bluuebunny/crossref_metadata_2025 huggingface dataset:
P01-298-Psychiatric family treatment autisme (PFA) : A new concept from practice evidence to evidence based practice
Authors: Aerts C. , Teunisse J. , Veerman J. , Kroes G. , Huskens B.
Published: May 2011

Introduction

Autism Spectrum Disorder (ASD) determines to a large extent the lifestyle of the person and his environment; there are many problems for most of the family members. We developed the Psychiatric Family treatment for Autism (PFA) from practice evidence to evidence based practice.

Objectives

The PFA is a competence directed home-treatment for families with one or more persons with ASD. The focus is on the whole family and every family member. A family trainer works weekly at home at targets the family made.

Aims

To involve every family member to improve the individual and family problems.

Methods

Parent's practises, parent's personal well-being and their experiences of all their children's were measured before and after the PFA treatment. Also each child of the family about his competences. The instruments (VGFO, SCL-90, SDQ and CBS-A/K) are standardized and validated questionnaires. We measured the treatment integrity of the PFA by questionnaires and home observations.

Results

Also in our families with ASD there are a complexity of problems. The research shows is an overall improvement of the parental functioning and the parent's perception of their children's problems and the self esteem of the children. The mothers reported a progress in personal well-being The trainers have a high treatment integrity

Conclusion

Our concept that an integrated family treatment (PFA) has a spin-ff for the wellbeing of all the family members has been proved. We can discuss if PFA can be a prevention treatment for ASD family problems in the future.
P01-299-Behavioral characteristics of bullies, victims and bully/victims
Authors: Inoko K. , Aoki T. , Kodaira K. , Osawa M.
Published: May 2011

Introduction

Bulling is related with emotional and behavioral problems.

Objectives

To investigate the behavioral characteristics of pure bullies, pure victims, bully/victims, pure witness and children with no involvement.

Methods

Subjects were 112 children (6–13 years old). They completed questionnaire regarding acting the bully, being bullied and seeing someone bullied (Bully-victim-witness questionnaire). The questionnaire includes 5 psychological bully questions, 5 being bullied and 5 seeing bullies, respectively. Their parents completed the Child Behavior Checklist (CBCL).

Results

112 children were divided into pure bullies (n = 12), pure victims (n = 30), bully/victims (n = 40), pure witnesses (n = 9) and children who were not involved (n = 21). The figure shows the mean scores of CBCL of pure bullies, pure victims, bully/victims and pure witnesses. The mean CBCL (withdrawal, social problems, attention and aggression) scores of bully/victims were higher than other groups.

[Figure 1]

Conclusions

We have to pay attention to the behavior problems of bully/victims, and the children with behavioral problems should be concerned about bullying problems.
P01-301-Journey through an adolescent picu. three years on…
Authors: Jasti M. , Khan F. , Jacob G.
Published: May 2011

Introduction

The age of onset of mental health problems is becoming younger and the severity of illness presentation throws lots of challenges for health professionals and service providers. Currently there are only four recognised Psychiatric intensive care units in England.

Objectives

Little data is available regarding the characteristics of patients referred and treated in adolescentPICU's. This presents a challenge for clinicians and service providers for delivery of care for this patient group and developing care pathways. The main objective of this study to get a better understanding of the young people referred to help optimise care whilst in hospital and develop appropriate care pathwaysAimsThe study aims at identifying demographic, diagnostic characteristics and care pathways for young people admitted to an adolescent PICU.

Methods

A retrospective case note study was undertaken of all the patients admitted over three years since opening of the adolescent PICU at Cheadle Royal hospital.

Results

Data was collected from all the young people admitted to the ward between April 2007 and April 2010.Information regarding demographics including age of presentation, gender characteristics, ethnicity and area of referral were looked. The authors looked at the care pathways including reasons for referral, where admitted from, risk issues on admission, diagnostic criteria and discharge pathways.

Conclusion

This study has highlighted the widely held impression that there are still gaps in adolescent crisis provisions and the need for further acute interventions. The study highlights the challenges for service providers the current gaps in care pathways for young people with multiple diagnosis and lack of adequate crisis interventions in the community.
P01-302-Psychosomatics in children with cardiopathies
Authors: Kalinina M. , Fedorova Y.B.
Published: May 2011

Introduction

It is known the prevalence of mental pathology among patients with connective tissue disorders and functional cardiopathies essentially exceeds their prevalence in the general pediatric population.

Objectives

To study the clinic features of psychosomatic disorders in childhood in the cardiology clinic 26 children of 5–12 years with functional cardiopathies have been investigated.

Methods

Children were surveyed by psychopathological, neurological, pediatric methods. The clinical and biochemical blood tests, urine tests, ECG, ultrasonic cardiography, sono-encephalography, EEG were investigated.

