bluuebunny/crossref_metadata_2025 huggingface dataset:
P01-338-The family- predisposal, precipitant, maintaining or protection factor in schizoaffective disorder
Authors: Rauca I. , Ardelean L. , Turcu A.-M. , Andreica B.
Published: May 2011

Each person is part of a whole, a complex emotional unit (the family) and any change in a part of a family system influence the individual.

The paper aim is to present an assessment of family functioning in patients diagnosed with Schizoaffective Disorder admitted for treatment in Child and Adolescent Psychiatry Department Cluj-Napoca between 2009–2010, and to estimate how the model of family functioning influence the onset and the evolution of the disease.

We followed the identification of existing borders in the family, coalitions, rules, roles, taboo subjects, resources, expressed emotions (EE) in families taken in the study, positive remarks to the patient and warmth.

Expressed emotion (EE) refers to a construct encompassing several key aspects of close interpersonal relationships. It reflects critical, hostile or emotionally overinvolved attitudes on the part of a family member toward a relative with a disorder or impairment.

The studied families were shown to be heterogeneous in terms of structure, rules and roles assigned to the patients within the family, which has hampered the expression of general conclusions. However, the study revealed that the positive family involvement correlate with improvement in social functioning, while criticism and hostility are factors for relapse.
P01-341-Socialization aspects in children with stuttering
Authors: Samochis L. , Lazar S. , Andreica B. , Iftene F.
Published: May 2011

Stuttering, as a communication disorder, is a field of great interest, with many hypothesis regarding its nature and appropriate treatment. Many studies tried to emphasize the bond between stuttering and anxiety. Frequently, stuttering is associated with strong emotional reaction, as anxiety, emphasized by negative consequences of “not being able to talk accurately”. This turns in avoidance of speak and social problems as school difficulties.

The aim of this study is anxiety evaluation in children with stuttering through specialized psychological intervention.

We applied MASC (Multidimensional Anxiety Scale for Children) and CDI (Child Depression Inventory) to 20 children diagnosed with stuttering, aged 6–16, from Cluj -Napoca, both at the beginning and at the end of the study. Psychological intervention consisted of two evaluation sessions (one with the parent and one with the child) and ten group sessions (psychodrama and cognitive-behavioral techniques).

The results showed a significant decrease of anxiety (p < 0.05), and no difference in depression symptoms (for statistical data we used SPSS 16.0 Program).
P01-342-Almost autism
Authors: Perlov J. , Sawyer A.
Published: May 2011

Introduction

The hallmark social deficits of ASD are:

1.

Poor eye contact

2.

Limited emotional, facial and voice expression

3.

Deficits in joint attention including deficits in showing and seeking recognition

4.

Deficits in mutual enjoyment

5.

Deficits in reading body language

These social deficits can be difficult to identify and to define even by trained clinicians, especially when there are multiple diagnoses, and other psychiatric disorders may have/mimic these social deficits.

Some of the social deficits characteristic of an ASD are found in conditions that are not ASD. The social deficits found in some children with ADHD are amplfied when the ADHD is co-morbid with Social Anxiety disorders, Language disorders, OCD and/or Global Developmental Delay, making these children look “almost autistic”.

Objective

To demonstrate the difficulty in trying to differentiate the “almost autistic” child from a child with ASD.

Aim

To stimulate discussion over the difficulty of diagnosing ASD and differentiating ASD from other childhood psychiatric disorders.

Method

A Poster presentation with a video has been developed demonstrating “difficult to diagnose” children, and raising the alternative diagnoses.

Results

The distinction between ADHD, ASD, and other disorders and not clear

Conclusions

The prevalence of ASD has mushroomed in the last 20 years, partly because of greater awareness, but also because of criteria have been diffused to include other diagnostic groups. Until better diagnostic approaches occur, the clinician is dependent on observational strategies to make the diagnosis of ASD. Given the importance of the diagnosis, better techniques for diagnosis is required.
P01-343-Group and integrative activities in adolescent's health promotion at a primary social protection service
Authors: Scherer Z.A.P. , Abrahão E.S. , Abrahão-Curvo P. , Scherer E.A. ,   GREIVI - Grupo de Estudos Interdisciplinar Sobre Violência
Published: May 2011

Introduction

External causes have been responsible for increased morbidity and mortality rates in Brazil. The most affected age range includes adolescent and young people, indicating the need for investments in public policies with a focus on health promotion. Violence, as one of these causes, has become treated as a public health problem, influenced by social determinants of health.

Objective

Describe health promotion practices involving adolescent participants in a health promotion and education group.

Aims

Enhance the understanding of adolescent's health promotion.

Method

A qualitative and descriptive experience report was carried out at the Child and Adolescent Care Center in the interior of São Paulo State - Brazil. The programmed activities involved 15 adolescents and took place on sports courts, streets and sidewalks near the Center and in a room for group discussions.

Results

The themes drugs, sexual and reproductive health, interpersonal violence at school and in the neighborhood emerged from the adolescents’ inquiries while accomplishing the proposed tasks in the different study environments. Group discussions were perceived as spaces for reflection and relaxation, and also as facilitators of bonding and, at the same time, of group adherence.

