies have identified early life exposures to pet cats and dogs as environmental factors that may alter the immune system through various means, including allergic responses, contact with zoonotic (animal) bacteria and viruses, changes in a home’s microbiome, and pet-induced stress reduction effects on human brain chemistry.
Some investigators, Yolken notes, suspect that this “immune modulation” may alter the risk of developing psychiatric disorders to which a person is genetically or otherwise predisposed.
In their current study, Yolken and colleagues looked at a population of 1,371 men and women between the ages of 18 and 65 that consisted of 396 people with schizophrenia, 381 with bipolar disorder and 594 controls. Information documented about each person included age, gender, race/ethnicity, place of birth and highest level of parental education (as a measure of socioeconomic status). Patients with schizophrenia and bipolar disorder were recruited from inpatient, day hospital and rehabilitation programs of Sheppard Pratt Health System. Control group members were recruited from the Baltimore area and were screened to rule out any current or past psychiatric disorders.
All study participants were asked if they had a household pet cat or dog or both during their first 12 years of life. Those who reported that a pet cat or dog was in their house when they were born were considered to be exposed to that animal since birth.
The relationship between the age of first household pet exposure and psychiatric diagnosis was defined using a statistical model that produces a hazard ratio—a measure over time of how often specific events (in this case, exposure to a household pet and development of a psychiatric disorder) happen in a study group compared to their frequency in a control group. A hazard ratio of 1 suggests no difference between groups, while a ratio greater than 1 indicates an increased likelihood of developing schizophrenia or bipolar disorder. Likewise, a ratio less than 1 shows a decreased chance.
Analyses were conducted for four age ranges: birth to 3, 4 to 5, 6 to 8 and 9 to 12.
Surprisingly, Yolken says, the findings suggests that people who are exposed to a pet dog before their 13th birthday are significantly less likely—as much as 24%—to be diagnosed later with schizophrenia.
“The largest apparent protective effect was found for children who had a household pet dog at birth or were first exposed after birth but before age 3,” he says.
Yolken adds that if it is assumed that the hazard ratio is an accurate reflection of relative risk, then some 840,000 cases of schizophrenia (24% of the 3.5 million people diagnosed with the disorder in the United States) might be prevented by pet dog exposure or other factors associated with pet dog exposure.
“There are several plausible explanations for this possible ‘protective’ effect from contact with dogs—perhaps something in the canine microbiome that gets passed to humans and bolsters the immune system against or subdues a genetic predisposition to schizophrenia,” Yolken says.
For bipolar disorder, the study results suggest there is no risk association, either positive or negative, with being around dogs as an infant or young child.
Overall for all ages examined, early exposure to pet cats was neutral as the study could not link felines with either an increased or decreased risk of developing schizophrenia or bipolar disorder.
“However, we did find a slightly increased risk of developing both disorders for those who were first in contact with cats between the ages of 9 and 12,” Yolken says. “This indicates that the time of exposure may be critical to whether or not it alters the risk.”
One example of a suspected pet-borne trigger for schizophrenia is the disease toxoplasmosis, a condition in which cats are the primary hosts of a parasite transmitted to humans via the animals’ feces. Pregnant women have been advised for years not to change cat litter boxes to eliminate the risk of the illness passing through the placenta to their fetuses and causing a miscarriage, stillbirth, or potentially, psychiatric disorders in a child born with the infection.
In a 2003 review paper, Yolken and colleague E. Fuller Torrey, M.D., associate director of research at the Stanley Medical Research Institute in Bethesda, Maryland, provided evidence from multiple epidemiological studies conducted since 1953 that showed there also is a statistical connection between a person exposed to the parasite that causes toxoplasmosis and an increased risk of developing schizophrenia. The researchers found that a large number of people in those studies who were diagnosed with serious psychiatric disorders, including schizophrenia, also had high levels of antibodies to the toxoplasmosis parasite.
Because of this finding and others like it, most research has focused on investigating a potential link between early exposure to cats and psychiatric disorder development. Yolken says the most recent study is among the first to consider contact with dogs as well.
“A better understanding of the mechanisms underlying the associations between pet exposure and psychiatric disorders would allow us to develop appropriate prevention and treatment strategies,” Yolken says.
________________________________________
Explore further
Schizophrenia linked with abnormal immune response to Epstein-Barr virus
________________________________________
More information: Robert Yolken et al, Exposure to household pet cats and dogs in childhood and risk of subsequent diagnosis of schizophrenia or bipolar disorder, PLOS ONE (2019). DOI: 10.1371/journal.pone.0225320
Journal information: PLoS ONE
Provided by Johns Hopkins University School of Medicine

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Columbia University Irving Medical Center study: Brain differences detected in children with depressed parents

8 Dec

Moi said in Schools have to deal with depressed and troubled children:

Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.
As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Schools are developing strategies to deal with troubled kids.