Results

In a mental condition of children the neurotic frustration which plot was defined by cardiac complaints acted. They aroused in 52, 3% against schizotipical disorders, in 47, 7% accentuations of psychasthenic and dissociative type. In 15, 3% cases were detected transient psychotic episodes with fragmented polymorphic psychopathology. More than half of 26 children, had family history of social factors, were brought under partial maternal deprivation. Detect violations of lateralization, visual perception and information processing with weakness predominantly right-brain functions were revealed. In 92, 3% identified functional abnormalities of the structure of the heart (more trabeculae, patent foramen ovale) without hemodynamic instability.

Conclusions

Thus, the violations constitute one of the variants of psychosomatic disorders in children masquerading cardiac pathology. Further studies will clarify the more subtle mechanisms of marked pathology, but now there is no doubt that in creating it plays the role of a range of factors.
P01-305-Problems of mental health in children with hearing disorder
Authors: Karaush I.S.
Published: May 2011

Problem of mental health and personality development of persons with sensory disorders currently is of extraordinary relevance because it is associated with success of their social adaptation and integration into the society.

Objective of investigation

Study of level of mental health of children with hearing disorder.

Object of investigation

Schoolchildren of Tomsk Special (Correctional) General Boarding School № 15 of kind I, II where 165 children from 5 till 20 years study. At the moment 45 schoolchildren at the age of 10–20 years have been examined, from them 37 – hard-of-hearing (sensory-neural poor hearing of stage II- IV) and 8 deaf (sensory-neural deafness), consultations with parents have been conducted. 18 children are school leavers (16–20 years). All children have disability on basic disease.

Methods of investigation

Clinical, neuropsychological methods, Anxiety Scale SMAS, drawing tests, Luscher Test.

Results

Children are well adapted in stable, familiar for them conditions of the boarding school and try to cut themselves off thoughts about their own perspectives. Revealed abilities of mental status require psychological and psychotherapeutic correction, in some cases administration of medication. Absence of complaints may be conditioned by speech disorders against the background of the basic defect, disturbances of emotional-volitional sphere as one of the basic characteristics of delay of mental development.

Conclusion

Accessibility of education for deaf and heard-of-hearing children in the collectives of hearing ones supposes opposite moving of the society and children with hearing disorder, which interests should be represented by parents and specialists.
P01-306-Adhd, gender, and psychiatric comorbidity in a populaiton-based birth cohort
Authors: Yoshimasu K. , Barbaresi W.J. , Colligan R.C. , Killian J.M. , Voigt R.G. , Weaver A.L. , Katusic S.K.
Published: May 2011

Introduction

ADHD is frequently associated with comorbid psychiatric disorders. However, epidemiologic studies in the general population are rare.

Objective

To evaluate associations between ADHD and comorbid psychiatric disorders using research-identified incident ADHD cases and population-based controls.

Method

Subjects included a birth cohort of all children born 1976-1982 remaining in Rochester, MN after age five (n = 5718). Among them we identified 379 ADHD incident cases and 758 age-sex matched non-ADHD controls, passively followed to age 19. Through a systematic, multistaged process, utilizing detailed, routinely collected data, all psychiatric diagnoses confirmed by medical professionals were identified (n = 314 ADHD cases, n = 712 controls with research authorization). For each psychiatric disorder, cumulative incidence rates for subjects with and without ADHD were calculated; corresponding hazard ratios (HR) adjusted for sex, mothers age/education, were estimated using a Cox model. Associations between ADHD status and Internalizing-Externalizing dimensions were estimated using odds ratios (OR).

Results

ADHD was associated with significantly increased risk for adjustment disorders (HR = 3.82), conduct disorder/oppositional defiant disorder (HR = 9.45), mood disorders (HR = 3.57), anxiety disorders (HR = 2.95), tic disorders (HR = 6.41), eating disorders (HR = 5.52), personality disorders (HR = 5.49), and substance-related disorders (HR = 4.04). When psychiatric comorbidities were classified on the Internalizing-Externalizing dimension, ADHD was strongly associated with coexisting internalizing/externalizing (OR = 10.6, vs none), and externalizing-only (OR = 10.0), disorders. No significant gender x ADHD interactions were observed.

Conclusion

This population-based study confirms that children with ADHD are at significant risk for co-morbid psychiatric disorders. Besides treating the ADHD, clinicians should assess and monitor potential psychiatric comorbidities in children with ADHD.
P01-307-Emotional self-awareness: preliminary analyses of a rct using a cellular phone self-monitoring program (mobiletype) to decrease early symptoms of depression
Authors: Kauer S. , Reid S. , Patton G. , Jackson H. , Jorm A.
Published: May 2011

Background

Behavioural therapy often involves self-monitoring techniques to increase awareness about mood and stressful events. In turn, emotional self-awareness is likely to decrease symptoms of depression. Self monitoring also has potential as an early intervention tool for young people, particularly when mobile phones are used as a medium. Previous qualitative research indicates that self-monitoring via mobile phones increase emotional self-awareness with five categories proposed: awareness, identification, communication, contextualisation and decision-making.

Aims

This RCT investigates the relationships between self-monitoring, emotional self-awareness and depression using an early intervention mobile phone self-monitoring tool with young people at risk of developing depression.

