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1.
Fortschr Neurol Psychiatr ; 87(11): 634-637, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31756742

RESUMO

Aggressive behaviour is a typical phenomenon in childhood and adolescence. Aggression is one of the frequent reasons for parents to seek child and adolescent psychiatric and psychotherapeutic treatment. Disorders with increased aggressive behaviour, such as conduct or oppositional defiant disorder, carry an increased risk for long-lasting negative impact on well-being, especially when comorbid with substance abuse or affective symptoms. Barriers for treatment are frequently a lack of insight into consequences and non-compliance with intervention shown by adolescents. In addition, interdisciplinary intervention needs to combine psychiatric and psychotherapeutic interventions as well as complex interventions supported by the youth welfare system, and in particular including families. Further research is needed for the implementation of evidence-based treatments in routine care as well in special populations, such as girls with conduct disorders or youth with substance abuse.


Assuntos
Transtorno da Personalidade Antissocial/terapia , Transtorno da Conduta/terapia , Adolescente , Agressão , Transtorno da Personalidade Antissocial/complicações , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Conduta/complicações , Transtorno da Conduta/psicologia , Feminino , Humanos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
2.
Psychiatr Hung ; 34(3): 280-286, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31570659

RESUMO

BACKGROUND: Quality of life is the individuals' subjective evaluation of their general well-being, including physical and mental health, social relationships and everyday functionality. The aim of our study was to examine conduct disorder in terms of gender differences in prevalence, and relationship to quality of life domains in the presence or absence of comorbid oppositional defiant disorder. METHODS: Altogether 392 adolescents, aged 13-18 years (M=14.5; SD= 1.37), participated in this study. The members of the clinical group were selected from Vadaskert Child and Adolescent Psychiatry Hospital, Budapest, Hungary with externalizing symptoms in their case history. The control group was selected from public schools in Budapest, Hungary. Mini International Neuropsychiatric Interview Kid was used to diagnose conduct disorder and oppositional defiant disorder, and parent and adolescent version of the Inventory of Quality of Life in Children and Adolescents (Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen) was used to measure the children's quality of life. RESULTS: In this sample 8.5% of adolescents were diagnosed with conduct disorder, of which 52.9% had a comorbid oppositional defiant diagnosis. Conduct disorder diagnosis was only present in the clinical group, 9 of participants with such diagnosis were male and 24 were female. Girls with conduct disorder evaluated their family life domain (p<0.01) and their global quality of life (p<0.05) lower than the boys. Compared to adolescents without comorbid oppositional defiant disorder diagnosis, adolescents with conduct disorder and comorbid oppositional defiant disorder had significantly worse quality of life in the domain of time spent alone (p<0.05). CONCLUSIONS: Conduct disorder is associated with decreased quality of life. The presence of comorbid oppositional defiant disorder correlates with lower quality of life in several domains. These findings are considerable for the clinical management of these externalizing disorders.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Qualidade de Vida , Caracteres Sexuais , Adolescente , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Comorbidade , Transtorno da Conduta/complicações , Feminino , Humanos , Hungria/epidemiologia , Masculino
3.
PLoS One ; 13(11): e0206442, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30383806

RESUMO

Externalizing problems (EP), including rule-breaking, aggression, and criminal involvement, are highly prevalent during adolescence, but the adult outcomes of adolescents exhibiting EP are characterized by heterogeneity. Although many youths' EP subside after adolescence, others' persists into adulthood. Characterizing the development of severe EP is essential to prevention and intervention efforts. Multiple predictors of adult antisocial personality disorder (ASPD) and legal outcomes of a large sample (N = 1205) of clinically- or legally-ascertained adolescents (ages 12-19 years) with severe EP were examined. Many psychosocial predictors hypothesized to predict persistence of EP demonstrated zero-order associations with adult outcomes, but accounted for little unique variation after accounting for baseline conduct disorder symptoms (CD) and demographic factors. Baseline measures of intelligence, which explained independent variation in legal outcomes, provided the only consistent exception to this pattern, though future work is needed to parse these effects from those of socioeconomic factors. CD severity during adolescence is a parsimonious index of liability for persistence of EP into adulthood that explains outcome variance above and beyond all other demographic and psychosocial predictors in this sample.


