RESUMO
The aims of the study were to assess health-related quality of life (HRQoL) in children and adolescents with perinatal HIV infection and to establish possible relationships with clinical and socio-demographic variables. About 56 children with perinatal HIV infection, aged 6-18 years (PHIV+ group), 24 healthy perinatally HIV-exposed but uninfected (PHEU) children, and 43 children HIV-unexposed uninfected (HUU) were assessed using the PedsQL 4.0. Generic Core. The perceptions of school functioning according to children and social functioning, according to parents, were worse in the PHIV+ group compared to those in the PHEU group. In comparison to the HUU group, PHIV+ children received lower total HRQoL scores in the caregivers' perception. Most of the life-quality indices increased systematically with age in PHIV+ group, whereas opposite trends were present in both control groups. Caregivers of children with a final CDC category C and caregivers of children diagnosed with encephalopathy perceived most domains of their children functioning as more problematic. A more serious course and more severe HIV infection before treatment were associated with worse multidimensional functioning and a worse total HRQoL score. Results highlight the importance of early diagnosis and treatment initiation as having significant implications for the quality of life.
Assuntos
Infecções por HIV , Qualidade de Vida , Adolescente , Cuidadores , Criança , Cognição , Feminino , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Masculino , Assistência Perinatal , Polônia , Gravidez , Efeitos Tardios da Exposição Pré-NatalRESUMO
OBJECTIVE: to assess the prevalence of obsessive-compulsive disorder (OCD) or OC symptoms in patients with anorexia nervosa (AN) and to find a possible relationship between the presence of OC symptoms and the course of AN. METHOD: 137 adolescent female patients with AN, aged 14.8 +/- 1.8 years, completed the Polish version of the LOI-CV. Two groups, High-risk (HR) and no High-risk (nHR), were defined according to the cut-off score of LOI-CV. The diagnosis of OCD was confirmed with the Polish version of K-SADS-PL. The relationship between the number and intensity of OC symptoms and the following data were analyzed: age of onset and on admittance to a psychiatric facility, weight loss, BMI on admittance and its changes, age of first menstruation, time of amenorrhea and of restitution of menses, length of treatment and number of relapses. RESULTS: OCD was not diagnosed in any subject, but 25% of the examined patients had OC symptoms which qualified them to High-risk group. Differences in HR and nHR groups were found between duration of AN before hospitalization, age and body mass after release from hospital. Negative correlation was found between "Yes" Score and Interference Score in LOI-CV and the age of patient at the time of release from hospital. CONCLUSIONS: the results of our study do not support the observations about a high co-occurrence of AN and OCD, but indicate the frequent co-occurrence of OK symptoms.
Assuntos
Comportamento do Adolescente/psicologia , Anorexia Nervosa/epidemiologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Adolescente , Anorexia Nervosa/diagnóstico , Causalidade , Comorbidade , Feminino , Humanos , Transtorno Obsessivo-Compulsivo/diagnóstico , Polônia/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
The main focus of research on consequences of HIV infection is on adult population and not much attention is given to children, especially to children with perinatally acquired HIV. Researches have shown higher frequency of mental disorders in this group. HIV infection also has a negative impact on cognitive functions, especially attention concentration. Among the possible causes of mental disorders and cognitive impairment, attention is not only paid to the neurotoxic effects of HIV on the CNS, but also on other factors, such as awareness of chronic disease, the impact of opportunistic infections and side effects of antiviral therapy. Comorbid psychiatric disorders correlate with worse compliance and higher prevalence of risk behaviors among infected adolescents. This article reviews what is known about psychiatric disorders and cognitive disorders among perinatal HIV-infected children.
