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Ágora (Rio J. Online) ; 22(3): 319-325, set.-dez. 2019.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1043575


RESUMO: A clínica da intervenção precoce nos leva a questionar as nuances sintomatológicas entre os sinais de risco de autismo e os da depressão no bebê. Partindo-se do conceito freudiano que associa a depressão à perda do objeto, como se poderia pensar sobre o quadro depressivo no caso dos bebês que estão em processo de construção de sua relação objetal? Em ambos os casos, trata-se de um desencontro no arranjo pulsional do laço mãe-bebê, embora com características distintas, vivenciadas, sobretudo, por meio da relação contratransferencial com o analista. A partir da exposição de dois casos clínicos, discute-se em quais aspectos o retraimento relacional autístico e o depressivo do bebê convergem e se diferenciam.

Abstract: The early intervention clinic leads us to question the symptomatic nuances between the signs of risk of autism and the signs of depression of the baby. In considering the Freudian concept that associates the depression with the loss of the object, how could we think about be regarded the depressive condition of babies who are in the process of constructing their relationship to the object? In both cases, there is a mismatch in the establishment of the impulse drive between the mother and the baby which, although being distinct experienced features, are associated to the counter transfer with the analyst. On the basis of two different clinical cases, we address under which conditions the autistic withdrawal and the depression of the baby converge and differentiate one from another.

Humanos , Lactente , Interpretação Psicanalítica , Transtorno Autístico , Depressão
Psychiatr Danub ; 31(3): 340-346, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31596827


BACKGROUND: Autism is a widespread developmental disorder that occurs mostly among children. Children with autism are prone to problematic behaviors due to their deficiencies in language communication and social development. Thus, children with a high degree of autism suffer lower life satisfaction. Moreover, sensory integration dysfunction is closely related to autism. Therefore, the effect of Sensory Integration Training (SIT) on the behaviors and quality of life of children with autism was explored in this study. SUBJECTS AND METHODS: From September 2017 to December 2018, 108 patients from Fuzhou Fourth Hospital and Xiangtan Fifth Hospital were included in the intervention group (group A) and the control group (group B), with 54 members in each group. The 54 members in group B, with an average age of 5.18±2.94, received routine treatment. In addition to the same routine treatment, the members in group B also received sensory integration training and physical exercise intervention, which lasted for three months. The Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) were used before and after the intervention experiment to evaluate the curative effect. RESULTS: After the treatment, statistically significant differences were observed in the CARS and ABC scores (P<0.05); the total effective rate was 86.11% in group A and 64.10% in group B. The difference in the CARS score was statistically significant (P<0.05), whereas the difference in the ABC score was also statistically significant (P<0.05). In general, the difference in CARS is statistically significant. Specifically, group A is better than group B, t=3.492, df=73, and bilateral P=0.001<0.01. CONCLUSIONS: SIT intervention had a certain effect on autism and is of great value for the future development of SIT courses or intervention programs for children with autism.

Transtorno Autístico/psicologia , Transtorno Autístico/terapia , Qualidade de Vida , Lista de Checagem , Pré-Escolar , Humanos
Life Sci ; 237: 116930, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31610190


Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by symptoms that include social communication impairments, interaction deficits, and repetitive and stereotyped behaviors. Recent studies have suggested that imbalanced cytokine levels are associated with impaired behavioral outcomes in individuals with ASD. VGX-1027 is a potent immunomodulatory compound that has shown promise for the treatment of several neuroinflammatory disorders. Here, we studied the effects of VGX-1027 on BTBR T+ Itpr3tf/J (BTBR) mice, an animal model of autism. BTBR mice exhibit most of the core behavioral features of ASD, such as reduced sociability and increased repetitive behaviors. In this study, we investigated the effects of VGX-1027 on self-grooming, marble burying and sociability tests using BTBR mice. We further examined its effect on IL-1ß, IL-6, IL-10, TNF-α, IFN-γ, and NF-κB p65 production in splenic CD4+ cells and on IL-1ß, IL-6, IL-10, TNF-α, IFN-γ, COX-2, and iNOS (NOS2) protein and mRNA expression in brain tissues. The administration of VGX-1027 was found to attenuate self-grooming and marble burying behaviors, and enhance social interactions in BTBR mice. Additionally, VGX-1027 treatment resulted in a substantial decrease in IL-1ß, IL-6, TNF-α, IFN-γ, and NF-κB p65 production, but increased IL-10 production in CD4+ T cells. Moreover, this agent was also found to significantly decrease IL-1ß, IL-6, TNF-α, IFN-γ, COX-2, and NOS2 levels and increase IL-10 expression at the protein and mRNA level in brain tissues. Based on results using BTBR mice, our data provide the first evidence that VGX-1027 could potentially be used for the amelioration of autism-like symptoms.

