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PubMedDate not supplied

Epidemiology of childhood behavioural disorders in Ilorin, Nigeria--findings from parental reports.

We report the findings of a survey aimed at determining the prevalence, pattern and psychosocial correlates of childhood psychiatric disorders among primary school pupils in Ilorin, Kwara State. Eight hundred and forty-six parents completed the 31-item Rutter scale A2 and an additional pro-forma on the developmental and family history of their children. The most commonly reported symptoms were headache, vomiting, tempertantrums, restlessness, disobedience and fearfulness. Using Rutter's cut off point of 13, 157 (18.6%) qualified as cases: neurotic disorders (7.3%), antisocial disorders (8%) and undifferentiated disorders (3.3%). Males were over-represented, albeit non-significantly, among the neurotic and antisocial groups. Mothers of high scorers (HSs) reported significantly more physical and emotional problems during pregnancy. HSs were significantly more likely to (i) have had delayed developmental milestones (ii) have suffered a major illness during childhood (iii) come from broken homes, and (iv) attend school located in the rural area. Our prevalence rate compares well with those reported in Africa and elsewhere. To address the identified unmet needs of children in this environment, we suggest the need to establish a comprehensive child mental health package, which could be incorporated into the existing primary health care programme. The package should encompass the three tiers of prevention, and involve the active participation of parents, teachers, educational, as well as health professionals.

Adolescent↗
PubMed1994

Obsessive-compulsive disorder: admission patterns and diagnostic stability. A case-register study.

All first-time admissions from 1970 to 1986 with obsessive-compulsive neurosis (OCD) (ICD-8 diagnosis number 300.39) or obsessive-compulsive personality disorder (OCPD) (ICD-8 diagnosis number 301.49) were analyzed based on an extract from the nationwide Psychiatric Case Register in Denmark. All patients with secondary diagnoses other than neurotic disorders or personality disorders (including "neuroses characterogenes") were excluded from the study. A total of 284 patients were first-time admitted with a main diagnosis of OCD during the period. The sex ratio was 0.67 (males/females). A total of 126 were first-time admitted with a diagnosis of OCPD, with a sex ratio of 1.18 (males/females). Seventy-seven percent of the readmitted patients with a first-time diagnosis of OCD kept a diagnosis within the "emotional spectrum" at the last admission. About half kept OCD as a main diagnosis, whereas only 15% shifted to a severe psychiatric diagnosis such as schizophrenia or manic-depressive psychosis. Of the readmitted patients with OCPD, 13% later developed a diagnosis of manic-depressive psychosis.

Adult↗
PubMedDate not supplied

[Sleeping sickness in children and its long term after-effects. Apropos 110 personal observations at Fontem Hospital (Cameroon)].

This study has been conducted in Fontem hospital (Cameroon). In the first part, the author describes the clinical symptoms leading to the diagnosis : change in the general condition, headache, fever and sleeping disorder are starting symptoms, which are rarely observed in the youngest children. One child out of three has encephalic troubles such as altered motor development or psycho-neurotic disorders. Motor troubles affect only children in the cerebral polarisation phase. The second part of this paper considers the sequellae observed in 120 children: half of them are affected but 12 p. 100 are seriously handicapped. Slow psychomotor development and psychoneurotic troubles exist in 11,5 p. 100 of the children, even for those a diagnosis was made at an early stage. Adversely a late diagnosis is responsible of severe motor sequellae in 6,5 p. 100 of all the young patients.

Adolescent↗
PubMed2003

Mortality of mental disorders in relation to potential pesticide exposure.

Some studies have suggested a role of pesticide exposure in the development of neurobehavioral disorders. This case-control study examined the association between mortality from mental disorders and occupational exposure to pesticides. The study population consisted of 7756 deaths and 330,452 eligible controls identified from US death certificate files for the years 1988 through 1992. Exposure assignment was based on job title reported on the death certificates. Employment in jobs potentially involving pesticide exposure was weakly associated with the risk of death from mental disorders (odds ratio [OR] = 1.46; 95% confidence interval (95% CI) = 1.33-1.60). This association was stronger among women (OR = 2.65; 95% CI = 1.89-3.71), in particular for deaths from neurotic disorders (OR = 4.32; 95% CI = 2.44-7.64). These results must be interpreted with caution, however, because the impact of social and work-related factors other than pesticide exposure is not known.

