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1.
J Rheumatol ; 49(5): 489-496, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35105715

RESUMO

OBJECTIVE: Few studies examine psychopathology in different juvenile idiopathic arthritis (JIA) subtypes and disease activity states. We aimed to (1) evaluate emotional and behavioral symptoms in children with juvenile spondyloarthritis (SpA) and polyarticular arthritis (PolyA) as compared to a national normative population using the Child Behavior Checklist (CBCL), and (2) evaluate the relationship between CBCL scores and disease activity. METHODS: Patients with JIA aged 6-17 years with SpA or PolyA were recruited from our pediatric rheumatology clinic from April 2018 to April 2019 and the CBCL and clinical Juvenile Arthritis Disease Activity Score in 10 joints (cJADAS10) were completed. Primary outcome measures were CBCL total competence, internalizing, externalizing, and total problems raw scores. We compared outcomes from each group to national CBCL normative data. To investigate the relationship between CBCL scores and disease activity, we ran a generalized linear regression model for all patients with arthritis with cJADAS10 as the main predictor. RESULTS: There were 111 patients and 1753 healthy controls (HCs). Compared to HCs, patients with SpA or PolyA had worse total competence and internalizing scores. Higher cJADAS10 scores were associated with worse total competence, worse internalizing, and higher total problems scores. Most of these differences reached statistical significance (P < 0.01). Self-harm/suicidality was almost 4-fold higher in patients with PolyA than HCs (OR 3.6, 95% CI 1.3-9.6, P = 0.011). CONCLUSION: Our study shows that patients with SpA and PolyA with more active disease have worse psychological functioning in activities, school, and social arenas, and more internalized emotional disturbances, suggesting the need for regular mental health screening by rheumatologists.


Assuntos
Artrite Juvenil , Transtornos do Comportamento Infantil , Espondilartrite , Sintomas Afetivos , Artrite Juvenil/complicações , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Emoções , Humanos
2.
PLoS One ; 17(1): e0262690, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35041701

RESUMO

BACKGROUND: There is a substantial gap in our knowledge about family correlates of child emotional and behavioral problems in low- and middle-income countries (LMIC). The present study contributes to filling this gap by examining such correlates in a larger population study in Nepal. METHODS: Our study is a cross-sectional, observational study among 3840 Nepali children aged 6-18 years from 64 schools and 16 districts in the three main geographical regions in the country. We used the Nepali version of the Child Behavior Checklist (CBCL)/6-18 to assess children's internalizing and externalizing problems and an additional background information questionnaire to assess possible family correlates which included parental education, family structure, migrant worker parents, parental mental and physical illness, family conflicts, and child-rearing. The associations between family variables and child internalizing and externalizing problems were analyzed using bivariate correlations and multiple regression. RESULTS: Using bivariate analysis, we found that mental and physical illness in parents, conflict in the family, parental disagreement in child-rearing, and physical punishment of child correlated positively with both Internalizing Problems and Externalizing Problems. The same associations were found by using multiple regression analysis. In addition, parental education, family structure, and migrant worker mothers were associated with Externalizing Problems. However, the effect sizes were small. CONCLUSION: The results suggest that in Nepal, child mental problems were associated with several family risk factors. Further, the study points to the need of strengthening prevention- and intervention measures to minimize family risk factors of child mental health disorders.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Emoções/fisiologia , Conflito Familiar/psicologia , Relações Familiares/psicologia , Pais/psicologia , Pobreza , Comportamento Problema/psicologia , Adolescente , Criança , Transtornos do Comportamento Infantil/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Nepal/epidemiologia
3.
J Pediatr ; 241: 188-195.e3, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34571019

RESUMO

OBJECTIVE: To assess the relation between leisure screen time and emotional and behavioral problems in Spanish children aged 4-14 years. STUDY DESIGN: This cross-sectional study used a representative sample of children aged 4-14 years included in the 2017 Spanish National Health Survey (n = 4073). Emotional and behavioral problems of children were assessed through the parent-report Strengths and Difficulties Questionnaire. Daily leisure screen time in minutes was categorized as 0-59, 60-119, 120-179, and ≥180. We calculated adjusted prevalence ratios (aPR) and their 95% CIs of being at risk of developing emotional and behavioral problems. Associations were adjusted for potential confounding variables. RESULTS: Children spending 180 minutes or more of daily leisure screen time compared with children spending less than 1 hour were more likely to be at risk of developing emotional and behavioral problems: aPR≥180: 2.19 (95% CI 1.53-3.14), emotional symptomology: aPR≥180: 2.09 (95% CI 1.37-3.18), conduct problems aPR≥180: 1.85 (95% CI 1.34-2.54), peer problems aPR≥180: 1.78 (95% CI 1.15-2.75), and to behave less prosocially: aPR≥180: 2.20 (95% CI 1.43-3.37). CONCLUSIONS: We have found significant associations between daily leisure screen time and emotional and behavioral problems in Spanish children between 6 and 14 years of age. However, these findings should be confirmed in cohort studies, so institutions might consider including screen time as a new risk factor for children.