Acetatos/farmacologia , Transtorno Autístico/prevenção & controle , Comportamento Animal/efeitos dos fármacos , Linfócitos T CD4-Positivos/imunologia , Mediadores da Inflamação/metabolismo , Inflamação/prevenção & controle , Receptores de Inositol 1,4,5-Trifosfato/fisiologia , Oxazóis/farmacologia , Animais , Transtorno Autístico/etiologia , Transtorno Autístico/metabolismo , Transtorno Autístico/patologia , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/metabolismo , Citocinas/metabolismo , Modelos Animais de Doenças , Inflamação/etiologia , Inflamação/metabolismo , Inflamação/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Transdução de Sinais
Nature ; 574(7779): 543-548, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31645720


Multicellular organisms have co-evolved with complex consortia of viruses, bacteria, fungi and parasites, collectively referred to as the microbiota1. In mammals, changes in the composition of the microbiota can influence many physiologic processes (including development, metabolism and immune cell function) and are associated with susceptibility to multiple diseases2. Alterations in the microbiota can also modulate host behaviours-such as social activity, stress, and anxiety-related responses-that are linked to diverse neuropsychiatric disorders3. However, the mechanisms by which the microbiota influence neuronal activity and host behaviour remain poorly defined. Here we show that manipulation of the microbiota in antibiotic-treated or germ-free adult mice results in significant deficits in fear extinction learning. Single-nucleus RNA sequencing of the medial prefrontal cortex of the brain revealed significant alterations in gene expression in excitatory neurons, glia and other cell types. Transcranial two-photon imaging showed that deficits in extinction learning after manipulation of the microbiota in adult mice were associated with defective learning-related remodelling of postsynaptic dendritic spines and reduced activity in cue-encoding neurons in the medial prefrontal cortex. In addition, selective re-establishment of the microbiota revealed a limited neonatal developmental window in which microbiota-derived signals can restore normal extinction learning in adulthood. Finally, unbiased metabolomic analysis identified four metabolites that were significantly downregulated in germ-free mice and have been reported to be related to neuropsychiatric disorders in humans and mouse models, suggesting that microbiota-derived compounds may directly affect brain function and behaviour. Together, these data indicate that fear extinction learning requires microbiota-derived signals both during early postnatal neurodevelopment and in adult mice, with implications for our understanding of how diet, infection, and lifestyle influence brain health and subsequent susceptibility to neuropsychiatric disorders.

Extinção Psicológica/fisiologia , Medo/fisiologia , Metabolômica , Microbiota/fisiologia , Neurônios/fisiologia , Animais , Antibacterianos/farmacologia , Transtorno Autístico/metabolismo , Sangue/metabolismo , Cálcio/metabolismo , Líquido Cefalorraquidiano/química , Líquido Cefalorraquidiano/metabolismo , Sinais (Psicologia) , Espinhas Dendríticas/efeitos dos fármacos , Espinhas Dendríticas/patologia , Espinhas Dendríticas/fisiologia , Extinção Psicológica/efeitos dos fármacos , Medo/efeitos dos fármacos , Fezes/química , Vida Livre de Germes , Indicã/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Microbiota/efeitos dos fármacos , Microbiota/imunologia , Inibição Neural , Neuroglia/patologia , Neuroglia/fisiologia , Neurônios/efeitos dos fármacos , Neurônios/imunologia , Neurônios/patologia , Fenilpropionatos/metabolismo , Córtex Pré-Frontal/citologia , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/imunologia , Córtex Pré-Frontal/fisiologia , Esquizofrenia/metabolismo , Transcriptoma , Nervo Vago/fisiologia
Invest. educ. enferm ; 37(3): [E03], 15 Octubre 2019. Tab 1, Tab 2, Fig 1
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1023476