Assuntos
Transtornos Cognitivos/epidemiologia , Infecções por HIV/congênito , Infecções por HIV/epidemiologia , Transtornos Mentais/epidemiologia , Qualidade de Vida , Adolescente , Terapia Antirretroviral de Alta Atividade , Atitude Frente a Saúde , Criança , Comorbidade , Feminino , Infecções por HIV/tratamento farmacológico , Nível de Saúde , Humanos , Masculino , Transtornos Mentais/psicologia , Grupo Associado , Prevalência , Assunção de Riscos , Índice de Gravidade de Doença , Meio SocialRESUMO
AIM: To compare the self concept of boys with ADHD and health subjects; to determine which symptoms ofADHD, oppositional defiant disorder (ODD) or conduct disorder (CD) have the greatest impact on self-concept. METHOD: Polish version of The Harter Self-Esteem Questionnaire (HSEQ) was filled by boys with ADHD and control group. In addition, a diagnosis of ODD and CD was made in ADHD group. RESULTS: A significant difference was observed between boys with ADHD and control group on the following scales of HSEQ: Global Self-Esteem Subscale, Social Acceptance Subscale and Scholastic Performance Subscale. No significant influence of the quantity and intensity of ADHD and ODD symptoms on self-esteem was found. A significant correlation was indicated between all scales of HSEQ and quantity and intensity of symptoms ofADHD. CONCLUSIONS: Boys with ADHD have lower self-esteem than their healthy peers and their global self-esteem, social acceptance and school skills are most affected. The presence of conduct disorder (CD) had the greatest impact on the decrease of self esteem in ADHD group.
Assuntos
Comportamento do Adolescente/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Comportamento Infantil/psicologia , Autoimagem , Autorrelato , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Humanos , Masculino , Grupo Associado , Projetos Piloto , Qualidade de Vida/psicologia , Autoavaliação (Psicologia) , Ajustamento SocialRESUMO
Multiple functional imaging techniques help to a better understanding of the neurobiological basis of autism-spectrum disorders (ASD). The early functional imaging studies on ASD focused on task-specific methods related to core symptom domains and explored patterns of activation in response to face processing, theory of mind tasks, language processing and executive function tasks. On the other hand, fMRI research in ASD focused on the development of functional connectivity methods and has provided evidence of alterations in cortical connectivity in ASD and establish autism as a disorder of under-connectivity among the brain regions participating in cortical networks. This atypical functional connectivity in ASD results in inefficiency and poor integration of processing in network connections to achieve task performance. The goal of this review is to summarise the actual neuroimaging functional data and examine their implication for understanding of the neurobiology of ASD.
Assuntos
Transtorno Autístico/patologia , Transtorno Autístico/fisiopatologia , Neuroimagem/métodos , Lobo Temporal/patologia , Lobo Temporal/fisiopatologia , Criança , Diagnóstico Diferencial , Imagem de Tensor de Difusão/métodos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética , Índice de Gravidade de DoençaRESUMO
Although the aetiology of autistic-spectrum disorder (ASD) remains unclear, great advances have been made to clarify the underlying neuroanatomical abnormalities and brain-behaviour relationships in autism. There is variability in the literature on structural neuroimaging findings in ASD. Early brain overgrowth is probably the most replicated finding in this subgroup. Additionally some specific brain regions are particularly implicated, including the frontal, limbic, basal ganglia and cerebellar regions. There is also evidence of volume abnormalities in both grey and white matter. New techniques, such as cortical-thickness measurements, surface morphometry and diffusion tensor imaging help to understand in more detail the patterns of abnormalities. More work is required, involving the use of large and homogeneous samples, to investigate the neuroanatomical determinants and their role in aetiology of ASD. The goal of this review is to summarise the available structural neuroimaging data and examine their implication for understanding of the neurobiology of ASD.
