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PubMed2001

Treatment of pathological crying with citalopram.

Pathological laughing and/or crying may occur as a concomitant symptom of various diseases of the central nervous system. No known anatomical basis for any of these disorders exists at present. However, references to a disturbance in central serotoninergic neurotransmission have become frequent in the literature, implicating this as an important etiological factor. In the present communication three cases of successful treatment of pathological crying using the SSRI citalopram are reported. Besides the response of pathological crying in cerebral ischemia to SSRIs, which has already been described in earlier publications, this is the first report on the successful administration of citalopram for treating pathological crying in Parkinson's disease. Onset of response was very rapid in all cases.

Aged↗
PubMed1978

Some developmental aspects of infants cry.

Respiratory activity during crying was measured in a semilongitudianl study of 10 normal infants aged two days to eight months. Temporal aspects of respiration during crying showed marked change with age: athe duration of the expiratory phase steadily increased, while the duration of the inspiratory phase remained remarkable constant, producing an ever-lower I-fraction. A previous study reported no developmental changes in the temporal aspects of the acoustic cry signal from one to seven months of age. Reasons for the divergent findings of the present study arepresented, and it is suggested that respiratory behavior may be a better indicator of developmental changes in the crying act thanthe acoustic signal.

Child Development↗
PubMed2005

High-resolution mapping of genotype-phenotype relationships in cri du chat syndrome using array comparative genomic hybridization.

We have used array comparative genomic hybridization to map DNA copy-number changes in 94 patients with cri du chat syndrome who had been carefully evaluated for the presence of the characteristic cry, speech delay, facial dysmorphology, and level of mental retardation (MR). Most subjects had simple deletions involving 5p (67 terminal and 12 interstitial). Genotype-phenotype correlations localized the region associated with the cry to 1.5 Mb in distal 5p15.31, between bacterial artificial chromosomes (BACs) containing markers D5S2054 and D5S676; speech delay to 3.2 Mb in 5p15.32-15.33, between BACs containing D5S417 and D5S635; and the region associated with facial dysmorphology to 2.4 Mb in 5p15.2-15.31, between BACs containing D5S208 and D5S2887. These results overlap and refine those reported in previous publications. MR depended approximately on the 5p deletion size and location, but there were many cases in which the retardation was disproportionately severe, given the 5p deletion. All 15 of these cases, approximately two-thirds of the severely retarded patients, were found to have copy-number aberrations in addition to the 5p deletion. Restriction of consideration to patients with only 5p deletions clarified the effect of such deletions and suggested the presence of three regions, MRI-III, with differing effect on retardation. Deletions including MRI, a 1.2-Mb region overlapping the previously defined cri du chat critical region but not including MRII and MRIII, produced a moderate level of retardation. Deletions restricted to MRII, located just proximal to MRI, produced a milder level of retardation, whereas deletions restricted to the still-more proximal MRIII produced no discernible phenotype. However, MR increased as deletions that included MRI extended progressively into MRII and MRIII, and MR became profound when all three regions were deleted.

Adult↗
PubMed2001

Subclinical mastitis presenting as acute, unexplained, excessive crying in an afebrile 31-day-old female.

We present a case of a 31-day-old female who presented with an acute, unexplained, episode of excessive crying. The patient had no history of fever and no fever on presentation. There was no evidence of skin erythema or swelling on presentation. Chest radiograph and computed tomography of the head were normal. Urinalysis and cerebral spinal fluid analysis were normal. The white blood cell count was within normal limits (17,400 cells/mm3). It was not until 6 hours after the onset of inconsolable crying (2.5 hours after presentation to the emergency department) that the patient's temperature rose to 38.5 degrees C (101.3 degrees F). Clinical signs of mastitis did not become appreciable until the 2nd hospital day. We review the literature on infantile mastitis and acute, unexplained, excessive crying. The importance of a thorough, conservative approach to the infant with acute, unexplained, excessive crying is discussed.

Acute Disease↗
PubMedDate not supplied

Crying, feeding and sleeping patterns in 1 to 12-month-old infants.

The crying, feeding and sleeping patterns of 270 infants 0-12 months old were studied using a 24-hour schedule included in a questionnaire given to mothers visiting four well-baby clinics in Finland in 1987-88. Of these infants 78 were under 3, 84 were 3-5, 65 were 6-8 and 43 were over 9 months old. The results showed that the infants less than 3 months old slept on average 15.2 hours per day, whereas those over 9 months slept 13.4 hours. The sleeping periods were longer at night. Continuous night-time sleep for at least 6 hours was noted in 35% of the infants under 3 months old and the proportion increased to 72% by the age of 9-12 months. The youngest infants were fed on average 6-7 times per day at 2- to 3-hour intervals in the daytime and at 4- to 6-hour intervals at night. The number of feedings decreased slightly with age. The average total crying time decreased from 1.6 hours per day for the youngest group to 1.1 hours for the 9-12 months old. At the time of the study, 23 mothers felt the need for help because of excessive crying or night waking. The help needed ranged from information about colic and child care, help with housework or the baby and encouragement. Of the mothers who needed help, a significantly higher proportion had a first-born baby compared with those not in need of help. There were also significant differences in the mothers' perception of the cry and feelings towards it.

