ABSTRACT
Pregnancy and childbirth are among the strongest risk factors for depression but the neurocognitive mechanisms underlying this enhanced risk are unknown. This study investigated emotional and non-emotional cognition in 57 pregnant women with or without an affective disorder during their third trimester, and the association between cognitive biases and subsequent postpartum depression (PPD). Of the pregnant women, 22 had a diagnosis of unipolar disorder (UD) and seven of bipolar disorder (BD) in full or partial remission, while 28 had no history of affective disorder. We included a control group of 29 healthy non-pregnant women. First, participants were interviewed, completed non-emotional and emotional cognitive tests and lastly filled out questionnaires. The participants were assessed two times after birth: at a home visit shortly after birth, and with a telephone interview to assess PPD in the first six months after birth. Healthy pregnant women rated infant cries less negatively than non-pregnant women, possibly reflecting preparation for motherhood. Pregnant women with UD exhibited a negative bias in ratings of infant cries, whereas pregnant women with BD showed a positive bias in ratings of infant happy faces and recognition of adult facial expressions. Across all pregnant women, more negative ratings of infant cries were associated with enhanced risk of PPD. Negatively biased perception of infant cries during pregnancy may thus signal vulnerability toward PPD.
Subject(s)
Bipolar Disorder , Depression, Postpartum , Adult , Cognition , Emotions , Female , Humans , Infant , Pregnancy , Pregnant WomenABSTRACT
Infant psychiatry is a discipline concerned with diagnostic assessment, treatment, and prevention of mental health problems in infancy and early childhood. A new diagnostic framework: Zero to three (DC 0-3) has been designed to complement the ICD 10/DSM IV, including new diagnostic categories, and a multiaxial construct addressing developmental and relational aspects. Prevalence and outcome for mental retardation and pervasive developmental disorders are well known. Our knowledge of variations in attachment patterns, disorders of neurophysiological regulation, eating disorders, failure to thrive, emotional, affective, and behavioural problems, disorders of relating and communication, and eventually parent-child relationship disorders is still incomplete. It is recommended to use video and combine clinical evaluation with structured tests in assessment. Intervention may include guidance, psychoeducation, psychotherapy, as well as social and educational support. Parent-child relationship treatment seems effective. Evaluating intervention and treatment raises immense methodological problems. Future research should address how risk and resilience interacts in the psychopathological process and enhance our knowledge of effective intervention strategies.
Subject(s)
Child Psychiatry , Mental Disorders , Child , Child Behavior Disorders/diagnosis , Child Behavior Disorders/therapy , Child, Preschool , Developmental Disabilities/diagnosis , Developmental Disabilities/therapy , Humans , Infant , Intellectual Disability/diagnosis , Intellectual Disability/therapy , Mental Disorders/classification , Mental Disorders/diagnosis , Mental Disorders/therapy , Mental Status Schedule , Psychiatric Status Rating Scales , Psychomotor PerformanceABSTRACT
INTRODUCTION: A descriptive epidemiological study of children aged 0-36 months. METHODS: Diagnoses reported from the child psychiatric departments to The National Psychiatric Register were collected from a three-year period 1996, 1997, and 1998. The child psychiatric departments in Denmark filled in a questionnaire concerning referral, assessment, treatment, and consultant/liason functions. All the child psychiatric departments took part in the study. RESULTS: 529 children aged 0-3 years were reported to the National Psychiatric Register. In the period studied, there was a 30% increase in the number of children reported. Adjustment reactions were the commonest diagnosis in the youngest children, aged 0-12 months. Pervasive developmental disorders, particularly infantile autism, were commonest used in the age group 2-3 years. Twenty-four per cent of the children reported, especially the youngest children, had no specific psychiatric diagnosis. The increase in the number of children aged 0-1 year with adjustment reactions and non-specific diagnoses is discussed. Children aged 0-3 years are mainly treated as outpatients or by a consultant/liason child psychiatric service. The children referred to the child psychiatric departments in 1997 varied from fewer than 10 to about 100 children. Infant psychiatric units were established in two places in Denmark, in 1992 and 1997. DISCUSSION: The increasing number of children aged 0-3 years reported to the National Psychiatric Register in the period 1996-1998 reflects an increase in the children aged 2-3 years diagnosed with pervasive developmental disorders, and in the case of the youngest children, aged 0-1 year, a more extensive child psychiatric intervention in relation to populations at risk, such as infants with mentally ill mothers.
Subject(s)
Child Psychiatry , Mental Disorders/epidemiology , Child , Child Development Disorders, Pervasive/diagnosis , Child Development Disorders, Pervasive/epidemiology , Child Development Disorders, Pervasive/therapy , Child Health Services/organization & administration , Child Health Services/statistics & numerical data , Child, Preschool , Denmark/epidemiology , Developmental Disabilities/diagnosis , Developmental Disabilities/epidemiology , Developmental Disabilities/therapy , Humans , Infant , Mental Disorders/diagnosis , Mental Disorders/therapy , Mental Health Services/organization & administration , Mental Health Services/statistics & numerical data , Mental Status Schedule , Psychiatric Department, Hospital/organization & administration , Psychiatric Department, Hospital/statistics & numerical data , Psychiatric Status Rating Scales , Referral and Consultation , Registries , Surveys and QuestionnairesABSTRACT
Factitious illness by proxy is a highly pathological form of parent-child relationship. To our knowledge no former case of polydipsia by proxy has been published. The case of a 2-y-old boy suffering from malnutrition due to displacement of maternal anorexia and polydipsia is presented. Child psychiatric evaluation found cognitive delay and psycho-social impairment in the child, as well as a severe mother-child relationship disturbance. Psychological assessment showed a personality disorder with depressive and paranoid features in the mother. The father was described as a schizoid personality. The possible mechanisms of displacement are hypothesized.
Subject(s)
Failure to Thrive/etiology , Munchausen Syndrome by Proxy/diagnosis , Anorexia , Child, Preschool , Developmental Disabilities/etiology , Humans , Male , Mother-Child RelationsABSTRACT
The serum levels of 25-hydroxycholecalciferol (25-OHD3) and 1,25-dihydroxycholecalciferol[1,25-(OH)2D3] were measured simultaneously in nephrectomized patients on maintenance haemodialysis, in haemodialyzed patients with preserved kidneys who were receiving different vitamin D supplement, and in patients who had undergone renal transplantation. The results indicate that the production of 1,25-(OH)2D3 can be stimulated in patients with minimal residual renal excretory function by increasing the serum levels of 25-OHD3. Successful renal transplantation was followed by a rise in serum 1,25-(OH)2D3 concentrations.