Trajectory of maternal depression and parasomnias.

Maternal depressive symptoms are associated with poorer sleep quality in their children. Although parasomnias can occur at any age, this group of sleep disorders is more common in children. The aim of this study was to assess whether maternal depression trajectories predict parasomnias at the age of 11 years. Data were from a Birth Cohort of 4231 individuals followed in the city of Pelotas, Brazil. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 12, 24, and 48 months, and 6 and 11 years postpartum. Maternal depression trajectories were calculated using a group-based modelling approach. Information on any parasomnias (confused arousals, sleepwalking, night terrors, and nightmares) was provided by the mother. Five trajectories of maternal depressive symptoms were identified: chronic-low (34.9%), chronic-moderate (41.4%), increasing (10.3%), decreasing (8.9%), and chronic-high (4.4%). The prevalence of any parasomnia at the age of 11 years was 16.8% (95% confidence interval [CI] 15.6%-18.1%). Confusional arousal was the most prevalent type of parasomnia (14.5%) and varied from 8.7% to 14.7%, 22.9%, 20.3%, and 27.5% among children of mothers at chronic-low, moderate-low, increasing, decreasing, and chronic-high trajectories, respectively (p < 0.001). Compared to children from mothers in the chronic-low trajectory, the adjusted prevalence ratio for any parasomnia was 1.58 (95% CI 1.29-1.94), 2.34 (95% CI 1.83-2.98), 2.15 (95% CI 1.65-2.81), and 3.07 (95% CI 2.31-4.07) among those from mothers in the moderate-low, increasing, decreasing, and chronic-high trajectory groups, respectively (p < 0.001). In conclusion, parasomnias were more prevalent among children of mothers with chronic symptoms of depression.

Trastorno mixto ansioso-depresivo en funcionarios de la salud, durante la pandemia del SARS-CoV-2 / Mixed anxiety-depressive disorder in health workers, during the SARS-CoV-2 pandemic

Resumen Objetivo: Evaluar la existencia del trastorno mixto ansioso-depresivo en funcionarios de la salud de los servicios de Farmacia, Enfermería y personal de apoyo, durante la pandemia del SARS-CoV-2. Métodos: Se llevó a cabo un estudio transversal - analítico, en el periodo de marzo a septiembre 2020, en funcionarios de la salud, quienes estaban expuestos directamente con el SARS-CoV-2, consecuencia de su trabajo. Se realizó una encuesta bajo consentimiento informado, con parámetros como edad, sexo, estado civil, dependencia económica, servicio en que laboran, profesión ejercida, jornada laboral, entre otros; con una participación de 200 voluntarios, mediante un enlace virtual. Resultados: Un total de 127 trabajadores de la salud, es decir un 63.5% de la muestra, presentaron más de cuatro síntomas sugestivos de trastorno mixto ansioso-depresivo. Los síntomas más predominantes fueron preocupación (88,2%), fatiga (88,2%), falta de energía (78,0%) y trastornos del sueño (74,8%). Conclusión: El trastorno mixto ansioso depresivo cobró auge durante la pandemia del SARS-CoV-2, factores como la exposición prolongada a escenarios estresores, así como el sexo femenino, no contar con pareja o pertenecer a un grupo etario menor a los 45 años, pueden propiciar el desarrollo de un trastorno mental. Por lo cual es importante poder identificar a la población de riesgo, brindarle el apoyo y seguimiento necesario, así como la creación de protocolos que brinden una guía sobre como actuar para procurar la integridad del personal de salud.

Abstract Aim: To evaluate for mixed anxiety-depressive disorder in health care workers in the Pharmacy, Nursing and Support Staff during the SARS-CoV-2 pandemic. Methods: A cross-sectional-analytical study was carried out from March to September 2020 in health care workers who were directly exposed to SARS-CoV-2 because of their work. A survey was conducted previous informed consent, with variables including age, sex, marital status, economic dependence, service in which they work, profession, working day, among others; with the participation of 200 volunteers, through a virtual link. Results: A total of 127 health workers, that is, 63.5% of the sample, presented more than four symptoms suggestive mixed anxious-depressive disorder. The most predominant symptoms were worry (88.2%), fatigue (88.2%), lack of energy (78.0%) and sleep disorders (74.8%). Conclusion: mixed anxiety-depressive disorder was prevalent during the SARS-CoV-2 pandemic. Factors such as prolonged exposure to stressful scenarios, as well as female sex, not having a partner or belonging to an age group younger than 45 years old, can lead to the development of a mental disorder. It is therefore important to be able to identify the population at risk, provide the necessary support and follow-up, as well as the creation of protocols that provide guidance on how to act to ensure the integrity of health personnel.

