Pediatric Psychopharmacology & Adult ADHD Program

The mission of the Pediatric Psychopharmacology and Adult ADHD Program at Massachusetts General Hospital is to advance the well-being of children and families afflicted with mental illness through research, education and clinical care to identify, prevent and treat those afflicted with mental illness.

Overview

child psychopharmocology patient

The Pediatric Psychopharmacology and Adult ADHD Program at Massachusetts General Hospital takes a state-of-the-art approach to research into emotional and behavioral disorders that afflict the young. Through our research we strive to understand not only their clinical features, but also their causes, symptoms and neurological and genetic underpinnings.

Clinicians in our program specialize in medication management of all psychiatric disorders afflicting the young, with a special focus on:

  • Pediatric mood and anxiety disorders
  • Pediatric bipolar disorder
  • Autism spectrum disorders (ASD)
  • Child and adult attention-deficit/hyperactivity disorder (ADHD)

In addition to our young patients, we also work with adult patients suffering from certain psychiatric disorders, including ADHD and ASD. We also work closely with the Alan and Lorraine Bressler Clinical and Research Program to provide specialized care for young people with ASD.

Treatment through our research program includes an assessment of various treatment options for both children and adults, including:

  • Pharmacological medications
  • Natural products
  • Psychological treatments
  • Novel therapeutic opportunities, such mindfulness and photo-modulation

About Our Research Program

Conditions we treat
Learn more about the disorders our clinicians specialize in treating.

Research activities
In our research, we use a variety of programs to collect data for a better understanding of disorders and study the effectiveness of various treatments.

Meet our staff
Our programs are staffed by clinicians and researchers who are widely acknowledged to be experts in their fields.

Contact us
Learn more about our research or enroll in a study.

 

Conditions

Conditions and Disorders We Treat

Clinicians in our programs specialize in medication management of all psychiatric disorders afflicting the young in general, with an emphasis on the following disorders:

  • Pediatric mood and anxiety disorders
  • Pediatric bipolar disorder
  • Autism spectrum disorders (ASD)
  • Child and adult attention-deficit/hyperactivity disorder (ADHD)

Attention-Deficit/Hyperactivity Disorder (ADHD)

ADHD refers to a set of clinical features that include:

  • A deficit in attention to tasks
  • Distractibility
  • Trouble regulating activity (also known as hyperactivity)
  • Lowered impulses inhibition (also known as impulsivity)

ADHD is a biological disorder most likely caused by genes that affect how key circuits in the brain function, leading to the symptoms listed above. This set of symptoms usually starts in early childhood, but tends to become more noticeable when the child begins school. Unfortunately, many children with ADHD are not identified or treated until adulthood. The symptoms tend to be stronger when circumstances are boring or less interesting, so they tend to more negatively schoolwork or work. The variability in ADHD symptoms is often confusing to parents, patients, doctors, teachers and employers since the affected person, at any age, can concentrate well on tasks and activities that he or she finds interesting (such as videogames or hobbies), but not on other, less interesting activities. The most prominent and visible symptoms of ADHD, those associated with hyperactivity, tend to wane or change over time, yet the problems with attention deficits and impulsivity tend to persist.

Unfortunately there is currently no test to diagnose this disorder. The diagnosis is done through clinical assessment by a trained clinician focusing on creating a detailed history of the symptoms. Although treatment with various medications can be very helpful to reduce the symptoms that characterize ADHD, improve function and enhance quality of life, these treatments are not curative and need to be taken continuously to maintain their benefits.

In addition to medication, some individuals with ADHD benefit from additional psychological and educational support. Untreated, ADHD can have very negative effects on all aspects of life including educational and occupational attainment, driving accidents, substance use, and social and marital difficulties.

Autism Spectrum Disorders (ASD)

For more about ASD, please visit the Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorders.

Pediatric Bipolar Disorder

Pediatric bipolar disorder is a severe condition marked by dramatic shifts in mood from hopelessness and depression, to rage and irritability, to high energy and euphoria. Pediatric bipolar disorder is among the most impairing psychiatric conditions facing the mental health field. Recent research has documented that the majority of adults with bipolar disorder had an onset of their illness during childhood or adolescence. Groundbreaking research from our program and others has shown that at least 1% of youth are afflicted with bipolar disorder.