Assuntos
Sintomas Afetivos/etiologia , Transtornos do Comportamento Infantil/etiologia , Atividades de Lazer/psicologia , Comportamento Problema/psicologia , Tempo de Tela , Adolescente , Sintomas Afetivos/epidemiologia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Fatores de Risco , Espanha
4.
Eur Child Adolesc Psychiatry ; 31(3): 519-527, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33624130

RESUMO

There is growing evidence that insufficient sleep has negative effects on the mental health of children. The aim of this study is to examine the associations between device-measured sleep duration and internalizing and externalizing problems in 8-year-old children. The study is a secondary analysis of data from the Childhood Obesity Project conducted in five European countries. Nocturnal sleep duration was measured with the SenseWear™ Armband 2. Parents rated their child's internalizing and externalizing problems on the Child Behaviour Checklist. Behaviour scores were dichotomized at the 90th percentile based on sex- and country-specific z-scores. Logistic regression models were applied to test the associations between sleep duration and behaviour. Data were available for 406 8-year-old children. The average sleep duration was 9.25 h per night (SD: 0.67) with 1464 nights measured in total. The sleep duration recommendation of the American Academy of Sleep Medicine for school-aged children (9-12 h) was met by 66.7% of children. One hour of additional sleep per night significantly reduced the risk of having internalizing problems (adjusted OR = 0.51; 95% CI 0.29-0.91). Children who adhered to the sleep duration recommendation had a lower risk for internalizing problems (adjusted OR = 0.45; 95% CI 0.21-0.99). Sleep duration and externalizing problems showed no significant association. Longer sleep duration was associated with a reduced risk of having internalizing problems but not externalizing problems. Results highlight that it is important to ensure adequate sleep duration throughout primary-school years for the optimal emotional health of children. Trial registration number: NCT00338689. Registered: June 19, 2006.


Assuntos
Transtornos do Comportamento Infantil , Obesidade Pediátrica , Comportamento Problema , Transtornos do Sono-Vigília , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etiologia , Feminino , Humanos , Masculino , Obesidade Pediátrica/complicações , Obesidade Pediátrica/epidemiologia , Comportamento Problema/psicologia , Sono , Transtornos do Sono-Vigília/psicologia
5.
Pediatr Int ; 64(1): e14910, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34233074

RESUMO

BACKGROUND: The Eyberg Child Behavior Inventory (ECBI) is one of the standardized parent rating scales used to identify disruptive behavior problems in children in Western countries. This study aimed to determine norms for the Japanese version of the ECBI, including clinical cutoff scores among the general population in Japan. METHODS: This study established norms for the Japanese version of the ECBI using a sample of 1,992 parents of children aged 2-7, living in Japan. The research evaluates the validity and the reliability of the ECBI scores for the Intensity Scale and the Problem Scale. After validation, a clinical cutoff value of the ECBI scores was calculated, setting the cutoff to above the +1 standard deviation (SD) level based on the population distribution. RESULTS: The means of the Intensity and Problem Scale scores were 100.07 and 6.57, respectively. Cronbach's α for both the Intensity and the Problem scores was 0.91. At this point, we propose cutoff scores of 125 for the Intensity Scale and 14 for the Problem Scale. CONCLUSIONS: Our results suggest that the Japanese version of the ECBI is highly reliable and may be useful as a tool for assessing behavior problems in children.


Assuntos
Transtornos do Comportamento Infantil , Comportamento Problema , Criança , Comportamento Infantil , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Humanos , Japão , Psicometria , Reprodutibilidade dos Testes
6.
J Expo Sci Environ Epidemiol ; 32(1): 124-134, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34257388

RESUMO

BACKGROUND: Coal-fired power plants are a major source of air pollution that can impact children's health. Limited research has explored if proximity to coal-fired power plants contributes to children's neurobehavioral disorders. OBJECTIVE: This community-based study collected primary data to investigate the relationships of residential proximity to power plants and neurobehavioral problems in children. METHODS: 235 participants aged 6-14 years who lived within 10 miles of two power plants were recruited. Exposure to particulate matter ≤10 µm (PM10) was measured in children's homes using personal modular impactors. Neurobehavioral symptoms were assessed using the Child Behavior Checklist (CBCL). Multiple regression models were performed to test the hypothesized associations between proximity/exposure and neurobehavioral symptoms. Geospatial statistical methods were used to map the spatial patterns of exposure and neurobehavioral symptoms. RESULTS: A small proportion of the variations of neurobehavioral problems (social problems, affective problems, and anxiety problems) were explained by the regression models in which distance to power plants, traffic proximity, and neighborhood poverty was statistically associated with the neurobehavioral health outcomes. Statistically significant hot spots of participants who had elevated levels of attention deficit hyperactivity disorder, anxiety, and social problems were observed in the vicinity of the two power plants. SIGNIFICANCE: Results of this study suggest an adverse impact of proximity to power plants on children's neurobehavioral health. Although coal-fired power plants are being phased out in the US, health concern about exposure from coal ash storage facilities remains. Furthermore, other countries in the world are increasing coal use and generating millions of tons of pollutants and coal ash. Findings from this study can inform public health policies to reduce children's risk of neurobehavioral symptoms in relation to proximity to power plants.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Adolescente , Poluentes Atmosféricos/toxicidade , Poluição do Ar/estatística & dados numéricos , Criança , Transtornos do Comportamento Infantil/epidemiologia , Saúde da Criança , Carvão Mineral/toxicidade , Cinza de Carvão/análise , Humanos , Centrais Elétricas
7.
Prenat Diagn ; 42(2): 278-286, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34907545