Methods

Young people (between 14 and 24 years of age) identified by their GP as being at risk of depression were recruited by GPs in rural and metropolitan Victoria and randomly assigned to either the intervention group (where they monitored their mood, stress and daily activities) or the comparison group (where the questions about mood and stress were excluded). Participants completed baseline and follow-up measures of depression as well as measures of emotional self-awareness.

Results

Results will be presented on the effects of self-monitoring on emotional self-awareness, the effects of self-monitoring on depression, anxiety and stress and the relationship between emotional self-awareness and depression, anxiety and stress.

Conclusion

Emotional self-awareness as a mediator in the relationship between self-monitoring and depression will be discussed focusing on the relationships between

(i)

self-monitoring,

(ii)

emotional self-awareness and

(iii)

symptoms of depression, anxiety and stress.

Possible avenues for early intervention are suggested.
P01-308-Pervasive developmental disorders and inpatient admission in adolescents: Psychiatric co-morbidity and challenges in clinical and community interventions
Authors: Khan F.
Published: May 2011

Introduction

Co-morbidity is to be expected in autistic spectrum disorders directly or indirectly (1). 65% of children and adolescents with Asperger's suffer from an additional psychiatric disorder (2). Misdiagnosis or delayed diagnosis is a serious problem, and the average age at diagnosis of Aspergers is several years later than for autism (3).

A small yet significant number of offenders with autism who engage in illegal behaviour find themselves socially excluded or detained in secure provisions for prolonged periods(4).

Aims

Wider understanding of factors leading to inpatient admission in young people with Pervasive developmental disorder.

Early detection and management of mental disorder and risks, in order to meet complex needs in community.

Objectives

Innovative and comprehensive assessment of mental health, psychological and social needs.

Risk assessment and management shared by multidisciplinary team and Community teams.

Method

Retrospective case notes study of 11 patients admitted over 2 years.

Results

81.8% presented with risk to others.54.5% had diagnosis of ASD on admission. 36.3% had forensic history. Average age of diagnosis was 14 years. 18.1%were misdiagnosed.

Conclusion

The review confirms that misdiagnosis and delayed diagnosis remains a problem. Also co-morbid substance misuse and risk taking behaviour get admitted to secure inpatient units. Inpatient assessment can in significant number of cases divert trajectory away from criminal justice system.
P01-309-The effects of the triple p- positive parenting program to on school-age children with adhd
Authors: Khodabakhshi Koolaee A. , Shahi A.
Published: May 2011

Introduction

Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood affecting approximately 3—5% of school age children (American Psychiatric Association). Some parent training in AD/HD is known to reduce external behaviors in theses children. One of them is Triple P (Sanders, 1999).

Aims

The goal of this study was to examine the effectiveness of the group positive parenting program (Triple p) on reduce to externalizing behaviors of children with Attention Deficit/Hyperactivity Disorder (ADHD) in Iranian families.

Methods

Randomized controlled trial in Iran with 22 mothers of children with AD/HD, of whom 10 received program, 12 group control. For carried out this research, authors were design the intervention program. The methodology of this study was quasi- experimental design with control group. Data were collected by child behavior checklist (CBCL) that reported by parents.

Findings

Results indicated that children's externalizing behaviors significantly reduced after training in triple p group.

Conclusion

Triple p- positive parenting program could be applied with pharmacotherapy as a supplement treatment in reduce and control of disruptive behaviors of children with ADHD.
Obesity in children with high-function autism
Authors: Kordi R. , Memari A.H.
Published: May 2011

Introduction

Childhood obesity is a major issue and puts children at risk of physical and psychological health complications. Some studies have evaluated obesity in autism in different countries. However there is few data on the rate of obesity in high-function autism (HFA).

Aim

To evaluate the weight status of children with HFA in Iran

Methods

This cross-sectional survey was carried out in autism specific schools of Tehran in 2010. In total 113 children with HFA ages 6–15 were evaluated. They were classified according to WHO references (2007) for body mass index (BMI) for age and sex as obese, overweight, healthy weight and underweight. We then examined the associations of weight status of these children with some variables and comorbodities.

Results

The prevalence of obesity in children with HFA was 27.0%, overweight 13.0% and underweight 7.0%. There was a significant correlation between age and BMI (r = 0.26, Pvalue < 0.01). Underweight was associated with neurologic comorbidities (p < 0.05). The rate of obesity has not correlated with some other medical and psychiatric comorbidities, as well as sex, and parents’ weight status.

Conclusions

Prevalence of obesity in autistic children with high intelligence profile is high and at the same levels of both normal children and children with autistic spectrum disorders.
Clinical results of a scientific medical association - therapeutic center (A.P.P.A.C.) during the last two years (2007 – 2009)
Authors: Kouros J. , Kotta D. , Tsochandari R.
Published: May 2011

Introduction

The A.P.P.A.C. has created, through years, a significant data base of clinical results derived from the systematic approach of a wide range of psychiatric diseases. The aim of this study was to evaluate the current state of psychiatric diseases and associated parameters with social impact.