Andrew M. Seaman of Reuters reported in Parents’ depression may affect kids’ school performance:

Children perform worse in school when their parents are diagnosed with depression, suggests a study from Sweden.
The study found a significant negative link between parents’ depression and kids’ school performance, said senior author Brian Lee, of the Drexel University School of Public Health in Philadelphia.
“We obviously know that depression is a bad thing like any other mental health outcome,” Lee said. “It’s less recognized that mental health outcomes affect other people than the people themselves. So for parents or guardians, a vulnerable population would be their children.”
Previous studies found children with depressed parents are more likely to have problems with brain development, behavior and emotions, along with other psychiatric problems, Lee and his colleagues write in JAMA Psychiatry. Few studies have looked at school performance, however.
For the new study, they used data from more than 1.1 million children born in Sweden between 1984 and 1994.
Three percent of the mothers and about 2 percent of fathers were diagnosed with depression before their children finished their last required year of school, which occurs around age 16 in Sweden.
Overall, when parents were diagnosed with depression during their children’s lifetime, the kids’ grades suffered. A mother’s depression appeared to affect daughters more than sons, they note.
Lee characterized the link between parental depression and children’s school performance as “moderate.”
On the range of factors that influence a child’s school performance, Lee said parental depression falls between a family’s economic status and parental education, which is one of the biggest factors in determining a child’s success in school.
The researchers caution that depression may have been undermeasured in the population. Also, they can’t say that a parent’s depression actually causes children to perform worse in school…. http://www.reuters.com/article/us-health-school-depression-parents-idUSKCN0VC2VS

Citation:

Parental depression associated with worse school performance by children

Date: February 3, 2016

Source: The JAMA Network Journals

Summary:
Having parents diagnosed with depression during a child’s life was associated with worse school performance at age 16 a new study of children born in Sweden reports.

Journal References:
1. Hanyang Shen, Cecilia Magnusson, Dheeraj Rai, Michael Lundberg, Félice Lê-Scherban, Christina Dalman, Brian K. Lee. Associations of Parental Depression With Child School Performance at Age 16 Years in Sweden. JAMA Psychiatry, 2016; DOI: 10.1001/jamapsychiatry.2015.2917
2. Myrna M. Weissman. Children of Depressed Parents—A Public Health Opportunity. JAMA Psychiatry, 2016; DOI: 10.1001/jamapsychiatry.2015.2967

A Columbia University study that there are brain differences in children with depressed parents.

Science Daily reported in Brain differences detected in children with depressed parents:

The largest brain imaging study of children ever conducted in the United States has revealed structural differences in the brains of those whose parents have depression.
Depression is a common and debilitating mental health condition that typically arises during adolescence. While the causes of depression are complex, having a parent with depression is one of the biggest known risk factors. Studies have consistently shown that adolescent children of parents with depression are two to three times more likely to develop depression than those with no parental history of depression. However, the brain mechanisms that underlie this familial risk are unclear.
A new study, led by David Pagliaccio, PhD, assistant professor of clinical neurobiology in the Department of Psychiatry at Columbia University Vagelos College of Physicians and Surgeons, found structural differences in the brains of children at high risk for depression due to parental depressive history.
The study was published in the Journal of the American Academy of Child & Adolescent Psychiatry.
The researchers analyzed brain images from over 7,000 children participating in the Adolescent Brain Cognitive development (ABCD) study, led by the NIH. About one-third of the children were in the high-risk group because they had a parent with depression.
In the high-risk children, the right putamen — a brain structure linked to reward, motivation, and the experience of pleasure — was smaller than in children with no parental history of depression.
Randy P. Auerbach, PhD, associate professor of medical psychology at Columbia University Vagelos College of Physicians and Surgeons and senior author of the study, notes, “These findings highlight a potential risk factor that may lead to the development of depressive disorders during a peak period of onset. However, in our prior research, smaller putamen volumes also has been linked to anhedonia — a reduced ability to experience pleasure — which is implicated in depression, substance use, psychosis, and suicidal behaviors. Thus, it may be that smaller putamen volume is a transdiagnostic risk factor that may confer vulnerability to broad-based mental disorders….” https://www.sciencedaily.com/releases/2019/12/191205130534.htm

Citation:

Brain differences detected in children with depressed parents
Date: December 5, 2019
Source: Columbia University Irving Medical Center
Summary:
The largest brain imaging study of children ever conducted in the United States has revealed structural differences in the brains of those whose parents have depression.