Alteraciones del sueño en niños con trastorno del espectro autista y su afectación individual y familiar. Un estudio observacional de centro único en México / Sleep disturbances in children with autism spectrum disorder and their individual and family affectation. A single-center observational study in Mexico

Introducción: Los trastornos del sueño en niños, tienen un impacto en el desarrollo, afecta el comportamiento, el estado de ánimo, las funciones cognitivas, disminuyendo la atención selectiva y la memoria. El objetivo del presente estudio fue determinar las alteraciones del sueño en niños con trastorno del espectro autista (TEA), su afectación individual y familiar en el Centro Regional de Autismo Delicias Chihuahua. Métodos: El presente estudio transversal, incluye niños con TEA en quienes se determinó alguna alteración del sueño y se buscó su relación con la afectación individual y familiar, además se evaluaron, edad, sexo, grado escolar, nivel funcional de TEA, afectaciones familiares. Se aplicó el cuestionario de cribado del sueño en niños con TEA, el cuestionario adaptado para niños con TEA -BRUNI y el cuestionario de satisfacción sobre las actividades de los padres, cuidadores primarios y familiares de primera línea. Se usa estadística descriptiva y en un segundo análisis se usa Razón de Momios de Prevalencia (RMP). Resultados: Se analizan 57 pacientes, 43 (75.4%) hombres, 28 (49.1%) en grado 1 de nivel funcional TEA, 16 (28.1%) tenían mal desempeño individual, 56 (98.2%) sus familiares referían mal desempeño, 43 (75.4%) tenían alteraciones del sueño. Los niños preescolares tienen 2.5 veces riesgo de tener afec-tación individual. Los pacientes en nivel funcional TEA grado 3 tienen 2.15 veces riesgo de tener afectación individual. Los que despiertan cansados tienen 5.93 veces riesgo de tener afectación individual. Conclusión: La afectación familiar del desempeño es mucho mayor a la afectación individual de los niños con TEA, lo cual genera alteraciones en la dinámica familiar.

Introduction: Sleep disorders in children impact development, affecting behavior, mood, and cognitive functions and decreasing selective attention and memory. This study aimed to determine sleep disturbances in children with autism spectrum disorder (ASD) and their individual and family involvement at the Delicias Chihuahua Regional Autism Center. Methods: This cross-sectional study included children with ASD in whom some sleep disturbance was determined, and its relationship with individual and family affectation was sought; in addition, age, sex, school grade, functional level of ASD, and family affectations were evaluated. The sleep screening questionnaire for children with ASD, the adapted questionnaire for children with ASD -BRUNI, and the satisfaction questionnaire on the activities of parents, primary caregivers, and first-line family members were applied. Descriptive statistics were used, and the prevalence odds ratio (MPR) was used in a second analysis. Results: A total of 57 patients were analyzed; 43 (75.4%) were men, 28 (49.1%) were at the grade 1 ASD functional lev-el, 16 (28.1%) had poor individual performance, 56 (98.2%) their relatives reported poor performance, and 43 (75.4%) had sleep disturbances. Preschool children have a 2.5 times higher risk of having individual involvement. Patients in functional level ASD grade 3 have a 2.15 times higher risk of having individual involvement. Those who wake up tired have a 5.93 times higher risk of having individual involvement. Conclusion: The family affectation of performance is much greater than the personal affectation of children with ASD, which generates changes in family dynamics.

Trastornos del sueño en un escolar posterior al aislamiento social por la COVID-19 / Sleeping disorders in a school boy after social isolation due to the COVID-19

Se describe caso clínico de un escolar de 6 años y 3 meses de edad, quien a partir del aislamiento social por la COVID-19 presentó pesadillas asociadas a irritabilidad, desinterés por las clases y necesidad de la presencia de los padres a la hora de dormir. Se efectuó evaluación y se descartaron clínicamente enfermedades orgánicas, así como trastornos mentales. Se realizaron recomendaciones psicológicas y se indicó la terapia floral de Bach. El paciente tuvo una evolución favorable.