Adult↗
PubMed2000

[Posttraumatic stress disorder, dissociation and self-destructive behavior in borderline patients]

We studied traumatic childhood experiences, comorbid posttraumatic stress disorders (PTSD), dissociation and self-destructive behavior in 30 inpatients with a borderline personality disorder. A standardized interview for the assessment of PTSD, the Dissociative Experience Scale and the Symptom-checklist were administered. Results were compared to a control of inpatients with neurotic disorders matched for gender and age. Borderline patients showed significantly more childhood sexual and physical abuse as well as emotional neglect than the control patients. Of the borderline patients, 67% met criteria for PTSD and only 13% of the control group. Dissociative symptoms were significantly more frequent in borderline patients and predicted in combination with PTSD symptoms and self-destructive behavior. We discuss our findings with respect to their etiological and clinical significance and propose a model for self-destruction in borderline patients which focusses on dissociation and trauma.

Journal Article↗
PubMed1978

Chronic neurotic encopresis as a paradigm of a multifactorial psychiatric disorder.

Chronic neurotic encopresis (CNE), a childhood psychiatric disorder characterized by inappropriate fecal soiling, necessitated the formation of the following specific etiological factors: a) a neurologically immature developmental musculature, an organic condition which may complicate toilet training; b) premature or harsh toilet training; c) a family constellation in which the father is frequently absent and the mother erratic, emotionally inappropriate, and distant; d) the child's formation of a noncommunicative, passive, dependent personality. All of these factors are helpful in explaining the occurrence of CNE, which is thus seen as the result of a synergistic interaction among them. The complexity of etiological agents dictates a multifactorial rather than unicausal model of mental illness. Future research and tactics of psychotherapeutic intervention should focus on the interplay among these factors rather than attempting to single out one primary predisposing factor.

Central Nervous System↗
PubMed1984

Epidemiological and clinical research as a guide in the search for risk factors and biological markers.

One of the major events in psychiatric research in the last decade has been the firm establishment of the concept of biological markers and risk factors as legitimate signposts in the search for causes and pathogenetic mechanisms in mental disorders. However, to date, no single variable and no group of variables have been unequivocally identified as markers or risk factors, as far as the functional psychoses, or personality and neurotic disorders are concerned. The reasons for this state of affairs lie in the multifactorial nature of "idiopathic" psychiatric disorders, in persisting differences between the diagnostic criteria employed by various "schools", in the low statistical power of most research designs in biological psychiatry and in the lack of a general theory of cerebral and mental functioning which can yield testable hypotheses. Epidemiological methods, which had produced spectacular results in the past, are now rarely applied to narrow down the field of investigation where disease markers are most likely to be found. There are obvious similarities between the epidemiological strategy of risk factor identification and the biological strategy of disease marker research. A combination of these two strategies is more likely to advance the field than continued use of each singly. Schizophrenia research is an example of an area presenting interesting opportunities in this respect. The following priorities are suggested: development of a research classification of schizophrenia proceeding from well-defined sub-divisions of the phenotype; studies of the schizophrenia spectrum of disorders; search for populations with extremely high or extremely low incidence; studies of large pedigrees; further attempts to clarify the phenomenon of seasonal distribution of births of schizophrenia patients; studies on the occurrence of schizophrenic syndromes in association with other, well-defined diseases; search for early developmental precursors of the disorder; and subtyping of schizophrenia according to therapeutic response.

Epidemiologic Methods↗
PubMed1996

Neurotic and psychosomatic disorders (F4, F5). Results from the ICD-10 field trial of the Diagnostic Criteria for Research in German-speaking countries.

The concept of neurotic and psychosomatic disorders in ICD-10, chapter V (F), follows the principle of descriptive diagnosis; therefore the classical approaches with special regard to psychoanalytic terminology were abandoned. These changes were subject of a multicentric field trial in German speaking countries evaluating practicability, acceptability, feasibility, reliability and aspects of validity of the ICD-10 Diagnostic Criteria for Research: Involving 34 psychiatric, child-psychiatric and psychosomatic centres 17 video-documented cases with ICD-10 diagnoses from sections F4 and F5 were assessed independently in case conferences. On the basis of 1,116 ratings, acceptability and practicability were rated as comparatively sufficient. For 3-character diagnostic categories, the chance-corrected interrater reliability coefficients (kappa) showed a range from 0.62 to 0.95. The concordance with the independently assessed expert consensus diagnosis for the different cases showed a range between 87 and 100%.