Assuntos
Transtorno Autístico/diagnóstico , Transtorno Autístico/etiologia , Encéfalo/patologia , Sistema Nervoso Central/patologia , Neuroimagem/métodos , Encéfalo/fisiopatologia , Sistema Nervoso Central/fisiopatologia , Criança , Diagnóstico Diferencial , Lobo Frontal/patologia , Humanos , Lobo Parietal/patologia , Índice de Gravidade de Doença , Lobo Temporal/patologiaRESUMO
There is constant interest in possible relations between obsessive-compulsive disorder (OCD) and eating disorders, particularly anorexia nervosa (AN). The comorbidity rate for OCD and AN is reported to be between 10% and even 40%. There is also an increased incidence of prior AN in OCD patients and high number of anorectic patients with obsessional premorbid personality. Similarities between AN and OCD lie in the symptoms of the disorders: intrusive, fearful thoughts, a compulsive need to perform rituals aimed at reducing the level of anxiety and obsessions maintaining these rituals. In case of AN, these behaviours revolve around food and thinness, whereas in OCD they are of more general and differential in type. Research on AN-OCD relations provides interesting insights, but also presents some limitations. The purpose of this review is to analyse and discuss the specificity of relations between symptoms of AN and OCD.
Assuntos
Anorexia Nervosa/epidemiologia , Saúde Mental , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtornos da Personalidade/epidemiologia , Índice de Gravidade de Doença , Causalidade , Comorbidade , Nível de Saúde , Humanos , Incidência , PersonalidadeRESUMO
Anorexia nervosa is a physical and mental health condition with high mortality and long-term history. Its most characteristic symptom is a significant underweight caused and maintained by a patient who is perceived as an obese person and sets a low weight limit. The course of treatment is usually long-term, involving a large group of specialists, and, depending on the patient's condition, outpatient care, day care or - in the event of high weight loss or malnutrition complications - hospitalization for several months is necessary. Currently, there is a tendency to shorten the length of stay in the inpatient ward of patients with AN in favor of other forms of care. The aim of this article is to collect and present the results of a small number of studies on factors affecting the length of hospitalization in the treatment of anorexia nervosa. Based on the currently available tests, the body mass index at admission should be considered as a factor significantly affecting the length of hospitalization. However, the discussion remains open and further research in this area is advisable. Clarification of the above issue may provide the basis for a more patient-oriented determination of the duration of hospital treatment. Further research on factors identified in individual studies and their relationships will also be needed.
Assuntos
Anorexia Nervosa , Anorexia Nervosa/complicações , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/terapia , Índice de Massa Corporal , Hospitalização , Humanos , Pacientes InternadosRESUMO
OBJECTIVES: Goal: to evaluate changes in the grey matter volume using the VBM method in a group of adolescents with ASD, who met the criteria for Asperger's Syndrome. METHODS: Material and methods: Morphometric evaluations based on Voxel Based Morphometry (VBM) were performed on 37 male adolescents aged 12 to 19 (M = 14.3 ± 2.0), with autism spectrum disorders, who met the DSM-IV-TR criteria for Asperger's Syndrome and 15 neurotypical adolescents matched by age. Significance was set at p<0.007 without FWE correction and p<0.05 with FWE correction. RESULTS: Results: the decrease in the volume of the grey matter was observed in ASD group including the pre- and postcentral gyrus, the superior and middle frontal gyrus, the inferior and superior parietal lobule, the praecuneus, the anterior and posterior cingulate cortex, the fusiform gyrus, the parahippocampal gyrus, the lingual gyrus, the middle occipital region, the cuneus and the angular gyrus, the regions of calcarine sulcus and the cerebellum. The majority of changes was localized bilaterally. CONCLUSIONS: Conclusions: the decrease in the volume of grey matter observed in ASD group can be related functionally with the characteristics of deficits observed in autism spectrum disorders which highlights the role of abnormal organization of numerous CNS structures in the genesis of symptoms observed in cognitive and behavioural domains.
