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1.
BMC Psychiatry ; 21(1): 204, 2021 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-33888067

RESUMO

BACKGROUND: The purpose of this study was to evaluate the post-marketing safety and effectiveness of aripiprazole in treating irritability in pediatric patients (6-17 years) with autism spectrum disorder (ASD) in actual clinical sites of Japan. METHODS: In this post-marketing surveillance, patients were enrolled into the multicenter, prospective, non-interventional, observational study for 52 weeks, and were dosed with aripiprazole (1-15 mg/day) under daily clinical settings in Japan. RESULTS: In 510 patients, the continuation rate of aripiprazole treatment was 84.6% at day 168 (week 24) and 78.1% at day 364 (week 52). Adverse drug reactions (ADRs) occurred in 22.7% of patients (n = 116), and the most common ADRs were somnolence (9.4%), followed by weight increased (3.3%). At week 4, the mean change from baseline in the irritability subscale score for the Aberrant Behavior Checklist Japanese version (ABC-J) was - 5.7 ± 6.8 (n = 288). Based on multiple regression analysis, comorbid attention deficit and hyperactivity did not affect the ABC-J irritability subscale score at endpoint. At week 24, the mean change from baseline for the Strengths and Difficulties Questionnaire was - 3.3 ± 4.9 (n = 215) for the total difficulties score and 0.6 ± 1.7 (n = 217) for the prosocial behavior subscale score. CONCLUSIONS: Aripiprazole was well tolerated and effective in the long-term treatment of irritability associated with ASD in Japanese pediatric patients in the real-world clinical practice. TRIAL REGISTRATION: This surveillance was registered with Clinical Trial.gov (no. NCT03179787 ) on June 7, 2017 (retrospectively registered).


Assuntos
Antipsicóticos , Transtorno do Espectro Autista , Adolescente , Antipsicóticos/efeitos adversos , Aripiprazol/efeitos adversos , Transtorno do Espectro Autista/tratamento farmacológico , Criança , Humanos , Humor Irritável , Japão , Marketing , Vigilância de Produtos Comercializados , Estudos Prospectivos , Resultado do Tratamento
2.
J Affect Disord ; 286: 27-32, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33667753

RESUMO

BACKGROUND: Little is known how often depressive episodes are accompanied by gastrointestinal symptoms in major depressive disorders (MDD). The authors sought to determine the frequency and clinical correlates of gastrointestinal symptoms during episodes of depressive disorder. METHODS: 3,256 MDD patients from the National Survey on Symptomatology of Depression (NSSD), which was designed to investigate the magnitude of symptoms of current major depressive episodes in China, were enrolled and assessed for gastrointestinal symptoms in this study. Illness characteristics were compared in patients with a different frequency of gastrointestinal symptoms. Pearson correlation analysis and multiple linear regression analysis were employed to investigate the associations between gastrointestinal symptoms and psychological characteristics in the patients. RESULTS: More than 70% of the subjects with depressive episodes had concomitant gastrointestinal symptoms. A higher frequency of gastrointestinal symptoms was associated with an increased risk of suicide ideation, suicide attempts, anxious mood, depressed mood, insomnia, feeling a failure, poor concentration, body pain, hopelessness, anger, and irritability. Pearson correlation analysis indicated moderate but significant associations between gastrointestinal symptoms and psychological characteristics (p<0.001). Multiple linear regression analysis showed that suicide ideation (ß=0.161, p<0.001), anxiety mood (ß=0.166, p = 0.006), insomnia (ß =0.262, p<0.001), anger (ß=0.144, p<0.001), feeling a failure (ß =0.365, p<0.001), and body pain (ß=0.581 p<0.001) were independently associated with gastrointestinal symptoms in MDD patients. CONCLUSION: Gastrointestinal symptoms were one of the most prevalent clinical presentations of MDD. The associations between gastrointestinal symptoms and psychological characteristics may prove useful in expanding our understanding of how gastrointestinal symptoms contributes to MDD.


