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1.
BMC Psychiatry ; 24(1): 290, 2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38632560

RESUMO

BACKGROUND: The diagnosis of adolescent Depressive Disorder (DD) lacks specific biomarkers, posing significant challenges. This study investigates the potential of Niacin Skin Flush Response (NSFR) as a biomarker for identifying and assessing the severity of adolescent Depressive Disorder, as well as distinguishing it from Behavioral and Emotional Disorders typically emerging in childhood and adolescence(BED). METHODS: In a case-control study involving 196 adolescents, including 128 Depressive Disorder, 32 Behavioral and Emotional Disorders, and 36 healthy controls (HCs), NSFR was assessed. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) and anxious symptoms with the Generalized Anxiety Disorder 7-item scale (GAD-7). Pearson correlation analysis determined the relationships between NSFR and the severity of depression in DD patients. Receiver Operating Characteristic (ROC) was used to identify DD from BED integrating NSFR data with clinical symptom measures. RESULTS: The adolescent Depressive Disorder group exhibited a higher rate of severe blunted NSFR (21.4%) compared to BED (12.5%) and HC ( 8.3%). Adolescent Depressive Disorder with psychotic symptoms showed a significant increase in blunted NSFR (p = 0.016). NSFR had negative correlations with depressive (r = -0.240, p = 0.006) and anxious (r = -0.2, p = 0.023) symptoms in adolescent Depressive Disorder. Integrating NSFR with three clinical scales improved the differentiation between adolescent Depressive Disorder and BED (AUC increased from 0.694 to 0.712). CONCLUSION: The NSFR demonstrates potential as an objective biomarker for adolescent Depressive Disorder, aiding in screening, assessing severity, and enhancing insights into its pathophysiology and diagnostic precision.


Assuntos
Niacina , Humanos , Adolescente , Depressão , Transtornos de Ansiedade/psicologia , Estudos de Casos e Controles , Biomarcadores
2.
Artigo em Inglês | MEDLINE | ID: mdl-38537777

RESUMO

BACKGROUND: Family environment has long been known for shaping brain function and psychiatric phenotypes, especially in childhood and adolescence. Accumulating neuroimaging evidence suggests that across different psychiatric disorders, common phenotypes might share common neural bases, indicating latent brain-behavior relationships beyond diagnostic categories. However, the influence of family environment on the brain-behavior relationship from a transdiagnostic perspective remains unknown. METHOD: We included a community-based sample of 699 subjects (5-22 yrs.) and applied partial least squares regression analysis to determine latent brain-behavior relationships from the whole brain functional connectivity and comprehensive phenotypic measures. Comparisons were conducted between diagnostic and non-diagnostic groups to help interpret the latent brain-behavior relationships. A moderation model was introduced to examine the potential moderating role of family factors in the estimated brain-behavior association. RESULTS: Four significant latent brain-behavior pairs reflecting relationship of dissociable brain network and general behavioral problems, cognitive and language skills, externalizing problems, and social dysfunction, respectively, were identified. The group comparisons exhibited interpretable variations across different diagnostic groups. Warmth family environment was found to moderate the brain-behavior relationship of core symptoms in internalizing disorders. However, in neurodevelopmental disorders, family factors were not found to moderate the brain-behavior relationship of core symptoms, but were found to affect brain-behavior relationship in other domains. CONCLUSION: Our findings leveraged the transdiagnostic analysis investigating the moderating effects of the family factors on brain-behavior association, emphasizing the different role family factors take in developmental period across distinct diagnostic groups.

3.
Clin Child Fam Psychol Rev ; 27(1): 257-274, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38402358

RESUMO

OBJECTIVE: Patient and public involvement (PPI) is an essential ethical component in mental health research, and represents a major opportunity to improve translational mental health research. The goals of this review were to (1) provide a comprehensive overview of empirical research focusing on PPI of children and young people (CYP) in mental health research studies; (2) evaluate the results with CYP and parents of those affected; and (3) derive recommendations for PPI of CYP in future mental health research studies. METHODS: Based on an extensive literature review following the PRISMA guidelines, studies including CYP (age range: 0-21 years) in mental health research were identified and examined along a two-part analysis process considering their usability for mental health research. The conclusions drawn from the studies concerning CYP involvement were summarized and recommendations derived. RESULTS: Overall, 19 articles reported PPI of CYP (age range: 10-26 years) in mental health research and were included for further analyses. The integrated studies differed in the type of PPI, and in the way the participation and involvement processes were presented. CONCLUSION: Progress has been made in engaging CYP in mental health research, but there is a need for international standards, operationalization, and evaluation measures. Future research should go beyond merely reporting the PPI process itself. It should clearly indicate how and to what extent feedback from these PPI members was incorporated throughout the research process.


