Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 205
Filtrar
1.
Nat Commun ; 10(1): 4679, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31616000

RESUMO

Postsynaptic density (PSD) proteins have been implicated in the pathophysiology of neurodevelopmental and psychiatric disorders. Here, we present detailed clinical and genetic data for 20 patients with likely gene-disrupting mutations in TANC2-whose protein product interacts with multiple PSD proteins. Pediatric patients with disruptive mutations present with autism, intellectual disability, and delayed language and motor development. In addition to a variable degree of epilepsy and facial dysmorphism, we observe a pattern of more complex psychiatric dysfunction or behavioral problems in adult probands or carrier parents. Although this observation requires replication to establish statistical significance, it also suggests that mutations in this gene are associated with a variety of neuropsychiatric disorders consistent with its postsynaptic function. We find that TANC2 is expressed broadly in the human developing brain, especially in excitatory neurons and glial cells, but shows a more restricted pattern in Drosophila glial cells where its disruption affects behavioral outcomes.


Assuntos
Transtornos Mentais/genética , Proteínas do Tecido Nervoso/metabolismo , Transtornos do Neurodesenvolvimento/genética , Proteínas/genética , Adolescente , Adulto , Animais , Transtorno Autístico/genética , Transtorno Autístico/psicologia , Comportamento Animal , Encéfalo/metabolismo , Criança , Pré-Escolar , Anormalidades Craniofaciais/genética , Deficiências do Desenvolvimento/genética , Deficiências do Desenvolvimento/psicologia , Proteínas de Drosophila/genética , Proteínas de Drosophila/metabolismo , Drosophila melanogaster , Epilepsia/genética , Feminino , Humanos , Deficiência Intelectual/genética , Deficiência Intelectual/psicologia , Transtornos do Desenvolvimento da Linguagem/genética , Transtornos do Desenvolvimento da Linguagem/psicologia , Masculino , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Transtornos Mentais/psicologia , Proteínas Musculares/genética , Proteínas Musculares/metabolismo , Mutação , Transtornos do Neurodesenvolvimento/psicologia , Neuroglia/metabolismo , Neurônios/metabolismo , Proteínas/metabolismo , Sequenciamento Completo do Exoma , Adulto Jovem
2.
Codas ; 31(4): e20180177, 2019 Aug 22.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31460569

RESUMO

PURPOSE: This study aimed to present findings on language, behavior, and neurodevelopment in a girl diagnosed with Angelman Syndrome, evaluated when she was three and eight years old. METHODS: The following evaluation instruments were used: Observation of Communication Behavior, Early Language Milestone (ELM) Scale, and Denver Developmental Screening Test, 2nd edition (DDST-II). RESULTS: In this case report, presence of AS phenotype signals such as wide mouth and wide-spaced teeth, tongue thrusting, strabismus, up slanting palpebral fissures, and sialorrhea are verified. Expressive and receptive deficits were verified in the language assessment, with the absence of orality and loss of comprehension with very similar performances in both evaluations. The ELM and DDST-II tests indicated severe impairment of all abilities evaluated at both three and eight years of age. Performance was quite similar in both evaluations in all areas of child development. Little progress was observed over time despite the great therapeutic and educational investment. CONCLUSION: The presence of a complex scenario such as AS demands high complexity clinical needs, a situation that is worsened due to scarcity of therapeutic resources that could minimize the harmful impacts of AS and culminate in increased quality of life for the AS population and their families.


