nach oben

Erschienen in:

01.05.2014 | Original Contribution

Recognition of facial emotion and affective prosody in children with ASD (+ADHD) and their unaffected siblings

verfasst von: Anoek M. Oerlemans, Jolanda M. J. van der Meer, Daphne J. van Steijn, Saskia W. de Ruiter, Yvette G. E. de Bruijn, Leo M. J. de Sonneville, Jan K. Buitelaar, Nanda N. J. Rommelse

Erschienen in: European Child & Adolescent Psychiatry | Ausgabe 5/2014

Einloggen, um Zugang zu erhalten

Abstract

Autism is a highly heritable and clinically heterogeneous neuropsychiatric disorder that frequently co-occurs with other psychopathologies, such as attention-deficit/hyperactivity disorder (ADHD). An approach to parse heterogeneity is by forming more homogeneous subgroups of autism spectrum disorder (ASD) patients based on their underlying, heritable cognitive vulnerabilities (endophenotypes). Emotion recognition is a likely endophenotypic candidate for ASD and possibly for ADHD. Therefore, this study aimed to examine whether emotion recognition is a viable endophenotypic candidate for ASD and to assess the impact of comorbid ADHD in this context. A total of 90 children with ASD (43 with and 47 without ADHD), 79 ASD unaffected siblings, and 139 controls aged 6–13 years, were included to test recognition of facial emotion and affective prosody. Our results revealed that the recognition of both facial emotion and affective prosody was impaired in children with ASD and aggravated by the presence of ADHD. The latter could only be partly explained by typical ADHD cognitive deficits, such as inhibitory and attentional problems. The performance of unaffected siblings could overall be considered at an intermediate level, performing somewhat worse than the controls and better than the ASD probands. Our findings suggest that emotion recognition might be a viable endophenotype in ASD and a fruitful target in future family studies of the genetic contribution to ASD and comorbid ADHD. Furthermore, our results suggest that children with comorbid ASD and ADHD are at highest risk for emotion recognition problems.

Nur mit Berechtigung zugänglich

APA (2000) Diagnostic and statistical manual of disorders, 4th edn. Text Revision. American Psychiatric Association, Washington, DC

Freitag CM (2007) The genetics of autistic disorders and its clinical relevance: a review of the literature. Mol Psychiatry 12(1):2–22. doi:10.1038/sj.mp.4001896 PubMedCrossRef

Neves MD, Tremeau F, Nicolato R, Lauar H, Romano-Silva MA, Correa H (2011) Facial emotion recognition deficits in relatives of children with autism are not associated with 5HTTLPR. Revista brasileira de psiquiatria 33(3):261–267

Pelphrey KA, Shultz S, Hudac CM, Vander Wyk BC (2011) Research review: constraining heterogeneity: the social brain and its development in autism spectrum disorder. J Child Psychol Psychiatry Allied Discipl 52(6):631–644. doi:10.1111/j.1469-7610.2010.02349.x CrossRef

Gottesman II, Gould TD (2003) The endophenotype concept in psychiatry: etymology and strategic intentions. Am J Psychiatry 160(4):636–645PubMedCrossRef

Wang HM, Hsiao CL, Hsieh AR, Lin YC, Fann CS (2012) Constructing endophenotypes of complex diseases using non-negative matrix factorization and adjusted rand index. PLoS ONE 7(7):e40996. doi:10.1371/journal.pone.0040996 PubMedCentralPubMedCrossRef

Almasy L, Blangero J (2001) Endophenotypes as quantitative risk factors for psychiatric disease: rationale and study design. Am J Med Genet 105(1):42–44PubMedCrossRef

Viding E, Blakemore SJ (2007) Endophenotype approach to developmental psychopathology: implications for autism research. Behav Genet 37(1):51–60. doi:10.1007/s10519-006-9105-4 PubMedCrossRef

Waldman ID (2005) Statistical approaches to complex phenotypes: evaluating neuropsychological endophenotypes for attention-deficit/hyperactivity disorder. Biol Psychiatry 57(11):1347–1356. doi:10.1016/j.biopsych.2005.03.002 PubMedCrossRef

10.