RESUMO

OBJECTIVE: To analyse prenatal work-up, associated anomalies and postnatal outcomes of foetuses with cerebral lateral ventricular width 9-9.9 mm. METHOD: This retrospective, observational, case-control study included 121 foetuses with initial presentation of isolated cerebral lateral ventricular width 9-9.9 mm detected during routine ultrasound scans, 21-24 weeks' gestation, in a tertiary referral centre, January 2001-December 2018. Controls included 123 foetuses with lateral ventricular width <9 mm measured under the same parameters. Clinical characteristics, obstetrical history, ultrasound findings, prenatal work-up and pregnancy outcomes were collected from medical records. Information about postnatal functional and neurodevelopmental sequelae were obtained from telephone-based questionnaires. RESULTS: The study group had more males (82/116 (70.6%) versus 65/123 (52.8%), p = 0.004), more prenatal testing, including brain magnetic resonance imaging (28/116 (24.1%) versus 0/123 (0%), p < 0.001), echocardiography (46/116 (39.7%) versus 15/123 (12.2%), p < 0.001) and targeted anomaly scans (102/116 (87.9%) versus 1/123 (0.008%), p < 0.001). Long-term follow-up did not reveal more neurodevelopmental sequelae compared to controls. Gender-based analysis found more males with ventricular dilatation 9-9.9 mm treated for developmental delay compared to females with similar findings (15/82 (18.2%) versus 1/34 (2.9%), p = 0.010). CONCLUSION: Foetuses with 9-9.9 mm cerebral lateral ventricular width versus <9 mm underwent more prenatal testing but had similar rates of neurodevelopmental sequelae.


Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Ventrículos Cerebrais/anormalidades , Ventrículos Cerebrais/diagnóstico por imagem , Hidrocefalia/diagnóstico por imagem , Ultrassonografia Pré-Natal , Adolescente , Estudos de Casos e Controles , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etiologia , Pré-Escolar , Feminino , Seguimentos , Humanos , Hidrocefalia/complicações , Hidrocefalia/congênito , Lactente , Recém-Nascido , Masculino , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/etiologia , Gravidez , Prognóstico , Estudos Retrospectivos
8.
Sci Rep ; 11(1): 22182, 2021 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-34772976

RESUMO

High levels of persistent organic pollutants (POPs) and heavy metals are found in Arctic populations. POP and heavy metals are linked to impaired cognitive development. This study examined associations between prenatal POP and metals exposure and problematic child behavior using the Strength and Difficulties Questionnaire (SDQ). POPs and metals were measured in 102 pregnant Greenlandic women. During follow-up at 3-5 years, parents answered an assisted questionnaire including children's SDQ scores. Associations were analyzed using linear and logistic regression analyses and adjusted for maternal plasma cotinine, educational level and age at delivery. In the adjusted analyses, the medium tertile of hexachlorobenzene (ß = 3.06, p = 0.010), ß-hexachlorocyclohexane (ß = 3.58, p = 0.004) and trans-nonachlor (ß = 2.06, p = 0.082) were positively associated with SDQ scores. The continuous cis-nonachlor (OR = 1.09, p = 0.079), dichloro-diphenyl-dichloroethylene (OR = 1.01, p = 0.077), trans-nonachlor (OR = 1.01, p = 0.091), and sum Organochlorine-Pesticides (OR = 1.00, p = 0.094) were positively associated with abnormal SDQ score and the continuous mirex (OR = 1.28, p = 0.096), oxychlordane (OR = 1.04, p = 0.066), and trans-nonachlor (OR = 1.02, p = 0.071) with abnormal hyperactivity score. We found no consistent evidence of associations between polychlorinated biphenyls, perfluoroalkylated substances and heavy metals and problematic behavior. Prenatal organochlorine pesticide exposure associated significantly with problematic behavior in 3-5 year old children.


Assuntos
Comportamento Infantil , Exposição Ambiental/efeitos adversos , Exposição Materna/efeitos adversos , Metais Pesados/efeitos adversos , Poluentes Orgânicos Persistentes/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal , Biomarcadores/sangue , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etiologia , Pré-Escolar , Estudos de Coortes , Feminino , Groenlândia/epidemiologia , Humanos , Masculino , Razão de Chances , Gravidez , Vigilância em Saúde Pública , Inquéritos e Questionários
9.
Child Abuse Negl ; 122: 105355, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34655993

RESUMO

BACKGROUND: Child abuse is a serious social problem in the USA as many children suffer from child abuse and its negative consequences are severe. To prevent future victimization, it is essential to understand unique patterns of child abuse trajectories over time and the factors associated with their victimization. OBJECTIVE: The primary goal of this study was to identify individual differences in developmental trajectories of alleged physical abuse between the ages of 2 and 12. PARTICIPANTS AND SETTING: The sample included all children drawn from Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), which is a consortium of five study sites (South, East, Midwest, Northwest, and Southwest). METHODS: Using the high-risk sample with Child Protective Service record reviews prior to age 4, significant variability in trajectory class membership was observed in the unconditional Latent Class Growth Analysis. RESULTS: Three trajectory classes were obtained from the data: Early Onset, Late Peak and Non-Victims. The findings showed that children who had an attention problem at age 4 were more likely to become members of both the Early Onset and Late Peak groups, relative to Non-victims. Also, membership in the Late Peak group was predicted by caregivers' childhood physical abuse, supporting for the cycle of physical abuse across generations. Finally, children in the Late Peak group were at the highest risk of being physically, psychologically, and sexually abused in a dating relationship at age 14. CONCLUSIONS: These results suggest that children's internal and external behavior problems and caregivers' childhood physical abuse are predictive of child abuse trajectory class membership. Parental education programs that increase their knowledge about children with special needs and intervention programs targeting caregivers with a history of physical abuse would be beneficial to prevent child abuse (re)victimization.