Assuntos
Síndrome de Angelman/reabilitação , Transtornos do Neurodesenvolvimento/reabilitação , Síndrome de Angelman/diagnóstico , Síndrome de Angelman/psicologia , Criança , Desenvolvimento Infantil , Comunicação , Feminino , Humanos , Desenvolvimento da Linguagem , Testes de Linguagem , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/psicologia , Testes Neuropsicológicos , Desempenho Psicomotor
3.
Z Kinder Jugendpsychiatr Psychother ; 47(6): 547-553, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31448668

RESUMO

Rejection of closed placement in youth welfare: Two case reports and a discussion of needs and effectiveness Abstract. Locked-door residential care in the custody of adolescents with severe behavioral problems has been a controversial subject in Germany for many decades. Sometimes the debate is held on an ideological level, sometimes it concerns the legal and ethical legitimacy of such actions, but it always is about providing the best care possible for severely disturbed adolescents with attachment disorder, severe conduct disorder, and psychosocial disintegration. Because of differing viewpoints on this issue, some German federal states have set up locked-door youth welfare institutions, whereas as others do not. Here, we present two stereotypical case constellations from the state of Saxony, where the absence of such locked-door residential institutions has served to shift the problem to clinics for child and adolescent psychiatry. Based on these case constellations, we discuss the present knowledge concerning the necessity and efficacy of these institutions. The discussion is followed by a critical reflection on constraint and autonomy in youth welfare.


Assuntos
Psiquiatria do Adolescente , Psiquiatria Infantil , Bem-Estar da Criança , Determinação de Necessidades de Cuidados de Saúde , Transtornos do Neurodesenvolvimento/psicologia , Transtornos do Neurodesenvolvimento/terapia , Adolescente , Criança , Transtorno da Conduta/psicologia , Transtorno da Conduta/terapia , Alemanha , Humanos , Apego ao Objeto
4.
J Fam Psychol ; 33(6): 690-703, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31318261

RESUMO

Despite widespread acknowledgment that "frequent, continuing, and meaningful" (Pruett & DiFonzo, 2014) time with both parents is beneficial for children from divorced or separated families, and that interparental conflict (IPC) is associated with increased child mental health problems, the joint effects of parenting time (PT), parenting quality (PQ), and IPC on children's mental health problems are less clear. The current study integrates two theoretical models in multiple mediator analyses to test indirect effects of mothers' and fathers' PQ and IPC to explain the association between PT and children's mental health problems within the same model. Participants were children aged 9-18 years (N = 141) who had one or both parents participate in a randomized comparative effectiveness trial of a court-based prevention program for high-conflict divorcing or separating families. Data were collected at pretest and 9-month follow-up. Analyses revealed an indirect effect in which fathers' PQ mediated the association between PT and child internalizing problems both concurrently and 9 months later. There were no significant indirect effects involving IPC. Analyses indicated a significant quadratic relation between PT and fathers' PQ, suggesting that although more PT is associated with better father-child relationships, there is a point beyond which more time is not related to a better relationship. We discuss the study findings, research limitations, and implications for public policy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Divórcio/psicologia , Conflito Familiar/psicologia , Transtornos do Neurodesenvolvimento/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Pais/psicologia , Adolescente , Adulto , Criança , Divórcio/estatística & dados numéricos , Feminino , Humanos , Masculino , Tempo
7.
Nord J Psychiatry ; 73(4-5): 244-247, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31074670

RESUMO

Background: Body dysmorphic disorder (BDD) is preoccupation with perceived body defects leading to distress and impairment in social functioning. Most of adolescent BDD literature has been done on patients within the outpatient setting with prior versions of DSM with dearth of information about BDD and comorbid psychiatric conditions among adolescents within the inpatient setting. Aims: This pilot study evaluated the prevalence rate, clinical characteristics in adolescent BDD compared to non-BDD adolescents in a psychiatric in patient setting in addition to their comorbid issues like anxiety, OCD, ADHD and substance abuse. Methods: Forty-five consecutively admitted adolescent patients participated with 17 meeting the DSM 5 criteria for BDD while 28 did not. Patients were asked four questions designed around the DSM-5 criteria for BDD after which they were asked to complete questionnaires like BDDQ child and adolescent version, BDDM, Multiaxial Anxiety Scale for Children, Children's Depression Inventory, Y-BOCS and Vanderbilt ADHD rating scales. Results: Seventeen participants had BDD. Mean age of BDD patients was 13.1 while non-BDD was 12.4. Male patients with BDD were seven (41%) while female BDD patients were 10 (58.8%). Anxiety, depression, OCD and substance use disorders were common comorbid diagnoses. Majority of patients in the BDD group classified their BDD as a severe problem with more BDD, patient's considering suicide because of their BDD. Discussion: BDD is present in adolescents admitted in inpatient psychiatric hospital with more female patients endorsing BDD versus their male counterparts. Patients with BDD are more likely to endorse more comorbid psychiatric issues such as anxiety, OCD, ADHD and substance abuse.