Allen AJ, Griss ME, Folley BS, Hawkins KA, Pearlson GD (2009) Endophenotypes in schizophrenia: a selective review. Schizophr Res 109(1–3):24–37. doi:10.1016/j.schres.2009.01.016 PubMedCentralPubMedCrossRef

11.

Hoff AL, Svetina C, Maurizio AM, Crow TJ, Spokes K, DeLisi LE (2005) Familial cognitive deficits in schizophrenia. Am J Med Genet Part B, Neuropsychiatr Genet: Off Publ Int Soc Psychiatr Genet 133B(1):43–49. doi:10.1002/ajmg.b.30120 CrossRef

12.

Rommelse NN, Geurts HM, Franke B, Buitelaar JK, Hartman CA (2011) A review on cognitive and brain endophenotypes that may be common in autism spectrum disorder and attention-deficit/hyperactivity disorder and facilitate the search for pleiotropic genes. Neurosci Biobehav Rev 35(6):1363–1396. doi:10.1016/j.neubiorev.2011.02.015 PubMedCrossRef

13.

Chen J, Calhoun VD, Pearlson GD, Ehrlich S, Turner JA, Ho BC, Wassink TH, Michael AM, Liu J (2012) Multifaceted genomic risk for brain function in schizophrenia. NeuroImage 61(4):866–875. doi:10.1016/j.neuroimage.2012.03.022 PubMedCentralPubMedCrossRef

14.

Doyle AE, Ferreira MA, Sklar PB, Lasky-Su J, Petty C, Fusillo SJ, Seidman LJ, Willcutt EG, Smoller JW, Purcell S, Biederman J, Faraone SV (2008) Multivariate genomewide linkage scan of neurocognitive traits and ADHD symptoms: suggestive linkage to 3q13. Am J Med Genet Part B, Neuropsychiatr Genet: Off Publ Int Soc Psychiatr Genet 147B(8):1399–1411. doi:10.1002/ajmg.b.30868 CrossRef

15.

Rommelse NN, Arias-Vasquez A, Altink ME, Buschgens CJ, Fliers E, Asherson P, Faraone SV, Buitelaar JK, Sergeant JA, Oosterlaan J, Franke B (2008) Neuropsychological endophenotype approach to genome-wide linkage analysis identifies susceptibility loci for ADHD on 2q21.1 and 13q12.11. Am J Hum Genet 83(1):99–105. doi:10.1016/j.ajhg.2008.06.006 PubMedCentralPubMedCrossRef

16.

Tierney AL, Gabard-Durnam L, Vogel-Farley V, Tager-Flusberg H, Nelson CA (2012) Developmental trajectories of resting EEG power: an endophenotype of autism spectrum disorder. PLoS ONE 7(6):e39127. doi:10.1371/journal.pone.0039127 PubMedCentralPubMedCrossRef

17.

Soorya LV, Halpern D (2009) Psychosocial interventions for motor coordination, executive functions, and socialization deficits in ADHD and ASD. Primary Psychiatry 6:48–54

18.

Anokhin AP, Golosheykin S, Heath AC (2010) Heritability of individual differences in cortical processing of facial affect. Behav Genet 40(2):178–185. doi:10.1007/s10519-010-9337-1 PubMedCentralPubMedCrossRef

19.

Harms MB, Martin A, Wallace GL (2010) Facial emotion recognition in autism spectrum disorders: a review of behavioral and neuroimaging studies. Neuropsychol Rev 20(3):290–322. doi:10.1007/s11065-010-9138-6 PubMedCrossRef

20.

Sinzig J, Morsch D, Lehmkuhl G (2008) Do hyperactivity, impulsivity and inattention have an impact on the ability of facial affect recognition in children with autism and ADHD? Eur Child Adolesc Psychiatry 17(2):63–72. doi:10.1007/s00787-007-0637-9 PubMedCrossRef

21.