Germany↗
PubMed1986

Symptom patterns and causes of somatization in men: II. Genetic and environmental independence from somatization in women.

The genetic and environmental antecedents of clinically distinct disorders leading to somatization were compared in 807 Swedish men and 859 Swedish women adopted at an early age by non-relatives. Asthenic somatization, the predominant form in men, was a neurotic disorder associated with a lower incidence of criminality in the somatizers' biological parents than in the biological parents of non-somatizers of either sex. In contrast, most female somatizers and a minority of men with diversiform somatization had disorders that were associated with a higher incidence of criminality in their biological parents than in other biological parents. Likewise, female somatizers, but not male somatizers, had an excess of alcoholic biological fathers when compared to other adoptees. In addition, different postnatal environmental background factors contributed to the risk for somatization in each sex. These findings support the distinctions among the different types of somatizers and show that the usual causes of somatization are fundamentally different in men and women. This illustrates the utility of the adoption paradigm in resolving genetic and environmental contributions to the familial aggregation of developmentally complex phenotypes.

Adoption↗
PubMed1983

Psychologic implications of the maltreated-child syndrome.

A retrospective investigation of 97 psychologically maltreated children showed a clear relationship between clinical symptoms and the intensity of the abuse. Parental neglect resulted in impairment of intellectual and locomotor development and emotional and behavioral disorders. Neurotic manifestations of regressive type appeared in nearly half the preadolescents who suffered severe psychological abuse. Children under 6 years of age presented functional symptoms, including regression in toilet training and sleep disorders secondary to inadequate mothering.

Adolescent↗
PubMed1991

[Psychological disorders in Ethiopian university students--problems in transcultural psychiatry].

In the course of the ten-year period 1979-1988 the authors subjected to psychiatric examination or hospitalized 52 Ethiopian university students. The authors were concerned with the problem whether in the development and character of the psychopathological symptoms factors of the different cultural environment participated. University students sent to Czechoslovakia are a specific group which is not representative of the Ethiopian population. This may be the reason why the revealed symptoms did not differ markedly from conditions in the local population. This applies in particular to neurotic disorders, among which the neurasthenic syndrome predominated. In 14 hospitalized students schizophrenia was diagnosed 6 times, endogenous depression 6 times and neurotic symptoms due to maladaptation twice. The schizophrenic attacks presented classical symptoms, after their regression there was however, complete remission and thus the original diagnosis was somewhat doubtful.

Adolescent↗
PubMed2001

Psychosomatic disorders in pediatrics.

Psychosomatic symptoms are by definition clinical symptoms with no underlying organic pathology. Common symptoms seen in pediatric age group include abdominal pain, headaches, chest pain, fatigue, limb pain, back pain, worry about health and difficulty breathing. These, more frequently seen symptoms should be differentiated from somatoform or neurotic disorders seen mainly in adults. The prevalence of psychosomatic complaints in children and adolescents has been reported to be between 10 and 25%. These symptoms are theorized to be a response to stress. Potential sources of stress in children and adolescents include schoolwork, family problems, peer pressure, chronic disease or disability in parents, family moves, psychiatric disorder in parents and poor coping abilities. Characteristics that favour psychosomatic basis for symptoms include vagueness of symptoms, varying intensity, inconsistent nature and pattern of symptoms, presence of multiple symptoms at the same time, chronic course with apparent good health, delay in seeking medical care, and lack of concern on the part of the patient. A thorough medical and psychosocial history and physical examination are the most valuable aspects of diagnostic evaluation. Organic etiology for the symptoms must be ruled out. Appropriate mental health consultation should be considered for further evaluation and treatment.

Abdominal Pain↗
PubMed1989

Person perception in children with conduct disorders.

In his object-relations theory, O. Kernberg discerns different levels of personality organization. From a structural point of view these are described with respect to the object-relations. So, according to Kernberg, the antisocial personality is more primitively organized (so-called borderline) than most patients with neurotic disorders, as manifested by his object-relations. We hypothesize that this also applies to children with conduct disorders in comparison with emotionally disturbed children. In this explorative study, we investigated whether suppositions concerning the object/self representations (i.e. the internal object-relations) of children with conduct disorders can be tested using a research method from empirical psychology. We chose the method of the free (written) description of persons, which in the psychology of social cognitions is used to study person perception. The results indicate that person perception (i.e. the conscious part of the object/self representations) in children with conduct disorders differs characteristically from that in a normal age- and intelligence-matched control group.