Assuntos
Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Hospitais Psiquiátricos , Pacientes Internados/psicologia , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/psicologia , Adolescente , Transtornos Dismórficos Corporais/diagnóstico , Criança , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Hospitalização/tendências , Humanos , Masculino , Transtornos do Neurodesenvolvimento/diagnóstico , Projetos Piloto , Prevalência , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários
8.
Psychiatry Res ; 276: 115-123, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31075706

RESUMO

Pediatric obsessive-compulsive disorder (OCD) co-occurs frequently with other mental health conditions, adding to the burden of disease and complexity of treatment. Cognitive behavioral therapy (CBT) is efficacious for both OCD and two of its most common comorbid conditions, anxiety and depression. Therefore, treating OCD may yield secondary benefits for anxiety and depressive symptomatology. This study examined whether anxiety and/or depression symptoms declined over the course of OCD treatment and, if so, whether improvements were secondary to reductions in OCD severity, impairment, and/or global treatment response. The sample consisted of 137 youths who received 12 sessions of manualized CBT and were assessed by independent evaluators. Mixed models analysis indicated that youth-reported anxiety and depression symptoms decreased in a linear fashion over the course of CBT, however these changes were not linked to specific improvements in OCD severity or impairment but to global ratings of treatment response. Results indicate that for youth with OCD, CBT may offer benefit for secondary anxiety and depression symptoms distinct from changes in primary symptoms. Understanding the mechanisms underlying carryover in CBT techniques is important for furthering transdiagnostic and/or treatment-sequencing strategies to address co-occurring anxiety and depression symptoms in pediatric OCD.


Assuntos
Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Depressão/terapia , Transtornos do Neurodesenvolvimento/terapia , Transtorno Obsessivo-Compulsivo/terapia , Adolescente , Ansiedade/diagnóstico , Ansiedade/psicologia , Criança , Terapia Cognitivo-Comportamental/tendências , Depressão/diagnóstico , Depressão/psicologia , Feminino , Humanos , Masculino , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/psicologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Resultado do Tratamento
9.
Trials ; 20(1): 268, 2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088531

RESUMO

BACKGROUND: Children requiring hospitalization for psychiatric care have serious disorders, high use of psychotropic medication, and frequent readmissions. The development and implementation of therapies focused on incorporating primary caregivers or attachment figures is necessary for working with children with severe psychiatric disorders. Mentalization or parental reflective functioning (PRF) is the ability of parents to understand their children's behaviors as an expression of internal emotional states and act accordingly to help them regulate their emotions; in this way mentalizing is a key component of sensitive parenting. Video-assisted therapies have proven to be effective in promoting change in parent-child relationships. The majority of studies have been carried out with mothers of pre-school children and in an outpatient setting. Video intervention therapy (VIT) is a flexible manualized therapy, which allows the intervention to be individualized to the context where it is applied, according to the needs and resources of the people who participate in it. The objective of the study is to evaluate the feasibility and acceptability of applying VIT to improve the PRF of the parents as primary carers of children hospitalized in a psychiatric service. METHODS: This is a pilot randomized, single-masked (outcome assessor) study with a qualitative component. It will involve a block randomization procedure to generate a 2:1 allocation (with more people allocated to the intervention arm). The intervention consists of four modules; every module has both one video-recorded play session and one VIT session per week. People assigned to the control group will receive treatment as usual plus weekly play sessions. Feasibility and acceptability of the study will be quantitatively and qualitatively assessed. Evaluation of the caregivers will include assessments of PRF, wellbeing and personality structure; assessments of children will include parent-ratings and clinician-ratings of symptomatology and general functioning. After every video feedback (VF) session, PRF, the caregiver's wellbeing and children's general functioning will be reassessed. DISCUSSION: This study will contribute to the currently scarce evidence on how to provide family attachment-based interventions in a child inpatient psychiatric unit. It will also inform the design and implementation of a future randomized clinical trial. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03374904 . Registered on 14 December 2017 (retrospectively registered).