Objective. This work aimed to define and assess the parental competence of parents with autistic children. Methods. This study was conducted through a systematic review. The search was done in databases, including Cochrane Library, PubMed, CINAHL, Science Direct, Wiley Scopus, Pro Quest, Web of Science, Elsevier, Google Scholar, and Ovid by using keywords, like "children, autism, parenting, competence, and scale" from 1974 to 2019. Inclusion criteria were that the article should be quantitative, qualitative, and mixed-method studies in nursing, psychology, and medicine; the full text of the article should be available and the article should be in English or Persian. Results. Competence among these parents was affected by more factors and they reported lower competence compared to other parents. Moreover, only two instruments were available to assess parenting competence, which were not designed for parents of autistic children. Variables and factors affecting parenting competence has not been examined well in parents of children with autism, and no specialized instrument is available to evaluate parenting competence in parents with autistic children either. Conclusion. Although parental competence has been known as the main element to improve the quality of care, it has been studied restrictively from the viewpoints of the parents of children with autism. Therefore, the development of this concept is highly essential for clinical application and investigating its outcomes support.

Objetivo. Evaluar la competencia parental de los padres con hijos autistas. Métodos. Revisión sistemática narrativa. La búsqueda se realizó en las bases de datos de la Biblioteca Cochrane, PubMed, CINAHL, Science Direct, Wiley Scopus, ProQuest, Web of Science, Elsevier, Google Scholar y Ovid, mediante el uso de las palabras clave "niños, autismo, crianza, competencia y escala". Los criterios de inclusión fueron: artículos originales o de revisión publicados entre 1974 a 2019; estudios cuantitativos, cualitativos o de métodos mixtos en las disciplinas de enfermería, psicología o medicina, y estar disponible en texto completo en inglés. Resultados. La competencia de los padres de niños con trastorno del espectro autista fue menor en comparación con padres de niños sin este trastorno. Existen dos escalas para la evaluación de la competencia parental, pero no se diseñaron para su evaluación en padres de niños autistas. Los factores que afectan la competencia parental tampoco se han examinado exclusivamente para estos padres. Conclusión. Aunque se sabe que la competencia de los padres es un elemento primordial para mejorar la calidad del cuidado del niño con autismo, el tema se ha estudiado de manera restrictiva. Es necesario el desarrollo de este concepto para la aplicación en la práctica clínica y para la investigación de sus resultados.

Objetivo. Avaliar a competência parental dos pais com filhos autistas. Métodos. Revisão sistemática narrativa. A busca se realizou nas bases de dados da Biblioteca Cochrane, PubMed, CINAHL, Science Direct, Wiley Scopus, ProQuest, Web of Science, Elsevier, Google Scholar e Ovid, mediante o uso das palavras clave "crianças, autismo, criança, competência e escala". Os critérios de inclusão foram: artigos originais ou de revisão, publicados entre 1974 a 2019, ser estudos quantitativos, qualitativos ou de métodos mistos, nas disciplinas de enfermagem, psicologia ou medicina, e estar disponível em texto completo em inglês. Resultados. A competência dos pais de crianças com transtorno do espectro autista foi menor em comparação com pais de crianças sem este transtorno. Existem duas escalas para a avaliação da competência parental, mas não foram desenhadas para sua avaliação em pais de crianças autistas. Os fatores que afetam a competência parental tampouco se hão examinado exclusivamente para estes pais. Conclusão. Embora se sabe que a competência dos pais é um elemento primordial para melhorar a qualidade do cuidado da criança com autismo, o tema se há estudado de maneira restritiva. É necessário o desenvolvimento deste conceito para a aplicação na prática clínica e para a investigação de sus resultados.

Humanos , Pais , Transtorno Autístico , Criança
Recurso na Internet em Inglês | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46802


The two conditions share many traits, but the connection has been largely overlooked until now.

Síndrome de Asperger , Transtornos de Estresse Pós-Traumáticos , Transtorno do Espectro Autista , Transtorno Autístico
Georgian Med News ; (292-293): 54-56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31560663


The present paper aims to summarize and review available research on the manifestations of comorbid depression in persons with ASD (Autism spectrum Disorder) and its impact on the course of autism;as well as to review the pharmacological treatment of comorbid depression with ASD. The existence of a comorbid depression affects the state of individuals with ASD, which often remains unnoticed for the people around. Literary review permits us to get familiar with the peculiarities of clinical manifestations of comorbid depression in autism, risk factors for comorbid depression the importance of diagnosis and the methods of pharmacological intervention. Few issues have been identified: the necessity of raising awareness and drawing attention to the clinical features of comorbid depression especially in low functioning persons. The nessecity of regular screening persons with ASD screening of all persons having ASD for determining the existence of depression and suicidal thoughts. The necessity of adaptation of relevant diagnostic instruments, which will be an important aid tool to diagnose comorbid depression in autism. The necessity of more research to establish guidelines for pharmacological management of symptoms for comorbid depression disorder.

