Search PubMed⌕ Search

Biomedical subjects

I M Goodyer

Publications and source records attributed to I M Goodyer.

45 records · Page 3Linked to original sources

Anorexia nervosa and food avoidance emotional disorder.

A retrospective and longitudinal study was carried out on all children and adolescents who presented to a child psychiatry service over a period of 26 years to identify the nature, course, and outcome of cases meeting criteria for anorexia nervosa (n = 27). Two groups of the same age were identified for comparison, firstly those with food avoidance and emotional disorders (n = 23), and secondly those with emotional disorders but no symptoms associated with eating (n = 22). The results confirm previous reports that early onset anorexia nervosa shows a similar nature, course, and outcome to the adult disease. Being tall at presentation seems to be associated with a poor outcome. Self starvation of early onset may result in short stature in some cases. There seem to be more boys among the group in whom the disease was of early onset than would be predicted from the sex ratio among adult patients. In addition boys with anorexia nervosa may have a better prognosis than girls. Children with food avoidance emotional disorders seem to have a worse prognosis than expected for childhood emotional disorders. They may represent a middle group between those with anorexia nervosa and those with emotional disorders but no symptoms associated with eating.

Adolescent↗

Salivary cortisol hypersecretion in juvenile depression.

Thirty depressed inpatients aged 7-16 yrs were compared for salivary hypercortisolism with a control group of 16 inpatients of mixed diagnosis matched for age and sex. Four cortisol samples were taken over a 48 hr period: 8 a.m. and 11 p.m. on the first day; then, with 1 mg of dexamethasone given immediately after the second sample, at 4 p.m. and 11 p.m. on the second day. All except the 8 a.m. value were significantly greater (P less than 0.03) in the depressed group. A 4 nmol/l cutoff for the 4 p.m. sample gave 48% sensitivity and 91% specificity for discriminating depressed cases (P = 0.03). The results indicate that the salivary method for estimating cortisol levels in children and adolescents with depression warrants further study.

Adjustment Disorders↗

Maternal adversity and recent stressful life events in anxious and depressed children.

Poor confiding relations in mothers' own lives, the presence of maternal distress and recent stressful life events focussed on children are all significantly and independently associated with emotional disorder in the school-age child. The probability of being a case is best predicted by considering the contribution of all three factors. When this is done, an additive rather than multiplicative interaction for the three variables is found. The association between these maternal factors and events focussed on the child varies with the presence or absence of caseness. There appears to be no greater probability of being anxious rather than depressed as a consequence of these three stressful factors occurring in the lives of school-age children.

Adaptation, Psychological↗

The impact of recent undesirable life events on psychiatric disorders in childhood and adolescence.

The timing and number of recent stressful life events occurring in the year before onset of emotional or behavioural disorder was examined in a consecutive sample of children. Overall, events increase the relative risk of psychiatric disorder by 3-6 times. Events occur throughout the 12 months, but tend to cluster in the 16 weeks nearest onset of symptoms. The number of events influences the onset of disorder: cases with multiple events are more likely to have an event within 16 weeks of onset; cases with single events are more likely to have the event 36-52 weeks before onset. Cases whose onset occurs within 4 weeks of an event may have experienced single or multiple events. The results support the concept of additivity of recent stressful events in some cases of emotional and behavioural disorders in childhood.

Adolescent↗

Do age and sex influence the association between recent life events and psychiatric disorders in children and adolescents?--A controlled enquiry.

In a consecutive sample of school-aged children attending a routine child psychiatry clinic, four clinical groups were classified based on presenting signs and symptoms, conduct (N = 44), mild emotional (N = 55), severe emotional (N = 32) and somatic (N = 26). The groups were divided by age and sex and comparisons made between the groups and community subjects (N = 76) for the number of children experiencing one or more recent stressful life events. The results indicated that with the possible exception of severe emotional disorders, neither age nor sex substantially influenced the association between events and psychiatric disorder.

Adolescent↗

Emotional difficulties in diabetes mellitus.

Sixty children and adolescents with diabetes aged between 9 and 18 years were investigated for emotional difficulties in association with their diabetic control. Seventeen (28%) had appreciable emotional or behavioural difficulties according to parental report, and seven (12%) considered themselves 'possibly depressed'. These latter patients had a mean glycosylated haemoglobin concentration below 10%, poorer self esteem, and a greater external locus of control. Three were considered not to have pronounced emotional difficulties according to parental report.

Adolescent↗

The value of a neuropsychiatric examination of children with complex severe epilepsy.

The feasibility and utility of a neuropsychiatric assessment in a cohort of severely impaired children with long-standing epilepsy (n = 96) is tested. This assessment is described, and some results reported in this highly selected group. Substantial difficulties in coordination were present in nearly three-quarters of the sample, and dysarthria identified in two-thirds. Psychiatric interviewing identified cases of mood disturbance that altered overall treatment of that child, and a more systematic behavioural assessment permitted clearer management of behavioural problems already known to staff. This research supports previous findings that a full neuropsychiatric evaluation is both practical and has an important place in the early assessment and ongoing management of complex childhood epilepsy.

Adolescent↗