Journal Reference:
David Pagliaccio, Kira L. Alqueza, Rachel Marsh, Randy P. Auerbach. Brain Volume Abnormalities in Youth at High Risk for Depression: Adolescent Brain and Cognitive Development Study. Journal of the American Academy of Child & Adolescent Psychiatry, 2019; DOI: 10.1016/j.jaac.2019.09.032

Here is the press release from Columbia University:

NEWS RELEASE 5-DEC-2019

Brain differences detected in children with depressed parents

COLUMBIA UNIVERSITY IRVING MEDICAL CENTER

The largest brain imaging study of children ever conducted in the United States has revealed structural differences in the brains of those whose parents have depression.
In Brief
Depression is a common and debilitating mental health condition that typically arises during adolescence. While the causes of depression are complex, having a parent with depression is one of the biggest known risk factors. Studies have consistently shown that adolescent children of parents with depression are two to three times more likely to develop depression than those with no parental history of depression. However, the brain mechanisms that underlie this familial risk are unclear.
A new study, led by David Pagliaccio, PhD, assistant professor of clinical neurobiology in the Department of Psychiatry at Columbia University Vagelos College of Physicians and Surgeons, found structural differences in the brains of children at high risk for depression due to parental depressive history.
The study was published in the Journal of the American Academy of Child & Adolescent Psychiatry.
What the Study Found
The researchers analyzed brain images from over 7,000 children participating in the Adolescent Brain Cognitive development (ABCD) study, led by the NIH. About one-third of the children were in the high-risk group because they had a parent with depression.
In the high-risk children, the right putamen–a brain structure linked to reward, motivation, and the experience of pleasure–was smaller than in children with no parental history of depression.
What the Study Means
Randy P. Auerbach, PhD, associate professor of medical psychology at Columbia University Vagelos College of Physicians and Surgeons and senior author of the study, notes, “These findings highlight a potential risk factor that may lead to the development of depressive disorders during a peak period of onset. However, in our prior research, smaller putamen volumes also has been linked to anhedonia–a reduced ability to experience pleasure–which is implicated in depression, substance use, psychosis, and suicidal behaviors. Thus, it may be that smaller putamen volume is a transdiagnostic risk factor that may confer vulnerability to broad-based mental disorders.”
Dr. Pagliaccio adds that, “Understanding differences in the brains of children with familial risk factors for depression may help to improve early identification of those at greatest risk for developing depression themselves, and lead to improved diagnosis and treatment. As children will be followed for a 10-year period during one of the greatest periods of risk, we have a unique opportunity to determine whether reduced putamen volumes are associated with depression specifically or mental disorders more generally.”
###
More Details
The paper is titled “Brain Volume Abnormalities in Youth at High Risk for Depression: Adolescent Brain and Cognitive Development Study.” Its findings were published online October 18, 2019 in the Journal of the American Academy of Child & Adolescent Psychiatry.
Additional authors are Kira L. Alqueza, BA, Rachel Marsh, PhD.
The ABCD Study is supported by the National Institutes of Health (NIH) and additional federal partners under award numbers U01DA041022, U01DA041028, U01DA041048, U01DA041089, U01DA041106, U01DA041117, U01DA041120, U01DA041134, U01DA041148, U01DA041156, U01DA041174, U24DA041123, and U24DA041147.
Columbia University Irving Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the Vagelos College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Irving Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cuimc.columbia.edu or columbiadoctors.org.
The Columbia University Department of Psychiatry is among the top ranked psychiatry departments in the nation and has contributed greatly to the understanding and treatment of brain disorders. Co-located at the New York State Psychiatric Institute on the NewYork-Presbyterian Hospital/Columbia University Irving Medical Center campus in Washington Heights, the department enjoys a rich and productive collaborative relationship with physicians in various disciplines at the Columbia University Vagelos College of Physicians and Surgeons. Columbia Psychiatry is home to distinguished clinicians and researchers noted for their clinical and research advances in the diagnosis and treatment of depression, suicide, schizophrenia, bipolar and anxiety disorders, eating disorders, substance use disorders, and childhood psychiatric disorders.
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Related:

Schools have to deal with depressed and troubled children
https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children
https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’
https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:

1. About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

2. Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

3. Psychiatric News’ Study Helps Pinpoint Children With Depression http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

4. Family Doctor’s What Is Depression? http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

5. WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children

6. Healthline’s Is Your Child Depressed?
http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

7. Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
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