Asunto(s)
Síndrome de Lennox-Gastaut/complicaciones , Convulsiones/complicaciones , Ronquido/complicaciones , Trastorno del Espectro Autista/complicaciones , Niño , Preescolar , Deleción Cromosómica , Cromosomas Humanos Par 22/genética , Electroencefalografía , Humanos , Masculino , Convulsiones/tratamiento farmacológicoRESUMEN
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) and enuresis co-occur at a higher rate than expected; the cause for this is unclear. STUDY DESIGN: Diagnostic and demographic variables were compared in 344 children ages 6 to 12 years, with and without enuresis, recruited in an ADHD genetic study. Sleep variables were investigated in a subgroup of 44 enuretic children with age- and sex-matched nonenuretic controls. The association of enuresis with single nucleotide polymorphisms located in regions reported in linkage with enuresis was explored. RESULTS: The prevalence rate of nocturnal enuresis was 16.9% for the entire cohort. There were no differences in sex, age, socioeconomic status, intelligence quotient, medication treatment, or comorbidities. The enuresis group had a higher likelihood of inattentive symptoms than the nonenuretic group. Night wakings and ability of children to wake themselves in the morning were both significantly decreased in children with enuresis compared with control children in the Child Sleep Habits Questionnaire Night Wakings subscale. No significant association was found with chromosomal regions previously reported in linkage with enuresis. CONCLUSIONS: Deficits in arousal may contribute to both enuresis and inattentive ADHD. Nocturnal enuresis may be a useful clinical marker in identifying a subgroup of the inattentive phenotype in ADHD genetic studies.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/genética , Enuresis Nocturna/epidemiología , Enuresis Nocturna/genética , Nivel de Alerta , Estudios de Casos y Controles , Niño , Cromosomas Humanos/genética , Femenino , Marcadores Genéticos , Humanos , Masculino , Fenotipo , Polimorfismo de Nucleótido Simple , Índice de Severidad de la Enfermedad , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiologíaRESUMEN
Neste trabalho, o autor retoma a noção de trauma em Freud e em outros pensadores contemporâneos, mostrando como surge na clínica, através da transferência. Utilizando-se das idéias de Bion sobre o Pensar, Brown expõe seu ponto de vista de que um trauma psicológico intenso tem o efeito de reverter a função alfa, levando à formação de uma tela beta rigidamente organizada, condenado o paciente a repetições de funcionamento que o impedem de aprender com a experiência. O artigo é ilustrado com um relato clínico que exemplifica a teoria exposta, acompanhado de uma detalhada discussão, concluindo que o trabalho analítico pode redirecionar o significado inconsciente que o trauma provoca no paciente(AU)