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Biomedical subjects

M E Garralda

Publications and source records attributed to M E Garralda.

At least 55 records · Page 3Linked to original sources
PubMed1989

Psychiatric disorders in general paediatric referrals.

Detailed interviews with parents of 128 children aged 7 to 12 years consecutively referred to general paediatric clinics identified psychiatric disturbance in 36 (28%) of the children. Emotional disorders were the commonest psychiatric diagnoses (present in two thirds); less frequent diagnoses were conduct disorders (5/36, 14%), mixed conduct/emotional disorders (six, 17%), and hyperkinetic syndrome (three, 8%). Disturbance was related to level of energy, with disturbed children being described significantly more frequently as 'bounding with energy' or conversely 'tired and apathetic'. Psychosocial problems (broken homes, mentally distressed mothers, family stress including financial stress and marital difficulty) were also increased in the disturbed group, but most of all these mothers reported feeling stressed in relation to the children. Psychiatric disorders, particularly emotional disorders, are common associated problems in paediatric referrals. Family stress, specially that focused on parenting, is likely to be an important factor contributing to disturbed children's consultations in general paediatric clinics.

Affective Symptoms↗
PubMed1988

Psychiatric adjustment in children with chronic renal failure.

Problems in psychiatric adjustment were found to be more common in children and adolescents with chronic renal failure (22 subjects on hospital haemodialysis and 22 with less severe renal failure) than in healthy matched controls. There was a trend towards more definite and marked psychological difficulties in patients with more severe renal condition. However, the less severely physically ill children tended to have increased difficulties in school adjustment and they reported more feelings of loneliness. The findings have implications on the management of children with chronic renal failure.

Adaptation, Psychological↗
PubMed1988

How parents and families cope with chronic renal failure.

We studied the effects on the family of childhood chronic renal failure by contrasting children with varying degrees of severity of illness with healthy controls. Disruption of family life was most common in families with the more severely ill children (on hospital haemodialysis) and there was a tendency for more mental health problems in the parents in this group. Although more of these parents reported that the child's illness had had an impact on the marriage, marital break up was not related to illness status. There were indications that illness had resulted in an increase of subjective stress but also of support in a number of psychosocial areas for parents, especially those in the more severely affected group. Nevertheless at the time of assessment, fewer mothers in this group were deriving support from their social life and fewer fathers of ill children from their jobs or finances.

Adaptation, Psychological↗
PubMed1988

Child and family factors associated with referral to child psychiatrists.

We compared children aged 7-12 years referred to child psychiatrists by general practitioners (GPs) with community control children matched for the presence of psychiatric disorder. Referral status in psychiatrically disturbed children was linked to male sex, severity of the disorder, mental problems in the mothers, high levels of psychosocial stress in the family, and less support from extended families. For the whole group of referred children, the referral was associated with high antisocial scores on parental questionnaires, with parental reports of problems in controlling the children, and of high levels of stress felt in relation to them. In addition, parents of referred children were in disadvantaged socioeconomic groups.

Affective Symptoms↗
PubMed1987

Psychosomatic aspects of children's consultations in primary care.

Family doctors identified psychological factors associated with the presenting complaint in 17% of children aged 7 to 12 years attending their care. When compared with other children attending within the same age group, children said by their doctors to show associated psychological factors tended to present with psychosomatic-type symptoms (bed-wetting, asthma, skin rashes, abdominal pains, blackouts and headaches) and to make more use of medical services (both hospital and primary care). Our findings suggest that the families from which these children came had relatively high surgery attendance rates and more mothers with health problems. More of these families were regarded by the doctors as being under stress, and there were indications that concern about the children and their schooling was particularly common amongst the parents. Exploration of parental concerns about their children's health and about educational expectations would appear specially indicated in these cases.

Child↗
PubMed1986

Resident parents during paediatric admissions.

During a 9-month study period, 20% of parents (usually mothers) of children admitted to an acute medical paediatric ward opted to live in the hospital. We compared 34 resident parents with 23 from within the visiting group; the children were group-matched for age and sex. Our findings suggest that a number of resident parents perceive their children as temperamentally vulnerable and that they are in special need of reassurance and explanation. Thought needs to be given to how the hospital can respond optimally to them.

Attitude↗
PubMed1986

The accuracy of dating childhood life events on a parental questionnaire.

The accuracy in dating events by parents on the Coddington childhood life-event self-report inventory was assessed, by examining the concordance between events reported on the inventory and at a subsequent life-events interview. Seventy per cent of all the events reported on the inventory were dated at interview within the stated three month period. On group comparisons of all events reported, concordance in dating was not significantly related to the nature of the events classified according to desirability, specificity or direction (exit/entrance). Nor was it related to psychological deviance in the mother or in the child. However, when statements in the questionnaire were examined individually for concordance, there was full concordance for desirable events and for hospitalizations. In contrast, there was no concordance when marital separation, remarriage and birth of a sib were reported. The reasons for this are explored.

Child↗
PubMed1986

Psychological deviance in children attending general practice.