Assuntos
Comportamento do Adolescente , Cuidadores/psicologia , Comportamento Infantil , Retroalimentação Psicológica , Pacientes Internados/psicologia , Transtornos do Neurodesenvolvimento/terapia , Pais/psicologia , Gravação em Vídeo , Adolescente , Fatores Etários , Criança , Emoções , Estudos de Viabilidade , Feminino , Humanos , Masculino , Mentalização , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/psicologia , Relações Pais-Filho , Poder Familiar , Projetos Piloto , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
10.
Nutrients ; 11(4)2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30986970

RESUMO

Cognitive impairment is strongly associated with functional outcomes in psychiatric patients. Involvement of n-3 long chain polyunsaturated fatty acid (n-3 LC-PUFA), in particular docosahexaenoic acid (DHA), in brain functions is largely documented. DHA is incorporated into membrane phospholipids as structural component, especially in the central nervous system where it also has important functional effects. The aim of this review is to investigate the relationship between DHA and cognitive function in relation to mental disorders. Results from few randomized controlled trials (RCTs) on the effects of DHA (alone or in combination) in psychotic, mood and neurodevelopmental disorders, respectively, suggest that no conclusive remarks can be drawn.


Assuntos
Encéfalo/efeitos dos fármacos , Fármacos do Sistema Nervoso Central/uso terapêutico , Transtornos Cognitivos/tratamento farmacológico , Cognição/efeitos dos fármacos , Ácidos Docosa-Hexaenoicos/uso terapêutico , Transtornos Mentais/tratamento farmacológico , Afeto/efeitos dos fármacos , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Transtornos Cognitivos/metabolismo , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Ácidos Docosa-Hexaenoicos/metabolismo , Humanos , Transtornos Mentais/metabolismo , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Transtornos do Humor/tratamento farmacológico , Transtornos do Humor/metabolismo , Transtornos do Humor/fisiopatologia , Transtornos do Humor/psicologia , Transtornos do Neurodesenvolvimento/tratamento farmacológico , Transtornos do Neurodesenvolvimento/metabolismo , Transtornos do Neurodesenvolvimento/fisiopatologia , Transtornos do Neurodesenvolvimento/psicologia
11.
J Autism Dev Disord ; 49(7): 2838-2848, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30972652

RESUMO

Alterations in social cognition (SC) are hypothesized to underlie social communication and interaction challenges in autism spectrum disorder (ASD). The aetiological underpinnings driving this association remain unclear. We examined SC in 196 twins with ASD, other neurodevelopmental disorders or typical development using the naturalistic Movie for the Assessment of Social Cognition. Autism and its severity were assessed with the Autism Diagnostic Observation Schedule-2, and autistic traits with the Social Responsiveness Scale-2. Using within twin-pair regression models, controlling for age, sex, IQ, and unmeasured familial confounders such as genetic background and shared-environment, SC correlated with ASD diagnosis, autism severity, and autistic traits. Our findings highlight the importance of SC alterations in autism and suggest a non-shared environmental impact on the association.


Assuntos
Transtorno do Espectro Autista/psicologia , Cognição , Doenças em Gêmeos/psicologia , Transtornos do Neurodesenvolvimento/psicologia , Comportamento Social , Criança , Comunicação , Meio Ambiente , Feminino , Humanos , Masculino , Gêmeos Dizigóticos/psicologia , Gêmeos Monozigóticos/psicologia
12.
Nord J Psychiatry ; 73(2): 132-140, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30964388

RESUMO

AIM: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. METHOD: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. RESULTS: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. CONCLUSION: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.


