Exploration of 19 serotoninergic candidate genes in adults and children with attention-deficit/hyperactivity disorder identifies association for 5HT2A, DDC and MAOB.

Attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder in which different genetic and environmental susceptibility factors are involved. Several lines of evidence support the view that at least 30% of ADHD patients diagnosed in childhood continue to suffer the disorder during adulthood and that genetic risk factors may play an essential role in the persistence of the disorder throughout lifespan. Genetic, biochemical and pharmacological studies support the idea that the serotonin system participates in the etiology of ADHD. Based on these data, we aimed to analyze single nucleotide polymorphisms across 19 genes involved in the serotoninergic neurotransmission in a clinical sample of 451 ADHD patients (188 adults and 263 children) and 400 controls using a population-based association study. Several significant associations were found after correcting for multiple testing: (1) the DDC gene was strongly associated with both adulthood (P=0.00053; odds ratio (OR)=2.17) and childhood ADHD (P=0.0017; OR=1.90); (2) the MAOB gene was found specifically associated in the adult ADHD sample (P=0.0029; OR=1.90) and (3) the 5HT2A gene showed evidence of association only with the combined ADHD subtype both in adults (P=0.0036; OR=1.63) and children (P=0.0084; OR=1.49). Our data support the contribution of the serotoninergic system in the genetic predisposition to ADHD, identifying common childhood and adulthood ADHD susceptibility factors, associations that are specific to ADHD subtypes and one variant potentially involved in the continuity of the disorder throughout lifespan.

Contribution of LPHN3 to the genetic susceptibility to ADHD in adulthood: a replication study.

Attention-deficit/hyperactivity disorder (ADHD) is a common and highly heritable developmental disorder characterized by a persistent impairing pattern of inattention and/or hyperactivity-impulsivity. Using families from a genetic isolate, the Paisa population from Colombia, and five independent datasets from four different populations (United States, Germany, Norway and Spain), a highly consistent association was recently reported between ADHD and the latrophilin 3 (LPHN3) gene, a brain-specific member of the LPHN subfamily of G-protein-coupled receptors that is expressed in ADHD-related regions, such as amygdala, caudate nucleus, cerebellum and cerebral cortex. To replicate the association between LPHN3 and ADHD in adults, we undertook a case-control association study in 334 adult patients with ADHD and 334 controls with 43 single nucleotide polymorphisms (SNPs) covering the LPNH3 gene. Single- and multiple-marker analyses showed additional evidence of association between LPHN3 and combined type ADHD in adulthood [P = 0.0019; df = 1; odds ratio (OR) = 1.82 (1.25-2.70) and P = 5.1e-05; df = 1; OR = 2.25 (1.52-3.34), respectively]. These results further support the LPHN3 contribution to combined type ADHD, and specifically to the persistent form of the disorder, and point at this new neuronal pathway as a common susceptibility factor for ADHD throughout the lifespan.

Aspectos psicológicos y trastornos psiquiátricos en el trasplante renal pediátrico / Psychological issues and psychiatric diseases in pediatric kidney transplantation

INTRODUCCIÓN: El trasplante renal está ampliamente aceptado como tratamiento de primera línea para el fallo renal terminal en pacientes pediátricos. El estado postrasplante implica cambios en la vida de estos jóvenes e influencia su estado psicológico, pudiendo hacerlos más vulnerables a presentar patologías psiquiátricas. OBJETIVO: Examinar la literatura disponible acerca del bienestar psicológico y la psicopatología en niños y adolescentes que han recibido un trasplante de riñón. METODOLOGÍA: Revisión bibliográfica de la literatura mundial sobre el tema. RESULTADOS: Se encuentran diferencias en la prevalencia de psicopatología y en el bienestar de estos pacientes comparados con grupos de control, observándose mayor sintomatología desadaptativa y problemas del desarrollo, y menor calidad de vida en los trasplantados. CONCLUSIONES: Se debe profundizar el conocimiento científico acerca de las patologías psiquiátricas y la calidad de vida en este grupo. Son especialmente relevantes los estudios que evalúen lo que sucede en el primer año postrasplante y aquellos que planteen un seguimiento longitudinal

INTRODUCTION: Kidney transplantation is widely accepted as first-line treatment for end-stage renal failure in pediatric patients. The state post-transplant involves changes in the lives of these young people and influences their psychological state, and can make them more vulnerable to present sychiatric disorders. OBJECTIVE: To review the available literature on the psychological well being and psychopathology in children and adolescents who have received a kidney transplant. METHODOLOGY: Literature review of world literature on the subject. RESULTS: Differences in the prevalence of psychopathology was found and well-being of these patients compared with control groups, showing higher maladaptive symptoms and developmental problems, and lower quality of life for transplant. CONCLUSIONS: We must deepen scientific knowledge about psychiatric disorders and quality of life in this group. They are especially relevant studies assessing what happens in the first year post-transplant and those who pose a longitudinal follow-up