Method

Data was obtained from the Association of Psychology & Psychiatry for Adults & Children (A.P.P.A.C.) from January 2007 until December 2009. A sample N = 219 patients has been studied during the last 2 years. The mean age of patients was 35 years. Statistic analysis is based on z-criterion as well as X2-test.

Results

P-values of 0.05 were considered to be statistically significant. 20% of the patients were diagnosed with 2 psychiatric diseases, 70% of widowers have been suffered from depression. 37,84% of patients with depression have hereditary predisposition. Therapeutic interventions to patients were made using psychotherapy, medication or both. The analogy of psychotherapy to medication is almost 1:2, while in 18.75% of the patients, who needed drug treatment, psychotherapy was mandatory. Finally, our study indicated that sex (females versus males) and hereditary predisposition are significant factors for depression in comparison to other psychiatric diseases.
Signs of nutrition in ADHD children
Authors: Kuzelova H. , Ptacek R. , Papezova H.
Published: May 2011

According to current studies and clinical practice ADHD children show probable changes in growth and development, mainly in signs of nutrition. ADHD can be associated with higher predisposition to obesity, higher values of signs of nutrition, as body mass index or higher value of fat. Growth and weight changes in ADHD children are usually described in connection to stimulants use, the most common medication of the disorder. However, present research confirmed that these changes could be more typical for the disorder than for the treatment. These characteristics are considered to be directly connected with the disorder.

The presented study compared anthropometric characteristics - mainly signs of nutrition - skin folds, abdominal circumference, in medicated and non-medicated ADHD boys (n = 104, age 4–16 years) with the normal non-clinical population. The results of the presented study showed significant differences between children with ADHD and those without the diagnosis. The differences found to be statistically significant (p < 0.01) being signs of nutrition (percentage of fat, abdominal circumference) and also growth suppression (lower body height). Differences between the medicated and non-medicated groups corresponded only to a lower value of body fat in the medicated children.

ADHD can higher values of nutrition signs (percentage of fat, abdominal circumference, BMI, weight) in comparison to normal population. It could be caused by specific feeding customs which should be monitored in further studies.
Safety and tolerability of aripiprazole in the treatment of irritability associated with autistic disorder in pediatric patients: Results from a 52-week open-label study
Authors: Landsberg W. , Loze J.-Y. , Lau G. , Manos G. , McQuade R. , Kamen L. , Marcus R. , Mankoski R.
Published: May 2011

Objective

Evaluate the time-course, severity and resolution patterns of adverse events (AEs) occurring with long-term aripiprazole treatment for irritability associated with autistic disorder.

Methods

Participants were treated with aripiprazole in a 52-week, open-label, flexibly dosed (2–15 mg/day) study. Subjects had either completed one of two 8-week randomised trials or were de novo. AEs with an incidence of ≥10% were evaluated by incidence, peak first onset, severity, percent resolved and time to resolution.

Results

A total of 330 subjects entered open-label treatment; 199 completed 52 weeks. Mean dose for the population stabilised at around 10 mg/day after approximately 4 months. Thirteen AEs had an incidence of ≥10%; most were mild or moderate in severity. Vomiting, diarrhoea and headache had an early first onset and tended to resolve fairly quickly.

Sedation, fatigue and insomnia also appeared early and resolved in a majority of cases, but not as quickly. Increased appetite appeared early (followed by increased weight) and fewer weight-related AEs resolved. More than half of the subjects increased their weight by at least one percentile category rank; nevertheless, only a small proportion of subjects with normal baseline metabolic or glucose measures had a treatment-emergent, clinically relevant laboratory abnormality. Nasopharyngitis, upper respiratory infection, cough, nasal congestion and pyrexia all had peak onset at variable times during the study, resolving in nearly all cases, with short time to resolution.

Conclusion

AEs were mostly mild or moderate and of variable duration. Increased weight was observed.
Therapeutic effect of risperidona inyetable of long evolution in teenagers
Authors: López Marco D. , Consuegra Sánchez R. , Mártinez Pérez I. , Gómez Poveda A.
Published: May 2011

The pharmacological treatment with oral Risperidona is used for years in infanto-juvenile psychiatry. In many occasions difficulty exists for the fulfillment; well for the appearance of adverse effects or for rejection to the capture or for difficulty of familiar fulfillment.

Aims

To expose from the clinical and welfare expectation, the experience with injectable Risperidona of long duration with three cases clinical whose principal diagnosis is of Mental Delay Moderated with alteration of the associate behavior.

Material and methods

I marry 1: 14-year-old Teenager of age attended in our CSM for Mental Delay and Disorder of conduct to familiar and school level.

CI = 50. It has received diverse antipsychotic and stabilizing treatments of oral form being the discontinuous capture. For one year in treatment with injectable Risperidona 50 mgr/14 days, answering favorably to the treatment, diminishing the conducts heteroagresivas that he was presenting to the beginning.

I marry 2: 15-year-old Teenager of age late Mental and disorder of the disturbing behavior with episodes d excitation, irritability and loss of control.