Assuntos
Experiências Adversas da Infância , Cuidadores , Maus-Tratos Infantis , Transtornos do Comportamento Infantil , Abuso Físico , Adolescente , Experiências Adversas da Infância/estatística & dados numéricos , Cuidadores/estatística & dados numéricos , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Vítimas de Crime/estatística & dados numéricos , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Estudos Longitudinais , Abuso Físico/estatística & dados numéricos , Fatores de Risco , Estados Unidos/epidemiologia
10.
J Pediatr ; 239: 175-181.e2, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34461062

RESUMO

OBJECTIVE: To evaluate the odds of a behavioral health diagnosis among youth with differences of sex development (DSD) or congenital adrenal hyperplasia (CAH) compared with matched controls in the PEDSnet database. STUDY DESIGN: All youth with a diagnosis of DSD (n = 1216) or CAH (n = 1647) and at least 1 outpatient encounter were extracted from the PEDSnet database and propensity-score matched on 8 variables (1:4) with controls (n = 4864 and 6588, respectively) using multivariable logistic regression. The likelihood of having behavioral health diagnoses was examined using generalized estimating equations. RESULTS: Youth with DSD had higher odds of a behavioral health diagnosis (OR, 1.7; 95% CI, 1.4-2.1; P < .0001) and neurodevelopmental diagnosis (OR, 1.7; 95% CI, 1.4, 2.0; P < .0001) compared with matched controls. Youth with CAH did not have an increased odds of a behavioral health diagnosis (OR, 1.0; 95% CI, 0.9, 1.1; P = .9) compared with matched controls but did have higher odds of developmental delay (OR, 1.8; 95% CI, 1.4, 2.4; P < .0001). CONCLUSIONS: Youth with DSD diagnosis have higher odds of a behavioral health or neurodevelopmental diagnosis compared with matched controls. Youth with CAH have higher odds of developmental delay, highlighting the need for screening in both groups.


Assuntos
Hiperplasia Suprarrenal Congênita/psicologia , Transtornos do Desenvolvimento Sexual/psicologia , Transtornos Mentais/etiologia , Adolescente , Hiperplasia Suprarrenal Congênita/complicações , Estudos de Casos e Controles , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etiologia , Pré-Escolar , Bases de Dados Factuais , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/etiologia , Transtornos do Desenvolvimento Sexual/complicações , Registros Eletrônicos de Saúde , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/etiologia , Razão de Chances , Pontuação de Propensão , Fatores de Risco
11.
PLoS One ; 16(8): e0255596, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34343215

RESUMO

BACKGROUND: As epidemiological data on child mental health in low- and middle-income countries are limited, a large-scale survey was undertaken to estimate the prevalence and amount of child emotional and behavioral problems (EBP) in Nepal as reported by the parents. METHODS: 3820 schoolchildren aged 6-18 years were selected from 16 districts of the three geographical regions of Nepal, including rural, semi-urban and urban areas. We used the Nepali version of the Child Behavior Checklist (CBCL)/6-18 years as screening instrument. Comparisons of child problems between genders and between the seven largest castes and ethnic groups were carried out by analysis of variance. Prevalence was computed based on American norms. RESULTS: Adjusted prevalence of Total Problems was 18.3% (boys: 19.1%; girls:17.6%). The prevalence of internalizing problems was higher than externalizing problems. The mean scores of Total, Externalizing, and Internalizing problems were 29.7 (SD 25.6), 7.7 (SD 8.0), and 9.1 (SD 8.1), respectively. The Khas Kaami (Dalit) group scored the highest, and the indigenous Tharu group scored the lowest on all scales. In the Mountains and Middle Hills regions, problem scores were higher in the rural areas, whereas in the Tarai region, they were higher in the urban areas. CONCLUSION: The prevalence and magnitude of emotional and behavioral problems in Nepali children were found to be high compared to findings in meta-analyses worldwide. Problem scores varied according to gender, castes /ethnic groups, and living areas. Our findings highlight the need for a stronger focus on child mental problems in a low-and middle-income country like Nepal.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Emoções/fisiologia , Pais , Pobreza/psicologia , Comportamento Problema/psicologia , Adolescente , Criança , Transtornos do Comportamento Infantil/economia , Feminino , Humanos , Masculino , Nepal/epidemiologia , Pobreza/estatística & dados numéricos
12.
JAMA Netw Open ; 4(6): e2111342, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34086035