Assuntos
Síndrome de Asperger , Transtorno do Espectro Autista , Humanos , Masculino , Adolescente , Transtorno do Espectro Autista/diagnóstico por imagem , Síndrome de Asperger/diagnóstico por imagem , Síndrome de Asperger/psicologia , Giro do Cíngulo , Lobo Frontal , Imageamento por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagemRESUMO
OBJECTIVES: Goal: to assess fMRI activation during semantic tasks in adolescents with ASD. METHODS: Material: 44 right-handed male adolescents aged 12-19 (mean 14.3 ± 2.0) - 31 with autism spectrum disorders who met DSM-IV-TR criteria for Asperger's syndrome and 13 neurotypical adolescents matched according to age and handiness. Method: Functional testing (fMRI) was performed during semantic decisions tasks and phonological decisions in three categories of tasks: concrete nouns, verbs with plural meanings, words describing states of mind, as a control condition. Statistical analyzes were performed at the level of p <0.05 with FWE (family-wise error) correction and p <0.001. RESULTS: Results: lower BOLD signal was demonstrated in many brain areas including precuneus, posterior cingulate gyrus, angular gyrus, parahippocampal gyrus, regardless of task category and processing method in the ASD group. The smallest differences in semantic processing were found for concrete nouns and the greatest ones for words describing states of mind. CONCLUSIONS: Conclusions: the presence of different activation patterns in the ASD group suggests that far more than just the areas traditionally attributed to language processing, are involved in semantic deficits in ASD.
Assuntos
Síndrome de Asperger , Transtorno do Espectro Autista , Humanos , Masculino , Adolescente , Semântica , Transtorno do Espectro Autista/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Síndrome de Asperger/diagnóstico por imagem , Mapeamento Encefálico/métodosRESUMO
OBJECTIVES: Comparison of the functioning of families of teens (13-16 years) with the diagnosis of attention deficit hyperactivity disorder (ADHD) or ADHD and oppositional defiant disorder (ODD). METHODS: Assessment using the Family Assessment Questionnaire in three groups of adolescents growing up in biological families: (1) ADHD/ODD group (n = 40), (2) ADHD group (n = 40) and (3) group C (control group) adolescents (n = 40) who have not used psychological or psychiatric care in the past or at present. RESULTS: Mothers, fathers and adolescents from the ADHD/ODD group scored significantly lower in all important aspects of family functioning compared to the control group. In the ADHD group, less favorable mother's and father's assessment was shown for all areas of family functioning compared with the control group. Adolescents' assessment in the dimension of "Role performance", "Emotionality", "Affective involvement", and "Control" was also lower. The ADHD/ODD group participants and their parents rated the functioning of the family lower compared with the ADHD group: mothers - in all described areas, teenagers - in most of the described areas except the dimension of "Control", and fathers - in most areas except the dimension of "Emotionality". CONCLUSIONS: The functioning of families of patients with ADHD and ODD, and families of patients with ADHD significantly differs in all or most of the examined dimensions compared with families of people without diagnosis, while the functioning of families of patients with ADHD and oppositional defiant patients can be described as more abnormal than that of families of ADHD patients.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Feminino , Humanos , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Pais , Mães , Inquéritos e Questionários , ComorbidadeRESUMO
OBJECTIVES: To assess attachment styles among adolescents (13-16 years) with ADHD or ADHD and oppositional defiant disorders (ODD). METHODS: The Parents and Peers Attachment (IPPA) and the Parent Bonding Questionnaire (PBI) were used in three groups of teenagers raised in biological families: (1) ADHD/ODD group (n = 40), (2) ADHD group (n = 40) and (3) K (control) group of teenagers (n = 40) who have not benefited from psychological or psychiatric care in the past or at present. RESULTS: Parental attachment styles in the area of "Trust", "Communication" and "Alienation" (IPPA), and "Care" and "Control" (PBI) in the ADHD/ODD group differ significantly compared to the control group. Teens from the ADHD/ODD group report to have experienced significantly less "Trust" and "Communication" (IPPA), and "Care" (PBI) in relationships with parents and more "Alienation" (IPPA) and "Control" (PBI) than adolescents in the ADHD group. Attachment patterns with peers in both clinical and control groups differ significantly. The ADHD/ODD group is dominated by the anxious-avoidant style of attachment to the mother and father, in the ADHD group, a secure style in relation to the mother and anxious-avoidant in relation to the father. In relations with peers in the ADHD/ODD group and the ADHD group, the anxious-avoidant style dominates. CONCLUSIONS: The attachment style is significantly different in adolescents diagnosed with ADHD and ODD than in adolescents with only ADHD. In the ADHD/ODD group and the ADHD group, unlike in the group of adolescents without a psychiatric diagnosis, insecure attachment styles for parents and peers dominate (mainly anxious-avoidant style).