Assuntos
Saúde Mental , Participação do Paciente , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Adulto Jovem , Pais , Participação do Paciente/métodos , Projetos de Pesquisa
4.
Orphanet J Rare Dis ; 19(1): 27, 2024 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-38281056

RESUMO

BACKGROUND: Approximately 50% of rare diseases have symptom onset during childhood. A high level of nursing care and an often uncertain prognosis put caregivers of the affected children at high risk for psychological distress. At the same time, their caregivers have limited access to appropriate psychological care. The aim of this study was to evaluate a web-based psychological support program for caregivers of children with chronic rare diseases (WEP-CARE). METHODS: German-speaking parents (recruited between May 2016 and March 2018) caring for children aged 0-25 years with a rare disease showing clinically relevant anxiety symptoms, were assigned to either the WEP-CARE (n = 38) or treatment as usual (n = 36) condition within a randomized controlled trial. The primary outcome measure was parental anxiety, assessed with the Generalized Anxiety Disorder Questionnaire (GAD-7). Secondary outcomes were fear of disease progression, depression, coping, quality of life and user satisfaction. The group differences were tested through repeated-measures analyses of variance. The WEP-CARE group was additionally followed up three months after the treatment. RESULTS: A significant time-group interaction was found for anxiety (F (1,35) = 6.13, p = .016), fear of disease progression (F (1,331) = 18.23, p < .001), depression (F (1,74) = 10.79, p = .002) and coping (F (1,233) = 7.02, p = .010), suggesting superiority of the WEP-CARE group. Sustainability of the treatment gains regarding anxiety, fear of disease progression and coping was confirmed at the 6-month follow-up assessment (p < .01). A significant interaction effect could not be found for quality of life (F(1,2) = 0.016; p = .899). Both participating parents and therapists were satisfied with WEP-CARE. CONCLUSIONS: Our results underline the efficacy and feasibility of WEP-CARE for parents of children with various rare diseases.


Assuntos
Cuidadores , Terapia Cognitivo-Comportamental , Criança , Humanos , Cuidadores/psicologia , Doenças Raras , Depressão , Qualidade de Vida , Terapia Cognitivo-Comportamental/métodos , Doença Crônica , Progressão da Doença , Internet
5.
J Pediatr (Rio J) ; 100 Suppl 1: S82-S87, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38142715

RESUMO

OBJECTIVE: To investigate the relationship between the biopsychosocial environment and eating habits and behaviors that lead to the selection and consumption of certain food from the earliest stages of life. To clarify whether there is an interaction between genetic and epigenetic factors, and how they shape eating habits. DATA SOURCE: A narrative review based on research in PubMed and Web of Science electronic databases was carried out over the last 10 years, searching the title and summary fields using the keywords Children OR adolescents Feeding Behavior eating OR Dietary Habits OR Eating Behavior OR Eating Habits OR Children obesity. DATA SYNTHESIS: The generational transmission of eating habits is related to the home, community, and school environments, mainly during the first years of life, and can exert the modulation of habits during all stages of life. During childhood, the family's role in consolidating eating habits is very broad and ranges from choosing foods to prioritizing family meals, including the lifestyle. CONCLUSIONS: Eating habits are transmitted from parents to children in different ways: environmental, emotional, social, and educational. In cases of obesity, a greater association of genetic influence can be observed.