The case report of a 6 year and three months school boy is described; he had nightmares associated with irritability, lack of interest for the classes and necessity of his parents presence at bed time, due to social isolation for the COVID 19. An evaluation was carried out and organic diseases were clinically ruled out, as well as mental disorders. Psychological recommendations were carried out and Bach's floral therapy was indicated. The patient had a favorable clinical course.

Biblioterapia para medos noturnos em crianças: um estudo de caso / Bibliotherapy for nighttime fears in children: a case study / Biblioterapia para miedos nocturnos en niños: un estudio de caso

Medos noturnos na infância estão associados a ansiedade, problemas de sono e problemas de comportamento diurnos. O objetivo deste artigo é apresentar um estudo de caso de uma intervenção comportamental breve para o medo noturno severo e comportamento de dormir com os pais em uma menina de oito anos de idade. O tratamento consistiu em uma sessão em que os pais foram orientados a ler o livro Dormindo com Rafi: Boa Noite Filhote para sua criança por um período de quatro semanas e a encorajá-la a conduzir uma série de rotinas pré-sono e dormir sozinha. Medo noturno, padrões de sono e problemas de comportamento foram avaliados com medidas de relato parental. A menina também foi questionada para reportar seus medos noturnos por meio de uma escala visual analógica. Verificou-se aumento no número de noites em que a criança dormiu em sua própria cama e redução dos medos noturnos. Os efeitos positivos no pós-tratamento foram mantidos no seguimento de três meses. O presente estudo fornece suporte inicial para o uso desta breve intervenção, que empregou princípios comportamentais básicos, como modelação, modelagem e dessensibilização sistemática no tratamento de medos noturnos em crianças.(AU)

Nighttime fears in childhood are associated with anxiety, sleeping problems, and daytime behavioral problems. This article presents a case study of a brief intervention for severe nighttime fears and co-sleeping problems in an eight-year-old girl. The treatment consisted of instructing the parents to read the book Dormindo com Rafi: Boa Noite Filhote (Sleeping with Rafi: Good Night, Darling) to their daughter for a four-week period, besides encouraging her to adopt a bedtime routine and to sleep on her own. Nighttime fear, sleep patterns, and behavioral problems were assessed with parent-report measures, and the girl was asked to track her nighttime fears using a visual analogue scale. The results showed an increase in the number of nights the child slept in her own bed and a reduction of nighttime fears, which were maintained at the 3-month follow-up. This study provides initial support for the use of this brief intervention that enlisted basic behavioral principles such as shaping, modeling, systematic desensitization, and reinforcement in the treatment of nighttime fears in children.(AU)

Los miedos nocturnos en la infancia están asociados a la ansiedad, a los problemas de sueño y a los problemas de comportamiento diurno. El objetivo de este artículo es presentar un estudio de caso de una intervención conductual breve para el miedo nocturno severo y comportamiento de dormir con los padres de una niña de 8 años de edad. El tratamiento consistió en una sesión en la que se orientó a los padres a leer el libro Dormindo com Rafi, Boa Noite, Filhote! ("Durmiendo con Rafi: buenas noches, mi hijo") para su hija, por un período de cuatro semanas, y la alentasen a conducir una serie de rutinas de presueño y a dormir sola. El miedo nocturno, los patrones de sueño y los problemas de comportamiento fueron evaluados con medidas de relato parental. Los miedos nocturnos de la niña también se evaluaron por una escala visual analógica. Se verificó un incremento de la cantidad de veces en que la niña durmió por las noches en su propia cama y una reducción de sus miedos nocturnos. Los efectos positivos en el postratamiento se mantuvieron tras tres meses. Este estudio proporciona soporte inicial para el uso de esta breve intervención que empleó principios comportamentales básicos, como modelado, desensibilización sistemática y refuerzo en el tratamiento de miedos nocturnos en niños.(AU)

Psychotherapy improved the sleep quality in a patient who was a victim of child sexual abuse: a case report.

