What exactly is catatonia in children and adolescents. / Czym jest katatonia u dzieci i mlodziezy.

The current study is a review of the literature on catatonia syndrome with focus on children and adolescent's specificity. Previous catatonia conceptualizations were significantly modified in the newest classification systems. Catatonia may be considered either a separate syndrome or a specifier of the course of other psychiatric disorders. Although diagnostic criteria for children and adolescent do not differ from those for adults, the clinical presentation and course may not be the same. In this age group relatively common are somatic conditions taking the form of catatonia. There is agrowing body of literature focused on catatonia in the course of pervasive developmental disorder. On the other hand, pervasive refusal syndrome and lethal catatonia are discussed in the literature, but they are not present in the classification systems. In the current paper basic treatment guidelines were also described. First-line treatment is the use of benzodiazepines and electroconvulsive therapy. The diagnosis and treatmentof catatonia is of great practical importance. While improper diagnosis and non-optimal treatment may have fatal consequences, in the case of proper diagnosis an effective treatment may be administered.

Prevalence of Overweight and Obesity in Children and Adolescents With ADHD: The Significance of Comorbidities and Pharmacotherapy.

OBJECTIVE: Assessment of the prevalence of overweight and obesity in children and adolescents with ADHD with emphasis on pharmacological treatment and comorbid disorders. METHOD: We analyzed 408 medical records of patients with ADHD aged 7 to 18. RESULTS: The prevalence of overweight (14.71% vs. 12.83%, χ2 = 3,586.43, p < .001) and obesity (6.37% vs. 3.45%, χ2 = 3,588.19, p < .001) was significantly higher in children with ADHD compared with the population. There was significantly higher incidence of obesity in patients with comorbid diagnosis of adjustment disorder (22.22% vs. 4.42%, χ2 = 5.66, p = .02) and mental retardation (19.05% vs. 4.42%, χ2 = 7.63, p = .005). Pharmacological treatment was associated with a higher incidence of obesity (8.37% vs. 2.76%, χ2 = 4.92, p = .03). CONCLUSION: Standardized body mass index (BMI), prevalence of overweight, and obesity was higher in patients with ADHD compared with the population. Higher incidence of obesity was shown in patients with analyzed comorbidities.

Bone mineralization and densitometric evaluation of vertebral fractures in women 6-21 years after the onset of anorexia nervosa symptoms. / Mineralizacja kosci i ocena densytometryczna zlaman kregoslupa u kobiet po uplywie 6­21 lat od pojawienia sie objawów jadlowstretu psychicznego.

OBJECTIVES: We attempted to assess bone mineralization and the frequency of fractures occurrence in women with a history of treatment of anorexia nervosa (AN) in adolescence. METHODS: 47 women (age 20-36.8 years) were re-examined 6.33-21,2 years after the onset of AN symptoms. Bone mineral density (BMD) of total body, lumbar spine, femoral neck, total hip (DXA) and densitometric Vertebral Fracture Assessment (VFA) were performed on 46 of women and BAP, P1NP, CTX, estradiol, testosterone, cortisol, IGF-1, leptin, DHEA-S on 45 of women entered for the current study. Current BMD results were compared with available baseline results from the time of hospitalization. RESULTS: Currently BMD Z-score <-1 examined at any location occurred in 28 from 46 women (including Z-score <-2 in 5 women). In 11 from 12 women with reduced BMD at the time of hospitalization current total body BMD was within the normal range. Lumbar spine BMD was normalized or improved respectively in 5 and 6 from 15 women. Currently increased levels/activity of bone formation markers: P1NP in 27 (60%) and BAP in 28 women (62.2%) were observed. In 7 women (15.6%) increased values of bone formation markers with increased marker of bone resorption (CTX) occurred. Osteoporotic fractures and fractures in the spine in VFA were not observed during the observation period. CONCLUSIONS: Despite early treatment of adolescent-onset AN and good outcomes of the treatment, decreased BMD was currently present in 60.9% of women. During follow-up normalization or significant improvement in BMD results (total body, lumbar spine) were observed in majority of cases.

Self-injury - placement in mental disorders classifications, risk factors and primary mechanisms. Review of the literature. / Samouszkodzenia ­ miejsce w klasyfikacjach zaburzen psychicznych, czynniki ryzyka i mechanizmy ksztaltujace. Przeglad badan.