Transtorno do Espectro Autista/complicações , Transtorno Autístico/diagnóstico , Depressão/diagnóstico , Depressão/etiologia , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Transtorno Autístico/epidemiologia , Comorbidade , Depressão/epidemiologia , Transtorno Depressivo , Humanos
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(7. Vyp. 2): 83-90, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31532595


The paper considers the phenomenon of «mental atony¼ in children with developmental delay, intellectual disability and autism. The condition of mental atony is a congenital or early acquired even decrease in mental tone, manifested by the reduced ability to concentrate attention, a decline of the targeted activity, difficulties in contacting, weakening of unconditioned reflexes, lack of instinctive manifestations, «mobilization¼ of mental functions by persistent verbal and tactile stimulation. The article provides the history of the «mental atony¼ theory, as well as clinical features, epidemiology, etiology, pathogenesis and nosological specificity of the condition. Moreover, the criteria for the differential diagnosis between the atonic form of intellectual disability and autism are discussed in detail. Based on the analysis of literature and the results of own clinical observations, the authors conclude that a thorough differential analysis between childhood autism and atonic form of intellectual disability in children is necessary, otherwise, there is a risk of overdiagnosis of autistic disorders. The authors also point to the role of the brain lesion, particularly in the area of reticular formation, in the occurrence of phenomena of mental atony.

Transtorno Autístico , Deficiência Intelectual , Teoria da Mente , Criança , Deficiências do Desenvolvimento , Humanos , Processos Mentais
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 36(9): 935-937, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31515794


OBJECTIVE: To explore the genetic basis for a patient with autism. METHODS: High-throughput sequencing was carried out to detect copy number variations in the patient. RESULTS: DNA sequencing found that the patient has carried a 0.11 Mb deletion in distal 2p16.3 spanning from genomic position 50 820 001 to 50 922 000, which resulted removal of exon 6 and part of intron 7 of the NRXN1 gene. The same deletion was not found his parents and brother. CONCLUSION: Partial deletion of the NRXN1 gene may underlie the disease in this patient.

Transtorno Autístico/genética , Moléculas de Adesão Celular Neuronais/genética , Deleção de Genes , Proteínas do Tecido Nervoso/genética , Variações do Número de Cópias de DNA , Humanos , Masculino
Eur J Paediatr Dent ; 20(3): 237-241, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489825


AIM: The aim of the present study was to comparatively evaluate the oral health status and influential factors, brushing, developmental and orthodontic disorders, bruxism, drug intake, sweet eating habits, sociodemographic factors and lifestyles of autistic and healthy children. Participants in this study were greater in number compared to the previous studies investigating the same phenomenon. Furthermore, it was a more comprehensive study than other studies in the literature in terms of number of variables included. METHODS: The study was carried out with a total of 407 participants, 285 autistic (test group) and 122 healthy children (control group). The ages ranged from 5 to 16. A total of 407 children were examined. DMFT, dmft, plaque index, dental trauma, oral symptoms, developmental and orthodontic disorders of these children were recorded. Participants were also asked to fill a two-part questionnaire. The first part included questions related to the child's and parents' demographics such as the child's age, gender, number of siblings, the mother's and father's age, education, occupation and income. The second part included questions related to systemic diseases, drug intake, the dental history of children and their parents, brushing and nutrition habits. RESULTS: The results from the inferential statistics showed that both DMFT and dmft indices values of the autistic children were lower than those of the healthy children. Caries prevalence of the autistic children was lower compared to the control group. There was also no difference in the plaque index values between the two groups. Drooling of saliva of the autistic children was higher than that of the healthy children. The results showed statistically significant differences between the two groups regarding bruxism, deep-palate and tongue thrusting, though no statistically significant differences were found between the two groups regarding open bite. However, significant differences were observed in terms of dental crowding between the two groups in that the healthy children had more dental crowding than the autistic children. CONCLUSION: One of the main findings of the study was observed in relation to caries prevalence in that autistics had lower caries prevalence values than controls. Another main finding was that no statistically significant differences were found in terms of plaque index values when the groups were compared. When the findings related to deep palate, open bite and dental crowding were examined, it was seen that deep palate was higher but dental crowding was lower in the autistic children. However, in this study there were no statistically significant differences between the two groups in terms of open bite.