Not clinical stabilization with oral treatment for lack of familiar adherence. We introduce injectable Risperidona, 7,5 mgr/14 days, pupil to the family to mint of the importance of the treatment and the facility of administration. It improved the adherence to the center and therefore, clinical improvement.

I marry 3: Preadolescente and 13 years and age with compatible symptoms late Mental Moderates do and autistic features with important estereotipias and autoaggressions. For a few months in treatment with Risperidona inyecable 37,5 mgr/14 days with clinical improvement.
Functional change of the auditory cortex related to brain serotonergic neurotransmission in type 1 diabetic adolescents with and without depression
Authors: Manjarrez G. , Herrera R. , Manjarrez J. , Mejenes S. , Hernandez-R J.
Published: May 2011

Objective

The aim of this study was to determine whether diabetic patients who were depressed present a decrease of brain serotonergic activity compared to diabetic patients without depression or patients with depression but without diabetes. Determination was made with plasma free fraction of l-tryptophan (FFT) and intensity-dependent auditory-evoked potentials (IDAEPs).

Methods

Thirty seven adolescents were studied (20 type 1 diabetic subjects: 9 with depression, 11 without depression), 9 controls and 8 subjects with only depression. FFT, glucose, glycated hemoglobin, free fatty acids, albumin and IDAEPs were determined.

Result

All diabetic patients showed a significant decrease of FFT. The group diabetic subjects with depression presented a steeper slope of the amplitude-intensity function of N1/P2 component, suggesting a higher reactivity of the auditory cortex in comparison to diabetic subjects without depression, subjects with only depression, and controls. This was associated with lower plasma FFT. Diabetic subjects with depression had a deficiency of metabolic control due to poor treatment adherence.

Conclusions

These findings suggest an enhanced deterioration of brain serotonergic neurotransmission in diabetic subjects with depression with abnormal responses of the auditory cortex. The N1/P2 component of IDAEP is proposed as a noninvasive indicator of brain serotonergic tone that differentiates depressed from nondepressed diabetic patients.
Use of atypical antipsychotics in early onset schizophrenia
Authors: Marin Mayor M. , Martinez Martin N. , Verdura Vizcaino E. , Codesal Julian R.A.
Published: May 2011

Introduction

Childhood or Early Onset Schizophrenia (EOS), defined as the onset of psychotic symptoms before the thirteenth birthday, represents a rare, clinically severe variant, associated with significant chronic functional impairment and poor response to antipsychotic treatment. Despite of that, in clinical practice, atypical agents have become the treatment of choice in patients with EOS.

Aims

To review the different pharmacological strategies, in which an atypical antipsychotic was used in the management of EOS in childhood and adolescence.

Methods

We conducted a literature search of articles related to the use of atypical antipsychotics in children and adolescents with EOS in the last 20 years from the Medline database.

Results

Several atypical antipsychotics, such as Risperidone, Olanzapine, Quetiapine, Aripiprazol and Clozapine were consistently found to reduce the severity of psychotic symptoms in EOS when compared to placebo. Although Clozapine has demonstrated to be more efficacious than other atypical and typical antipsychotics, it remains the medication of last resort due to its profile of side effects. Finally, in general, children and adolescent have a higher risk of extrapyramidal symptoms, akathisia, prolactin elevation, sedation and metabolic effects of atypical antipsychotics than adults.

Conclusions

Antipsychotics are the mainstay of treatment of EOS. Randomized controlled trials suggest a trend to superior efficacy for atypical antipsychotics over classic antipsychotic. Children and adolescents trend to be more sensible to antipsychotic side effects. Clinicians should be aware of this problem and be careful when monitoring this type of treatment.
Diabetes type 1 and eating disturbances among child and adolescents
Authors: Marin Mayor M. , Codesal Julian R.A. , Fernandez I. , Verdura Vizcaino E. , Martinez Martin N. , Espin Jaime J.C.
Published: May 2011

Introduction

Disturbed eating behaviors are a significant health concern among child and adolescents with type 1 diabetes mellitus (DM1) and are generally related to poor glycemic control, ketoacidosis, hospitalization and microvascular complications. Rates of eating problems among youths with DM1 have been reported to be as high as 38%.

Aims

To review clinical characteristics, demographic profiles and risk factors for the development of eating disturbances among child and adolescents with DM1.

Methods

We performed a literature research of articles from 1980 until present, in which a Disturbed Eating Behavior appeared comorbid with DM1 in children and adolescents, using Medline database.

Results

Almost all studies selected report a high prevalence of eating disturbances of child and adolescents with DM1 when compared with healthy pairs. This population trend to develop body image discontent and lower self-esteem. They are more likely to diet, skip meals, and omit insulin. All these practices have been associated with worsening diabetic medical complications and poorer psychological outcome.