Conclusion

For the study subjects, making good friends, participating in sports and leisure, and talking about themes that are in line with their needs represented an important facilitator for health promotion and social inclusion.
P01-345-Prevalence and impact of cannabis use disorders in adolescents with early onset first episode psychosis
Authors: Schimmelmann B. , Cotton S. , Conus P. , Kupferschmid S. , McGorry P. , Lambert M.
Published: May 2011

Objective

Previous studies on the impact of cannabis use disorders (CU) on outcome in psychosis were mostly based on non-representative samples, have often not controlled for confounders and rarely focused on adolescents. Thus, the aims of the present study were to assess;

(i) prevalence of CU;

(ii) pre-treatment and baseline differences between CU and those without CU (NCU); and

(iii) the impact of baseline and course of CU on 18-month outcomes in a representative cohort of adolescents with early onset first episode psychosis (EOP).

Method

The sample comprised 99 adolescents (age 14 to 18) with EOP (onset age 14 to 17), admitted to the Early Psychosis Prevention and Intervention Centre in Australia. Data were collected from medical files using a standardized questionnaire.

Results

Prevalence of lifetime CU was 65.7%, baseline CU 53.5%, and persistent CU 26.3%. Baseline CU compared to NCU was associated with higher illness-severity, lower functioning, less insight, lower premorbid functioning and longer duration of untreated psychosis. Compared to both NCU and those who decreased or stopped CU during treatment, only persistent CU was linked to worse outcomes and more service disengagement. Effect sizes were medium controlling for relevant confounders. Medication non-adherence did not explain the link between persistent CU and worse outcome.

Conclusions

The prevalence of CU in adolescents with EOP is high, while only persistent CU use was associated with worse outcome with medium effect sizes. Specific needs of adolescent patients with respect to cannabis interventions within integrated care settings should be addressed in future studies.
P01-346-Current priorities of investigation of mental health of growing generation
Authors: Semke V.Y.
Published: May 2011

Complex approach allows identifying from many-sided positions integrative trends in research of mental health of growing generation. The case in point is evolutionary analysis of risk factors, role of adverse microsocial environment, negative impact of exogenous-organic and endogenous harms. In this aspect of relevance is distinguishing and all-sided development of new branch of the contemporary medicine – micropsychiatry (for this there are interesting basic data on grounding and propriety of description ecological fetal syndrome reflecting, in particular, influence of microdoses of radiation of negative consequences of the Semipalatinsk polygon etc.). Avalanche-like growth of indices of child homelessness and neglect is explained by consequences of microsocial crisis that is experienced by Russian family: this makes extraordinarily relevant problem of social orphanhood. The great attention must be paid to problem of mental health care of participants of pedagogical process (in a-chain-like-way “parent-child-teacher”).

Researchers and physicians of child-adolescent subdivision of SI Mental Health Research Institute TSC SB RAMSci conduct work on psychotherapy of childhood and adolescence. In addition, there are many-year results of trials in the field of child-adolescent transculturology, conducted under auspices of the International Association of Ethnopsychologists and Ethnopsychotherapists (with active participation of Siberian scientists and physicians).

Efforts of young researchers and representatives of older generation promote the successful development of new media, organizing-medical and preventive technologies allowing resolving the complex of tasks in heightening and mastering “quality of life” of Russian families, strengthening of the individual and societal health of the population of various regions of the country.
P01-347-Cognitive function in children. gander specific difference in general public primary school children in pakistan
Authors: Shaheen A. , Ullah S.
Published: May 2011

Objective

The primary objective of this study was to assess the gander specific cognitive function of primary school children in Pakistan.

Design

Prospective observational study conducted in 4 schools in a small district of Pakistan.

Method

Two hundred children (90 male,110 female), age 7–12 years class 3, 4 and 5 were assessed using McCarthy scale of child cognition. Verbal and linguistic skills, mathematical skills, reasoning in conversation, memory (word, number, picture, past) and Gross fine movements were assessed.

Results

Verbal and linguistic skills: Better skills demonstrated in girls mean score 3.99 SD(0.84), 95% CI (3.81,4.17) when compared to boys mean score 3.81 SD(0.91),95% CI (3.64,3.98).Comparison of two groups did not reach to the statistical significance T = 2.05, P = 0.15.

Mathematical ability

Girls mean score 2.66 SD (0.52), 95% CI (2.55,2.77) whereas boys mean score 2.40 SD (0.69),95% CI (2.27,2.53).It was statistically significant T = 8.3,P = 0.004. Reasoning in conversation: Better reasoning among girls demonstrated with mean score 3.90 SD (2.17), 95% CI (3.44,4.36) whereas boys scored 3.47 SD(1.89), 95% CI(3.11,3.83).It was not statistically significant T = 2.19,P = 0.14.

Memory

Girls mean score 3.52 SD(0.60),95% CI (3.40,3.65) whereas boys scoring 3.22 SD (0.87) 95% CI(3.05,3.38).It was statistically significant with T = 7.8,P = 0.006.

Gross movements

Girls scored 4.29SD(0.75),95% CI (4.13,4.45) whereas boys scoring 4.08 SD(0.91), 95% CI (3.91,4.25).Though better gross movements demonstrated by girls they did not reach to statistical significance T = 2.98,P = 0.08.