RESUMO

Importance: Childhood suicidality (ie, suicidal ideation or attempts) rates are increasing, and attention-deficit/hyperactivity disorder (ADHD) and externalizing symptoms are common risk factors associated with suicidality. More data are needed to describe associations of ADHD pharmacotherapy with childhood suicidality. Objective: To investigate the associations of ADHD pharmacotherapy with externalizing symptoms and childhood suicidality. Design, Setting, and Participants: In this cohort study, cross-sectional and 1-year-longitudinal associations were examined using data (collected during 2016-2019) from the Adolescent Brain Cognitive Development (ABCD) Study, a large, diverse US sample of children aged 9 to 11 years. Data analysis was performed from November to December 2020. Exposures: Main and interaction associations of externalizing symptoms (hyperactivity ADHD symptoms, oppositional defiant, and conduct disorder symptoms) and ADHD medication treatment (methylphenidate and amphetamine derivatives, α-2-agonists, and atomoxetine) at baseline assessment. Main Outcomes and Measures: Child-reported suicidality (past and present at baseline; current at longitudinal assessment). Covariates were age, sex, race/ethnicity, parents' education, marital status, and concomitant child psychiatric pharmacotherapy (antidepressants and antipsychotics). Results: Among 11 878 children at baseline assessment (mean [SD] age, 9.9 [0.6] years; 6196 boys [52.2%]; 8805 White [74.1%]), 1006 (8.5%) were treated with ADHD medication and 1040 (8.8%) reported past or current suicidality. Externalizing symptoms (median [range], 1 [0-29] symptom count) were associated with suicidality (for a change of 1 SD in symptoms, odds ratio [OR], 1.34; 95% CI, 1.26-1.42; P < .001), as was ADHD medication treatment (OR, 1.32; 95% CI, 1.06-1.64; P = .01). ADHD medication use was associated with less suicidality in children with more externalizing symptoms (significant symptom-by-medication interaction, B = -0.250; SE = 0.086; P = .004), such that for children who were not receiving ADHD medications, there was an association between more externalizing symptoms and suicidality (for a change of 1 SD in symptoms, OR, 1.42; 95% CI, 1.33-1.52; P < .001); however, for children who were receiving ADHD medication, there was no such association (OR, 1.15; 95% CI, 0.97-1.35; P = .10). The association with medication remained even when covarying for multiple confounders, including risk and protective factors for suicidality in ABCD, and was replicated in 1-year longitudinal follow-up. Sensitivity analyses matching participants with high numbers of externalizing symptoms taking and not taking ADHD medication treatment confirmed its association with less suicidality. Conclusions and Relevance: These findings suggest that ADHD medication treatment is associated with less suicidality in children with substantial externalizing symptoms and may be used to inform childhood suicide prevention strategies.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos do Comportamento Infantil/epidemiologia , Suicídio/estatística & dados numéricos , Criança , Estudos de Coortes , Estudos Transversais , Nível de Saúde , Humanos , Fatores de Risco , Índice de Gravidade de Doença , Fatores Socioeconômicos , Ideação Suicida
13.
J Korean Med Sci ; 36(25): e184, 2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34184439

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is different from previous disasters in that it continues to the present and has affected all aspects of family life. During epidemics, psychosocial support is not less important than infection control. During COVID-19-related school closures, prolonged partial closures of schools could have detrimental social and health consequences for children and may increase the burden on the family. Based on a community sample in Korea, this study identified parental concerns, children's media usage, other various factors and examined whether parental stress level or depression were positively associated with problem behaviors, media exposure, and sleep problems of the primary school children during school closure under COVID-19. METHODS: Participants were 217 parents residing in Suwon, South Korea, who had primary school children and responded to a web-based questionnaire on parental concerns from school closure under COVID-19, subjective stress, depression, whether having received mental health services, and family characteristics; children's sleep patterns, problem behaviors, media usage during the online-only class period, and changes in activity level following the pandemic. RESULTS: During school closure, children gained body weight, spent less time in physical activities and more in media usage. Besides online learning content (97.2%), YouTube was highly used content (87.6%), and games followed (78.3%). Parental subjective stress index was highly associated with parental depression (Pearson correlation 0.439, P < 0.001), children's sleep problems (0.283, P < 0.001), tablet time (0.171, P = 0.012) and behavior problems (0.413, P < 0.001). Parental depression was associated with children's sleep problems (0.355, P < 0.001), TV time (0.153, P = 0.024), tablet time (0.159, P = 0.019), and behavior problems (0.524, P < 0.001). Parents who previously received mental services seemed to be more concerned about the problems their children already have getting worse because of COVID-19 than the disease itself. Children's sleep problem was associated with tablet (0.172, P = 0.011) and smartphone time (0.298, P < 0.001), but not its frequency. CONCLUSION: During COVID-19-related school closures, many parents and children had various difficulties relating to mental health. Ongoing monitoring of mental health of high-risk groups and multiple support systems may need to be expanded to cover those parents having difficulty in caring for their children.