Conclusions

Due to the high prevalence and severe medical and psychological complications associated with disturbed eating behaviors among pediatric population with DM1, clinicians and school professionals may benefit from specialized training to identify the range of unhealthy weight control behaviors used by youths with DM1. Preventive programs that address disturbed eating behaviors should be provided for adolescents with DM1 in order to reduce the psychological and medical impact of this comorbid situation.
Prevalence of behavioral and emotional problems in children at-risk for learning difficulties
Authors: Mehrotra K. , Ahamad Manzur S. , Ooi Y.P. , Lim C.G. , Fung D.S.S. , Ang R.P.
Published: May 2011

Introduction

Studies have shown that children with learning difficulties are likely to demonstrate a host of shared behavioral and emotional problems that affect their daily functioning.

Objectives/Aims

The goal of this study was to examine profiles of behavioral and emotional problems in children at risk for Learning Disorders (LD) and Communication Disorders (COMM), without intellectual disabilities.

Method

Data on the Child Behavior Checklist (CBCL) of 52 participants (4–12 years old) at-risk for LD and 52 age- and gender- matched participants at-risk for COMM were obtained from the archival records of a local outpatient child psychiatric clinic. For all CBCL scales, T scores ranging from 65 to 69 are in the borderline clinical range, whereas a T score of 70 and above are in the clinical range. T scores of below 65 are considered as non-clinical. For the purposes of this study, a T score of 65 and above for the CBCL syndromes indicated the problem to be of clinical concern.

Results

A total of 51.9% of these children had at least one problem of clinical concern, with Attention Problems (LD: 36.5% vs. COMM: 17.3%), Social Problems (LD: 21.2% vs. COMM: 30.8%), and Withdrawn/Depressed (LD: 23.1% vs. COMM: 26.9%) syndromes being commonly reported. There were no significant differences between the 2 groups on the CBCL syndromes.

Conclusions

Findings from the study suggest that children with any form of learning difficulties demonstrate high prevalence of behavioral and emotional problems, suggesting possible comorbidities such as Attention Deficit Hyperactivity and Depression.
What about pseudologia fantastica?
Authors: Mesquita J. , Queirós O. , Silva L.
Published: May 2011

Introduction

Pseudologia Fantastica (PF) is an understudied and poorly understood entity, first described by a German psychiatrist in the late 19th century. The terms mythomania and pathological lying are often used interchangeably.

Objectives

In addition to reviewing the literature around PF and its place nowadays in the current diagnostic system, we report the case of an adolescent female who suffered from PF.

Methods

We describe and analyse a clinical case of PF and make a bibliographic review about this disorder.

Results

Typically, PF has its onset during adolescence and the clinical picture is often very uniform. The central features include a marked tendency to lie that is both quantitatively and qualitatively quite distinct from “normal” lying. Instead of being a goal-directed lie, pseudology lacks an obvious motive and is often more associated with internal motives, which can constitute some kind of gratification on their own.

The only diagnosis available in our current diagnosis system that accounts for prominent purposeless deception is the Axis I Factious Disorder diagnosis. Despite this, some Personality Disorders should always be considered as possible comorbidity of PF.

Conclusions

While cases of PF are thought to be quite rare overall, they have been documented all over the world. There is the need for further case studies and reviews to be published on this issue in order to determine whether PF should be better understood on Axis I or Axis II of our diagnostic system. Greater awareness of its medical, social and legal consequences is mandatory.
Diagnostic criteria and the time of triadic impairment occurrence in autism
Authors: Milacic Vidojevic I. , Dragojevic N.
Published: May 2011

Aim

Early diagnosing of autism is supposed to rely on behavioral patterns that cannot all be manifested in children before older age. It seems that all diagnostic criteria from DSM/IV and ICD/10 do not apply for children under two years of age and are relevant only for children above this age. The aim of our research has been to reveal the timing of occurrence of diagnostically relevant behaviors as noticed by parents of autistic children.

Method

The sample consisted of 105 parents of autistic children. Questionnaire for appraising the behavioral abnormalities of autistic children provided information on the parents estimation at what age their children started to show these abnormalities.

Results

Deficit in social interactions is first to be noticed by parents (at the child's age of 13–37 months). Problems in communication occur later, at age 18.8–49.5 months. Stereotypic behaviors and interests occur at age of 20.2–34.8 months, the most common being: “plays with toys in an unusual way” (90.6%), and “unusual moving of arms” (80%), observed at age of 2–3.

Conclusion

The most common parents concern are language difficulties, never mind findings that social deficits are observed first (13–37 months). Diagnostic criteria in psychiatric manuals such as ICD-10 or DSM-IV pay little attention to early manifestations of the disturbance. It seems that accurate diagnosis of autism only exceptionally can be made before age 3–4, mostly because diagnostically relevant behaviors do not occur before that age.
The impact of the efficacy and the safety warnings of antidepressants in the treatment of childhood depression. Changes in patterns of use and scientific evidences
Authors: Palanca Maresca I. , Fernández Mayo L. , Morant Ginestar C.
Published: May 2011

Introduction

Childhood depression is a cause of substantial morbidity and mortality in this population. Although antidepressants are used frequently for the treatment of this disorder, there has been recent controversy about their efficacy and safety in this population.

Objective

Providing updated information from the scientific point of view on some burning issues in relation to the prescription of antidepressants in childhood depression.