Assuntos
Comportamento Alimentar , Obesidade Pediátrica , Criança , Adolescente , Humanos , Pais , Estilo de Vida , Obesidade Pediátrica/genética , Inquéritos e Questionários
6.
Zh Nevrol Psikhiatr Im S S Korsakova ; 123(9. Vyp. 2): 77-82, 2023.
Artigo em Russo | MEDLINE | ID: mdl-37942976

RESUMO

OBJECTIVE: To determine the frequency of prescribing and the main therapeutic targets of Teraligen in the treatment of Schizotypal disorder (STD) in childhood and adolescence. MATERIAL AND METHODS: The sample consisted of 151 patients aged 7 to 16 years with a diagnosis of STD (F 21), of which 31.1% (n=47) of female patients and 68.9% (n=104) of male patients who received inpatient or outpatient treatment at the FSBI NCPZ from 2008 to 2020. The study was conducted by clinical-psychopathological, clinical-catamnestic, and statistical methods. RESULTS: Teraligen was prescribed by psychiatrists to patients with STD in 74.2% of cases, of which in 46.4% of cases patients received Teraligen even before the diagnosis of STD in connection with complaints of neurotic disorders (anxiety, fears and sleep disorders) (n=30), as well as in connection with autistic-like behavior (n=22). At the time of follow-up, 55% (n=83) of patients received Teraligen, of which 63.9% (n=53) of patients were prescribed it for the first time. The applied schemes of prescribing Teraligen for the treatment of anxiety-phobic, depressive and behavioral syndromes within the framework of the STD in a relatively age-related aspect are presented. CONCLUSION: The high frequency of prescribing Teraligen by psychiatrists and neurologists to children and adolescents with STD at different stages of observation is shown, which reflects the confidence of specialists in this drug. Teraligen has demonstrated a multidimensional pharmacological effect, including a mild antipsychotic effect, providing reduction of a wide range of psychopathological symptoms, with good tolerability and drug interaction. The study of the possibilities of Teraligen, both for monotherapy and for augmentation of the treatment of mental pathology in childhood, remains relevant.


Assuntos
Transtorno da Personalidade Esquizotípica , Trimeprazina , Adolescente , Criança , Feminino , Humanos , Masculino , Ansiedade/tratamento farmacológico , Ansiedade/etiologia , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/etiologia , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/etiologia , Transtorno da Personalidade Esquizotípica/complicações , Transtorno da Personalidade Esquizotípica/tratamento farmacológico , Transtornos Fóbicos/tratamento farmacológico , Transtornos Fóbicos/etiologia , Trimeprazina/uso terapêutico
7.
Child Adolesc Psychiatry Ment Health ; 17(1): 121, 2023 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-37848951

RESUMO

BACKGROUND: Our aim was to determine whether child attachment to parents, parent attachment style, and morning cortisol levels were related to diabetes outcomes measured by average glycated hemoglobin (HbA1c), HbA1c variability over 4 years and time in range (TIR) in children with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: 101 children with T1D and one of their parents were assessed at baseline for child attachment (Child Attachment Interview; CAI) and parent attachment (Relationship Structures Questionnaire; ECR-RS). Serum samples were collected for cortisol measurements before the interviews. HbA1c levels were measured during a 4-year follow-up period at regular 3-monthly visits, and data for TIR were exported from blood glucose measuring devices. Multivariate linear regression models were constructed to identify independent predictors of glycemic outcomes. RESULTS: More girls than boys exhibited secure attachment to their mothers. The results of the regression models showed that securely attached girls (CAI) had higher average HbA1c than did insecurely attached girls (B = -0.64, p = 0.03). In boys, the more insecure the parent's attachment style, the worse the child's glycemic outcome: the higher the average Hb1Ac (B = 0.51, p = 0.005), the higher the HbA1c variability (B = 0.017, p = 0.011), and the lower the TIR (B = -8.543, p = 0.002). CONCLUSIONS: Attachment in close relationships is associated with glycemic outcomes in children with T1D, and we observed significant differences between sexes. A sex- and attachment-specific approach is recommended when treating children with less favorable glycemic outcomes. Special attention and tailored support should be offered to securely attached girls in transferring responsibility for diabetes care and at least to male children of insecurely attached parents to prevent suboptimal glycemic control. Further studies in larger samples and more daily cortisol measurements may help us better understand the links between stress response, attachment and T1D.