Charbonneau G, Bertone A, Lepore F, Nassim M, Lassonde M, Mottron L, Collignon O (2013) Multilevel deficits in the processing of audio-visual emotion expressions in autism spectrum disorders. Neuropsychologia. doi:10.1016/j.neuropsychologia.2013.02.009 PubMed

22.

Uljarevic M, Hamilton A (2012) Recognition of emotions in autism: a formal meta-analysis. J Autism Dev Disord. doi:10.1007/s10803-012-1695-5

23.

Downs A, Smith T (2004) Emotional understanding, cooperation, and social behavior in high-functioning children with autism. J Autism Dev Disord 34(6):625–635PubMedCrossRef

24.

Losh M, Adolphs R, Poe MD, Couture S, Penn D, Baranek GT, Piven J (2009) Neuropsychological profile of autism and the broad autism phenotype. Arch Gen Psychiatry 66(5):518–526. doi:10.1001/archgenpsychiatry.2009.34 PubMedCentralPubMedCrossRef

25.

Adolphs R, Spezio ML, Parlier M, Piven J (2008) Distinct face-processing strategies in parents of autistic children. Current Biol 18(14):1090–1093. doi:10.1016/j.cub.2008.06.073 CrossRef

26.

Buitelaar JK, van der Wees M, Swaab-Barneveld H, van der Gaag RJ (1999) Theory of mind and emotion-recognition functioning in autistic spectrum disorders and in psychiatric control and normal children. Dev Psychopathol 11(1):39–58PubMedCrossRef

27.

Castelli F (2005) Understanding emotions from standardized facial expressions in autism and normal development. Autism: Int J Res Pract 9(4):428–449. doi:10.1177/1362361305056082 CrossRef

28.

McCann J, Peppe S (2003) Prosody in autism spectrum disorders: a critical review. Int J Lang Commun Disord/Royal Coll Speech Lang Ther 38(4):325–350. doi:10.1080/1368282031000154204 CrossRef

29.

Golan O, Baron-Cohen S, Hill JJ, Rutherford MD (2007) The ‘reading the mind in the voice’ test-revised: a study of complex emotion recognition in adults with and without autism spectrum conditions. J Autism Dev Disord 37(6):1096–1106. doi:10.1007/s10803-006-0252-5 PubMedCrossRef

30.

Korpilahti P, Jansson-Verkasalo E, Mattila ML, Kuusikko S, Suominen K, Rytky S, Pauls DL, Moilanen I (2007) Processing of affective speech prosody is impaired in Asperger syndrome. J Autism Dev Disord 37(8):1539–1549. doi:10.1007/s10803-006-0271-2 PubMedCrossRef

31.

Lindner JL, Rosen LA (2006) Decoding of emotion through facial expression, prosody and verbal content in children and adolescents with Asperger’s syndrome. J Autism Dev Disord 36(6):769–777. doi:10.1007/s10803-006-0105-2 PubMedCrossRef

32.

Philip RC, Whalley HC, Stanfield AC, Sprengelmeyer R, Santos IM, Young AW, Atkinson AP, Calder AJ, Johnstone EC, Lawrie SM, Hall J (2010) Deficits in facial, body movement and vocal emotional processing in autism spectrum disorders. Psychol Med 40(11):1919–1929. doi:10.1017/S0033291709992364 PubMedCrossRef

33.

Baker KF, Montgomery AA, Abramson R (2010) Brief report: perception and lateralization of spoken emotion by youths with high-functioning forms of autism. J Autism Dev Disord 40(1):123–129. doi:10.1007/s10803-009-0841-1 PubMedCrossRef

34.

Grossman RB, Bemis RH, Plesa Skwerer D, Tager-Flusberg H (2010) Lexical and affective prosody in children with high-functioning autism. J Speech Lang Hear Res 53:778–793PubMedCentralPubMedCrossRef

35.