Assuntos
Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/epidemiologia , Adolescente , Criança , Estudos Transversais , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Transtornos do Neurodesenvolvimento/psicologia , Pais/psicologia , Prevalência , Psicopatologia , Distribuição Aleatória , Estudantes/psicologia , Turquia/epidemiologia
13.
Behav Ther ; 50(2): 367-379, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30824252

RESUMO

Mental health systems need scalable solutions that can reduce the efficacy-effectiveness gap and improve mental health outcomes in community mental health service settings. Two major challenges to delivery of high-quality care are providers' fidelity to evidence-based treatment models and children's and caregivers' engagement in the treatment process. We developed a novel, tablet-based application designed to enhance via technology the quality of delivery of trauma-focused cognitive-behavioral therapy (TF-CBT). We piloted its use in four community mental health service organizations using a blocked randomized controlled trial to examine the feasibility of implementing tablet-facilitated TF-CBT versus standard TF-CBT with 13 providers and 27 families. Provider fidelity and child engagement in treatment were observationally measured via session audio recording. Parent and child perceptions of the tablet application were assessed using structured interviews and mixed-method analyses. Providers actively and appropriately used tablet TF-CBT to facilitate treatment activities. Providers and families expressed high satisfaction with its use, demonstrating acceptability of this approach. Youth and caregivers in both conditions reported high alliance with their providers. Overall, we found that tablet-facilitated treatment is accepted by providers and families and may be integrated into mental health treatment with minimal training. Further study is needed to examine the extent to which technology-based applications may enhance the reach, quality, and clinical outcomes of mental health treatment delivered to children and families.


Assuntos
Saúde Mental/normas , Transtornos do Neurodesenvolvimento/psicologia , Transtornos do Neurodesenvolvimento/terapia , Qualidade da Assistência à Saúde/normas , Terapia Assistida por Computador/normas , Adolescente , Adulto , Criança , Terapia Cognitivo-Comportamental/métodos , Terapia Cognitivo-Comportamental/normas , Feminino , Humanos , Masculino , Pais , Projetos Piloto , Psicoterapia/métodos , Psicoterapia/normas , Terapia Assistida por Computador/métodos , Resultado do Tratamento
14.
Trials ; 20(1): 158, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832708

RESUMO

BACKGROUND: Difficulties with delaying gratification, coping with frustration, and regulating emotions are significant predictors of aggression and behavioural and interpersonal problems early in life and mental health disorders during childhood, adolescence, and adulthood. Mental health problems generate a high burden of disease in society in general, and there is a significant treatment gap, especially among economically vulnerable populations. Prevention strategies appear to be the more recommendable options, mainly if these interventions can be implemented early in life and at low cost. Few preventive interventions aiming to increase resilience in the face of adversity have been rigorously evaluated among Chilean preschoolers. Substantial international evidence indicates that strengthening basic psychological skills, such as emotion regulation and social problem-solving, can reduce the incidence of mental pathology and improve various academic indicators. The curriculum of the Interpersonal Cognitive Problem-Solving Programme, also known as I Can Problem Solve (ICPS), is focussed on the development of the cognitive process and children's social problem-solving skills. ICPS is effective at increasing prosocial behaviours and reducing aggressive behaviour among preschoolers. ICPS provides children with the skills to think about how to solve problems using sequenced games, discussion, and group-interaction techniques focussed on listening to, and observing, others, promoting empathy and alternative and consequential thinking. The aims of this study are (1) to develop a culturally appropriate version of the ICPS programme and (2) to evaluate the acceptability and feasibility of the adapted version of ICPS among vulnerable schools in Santiago, Chile, conducting a pilot randomised controlled trial with three arms: (1) the ICPS programme delivered by an internal early teacher, (2) the ICPS programme delivered by an external early teacher, and (3) a control group. METHODS AND DESIGN: This is a pilot, three-armed randomised controlled trial of the adapted version of ICPS with an enrolment target of 80 preschoolers attending four schools per arm. Children in both intervention groups will receive the ICPS programme: 59 sessions of 20 min each delivered three times a week by trained internal or external early teachers over 5-6 months. Internal teachers are part of the school staff, and external teachers are facilitators hired by the research team to go to schools and deliver the intervention during a normal school day, working together with the early teacher present in the classroom. The intervention consists of games using pictures, puppets, and simple role-playing techniques to facilitate the learning process. Cognitive regulation, emotion recognition, social-problem-solving skills, and psychological functioning will be measured at baseline and after the intervention. DISCUSSION: No previous studies in Spanish-speaking Latin American countries have been conducted to explore the acceptability and feasibility of ICPS to provide information to evaluate the effectiveness of this intervention on a larger scale. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03383172 . Registered on 26 December 2017.


