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Biomedical subjects

C Gillberg

Publications and source records attributed to C Gillberg.

At least 55 records · Page 3Linked to original sources
PubMed2000

Ten-year follow-up of adolescent-onset anorexia nervosa: physical health and neurodevelopment.

To study the development of physical health and some neuromotor functions in anorexia nervosa (AN) 51 individuals (48 females, three males) with a mean AN onset of 14 years, recruited after community screening, were followed prospectively together with 51 age-, sex-, and school-matched individuals without AN (controls). About 10 years after AN onset, all individuals were examined in respect of physical health and neurodevelopment. There were no deaths. Weight and height had normalised, except in three participants with persistent AN. Significantly more participants with AN had a physical complaint/disorder, including hirsutism. This might be a long-term complication in weight restored AN. Dysdiadochokinesis occurred almost exclusively among individuals with former AN in accordance with our previous studies.

Adolescent↗
PubMed2000

Autism and Asperger syndrome: coexistence with other clinical disorders.

OBJECTIVE: : To provide a clinically useful analysis of the extent to which autism and Asperger syndrome coexist with other disorders. METHOD: Selective review of the literature detailing data pertaining to symptoms and disorders sometimes encountered in connection with autism or Asperger syndrome. RESULTS: A large number of medical conditions, psychiatric disorders and behavioural and motor dyscontrol symptoms are associated with autism and Asperger syndrome. CONCLUSION: Comorbidity is to be expected in autism spectrum disorders -directly or indirectly. Comorbid conditions may be markers for underlying pathophysiology and suggest a more varied treatment approach. There is a great need for in-depth research into this area, meaning that the exclusion criteria of current diagnostic manuals, i.e. those that rule out a diagnosis of autism in some disorders, and a diagnosis of certain other disorders in autism may have to be revised.

Age Factors↗
PubMed2000

Tourette's disorder: epidemiology and comorbidity in primary school children.

OBJECTIVE: To study prevalence and comorbidity of Tourette's disorder in the general population of children and in a clinical setting. METHODS: School-age children in the general population and children attending a county-wide tic disorder clinic were screened and examined by the same doctor. Behavioral-psychometric instruments with demonstrated reliability and validity were used. RESULTS: Depending on the sample characteristics, 0.15% to 1.1% of all children had Tourette's disorder. Boys outnumbered girls by 4:1 through 6:1. Attention deficits and empathy/autism spectrum problems (including Asperger's disorder) were very common, each type of comorbidity affecting approximately two thirds of individuals with Tourette's disorder. Overall behavior problem scores were high, and affected children exhibited a marked degree of functional impairment. CONCLUSIONS: Tourette's disorder is a common disorder with high rates of significant comorbidity. In most cases, attention deficits and empathy problems are likely to cause more suffering than the tics per se.

Adolescent↗
PubMed2000

Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study.

OBJECTIVE: There is a need for controlled longitudinal studies in the field of attention disorders in the general population. METHOD: In a community-based follow-up study, 55 of 61 subjects aged 22 years, who had attention-deficit/hyperactivity disorder (ADHD) with and without comorbid developmental coordination disorder (DCD) at initial workup at age 7 years, were compared, on a multitude of outcome variables, with 46 of 51 age-matched subjects without such diagnoses. None of the subjects had received stimulant treatment. Psychiatrists performing the follow-up study were blind to original diagnostic group status. RESULTS: In the ADHD/DCD group 58% had a poor outcome compared with 13% in the comparison group (p < .001). Remaining symptoms of ADHD, antisocial personality disorder, alcohol abuse, criminal offending, reading disorders, and low educational level were overrepresented in the ADHD/DCD groups. The combination of ADHD and DCD appeared to carry a particularly gloomy outlook. CONCLUSIONS: Childhood ADHD and DCD appears to be a most important predictor of poor psychosocial functioning in early adulthood. It would seem appropriate to screen for such disorders in schools and clinics so that therapies may be started early.

Adolescent↗
PubMed2000

Deficits in attention, motor control and perception (DAMP): a simplified school entry examination.

OBJECTIVE: To suggest an empirically based school entry screening examination for the detection of deficits in attention, motor control and perception (DAMP) in 6-y-old children. MATERIAL AND METHODS: A population-based cohort of 113 children, 6-7 y of age (62 with and 51 without DAMP), compared on measures of attention, motor functions, language and cognition. RESULTS: Attention deficits were convincingly identified by both parents and paediatrician. The motor function tests clearly distinguished between the two groups. Linguistic and meta-linguistic tests demonstrated greater phonological processing difficulties in the DAMP group. The cognitive test revealed an overall lower IQ but no consistent characteristic pattern in the DAMP group. CONCLUSIONS: A simplified paediatric school entry examination test is suggested. Four motor tests (standing on one foot, Fog test, design copying and diadochokinesis) administered by the paediatrician, combined with a brief structured clinical observation and a structured parent interview, identified 80% of children with DAMP-and all those with severe DAMP-as well as a small number of false positives.