Conclusion

Girls demonstrate better cognitive function in general and there mathematical ability and memory in particle are better than there age and background matched male classmates.
P01-348-Female adolescents’health needs:the role of family
Authors: Shahhosseini Z. , Simbar M. , Ramezankhani A.
Published: May 2011

Introduction

Adolescents health needs are unique. An understanding of these needs will assist in the development of services, risk-reduction strategies and preventive health activities.

Methods

This qualitative study was a part of a mixed method study about female adolescents health needs and conducted in Mazandaran province, a province in the north of Iran. 67 female adolescents between 12–19 years of age participated in 8 focus group discussion. Inaddittion, semi structured interviews were done with 11 key informants including:5 parents,3 teachers and school counselors, 2 obstetricians and one midwife. Participants were selected based on purposeful sampling and with maximum variety. All tape-recorded data was fully transcribed and thematic analysis was done.

Results

Findngs of this research around the role of family in adolescents health needs emphasized on 4 overarching themes including :supportive family relationships, needs for responsible parents, well-informed parents and parental monitoring.

Conclusion

In attention to the critical role of family relationships in adolescents health needs, Parents education in order to help them to improve their relationships with their adolescents is necessary.
The specificity of children-parental relations in families, bringing up the child with speech impairment
Authors: Shuvarova S. , Borisova E. , Sevastyanov V. , Leontyeva N.
Published: May 2011

Objective

Study of specificity of emotional - personal features of parents and children-parental relations in families, bringing up the child with speech impairment. 95 parents of children with deviations in speech development were examined by tests. Contradictory style of the relation of parents to the child is revealed. High parameters on scales “Acceptance - Rejection” (64, 3%), “Cooperation” (64, 3%), “Symbiosis” (56%) are diagnosed. As prevailing leading style of the relation “parent - child” is allocated “Symbiosis” (48%) as aspiration for satisfying all child necessities, protecting him from difficulties and troubles, constant alarm for the child. The second on frequency of occurrence is the relation of rejection, (mistrust and disrespect for the child, perception his as unadapted and unlucky person). Discrepancy in perception of the child and in the relation to him, shown as a combination of high parameters on different of direction scales (meeting in 50% of cases) and reflecting simultaneous rejection, symbiotic attachment and trust, are indicate unsolved interpersonal conflict of the parent and demand specially organized treatment. Research of features of parents emotional - personal sphere allow to establish a presence of heightened reactive and personal anxiety which isn’t resulting in depression, however breaking adequate interaction with society. Results of research allow to assume a presence of the certain not realized parents attitudes (non-acceptance personality of diseased child, non-constructive forms of interaction with him; fear of the responsibility; refusal of understanding of existing problems, their partial or full denying).
Child ombudsmen as collaborators of child psychiatry ?
Authors: Škodáček I.
Published: May 2011

Legislation regulates rights also of individuals with mental disorders. Observance of these regulations is monitored by so-called Ombudsperson,or the Public Defender of the Rights. Since 2002, special attention has been paid to young generation in Slovakia. Developmental problems and issues of rights of ordinary and mentally handicapped children have also been dealt with, applying the paradigm that childhood is entitled to special care and assistance. And this is the ground for collaborators of the Public Defender of Rights, i.e. for school. They are helpful to parents of the minor, to teachers, healthcare professionals and to other adults working with minors. Thus the children ombudspersons become assistants of pedopsychiatry. From the viewpoint of a child psychiatrist, it was important to solve cases of Child Abuse and Neglect syndrome of various scope. Since December 2008, a project for creating the network of children collaborators of the Public Defender of Rights is in operation in Slovakia. Children from a school or other institution selected from their ranks a “children ombudsperson” who is willing to defend the rights of each member also with mental problems and disorders. For this reason is the necessity of development of international cooperation of ombudspersons for children which takes place in 22 European countries within the ENOC (The European Network of Ombudspersons for Children) which was commenced in a greater scale in April 2010. The children ombudspersons should be taken into account in the public healthcare system and they should become a part of the standard care for minor patients.
Mental health problems in children with prader-willi syndrome
Authors: Skokauskas N. , Meehan J. , Gallagher L.
Published: May 2011

Introduction

Prader-Willi Syndrome (PWS) is a genetically determined neurodevelopmental disorder which occurs in approximately 1 in 22000 births.

Methods

Parents of subjects with genetically confirmed PWS (participating in the First National Irish PWS study) were asked to fill in a demographic questionnaire, The Child Behaviour Checklist 6–18 (CBCL/6–18), Brief Symptom Inventory (BSI). The age, gender and IQ matched control group was collected through Special Schools.