Arousal↗
PubMedDate not supplied

Perinatal information on infant crying.

Research and postnatal service developments have begun to draw attention to the frequency with which mothers encounter difficulties in the management of infant crying. Such difficulties may have unfavourable long-term consequences for the mother-infant relationship. This study investigated the effect of providing first-time mothers with information and advice specific to cry management, during the in-stay period. A sample of 70 mothers was recruited antenatally and subjects allocated to an intervention or non-intervention group. All mothers were asked to complete a range of measures at 2 days postpartum and again 1 month after birth. A post-intervention comparison of groups indicated interesting evidence of a selective intervention effect. Results indicated that certain mothers in the non-intervention group were significantly more likely than intervention group mothers to experience higher levels of negative emotional arousal in response to crying. They were also more likely to adopt a passive response strategy to infant crying and to report generally higher levels of present state anxiety. The significance of the findings is discussed.

Adult↗
PubMed2005

A variant Cri du Chat phenotype and autism spectrum disorder in a subject with de novo cryptic microdeletions involving 5p15.2 and 3p24.3-25 detected using whole genomic array CGH.

Cri du Chat syndrome (CdCs) is a well-defined clinical entity, with an incidence of 1/15,000 to 1/50,000. The critical region for CdCs has been mapped to 5p15, with the hallmark cat-like cry sublocalized to 5p15.3 and the remaining clinical features to 5p15.2. We report findings in a subject with a de novo t(5;7)(p15.2;p12.2) and an inv(3)(p24q24), who was found to have a cryptic microdeletion in the critical region for CdCs detected using a 1-Mb genomic microarray. In addition to 5p deletion, the proband had a de novo single clone loss at the 3p breakpoint of inv(3)(p24q24) and a familial single clone deletion at 18q12. Deletions were confirmed using microsatellite analysis and fluorescence in situ hybridization. The 5p deletion encompasses approximately 3 Mb, mapping to the border between bands 5p15.2 and 5p15.31. The single clone deletion on chromosome 3 maps to 3p24.3-3p25, for which there is no known phenotype. The clinical features of our proband differ from the characteristic CdC phenotype, which may reflect the combined effect of the two de novo microdeletions and/or may further refine the critical region for CdCs. Typical features of CdCs that are present in the proband include moderate intellectual disability, speech, and motor delay as well as dysmorphic features (e.g. broad and high nasal root, hypertelorism, and coarse facies). Expected CdCs features that are not present are growth delay, microcephaly, round facies, micrognathia, epicanthal folds, and the signature high-pitched cry. Behavioral traits in this subject included autism spectrum disorder, attention-deficit hyperactivity disorder, and unmanageable behavior including aggression, tantrums, irritability, and self-destructive behavior. Several of these behaviors have been previously reported in patients with 5p deletion syndrome. Although most agree on the cat-cry critical region (5p15.3), there is discrepancy in the precise location and size of the region associated with the more severe manifestations of CdCs. The clinical description of this proband and the characterization of his 5p deletion may help to further refine the phenotype-genotype associations in CdCs and autism spectrum disorder.

Adolescent↗
PubMed1995

CRIES: a new neonatal postoperative pain measurement score. Initial testing of validity and reliability.

We have developed a neonatal pain assessment tool CRIES. The tool is a ten point scale similar to the APGAR score (Apgar 1953). It is an acronym of five physiological and behavioural variables previously shown to be associated with neonatal pain. C--Crying; R--Requires increased oxygen administration; I--Increased vital signs; E--Expression; S--Sleeplessness. We have tested CRIES for validity and reliability. This report is the result of that testing. We have found CRIES to be valid, reliable and well accepted by neonatal nurses.

Crying↗
PubMed1991

Crying in !Kung San infants: a test of the cultural specificity hypothesis.

The pattern of crying and fretting behavior during the first two years is described for 46 !Kung San infants from a hunter-gatherer society in northwestern Botswana. Despite markedly different caretaking practices predisposing to quieter infants, crying and fretting were significantly greater during the first three months, and a peak pattern was present. Measurement of crying 'intensity' indicated that it was predominantly short and fretful. The results support the concept that the early peak pattern is not specific to infants in western industrialized societies, and may represent a behavior universal to the human species. The caretaking differences between societies primarily appear to affect crying duration rather than its frequency and pattern in early infancy.