Attention Deficit Disorder with Hyperactivity↗
PubMed1999

[Who attends the department of child psychiatry? Visits to a child and adolescent psychiatry center in Gothenburg over five years].

All case-records of first-time visitors to an outpatient child and adolescent psychiatric centre from 1992 to 1996 were reviewed, and re-diagnosis was performed according to DSM-III-R. Assessment procedures and routines were seen to change over this period as awareness of neuropsychiatric disorders increased. Slightly more than 5% of all children in the catchment area (10,522 individuals) sought psychiatric help during the study period; about 40% of these made 1-3 visits. One fifth of health care resources was consumed by 2% of all clinic attenders. Fewer than 50% were seen by a psychiatrist. Half were living in single-parent families, one third had experienced mild stress, and nearly one third had been exposed to marked psychosocial stress. The proportion of patients receiving a neuropsychiatric diagnosis rose markedly from 24% in 1992 to 45% in 1996.

Adolescent↗
PubMed1999

Autistic disorders in children with CHARGE association.

Three children with CHARGE association (coloboma, heart defect, atresia of the choanae, retarded growth and development, genital hypoplasia, ear anomalies and hearing defects) as well as concomitant autistic disorder are reported. Two of the children also had mental retardation. Several types of cerebral maldevelopment/dysfunction have been reported in CHARGE association. With regard to aetiology, involvement of the neural crest has been suggested. Autism in CHARGE association may represent a neuro-endocrine dysfunction. Children with a CHARGE association have many medical problems and therefore autistic behaviour can easily be overlooked. A multidisciplinary approach with respect to assessment, treatment, and habilitation is of vital importance.

Abnormalities, Multiple↗
PubMed1999

Neurodevelopmental processes and psychological functioning in autism.

Autism is a developmental disorder with variable severity, occurring at all levels of cognitive ability and having a number of slightly different clinical presentations. It is associated with neuropsychological deficits that occur in other conditions also, but its pattern may be specific to autism. Genetic and environmental early insults to brain development are etiological determinants of the disorder. Brain circuitries important for social, communicative, and integrational purposes have been suggested to be dysfunctional in autism. There could be at least two different pathways to autism, one connected with primary temporofrontal dysfunction (and late prenatal-early postnatal origins) and another linked to primary brain-stem dysfunction (and early prenatal origins). Further study of neurodevelopmental and neuropsychological processes in autism will help elucidate not only the pathological mechanisms involved in the specific syndromes but also the underpinnings of normal brain development.

Aging↗
PubMed1999

Autism and hearing loss.

A group of 199 children and adolescents (153 boys, 46 girls) with autistic disorder was audiologically evaluated. Mild to moderate hearing loss was diagnosed in 7.9% and unilateral hearing loss in 1.6% of those who could be tested appropriately. Pronounced to profound bilateral hearing loss or deafness was diagnosed in 3.5% of all cases, representing a prevalence considerably above that in the general population and comparable to the prevalence found in populations with mental retardation. Hearing deficits in autism occurred at similar rates at all levels of intellectual functioning, so it does not appear that the covariation with intellectual impairment per se can account for all of the variance of hearing deficit in autism. Hyperacusis was common, affecting 18.0% of the autism group and 0% in an age-matched nonautism comparison group. In addition, the rate of serous otitis media (23.5%) and related conductive hearing loss (18.3%) appeared to be increased in autistic disorder. The study emphasizes the need for auditory evaluation of individuals with autism in order to refer those with pronounced to profound hearing loss for aural habilitation and to follow those with mild to moderate hearing loss because of the risk of deterioration.

Adolescent↗
PubMed1999

A screening questionnaire for Asperger syndrome and other high-functioning autism spectrum disorders in school age children.

The high-functioning Autism Spectrum Screening Questionnaire (ASSQ) is a 27-item checklist for completion by lay informants when assessing symptoms characteristic of Asperger syndrome and other high-functioning autism spectrum disorders in children and adolescents with normal intelligence or mild mental retardation. Data for parent and teacher ratings in a clinical sample are presented along with various measures of reliability and validity. Optimal cutoff scores were estimated, using Receiver Operating Characteristic analysis. Findings indicate that the ASSQ is a useful brief screening device for the identification of autism spectrum disorders in clinical settings.