Children with bipolar disorder have always been in our midst, but in years past many professionals thought that children could not have bipolar disorder due to preconceived ideas and prejudice. Clinicians often recognized other conditions that co-occur with bipolar disorder, such as attention-deficit/hyperactivity disorder, conduct disorder and oppositional defiant disorder, and missed the mood diagnosis. Through our research we have consistently documented that bipolar disorder in children presents with mood episodes characterized by highly irritable, often aggressive behavior, which can be long-lasting and frequent, along with states of sadness and joylessness characteristic of depression.

Because bipolar disorder itself is so disruptive to family life, school and play, we strive to treat patients as soon as they are diagnosed with both medication and non-medication interventions, according to the needs of each individual patient. Early intervention efforts can help prevent other negative outcomes associated with untreated bipolar disorder, including substance use issues, delinquency and legal problems, and even suicide.

Research

The Pediatric Psychopharmacology and Adult ADHD Program relies on a variety of methodologies to collect data for a better understanding of the psychiatric disorders afflicting the young.

Contact us to learn enroll in a study


Neuroimaging Research

Our neuroimaging program uses a variety of technologies to gain insight into the brain systems underlying childhood psychiatric conditions. With non-invasive magnetic resonance imaging (MRI) we can analyze brain volumes, brain function, cortical thickness, the integrity of white matter tracts and brain biochemistry among others. We also use positron emission tomography (PET), to measure the flow of different substances (including drugs or oxygen) in the brain and Magnetic Encephalography (MEG) to assess electrophysiology.

Our neuroimaging research focuses on the following topics:

  • Attention-deficit/hyperactivity disorder (ADHD) across the lifespan
  • Autism spectrum disorders (ASD)
  • Children at risk for mood disorders
  • Predicting response to medication treatment using neuroimaging
  • Genetic imaging
  • Emotional dysregulation
  • Early detection of emotional disorders

Preclinical Research Program: Animal Models

We use rodent research to understand the neural basis of common disorders such as ADHD, traumatic brain injury and PTSD, as well as to gain better understanding of the mechanisms of action and adverse effects of stimulant medications on brain structure and function at cellular, molecular and system levels. Animal models offer unprecedented insight into the mechanisms of drug action in the central nervous system and permit us to design and develop novel safe and highly effective, novel treatments for ADHD and other neuropsychiatric conditions.


Cognition Research

Cognition is a central aspect of human functioning that affects all individuals regardless of their psychiatric diagnosis. Therefore, understanding the cognitive processes of those suffering from emotional and behavioral disorders can be enormously helpful in making recommendations for education, vocation and therapeutic interventions. Our cognition research strives to find commonalities and differences in individuals afflicted with the different disorders we study. Our studies on executive functions (the part of the brain that assists with attention, impulsivity, planning and organization) have been especially fruitful in helping show the impact of cognition on functional outcomes.


Attention-Deficit/Hyperactivity Disorder (ADHD) Research

Our ADHD Research Program conducts research on all aspects of the disorder with a focus on the clinical course, neurobiology and treatment across the lifecycle. This includes research on both children and adults with ADHD, as well as long-term follow-up studies examining the course of the disorder as children mature into adulthood.

Our ADHD research focuses on the following topics:

  • Emotional regulation in ADHD
  • Executive function in ADHD
  • Ways to improve adherence to treatment
  • Predicting responses to medication treatment using neuroimaging
  • Concussions and their relationship to ADHD
  • PTSD and its relationship to ADHD
  • New treatments for ADHD and related symptoms
  • Mindfulness for stress reduction in ADHD

A very important aspect of our work is conducting studies of comorbid (co-occurring) psychiatric and cognitive disorders afflicting individuals of all ages with ADHD, as well as genetic and neuroimaging research on ADHD across the lifecycle. We investigate the safety and efficacy of new treatments for ADHD and its associated conditions. Our program publishes dozens of scientific articles on ADHD every year.