Assuntos
COVID-19/epidemiologia , Meios de Comunicação de Massa , Pandemias , Pais/psicologia , Psicologia da Criança , SARS-CoV-2 , Instituições Acadêmicas , Isolamento Social , Adulto , Índice de Massa Corporal , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etiologia , Cuidado da Criança , Depressão/epidemiologia , Depressão/etiologia , Educação à Distância , Exercício Físico , Feminino , Humanos , Renda , Atividades de Lazer , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Relações Pais-Filho , Utilização de Procedimentos e Técnicas , Quarentena , República da Coreia/epidemiologia , Comportamento Sedentário , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Apoio Social , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários
14.
Recenti Prog Med ; 112(5): 360-370, 2021 05.
Artigo em Italiano | MEDLINE | ID: mdl-34003188

RESUMO

BACKGROUND: During the first semester 2020 almost all country implemented rigid measures of social distances, including schools closure, to limit the transmission of SARS-CoV-2 infection. Up to now, however, the efficacy of school closure to reduce the spread of the disease in the community still remains unclear and no much is known about the potential negative effects of such measures on physical health and psychological wellbeing of youths, mainly if protracted for long periods. OBJECTIVE: To summarize the data of a systematic review on the impact of the 2020 school closure and social distances measures implemented in response to covid-19 pandemic on youths' physical health and psychological wellbeing. In the present paper we describe the impact on psychological wellbeing. METHODS: We searched 11 international databases up to 1st September 2020 to retrieve cohort studies, cross sectional surveys, uncontrolled pre-post studies and modelling studies. Methodological quality of included studies has been assessed with validated checklists. RESULTS: Sixty-four studies have been included; 27 assessed the impact on psychological wellbeing. All the studies have been conducted during the first wave of pandemic and assessed the short-term effect of social distances measures implemented for relatively short periods. The majority of the studies were conducted in the UK (37,6%) and China (27%). The 42.3% has been judged of high methodological quality. Two studies reported an increase of suicides, while two studies reported a reduction of the access to Psychiatric Emergency Department, Maltreatment allegations decreased substantially, likely due to a reduction in reports rather than actual incidence. Prevalence of anxiety among adolescents ranged between 19% and 64%, depression between 22.3% and 43.7%. Among children 5-12 years old, prevalence of anxiety varied between 19% and 78%, while depression between 6.3% and 22.6%. Among pre-school children, some studies found worsening of behavioural and emotional problems while others did not. CONCLUSIONS: Most of the studies reported relevant worsening of the psychological wellbeing, mainly among adolescents. If school closure and rigid social distances measures will extend for a long time, an even more pronounced negative effect can be expected. Further studies are needed on the long-term effect of prolonged social distances measures, as well as a careful harm-benefit analysis of the impact of such measures.


Assuntos
COVID-19/prevenção & controle , Saúde Mental , Pandemias , Distanciamento Físico , Adolescente , Ansiedade/epidemiologia , COVID-19/epidemiologia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Depressão/epidemiologia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Lactente , Serviços de Saúde Mental/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Prevalência , Psicologia do Adolescente , Psicologia da Criança , Quarentena , Instituições Acadêmicas , Estresse Psicológico/epidemiologia , Suicídio/estatística & dados numéricos , Fatores de Tempo , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-33850037

RESUMO

OBJECTIVE: Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is a severe immune-mediated disorder. We aim to report the neurologic features of children with PIMS-TS. METHODS: We identified children presenting to a large children's hospital with PIMS-TS from March to June 2020 and performed a retrospective medical note review, identifying clinical and investigative features alongside short-term outcome of children presenting with neurologic symptoms. RESULTS: Seventy-five patients with PIMS-TS were identified, 9 (12%) had neurologic involvement: altered conciseness (3), behavioral changes (3), focal neurology deficits (2), persistent headaches (2), hallucinations (2), excessive sleepiness (1), and new-onset focal seizures (1). Four patients had cranial images abnormalities. At 3-month follow-up, 1 child had died, 1 had hemiparesis, 3 had behavioral changes, and 4 completely recovered. Systemic inflammatory and prothrombotic markers were higher in patients with neurologic involvement (mean highest CRP 267 vs 202 mg/L, p = 0.05; procalcitonin 30.65 vs 13.11 µg/L, p = 0.04; fibrinogen 7.04 vs 6.17 g/L, p = 0.07; d-dimers 19.68 vs 7.35 mg/L, p = 0.005). Among patients with neurologic involvement, these markers were higher in those without full recovery at 3 months (ferritin 2284 vs 283 µg/L, p = 0.05; d-dimers 30.34 vs 6.37 mg/L, p = 0.04). Patients with and without neurologic involvement shared similar risk factors for PIMS-TS (Black, Asian and Minority Ethnic ethnicity 78% vs 70%, obese/overweight 56% vs 42%). CONCLUSIONS: Broad neurologic features were found in 12% patients with PIMS-TS. By 3-month follow-up, half of these surviving children had recovered fully without neurologic impairment. Significantly higher systemic inflammatory markers were identified in children with neurologic involvement and in those who had not recovered fully.