Arousal↗
PubMed1994

The crying pattern of Korean infants and related factors.

In a study of 160 Korean infants aged between one and six months, average time spent sleeping decreased, and total daily maternal periods of contact increased, with age (though not significantly). The increment of total periods spent by the infant alone was significant, but the decrease of crying duration was not. There was no definite clustering of crying during the evening hours. The most common responses of mothers towards their baby's crying were feeding, contact and no response, in order of frequency. Compared with Western studies, the duration of crying of Korean infants was shorter and the time of holding and/or close contact with mothers longer, and colic was not found in this study. These findings may be related to the caring practice of mothers.

Age Factors↗
PubMed1991

Troublesome crying in infants: effect of advice to reduce stimulation.

The observation that babies with troublesome crying improve quickly in hospital suggested that, if true, a common, quickly reversible, factor may operate. Histories from parents of such babies suggest that much work goes into trying to console them. It is hypothesised that this may lead to excessive stimulation and the improvement seen in hospital reflects a reduction in stimulation. Two studies were undertaken. (1) Carers were asked to agree to randomisation of their infants to hospital or home management. Those at home were advised to reduce stimulation. A 10 point questionnaire was used to describe distress in mothers of subjects and age matched controls. (2) A randomised controlled study compared advice to reduce stimulation with an empathic interview using a +5 to -5 scale to chart change. In the first study too few subjects agreed to randomisation and thus a rigorous study to validate the observation could not proceed. There was good evidence, however, that crying improved. Results from the home group justified the second study. The median distress score for subjects was 7/10 and for controls 3/10 (p less than 0.001). In the second study at seven days, 18/22 subjects given advice scored +2 or better on the change chart for crying, compared with 7/20 of those who did not receive advice (p less than 0.01). After the latter received advice 79% improved (95% confidence interval 61 to 97%). For babies under 12 weeks, the customary upper limit for a diagnosis of colic, 14/15 subjects advised improved compared with 6/12 who were not advised (p less than 0.02). These studies have shown that infants with troublesome crying admitted to hospital seem to improve quickly as do those whose carers are advised to reduce stimulation.

Crying↗
PubMed1994

Pathoanatomic correlation between poststroke pathological crying and damage to brain areas involved in serotonergic neurotransmission.

BACKGROUND AND PURPOSE: The aim of the study was to correlate the severity of poststroke pathological crying with lesion size and location. METHODS: Twelve selected stroke patients were ranked in terms of overall clinical severity of the syndrome of pathological crying, and the size and location of the stroke lesion(s) were determined by magnetic resonance imaging. RESULTS: The patients with the clinically most severe pathological crying had relatively large bilateral pontine lesions without lesions in the hemispheres. The intermediate group had bilateral central hemispheric lesions, and the clinically least affected patients had mainly unilateral large subcortical lesions. CONCLUSIONS: Poststroke pathological crying may be attributable to stroke-induced partial destruction of the serotonergic raphe nuclei in the brain stem or their ascending projections to the hemispheres.

Adult↗
PubMed2005

Left auditory cortex and amygdala, but right insula dominance for human laughing and crying.

Evidence suggests that in animals their own species-specific communication sounds are processed predominantly in the left hemisphere. In contrast, processing linguistic aspects of human speech involves the left hemisphere, whereas processing some prosodic aspects of speech as well as other not yet well-defined attributes of human voices predominantly involves the right hemisphere. This leaves open the question of hemispheric processing of universal (species-specific) human vocalizations that are more directly comparable to animal vocalizations. The present functional magnetic resonance imaging study addresses this question. Twenty subjects listened to human laughing and crying presented either in an original or time-reversed version while performing a pitch-shift detection task to control attention. Time-reversed presentation of these sounds is a suitable auditory control because it does not change the overall spectral content. The auditory cortex, amygdala, and insula in the left hemisphere were more strongly activated by original than by time-reversed laughing and crying. Thus, similar to speech, these nonspeech vocalizations involve predominantly left-hemisphere auditory processing. Functional data suggest that this lateralization effect is more likely based on acoustical similarities between speech and laughing or crying than on similarities with respect to communicative functions. Both the original and time-reversed laughing and crying activated more strongly the right insula, which may be compatible with its assumed function in emotional self-awareness.

Acoustic Stimulation↗
PubMed2001

Effect of maturity on maximal transdiaphragmatic pressure in infants during crying.