Heikkinen J, Jansson-Verkasalo E, Toivanen J, Suominen K, Väyrynen E, Moilanen I, Seppänen T (2009) Perception of basic emotions from speech prosody in adolescents with Asperger’s syndrome. Logop Phoniatr Vocol 1:1–8

36.

Jones CRG, Pickles A, Falcaro M, Marsden AJS, Happé F, Scott SK, Sauter D, Tregay J, Phillips RJ, Baird G, Simonoff E, Charman T (2011) A multimodal approach to emotion recognition ability in autism spectrum disorders. J Psychol Psychiatry 52:275–285CrossRef

37.

de Bruin EI, Ferdinand RF, Meester S, de Nijs PF, Verheij F (2007) High rates of psychiatric co-morbidity in PDD-NOS. J Autism Dev Disord 37(5):877–886. doi:10.1007/s10803-006-0215-x PubMedCrossRef

38.

Baird G, Brown D, Simonoff E, Pickles A, Charman T (2008) No evidence for MMR-ASD link. Practitioner 252(1704):6PubMed

39.

Leyfer OT, Folstein SE, Bacalman S, Davis NO, Dinh E, Morgan J, Tager-Flusberg H, Lainhart JE (2006) Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord 36(7):849–861. doi:10.1007/s10803-006-0123-0 PubMedCrossRef

40.

Rommelse NN, Franke B, Geurts HM, Hartman CA, Buitelaar JK (2010) Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder. Eur Child Adolesc Psychiatry 19(3):281–295. doi:10.1007/s00787-010-0092-x PubMedCentralPubMedCrossRef

41.

Nijmeijer JS, Hoekstra PJ, Minderaa RB, Buitelaar JK, Altink ME, Buschgens CJ, Fliers EA, Rommelse NN, Sergeant JA, Hartman CA (2009) PDD symptoms in ADHD, an independent familial trait? J Abnorm Child Psychol 37(3):443–453. doi:10.1007/s10802-008-9282-0 PubMedCrossRef

42.

Corbett B, Glidden H (2000) Processing affective stimuli in children with attention-deficit/hyperactivity disorder. Child Neuropsychol: J Norm Abnorm Dev Child Adolesc 6(2):144–155. doi:10.1076/chin.6.2.144.7056 CrossRef

43.

Da Fonseca D, Seguier V, Santos A, Poinso F, Deruelle C (2009) Emotion understanding in children with ADHD. Child Psychiatry Hum Dev 40(1):111–121. doi:10.1007/s10578-008-0114-9 PubMedCrossRef

44.

Uekermann J, Kraemer M, Abdel-Hamid M, Schimmelmann BG, Hebebrand J, Daum I, Wiltfang J, Kis B (2010) Social cognition in attention-deficit/hyperactivity disorder (ADHD). Neurosci Biobehav Rev 34(5):734–743. doi:10.1016/j.neubiorev.2009.10.009 PubMedCrossRef

45.

Shapiro EG, Hughes SJ, August GJ, Bloomquist ML (1993) Processing of emotional information in children with attention-deficit hyperactivity disorder. Dev Neuropsychol 9(3–4):207–224. doi:10.1080/87565649309540553 CrossRef

46.

Van der Meer JMJ, Oerlemans AM, Van Steijn DJ, Lappenschaar MGA, De Sonneville LMJ, Buitelaar JK, Rommelse NNJ (2012) Are autism spectrum disorder and attention-deficit/hyperactivity disorder different manifestations of one overarching disorder? Cognitive and symptom evidence from a clinical and population-based sample. J Am Acad Child Adolesc Psychiatry 51(11):1160–1172PubMedCrossRef

47.

Berument SK, Rutter M, Lord C, Pickles A, Bailey A (1999) Autism screening questionnaire: diagnostic validity. Br J Psychiatry: J Mental Sci 175:444–451CrossRef

48.

Conners K (1996) Rating scales in ADHD. Duke University Medical Center, Durham

49.