Results

Both groups (PWS and Controls) were comprised of 24 children. Internalizing problems score was higher in children with PWS than controls (T mean score (62.02 (SD = 10.17) vs. 58.13 (SD = 7.53) p < . 05). The comparison of PWS and control group along CBCL/6–18 syndromes profiles indicated that children with PWS had more sever somatic problems (mean T 63.50 SD = 8.41 vs. 56.13 SD = 6.31, p< .05), social problems (mean T 64.71 SD = 8.95 vs. 58.79 SD = 9.41, p < .05), thoughts problems (mean T 67.71 SD = 9.71 vs. 58.04 SD = 7.17, p < .05) and were more withdrawn/depressed (mean T 64.04 SD = 9.11 vs. 55.46 SD = 6.48, p < .05). Borderline difficulties were detected for the affective, somatic and ADHD CBCL DSM orientated subscales in PWS group with PWS children having significantly more somatic (mean T 63.05 SD = 8.33 vs. 52.00 SD = 6.48, P < .05) and affective (mean T 66.22 SD = 8.51, vs. 60.08 SD = 6.829 P < .05) problems than controls. The analysis of BSI scales revealed that parents of PSW children in comparison to controls had more somatization, phobic anxiety, obsessive compulsion, and anxiety problems.

Conclusions

PWS represents a complex psychological disorder with multiple areas of disturbances.
A comparative efficacy of holistic multidimensional treatment model (HMTM) and applied behavioral analysis (ABA) in the treatment of children with autism spectrum disorder (ASD)
Authors: Soltanifar A. , Hojati M. , Mashhadi A. , Reebye P.
Published: May 2011

Introduction

Several approaches have been presented for treatment of children with ASD. The aim of the present study was to compare the efficacy of Holistic Multidimensional Treatment Model (HMTM) with Applied Behavioral Analysis (ABA) in the improvement of clinical symptoms of children with ASD.

Method

The present study was an experimental pre and post test research. The statistical population included the 3 to 8 year old children with ASD who were referred to the child psychiatry clinics in two academic Hospitals- Mashhad,Iran. The sample included 20 children who were selected with convenience sampling and randomly divided to 2 groups of ABA (8 boys and 2 girls) and HMTM (7 boys and 3 girls).The diagnosis was made by a child psychiatrist based on DSM-IV-TR criteria and using Autism Diagnostic Interview-Revised (ADIR) and Autism Diagnostic Observation Schedule (ADOS).Then the children were referred to Noore Hedayat center for the treatment. Childhood Autism Rating Scale (CARS), Bender Gestalt Test, Draw-A-Man Test Good enough, Raven's Colored Progressive Matrices Test for children, Vineland Social Maturity Scale (VSMS) and performance charts of children based on their videotaped behaviors. Data analysis was done using ANCOVA test.

Results

Findings showed that in spite of more efficacy of HMTM compared to ABA, the differences of standard tests except Bender Gestalt Test and performance charts did not reach to the significant level(p > 0.05).

Conclusion

In conclusion, HMTM at least had the equal efficacy to ABA in the treatment of children with Autism Spectrum Disorder. Further researches are needed to compare the efficacy of these 2 methods.
Asperger syndrome and schizophrenia in a sixteen year old female - A case report
Authors: Steiner A.B.
Published: May 2011

Schizophrenia is a serious mental disorder that affects 1% of the population.

In childhood and adolescence it is an extremely rare disease.

This case shows a comorbidity between Schizophrenia and Asperger Syndrome.

A sixteen year old female was admitted in a psychiatry unit in order to prevent suicide.

The girl was delusional about her appearance. She felt like did not have hips and would like to die.

She was always complaining as well about her hair and nose. She did not recognize herself as a girl.

Efforts were made in order to persuade the patient about the inveracity of her ideas but she insisted with the thoughts.

When asked, she affirmed to hear voices that cursed her and controlled her actions.

She was first treated with risperidone 4 mg day without good response. Then she was given olanzapine 10 mg day with partial response. The best response was achieved with clozapine 400 mg day.

The patient presented childish behavior. Could be noticed difficulty in social interaction and repetitive movements as rocking, spinning and hand - flapping.

She did not presented signs of mental reatardation.

Nowadays the patient did not present delusional ideas, her behavior is more stable. She is finishing the first grade at school and under the use of clozapine.
The tripartite model and dimensions of anxiety and depression in children and adolescents: Preliminary data from Serbia
Authors: Stevanovic D. , Lakic A.
Published: May 2011

Introduction and objectives

The tripartite model of emotions (TME) specifies a general factor, negative affect (NA), which represents a shared influence on anxiety and depression, and two specific factors, physiological hyperarousal (PH) common to anxiety, and (low) positive affect (PA) common to depression (Clark & Watson, 1991).

Aims

To examine the relationships between TME and anxiety and depressive symptoms in children and adolescents.

Methods

In the study participated 126 non-referred children and adolescents, aged 10–18 years. TME was assessed by the Affect and Arousal Scale (AFARS). Anxiety symptoms were identified using the Screen for Child Anxiety Related Emotional Disorders questionnaire (SCARED). This questionnaire reports five types of anxiety disorders: panic/somatic, generalized, separation, social, and school phobia. Finally, depressive symptoms were identified using the Short Mood and Feeling Questionnaire (SMFQ). Zero-order correlations between all measures were presented.

Results

PA negatively correlated with the depression scale only, −0.2 (p = 0.012), while NA significantly correlated with the depression and all anxiety scale, except the separation anxiety scale (p < 0.05). PH significantly correlated with the depression, panic-somatic and separation anxiety and school avoidance scale. The highest correlations were between the depression (0.39) and panic scale (0.33).