Adolescent↗
PubMed1999

Genome-wide scan for autism susceptibility genes. Paris Autism Research International Sibpair Study.

Family and twin studies have suggested a genetic component in autism. We performed a genome-wide screen with 264 microsatellites markers in 51 multiplex families, using non-parametric linkage methods. Families were recruited by a collaborative group including clinicians from Sweden, France, Norway, the USA, Italy, Austria and Belgium. Using two-point and multipoint affected sib-pair analyses, 11 regions gave nominal P -values of 0.05 or lower. Four of these regions overlapped with regions on chromosomes 2q, 7q, 16p and 19p identified by the first genome-wide scan of autism performed by the International Molecular Genetic Study of Autism Consortium. Another of our potential susceptibility regions overlapped with the 15q11-q13 region identified in previous candidate gene studies. Our study revealed six additional regions on chromosomes 4q, 5p, 6q, 10q, 18q and Xp. We found that the most significant multipoint linkage was close to marker D6S283 (maximum lod score = 2.23, P = 0.0013).

Adolescent↗
PubMed1999

Behavior and personality characteristics of children and young adults with Prader-Willi syndrome: a controlled study.

OBJECTIVE: To analyze (1) which behavior and personality characteristics in Prader-Willi syndrome (PWS) are primarily linked to the syndrome and not to mental retardation or being overweight, (2) how early in life such traits appear, and (3) whether current therapies affect behavior. METHOD: Parents of a group of 44 individuals with PWS and of a comparison group were interviewed and completed questionnaires about their children's behavior and personality. RESULTS: Individuals with PWS had more behavior problems than those in the comparison group. Some behaviors were specific to PWS. Younger PWS cases had fewer behavior problems than older PWS cases. Treated individuals had approximately the same degree of behavior problems as those untreated, even though a few symptoms occurred at lower rates. CONCLUSIONS: PWS is associated with behavior correlates that are not related to weight or IQ. In the first few years of life, children with PWS do not demonstrate the characteristic profile of preoccupation with food, ritualism, irritability, temper tantrums, and skin-picking which is typical of older individuals with PWS. Current therapies (including treatment with growth hormone) do not seem to radically affect the behavioral expression of the disorder, even though some problems tended to abate with treatment.

Adolescent↗
PubMed1999

Developmental coordination disorder in Swedish 7-year-old children.

OBJECTIVE: To estimate the prevalence, comorbidity, and outcome in developmental coordination disorder (DCD). METHOD: In this population study of 7-year-olds undergoing individual examination plus teacher and parent interviews, children were followed up at ages 8, 9, and 10 years. RESULTS: Severe DCD occurred in 4.9% and moderate DCD in another 8.6%. Boy-girl ratios ranged from 4:1 to 7:1. Children with severe and moderate DCD did not differ from each other on any measure, but both groups were clearly separated from children without DCD with respect to associated attention deficit symptoms. Asperger's disorder symptoms, school dysfunction scores, and outcome. Approximately half of all children with DCD had moderate to severe symptoms of attention-deficit/hyperactivity disorder (ADHD). CONCLUSIONS: DCD is a common problem, and it is strongly associated with ADHD symptoms. A diagnosis of DCD at age 7 years predicts DCD at age 8 years and restricted reading comprehension at age 10 years. Clinicians need to acquaint themselves with DCD and its comorbidity so that they can provide better services to affected children.

Attention Deficit Disorder with Hyperactivity↗
PubMed1999

Ten-year follow-up of adolescent-onset anorexia nervosa: personality disorders.

OBJECTIVE: To study the development of personality disorders, especially those involving obsessions, compulsions, and social interaction problems, in a representative group of anorexia nervosa (AN) cases. METHOD: The prevalence of personality disorders, obsessive-compulsive disorder, and autism spectrum disorders at mean age 24 years (10 years after reported onset) was examined in 51 adolescent-onset AN cases recruited after community screening and 51 comparison cases matched for age, sex, and school. All 102 cases had originally been examined at age 16 years and followed up at 21 years. At 24 years, structured and validated psychiatric diagnostic interviews were performed by a psychiatrist who was blind to original diagnosis. The majority of AN cases (94%) were weight-restored. RESULTS: Personality disorders, particularly cluster C, and autism spectrum disorders were overrepresented in the AN group. Obsessive-compulsive personality disorder and/or autism spectrum disorder was diagnosed in a subgroup of AN cases in all 3 studies. This subgroup had a very poor psychosocial outcome. CONCLUSIONS: Persistent problems with obsessions, compulsions, and social interaction characterized a substantial minority of weight-restored AN cases at 10-year follow-up. These problems appear to be constitutional rather than a result of AN, and they may warrant a different treatment approach.

Adolescent↗