Assuntos
Comportamento do Adolescente/fisiologia , Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Conduta/diagnóstico , Comportamento Criminoso , Emoções Manifestas , Delinquência Juvenil , Adolescente , Comportamento do Adolescente/psicologia , Adulto , Idade de Início , Transtorno da Personalidade Antissocial/complicações , Transtorno da Personalidade Antissocial/epidemiologia , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Conduta/complicações , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Comportamento Criminoso/fisiologia , Comportamento Perigoso , Progressão da Doença , Feminino , Humanos , Delinquência Juvenil/legislação & jurisprudência , Delinquência Juvenil/psicologia , Delinquência Juvenil/estatística & dados numéricos , Estudos Longitudinais , Masculino , Prognóstico , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
5.
Child Psychiatry Hum Dev ; 49(6): 956-965, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29752662

RESUMO

This is a first study that investigated the relationships between executive attention-as an important aspect of emotion regulation-and state empathy and sympathy in ODD/CD boys with (N = 31) and without (N = 18) comorbid anxiety disorder (7-12 years). Empathic reactions were evoked using three sadness-inducing film clips. One clip was highly evocative involving a bear cub losing his mother, whilst two other clips were mildly evocative involving children in common childhood situations. Self-reports of empathy and sympathy were collected and executive attention was assessed with a performance task. Poor executive attention skills were associated with less empathy and sympathy, particularly in ODD/CD boys with anxiety and under conditions of a highly evocative stimulus. Our findings support the view that different mechanisms may be involved in empathy problems of ODD/CD children.


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Atenção/fisiologia , Transtorno da Conduta/psicologia , Empatia/fisiologia , Função Executiva/fisiologia , Transtornos de Ansiedade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Criança , Transtorno da Conduta/complicações , Humanos , Masculino
6.
Child Psychiatry Hum Dev ; 49(6): 853-864, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29594940

RESUMO

This study examined the effects of comorbid ADHD symptoms, internalizing psychopathology, Callous-Unemotional (CU) Traits, and conduct problem severity on children's response to an evidence-based psychosocial intervention. Clinic-referred children with DBD ages 8-12 years (N = 76) participated in a 15-week multi-component intervention. Parents provided weekly ratings of children's oppositionality-defiance, peer problems, and impairment. Oppositionality-defiance, peer problems, and impairment decreased significantly over the course of the intervention; however, there was considerable variability in weekly ratings. Baseline ADHD symptoms, internalizing psychopathology, CU traits, and conduct problem severity were unrelated to rate of change across treatment. However, ADHD symptoms uniquely predicted more oppositionality-defiance, peer problems, and impairment averaged across the 15 weeks of treatment. Follow-up analyses suggested this was driven by hyperactivity-impulsivity rather than inattention. Children with DBD and comorbid symptoms appear to benefit from a multi-component intervention, but those with ADHD symptoms may require additional support to address social and behavioral challenges.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Terapia Comportamental , Transtorno da Conduta/complicações , Comportamento Problema/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Criança , Transtorno da Conduta/psicologia , Transtorno da Conduta/terapia , Emoções/fisiologia , Feminino , Humanos , Masculino , Índice de Gravidade de Doença
7.
Sci Rep ; 8(1): 1101, 2018 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-29348532

RESUMO

Conduct disorder (CD) and anxiety disorders (ADs) are often comorbid and both are characterized by hyper-sensitivity to threat, and reduced structural and functional connectivity between the amygdala and orbitofrontal cortex (OFC). Previous studies of CD have not taken account of ADs nor directly compared connectivity in the two disorders. We examined three groups of young women: 23 presenting CD and lifetime AD; 30 presenting lifetime AD and not CD; and 17 with neither disorder (ND). Participants completed clinical assessments and diffusion-weighted and resting-state functional MRI scans. The uncinate fasciculus was reconstructed using tractography and manual dissection, and structural measures extracted. Correlations of resting-state activity between amygdala and OFC seeds were computed. The CD + AD and AD groups showed similarly reduced structural integrity of the left uncinate compared to ND, even after adjusting for IQ, psychiatric comorbidity, and childhood maltreatment. Uncinate integrity was associated with harm avoidance traits among AD-only women, and with the interaction of poor anger control and anxiety symptoms among CD + AD women. Groups did not differ in functional connectivity. Reduced uncinate integrity observed in CD + AD and AD-only women may reflect deficient emotion regulation in response to threat, common to both disorders, while other neural mechanisms determine the behavioral response.