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adolescente , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo , PaisRESUMO
OBJECTIVES: The aim of the study was to assess the presence of cognitive impairments in children and adolescents with vertically transmitted HIV infection and to determine possible relationships with clinical and socio-demographic variables. METHODS: Fifty children with perinatal HIV infection aged 6-18 years were included in the experimental group (PHIV+). Two sex- and age-matched groups were recruited as reference groups: (1) a PHEU group that included 24 healthy children perinatally HIV-exposed but uninfected, and (2) an HIV-nA group that included 43 healthy children of uninfected parents. CANTAB Research Suite was used to assess cognitive functioning. RESULTS: In comparison with the HIV-nA group, the PHIV+ group scored worse in movement execution, shifting and flexibility of attention, reversal learning and working memory. In comparison with the PHEU group, the PHIV+ group had significantly longer planning time in the memory task. The analysis of results for the 12-18 year-old age group revealed deterioration of cognitive functions in all tests of the PHIV+ children in comparison with the HIV-nA group. A higher logarithm of viral load at the start of the ARV treatment was associated with worse results in the use of feedback, shifting of attention, cognitive flexibility and worse information processing. CONCLUSIONS: Results of the research indicate deterioration of executive functioning in the PHIV+ group associated with longer duration of HIV neuroinfection and severity of infection before treatment.
Assuntos
Disfunção Cognitiva , Infecções por HIV , Gravidez , Feminino , Humanos , Criança , Adolescente , Infecções por HIV/complicações , Polônia , Função Executiva , Cognição , Disfunção Cognitiva/etiologiaRESUMO
Pervasive Developmental Disorders (PPD) refers to the group of disorders characterised by delayed or inappropriate development of multiple basic functions including socialisation, communication, behaviour and cognitive functioning. The term,,autistic spectrum disorders" was established as a result of the magnitude of the intensity of symptoms and their proportions observed in all types of pervasive developmental disorders. Asperger's Syndrome (AS) remains the most controversial diagnosis in terms of its place within autism spectrum disorders. AS if often described as an equivalent of High Functioning Autism (HFA) or as a separate spectrum-related disorder with unique diagnostic criteria. Another important issue is the relationship between AS and speech disorders. Although it is relatively easy to draw a line between children with classical autism and speech disorders, the clear cut frontiers between them still remain to be found. The main distinguishing feature is the lack of stereotypic interests and unimpaired social interaction observed in children with speech disorders, such as semantic-pragmatic disorder.