Trastornos psiquiatricos en niños y adolescentes con cardiopatía congénita / Psychiatric disorders in children and adolescents with congenital heart diseases

Introducción: existen múltiples motivos para considerar que la cardiopatía congénita en niños y adolescentes pueda estar en relación con la presentación de trastornos psiquiátricos en este grupo, debido a diferentes factores como: biológicos, del neurodesarrollo, psicológicos, familiares y sociales. Objetivos: revisar la literatura científica existente sobre la psicopatología y los trastornos psiquiátricos en niños y adolescentes que han sido diagnosticados de cardiopatías congénitas. Metodología: revisión de la literatura, mediante búsqueda en las bases bibliográficas de PubMed-Medline, OVID y SCIELO; con posterior revisión de los artículos encontrados. Resultados: hay evidencias que apuntan a que en este grupo poblacional existen diferencias en la prevalencia de trastornos psiquiátricos, incluyendo aspectos cognitivos, de aprendizaje y del desarrollo, comparado con grupos control y con la población infantil general. Comentario: se enfatiza la necesidad de ampliar la investigación en este campo, y consecuentemente adecuar la asistencia psiquiátrica para esta población. Estos estudios deberían incluir tanto la evaluación por servicios de psiquiatría infantil de enlace, como la intervención terapéutica, cuando fuera necesaria, adaptada al nivel de desarrollo del niño, considerando especialmente relevantes los estudios que diferenciaran los niños que han sido intervenidos en los últimos años, con los consecuentes avances en las técnicas quirúrgicas y de anestesia; así como los estudios que realicen un seguimiento longitudinal de los pacientes

Introduction: there are multiple reasons to consider that having a congenital heart disease can be related to the presence of psychiatric disorders in children and adolescents. It Can depend of different factors such as biological, neurodevelopmental, psychological, family and social ones. Objective: to examine the scientific literature on psychopathology and psychiatric disorders in children and adolescents with congenital heart diseases. Methodology: review of the literature on the subject, using the PubMed-Medline, OVID and SCIELO databases. Results: evidence exists to support that in this clinical group there are differences in the prevalence of psychiatric disorders, including cognitive, learning and developmental ones, compared to control groups and to general pediatric population. Commentaries: it is important to continue research on this subject and to develop specific psychiatric healthcare resources for this group. These should include both the evaluation by child liaison psychiatrists as well as therapeutically intervention when necessary. Studies to evaluate children who have been operated on in recent years with new surgical and anesthetic techniques as well as studies with a longitudinal design are especially relevant

Suicidio e intento de suicidio en niños y adolescentes: revisión e intervenciones terapéuticas / Suicide and suicide attempts in children and adolescents: review and therapeutic interventions

El comportamiento suicida en niños y adolescentes se ha convertido, a lo largo de la segunda mitad del siglo XX, en un problema de salud mental progresivamente más importante y frecuente, lo que ha llevado a la realización de múltiples investigaciones que lo reconocen como un riesgo importante en la enfermedad mental. A partir de los años 80 se han desarrollado nuevos métodos de investigación en este campo, que incluyen estudios epidemiológicos, autopsias psicológicas, así como estudios longitudinales que permiten desarrollar aspectos importantes para el desarrollo de estrategias de prevención a la hora de evitar los actos suicidas en pacientes jóvenes.En el presente artículo se pretende realizar una revisión de dicho fenómeno, desde su etiología hasta sus manifestaciones clínicas, haciendo especial hincapié en su evaluación y en los aspectos terapéuticos, tanto psicosociales como farmacológicos

Suicidal behaviour in children and adolescents has become, through the second half of the XXth century, amental health problem increasingly more frequent andimportant, which has led to the accomplishment of multiple researches that recognize it as an important risk in the mental illness. From the 80s new methods of research have been developed in the field, which there include epidemiological studies, psychological autopsies, as well as longitudinal studies that allow developing important aspects for the development of strategies of prevention in order to avoid the suicidal attempts in young patients.The present article tries to realize a review of the above mentioned phenomenon, from its etiology to its clinical manifestations, and with special emphasis in the assessment and therapeutic aspects, psychosocial and pharmacological ones

Tentativa de suicidio en adolescentes / Attempted suicide in adolescente

El propósito de este estudio es realizar una revisión general sobre el suicidio en la adolescencia, junto a una valoración de los aspectos clínicos y epidemiológicos de intentos de suicidio frustrado en una población de adolescentes de edades comprendidas entre los 12 y los 17 años, en una muestra de 25 casos estudiados en nuestra unidad y obtenidos en el periodo comprendido entre abril de 1996 y marzo de 1997.Las variables estudiadas son: edad, sexo, CI, modalidad de la tentativa, personas con las que convive, relaciones matrimoniales entre los padres, número de hermanos, lugar en la fatria, nivel socio-económico, desencadenarte, número de tentativas, grado de afectación clínica y fecha de la tentativa (AU)