Self-injury is a common phenomenon among adolescents and young adults, however its prevalence in clinical population is estimated at 40-80%, especially in regard to patients during puberty. Symptoms usually appear between 12th and 14th year of age, and their average duration is approx. 2 years. According to accepted sociocultural norms self-injury can be regarded as a normal behavior. Nevertheless, the prevalence of body art phenomenon in Western culture including professional tattooing, piercing, scarification, burning tattoos and other body modification typical for tribal cultures, has forced the need to redefine the boundaries for normative behavior. Introduction of a separate nosological unit of Non-Suicidal Self Injury in the fifth edition of DSM classification proves the validity of discussion, being hold for many years, regarding classification and understanding of the underlying mechanisms of self-harm. The aim of our study was to present the current state of knowledge regarding self-harm, with an emphasis on issues devoted to their placement in newest mental disorders classifications and mechanisms responsible for their development and maintenance. Databases such as: PubMed, EBSCO (medical and psychological resources) and WEB OF SCIENCE (years 1990-2016) have been screened for the following key words: self-injury, self-harm, self-mutilation, suicide, deliberate self-harm, affect regulation, NSSI, DSH, personality disorders, suicide attempt, neurobiology self-harm, DSM-5, adolescent, adults, stress coping styles, self-mutilation - children, adolescents and adults-prevalence. The analysis indicated 110 articles and 3 textbooks. We have used the following criteria: (1) for the articles presenting the latest research on risk factors for self-harm we have used the criterion of the study group number (>30 people) and meta-analyses have been included, (2) for theories explaining the mechanisms of self-harm criterion of empirical review of the assumptions and the number of the published studies that verify the theory has been applied.

Bone mineralization disorders as a complication of anorexia nervosa - etiology, prevalence, course and treatment. / Zaburzenia mineralizacji kosci jako powiklanie jadlowstretu psychicznego - etiologia, rozpowszechnienie, przebieg i leczenie.

Anorexia nervosa (AN) most often has its onset in adolescence, which is a crucial period to achieve peak bone mass. The hormonal abnormalities (hypoestrogenism, hypercortisolism, decreased secretion of dehydroepiandrosterone, testosterone, insulin-like growth factor) and malnutrition are associated with profound bone mineralization disorders. Densitomertic bone mineral density (BMD) values for osteopenia and osteoporosis were found respectively in 35-98% and 13-50% of women with AN. Prospective studies indicate a further decline in BMD at the beginning of treatment and a crucial importance of weight gain and return of spontaneous menses for its growth. Due to frequent chronic and relapsing course of AN densitometric assessment of BMD is recommended in all patients with AN and amenorrhea lasting around twelve months. In order to establish standards for the treatment of osteoporosis in AN, studies on pharmacological treatment are conducted. There are promising results indicating the improvement in BMD after treatment with physiologic oestrogen replacement treatment and sequential administration of medroxyprogesterone in teenage girls and bisphosphonates in adult women. Supplementation of vitamin D and adequate consumption of calcium from diet are recommended. Further studies on the effectiveness of long-term treatment of osteoporosis with regard to the possibility of increase in BMD and reducing the risk of osteoporotic fractures are needed.

Eating Disorders in children and adolescents with Type 1 and Type 2 Diabetes: prevalence, risk factors, warning signs.

Diabetes is associated with increased risk for eating disorders, various dependent on type of diabetes. Binge eating disorder is more common in patient with type 2 diabetes (T2DM). Whereas, intentional omission of insulin doses for the purpose of weight loss occurs mainly in patient with type 1 diabetes (T1DM), however, in some patients with type 2 diabetes omission of oral hypoglycemic drugs can be present. Risk factors for the development of eating disorders in patients with diabetes include: age, female gender, greater body weight, body image dissatisfaction, history of dieting and history of depression. Poor glycemic control, recurrent episodes of ketoacidosis or recurrent episodes of hypoglycemia, secondary to intentional insulin overdose, missed clinical appointments, dietary manipulation and low self-esteem should raise concern. The consequence of eating disorders or disordered eating patterns in patients with diabetes is poor glycemic control and hence higher possibility of complications such as nephropathy, retinopathy and premature death.

[Correlations between attention deficit hyperactivity disorder and obesity - a systematic review of the literature]. / Zwiazki miedzy zespolem nadpobudliwosci psychoruchowej (ADHD) a otyloscia - systematyczny przeglad literatury.

Recent studies suggest a possible correlation between Attention Deficit/Hyperactivity Disorder (ADHD) and obesity. In order to explore the topic a systematic review of the literature was performed excluding case reports, non-empirical studies, and studies not using the ADHD diagnostic criteria. Recent studies suggests that obese patients referred to obesity clinics may present themselves with a higher that predicted prevalence od ADHD. Moreover, all studies indicate that subjects with ADHD have higher body weight than expected. However, data on the prevalence of obesity in subjects with ADHD are still limited. Hypotheses about mechanisms underlying the potential correlation between ADHD and obesity suggests that ADHD may contribute to obesity by impulsive eating or disorganised eating habits, impulsivity associated with binge eating might contribute to ADHD symptoms in obese patients, or alternatively ADHD and obesity might be an expression of a common biological dysfunction such as deficit in the reward system. Prospective research, which ic still limited may lead to a better understanding of the correlation between ADHD and obesity as well as the possible mechanisms underlying this comorbidity, contributing to better therapy and thereby improve the quality of life in patient with ADHD and obesity.