Assuntos
Tonsila do Cerebelo/fisiopatologia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/psicologia , Transtorno da Conduta/complicações , Conectoma , Córtex Pré-Frontal/fisiopatologia , Tonsila do Cerebelo/patologia , Emoções , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética/métodos , Córtex Pré-Frontal/patologia , Fatores Sexuais
8.
Nat Hum Behav ; 2(7): 514-521, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-31097806

RESUMO

Common genetic influences offer a partial explanation for comorbidity between different psychiatric disorders1-3. However, the genetics underlying co-development-the cross-domain co-occurrence of patterns of change over time-of psychiatric symptoms during childhood and adolescence has not been well explored. Here, we show genetic influence on joint symptom trajectories of parent-reported conduct and emotional problems (overall N = 15,082) across development (4-16 years) using both twin- and genome-wide polygenic score analyses (genotyped N = 2,610). Specifically, we found seven joint symptom trajectories, including two characterized by jointly stable and jointly increasing symptoms of conduct and emotional problems, respectively (7.3% of the sample, collectively). Twin modelling analyses revealed substantial genetic influence on trajectories (heritability estimates range of 0.41-0.78). Furthermore, individuals' risk of being classified in the most symptomatic trajectory classes was significantly predicted by polygenic scores for years-of-education-associated alleles and depressive symptoms-associated alleles. Complementary analyses of child self-reported symptoms across late childhood and early adolescence yielded broadly similar results. Taken together, our results indicate that genetic factors are involved in the co-development of conduct and emotional problems across childhood and adolescence, and that individuals with co-developing symptoms across multiple domains may represent a clinical subgroup characterized by increased levels of genetic risk.


Assuntos
Sintomas Afetivos/genética , Transtorno da Conduta/genética , Adolescente , Desenvolvimento do Adolescente , Sintomas Afetivos/complicações , Criança , Desenvolvimento Infantil , Pré-Escolar , Transtorno da Conduta/complicações , Feminino , Humanos , Masculino
9.
Subst Use Misuse ; 53(8): 1252-1259, 2018 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-29185888

RESUMO

Conduct disorder (CD) symptoms cooccur at high rates with illicit drug use in juvenile justice involved youth, which results in poorer outcomes; however, research has not identified where best to intervene in this relationship, limiting the identification of modifiable risk factors to reduce negative effects of CD symptoms. Two mediation models were examined to investigate the potential for CD symptoms to influence a reciprocal relationship between illicit drug use and positive drug attitudes, controlling for age, gender, and race. Data were examined for 245 juvenile justice involved youth (mean age = 15.46, SD = 1.30, range 12-18, 64.9% Black, 80.4% male) who completed court-ordered psychological assessments. Findings indicate: (1) Positive attitudes toward illicit drug use significantly mediated the relationship between CD symptoms and illicit drug use (ß = 0.16, CI 0.09-0.27; test for indirect effect z = 4.17, p < .001) and (2) illicit drug use significantly mediated the relationship between CD symptoms and positive attitudes toward illicit drug use (ß = 0.20, CI 0.12-0.32; test for indirect effect z = 4.87, p < .001). Overall, the present study suggests that CD symptoms impart risk for illicit drug use both indirectly, through more positive attitudes toward illicit drug use, and directly, which further strengthens positive attitudes toward illicit drug use.


Assuntos
Transtorno da Conduta/complicações , Criminosos/psicologia , Usuários de Drogas/psicologia , Delinquência Juvenil/psicologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Criança , Transtorno da Conduta/psicologia , Feminino , Humanos , Masculino , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/psicologia
10.
J Atten Disord ; 22(5): 403-413, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-25525156

RESUMO

OBJECTIVE: This study examined the prevalence and correlates of anxiety disorders in Chinese children with ADHD. METHOD: Overall, 120 children with ADHD aged 6 to 12 years were recruited, and the parent version of computerized Diagnostic Interview Schedule for Children-Version 4 was administrated to their primary caretakers. RESULTS: The prevalence rate of anxiety disorders was 27.5%, which is consistent with the reports of previous Asian and Western studies. Among the children with ADHD and anxiety disorders, more than 50% of them also had comorbid oppositional defiant disorder or conduct disorder (ODD/CD), which yielded an adjusted odds ratio of 3.0 in multivariable analysis for anxiety disorder, with comorbid ODD/CD. In addition, anxiety disorders were positively associated with inattention symptoms in children with both disorders. CONCLUSION: Clinicians should perform screening and careful assessment for anxiety symptoms in children with ADHD, particularly those suffering from comorbid ODD/CD.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/etnologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/etnologia , Criança , China/etnologia , Transtorno da Conduta/complicações , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/etnologia , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Razão de Chances , Prevalência
12.
Psychiatry Res ; 258: 525-530, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28893412