8.
Artigo em Inglês | MEDLINE | ID: mdl-37794273

RESUMO

Overgeneralization of conditioned fear is associated with anxiety disorders (AD). Most results stem from studies done in adult patients, but studies with children are rare, although the median onset of anxiety disorders lies already in childhood. Thus, the goal of the present study was to examine fear learning and generalization in youth participants, aged 10-17 years, with AD (n = 39) compared to healthy controls (HC) (n = 40). A discriminative fear conditioning and generalization paradigm was used. Ratings of arousal, valence, and US expectancy (the probability of an aversive noise following each stimulus) were measured, hypothesizing that children with AD compared to HC would show heightened ratings of arousal and US expectancy, and decreased positive valence ratings, respectively, as well as overgeneralization of fear. The results indicated that children with AD rated all stimuli as more arousing and less pleasant, and demonstrated higher US expectancy ratings to all stimuli when compared to HC. Thus, rather than displaying qualitatively different generalization patterns (e.g., a linear vs. quadratic slope of the gradient), differences between groups were more quantitative (similar, but parallel shifted gradient). Therefore, overgeneralization of conditioned fear does not seem to be a general marker of anxiety disorders in children and adolescents.

9.
J Nutr Sci ; 12: e104, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37829085

RESUMO

Adequate nutrition is necessary during childhood and early adolescence for adequate growth and development. Hence, the objective of the study was to assess the association between dietary intake and blood levels of minerals (calcium, iron, zinc, and selenium) and vitamins (folate, vitamin B12, vitamin A, and vitamin D) in urban school going children aged 6-16 years in India, in a multicentric cross-sectional study. Participants were enrolled from randomly selected schools in ten cities. Three-day food intake data was collected using a 24-h dietary recall method. The intake was dichotomised into adequate and inadequate. Blood samples were collected to assess levels of micronutrients. From April 2019 to February 2020, 2428 participants (50⋅2 % females) were recruited from 60 schools. Inadequate intake for calcium was in 93⋅4 % (246⋅5 ± 149⋅4 mg), iron 86⋅5 % (7⋅6 ± 3⋅0 mg), zinc 84⋅0 % (3⋅9 ± 2⋅4 mg), selenium 30⋅2 % (11⋅3 ± 9⋅7 mcg), folate 73⋅8 % (93⋅6 ± 55⋅4 mcg), vitamin B12 94⋅4 % (0⋅2 ± 0⋅4 mcg), vitamin A 96⋅0 % (101⋅7 ± 94⋅1 mcg), and vitamin D 100⋅0 % (0⋅4 ± 0⋅6 mcg). Controlling for sex and socioeconomic status, the odds of biochemical deficiency with inadequate intake for iron [AOR = 1⋅37 (95 % CI 1⋅07-1⋅76)], zinc [AOR = 5⋅14 (95 % CI 2⋅24-11⋅78)], selenium [AOR = 3⋅63 (95 % CI 2⋅70-4⋅89)], folate [AOR = 1⋅59 (95 % CI 1⋅25-2⋅03)], and vitamin B12 [AOR = 1⋅62 (95 %CI 1⋅07-2⋅45)]. Since there is a significant association between the inadequate intake and biochemical deficiencies of iron, zinc, selenium, folate, and vitamin B12, regular surveillance for adequacy of micronutrient intake must be undertaken to identify children at risk of deficiency, for timely intervention.


Assuntos
Anemia Ferropriva , Selênio , Feminino , Adolescente , Humanos , Criança , Masculino , Estudos Transversais , Cálcio , Anemia Ferropriva/epidemiologia , Vitaminas , Ácido Fólico , Micronutrientes , Vitamina B 12 , Vitamina D , Zinco , Ingestão de Alimentos , Ferro
10.
Alpha Psychiatry ; 24(3): 87-92, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37440900