Corsello C, Hus V, Pickles A, Risi S, Cook EH Jr, Leventhal BL, Lord C (2007) Between a ROC and a hard place: decision making and making decisions about using the SCQ. J Child Psychol Psychiatry 48(9):932–940. doi:10.1111/j.1469-7610.2007.01762.x PubMedCrossRef

50.

Eaves LC, Wingert HD, Ho HH, Mickelson EC (2006) Screening for autism spectrum disorders with the social communication questionnaire. J Dev Behav Pediatr 27(2 Suppl):S95–S103PubMedCrossRef

51.

van Steijn DJ, Richards JS, Oerlemans AM, de Ruiter SW, van Aken MA, Franke B, Buitelaar JK, Rommelse NN (2012) The co-occurrence of autism spectrum disorder and attention-deficit/hyperactivity disorder symptoms in parents of children with ASD or ASD with ADHD. J Child Psychol Psychiatry 53(9):954–963. doi:10.1111/j.1469-7610.2012.02556.x PubMedCrossRef

52.

Lord C, Rutter M, Le Couteur A (1994) Autism diagnostic interview-revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord 24(5):659–685PubMedCrossRef

53.

Taylor E, Sandberg S, Thorley G, Giles S (1991) The epidemiology of childhood hyperactivity. Oxford University, New York

54.

Rommelse NN, Oosterlaan J, Buitelaar J, Faraone SV, Sergeant JA (2007) Time reproduction in children with ADHD and their nonaffected siblings. J Am Acad Child Adolesc Psychiatry 46(5):582–590. doi:10.1097/CHI.0b013e3180335af7 PubMedCrossRef

55.

Brookes K, Xu X, Chen W, Zhou K, Neale B, Lowe N, Anney R, Franke B, Gill M, Ebstein R, Buitelaar J, Sham P, Campbell D, Knight J, Andreou P, Altink M, Arnold R, Boer F, Buschgens C, Butler L, Christiansen H, Feldman L, Fleischman K, Fliers E, Howe-Forbes R, Goldfarb A, Heise A, Gabriels I, Korn-Lubetzki I, Johansson L, Marco R, Medad S, Minderaa R, Mulas F, Muller U, Mulligan A, Rabin K, Rommelse N, Sethna V, Sorohan J, Uebel H, Psychogiou L, Weeks A, Barrett R, Craig I, Banaschewski T, Sonuga-Barke E, Eisenberg J, Kuntsi J, Manor I, McGuffin P, Miranda A, Oades RD, Plomin R, Roeyers H, Rothenberger A, Sergeant J, Steinhausen HC, Taylor E, Thompson M, Faraone SV, Asherson P (2006) The analysis of 51 genes in DSM-IV combined type attention deficit hyperactivity disorder: association signals in DRD4, DAT1 and 16 other genes. Mol Psychiatry 11(10):934–953. doi:10.1038/sj.mp.4001869 PubMedCrossRef

56.

Wechsler D (2002) WISC-III Handleiding. Psychological Corporation, London

57.

Groth-Marnat G (1997) Handbook of psychological assessment, 3rd edn. Wiley, New York

58.

De Sonneville LM, Verschoor CA, Njiokiktjien C, Op het Veld V, Toorenaar N, Vranken M (2002) Facial identity and facial emotions: speed, accuracy, and processing strategies in children and adults. J Clin Experiment Neuropsychol 24 (2):200–213. doi:10.1076/jcen.24.2.200.989

59.

Vingerhoets G, Berckmoes C, Stroobant N (2003) Cerebral hemodynamics during discrimination of prosodic and semantic emotion in speech studied by transcranial doppler ultrasonography. Neuropsychology 17(1):93–99PubMedCrossRef

60.

De Sonneville LMJ (2005) Amsterdamse Neuropsychologische Taken: wetenschappelijke en klinische toepassingen. Tijdschrift voor Neuropsychology 1:27–41

61.

De Sonneville LMJ (1999) Amsterdam neuropsychological task: a computer aided assessment program. In: Cognitive ergonomics, clinical assessment and computer-assisted learning: computers in psychology, vol 6. Swets and Zeitlinger, Lisse, The Netherlands, pp 204–217

62.