RESUMO

This study examines attention-deficit/hyperactivity disorder (ADHD) and callous-unemotional (CU) traits as moderators of the association between conduct problems (CP) and young adult functioning. Young adults (n = 283; Mage = 20.82 years; 53.4% female), oversampled for attention and behavior problems, provided self-ratings of ADHD, CP, and CU, and adaptive functioning and psychopathology. ADHD and CU simultaneously moderated relationships between CP and family functioning, tobacco use, and internalizing symptoms. In addition, ADHD moderated the relation between CP and job functioning, and main effects of ADHD in the expected direction were found for educational performance and drug use. CU was associated with poorer educational outcomes. Interestingly, no ADHD, CU, or CP effects were observed for reported alcohol use. Our results highlight the importance of considering ADHD and CU in understanding the impact of CP on young adult functioning and psychopathology, and point to the importance of continued work on this topic.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno da Conduta/complicações , Transtorno da Conduta/psicologia , Comportamento Problema , Consumo de Bebidas Alcoólicas , Atenção , Feminino , Humanos , Masculino , Psicopatologia , Autorrelato , Uso de Tabaco , Adulto Jovem
13.
Cogn Affect Behav Neurosci ; 17(4): 869-885, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28695488

RESUMO

The phenotype and genotype of antisocial behavior among females are different from those among males. Previous studies have documented structural brain alterations in males with antisocial behavior, yet little is known about the neural correlates of female antisocial behavior. The present study examined young women who had presented conduct disorder (CDW) prior to age 15 to determine whether brain abnormalities are present in adulthood and whether the observed abnormalities are associated with comorbid disorders or maltreatment that typically characterize this population. Using magnetic resonance imaging and voxel-based morphometry, we compared gray matter volumes (GMV) of 31 women who presented CD by midadolescence and 25 healthy women (HW), age, on average, 23 years. Participants completed structured, validated interviews to diagnose mental disorders, and validated questionnaires to document physical and sexual abuse. Relative to HW, CDW presented increased GMV in the left superior temporal gyrus that was associated with past alcohol and drug dependence, current use of alcohol and drugs, and current anxiety and depression symptoms and maltreatment. Additionally, CDW displayed reduced GMV in lingual gyrus, hippocampus, and anterior cingulate cortex that was associated with past comorbid disorders, current alcohol and drugs use, current anxiety and depression symptoms, and maltreatment. The CDW also presented reduced total GMV that was associated with past comorbid disorders and current anxiety/depression symptoms. Alterations of brain structure were observed among young adult females with prior CD, relative to HW, all of which were associated with internalizing and externalizing disorders and maltreatment that typically accompany CD.


Assuntos
Encéfalo/anormalidades , Encéfalo/diagnóstico por imagem , Transtorno da Conduta/diagnóstico por imagem , Sobreviventes Adultos de Maus-Tratos Infantis , Idade de Início , Agressão , Encéfalo/patologia , Comorbidade , Transtorno da Conduta/complicações , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/patologia , Feminino , Substância Cinzenta/anormalidades , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Humanos , Processamento de Imagem Assistida por Computador , Entrevista Psicológica , Imagem por Ressonância Magnética , Tamanho do Órgão , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Adulto Jovem
14.
Neurología (Barc., Ed. impr.) ; 32(4): 253-263, mayo 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-162030