Acting Out↗
PubMed1984

Violence and psychosis. I. Risk of violence among psychotic men.

A survey of the records of 1241 men remanded in prison on criminal charges over four months yielded a high prevalence of psychiatric disorder. Of the total prison intake of 2743 men over the same period, 246 (9.0%) showed major symptoms of psychiatric illness and a further 237 (8.6%) symptoms of withdrawal from drugs or alcohol. Symptoms of neurotic disorders were underrecorded, so in terms of diagnosis 237 men (8.7%) were considered to be psychotic. Of these, 166 (70%) were schizophrenic. The influence of affective psychosis was small. The risk of violence among men with schizophrenia was high. Twenty five (9%) non-fatal personal assaults and 24 (21%) offences of damage to property were committed by men with schizophrenia. The presence of mental illness probably influences the decision to remand in custody for some of these offences, but this is unlikely to explain the substantially higher prevalence of schizophrenia among men convicted of homicide (five (11%) ) and arson (six (30%) ) than would be expected in the general population of Greater London (0.1-0.4%). The prevalence of schizophrenia among men convicted of homicide may even be an underestimate, as may the prevalence of affective psychosis and possibly of other psychiatric abnormalities, given the substantial incidence of concurrent suicide in such men.

Dangerous Behavior↗
PubMed2026

Metabolomic ageing across mental and behavioural disorders.

BACKGROUND: Individuals with mental disorders face excess morbidity and premature mortality. Accelerated ageing has been proposed as a contributing mechanism but population-scale evidence across diverse diagnoses is limited. OBJECTIVE: To examine whether metabolomic ageing differs across mental disorders and whether associations vary by sex, age group and genetic liability. METHODS: Using plasma metabolomic profiles from UK Biobank participants, we applied a metabolomic ageing clock (MileAge) to estimate disorder-specific differences between metabolite-predicted and chronological age. Mental disorders were ascertained from health records and self-reported physician diagnoses. We analysed nine diagnostic groups and 45 individual disorders and assessed sex and age group differences and associations with polygenic scores. FINDINGS: Among 225&#x2009;212 participants (54% female; mean age 56.97), 38&#x2009;524 had a diagnosis preceding baseline. Substance use, psychotic, affective and neurotic disorders were associated with a metabolite-predicted age older than chronological age, largest for psychosis (&#x3b2;=0.556, 95% CI 0.250 to 0.861, p<0.001). Obsessive-compulsive and eating disorders were associated with a metabolite-predicted age younger than chronological age. Several associations were stronger in males and in individuals aged <65 years. Higher genetic liability to depression, autism and attention-deficit/hyperactivity disorder predicted an older metabolomic age (&#x3b2; range=0.020&#x2009;to 0.047), whereas polygenic scores for psychosis and tobacco use disorder predicted a younger metabolomic age (&#x3b2; range=-0.023&#x2009;to -0.040). For obsessive-compulsive disorder and anorexia nervosa, clinical and genetic associations indicated younger metabolomic ageing. CONCLUSIONS: Metabolomic ageing in mental disorders is heterogeneous. While many disorders are associated with an older biological age, some are linked to a younger biological age. Divergence between genetic liability and clinical phenotypes suggests that non-genetic factors shape biological ageing differences. CLINICAL IMPLICATIONS: Biological age should not be assumed to uniformly exceed chronological age across mental disorders. Sex and age-specific approaches could improve understanding of biological ageing processes in psychiatry.

Humans↗
PubMed1983

Dysthymic disorder: psychopathology of proposed chronic depressive subtypes.

The author develops a nosologic framework for understanding the psychopathology of low-grade chronic depressions: 1) late-onset primary depressions with residual chronicity, 2) chronic secondary dysphorias, having a variable onset age and considered part of the symptomatic picture of nonaffective "neurotic" disorders or reactions to longstanding incapacitating medical diseases, and 3) early-onset characterologic depressions, which include a) character-spectrum disorders developing in the setting of tempestuous early object relationships and b) subaffective dysthymic disorders, conceptualized as genetically attenuated forms of primary affective illnesses. Differences in family history, REM latency, and pharmacologic responsiveness are presented in support of these distinctions. The author also proposes operational criteria to identify a thymoleptic-responsive subaffective dysthymic group.

Adult↗