[Social Networks of Children with Mental Disorders]. / Soziale Netzwerke von Kindern mit psychischen Störungen.

Social Networks of Children with Mental Disorders Abstract. The study compares the social networks of children with mental disorders with a matched control group (n = 75/75, male 69 %/69 %, age: 9.4/9.0 years). In addition, we examined the quantity and structure of social networks as well as the stresses and resources in the respective patient group in general and regarding specific disorders (hyperkinetic disorder, HKS, and childhood emotional disorder). We assessed their use of social networks with a revision of the Social Relationship Test for Children (SoBeKi-R) and their mental disorders via clinical diagnoses, CBCL, and SDQ. The patients reported significantly smaller networks overall and fewer social resources, particularly in the nonfamily domains. While children with emotional disorders were found to have fewer social strains than the comparison group, children with ADHD tended to have higher strain scores per network person, and externalizing symptoms were significantly associated with higher network strains. The results, which vary by disorder, suggest complex disorder-specific associations between the syndromes and the reported social network resources and strains.

Brain morphology alterations in the basal ganglia and the hypothalamus following prenatal exposure to antiepileptic drugs.

If humans are exposed prenatally to antiepileptic drugs (AEDs), cognitive impairment may be the consequence. Driven by results of experimental work showing that AEDs may induce neuronal death in the developing rodent brain, we wanted to explore whether prenatal exposure to AEDs (PAE) may result in structural changes in the human brain. For this purpose we investigated a group of healthy young adults with PAE and a group of age-matched unexposed healthy controls by magnetic resonance imaging (MRI) of the brain. Local differences in cerebral morphology associated with PAE were analysed in volumetric MRI data by use of voxelwise comparisons of grey and white matter images. Significant regional decreases of grey matter volumes were found in PAE subjects in the area of the lentiform nucleus, including both pallidum and putamen bilaterally, and the hypothalamus. No significant regional differences in white matter volumes were found. We conclude that PAE causes subtle morphological changes in grey matter of the human brain which are conform with lower cell numbers in the basal ganglia and the hypothalamus.

[Diagnostic classification of mental disorders in infants and toddlers age 0 to 5]. / Diagnostik und Klassifikation von Verhaltensauffälligkeiten bei Säuglingen und Kleinkindern von 0-5 Jahren.

The Article is working on developmental psychopathology, diagnosis, and treatment of behavioral problems in infants and toddlers age 0 to 5. An overview of the literature about the international discussion is given. In particular diagnostic classification is elaborated by mentioning the revision of "Diagnostic Classification 0-3 (DC: 0-3R)" and "Research Diagnostic Criteria-Preschool Age (RDC-PA)". State of the art and clinical implication is reported on the basis of principal considerations on infant psychiatry. The american practice parameters become adapted and a working title for diagnostic formulation is given. More research should be done against the background of the introduced standards.

[Parental relationship from the perspectives of children, adolescents and clinicians. Development and clinical validation of the Parental-Representation-Screening-Questionnaire (PRSQ)]. / Elternbeziehung aus Sicht von Kindern, Jugendlichen und Klinikern. Entwicklung und klinische Validierung des Elternbild-Fragebogens (EBF-KJ).

The Parental-Representation-Screening-Questionnaire (PRSQ) is a new instrument designed to asses how children and adolescents evaluate their relationship with their parents. The aim of the questionnaire is to assess those aspects in the child-parent relationship that are crucial for a psychopathological risk. Conceptually, the PRSQ is based on cognitive self theory and systemic family theory. The PRSQ consists of 8 scales (36 items) for each parent: "freedom of decision", "emotional burden by the parents", "fears / overprotection", "conflict", "hostility / indifference", "aid for the parents", "punishment", and "support from the parents''. A clinic-referred consecutive sample of 152 patients of a Berlin child and adolescent psychiatry, aged 10 to 18 years, were surveyed. Adverse educational and psychosocial family factors were assessed by clinicians according to the fifths axis of the multiaxial classification system (MAS, Dilling et al. 2000). The internal reliability for 13 of the 16 scales ranges from .90 to .72. Factor analyses confirmed the factorial independence of six of the eight scales separately for mother and father. Moreover, adolescent girls reported significantly worse relations to both parents on five of the 16 scales than boys. Furthermore we found concordant correlations with the clinician's diagnosis of adverse educational and psychosocial family situations. The present results confirm the PRSQ as an economic and discriminating instrument to assess the representation of parent-child relation for clinical and for scientific purposes.

Prenatal and family risks of children born to mothers with epilepsy: effects on cognitive development.

The offspring of mothers with epilepsy are considered to be at developmental risk during pregnancy from: (1) generalized maternal seizures (hypoxia); (2) teratogenicity of antiepileptic drugs (AEDs); and (3) adverse socio-familial conditions associated with having a chronically sick mother. Sixty-seven children of mothers with epilepsy and 49 children from non-affected mothers, matched for control variables, were followed from birth to adolescence (53 males, 63 females; mean age 14y 2mo, range 10-20y). Prediction of intellectual performance of these children during adolescence was calculated from the following variables: maternal generalized seizures, prenatal exposure to AEDs, and quality of family stimulation (HOME Inventory) assessed in children at 2 years of age. Children who were prenatally exposed to AEDs achieved lower IQs than control children at adolescence. This effect was moderately significant for children who had been exposed to monotherapy (6 IQ points lower), but was considerable in those exposed to polytherapy (12 IQ points lower). Generalized seizures during pregnancy, observed in half the mothers, did not exacerbate this effect. Relative to prenatal risk status, the quality of the family environment had varied effects on intellectual development. Children with prenatal risks appeared to be more vulnerable to environmental disadvantage than control children, but they also showed longer-lasting effects of environmental support.