Assuntos
COVID-19/complicações , Inflamação/complicações , Doenças do Sistema Nervoso/etiologia , Síndrome de Resposta Inflamatória Sistêmica/complicações , Adolescente , Biomarcadores/sangue , Encéfalo/diagnóstico por imagem , COVID-19/patologia , COVID-19/psicologia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etiologia , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Inflamação/patologia , Imageamento por Ressonância Magnética , Masculino , Doenças do Sistema Nervoso/patologia , Doenças do Sistema Nervoso/psicologia , Estudos Retrospectivos , Síndrome de Resposta Inflamatória Sistêmica/patologia , Síndrome de Resposta Inflamatória Sistêmica/psicologia , Trombose/sangue , Trombose/etiologia
16.
Schizophr Res ; 231: 108-114, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33838519

RESUMO

BACKGROUND: Psychopathology in childhood and adolescence, commonly indexed by co-occurring internalizing and externalizing problem behaviors, has been found to predict psychotic-like experiences (PLEs) in adults. However, studies to date have rarely examined internalizing and externalizing problem behaviors simultaneously or identified in which developmental period do these problem behaviors predict PLEs in adults. This study tests to what extent internalizing and externalizing problem behaviors in childhood (4-9 years) or adolescence (11-16 years) predict PLEs in young-adulthood (18 years). METHODS: Parent-rated child internalizing and externalizing problems on the Strengths and Difficulties Questionnaire at ages 4, 6, 8, 9, 11, 13, and 16 years from the Avon Longitudinal Study of Parents and Children (N = 4717) were modelled using two-piece latent growth curve modelling to predict clinician-rated PLEs at age 18 years, controlling for confounders (gender, ethnicity, socio-economic status, parental education and stressful life events) assessed prior to baseline at age 4 years. RESULTS: Controlling for confounders, an increase in childhood internalizing problems from 4 to 9 years and externalizing problems at baseline (at 4 years) predicted PLEs at 18 years, explaining 9.5% of the variance in adult PLEs. These associations were independent to controls for any changes in adolescent internalizing and externalizing problems from 11 to 16 years. CONCLUSIONS: High baseline levels of externalizing problems and increasing internalizing problems throughout childhood can predict PLEs at 18 years. Externalizing problems around the transition to primary school and internalizing problems throughout childhood may be particularly helpful in informing risk of PLEs in young-adulthood.


Assuntos
Transtornos do Comportamento Infantil , Comportamento Problema , Transtornos Psicóticos , Adolescente , Adulto , Criança , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Humanos , Estudos Longitudinais , Psicopatologia , Transtornos Psicóticos/epidemiologia
17.
J Intellect Disabil Res ; 65(7): 626-637, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33830566

RESUMO

BACKGROUND: Children with intellectual development disorder (IDD) have high rates of comorbid neuropsychological and behavioural problems. However, there are not many studies on this population in middle-income and low-income countries. Therefore, we aimed to investigate the prevalence of neuropsychological and behavioural problems in students with and without IDD and to assess the correlation between the responses from informants (parents and teachers) and the clinical diagnoses in Brazil. METHODS: After clinical diagnosis, 78 male and female students (7-15 years old) were divided into two groups: children with IDD (n = 39) and children without IDD (n = 39). The Child Behaviour Checklist (CBCL) and Teacher's Report Form (TRF) scales were used to track neuropsychological and behavioural problems. Calculations of prevalence ratios were performed using Poisson regression with Wald tests. The CBCL and TRF results were compared between groups with Mann-Whitney U-tests and receiver operating characteristic (ROC) analyses. The agreement between scales was assessed using the Spearman correlation test. RESULTS: Neuropsychological and behavioural problems were significantly more prevalent in students with IDD. The average amount of CBCL problems was significantly higher than that of TRF in the dimensions of thought, attention, somatic, attention deficit/hyperactivity, opposition defiant and total problems. Low-to-moderate correlations between CBCL and TRF dimensions in the IDD group were observed. ROC analyses revealed that the dimensions of internalising problems and total scores reflecting CBCL and TRF problems were the most important factors for identifying neuropsychological and behavioural problems in the IDD group. CONCLUSIONS: Students with IDD require early identification of behavioural and emotional symptoms to avoid the underdiagnoses of various mental health problems, especially those with internalising characteristics. The CBCL and TRF may assist in the early screening of these comorbidities.


Assuntos
Transtornos do Comportamento Infantil , Deficiência Intelectual , Comportamento Problema , Adolescente , Criança , Transtornos do Comportamento Infantil/epidemiologia , Emoções , Feminino , Humanos , Masculino , Pais , Estudantes
18.
Am J Med Genet A ; 185(5): 1421-1429, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33650172

RESUMO

Sleep disorders are frequent in tuberous sclerosis complex (TSC) during the developmental age but are not well characterized. Forty-six TSC patients and 46 healthy age- and sex-matched controls were enrolled. Their parents completed the Sleep Disturbances Scale for Children (SDSC) and the Child Behavior Checklist (CBCL). A total of 17.4% of the TSC patients obtained a total pathologic score at the SDSC versus 4.4% in the control group (p = 0.024). 45.7% of individuals with TSC reported a pathologic score in at least one of the factors. We found a statistically significant difference between the TSC cohort and healthy controls for most of the CBCL scales scores. A significant relationship was found between the Total SDSC score and the Total CBCL score (R-square = 0.387, p < 0.0001), between the Total SDSC score and the Internalizing and Externalizing areas scores (R-square = 0.291, p < 0.0001 and R-square = 0.350, p < 0.0001, respectively) of the CBCL. Sleep disorders are more frequent in TSC than in the general population and correlate with behavior. The use of SDSC and CBCL is proposed as part of the surveillance of TSC patients in the developmental age.