RESUMO

Introducción. La demencia se caracteriza por un deterioro cognitivo y por la aparición de síntomas psicológicos y conductuales, entre los que destacan las alteraciones de percepción, del contenido del pensamiento, estado de ánimo y de conducta. Para tratar estos síntomas, además del tratamiento farmacológico, se utilizan intervenciones no farmacológicas, entre ellas la musicoterapia. Esta técnica novedosa, por sus características no verbales, puede ser usada en todas las fases del tratamiento de las personas con demencia ya que, aunque haya un gran deterioro cognitivo, las respuestas ante la música se mantienen hasta los estadios más avanzados de la enfermedad. Desarrollo. Se realizó una búsqueda bibliográfica con un intervalo temporal entre 2003 y 2013 en las bases de datos Academic Search Complete, PubMed, Science Direct y Dialnet. Los términos de búsqueda incluyeron la combinación de las palabras claves «music therapy, dementia, behaviour, behavioural disorders y behavioural disturbances». Se seleccionaron 11 registros de los 2188 localizados tras aplicar los criterios de inclusión. Conclusiones. El tratamiento con musicoterapia es beneficioso para mejorar las alteraciones conductuales, la ansiedad y la agitación en pacientes con demencia (AU)


Introduction. Dementia is characterised by cognitive deterioration and the manifestation of psychological and behavioural symptoms, especially changes in perception, thought content, mood, and conduct. In addition to drug therapy, non-pharmacological treatments are used to manage these symptoms, and one of these latter treatments is music therapy. Since this novel technique in non-verbal, it can be used to treat patients with dementia at any stage, even when cognitive deterioration is very severe. Patients’ responses to music are conserved even in the most advanced stages of the disease Development. A literature research was carried out using the following databases: Academic Search Complete, PubMed, Science Direct y Dialnet. The period of publication was 2003 to 2013 and the search keywords were «Music Therapy, Dementia, Behaviour, Behaviour Disorders y Behavioural Disturbances». Out of the 2188 studies that were identified, 11 studies met inclusion criteria for the systematic review. Conclusions. Music therapy is beneficial and improves behavior disorders, anxiety and agitation in subjects diagnosed with dementia (AU)


Assuntos
Humanos , Masculino , Feminino , Demência/terapia , Sintomas Afetivos/terapia , Musicoterapia/métodos , Musicoterapia/tendências , Transtorno da Conduta/terapia , Transtornos Cognitivos/terapia , Transtorno da Conduta/complicações , Terapia Cognitivo-Comportamental/métodos , Qualidade de Vida/psicologia
15.
J Formos Med Assoc ; 116(12): 946-955, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28292624

RESUMO

BACKGROUND/PURPOSE: This study aimed to evaluate neuropsychological functioning of attention-deficit/hyperactivity disorder (ADHD) with and without comorbidities of oppositional defiant disorder (ODD) and/or conduct disorder (CD) and the mediation effects of the neuropsychological functions in the relationship between ADHD and ODD/CD symptoms to increase our understanding about these frequently co-occurring disorders. METHODS: Adolescents aged 11-18 years were interviewed by the Kiddie epidemiologic version of the Schedule for Affective Disorders and Schizophrenia to confirm their previous and current ADHD status and other psychiatric diagnoses. The performance of the Cambridge Neuropsychological Testing Automated Battery was compared among four groups: (1) ADHD with CD (ADHD+CD), regardless of ODD; (2) ADHD with ODD (ADHD+ODD) without CD; (3) ADHD without ODD/CD (ADHD-only); and (4) typically developing controls. Mediation effects of neuropsychological functioning were tested. RESULTS: All three ADHD groups had impaired spatial working memory and short-term memory. Deficits in verbal memory and response inhibition were found in ADHD+ODD, but not in ADHD-only. ADHD+CD did not differ from typically developing controls in verbal working memory, signal detectability, and response inhibition. Spatial working memory partially mediated the association between ADHD and CD symptoms and alerting/signal detectability of arousal partially mediated the association between ADHD and ODD symptoms. CONCLUSION: There were both common and distinct neuropsychological deficits between adolescents with ADHD who developed ODD only and who developed CD. ADHD comorbid with CD may be a different disease entity and needs different treatment strategies in addition to treating ADHD, while ADHD+ODD may be a severe form of ADHD and warrants intensive treatment for ADHD symptoms.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno da Conduta/complicações , Transtorno da Conduta/psicologia , Adolescente , Criança , Comorbidade , Feminino , Humanos , Modelos Logísticos , Masculino , Memória de Curto Prazo , Testes Neuropsicológicos , Memória Espacial , Taiwan/epidemiologia
16.
J Clin Psychopharmacol ; 37(2): 220-225, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28225747