Assuntos
Transtorno Depressivo Maior , China/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Humanos , Humor Irritável , Ideação Suicida , Tentativa de Suicídio
4.
Rev Gaucha Enferm ; 42(spe): e20200188, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33787721

RESUMO

OBJECTIVE: To identify the repercussions on mental health of groups and populations in the context of the new coronavirus pandemic. METHOD: Narrative review carired out in three databases, in March 2020, using the descriptors mental health and coronavirus. A total of 19 publications were analyzed, organized in a synoptic chart, containing type of publication, authors, country, sample, objective, and main results. From this analysis, two thematic axes emerged: identification of problems and vulnerable groups in mental health; and mental health interventions and actions. RESULTS: The first axis showed manifestations of suffering - anguish, insomnia, anger, stress, fear. The second revealed the need to build government policies and general guidelines; production of information and communication; and mental health care practices. CONCLUSIONS: The repercussions on mental health in the population intensified with the pandemic, identifying vulnerable groups, and the need to build coping strategies and policies aimed at mental health during epidemics.


Assuntos
/epidemiologia , Saúde Mental , Pandemias , Ira , Medo , Comportamentos de Risco à Saúde , Humanos , Humor Irritável , Serviços de Saúde Mental , Distúrbios do Início e da Manutenção do Sono/etiologia , Estresse Psicológico/etiologia , Populações Vulneráveis/psicologia
5.
J Affect Disord ; 282: 1170-1179, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33601692

RESUMO

BACKGROUND: Irritability is a common symptom in youth that is thought to be predictive of mood disorders. Its effects on mood are likely to be age-dependent, with direct and indirect mediators. We assessed age-related effects and mediators of irritability in adolescent girls with subthreshold depressive and manic symptoms. METHODS: We analysed the irritability item from the Mood Disorder Questionnaire in 3 cohorts of girls aged 12-18years (N=229); 12-13years (N=82); 14-15years (N=68); and 16-18years (N=79). They also completed mood, anxiety and emotion regulation questionnaires. MANOVA, correlations and bootstrapped mediation analyses were performed with SPSS®v25 and Hayes Processv3.5®. RESULTS: Overall, irritable girls had higher depressive and manic symptoms, trait anxiety and emotion dysregulation than those who were not irritable. Significantly higher rates of irritability were observed in mid-adolescents (aged 14-15years; p = 0.001). Notably, irritability exerted effects on depressive symptoms via trait anxiety, non-acceptance of emotions and dysregulation in emotion clarity throughout adolescence. However, irritability directly exerted effects on manic symptoms in mid-adolescence but in older adolescents, their relationship was indirect via impulse control dysregulation. LIMITATIONS: The cross-sectional design and non-clinical sample limit generalisability of our findings. CONCLUSIONS: Irritability is involved in subthreshold depressive symptoms, via trait anxiety and perceptual emotion dysregulation. On the other hand, irritability is directly and indirectly associated with subthreshold manic symptoms via dysregulated impulse control depending on age. Therefore, screening for irritability, trait anxiety and emotion dysregulation throughout adolescence may facilitate the early detection of subthreshold depressive and manic symptoms, and the implementation of preventive strategies.


Assuntos
Transtornos de Ansiedade , Humor Irritável , Adolescente , Ansiedade , Criança , Estudos Transversais , Feminino , Humanos , Transtornos do Humor
6.
J Affect Disord ; 285: 86-96, 2021 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-33639359

RESUMO

BACKGROUND: Emotion regulation is a relatively recent topic in psychiatry, and has only recently begun to be tested across Pediatric Bipolar Disorder (PBD). To date, no meta-analysis has investigated the presence of emotion regulation deficits in PBD patients. OBJECTIVES: The aim of this study is to understand where the literature stands on this topic, as well as how different researchers are measuring and grasping the concept of emotion regulation in pediatric bipolar disorders. METHODS: A systematic search of trials using the terms ("Pediatric Bipolar Disorder") AND ("Emotion Regulation" OR "Affect Regulation" OR "Mood Lability" OR "Mood Instability" OR "Irritability") was conducted using PubMed, Google Scholar, ResearchGate, Web of Science and Psych Info databases. Of the initial 366 articles identified, 8 met eligibility criteria for the meta-analysis and were included in this study. RESULTS: There is a statistically significant difference in Accuracy in Emotion Regulation tasks, with a tendency for lower accuracy in PBD patients; however, both groups did not differ statistically regarding Response Time. CONCLUSION: Our data suggests that PBD patients do present emotion regulation deficits, particularly regarding facial emotion recognition and affective language interference tasks mediated by cognitive assignments. These results have important implications in developing novel psychotherapeutic interventions for this population.