RESUMO

Objective: Several studies have highlighted that internalizing problems have not received all the attention it deserves because they are not visible in children's observable behavior. The aim of this study is to analyze the relationship between differences in parenting practices and internalizing problems in children and adolescents. Methods: Our study sample consisted of 554 children (288 boys and 266 girls) between 3 and 13 years of age who participated in the study. Their respective parents provided the information about them. The instruments used have been the Behavioral Assessment System for Children and Adolescents and parenting style, defined according to the Parental Parenting Questionnaire. The Parenting Questionnaire considers 7 factors: social and emotional support received by a mother or father, satisfaction with parenting, involvement, communication, limit setting, autonomy, and role orientation. Results: The results showed that children with high scores in internalizing problems tended to have parents with low levels of support, limit setting, and autonomy, along with low levels of maternal satisfaction with parenting. A regression analysis was also conducted, producing a model capable of predicting 14% of the variance in internalizing problems. The model was based on the following parenting variables: maternal support, autonomy and satisfaction with parenting, and paternal limit setting and role orientation. Conclusion: Our results indicate that the information obtained is very useful for the design of parenting programs related to certain aspects of current educational practice. Furthermore, parents' responses to the instruments used revealed patterns of behavior that can be modified in both parents and children.

11.
Scand J Psychol ; 64(6): 776-783, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37309265

RESUMO

BACKGROUND: Attachment quality may affect psychological functioning. However, evidence on attachment representations and their correlates in children born to parents with schizophrenia and bipolar disorder is sparse. METHODS: We compared attachment representations in a Danish sample of 482 children aged 7 years at familial high risk of schizophrenia, bipolar disorder, and population-based controls and examined associations between attachment and mental disorders and daily functioning. Attachment representations were examined with the Story Stem Assessment Profile (SSAP). Mental disorders were ascertained in diagnostic interviews. Daily functioning was assessed with the Children's Global Assessment Scale. RESULTS: We found no between-group differences in attachment. Higher levels of secure attachment were associated with decreased risk of concurrent mental disorders in the schizophrenia high-risk group. Higher levels of insecure and disorganized attachment were associated with increased risk of mental disorders across the cohort. Higher levels of secure and insecure attachment were associated with better and poorer daily functioning, respectively. In the current study, results regarding defensive avoidance could not be reported due to methodological limitations. CONCLUSION: Familial high risk of schizophrenia (FHR-SZ) or bipolar disorder is not associated with less secure or more insecure attachment at age 7. Insecure and disorganized attachment representations index risk of mental disorders and poorer functioning. Secure attachment may be a protective factor against mental disorders in children at FHR-SZ. Validation of the SSAP is needed.


Assuntos
Transtorno Bipolar , Transtornos Mentais , Esquizofrenia , Humanos , Criança , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Esquizofrenia/diagnóstico , Estudos de Coortes , Dinamarca
12.
Artigo em Inglês | MEDLINE | ID: mdl-37081139

RESUMO

The COVID-19 pandemic and associated containment measures have massively changed the daily lives of billions of children and adolescents worldwide. To investigate the global longitudinal effects on various mental health outcomes over a period of 1.5 years, we conducted a scoping review in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included the peer-reviewed articles from PubMed, Web of Science, and APA PsycInfo that were published between December 2019 and December 2021, followed a longitudinal or repeated cross-sectional design, and quantitatively assessed with clinical questionnaires the effect of the COVID-19 pandemic or a related stressor on mental health indicators in community samples of children and adolescents.The results of our qualitative analysis of 69 studies indicate a general trend of less psychological well-being and more mental health problems, such as heightened stress, and depressive and anxiety symptoms during the pandemic. Data suggest that both protection measure intensity and infection dynamics were positively associated with severity of the psychopathology. The most reported influencing factors were age, gender, socio-economic status, previous state of mental and physical health, self-regulation abilities, parental mental health, parenting quality, family functioning, social support, isolation and loneliness, health-related worries, and consistent routines and structure. Our results demonstrate that children and adolescents worldwide have experienced more mental health problems due to the COVID-19 pandemic. They call for improved access to child and adolescent mental health care and prioritisation of child and adolescent welfare in political decision making.