Methods

It has been made a review of the recent studies which have been published about the safety and efficacy of antidepressants, and the consequences of the warnings given by Regulatory Agencies on health care professionals to prescribe antidepressants for children.

Results

Impact of Safety Warnings: there has been a decrease in prescribing antidepressants and an increased suicide in this population since the FDA and EMA warnings announced an increased risk of suicide with pediatric antidepressant agents versus placebo. This is not possible to extract it because of causal relations. Effectiveness: nine of the sixteen controlled trials published between 1990 and 2010 provide evidence of effectiveness versus placebo in the treatment of major depressive disorder (MDD) in pediatric population (three for fluoxetine, two for sertraline, one for citalopram, two for escitalopram, and one for venlafaxine).

Conclusions

The antidepressant studies in children and adolescents have significant and methodological limitations that prevent getting conclusive findings. It is required further studies to determine which subgroups of patients and what drugs there have a risk / benefit ratio favorable, because no treatment can lead to serious damage in depressed children and adolescents.
P01-330-Case report of an adolescent psychotic patient
Authors: Koukoulas G. , Voura N. , Papanikolaou K. , Darai N. , Roboti P. , Angelidis G.F.
Published: May 2011

Introduction

5% of adults with schizophrenia report onset of psychosis before the age of 15. Despite the lack of precise incidence and prevalence rates from childhood or adolescent population-based studies, it is generally agreed that the prevalence of psychotic disorders increases markedly during adolescence.

The aim of this presentation is to demonstrate a case of an adolescent with psychosis and mild mental retardation.

Method/material

The material used comes from the archives of the Child/Adolescent Clinic of the CMHC.

Discussion/results

A 12-year-old boy was referred to the Child/Adolescent Clinic. He presented unwelcome repeated actions, (repeated opening/closing his books, allocating/reallocating things, sitting/re-sitting on the chair). He complained about auditory hallucinations (children talking/laughing ‘in his head’). He also presented self-destructive behavior (‘when I am angry I bang my head against the wall’). He was irritable, aggressive towards other children, with impulsive behavior. He had troubles understanding Greek language since he was from Russian origin.

From his history, both his father and grandfather were referred to suffer from mental disorder.

He was administered WISC and Rorschach tests. His intelligence quotient score was below 70 and the Rorschach test confirmed paranoid schizophrenic symptoms. Hospitalization was suggested but immediately rejected by his mother.

Risperidone was initiated (1 mg/day-1,5 mg/day). Soon, the symptoms began to be restricted. He began to be more concentrated, functional and sociable. 2 years after the initiation of risperidone, the patient's situation is stable (0,5 mg/day), appearing better mood.

Conclusion

Monotherapy with risperidone seems to provide significant levels of symptomatic improvement in young psychotic patients.
P01-332-Successful treatment of 23 patients with tourette syndrome with escalating doses of olanzapine + citalopram + high dose vitamin B6
Authors: Pirkalani K.K. , Talaee Rad Z.
Published: May 2011

Objective

To find more effective combinations for resistant and refractory tic disorders and to evaluate scheduled escalation of three drugs including high dose Vitamin B6 in psychiatric patients.

Methods

Twenty three adult patients (20 male, 3 female) with resistant Tourette syndrome were enrolled to this trial. They showed non compliance to different previous regimens including classic antipsychotics and newer dopamine/serotonin receptor antagonists. Mean age was 27yrs, global social functioning was impaired in all and substantially in 50%. Major depression and anxiety were encountered in 78 and 69% respectively as studied by way of MCMI-III and Hamilton.

Results

After six weeks, twenty patients improved substantially with 80–90% reduction of abnormal movements as judged by the physician in charge and first degree relatives. Depression and anxiety also improved by at least 60% and global functioning improved much as patients felt better in work, social activities, parties and relation to the opposite sex. Maximal tolerated dose of the three drugs were 12.5, 40 and 400 mg respectively. Three patients exhibited extra pyramidal signs that responded to addition of Biperiden and 10 showed some numbness and dysphoria some times during treatment for which the doses were reduced. Most patients could maintain good functioning at lower doses of 5–7.5, 20 and 240 mg or less respectively.

Conclusion

We conclude that this combination in addition to scheduled escalation is extremely effective with enough compliance. Scheduled escalation causes better patients commitment as the drug increments planned and a necessity of treatment and not merely due to refractory disease.
P01-333-Autism and epilepsy in a paediatric liaison unit – A brief review
Authors: Vilela L. , Silva F. , Portinha I. , Correia Z.
Published: May 2011

Introduction

Autism is a behavioural phenotype of unknown aetiology characterized by social and communication deficits and the presence of restricted interests/repetitive behaviours. The prevalence of epilepsy is increased but variable in children with autism. Epidemiological data suggests that 10–30% of patients with autism have the diagnosis of epilepsy. All seizure types can be associated with autism. There are several different studied risk factors for epilepsy prevalence in patients with autism: age, gender, cognitive level, type of language disorder and co-morbid medical conditions. It is speculated by some authors the possibility of common pathophysiological mechanisms between some clinical and subclinical epilepsy and autism. The diagnosis of seizures in autistic children can be difficult since behavioural abnormalities seen in complex partial and absence seizures can be due to autism itself.