RESUMO

BACKGROUND AND AIM: Emotional dysregulation (ED) is a frequent feature of attention-deficit/hyperactivity disorder (ADHD). It can be observed as a dysregulation profile or a deficient emotional self-regulation (DESR) profile. Oppositional defiant disorder/conduct disorder (ODD/CD) comorbidity is prevalent in ADHD and known to be related with ED. The first-line treatment of ADHD includes psychostimulants, but their effects on ED are not well studied. This study aimed to evaluate the outcomes of methylphenidate (MPH) treatment on ED in ADHD + ODD/CD cases. METHODS: A total of 118 ADHD + ODD/CD patients with a mean age of 9.0 ± 1.9 years were treated with MPH for 1 year. Also, parents of cases were recruited for a parent-training program, which initiated after first month of MPH treatment. Symptom severity was assessed at baseline and 12th month by Turgay Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Based Child and Adolescent Behavior Disorders Screening and Rating Scale-Parent Form, Children Depression Inventory, Child Behavior Checklist 4-18 years, and Parental Acceptance and Rejection Questionnaire-Mother Form. RESULTS: Emotional dysregulation (DESR + DP) was present in 85.6% of cases. Conduct disorder was significantly higher in patients with DP, whereas ODD was significantly higher in the DESR and non-ED groups (P < 0.0001). Symptoms of ADHD and ED were significantly improved with 1-year of MPH treatment (P < 0.05). The improvement in ED was independent of improvement in ADHD symptoms and parent training (P < 0.05). CONCLUSIONS: Emotional dysregulation is highly prevalent in disruptive behavioral disorders as ODD and CD, which are comorbid with ADHD. The MPH treatment is effective on ED independently from other clinical determinants.


Assuntos
Sintomas Afetivos/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno da Conduta/tratamento farmacológico , Metilfenidato/farmacologia , Autocontrole , Adolescente , Sintomas Afetivos/epidemiologia , Sintomas Afetivos/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Comorbidade , Transtorno da Conduta/complicações , Transtorno da Conduta/epidemiologia , Feminino , Humanos , Masculino , Metilfenidato/administração & dosagem
17.
J Child Adolesc Psychopharmacol ; 27(3): 243-249, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28099039

RESUMO

OBJECTIVE: Gilles de la Tourette syndrome (GTS) and depression are both common disorders. It has been suggested that depression occurs in 13%-76% GTS patients. Despite this, there are few studies into the specific relationships and correlates between the two disorders. There is only some consensus as to the precise relationship between the two disorders. MATERIALS AND METHODS: We undertook the study to investigate the relationship between depressive symptomatology and the core clinical features of GTS in a well-characterized clinical population of youth with this disorder. Our aim was to verify the association between depression and comorbid obsessive-compulsive disorder and explore further other potential associations highlighted in some, but not all, of the studies focused on this topic. RESULTS: Our results demonstrated that (1) the GTS patients were significantly older than the controls, (2) the GTS patients were significantly more depressed than controls, (3) depression was associated with tic severity, (4) the Diagnostic Confidence Index scores were higher in GTS patients without depression, (5) anxiety, attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and behavioral problems were significantly associated with depression, and (6) finally, patients with GTS and depression have a positive family history of depression. However, obsessionality (CY-BOCS) did not differentiate between depressed and not depressed GTS patients. CONCLUSIONS: Depression is common in patients with GTS and occurs significantly more in GTS than in controls. Depression is significantly associated with GTS factors such as tic severity, comorbidity with ADHD, and the presence of coexistent anxiety, CDs, and behavior problems. Depression is importantly significantly associated with a positive family history of depression. Intriguingly, depression in our sample was not related to obsessionality.


Assuntos
Depressão/complicações , Depressão/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Síndrome de Tourette/complicações , Síndrome de Tourette/psicologia , Adolescente , Ansiedade/complicações , Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Comorbidade , Transtorno da Conduta/complicações , Transtorno da Conduta/psicologia , Família , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Qualidade de Vida
18.
Autism Res ; 10(2): 267-275, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27305862