The aim of this study was to determine the effect of maturation on diaphragmatic function. In addition, we investigated whether noninvasive assessment yielded similar results to invasive measurement. Twenty-eight infants, median gestational age (GA) 35.5 wk (range, 25 to 42 wk) and postconceptional age (PCA), 37.6 wk (range, 32 to 44 wk), were examined. Diaphragmatic function was assessed by measuring the maximal transdiaphragmatic pressure during crying (cPdi) using balloon catheters in the midesophagus (Pes) and the stomach (Pgas). In 14 of the infants, a noninvasive measurement of inspiratory muscle strength, maximal inspiratory pressure (PImax), was also made. cPdi and PImax were recorded during a crying effort with the airway occluded at end-expiration. The median cPdi and Pes during crying (cPes), but not Pgas during crying (cPgas), were significantly lower in those studied at a PCA of less than term compared with those studied at an older age (p < 0.05). cPdi and cPes, but not cPgas, correlated significantly with PCA (r = 0.44, p < 0.02; r = 0.43, p < 0.03; respectively) and gestational age (r = 0.46, p < 0.02 and r = 0.56, p < 0.01; respectively). In the 14 infants, the median PImax was lower, but it correlated significantly with cPdi (r = 0.79, p < 0.01). We conclude maturation does affect diaphragm function, and PImax may provide a noninvasive index of diaphragm strength.

Crying↗
PubMed1993

The development of mothers' understanding of infant crying.

This study examines the development of mothers' understanding of their infants' crying. Semistructured tape-recorded interviews were conducted with 17 mothers at 6 weeks, 10 weeks, and 16 weeks postpartum. The mothers (9 primiparous, 8 multiparous) were chosen for their good health status and for their immediate support system. Two major themes were identified from the interviews. In general, it was found that as the mothers became more experienced, the understanding of the cry situation became more complete and soothing was more effective. The relation between crying and soothing became more differentiated, more cohesive, and more complete. The effect of experience on understanding was particularly dramatic in the case of multiparous mothers. Both health promotional and illness prevention programming are proposed as nursing care measures for mothers of crying infants. The important assumptions underlying each approach are delineated.

Adaptation, Psychological↗
PubMed2000

Infantile colic: crying time reduction with a whey hydrolysate: A double-blind, randomized, placebo-controlled trial.

OBJECTIVE: To determine the effectiveness of whey hydrolysate formula in the treatment of infantile colic in a primary care setting in the Netherlands. STUDY DESIGN: Randomized, double-blind, parallel trial with a 1-week qualification period and a 1-week intervention period. Participants. Forty-three healthy, thriving, formula-fed infants, <6 months old, crying >3 hours per day on at least 3 days per week. Infants were randomized to whey hydrolysate formula (n = 23) or standard formula (n = 20). MAIN OUTCOME MEASURE: Difference in duration of crying (minutes per day) between qualification week and intervention week. RESULTS: Analysis according to the intention to treat principle showed a difference in the decrease of crying duration of 63 minutes per day [95% confidence interval: 1-127 minutes per day] in favor of the whey hydrolysate formula. Five infants did not complete the trial. The scope of the study was not sufficient to expect significant differences in the subgroup analyses. CONCLUSIONS: An extensively hydrolyzed whey formula is effective in reducing the duration of crying in a primary care setting.

Colic↗
PubMed1995

Treatment of uncontrolled crying after stroke.

Uncontrolled crying after stroke is a disturbance of the motor concomitants of emotional affect. It manifests as stereotyped outbursts of crying that are excessive to an appropriate emotional response. The episodes can be triggered by almost any kind of emotional stimulus (happiness, excitement, sadness, just being looked at or talked to, the sight of a doctor, etc.) and can even occur without any obvious external or internal stimulus. The condition is socially embarrassing, and in the most severely affected patients the crying episodes can be so violent that they interfere with rehabilitation. Although frequent (1-year incidence is 20%), the condition often goes unrecognised because patients and relatives rarely complain about it spontaneously. Effective treatment has now been documented in 3 controlled studies of tricyclic antidepressants and the selective serotonin reuptake inhibitor citalopram. There seems to be a rationale for the latter approach to treatment, in that post-stroke pathological crying may be attributable to stroke-induced partial destruction of the serotonergic raphe nuclei in the brainstem or their ascending projections to the hemispheres. Although our knowledge of the aetiology and treatment of the condition is limited, and the need for further study is considerable, the present treatment possibilities can significantly improve quality of life for patients with this socially embarrassing and sometimes debilitating condition.

Cerebrovascular Disorders↗
PubMed1979

Effects of training versus non-training in identification of infant cry-signals: a longitudinal study.

The effects of training on the ability to identify 4 infants' cry-signals (birth, hunger, pain, and pleasure) were studied in 60 college students (aged 18 to 30 yr.). Subjects with training scored significantly higher than those without in identifying all but the pleasure cry-signal. In a follow-up retest 10 wk. later, scores for the birth and hunger cry-signals improved significantly (p less than .05) for subjects without training, while scores for subjects with training remained about the same. The suggestion that repeated exposure to cry-signals may serve as training was discussed.

Adolescent↗