Conclusions

The results indicate that the relationships between TME and symptoms of anxiety and depression in children and adolescents could be partially supported. However, they are consistent with the previous findings that reported that low PA correlate with depression and PH with panic disorder (Chorpita, 2000; Jacques & Mash, 2004; De Bolle, 2010).
The efficacy of a group cognitive training for high functioning autistic children
Authors: Taghva N. , Bagherian Khosroshahi S. , Pouretemad H.
Published: May 2011

Introduction

Cognitive impairments are partly associated with DSM-IV criteria for Autism. Cognitive studies in Autism posit domain-specific and domain-general deficits including Theory of Mind (ToM), Executive Function (EF), and Central Coherence (CC).

Objectives

Research indicates that early interventions for children with High Functioning Autism (HFA) predicate crucial cognitive gains.

Aims

The purpose of this study was to evaluate the effectiveness of a group cognitive training in increasing cognitive skills in children with HFA.

Methods

Four HFA children (2 girls, 2 boys) with mean age of 6.5 who had received intensive Applied Behavioral Analysis (ABA) participated in 18 group training sessions per week. Each session lasted 75 minutes, targeted ToM, EF, and CC using Art Therapy techniques. Picture Exchange Communication System (PECS), positive reinforcement, Token system and homework were used as well. All sessions were recorded. Session by session evaluation and parental attitudes were used to evaluate cognitive skills in this single subject design. ToM was tested by some stories and puppet shows. Problem solving tasks which were comprised of mental flexibility and planning assessed EF. visuospatial-constructional coherence and verbal-semantic coherence were explored by using pattern constructions and questions about the concepts of stories.

Results

All children improved significantly in cognitive skills especially in predicting emotional reactions in stories, EF, and visuospatial-constructional coherence; however some individual differences were considerable.

Conclusions

Group art-based cognitive training would be helpful for children with HFA to enhance their cognitive skills.
The effectiveness of parent management training in parent- child relationship and parental self-efficacy of mothers with autistic children
Authors: Tahmassian K. , Khorramabadi S.
Published: May 2011

Introduction

One of the most significant stressors for families is extent of behaviour problems exhibited by children with developmental disabilities. These affects parental efficacy and parent-child relationship which are important variables for optimal parenting (Hastig and Brow, 2002).

Aim

The aim of the present study was to examine the effectiveness of parent management training to increase child-parent relationship and parental self-efficacy of mothers with autistic children.

Methods

30 mothers of children with autism (17 in experimental group and 13 in control group) were included. The experimental group participate in parent management training sessions includes behaviour modification techniques for 6 weeks. The scales of this research were Parenting Self-Agency Measure (Dumka, Storerzinge, Jackson and Koosa, 1996) and Parent _Child Relationship test (Pianta, 1994). t test were used to compare the meanings of pre-tests and post-tests.

Results

The results indicate that there was significant differences between parenting self-efficacy (p < ./05) and parent-child relationship (p < ./001) scores. The experimental group's parental self-efficacy and positive parent-child relationship were significantly higher than control group and parent management trainings increase those important variables in mothers of children with autism.

Conclusion

Parent management training programmes can enhance parental self-efficacy and parent-child relationship and prevent many problems in families with autistic children.
Pediatric obsessive-compulsive disorder: A case report
Authors: Tatay A. , Almonacid C. , Castillo A. , Lloret M. , Harto M. , Calabuig R.
Published: May 2011

Introduction

Obsessive compulsive disorder (OCD) in childhood was first described by Legrand du Saulle in late XIX century, however, a systematic study in pediatric population was not made until 1986, by Rapoport. It is has been documented in scientific literature that younger patients usually hide their symptoms because of shame or that they do not find their obsessions and compulsions excessive, so that they feel them in an egosyntonic way, delaying diagnosis until several years after their first symptoms.

Aims and methodology

To highlight the specific symptoms in Pediatric OCD and review its treatment and approach through the study of a case report.

Results

A 11-year-old boy was referred by his paediatrician to a child mental outpatient service for behavioural disturbances in the last few months. For the last three years, he had been performing rituals of cleaning, order and checking, increasingly complex and with a significant impact on his life, to the point of not being able to go to school and have other members of his family involved. He also had religious and catastrophic obsessions that generated him important distress. He was treated with high doses of sertraline and low doses of risperidone, and cognitive-behavioral psychotherapy with exposure response prevention and training in relaxation techniques were associated to the treatment. The patient improved partially.

Conclusions

This case illustrates the delay in the diagnosis of Pediatric OCD itself as well as the complexity when treating this disorder.
Heart rate variability in adolescent major depression
Authors: Tonhajzerova I. , Ondrejka I. , Turianikova Z. , Chladekova L. , Javorka K. , Farsky I. , Kerna V. , Javorka M.
Published: May 2011

Introduction

Impaired cardiac autonomic regulation is likely important contributor to a potential cardiac complications in major depression. The knowledge regarding the depression effect on cardiac regulation in adolescent age is limited. Aim was to study short-term heart rate variability (HRV) as an index of cardiac autonomic control in never-treated major depressive disorder (MDD) adolescent patients using linear and nonlinear methods related to depressive symptoms severity.