Parental questionnaires identified 22% of children aged 7-12 years attending 8 general practices as psychologically deviant. Most attended for physical complaints. A comparison with general population rates showed that deviant children were over-represented among surgery attenders, particularly in the more socially advantaged areas. This finding may be explained through an excess of somatic symptoms in deviant children; increased parental concern about the child's health as an extension of concern about his behaviour; family stress. These possibilities are discussed.

Child↗
PubMed1986

Children with psychiatric disorders in primary care.

A substantial minority (23%) of children between 7 and 12 years of age attending general practice were found to have psychiatric disorders. Disturbance was slightly more frequent in girls than in boys, and emotional disorder was the most common diagnosis. Psychiatric disorder was associated with psychological disadvantage (broken homes, the child had lived away from the family, family history of psychiatric disorder) and with current high levels of parental stress in relation to their children. Disturbed children tended to present with symptoms of anxiety, bed-wetting, hayfever, nosebleeds or scabies. Amongst a subsample of children consulting in general practice, psychiatric disorder may be a relevant factor contributing to somatic consultation.

Affective Symptoms↗
PubMed1985

Characteristics of the psychoses of late onset in children and adolescents (a comparative study of hallucinating children).

In a retrospective design, 20 children and adolescents with psychoses of late onset and hallucinations were compared with 20 children with conduct or emotional disorders who also had hallucinations. Marked differences emerged between the two groups. Psychotic subjects showed significantly more delusions, abnormalities in language production, inappropriate affect, bizarre behaviour, hypoactivity, and social withdrawal. Some subjects had symptoms which indicated a specially profound breakdown in personality functioning, but schneiderian and other schizophrenic symptoms were relatively rare. This questions their diagnostic value in the psychoses of late onset of children and adolescents.

Adolescent↗
PubMed1984

Hallucinations in children with conduct and emotional disorders: I. The clinical phenomena.

In a retrospective study, children referred to the Maudsley Hospital with conduct or emotional disorders who also suffered from hallucinations were found to be older than other children seen with similar diagnoses, more of them had below-average IQs and they were more frequently admitted as in-patients. In most cases hallucinations were auditory. When compared with a group of 20 controls matched on these differentiating features, the 20 children with hallucinations had more precipitants of illness, a shorter duration of the disorder, symptoms of depression, and a family history of mood changes. They also had more symptoms suggestive of cognitive-perceptual dysfunction.

Adolescent↗
PubMed1984

Hallucinations in children with conduct and emotional disorders: II. The follow-up study.

In a controlled study, 20 children with hallucinations and emotional or conduct disorders were followed up into adulthood. The mean follow-up time was 17 years and the mean age at follow-up was 30 years. Hallucinations in childhood did not carry an increased risk for psychoses, depressive illness, organic brain damage or other psychiatric disorders. The continuation of hallucinations and episodes of altered awareness in some of the subjects may indicate a special predisposition to hallucinate.

Adolescent↗
PubMed1984

Psychotic children with hallucinations.

In a retrospective study, 20 psychotic children and adolescents with hallucinations were compared with 15 psychotic controls without hallucinations. In the former, auditory hallucinations predominated, which tended to be localised in the internal space of the child. Subjects with hallucinations had significantly more symptoms of depression and anxiety, more precipitants of illness and problems in reading ability. There was a trend for increased laconic speech in them. The findings suggest a link between hallucinations and mood and cognitive changes in children and adolescents with psychoses of late onset.

Adolescent↗
PubMed1983

Child psychiatric emergencies: a research note.

In a controlled study, emergency referrals to a child psychiatric clinic showed increased depressive and suicidal symptomatology and more perceptual abnormalities. There was also more commonly a recent deterioration in the presenting condition. Parents rated themselves as depressed more frequently and there were more problems in the father-child relationship. There were no significant associations between emergency referrals and ratings of family dysfunction, availability of an extended family or contact with social agencies, but there was a trend towards increased use of the latter by the emergency group. The results highlight the need for early child-centred psychiatric intervention in a minority of conditions of children and adolescents.

Adolescent↗
PubMed1983

A survey of training in child and adolescent psychiatry.

In a survey of training in child psychiatry in Great Britain, all senior registrars were sent questionnaires; the response rate was 69 per cent. We describe background factors of the trainees, details of the clinical and academic experience available to them, and their attitudes towards their training. Most trainees had had extensive previous experience in adult psychiatry and the predominant orientation was psychoanalytic. In general, they approved of the guidelines for training issued by the Joint Committee for Higher Psychiatric Training. Family therapy was the most popular treatment method. We comment on their training experience where the interest expressed was not matched by adequate availability of the training facilities.

Adolescent Psychiatry↗
PubMed1982

Hallucinations in psychiatrically disordered children: preliminary communication.

In a retrospective study children with hallucinations and nonorganic psychiatric conditions were compared with matched controls. Hallucinations were found to be a rare symptom except in children with a diagnosis of psychosis of late onset where they were commonly present. Children with hallucinations were older than the majority of subjects seen in the Child Psychiatric Clinic. The perceptual symptoms were associated with precipitants of illness and mood changes. In the nonpsychotic subjects, they were also associated with symptoms suggestive of minor brain dysfunction. The results are discussed and ideas for future research suggested.

Adolescent↗