Assuntos
Síndrome de Asperger/diagnóstico , Transtorno Autístico/diagnóstico , Comportamento Infantil/psicologia , Relações Interpessoais , Índice de Gravidade de Doença , Síndrome de Asperger/psicologia , Transtorno Autístico/psicologia , Criança , Diagnóstico Diferencial , Humanos , Modelos Psicológicos , Escalas de Graduação Psiquiátrica , Comportamento Social , Isolamento SocialRESUMO
Repetitive and stereotyped behaviours in the form of stereotyped interests or specific routine activities are one ofthe diagnostic criteria in pervasive developmental disorders. The occurrence of repetitive behaviours in patients with pervasive developmental disorders is a starting point for questions about the type and classification criteria of such behaviours. The aim of the article is to present case studies of patients with pervasive developmental disorders and co-morbid symptoms in the form of routine activities, tics, obsessive-compulsive symptoms or stereotyped behaviours. The first case study describes a patient with Asperger's syndrome and obsessive compulsive symptoms. The diagnostic problems regarding complex motor tics are discussed in the second case study which describes a patient with Asperger's syndrome and Gilles de la Tourette syndrome. The third and fourth case study describes mono-zygotic twins with so called High Functioning Autism whose repetitive activities point to either obsessive compulsive symptoms, stereotypic movements, need for absolute consistency or echopraxia. The possible comorbidity of pervasive developmental disorders and symptoms in the form of repetitive behaviours, possible interactions as well as diagnostic challenges is discussed in the article.
Assuntos
Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Deficiência Intelectual/diagnóstico , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno de Movimento Estereotipado/diagnóstico , Tiques/complicações , Adolescente , Síndrome de Asperger/complicações , Criança , Transtornos Globais do Desenvolvimento Infantil/complicações , Diagnóstico Diferencial , Humanos , Deficiência Intelectual/complicações , Masculino , Transtorno Obsessivo-Compulsivo/complicações , Transtorno de Movimento Estereotipado/complicações , Tiques/diagnóstico , Síndrome de Tourette/complicaçõesRESUMO
Central coherence allows for integration of different stimuli into a coherent whole. It also enables context-dependent information processing. This term was coined in an effort to arrange multiple observations of cognitive functioning of people with autism spectrum disorder (ASD). Weak central coherence, which is characteristic of ASD, is understood as adivergent cognitive style with a tendency to process incoming information locally. This allows us to describe central coherence as a continuous trait. Despite manifold research programs, a conclusive conceptualization of the construct is still lacking. The open question is whether weak central coherence constitutes alimited ability to integrate stimuli or rather an increased ability to focus on details. An important postulate concerns the establishment of a standard for measuring central coherence and its individual dimensions. Studies of central coherence outside of ASD context are scarce and deal predominantly with eating disorders. The following work is an overview of the current state of knowledge about central coherence construct and methods of research.
Assuntos
Transtorno do Espectro Autista , Transtorno do Espectro Autista/psicologia , Cognição , HumanosRESUMO
Autism spectrum disorder (ASD) is a heterogeneous group of neurodevelopmental disorders that can affect up to 2.6% of the population. Most of these people will have at least one other psychiatric disorder, often diagnosed with a delay or not recognized at all. This study describes the epidemiology, diagnostic difficulties and potential treatment of patients with ASD and comorbid bipolar disorder (BD). The prevalence of bipolar disorder in ASD is estimated at 5-8%. The study with the most numerous group included 700,000 children out of which 9,062 fulfilled ASD criteria at 16 - BD was found to be 6 times more prevalent in this group compared to the control group. Many factors affect the diagnosis. Patients with ASD often have limited insight into understanding the complex emotional states and difficulty in expressing them due to their impairment. The symptoms of bipolar disorder are in their case unspecific and differ from those occurring in the general population, which makes it difficult to make proper diagnosis. Despite the lack of research on the group of patients with ASD, psychometric tools designed to evaluate the general population are used to examine patients. This work aims to show the current state of knowledge and highlight areas that require further investigation.
