Illinois Medicine

of ChildhoodMental Disorders At the instruction of a technician in the neighboring control room, he participates in a series of games designed to test his ability both to respond to stimuli and to restrain that response. In one test, he's asked to press a button as quickly as possible when a dot appears on a screen. In another, he's instructed to identify whether the faces that appear for less than a second are male or female. Throughout these activities, the MRI takes thousands of digital A 10-YEAR-OLD BOY named Charlie lies in- side the circular mouth of a magnetic resonance imaging machine, look- ing up at a video screen above him. images of the flow of blood in Charlie's brain, which is perfectly healthy, showing which regions are activated as the boy performs his tasks. With his parents' consent, Charlie is volunteering in one of the many studies being conducted at the Pediatric Brain Research and Intervention Center to gain greater understanding of how children's brains function—and what's going wrong when they malfunction. Part of the Institute of Juvenile Research (see sidebar, page 20), which in turn is part of the University of Illinois at Chicago Department of Psychiatry, the BRAIN Center combines groundbreaking research in childhood mental illness with internationally recognized excellence in the treatment of these conditions. "We want to be delivering the best treatment for patients, and we want to make scientific discoveries that will improve those treatments," says the center's director, Mani Pavuluri, MD, PhD, associate professor of psychiatry at UIC. According to Pavuluri, 20 percent of children nationwide need mental health services for some form of mental disorder, divided about evenly between kids with mood disorders—that is, depression or bipolar disorder—and those with autism or attention deficit hyperactivity disor- der. These conditions can lead to devastat- ing consequences: A quarter of patients with mood disorders exhibit suicidal behavior, and half of them develop some form of substance abuse problem. Even when it's not life-threatening, the disruptive behavior driven by mental illness causes children to per- form poorly in school and have difficulty making and maintain- ing friendships, and it leaves parents at wit's end. In addition, chil- dren are stigmatized for behavior over which they have no control. "People will call them lazy, bad, as if they're not pulling them- The BRAIN Center is part of the century-old Institute of Juvenile Research, which is part of the University of Illinois at Chicago Department of Psychiatry. selves together intentionally, when they don't have the hardware to get up and go," says Pavuluri, whose personal experience taught her other- wise at an early age (see "Benefactors Share," page 22). "They're grossly misunderstood, and that could lead to the path of no treatment, or bad treatment. If you give stimulants to bipolar children, they get worse. If you give mood stabilizers for ADHD, the children get worse. People are overmedicating." To address these problems, the BRAIN Center is trying to make diagnosis and treatment for pediatric mental illness more scientifically rigorous. The center traces its origins to the Pediatric Mood Disorders Clinic at UIC, which Pavuluri founded in 2000. With funding from the National Institutes of Health, she added a research program in 2003. Today, the center encompasses the clinic and three research labo- ratories. It has a staff of 35, plus Illinois Medicine medical students, resi- dents, externs and fellows who are training there. With an annual budget of $2.8 million, the center is funded with $15 million in grants from the I L L INOI S MEDICINE | 19

• Cover