Aims and objectives

The authors intend to briefly review the association between autism and clinical epilepsy illustrated by 3 clinical vignettes of children followed in a Paediatric Liaison Unit.

Methods

Review of clinical files and relevant published literature.

Results and conclusions

There isn’t sufficient data helping clinicians to predict which children will develop epilepsy. The treatment is not substantially different from other cases of epilepsy, however, doesn’t seem to have a major impact on the autism symptomatology. Although there is controversy in the literature concerning the association between autism and epilepsy (“direct cause and effect” “association” or an “epiphenomenon”), the latter should be routinely screened in autism patients.
P01-334-Investigation the role of mother's parenting styles on locus of control and self – concept of children
Authors: Pourabdolisardroud M.
Published: May 2011

Introduction&Objectives

The present study investigated the relationship between mother's attitudes towards child rearing practices with child perception of those styles, locus of control and self – concept.

Method

The sample consisted of 388 third grade males in the junior high school students and their literate were selected from five educational districts who completed the Parental Authority Questionnaire, the Parenting Style Survey, the Nowicki – Strickland Locus of Control Scale and Tennessee Self- concept Test. The data were analyzed using Pearson correlation formula and Anova.

Results

The findings of the study are so follow: The relationship between mother's attitude toward child rearing practice and child's perception of those styles was not statistically significant. The relationship between mother's attitude toward child rearing practice, child locus of control and self-concept were not significant, but the relationship between child's perception of their mother's parenting style, child's locus of control and self-concept were statistically significant. The relationship between locus of control and self-concept was also statistically significant.
P01-335-Stress and trauma in children in foster and institutional care
Authors: Ptacek R. , Kuzelova H. , Celedova L. , Cevela R.
Published: May 2011

Current studies show that individuals who were in foster or institutional care experience higher rates of physical and psychiatric morbidity than the general population. Children in foster care have a higher probability of having Attention Deficit Hyperactivity Disorder, and deficits in executive functioning, anxiety as well other developmental problems. These children experience higher degrees of incarceration, poverty, homelessness, and suicide.

Recent studies show alarming occurrence of trauma and high stress load in children in institutional but as well as foster care.

We have conducted an extensive study (n = 360) monitoring occurrence of trauma in history of children in foster care (n = 120), in institutional care (n = 120) and in functional biological families (n = 120). We have also evaluated levels of social emotional development and occurrence of child psychopathology.

The results of the presented study showed that children in institutional and foster care show substantially higher occurrence of trauma in their history, higher incidence of reactive psychopathology (i.e. depression) and their level of social emotional development is substantially lower comparing to children from functional biological families (p < 0.01).

The study proposes that children in foster and institutional care require substantial psychosocial support and attention.

SUPPORTED BY THE RESEARCH GRANT GK MPSV-01-202.
P01-336-Social and emotional loneliness in children in foster and institutional care
Authors: Ptacek R. , Kuzelova H. , Celedova L.
Published: May 2011

Social and emotional loneliness represent a serious factor in etiology of psychiatric and somatic disorders. Current studies show that individuals suffering from severe social and emotional loneliness in their childhood may show substantial deficits in cognitive as well as in emotional development. It is supposed that children in foster care or institutional care may be exposed to higher level of social or emotional loneliness and thus show changes in cognitive and emotional development, that may play role in further life as well as in etiology of mental illnesses.

We have conducted an extensive study (n = 360) monitoring occurrence of social and emotional loneliness in children in foster care (n = 120), in institutional care (n = 120) and in functional biological families (n = 120). We have also evaluated the stage of cognitive and emotional development.

The results of the presented study showed that children in institutional and foster care show substantially higher occurrence of serious level of social and emotional development – comparing to children from biological families (p, 0.01). The intensity of social and emotional loneliness is in negative correlation with cognitive (r = 0, 6; p < 0.01) as well as with emotional development (r = 0, 7; p < 0.01).

The results of study propose that children in foster and institutional care require substantial psychosocial support and attention especially in the area of social and emotional development.
P01-337-The children living in orphanages in kashmir: an exploration of their nurture, nature and needs
Authors: Rather Y.
Published: May 2011

Introduction

One of the only few options available for rehabilitation of orphans in eastern societies is orphanage rearing. A lot many factors, however, go into determining the level of cognitive, behavioral and emotional development of children in these institutions.

Objectives

A study was conducted on four major orphanages located in Srinagar city, to assess the existing differences in available facilities and their impact on the psychological adjustment of these children.

Methods

The UCLA loneliness scale was used to assess levels of loneliness, an indicator of psychological distress, among the resident children.

Results

High scores were associated with adverse living conditions, like poor residential setup, rigid timetables, poor recreation facilities, poor nutrition and lack of modern educational facilities.

Conclusions

These facts could prove seminal in planning for better rehabilitation modules for orphans, especially in the wake of their exponential increase in the chronic conflict and disaster affected regions.