Assuntos
Comportamento Infantil , Terapia Cognitivo-Comportamental , Assistência à Saúde Culturalmente Competente , Transtornos do Neurodesenvolvimento/prevenção & controle , Adaptação Psicológica , Fatores Etários , Comportamento Infantil/etnologia , Pré-Escolar , Chile/epidemiologia , Cognição , Características Culturais , Assistência à Saúde Culturalmente Competente/etnologia , Emoções , Estudos de Viabilidade , Feminino , Humanos , Masculino , Saúde Mental , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/etnologia , Transtornos do Neurodesenvolvimento/psicologia , Projetos Piloto , Resolução de Problemas , Ensaios Clínicos Controlados Aleatórios como Assunto , Resiliência Psicológica , Método Simples-Cego , Comportamento Social , Fatores de Tempo , Resultado do Tratamento
15.
Psychiatry Res ; 272: 790-796, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30832200

RESUMO

Depressive symptoms are common in children and adolescents. The prevalence of depressive symptoms in children and adolescents in China vary significantly across studies. A meta-analysis of the prevalence of depressive symptoms in children and adolescents in China was conducted. Literature search was performed in both English (PubMed, PsycINFO and EMBASE) and Chinese (China National Knowledge Internet, WANFANG Data and SinoMed) databases. Random-effects model was used to synthesize the prevalence of depressive symptoms. Eighteen studies covering 29,626 participants were identified and analyzed. All these studies used the same measurement to identify depressive symptoms. The reported point prevalence of depressive symptoms ranged between 4% and 41% in the studies; the pooled prevalence of depressive symptoms was 19.85% (95% confidence interval: 14.75%-24.96%). In the subgroup analyses the prevalence of depressive symptoms was significantly associated with the region where the study was conducted: 17.8% in eastern, 23.7% in central, 22.7% in western, and 14.5% in northeast regions of China (P < 0.001). Considering the adverse impact of depressive symptoms on health outcomes, regular screening and effective interventions should be implemented in this population.


Assuntos
Depressão/epidemiologia , Depressão/psicologia , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/psicologia , Adolescente , Criança , China/epidemiologia , Bases de Dados Factuais/tendências , Depressão/diagnóstico , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/tendências , Transtornos do Neurodesenvolvimento/diagnóstico , Estudos Observacionais como Assunto/métodos , Prevalência
16.
Psychiatry Res ; 274: 247-253, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30818147

RESUMO

The Mental Health Inventory-5 (MHI-5) is a brief, valid, and reliable international instrument for assessing mental health in adults. The aim of the present study is to examine the psychometric properties of the MHI-5 in children and adolescents. A sample of 595 students (10-15 years old) completed the MHI-5 Spanish version adapted for this study, as well as another measure of anxiety and depression symptoms, and a clinical interview as a gold standard. The overall coefficient obtained indicate good internal consistency. A unique factor solution explaining a 53.70% and a two-factor structure explaining 69.20% of the total variance were obtained. The correlations with total and subscale scores of anxiety and depression were significant. A ROC analysis showed good properties as a screening test to predict anxiety and depressive diagnoses in children and adolescents. The Revised MHI-5 presents two essential changes: a simplified 4-point response format and a new factor solution including distress and well-being. These outcomes show that the Revised MHI-5 is a brief, valid, and reliable measure to bidimensionally assess mental health and screening emotional disorders in children and adolescents.