INTRODUCTION: Victims of child sexual abuse (CSA) often experience symptoms such as recurrent nightmares, which affect their adult life. AIM: This study aimed to evaluate the effect of psychotherapy on the quality of life and sleep in a female patient with a previous history of CSA. METHODS: The patient was climacteric (menopausal transition) and treated in an outpatient clinic. She underwent 40 sessions of psychotherapy and was evaluated before and after the sessions using questionnaires and polysomnography (PSG). MAIN OUTCOME MEASURES: Measurements were taken using the following: Kupperman Index (KI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Prospective and Retrospective Memory Questionnaire, and PSG. Reports of dream content were also evaluated during the study. RESULTS: After psychotherapeutic intervention, the frequency of nightmares and their attendant suffering decreased. Additionally, the context of the nightmares changed, and a decrease was noted in the KI, BAI, and BDI parameters. The PSG indicated an increase in rapid eye movement sleep. CONCLUSION: Psychotherapeutic intervention combined with zolpidem and fluoxetine treatment contributed to a resignification of the dreams of a patient with a history of CSA. The treatment also improved the quality of her dreams and her quality of life.

Sleep terrors antecedent is common in adolescents with migraine / O antecedente de terror noturno é frequente em adolescentes com migrânea

Migraines and sleep terrors (STs) are highly prevalent disorders with striking similarities. The aim of this study was to evaluate the effect of the antecedent of STs by comparing adolescents suffering from migraines with healthy controls in a large consecutive series. METHODS: All patients were subjected to a detailed headache questionnaire and were instructed to keep a headache diary during a two-month period. The age range was 10 to 19 years. The diagnosis of STs was defined according to the International Classification of Sleep Disorders. RESULTS: A total of 158 participants were evaluated. Of these participants, 50 suffered from episodic migraines (EMs), 57 had chronic migraines (CMs) and 51 were control subjects (CG). Participants who had a history of STs had significantly more migraines than participants who did not. CONCLUSIONS: Migraine is strongly associated with a history of STs in the adolescent population independent of demographics and pain intensity.

Migrânea e terror noturno (TN) são transtornos de alta prevalência que compartilham muitas similaridades. O objetivo desse estudo foi avaliar a ocorrência do antecedente de TN, comparando adolescentes com migrânea e adolescentes saudáveis. Métodos: Todos os pacientes foram submetidos a um questionário detalhado sobre sua cefaleia e foram instruídos a preencher um diário durante um período de dois meses. A idade dos sujeitos variou entre 10 e 19 anos. O diagnóstico de TN foi definido de acordo com a Classificação Internacional dos Transtornos do Sono. Resultados: Foram avaliados 158 sujeitos. Desses indivíduos, 50 apresentavam migrânea episódica, 57 migrânea crônica e 51 eram controles. Participantes que tinham o antecedente de TN apresentavam significativamente mais crises de migrânea do que aqueles que não tinham. Conclusões: Migrânea esteve fortemente associada ao antecedente de TN na população de adolescentes independentemente de variáveis demográficas e intensidade da dor.

Sleep terrors antecedent is common in adolescents with migraine.

UNLABELLED: Migraines and sleep terrors (STs) are highly prevalent disorders with striking similarities. The aim of this study was to evaluate the effect of the antecedent of STs by comparing adolescents suffering from migraines with healthy controls in a large consecutive series. METHODS: All patients were subjected to a detailed headache questionnaire and were instructed to keep a headache diary during a two-month period. The age range was 10 to 19 years. The diagnosis of STs was defined according to the International Classification of Sleep Disorders. RESULTS: A total of 158 participants were evaluated. Of these participants, 50 suffered from episodic migraines (EMs), 57 had chronic migraines (CMs) and 51 were control subjects (CG). Participants who had a history of STs had significantly more migraines than participants who did not. CONCLUSIONS: Migraine is strongly associated with a history of STs in the adolescent population independent of demographics and pain intensity.