Methods

We have examined 20 MDD girls and 20 healthy age-matched girls at the age from 15 to 18 years. The ECG was recorded in three positions: supine - orthostasis - supine. The HRV was analyzed using linear (time and frequency analysis) and novel nonlinear (symbolic dynamics, time assymetry) methods. The severity of depressive symptoms was evaluated using the scales Montgomery-Asberg Depression Rating Scale (MADRS) and Children’s Depression Inventory (CDI).

Results

Several HRV linear and nonlinear parameters were significantly reduced in MDD group compared to controls in supine rest and during orthostasis. The HRV nonlinear analysis indices significantly correlated with depressive symptoms severity.

Conclusions

Linear and nonlinear analyses revealed reduced magnitude and complexity of the HRV indicating impaired neurocardiac regulation in adolescent major depression. In addition, new approach of HRV analysis using nonlinear methods provided important information about depressive symptoms severity and cardiac autonomic regulation relations.
Listening to an asian teenager and the diversities of his transition in the South Brazil: A case report
Authors: Gonçalves N. , Fuji S.K. , Cordeiro S.N. , Turato E.R.
Published: May 2011

Introduction

From the viewpoint of society, adolescence can be considered a transition phase into adulthood. For many psychoanalysts, the changes originating from the puberty process are accompanied with an “anguish of growth”. The crisis installed due to this process can be marked by something peculiar in the life of each one.

Objectives

To discuss the clinical practice, looking towards an understanding of the peculiarities that mark the psychotherapy of an adolescent who lives through a cultural transition.

Method

Case report referring to a clinically listening to a 15 years old adolescent who was born and raised in Japan, then moved to Brazil with her family when was 12 years old.

Results

Adaptation to a different culture was what motivated the patient's mother to seek attention for her daughter. The family brings the image of an idealized Japan. The change did not only bring consequences to the daughter, but to the family that went through reorganization in the face of customs and material conditions. The new conditions ended up accentuating conflictive questions by the married couple and the difficulty of organizing the positions of the parents and children in family dynamics, interfering in the process of separation/ individualization of the adolescent. The patient found within a typical Japanese music group an outlet in which she could confront other discussions that stamp her identity.

Conclusions

Psychocultural transition has marked this phase in the life of this adolescent. Within a referential group of oriental culture, the patient has found support for these changes.
The associated risks among ADHD children and adolescent with internet addition in Taiwan
Authors: Tzang R.-F. , Chang Y.-C.
Published: May 2011

Objection

This study aimed to evaluate various associated risks between internet addiction (IA) and Attention deficit/Hyperactivity disorder (ADHD) children and adolescents by comparing ADHD group with and without IA problem.

Method

78 ADHD children and their parents were performed designed general demographic questionnaire and standardized measurement including Chen IA Scale (CIAS), Swanson, Nolan, and Pelham, Version IV ADHD questionnaire (SNAP-IV), Child Behavior Checklist (CBCL), Adult ADHD self Rating Scale (ASRS), Symptom Check List (SCL-90) and were then divided into ADHD with IA or without IA group according to IA cutting point. Various associated risks included the BMI value, general demographic data, subtype, comorbidity, childhood common behavior problem, parental ADHD diagnosis, parental symptom, nail biting, and media exposure problem.

Results

ADHD youth with IA problem was highly associated with overweight and playing computer game more than one hour. Stepwise logistic regression revealed that father of these ADHD children in this group were significantly younger, and children self having withdrawn tendency.

Conclusion

Father's younger age, overweight and withdrawal tendency on ADHD youth is risks associated with internet addiction problem and the presence of playing computer game more than one hour on ADHD child is at greater risk for developing internet addiction.
Paediatric medulloblastoma with anxiety as primary presentation: A case report and review of literature
Authors: Wan Y.M. , Gan B.K. , Fung D.
Published: May 2011

Introduction

Although paediatric medulloblastomas are well described in surgical literature, there is relatively little in child-and-adolescent psychiatry literature on them. Anxiety as the primary presenting complaint of a brain tumour, is rarely reported among the paediatric population with primary cerebral malignancy.

Objective

To highlight the prudence of an initial skeptical attitude towards the cause of symptoms, and also the importance of a comprehensive physical examination in child psychiatry units.

Method

A 14 year-old Chinese boy is described, who presented at the outpatient psychiatric clinic with a 3-month history of increasing anxiety, difficulties with social interaction, deteriorating academic performance, interspersed with about two episodes of nausea per week. Previously, he was known as an intelligent boy who enjoyed a good relationship with his classmates. He has no other focal neurological deficits, and no recent life events were reported. A CT scan of the brain done revealed a large tumour distending the fourth ventricle. Histology revealed medulloblastoma.

We will also briefly review the relevant literature.

Results

After surgical removal of the tumour, patient is described to be more participative in social interaction and almost back to his premorbid personality.