Assuntos
Transtornos do Comportamento Infantil/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia , Sono/fisiologia , Esclerose Tuberosa/fisiopatologia , Adolescente , Criança , Transtornos do Comportamento Infantil/complicações , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Pais , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia , Inquéritos e Questionários , Esclerose Tuberosa/complicações , Esclerose Tuberosa/epidemiologia
19.
Child Neuropsychol ; 27(5): 661-708, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33726631

RESUMO

As children with epilepsy may have a number of learning and behavioral problems, it is important that insight into the underlying neurocognitive differences in these children, which may underlie these areas of challenge is gained. Executive function (EF) problems particularly are associated with specific learning abilities as well as behavioral problems. We aim to review systematically the current status of empirical studies on the association between EF problems and behavior and socioemotional problems in children with epilepsy. After search, 26 empirical studies were identified, most of them of moderate quality. Overall, attention problems were the most reported cognitive deficit in test assessment and the most reported problem by parents. In 54% of the studies, children with epilepsy scored below average compared to controls/normative samples on different aspects of EF. Most studies reported behavior problems, which ranged from mild to severe. Forty-two percent of the studies specifically reported relationships between EF deficits and behavioral problems. In the remaining studies, below average neuropsychological functioning seemed to be accompanied by above average reported behavioral problems. The association was most pronounced for cognitive control and attention in relation to externalizing behavior problems. This cognitive control is also associated with social functioning. Relevant epilepsy variables in this relationship were early age at onset and high seizure frequency.Future research should distinguish specific aspects of EF and take age into account, as this provides more insight on the association between EF and behavior in pediatric epilepsy, which makes it possible to develop appropriate and early intervention.


Assuntos
Transtornos do Comportamento Infantil , Disfunção Cognitiva , Epilepsia , Criança , Transtornos do Comportamento Infantil/complicações , Transtornos do Comportamento Infantil/epidemiologia , Epilepsia/complicações , Função Executiva , Humanos , Testes Neuropsicológicos , Convulsões
20.
Pediatr. aten. prim ; 23(89): e1-e9, ene.-mar. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-202612

RESUMO

INTRODUCCIÓN: la calidad de vida relacionada con la salud (CVRS) es una dimensión relevante en la evaluación y consideración de los efectos de un tratamiento en el trastorno por déficit de atención con hiperactividad (TDAH). El objetivo del estudio es analizar las diferencias entre la percepción de padres e hijos en la CVRS en casos TDAH tratados farmacológicamente (TDAH-T), casos no tratados (TDAH-N) y controles. MATERIAL Y MÉTODOS: muestra de 228 participantes entre 8 y 14 años (114 controles, 57 TDAH-T y 57 TDAH-N). Muestreo consecutivo de TDAH según DSM-IV (ADHD RS-IV) y muestreo aleatorio de controles emparejados por sexo y edad. Evaluación de CVRS mediante las diez dimensiones del KIDSCREEN-52 versión padres y versión hijos. RESULTADOS: en los controles existen diferencias significativas entre padres e hijos en tres de las diez dimensiones del KIDSCREEN-52 (autonomía, autopercepción y recursos económicos), en cuatro dimensiones en TDAH-T (bienestar psicológico, autopercepción, entorno escolar y recursos económicos) y en seis dimensiones en TDAH-N (bienestar psicológico y físico, estado de ánimo, autopercepción, entorno escolar y recursos económicos). En todas las dimensiones donde existen diferencias significativas los hijos perciben mejor CVRS que la atribuida por los padres, excepto en la dimensión económica que sucede a la inversa. No existen diferencias significativas entre padres e hijos en controles, TDAH-N o TDAH-T en las dimensiones de aceptación social, relación con padres y amigos. CONCLUSIONES: es necesario que en la evaluación que precede a cualquier intervención clínica se deban tener en cuenta las perspectivas de padres e hijos sobre la CVRS


INTRODUCTION: health-related quality of life (HRQL) is a relevant dimension in the evaluation and consideration of the effects of a treatment in Attention Deficit Hyperactivity Disorder (ADHD). The objective of the study is to analyze the differences on the perception between parents and children in the HRQL in ADHD cases treated pharmacologically (ADHD-T), untreated cases (ADHD-N) and controls. MATERIAL AND METHODS: sample of 228 participants between 8 and 14 years old (114 controls, 57 ADHD-T and 57 ADHD-N). Consecutive sampling of ADHD according to DSM-IV (ADHD Rating Scales IV) and random sampling of controls matched by sex and age. HRQL assessment using the ten dimensions of the KIDSCREEN-52 parent version and child version. RESULTS: there are significant differences between parents/children in three out of ten dimensions of KIDSCREEN-52 (autonomy, self-perception, and financial resources), in four ADHD-T dimensions (psychological well-being, self-perception, school environment, and financial resources), and in six ADHD-N dimensions (psychological and physical well-being, mood, self-perception, school environment and financial resources) in controls. Children perceive HRQL better than parents in all dimensions with significant differences, except for economic dimension (the opposite). There are no significant differences between parents/children in controls, ADHD-N or ADHD-T in the dimensions of social acceptance, relationship with parents and friends. CONCLUSIONS: it is necessary to take into account the perspectives of parents and children regarding HRQL in the evaluation preceding any clinical intervention


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Qualidade de Vida , Percepção , Pais/psicologia , Psicometria/estatística & dados numéricos , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos do Comportamento Infantil/epidemiologia , Relações Pai-Filho , Inquéritos e Questionários
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