13.
Child Adolesc Psychiatry Ment Health ; 17(1): 23, 2023 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-36755284

RESUMO

BACKGROUND: Bereavement is a common traumatic event associated with adverse health outcomes across the life course. Despite these risks, not all bereaved individuals experience these negative effects. Limited scientific consensus exists on how to define resilience in individuals who have experienced the death of a loved one. METHODS: Using a sample of N = 3766 youth from the Avon Longitudinal Study of Parents and Children birth cohort, we identified bereavement of a family member between ages 7 and 8.5. We derived and compared three different approaches to assess resilience among bereaved youth. Trajectory-based psychological resilience identified sub-groups with similar psychological symptom profiles between ages 6 and 16 using latent growth mixture models. Relative psychological resilience at age 16 leveraged standardized residuals from a model regressing psychological symptoms on bereavement to determine better-than-expected psychological functioning relative to bereavement status. Relative cross-domain resilience around age 16 was a sum score of the residuals approach applied to eight unique domains of health. Predictive validity of each approach was assessed using depressive symptoms at age 17.5 RESULTS: Overall, N = 877 (23%) youth were bereaved of a family member between ages 7 and 8.5. Using latent growth mixture models, a three-class solution described 84% of bereaved youth with low and stable psychological symptoms over time, 8% with worsening symptoms, and 8% with improving yet elevated symptoms. Each relative resilience score was largely concordant with the trajectory-based approach in identifying individuals as resilient or not, though relative psychological resilience demonstrated a stronger degree of concordance than the cross-domain score. Relative psychological and cross-domain resilience exhibited moderate to low correlation, depending on the domains included (r = 0.14-0.43). For each approach, resilience significantly predicted lower depressive symptoms at age 17.5, highlighting predictive validity of these measures. CONCLUSIONS: Psychological symptom trajectories among bereaved youth aligned with those previously identified among bereaved adults. The residual-based approach to defining resilience exhibited limited utility in the context of bereavement. When identifying risk and resilience after bereavement, researchers and clinicians must address the interplay across psychosocial and physical health domains, as bereaved youth considered resilient from a mental health perspective may benefit from intervention in other domains.

14.
Psychol Med ; 53(5): 2072-2084, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-34689845

RESUMO

BACKGROUND: Peer victimization is associated with a wide range of mental health problems in youth, yet few studies described its association with mental health comorbidities. METHODS: To test the association between peer victimization timing and intensity and mental health comorbidities, we used data from 1216 participants drawn from the Quebec Longitudinal Study of Child Development, a population-based birth cohort. Peer victimization was self-reported at ages 6-17 years, and modeled as four trajectory groups: low, childhood-limited, moderate adolescence-emerging, and high-chronic. The outcomes were the number and the type of co-occurring self-reported mental health problems at age 20 years. Associations were estimated using negative binomial and multinomial logistic regression models and adjusted for parent, family, and child characteristics using propensity score inverse probability weights. RESULTS: Youth in all peer victimization groups had higher rates of co-occurring mental health problems and higher likelihood of comorbid internalizing-externalizing problems [odds ratios ranged from 2.06, 95% confidence interval (CI) 1.52-2.79 for childhood-limited to 4.34, 95% CI 3.15-5.98 for high-chronic victimization] compared to those in the low victimization group. The strength of these associations was highest for the high-chronic group, followed by moderate adolescence-emerging and childhood-limited groups. All groups also presented higher likelihood of internalizing-only problems relative to the low peer victimization group. CONCLUSIONS: Irrespective of timing and intensity, self-reported peer victimization was associated with mental health comorbidities in young adulthood, with the strongest associations observed for high-chronic peer victimization. Tackling peer victimization, especially when persistent over time, could play a role in reducing severe and complex mental health problems in youth.