RESUMO

Lack of empathy is one of the behavioral hallmarks in individuals with autism spectrum conditions (ASC) as well as youth with conduct disorder symptoms (CDS). Previous research has reliably documented considerable overlap between the perception of others' pain and first-hand experience of pain. However, the linkage between empathy for pain and sensitivity to physical pain needs to be empirically determined, particularly in individuals with empathy deficits. This study measured the pressure pain threshold, which indexes sensitization of peripheral nociceptors, and assessed subjective ratings of unpleasantness and pain intensity in response to empathy-eliciting stimuli depicting physical bodily injuries in three age- and sex-matched participant groups: ASC, CDS, and typically developing controls (TDC). The results indicated that the pain threshold was lowest in the ASC group and highest in the CDS group. The ASC group displayed lower ratings of unpleasantness and pain intensity than did the TDC and CDS groups. Within the ASC and CDS, pain intensity ratings were significantly correlated with unpleasantness ratings to others' pain. Moreover, the ASC significantly differed from the TDC in the correlation between pain threshold values and unpleasantness ratings. These findings may cast some light on the linkage between atypical low-level sensory functioning, for instance altered pain sensitivity, and high-level empathic processing. Autism Res 2017, 10: 267-275. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.


Assuntos
Transtorno do Espectro Autista/psicologia , Transtorno da Conduta/complicações , Transtorno da Conduta/psicologia , Empatia/fisiologia , Dor/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Adulto , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/fisiopatologia , Transtorno da Conduta/fisiopatologia , Humanos , Masculino , Dor/fisiopatologia , Adulto Jovem
19.
J Youth Adolesc ; 46(8): 1633-1642, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27017600

RESUMO

Individual heterogeneity exists in the onset and development of conduct problems, but theoretical claims about predictors and prognosis are often not consistent with the empirical findings. This study examined shape and outcomes of conduct problem trajectories in a Belgian population-based sample (N = 682; 49.5 % boys). Mothers reported on children's conduct problems across six waves (age 4-17) and emerging adults reported on their behavioral adjustment (age 17-20). Applying mixture modeling, we found four gender-invariant trajectories (labeled life-course-persistent, adolescence-onset, childhood-limited, and low). The life-course-persistent group was least favorably adjusted, but the adolescence-onset group was similarly maladjusted in externalizing problems and may be less normative (15 % of the sample) than previously believed. The childhood-limited group was at heightened risk for specifically internalizing problems, being more worrisome than its label suggests. Interventions should not only be aimed at early detection of conduct problems, but also at adolescents to avoid future maladjustment.


Assuntos
Transtorno da Conduta/epidemiologia , Transtornos Mentais/epidemiologia , Adolescente , Adulto , Bélgica , Criança , Pré-Escolar , Transtorno da Conduta/complicações , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/etiologia , Mães , Fatores de Risco
20.
Subst Abus ; 38(1): 77-81, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27897467

RESUMO

BACKGROUND: Some types of sexually transmitted infection (STI) have higher prevalence in females than males, and among black, relative to white, females. Identifying mechanisms of STI risk is critical to effective intervention. The authors tested a model in which alcohol and marijuana use serve as mediating factors in the associations between depression and conduct problems with sexual risk behavior (SRB) and STI in adolescent females. METHODS: The Pittsburgh Girls Study is a longitudinal observational study of females who have been followed annually to track the course of mental and physical health conditions. The 3 oldest cohorts (N = 1750; 56.8% black, 43.2% white) provided self-reports of substance use, depression and conduct problems, SRB, and STI at ages 16-18. A path model tested alcohol and marijuana use at age 17 as mechanisms that mediate the associations of depression and conduct problems at age 16 with SRB and STI at age 18. RESULTS: Race was involved in 2 risk pathways. In one pathway, white females reported greater alcohol use, which was associated with greater SRB. In another pathway, black females reported earlier sexual onset, which was associated with subsequent SRB. Public assistance use was independently associated with early sexual onset and STI. SRB, but not substance use, mediated the association of depression and conduct problems with STI. CONCLUSIONS: Differences by race in pathways of risk for SRB and STI, involving, for example, alcohol use and early sexual onset, were identified for young white and black females, respectively. Depression and conduct problems may signal risk for SRB and STI in young females, and warrant attention to improve health outcomes.


Assuntos
Comportamento do Adolescente , Afro-Americanos/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Uso da Maconha/psicologia , Doenças Sexualmente Transmissíveis/psicologia , Consumo de Álcool por Menores/psicologia , Adolescente , Transtorno da Conduta/complicações , Transtorno da Conduta/psicologia , Depressão/complicações , Depressão/psicologia , Feminino , Humanos , Estudos Longitudinais , Fatores de Risco , Doenças Sexualmente Transmissíveis/complicações , Sexo sem Proteção/psicologia , População Urbana
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