Assuntos
Saúde Mental/normas , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/epidemiologia , Escalas de Graduação Psiquiátrica/normas , Estudantes/psicologia , Adolescente , Criança , Depressão , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/psicologia , Programas de Rastreamento/normas , Transtornos do Neurodesenvolvimento/psicologia , Psicometria , Reprodutibilidade dos Testes , Espanha/epidemiologia
17.
Am J Psychiatry ; 176(3): 179-185, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30818985

RESUMO

The transition from childhood to adulthood represents the developmental time frame in which the majority of psychiatric disorders emerge. Recent efforts to identify risk factors mediating the susceptibility to psychopathology have led to a heightened focus on both typical and atypical trajectories of neural circuit maturation. Mounting evidence has highlighted the immense neural plasticity apparent in the developing brain. Although in many cases adaptive, the capacity for neural circuit alteration also induces a state of vulnerability to environmental perturbations, such that early-life experiences have long-lasting implications for cognitive and emotional functioning in adulthood. The authors outline preclinical and neuroimaging studies of normative human brain circuit development, as well as parallel efforts covered in this issue of the Journal, to identify brain circuit alterations in psychiatric disorders that frequently emerge in developing populations. Continued translational research into the interactive effects of neurobiological development and external factors will be crucial for identifying early-life risk factors that may contribute to the emergence of psychiatric illness and provide the key to optimizing treatments.


Assuntos
Transtornos Mentais/etiologia , Transtornos do Neurodesenvolvimento/complicações , Adolescente , Desenvolvimento do Adolescente , Encéfalo/crescimento & desenvolvimento , Criança , Desenvolvimento Infantil , Humanos , Transtornos do Neurodesenvolvimento/psicologia , Psicopatologia , Fatores de Risco , Estresse Psicológico/complicações , Estresse Psicológico/psicologia
18.
Psychiatry Res ; 273: 613-623, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30731430

RESUMO

Children's mental health problems substantially impact their functioning. For clinically treated children and adolescents, we explored the impact of mental health treatment on functioning and identified predictors of functional improvement. Outpatient clinical data from a regional publicly funded specialist outpatient treatment clinic were analyzed. The Child and Adolescent Functional Assessment Scale (CAFAS) was used to assess outcomes. Non-parametric tests were used to compare baseline and exit scores. Logistic regression analysis was used separately for children and adolescents to examine predictors of improvement. Total CAFAS scores at exit showed a significant decrease from initial scores for both age groups, indicating improvements in clients' functioning. Children and adolescents had shared predictors for initial level of dysfunction, length of treatment and the presence of pervasive behavioral impairment (PBI). Primary presenting problem, caregiver support and area of residence were only associated with outcome among children. Clients with higher initial levels of dysfunction and PBI require longer treatment cycles to reach an acceptable outcome. Shortening the length of treatment cycles may improve the efficiency of resource use but can be detrimental to some clients. Personalized treatment should be tailored to the clients with specific characteristics and needs.


Assuntos
Instituições de Assistência Ambulatorial , Assistência Ambulatorial/métodos , Serviços Comunitários de Saúde Mental/métodos , Transtornos do Neurodesenvolvimento/terapia , Recuperação de Função Fisiológica , Adolescente , Assistência Ambulatorial/psicologia , Criança , Estudos de Coortes , Feminino , Previsões , Humanos , Masculino , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/psicologia , Pacientes Ambulatoriais/psicologia , Estudos Prospectivos , Psicoterapia/métodos , Recuperação de Função Fisiológica/fisiologia , Saskatchewan/epidemiologia
19.
Trials ; 20(1): 112, 2019 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-30736834