Assuntos
Bullying , Vítimas de Crime , Humanos , Criança , Adolescente , Adulto Jovem , Adulto , Estudos Longitudinais , Saúde Mental , Grupo Associado , Desenvolvimento Infantil , Bullying/psicologia , Vítimas de Crime/psicologia
15.
Int J Gynaecol Obstet ; 160(3): 762-770, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35880405

RESUMO

Obstructive vaginal and uterine anomalies including imperforate hymen, transverse vaginal septum, and vaginal and/or cervical atresia or aplasia, might rarely present in infancy or childhood with hydrocolpos and/or hydrometra but they usually go unrecognized until presentation with amenorrhea and hematocolpos and/or hematometra in puberty. They should always be included in the differential diagnosis of a suprapubic and/or introital mass; in the latter case, vaginal vascular malformations and vaginal tumors should also be considered. Uterovaginal aplasia typically manifests with amenorrhea in puberty and needs to be differentiated from complete androgen insensitivity syndrome and gonadal dysgenesis of genetic males. Uterine fusion anomalies usually present with fertility and/or obstetrical complications in adulthood. However, a unicornuate uterus with a blind rudimentary contralateral horn containing functioning endometrium, and didelphys or septate uterus with a deviating obstructive septum might present in childhood or puberty with sequelae related with secretions or menstrual retention. This review provides a collective account of the most clinically important information about vaginal and uterine anomalies in childhood and adolescence for clinicians involved in the care of young females with the aim to provide guidance in appropriate evaluation and management.


Assuntos
Ginecologia , Doenças Vaginais , Feminino , Adolescente , Humanos , Criança , Amenorreia/etiologia , Vagina/cirurgia , Vagina/anormalidades , Útero/cirurgia
16.
Int J Gynaecol Obstet ; 161(3): 702-710, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36373872

RESUMO

Surgical abnormalities of the adnexa in children and adolescents include a variety of ovarian and paraovarian lesions ranging from benign functional cysts to malignant tumors, torsion of the ovary and/or the fallopian tube, and adnexal infectious lesions ranging from salpingitis to tubo-ovarian abscesses. Presentations vary from asymptomatic pelvic masses to acute abdomen, and some ovarian tumors might present with precocious puberty or virilization. Acute pain might be caused by hemorrhage or rupture of ovarian or paraovarian cysts, adnexal torsion or adnexal infection. Differential diagnosis of adnexal masses should include peri-appendiceal abscess in all age groups, and endometriomas and ectopic pregnancy in adolescents. This review provides guidance on the differentiation between adnexal abnormalities, based on important clues from clinical assessment and diagnostic workup, and ultimately on the decision making about the need for surgery, its level of urgency, and the type of surgery to clinicians of all specialties involved in the care of young females.


Assuntos
Doenças dos Anexos , Cistos , Ginecologia , Cistos Ovarianos , Feminino , Criança , Adolescente , Humanos , Cistos Ovarianos/diagnóstico , Cistos Ovarianos/cirurgia , Doenças dos Anexos/diagnóstico , Doenças dos Anexos/cirurgia , Doenças dos Anexos/patologia , Anormalidade Torcional/diagnóstico , Anormalidade Torcional/cirurgia
17.
Genes (Basel) ; 15(1)2023 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38254951

RESUMO

Autism spectrum disorder (ASD) is a common neurodevelopmental condition affecting ~1% of people worldwide. Core ASD features present with impaired social communication abilities, repetitive and stereotyped behaviors, and atypical sensory responses and are often associated with a series of comorbidities. Among these, epilepsy is frequently observed. The co-occurrence of ASD and epilepsy is currently thought to result from common abnormal neurodevelopmental pathways, including an imbalanced excitation/inhibition ratio. However, the pathological mechanisms involved in ASD-epilepsy co-morbidity are still largely unknown. Here, we propose a research protocol aiming to investigate electrophysiological and genetic features in subjects with ASD and epilepsy. This study will include a detailed electroencephalographic (EEG) and blood transcriptomic characterization of subjects with ASD with and without epilepsy. The combined approach of EEG and transcriptomic studies in the same subjects will contribute to a novel stratification paradigm of the heterogeneous ASD population based on quantitative gene expression and neurophysiological biomarkers. In addition, our protocol has the potential to indicate new therapeutic options, thus amending the current condition of absence of data and guidelines for the treatment of ASD with epilepsy.