Conclusion

Primary brain tumours may manifest only with psychiatric derangements. Somatic symptoms typically seen in anxious patients, such as nausea, may herald a more sinister underlying cause. We advocate further study on the relationship between anxiety and brain tumours, as well as urge an increased vigilance on the part of healthcare professionals in constantly utilizing a biopsychosocial diagnostic model in child-and-adolescent psychiatry.
P01-364 Associations of 5HTT-LPR with ADHD symptoms are moderated by platelet MAOB activity
Authors: Wargelius H.-L. , Malmberg K. , Larsson J.-O. , Oreland L.
Published: May 2011

Introduction

The monoamine systems have been suggested to play a role for the biological background of ADHD symptoms. Thus, polymorphisms in e.g. the serotonin transporter (5HTT) gene have been associated with ADHD like phenotypes.

Furthermore, platelet MAOB activity has frequently been linked to impulsiveness-related traits.

Objective

Biological markers and candidate genes for psychiatric problems are often studied separately. We study ADHD symptoms with regard to the combination of platelet MAOB activity and 5HTT genotype.

Aim

To test the hypothesis that associations between ADHD like behavior problems and 5HTT-LPR polymorphism, would be more robust if calculations were done in combination with platelet MAOB enzyme activity.

Methods

The study group consisted of 156 adolescent twin pairs, i.e. 312 individuals. ADHD symptoms were scored with a structured clinical interview of both the twin and a parent using Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL).

Results

Presence of a short 5HTT-LPR allele, in combination with high levels of platelet MAOB enzyme activity was associated with higher scores of ADHD like problems and disruptive behavior in boys. No such associations were found in girls.

Conclusion

This examination of ADHD scores in a non-clinical sample suggests that the effects of the 5HTT-LPR are moderated by platelet MAOB activity.
P01-365 Safety of second-generation antipsychotics in children-questionnaire evaluation in psychiatrists
Authors: Wisniewski A. , Acewicz A. , Brewczyk K.
Published: May 2011

Atypical antipsychotics are more safe than first generation drugs. But some researchers suggest that children and adolescents might be more sensitive than adults to developing antipsychotic-related adverse side effects. The standards of safety monitoring strategies do not exist in Poland.

Objective

The aim of this study was to estimate physicians awareness to side effects in youth population treated with antipsychotics.

Material

20 questionnaires filled up by polish child psychiatrists.

Method

Information from author's questionnaire concerns side effects observed in antipsychotics medicated children, psychiatrists own preferences in safety monitoring strategies were analyzed.

Results

Atypical antipsychotics are used in 25% of medicated children. Risperidon is the most popular antipsychotic in psychotic and non-psychotic indications (81%, 66%), afterwards olanzapine (54%, 30%) and quetiapine (34%, 24%). The most common indications for antipsychotics in children are: tics (55%), conduct disorders (53%) and schizophrenia (45%). Before drug initiation doctors check liver enzymes (GOT, GTP) (98%), hematology (98%), glucose level (95%), weight and height (91%), ECG (90%). The most common side effects observed are: weigh gain (63%), somnolence (59%), prolactin elevation (47%), attention deficits (43%).

Conclusion

In spite of lack of safety monitoring standards in youth population psychiatrists seem to be aware and careful in atypical neurolpetic treatment in children.
P01-366-New treatment option in resistant schizophrenia in adolescence - case study
Authors: Wisniewski A.
Published: May 2011

Early-onset schizophrenia has not only more severe course than in adults, it is also associated with poor response to antipsychotic treatment. There are only limited data about effectiveness, safety and tolerability of second generation antipsychotics (SGA) in children, but current recommendations suggest using atypical antipsychotics as the first line treatment.

Case study

15-year-old schoolboy admitted to psychiatric hospital after acute psychotic episode. His symptoms started 2 years ago. After a few months he was diagnosed schizophrenia paranoid type. During 2 years he has been hospitalized many times because of persistent psychotic symptoms. He was treated using: risperidon, olanzapine, amisulpride, quetiapine, ziprasidone, perfenazin. All the drugs were ineffective, all were used in full doses, given no shorter than 8 weeks. Patient did not cooperate in treatment - he spits out or has hide the tablets, has to be controlled during drug supplies. He did not responded to long-acting injections of risperidon. Finally the treatment has been changed to new form of olanzapine in extended release injections started 210 mg i.m. every 14 days increased to 300 mg after 2 weeks. After 2 months of treatment (5 injections) reduction of positive and negative symptoms of schizophrenia was observed. Patients starts to socialize, attend school. He is on the drug now, the drug is well tolerated.
P01-367-Evaluation of test anxiety in middle school students in one area of education of sanandaj city of kurdistan province of Iran, 2009
Authors: Zaheri F. , Zaheri H. , Hashemi Nasab L. , Ranaie F.
Published: May 2011

Child and adolescences experience a wide range of anxiety during their growth that some of them result in academic and daily difficulties. Test Anxiety as one of these anxieties, is common and important phenomenon in education and have a close relation with educational and academic achievement.

Because of importance of physical and mental health of these groups, this study was performed.

Methods

This descriptive study was performed with 1321 students selected from six middle schools (through random cluster) from schools in one area education of Sanandaj. For data Collection, Sarason test anxiety and demographic characters questionnaire was used.