Autism Spectrum Disorders (ASD) Research

Our program conducts research on all aspects on ASD, including treatment, genetics and comorbid disorders. We focus on research that can improve the lives of individuals (both children and adults) with high-functioning autism. By better understanding the neurobiology, the lifetime course of autism and co-occurring disorders, we are able use findings from this research to improve the care for people with ASD. In addition, we investigate the efficacy of new and old treatments for autism-related symptoms.

Our ASD research focuses on the following:

  • Neuroimaging to better understand brain function in individuals with autism
  • Genetics of autism
  • ADHD and autism
  • Anxiety and autism
  • Social cognition in people with autism
  • Cognitive rigidity in autism
  • Treatments for autism-related symptoms

For more information on ASD, visit the Bressler Clinical and Research Program for Autism Spectrum Disorders.


Pediatric Bipolar Disorder Research

Our pediatric bipolar disorder research focuses on early identification, screening and understanding of risks for mood disorders and treatment of these disorders. Through this research we aim to improve the lives of children and families coping with pediatric bipolar disorder and improve care for individuals struggling with mood disorders.

A particular area of interest in our research is in understanding what puts children at risk for developing mood disorders. Using neuroimaging and genetics, we examine children and siblings who have been diagnosed with a bipolar spectrum disorder and children with early symptoms of mood disorders (such as difficulties regulating emotions). In addition, we investigate the effectiveness of new and old treatments for children with mood disorders.

Our current research focuses on the following:

  • Natural treatments for children with mood disorders
  • Neuroimaging to understand who may be at risk for developing mood disorders
  • Medication treatment in children with mood disorders

Staff

Meet Our Staff

Our programs are staffed by clinicians and researchers who are widely acknowledged to be experts in their fields.

Our Staff

Joseph Biederman, MD – Chief
Thomas Spencer, MD – Associate Chief
Atilla Ceranoglu, MD – Child and Adult Psychiatrist
Ronna Fried, EdD – Director of Neuropsychology Program
Lynn Grush, MD – Child and Adult Psychiatrist
Gagan Joshi, MD – Director of Autism Spectrum Disorders Program
Jane Lanier, MD – Child and Adult Psychiatrist
Craig Surman, MD – Scientific Coordinator of Adult ADHD Program
Timothy Wilens, MD – Director of Substance Abuse Program
Janet Wozniak, MD – Director of Pediatric Bipolar Program
Mai Uchida, MD – Child and Adult Psychiatrist
Carrie Vaudreuil, MD – Child and Adult Psychiatrist
Amy Yule, MD – Child and Adult Psychiatrist

Collaborators

Steve Faraone, PhD – Senior Scientific Advisor
Pradeep Bhide, PhD – Professor, Florida State University College of Medicine
John Gabrieli, PhD – Director, Athinoula A. Martinos Imaging Center at the McGovern Institute at MIT
Staci Gruber, PhD – Director, Cognitive and Clinical Neuroimaging Core at McLean Hospital’s Brain Imaging Center
Robert Doyle, DDS, MD – Psychiatrist
Jefferson B. Prince, MD – Psychiatrist

Collaborators

Mass General Child Cognitive Behavioral Therapy Program
Mass General Psychiatric Neuroimaging Division
McLean Hospital
Spaulding Rehabilitation Hospital

Program Staff

Stefani Callinan – Assistant to Dr. Spencer and Dr. Joshi
Victoria Chippari – Assistant to Dr. Wilens
Maura Fitzgerald, MPH – Biostatistician Epidemiologist
Maribel Galdo, LICSW – Clinical Social Worker/Business Administrator
Philia Henderson – Patient Services Coordinator
Daniel Kaufman – Data Coordinator
Yvonne Woodworth – Assistant to Dr. Biederman

Contact Us

The Pediatric Psychopharmacology and Adult ADHD Program enrolls both pediatric and adult patients to participate in our research. Please contact us to learn more about participating in our research or to enroll in a study:

  • Attention-Deficit/Hyperactivity Hotline: 617-724-ADHD(2343)
  • Pediatric Bipolar Disorder Hotline: 617-724-4MGH(4644)
  • Bressler Program (Autism) Hotline: 617-726-7899

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