Assuntos
Transtorno Bipolar , Regulação Emocional , Reconhecimento Facial , Criança , Emoções , Humanos , Humor Irritável , Transtornos do Humor
7.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541952

RESUMO

We examined whether Instrumental Activities of Daily Living (IADL) improves with routinising therapy for a patient with frontotemporal dementia (FTD) living in a group home. The patient exhibited symptoms of agitation, apathy, disinhibition, irritability and stereotyped behaviour. The care staff experienced long-term care burden and the patient was spending time idly. An occupational therapist, in collaboration with care staff, evaluated the patient and routinised the household chores included in IADL. Consequently, a routine of household chores was established, reducing behavioural and psychological symptoms of dementia and long-term care burden, and the quality of life (QOL) of the patient improved. The results suggested that routinising IADL of the patient with FTD reduced long-term care burden and improved QOL of the patient.


Assuntos
Atividades Cotidianas , Demência Frontotemporal/terapia , Lares para Grupos , Habituação Psicofisiológica , Qualidade de Vida , Apatia , Feminino , Humanos , Humor Irritável , Assistência de Longa Duração , Pessoa de Meia-Idade
8.
Psychiatry Res ; 296: 113692, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33421841

RESUMO

The current study examined the impact of the lockdown due to the Covid-19 disease on mood state and behaviours of children and adolescents with ADHD. Nine hundred ninety-two parents of children and adolescents with ADHD filled out an anonymous online survey through the ADHD family association website. The survey investigated the degree of severity of six emotional and mood states (sadness, boredom, little enjoyment/interest, irritability, temper tantrums, anxiety) and five disrupted behaviours (verbal and physical aggression, argument, opposition, restlessness) based on their frequency/week (absent; low: 1-2 days/week; moderate: 3-4 days/week; severe: 5-7 days/week) before and during the lockdown. Important fluctuations were found in all dimensions during the lockdown independently by the severity degree. Subjects with previous low severity degree of these behaviors significantly worsened in almost all dimensions during the lockdown. On the contrary, ADHD patients with moderate and severe degree showed important improvement during the lockdown. Little enjoyment/interests and boredom resulted the dimensions more strongly affected by the condition of restriction, overall in children. Children vs. adolescents showed substantially similar trend but the former resulted significantly more vulnerable to emotive changes. The results provided both the individuation of domains affected, and the indirect benefits produced by restriction condition.


Assuntos
Sintomas Afetivos/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos do Comportamento Infantil/psicologia , Isolamento Social , Adolescente , Agressão/psicologia , Ansiedade/diagnóstico , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Tédio , Criança , Feminino , Humanos , Humor Irritável , Masculino , Fatores de Risco , Inquéritos e Questionários
9.
Medicina (Kaunas) ; 57(1)2021 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33435391

RESUMO

Background and objectives: Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. Materials and Methods: A total of 199 patients have been recruited in the outpatients units of two university sites. Patients' psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Results: Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitation of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. Conclusions: The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.


Assuntos
Transtorno Bipolar/psicologia , Transtorno Ciclotímico/psicologia , Humor Irritável , Qualidade de Vida/psicologia , Temperamento , Adulto , Afeto , Idade de Início , Agressão/psicologia , Ansiedade/psicologia , Transtorno Bipolar/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Índice de Gravidade de Doença , Ideação Suicida , Tentativa de Suicídio/psicologia
10.
Indian Pediatr ; 58(2): 126-128, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33340072

RESUMO

OBJECTIVE: To describe the broader clinical spectrum of COVID-19 in children. METHODS: In this descriptive, prospective study, we included confirmed pediatric patients with COVID-19 who presented to the emergency department of a pediatric tertiary care center from April to July, 2020. All patients were confirmed by the SARS-CoV-2 RT-PCR test, and we analyzed 24 symptoms and 25 signs. RESULTS: Among the 50 patients with COVID-19, the most common symptoms were fever, excessive cry and dry cough; digestive symptoms were frequently found (24%). The most common signs were pharyngeal erythema and irritability. CONCLUSIONS: Clinicians should recognize that the clinical spectrum of COVID-19 in children is wider than previously described, often with nonspecific signs and symptoms, and digestive symptoms should raise suspicion.