Transtorno Autístico , Cárie Dentária , Criança , Estudos Transversais , Índice CPO , Humanos , Higiene Bucal , Prevalência
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 36(8): 829-833, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31400139


OBJECTIVE: To explore the genetic basis for a family affected with mental retardation combined with autism. METHODS: For the family featuring X-linked recessive inheritance of mental retardation combined with autism, clinical data and peripheral blood samples were collected. Potential mutations of genes associated with intellectual impairment were sequenced with an Ion PGM platform. Suspected mutations were verified with a PCR-Sanger sequencing method. RESULTS: The patient with mental retardation had mild abnormal electroencephalograph(EEG), while brain MRI and CT scans showed no obvious abnormality. Two ABC (autism behavior checklist) testing scores were 73 and 66 when he was 7- and 13-year-old, respectively. A novel hemizygous mutation, c.64C>T (p.L22F), was detected in the GRIA3 gene in the patient, for which his mother was a heterozygous carrier. The mutation site was predicted to be possibly damaging and disease causing by PolyPhen_2 and MutationTaster. CONCLUSION: The novel hemizygous c.64C>T (p.L22F) mutation of the GRIA3 gene probably underlies the phenotypes of mental retardation combined with autism in this family. Considering the variable clinical manifestation of mental retardation and genetic heterogeneity of autism, genetic testing is essential for making the correct diagnosis.

Transtorno Autístico/genética , Deficiência Intelectual/genética , Retardo Mental Ligado ao Cromossomo X/genética , Receptores de AMPA/genética , Adolescente , Criança , Humanos , Masculino , Mutação
Lancet Psychiatry ; 6(10): 819-829, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31447415


BACKGROUND: Co-occurring mental health or psychiatric conditions are common in autism, impairing quality of life. Reported prevalences of co-occurring mental health or psychiatric conditions in people with autism range widely. Improved prevalence estimates and identification of moderators are needed to enhance recognition and care, and to guide future research. METHODS: In this systematic review and meta-analysis, we searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, and grey literature for publications between Jan 1, 1993, and Feb 1, 2019, in English or French, that reported original research using an observational design on the prevalence of co-occurring mental health conditions in people with autism and reported confirmed clinical diagnoses of the co-occurring conditions and autism using DSM or ICD criteria. For co-occurring mental health conditions reported with at least 15 datapoints (studies), we assessed risk of bias and we determined pooled estimates of prevalence for different co-occurring conditions in autism using random-effects models, and descriptively compared these with prevalence estimates for the general population from the literature (post hoc). We investigated heterogeneity in prevalence estimates using random-effects meta-regression models. This systematic review is registered with PROSPERO, CRD42018103176. FINDINGS: Of 9746 unique studies identified, 432 were selected for full-text review. 100 studies were eligible for inclusion in our qualitative synthesis, of which 96 were included in our meta-analyses. 11 categories of co-occurring conditions were investigated, of which eight conditions were included in the meta-analyses and three were descriptively synthesised (ie, trauma and stressor-related disorders, substance-related and addictive disorders, and gender dysphoria). From our meta-analyses, we found overall pooled prevalence estimates of 28% (95% CI 25-32) for attention-deficit hyperactivity disorder; 20% (17-23) for anxiety disorders; 13% (9-17) for sleep-wake disorders; 12% (10-15) for disruptive, impulse-control, and conduct disorders; 11% (9-13) for depressive disorders; 9% (7-10) for obsessive-compulsive disorder; 5% (3-6) for bipolar disorders; and 4% (3-5) for schizophrenia spectrum disorders. Estimates in clinical sample-based studies were higher than in population-based and registry-based studies, and these estimates were mostly higher than those in the general population (post hoc). Age, gender, intellectual functioning, and country of study were associated with heterogeneity in prevalence estimates, yet remaining heterogeneity not explained was still substantial (all I2 >95%). INTERPRETATION: Co-occurring mental health conditions are more prevalent in the autism population than in the general population. Careful assessment of mental health is an essential component of care for all people on the autism spectrum and should be integrated into clinical practice. FUNDING: Academic Scholars Awards, Department of Psychiatry, University of Toronto; O'Brien Scholars Program, Slaight Family Child and Youth Mental Health Innovation Fund, and The Catherine and Maxwell Meighen Foundation via the Centre for Addiction and Mental Health Foundation.

Transtorno Autístico/epidemiologia , Transtornos Mentais/embriologia , Comorbidade , Humanos , Prevalência