Norusis MJ (1992) Statistical package for the social sciences, SPSS/PC+. McGraw-Hill, New York

63.

Tabachnick BG, Fidell LS (2001) Using multivariate statistics, 4th edn. Allyn and Bacon, Needham Heights

64.

Aylward GP, Brager P, Harper DC (2002) Relations between visual and auditory continuous performance tests in a clinical population: a descriptive study. Dev Neuropsychol 21(3):285–303. doi:10.1207/S15326942DN2103_5 PubMedCrossRef

65.

Spencer MD, Holt RJ, Chura LR, Suckling J, Calder AJ, Bullmore ET, Baron-Cohen S (2011) A novel functional brain imaging endophenotype of autism: the neural response to facial expression of emotion. Trans Psychiatry 1:e19. doi:10.1038/tp.2011.18 CrossRef

66.

Kaiser MD, Hudac CM, Shultz S, Lee SM, Cheung C, Berken AM, Deen B, Pitskel NB, Sugrue DR, Voos AC, Saulnier CA, Ventola P, Wolf JM, Klin A, Vander Wyk BC, Pelphrey KA (2010) Neural signatures of autism. Proc Natl Acad Sci USA 107:21223–21228

67.

Hopkins IM, Gower MW, Perez TA, Smith DS, Amthor FR, Wimsatt FC, Biasini FJ (2011) Avatar assistant: improving social skills in students with an ASD through a computer-based intervention. J Autism Dev Disord 41(11):1543–1555. doi:10.1007/s10803-011-1179-z PubMedCrossRef

68.

Reichow B, Steiner AM, Volkmar F (2012) Social skills groups for people aged 6 to 21 with autism spectrum disorders (ASD). Cochrane Database Syst Rev 7:CD008511. doi:10.1002/14651858.CD008511.pub2

69.

Gadow KD, Devincent CJ, Drabick DA (2008) Oppositional defiant disorder as a clinical phenotype in children with autism spectrum disorder. J Autism Dev Disord 38(7):1302–1310. doi:10.1007/s10803-007-0516-8 PubMedCentralPubMedCrossRef

70.

Guttmann-Steinmetz S, Gadow KD, Devincent CJ (2009) Oppositional defiant and conduct disorder behaviors in boys with autism spectrum disorder with and without attention-deficit/hyperactivity disorder versus several comparison samples. J Autism Dev Disord 39(7):976–985. doi:10.1007/s10803-009-0706-7 PubMedCrossRef

71.

Cadesky EB, Mota VL, Schachar RJ (2000) Beyond words: how do children with ADHD and/or conduct problems process nonverbal information about affect? J Am Acad Child Adolesc Psychiatry 39(9):1160–1167. doi:10.1097/00004583-200009000-00016 PubMedCrossRef

Titel: Recognition of facial emotion and affective prosody in children with ASD (+ADHD) and their unaffected siblings
verfasst von: Anoek M. Oerlemans
Jolanda M. J. van der Meer
Daphne J. van Steijn
Saskia W. de Ruiter
Yvette G. E. de Bruijn
Leo M. J. de Sonneville
Jan K. Buitelaar
Nanda N. J. Rommelse
Publikationsdatum: 01.05.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Child & Adolescent Psychiatry / Ausgabe 5/2014
Print ISSN: 1018-8827
Elektronische ISSN: 1435-165X
DOI: https://doi.org/10.1007/s00787-013-0446-2

Neu im Fachgebiet Psychiatrie

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

23.04.2024 Depression antepartal oder postpartal Nachrichten

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2014

Parent–child hostility and child and adolescent depression symptoms: the direction of effects, role of genetic factors and gender

Problem coping skills, psychosocial adversities and mental health problems in children and adolescents as predictors of criminal outcomes in young adulthood

Translation gone awry: differences between commonsense and science

Comparison of clinical characteristics of bipolar and depressive disorders in Korean clinical sample of youth: a retrospective chart review