Assuntos
Doenças do Sistema Digestório , Avaliação de Sintomas , /epidemiologia , /psicologia , /estatística & dados numéricos , Criança , Pré-Escolar , Tosse/diagnóstico , Tosse/etiologia , Doenças do Sistema Digestório/diagnóstico , Doenças do Sistema Digestório/virologia , Feminino , Febre/diagnóstico , Febre/etiologia , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Humor Irritável/fisiologia , Masculino , México/epidemiologia , Estudos Prospectivos , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos
11.
J Affect Disord ; 278: 502-505, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33017677

RESUMO

Disruptive mood dysregulation disorder (DMDD) is common in children with ADHD yet it is not known how persistent DMDD is in this population. As such we aimed to investigate the persistence of disruptive mood dysregulation disorder (DMDD) in a community sample of children with ADHD. The sample comprised children (n = 136) participating in a cohort study with data available at age 7 and age 10. DMDD status was ascertained using proxy items from the Diagnostic Interview Schedule for Children, Version IV. Of those with DMDD at age 7 (n = 30), eight (21.1%) had DMDD that persisted at age 10. In the first study investigating the longitudinal course of DMDD in ADHD one in five children with ADHD+DMDD at age 7 continued to meet diagnostic criteria for DMDD three years later.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Humanos , Humor Irritável , Transtornos do Humor/epidemiologia
12.
J Am Acad Child Adolesc Psychiatry ; 60(3): 320-321, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33310158

RESUMO

Wiggins et al.1 recently used data from 3 longitudinal studies spanning preschool and early school children to form an empirically derived framework for early childhood disruptive mood dysregulation disorder (EC-DMDD), ie, a theoretical entity based on all DMDD criteria except the age at onset. The authors showed that the presence of EC-DMDD strongly predicted irritability-related syndromes at early school-ages. The most striking result is that virtually all youths with DMDD had chronic irritability in preschool years (>99%), a finding that challenges the view that DMDD cannot be diagnosed before 6 years of age. In our opinion, the developmental view on DMDD adopted by the authors is particularly welcome to address some of the nosological issues encountered with this disorder.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Transtornos do Humor , Adolescente , Criança , Pré-Escolar , Humanos , Humor Irritável , Estudos Longitudinais
13.
J Am Acad Child Adolesc Psychiatry ; 60(3): 321-323, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33310161

RESUMO

We thank Benarous et al. for their recognition of the necessity of a developmental view on disruptive mood dysregulation disorder (DMDD) and for their thoughtful comments.1 Indeed, a growing science base challenges the "old thinking" that developmental instability precludes earlier identification of DMDD syndromes. Notably, our paper was designed to promote a move toward a dimensional approach, which ultimately would obviate the need to make "you have it or you don't" decisions. In the short term, because real-world clinical decision making still rests on the presence or absence of DSM syndromes, our goal was to generate a developmentally informed evidence base for earlier identification and prevention of early-onset clinically significant irritability.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Transtornos do Humor , Criança , Pré-Escolar , Humanos , Humor Irritável
14.
J Am Acad Child Adolesc Psychiatry ; 60(2): 216-218, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33359030

RESUMO

Disruptive mood dysregulation disorder (DMDD) is a novel diagnosis emerging from a continuing discourse on the best diagnostic home for children with severe, chronic irritability. DMDD emerged from a research diagnosis that was developed to test the hypothesis that severe, chronic irritability is a developmental phenotype of pediatric bipolar disorder.1 That is, such irritability is a phenomenon that emerges prior to a hypo/manic episode that defines bipolar disorder. For many, such irritability in conjunction with attention-deficit/hyperactivity disorder (ADHD) symptoms had been treated as a prodrome of bipolar disorder. Although this line of research did not establish a deterministic association between the DMDD syndrome and later bipolar disorder, it did provide guidance for assessing the risk of irritability for later bipolar disorder.2 Among the outcomes was the introduction of DMDD as a new diagnosis in DSM-5. It is defined by 2 core symptoms-temper outbursts and irritable/angry mood-the 2 major features of irritability. However, what qualifies as DMDD-level irritable mood and temper outbursts is unclear, and, unlike other mood disorders, no ancillary symptom criteria are available to establish a diagnosis of DMDD. Through the example of the relationship between DMDD and ODD, we will illustrate the clinical impact of this lack of clarity and describe the current efforts to establish a developmentally sensitive clinical nosology for irritability.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno Bipolar , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtorno Bipolar/diagnóstico , Criança , Humanos , Humor Irritável , Transtornos do Humor/diagnóstico
15.
Child Care Health Dev ; 47(1): 128-135, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33047842