RESUMO

BACKGROUND: Children born to parents with a severe mental illness, like schizophrenia, bipolar disorder, or major recurrent depression, have an increased risk of developing a mental illness themselves during life. These children are also more likely to have developmental delays, cognitive disabilities, or social problems, and they may have a higher risk than the background population of experiencing adverse life events. This is due to both genetic and environmental factors, but despite the well-documented increased risk for children with a familial high risk, no family-based early intervention has been developed for them. This study aims to investigate the effect of an early intervention that focuses on reducing risk and increasing resilience for children in families where at least one parent has a severe mental illness. METHODS/DESIGN: The study is a randomized clinical trial with 100 children aged 6-12 with familial high risk. It is performed in the context of the Danish health-care system. Families will be recruited from registers or be referred from the primary sector or hospitals. The children and their parents will be assessed at baseline and thereafter randomized and allocated to either treatment as usual or VIA Family. The intervention group will be assigned to a multidisciplinary team of specialists from adult mental health services, child and adolescent mental health services, and social services. This team will provide the basic treatment elements: case management, psychoeducation for the whole family, parental training, a safety plan, and potentially an early intervention if the child has mental problems. The study period is 18 months for both groups, and all participants will be assessed at baseline and after 18 months. The primary outcome measure will be daily functioning of the child, and the secondary measures are the psychopathology of the child, days of absence from school, family functioning, child's home environment, and parental stress. DISCUSSION: This study is to our knowledge the first to explore the effects of a multidisciplinary team intervention that provides an intensive and flexible support to match the families' needs for children with a familial high risk for severe mental illness. The study will provide important knowledge about the potential for increasing resilience and reducing risk for children by supporting the whole family. However, a longer follow-up period may be needed. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03497663 . Registered on 13 April 2018.


Assuntos
Comportamento Infantil , Intervenção Médica Precoce/métodos , Terapia Familiar , Transtornos do Neurodesenvolvimento/prevenção & controle , Resiliência Psicológica , Fatores Etários , Criança , Dinamarca , Estudos de Equivalência como Asunto , Feminino , Predisposição Genética para Doença , Hereditariedade , Humanos , Masculino , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/genética , Transtornos do Neurodesenvolvimento/psicologia , Poder Familiar , Pais/educação , Pais/psicologia , Linhagem , Fenótipo , Medição de Risco , Fatores de Risco , Apoio Social , Fatores de Tempo , Resultado do Tratamento
20.
Infant Behav Dev ; 54: 140-150, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30784761

RESUMO

Infants learn about objects by exploring them. Typically developing infants actively explore objects through visual, manual, and oral modalities. Attenuated exploratory behavior has been observed in various neurodevelopmental disorders, including Down syndrome (DS), presumably limiting learning options. However, a direct link between exploration and overall developmental functioning has not been characterized. This study used a Latent Profile Analysis framework to examine within-syndrome variability in exploratory behavior in infants with DS and the developmental correlates of different exploratory behavior profiles. Participants were 45 infants with DS (CA = 9.58 months; SD = 3.62) who completed an object exploration activity and the Bayley Scales of Infant Development-III (BSID-III; Bayley, 2006). Exploration behavior was coded for the percentage of time engaged in visual, manual, and oral exploration. Results indicated that a 2-profile solution provided the best model fit for exploratory behavior, yielding profiles that represented either an Active (57.78% of the sample) or a Passive Exploratory (42.22% of the sample) profile. The Active Exploratory profile was associated with significantly higher age equivalent scores on the BSID-III Cognitive, Communication, and Motor domains than the Passive Exploratory profile. Other factors, such as sex and biomedical risk factors, were not associated with exploratory profiles. These findings offer a more nuanced understanding of early within-syndrome heterogeneity in DS, and demonstrate that impoverished early exploratory behavior may serve as an important indicator of increased risk for more pronounced developmental delays in DS.


Assuntos
Desenvolvimento Infantil/fisiologia , Síndrome de Down/psicologia , Comportamento Exploratório/fisiologia , Desempenho Psicomotor/fisiologia , Adulto , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/psicologia , Síndrome de Down/diagnóstico , Feminino , Humanos , Lactente , Masculino , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/psicologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA