Neuroleptic malignant syndrome.
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Adolescent↗
Biomedical subjects
B Lask
Publications and source records attributed to B Lask.
Children with pervasive refusal.
Four children are described with a potentially life threatening condition manifested by profound and pervasive refusal to eat, drink, walk, talk, or care for themselves in any way over a period of several months. The multiplicity and severity of the symptoms in these children do not fit comfortably into any existing diagnostic category. Long term and highly skilled nursing and psychiatric care is required to help these children to recover. The possible causes of this syndrome are discussed.
Adolescent↗
Heart-lung transplantation for cystic fibrosis. 1: Assessment.
Forty five patients with cystic fibrosis (age 5-15 years) were assessed for heart-lung transplantation between September 1987 and March 1990. The two main conditions for acceptance were (i) life expectancy less than 2 years and (ii) a severely impaired quality of life. Patients were accepted onto an active waiting list (n = 26), a provisional waiting list (n = 15), or not accepted (n = 4). Selection was made on clinical grounds with objective measurements used as an aid in assessment. As expected, the mean values for objective measures were significantly different between patients on the active waiting list compared with the provisional waiting list/not accepted group for resting heart rate (118/minute v 101/minute), percentage of ideal weight (83.2% v 93.1%), forced expiratory volume at one second as percent of predicted normal (27.3% v 47.6%), Shwachman-Kulczycki score (33.6 v 52.5), Chrispin-Norman x ray score (25.8 v 22.1), 12 minute walk (540 m v 854 m), and minimal oxygen saturation (81.5% v 92%). Psychological evaluation demonstrated a 55% incidence of individual and a 50% incidence of family morbidity. Of the 26 patients accepted onto the active waiting list, 11 have been transplanted (mean waiting time 3.3 months), 10 have died within a mean of 3.7 months of acceptance, and five remain on the active list (mean 5.6 months).
Adolescent↗
Anorexia nervosa in a group of Asian children living in Britain.
Four cases of anorexia nervosa occurring in Asian children are described. These case histories are set against the recent increase in eating disorders in patients of different racial origin. The role of sociocultural conflict in immigrant Asian families to Western countries is raised as a possible contributor to the emergence of eating disorders and the need to be aware of anorexia nervosa in such childhood populations is stressed.
Acculturation↗
Pisa syndrome in an adolescent on neuroleptic medication.
To our knowledge Pisa syndrome in childhood or adolescence has not previously been described. The syndrome developed in an adolescent girl following administration of neuroleptic medication for psychotic features, and was transiently thought to be abnormal illness behaviour. This case emphasises the need for early diagnosis and rapid effective treatment.
Adolescent↗
The experience of a child and adolescent inpatient unit in London.
The Mildred Creak Unit of the Hospital for Sick Children, Great Ormond Street, London, England, has been evaluating and treating children and adolescents now for over 16 years. A portion of their valuable experience, with 394 patients reviewed, is presented in this article. Items discussed include: (1) major diagnostic labels utilized and their frequency of use; (2) ages and sex of young people within the major diagnostic categories; and (3) information on discharge status plus average length of stay. This paper affords the reader an opportunity to compare the Mildred Creak Unit experience with his or her own experience, hopefully enhancing further international sharing of child and adolescent data.
Adolescent↗
Novel and non-toxic treatment for night terrors.
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Adolescent↗
Long term follow up of patients with early onset anorexia nervosa.
A long term follow up (mean 7.2 years) of 30 children with anorexia nervosa (mean age at onset 11.7 years) was carried out. The outcome was good in only 18 (60%), 10 children remaining moderately to severely impaired and two died. Poor prognostic factors included early age at onset (less than 11 years), depression during the illness, disturbed family life and one parent families, and those in which one or both parents had been married before.
Adolescent↗
Psychosocial factors in childhood diabetes and seizure disorders. The family approach.
Not infrequently chronic childhood illnesses such as diabetes and seizures disorders are not as well controlled as might be expected by standard medication, due to a wide range of adverse psychosocial factors. These may be a reaction to chronic ill health or coincidental. In either case it is vital to understand the interactions between the child, his family, the illness and environment if the failure to control the disorder is to be overcome. This paper outlines the family approach to assessment and management of chronic ill health in children.
Adolescent↗
Early onset anorexia nervosa.
This paper describes 48 children, aged 14 years or less, who met diagnostic criteria for anorexia nervosa modified from Morgan and Russell. The characteristics of the sample (13 boys and 35 girls) are described along with features of the illness, associated family characteristics, treatment in hospital, and a brief description of treatment. Difficulties in diagnosis are addressed, with reference in particular to the high incidence of depression in this group. Finally, the importance and difficulty of close paediatric/psychiatric liaison in diagnosis and treatment is emphasised.
Adolescent↗
Psychosocial sequelae of stoma surgery for inflammatory bowel disease in childhood.
Three matched groups of children with inflammatory bowel disease: (a) stroma group, (b) ileorectal anastomosis group and (c) no-surgery group were compared for psychosocial adjustment. No differences were found between the groups for psychological adjustment, selfesteem, or quality of life. It is concluded that providing children are well prepared and followed up carefully and sensitively, then stroma surgery should not be deferred for fear of adverse psychological consequences.
Adolescent↗
Study of written communication between general practitioners and departments of child psychiatry.
Previous studies have pointed to the general dissatisfaction with written communication between general practitioners and medical specialists, in terms of quality and usefulness to both groups. This study examined the letters of referral from general practitioners to two child psychiatry departments and the replies of the psychiatric staff, and looked at the information exchanged in the light of the needs of both groups. It was concluded that the requirements of both psychiatric staff and general practitioners were being met to a limited extent, but that there was room for improvementon both sides.
Child Psychiatry↗
Psychological aspects of inflammatory bowel disease.
Psychological factors play a major part in inflammatory bowel disease (I.B.D.). Stress influences motility, secretion and vascularity of the gastrointestinal tract and may produce functional disorders. Stressful events, which in childhood might be family tensions, separation or major changes such as that of school or house, may aggravate or even cause I.B.D. Physical symptoms of the active disease are distressing and can lead to stress and even behaviour problems. Stress and distress can themselves produce physical symptoms and aggravate pre-existing organic pathology, whilst behaviour problems such as non-compliance with treatment or diet can aggravate the organic pathology and/or the physical symptoms so setting up and maintaining a vicious circle. Not only the child, but also his family are affected. Taking into account the complex interaction between psychosocial and organic aspects of I.B.D. a comprehensive approach is essential for optimal care of the child with I.B.D. and his family.
Adaptation, Psychological↗
Viruses, neurodevelopmental disorder and childhood psychosis.
Four cases are described of prepubertal boys in whom the convergence of neurodevelopmental disorder, viral infection and psychosis seemed more than coincidental. Review of the literature highlights the possibility that viral infection of the central nervous system may play a contributory role in childhood psychosis. Whilst it is essential to avoid a reductionist stance when investigating these difficult conditions, the emergence of potent anti-viral treatments and sophisticated methods of identifying the presence of viral infection should encourage us to consider more carefully the relevance of viruses in childhood psychosis.
Chickenpox↗