Sampling was done before end year examination

Results

In this study, 51/9% of subjects were girls and 48/1% were boy. 29/7% of units were in first degree; 28/2% second and 42/1% in third year degree. Also, 35/4% of boys and 37/8% of girls were 14 years old. Severity of test anxiety in 20/2% was mild, 44/9% moderate and 34/9% was severe. In this research, we found statistical differences between severity of test anxiety and gender (p = /.001).

Discussion

The results showed high rate of test anxiety in middle school students. In our opinion, addition to gender effect on test anxiety levels, other factors such as stress of transition from one level to another level and access in special schools have significant role. Therefore, school coaches should attention to pathology and therapeutic methods for reducing test anxiety such as relaxation, systematic desensitization, immunization against stress and skills of reading correction in these groups.
P01-368-Premenstrual syndrome and psychiatric comorbidities
Authors: Arbabi M. , Shirmohammadi M. , Taghizadeh Z. , Haghanni H. , Parsafar H.
Published: May 2011

Objective

Premenstrual syndrome (PMS) is a common disorder with prevalence rate of approximately 30%; its concurrence with psychiatric symptoms will make it a disabling condition that resists usual treatment.This study was enrolled to assess the co-morbidity of PMS andpsychiatric disorders in a sample of girls with PMS compared to those without PMS.

Method

This study was conducted through a cross sectional method with 362 participants (166 with PMS and 196 healthy girls) who were selected randomly and completed the demographic questionnaire, premenstrual syndrome symptom daily record scale and the symptom checklist 90-revised (SCL-90-R).

Results

According to the result of the independent t test, the mean score of all the psychiatric symptoms in the PMS group was significantly higher than those in healthy group (P < 0.001). According to SCL-90-R measurement, most of the participants in the PMS group were categorized as extremely sick for somatization (44%), obsessive-compulsive (59%), depression (58.4%), anxiety (64.5%), hostility (47%) and psychoticism (69.3%); most of the participants were diagnosed as having borderline severity of disorders for interpersonal sensitivity (44.6%) and paranoid (42.8%) and most of the respondents with PMS (46.4%) were diagnosed as healthy only for phobic anxiety.

Conclusion

There is a considerable relationship between PMS and different psychiatric symptoms that can complicate the diagnosis of PMS and its treatment for the health care providers. Therefore, all health care providers who are in contact with women in their reproductive age should be sensitive to mental health status in women with PMS.
Coping styles among post-myocardial infarction patients with depressive symptoms
Authors: Bagherian R. , Maroufi M. , Said Zare F. , Niksirat P.
Published: May 2011

Objective

Although the adverse impact of post-myocardial infarction (MI) depressive symptoms on prognosis of heart disease has been found, the link between coping strategies and post-MI depressive symptoms has yet been unclear. The aim of this study was to determine the relationship between coping styles and post-MI depressive symptoms.

Methods

In a cross sectional study one hundred consecutive patients following MI admitted to the CCU wards of hospitals in Isfahan were selected in respect of inclusive and exclusive criteria. The patients completed Jalowiec Coping questionnaire, Hospital Anxiety and Depression Scale and Norbeck Social Support questionnaire. Then the data was analysed by using MANCOVA and Covariance.

Results

The findings indicated that 31% were the MI patients with depressive symptoms. The results of MANCOVA showed significant difference between two groups with and without depressive symptoms in coping styles (F = 2/185, P = 0.036). Also, the results of covariance indicated significant differences in coping styles including optimistic coping style (F = 3.754, P = 0.05) and supportant coping style (F = 6.66, P = 0.019). However, there was no significant difference in other coping styles between two groups.

Conclusion

The low tendency toward optimistic and supportant coping styles seem to play an important role in experiencing depressive symptoms among post-MI patients. Lock of optimism in dealing with life events is one of equivalents to hopelessness in Attribution theory explaining depression. Investigation of relationship between religious beliefs and effective coping styles would be worthwhile.
Outpatient treatment in mental health care
Authors: Bording M.K. , Sørensen H.Ø. , Puschner B. , Munk-Jørgensen P.
Published: May 2011

Introduction

There is a lack of knowledge on outpatient treatment in mental health and its outcome. The major reason for this is that research on clinical decision making in health care has primarily focused on well-defined situations in physical conditions, while there has not been any research in clinical decision making in people with schizophrenia with its high demands on patient's treatment adherence and establishing stable therapeutic relationships.

Objective

This study is about clinical decision making in outpatient mental health care with specific focus on patients diagnosed with schizophrenia.

Aims of the study

To identify the types of decision making between the patient and the therapist (paternalistic, shared and informed). Moreover, to investigate the patient's understanding of the decision making, involvement and analyse type of decision making as a possible predictor of adherence to treatment.

Methods

The study is an open, explorative study using a combination of both qualitative and quantitative methods. The study population consists of severe mentally ill outpatients diagnosed with schizophrenia. Data collection consists of both questionnaires, field observation and patient interviews.

Expected results

Specifications of primary areas for further improvement in CDM is an expected result of the study. Recommendations will be extracted and formulated from the study data to implement elements of best practice in CDM in the routine care for people with schizophrenia in particular and severe mental illness in general. The explicit focus will contribute to the strengthening of patient perspective.