Noite: escuridão sem tempo / Noche: oscuridad sin tiempo / Night: timeless darkness

Por meio da análise do material clínico de uma criança de quatro anos e de uma jovem de vinte e quatro, procuro desenvolver ideias a respeito das representações da noite e seus desdobramentos: insônia, pesadelos, terrores noturnos, angústias de morte. Analisando por um lado, a produção gráfica da criança e por outro, os sonhos da jovem, procuro estabelecer uma equivalência entre as diferentes formas de expressão que ambas encontram. Questões referentes ao tempo e atemporalidade do mundo psíquico são abordadas. Evidenciam-se situações de rivalidade fraterna, ataques ao corpo materno e configurações edípicas, vistos ora pelo prisma da menina, ora da moça, como se ambas teatralizassem a mesma personagem em momentos diferentes da existência.(AU)

La autora, por medio del análisis del material clínico de una niña de cuatro años y de una joven de veinticuatro, busca desarrollar ideas al respecto de las representaciones de la "noche" y sus desdobles: insomnio, pesadillas, terrores nocturnos y angustia de muerte. Por un lado, analiza la producción gráfica de la niña y, por otro, los sueños de la joven, buscando establecer una equivalencia entre las diferentes formas de expresión que ambas encuentran. En este trabajo se plantean cuestiones referidas al tiempo y a la intemporalidad del mundo psíquico. Se pueden evidenciar situaciones de rivalidad fraterna, ataques al cuerpo materno y configuraciones edípicas, todo eso visto ya sea o desde el prisma de la niña, o el de la joven, como si ambas mujeres teatralizaran al mismo personaje, pero en momentos diferentes de la existencia.(AU)

By analyzing the clinical samples of a four year-old child and of a twenty-four year-old woman, my attempt is to develop ideas in relation to night representations and its consequences, such as insomnia, nightmares, night terrors, and death anguish. While analyzing the child’s graphic production, on the one hand, and the young woman’s dreams, on the other, I try to establish a similarity among the different ways of expression used by both of them. Issues of the psychic world, related to time and to timelessness, are approached. Sibling rivalry situations become evident, as well as attacks to the mother’s body and oedipal configurations. These are viewed in the child and in the woman as if both play same character in different points in life.(AU)

Noite: escuridão sem tempo / Noche: oscuridad sin tiempo / Night: timeless darkness

Por meio da análise do material clínico de uma criança de quatro anos e de uma jovem de vinte e quatro, procuro desenvolver ideias a respeito das representações da noite e seus desdobramentos: insônia, pesadelos, terrores noturnos, angústias de morte. Analisando por um lado, a produção gráfica da criança e por outro, os sonhos da jovem, procuro estabelecer uma equivalência entre as diferentes formas de expressão que ambas encontram. Questões referentes ao tempo e atemporalidade do mundo psíquico são abordadas. Evidenciam-se situações de rivalidade fraterna, ataques ao corpo materno e configurações edípicas, vistos ora pelo prisma da menina, ora da moça, como se ambas teatralizassem a mesma personagem em momentos diferentes da existência.

La autora, por medio del análisis del material clínico de una niña de cuatro años y de una joven de veinticuatro, busca desarrollar ideas al respecto de las representaciones de la "noche" y sus desdobles: insomnio, pesadillas, terrores nocturnos y angustia de muerte. Por un lado, analiza la producción gráfica de la niña y, por otro, los sueños de la joven, buscando establecer una equivalencia entre las diferentes formas de expresión que ambas encuentran. En este trabajo se plantean cuestiones referidas al tiempo y a la intemporalidad del mundo psíquico. Se pueden evidenciar situaciones de rivalidad fraterna, ataques al cuerpo materno y configuraciones edípicas, todo eso visto ya sea o desde el prisma de la niña, o el de la joven, como si ambas mujeres teatralizaran al mismo personaje, pero en momentos diferentes de la existencia.

By analyzing the clinical samples of a four year-old child and of a twenty-four year-old woman, my attempt is to develop ideas in relation to night representations and its consequences, such as insomnia, nightmares, night terrors, and death anguish. While analyzing the child’s graphic production, on the one hand, and the young woman’s dreams, on the other, I try to establish a similarity among the different ways of expression used by both of them. Issues of the psychic world, related to time and to timelessness, are approached. Sibling rivalry situations become evident, as well as attacks to the mother’s body and oedipal configurations. These are viewed in the child and in the woman as if both play same character in different points in life.