Classification of postoperative behavior disturbances in preschool children: A qualitative study.

BACKGROUND/AIM: Negative postoperative changes in children are frequent and have been described for decades. However, there is currently no theoretical framework, nor any consensual operational criteria for identifying them. This study aims at characterizing the many dimensions involved in postoperative behavioral disturbances in early childhood, using a qualitative analysis applied for the first time to these symptoms. METHOD: Fifty-seven parents of preschool children (1-5 years old; 38 boys), who underwent general anesthesia, were interviewed 10 days after surgery. Semi-structured interviews investigated behavioral disturbances classically described in preschool children. Qualitative analysis of the transcripts allied both deductive and inductive reasoning, and inductive coding was carried out using constant comparison method with dedicated qualitative software. RESULTS: Parents reported both positive and negative postoperative changes. Negative changes were classified in four main categories: (a) Externalizing and (b) Internalizing problems behaviors, (c) Feeding sleeping disruption and (d) Somatic problems, each comprising different sub-categories. Importantly within these categories, the symptoms distribution changed in 5 years old children, compared to younger children. Finally, our method allowed defining whether these (negative or positive) changes were significant or not, that is, the importance of postoperative behavioral changes. CONCLUSION: The results of this study highlight the heterogeneity of postoperative disturbances in preschool children. These results are of primary importance for the definition and measurement of postoperative behavioral disturbances.

[A sensorymotor precursor of the hyperactivity syndrom. Study of a sample of swiss French-speaking children]. / Un précurseur sensorimoteur du syndrome d'hyperactivité - Etude d'un groupe d'enfants de la population romande.

Psychological examination aims at objectifying the key symptoms of hyperactivity, namely the disorders of attention and of the exe-cutive functions (briefly, the activation-inhibition control). The -records of 237 patients, aged 5 to 17 and attending our day clinics between 2004 and 2016, are analyzed retrospectively. 40 cases present an attention-deficit/hyperactivity disorder (ADHD), combined presentation, after DSM-5 criteria. These children and adolescents show not only a typical impulsivity on the computerized test of -attention, but also some deficit in learning to write, a precocious manifestation of their neurodevelopmental disorders. This comorbidity correctly classifies 82.4 % of the hyperactivity and control cases, a quite strong effect in the context of the hard to reach -diagnosis of the ADHD syndrom.

L'examen psychologique vise à objectiver les symptômes clés de l'hyperactivité, à savoir les troubles de l'attention et des fonctions exécutives (en bref, le contrôle activation-inhibition). Les dossiers de 237 patients de nos consultations, âgés de 5 à 17 ans et examinés entre 2004 et 2016, sont analysés rétrospectivement. 40 cas présentent un trouble déficitaire de l'attention avec hyper­activité (TDAH), présentation mixte, selon les critères du DSM-5. Ces ­enfants et adolescents montrent non seulement une impulsivité ­caractéristique aux épreuves informatisées de l'attention, mais aussi un déficit dans l'acquisition de l'écriture, une manifestation précoce de leurs troubles neurodéveloppementaux. Cette association classe correctement 82,4 % des hyper­actifs et des contrôles, un effet fort, vu le diagnostic difficile du syndrome TDAH.

Relationship of hyperactivity/inattention with adiposity and lifestyle characteristics in preschool children.

We performed a cross-sectional study in 450 nonreferred preschool children aged 4 to 6 years to assess the association between hyperactivity/inattention with adiposity and lifestyle characteristics. Measurements included scores of hyperactivity/inattention, adiposity, objectively measured physical activity, television viewing, and eating habits. Higher scores of hyperactivity/inattention were associated with lower percentage body fat, higher levels of physical activity, and less time spent in sedentary activity (all P ≤ .01). However, higher scores of hyperactivity/inattention were also associated with more television viewing and less healthy eating habits (all P ≤ .04). Except for some selected eating habits (P ≥ .07), those relationships remained significant after adjustment for age, sex, and sociodemographic confounders. To conclude, higher scores of hyperactivity/inattention are linked to different lifestyle characteristics that may in part contribute to a future development of overweight/obesity. Precise mechanisms explaining these associations and possible preventive approaches should be further investigated.

Binge eating in binge eating disorder: a breakdown of emotion regulatory process?

Current explanatory models for binge eating in binge eating disorder (BED) mostly rely on models for bulimia nervosa (BN), although research indicates different antecedents for binge eating in BED. This study investigates antecedents and maintaining factors in terms of positive mood, negative mood and tension in a sample of 22 women with BED using ecological momentary assessment over a 1-week. Values for negative mood were higher and those for positive mood lower during binge days compared with non-binge days. During binge days, negative mood and tension both strongly and significantly increased and positive mood strongly and significantly decreased at the first binge episode, followed by a slight though significant, and longer lasting decrease (negative mood, tension) or increase (positive mood) during a 4-h observation period following binge eating. Binge eating in BED seems to be triggered by an immediate breakdown of emotion regulation. There are no indications of an accumulation of negative mood triggering binge eating followed by immediate reinforcing mechanisms in terms of substantial and stable improvement of mood as observed in BN. These differences implicate a further specification of etiological models and could serve as a basis for developing new treatment approaches for BED.