Assuntos
Transtorno do Espectro Autista , Transtorno Bipolar , Transtornos do Neurodesenvolvimento , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/epidemiologia , Criança , Comorbidade , Humanos , PrevalênciaRESUMO
Theory of mind (ToM) is a complex cognitive mechanism which refers to our ability to understand that other people have beliefs, plans, desires, hopes, intentions, and knowledge that may differ from our own mental and emotional states. Theory of mind is critical for social and interpersonal functioning and allows people to make sense of other's behavior. Theinitial aim of theory of mind research was to record normative development in preschool age children. Almost 30 years ago, when researchers discovered that theory of mind is altered in individuals with autism spectrum disorder, they also explored impairments in ToM in different clinical disorders. Research results indicate the presence of ToM deficits in childhood mental and neurodevelopmental disorders, such as: autism spectrum disorders, attention deficit hyperactivity disorder, oppositional defiant disorder, Gilles de la Tourette Syndrome, fetus alcohol syndrome, mood disorders, eating disorders, or obsessive-compulsive disorder. This article reviews significant studies of theory of mind impairments in individual childhood disorders and selected mental disorders.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Transtornos do Espectro Alcoólico Fetal , Teoria da Mente , Criança , Pré-Escolar , Emoções , Feminino , Humanos , GravidezRESUMO
OBJECTIVES: Assessment of criterion validity and temporal stability of personality disorder diagnosis in adolescents and relationships between attachment styles and personality disorder diagnosis. METHODS: 50 adolescents (46 girls and 4 boys, aged 15-17) hospitalized at the department of child and adolescent psychiatry were assessed with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and the Inventory of Parent and Peer Attachment (IPPA). After one year, adolescents meeting the criteria for apersonality disorder (PD) diagnosis were reassessed with the SCID-II. RESULTS: In the first stage of assessment, diagnostic criteriafor different types of personality disorders were met by 41 adolescents (82%) (mean number of criteria = 5.9). Criteria were met most often for borderline personality disorder (BPD) (n = 26; mean number of criteria = 7.9). In the second stage of assessment, the interview was re-administered to 21 (51%) adolescents; the mean number of criteria was = 6.6. A statistically significant relationship between the number of PD diagnostic criteria in assessment one and the number of criteria in assessment two was obtained (r = 0.58; p < 0.01). 82% of the participants with PD were insecurely attached to their mothers. In the borderline group, 83% of the participants reported anxious-avoidant attachment style. CONCLUSIONS: PD traits in adolescence, specifically BPD, are stable across one year.
Assuntos
Transtorno da Personalidade Borderline , Transtornos da Personalidade , Adolescente , Transtorno da Personalidade Borderline/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Hospitalização , Humanos , Masculino , Determinação da Personalidade , Transtornos da Personalidade/diagnósticoRESUMO
OBJECTIVES: The aims of the study were to evaluate the prevalence of psychiatric, behavioral and emotional disorders in children and adolescents with perinatal HIV infection and to establish their possible relationships with clinical and sociodemographic variables. METHODS: 56 children with perinatal HIV infection (PHIV+ group), 24 healthy children perinatally HIV-exposed but uninfected (PHEU) and 43 healthy children of uninfected parents (HIV-nA), aged 6-18 years, were assessed. The Child Behavior Checklist (CBCL/4-18), completed by parents, and the Youth Self-Report (YSR) were used to assess behavioral and emotional disorders, while the semi-structured diagnostic interview K-SADS-PL was used to assess the symptoms of psychiatric disorders. RESULTS: Higher prevalence of psychiatric disorders was found in the PHIV+ group and the PHEU group compared to the HIV-nAgroup. Anxiety disorders and affective disorders were diagnosed most often. Prevalence of symptoms of emotional and behavioral disorders in the PHIV+ group and in the PHEU group was associated with similar sociodemographic variables (male, not living with the biological caregiver, the experience of stressful life events). Psychiatric disorders were noted more often among PHIV+ subjects whose ARV treatment was started after 12 months of age. Positive correlations were observed between the results of some YSR and CBCL/4-18 problem scales and CD4 counts at the time of the study, higher logarithm of viral load at the start of ARV treatment and at the time of HIV diagnosis. CONCLUSIONS: The prevalence of psychiatric disorders in PHIV+ group and the PHEU group is higher in comparison with HIV-nAgroup. Amore serious course of HIV infection and its severity before treatment are associated with the severity of internalizing problems.