Assuntos
Transtorno do Espectro Autista , Epilepsia , Humanos , Transtorno do Espectro Autista/genética , Epilepsia/genética , Pesquisa , Eletroencefalografia , Perfilação da Expressão Gênica
18.
BJPsych Open ; 9(1): e1, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36451604

RESUMO

Owing to restrictions of the COVID-19 pandemic, increased stress is evident in university students with a lifetime history of non-suicidal self-injury (NSSI). Therefore, we examined two groups of university students (n = 174) in an online survey, one that exhibited early NSSI in adolescence (n = 51) and another that exhibited continuous NSSI beyond the age of 18 (n = 123) (German Clinical Trials Register DRKS00023731). We compared the two groups in terms of depressive symptoms in the previous 2 weeks as well as self-perceived changes in emotional burden, urge to self-injure and NSSI frequency in the first year of the pandemic compared with the year before (pre-pandemic). Among other findings, both groups showed an increase in emotional burden and urge to self-injure.

19.
Children (Basel) ; 9(10)2022 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-36291452

RESUMO

Background: Childhood asthma is a major risk for low lung function in later adulthood, but what factors in asthma are associated with the poor lung function during childhood is not known. Objective: To identify clinical factors in children with asthma associated with low or declining lung function during the treatment. Methods: We enrolled children with asthma who had been treated throughout three age periods, i.e., 6−9, 10−12, and 13−15 years old, at seven specialized hospitals in Japan. Clinical information and lung function measurements were retrieved from the electronic chart systems. To characterize the lung function trajectories during each age period, we evaluated the forced expiratory volume 1 (FEV1) with % predicted values and individual changes by the slope (S) from linear regression. We defined four trajectory patterns: normal (Group N) and low (Group L), showing %FEV1 ≥80% or <80% throughout all three periods; upward (Group U) and downward (Group D), showing S ≥ 0 or S < 0%. Logistic regression analysis was performed to compare factors associated with the unfavorable (D/L) versus favorable (N/U) groups. Results: Among 273 eligible patients, 197 (72%) were classified into Group N (n = 150)/U (n = 47), while 76 (28%) were in Group D (n = 66)/L (n = 10). A history of poor asthma control, long-acting beta2 agonist use, and a lower height Z-score during 13−15 years were associated with an unfavorable outcome (Group D/L). Conversely, inhaled corticosteroid (ICS) use during 10−12 years and high-dose ICS use during 13−15 years were associated with a favorable outcome (Group N/U). Conclusion: We identified several factors that are associated with unfavorable lung function changes in pediatric asthma. Attention should be paid to the possible relationship between yearly changes in lung function and poor asthma control, use of ICS (and its dose) and use of LABA.

20.
Hum Mov Sci ; 85: 102993, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36054951

RESUMO

Perceiving and extracting information from others rely on functional Perception Action Coupling. Because motor experiences influence the strength of the perception action coupling, we explored the duality between vision and proprioceptive information about the self and others in body perception using a sequential same-different visual task from 6 to 7 years old to adults. Using a same-different matching task combined with congruent or incongruent action execution, this study explored in 30 children (M ± SD: 9.2 ± 1.5; 16♀), 33 adolescents (M ± SD: 14.7 ± 1.5; 16♀) and 28 adults (M ± SD: 29.5 ± 6.5; 12♀) how the congruence of the perception action coupling could influence the body representation building in memorizing and discriminating other's postures. The first result revealed better performances to perceive other's body postural changes compared to objects' shapes modifications as early as 6-7 years old. Nevertheless, this ability needs a long time to mature as reflected by the lower performances in children compared to older groups, i.e. adolescents and young adults. In addition, executing a congruent action during the encoding phase increased the RT, reflecting involvement of additional cognitive processes of self-other correspondence, without improving the performance accuracy, due to a slow maturation of multimodal body representations. On the other hand, executing an incongruent action during the encoding phase revealed an interference effect to perceive others' posture, demonstrated by the decrease of performance accuracy. As we initially hypothesized, the strength of perception action coupling appears to be modulated by age. Indeed, the interference effect had a greater impact in adolescents involved in a different judgment of two body postures. Therefore, the assessment of the perception action coupling may predict the body representation maturity in typical development or internal body representation dysfunction in neurodevelopmental disorders.


Assuntos
Corpo Humano , Julgamento , Adolescente , Criança , Humanos , Percepção , Postura , Propriocepção , Desempenho Psicomotor , Percepção Visual , Adulto Jovem
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