RESUMO

BACKGROUND: Lockdown is one of the prevalent tools that are used to control the spread of COVID-19 virus in India. Under the circumstances created during lockdown period, children are deprived from the social interaction and companionship; because of which, they are susceptible to psychiatric disorders. Therefore, in this study, efforts were to understand the impacts of lockdown on the mental status of the children of India and their specific causes. STUDY DESIGN: It is a questionnaire-based study. METHODS: A web-based questionnaire was prepared, and 400 parents from four districts of Punjab, India, namely, Ludhiana, Sahibzada Ajit Singh (SAS) Nagar, Sangrur and Ferozepur, were telephonically interviewed. Further, the information collected from the interviews was statistically analysed using Statistical Package for the Social Sciences (SPSS) software. RESULTS: Findings from this study revealed that 73.15% and 51.25% of the children were having signs of increased irritation and anger, respectively; 18.7% and 17.6% of the parents also mentioned the symptoms of depression and anxiety, respectively, among their children, which were also augmented by the changes in their diet, sleep, weight and more usage of the electronic equipment. Children (~76.3%) persistently urge to go outdoors and play with their friends; therefore, they could lag in social development. Further, observations from Pearson's correlation revealed that during lockdown, children's mental health is significantly related to the area of their house, number of children in the family, qualification of their mother and socio-economic status of their family. CONCLUSIONS: This study made it evident that the mental health of the children residing in Punjab, India, was compromised during the lockdown period induced by the COVID-19 pandemic. Findings of this study may also trigger the international authorities to frame the guidelines of lockdown in the interest of mental health of their native children.


Assuntos
/prevenção & controle , Comportamento Infantil/psicologia , Isolamento Social/psicologia , Ira , Ansiedade/epidemiologia , /transmissão , Criança , Depressão/epidemiologia , Feminino , Humanos , Índia , Humor Irritável , Masculino , Fatores Socioeconômicos , Inquéritos e Questionários
17.
J Acoust Soc Am ; 148(4): 1824, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33138499

RESUMO

Peru declared a state of emergency on March 16 in order to prevent SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) transmissions; thus, the International Airport was closed and the soundscape of urban zones under the flight tracks have been changed in view of the fact that airplane traffic was suspended. The authors have been conducting noise monitoring since February and because of that sufficient noise data for knowing the soundscape before and during the lockdown were obtained. This article presents a case of aircraft annoyance noise in one of Lima's city districts, which is near the aircraft climbing curve, toward the ocean on departure from Lima.


Assuntos
Viagem Aérea , Infecções por Coronavirus/transmissão , Exposição Ambiental/prevenção & controle , Humor Irritável , Ruído dos Transportes/prevenção & controle , Pneumonia Viral/transmissão , Isolamento Social , Saúde da População Urbana , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Monitoramento Ambiental , Humanos , Pandemias/prevenção & controle , Peru , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Espectrografia do Som , Fatores de Tempo
19.
Paediatr Drugs ; 22(5): 473-483, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32686015

RESUMO

Autism spectrum disorder (ASD) is a heterogeneous neuropsychiatric condition affecting an estimated one in 36 children. Youth with ASD may have severe behavioral disturbances including irritability, aggression, and hyperactivity. Currently, there are only two medications (risperidone and aripiprazole) approved by the US Food and Drug Administration (FDA) for the treatment of irritability associated with ASD. Pharmacologic treatments are commonly used to target ASD-associated symptoms including irritability, mood lability, anxiety, and hyperactivity. However, evidence for the efficacy of many commonly used treatments is limited by the lack of large placebo-controlled trials of these medications in this population. Research into the pathophysiology of ASD has led to new targets for pharmacologic therapy including the neuroimmune system, the endocannabinoid system, and the glutamatergic neurotransmitter system. The goal of this review is to provide an overview of the current evidence base for commonly used treatments, as well as emerging treatment options for common behavioral disturbances seen in youth with ASD.


Assuntos
Comportamento do Adolescente/efeitos dos fármacos , Antipsicóticos/uso terapêutico , Transtorno do Espectro Autista/tratamento farmacológico , Comportamento Infantil/efeitos dos fármacos , Adolescente , Agressão/efeitos dos fármacos , Ansiedade/tratamento farmacológico , Transtorno do Espectro Autista/psicologia , Criança , Humanos , Hipercinese/tratamento farmacológico , Humor Irritável/efeitos dos fármacos , Transtornos do Sono-Vigília/tratamento farmacológico
20.
Artigo em Inglês | MEDLINE | ID: mdl-32482781
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