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PubMed2002

[Children aged 0-3 years referred to child psychiatric department. A descriptive epidemiological study].

INTRODUCTION: In a Danish register study the incidence of children aged 0-3 years referred to child psychiatric services in Denmark increased by 30% during 1996-1998. The objective of this study was to further describe 0-3 year-old children referred to child psychiatric departments with a view to distribution of diagnoses, age, sex, and parental mental illness. MATERIAL AND METHODS: Children 0-3 years of age referred to child psychiatric departments in the County of Copenhagen in 1998 and 1999 were described on the basis of the clinical database and hospital records. RESULTS: A total of 159 children were admitted over a two-year period corresponding to an incidence of 0.4%. The ratio boys: girls were 1.3:1. However, with regard to pervasive developmental disorders boys dominated 6:1. Among girls, eating disorders were dominating in the youngest children with ratio girls: boys 5:2. Pervasive developmental disorders were the most common diagnoses in children aged 2-3 years, and the overall incidence of this diagnosis was 0.25 per 1000 per year. The most common diagnosis of the youngest children was Z-diagnoses, and most often these children had mentally ill parents. Attachment disorders, eating disorders, and adjustment reactions were common diagnoses in children with mentally ill parents, but more than half of these children did not have any diagnosis at all. DISCUSSION: The incidence of children with pervasive developmental disorder was found twice as high as observed in a register study covering referrals of children aged 0-3 years from all psychiatric departments in Denmark during 1996-1998. Reactive attachment disorder, eating and adjustment disorder, and Z-diagnosis are the most common diagnoses in the youngest children, and most often these children have mentally ill parents.

Child Development Disorders, Pervasive↗
PubMed2005

Autonomic dysfunction in children with sleep-disordered breathing.

STUDY OBJECTIVES: To measure sympathetic responses in children with and without sleep-disordered breathing. DESIGN: Prospective, observational study. SETTING: Kosair Children's Hospital Sleep Medicine and Apnea Center. PARTICIPANTS: Subjects were prospectively recruited from children undergoing overnight polysomnographic assessments and were retrospectively grouped according to the results of the polysomnogram. Sleep-disordered breathing was defined as an apnea-hypopnea index >5 and children were assigned to the control group if their apnea-hypopnea index was < 1. INTERVENTION: N/A. MEASUREMENTS AND RESULTS: During quiet wakefulness, pulse arterial tonometry was used to assess changes in sympathetic activity following vital capacity sighs in 28 children with sleep-disordered breathing and 29 controls. Each child underwent a series of 3 sighs, and the average maximal pulse arterial tonometry signal attenuation was calculated. Further, a cold pressor test was conducted in a subset of 14 children with sleep-disordered breathing and 14 controls. The left hand was immersed in ice cold water for 30 seconds while right-hand pulse arterial tonometry signal was continuously monitored during immersion and 20-minute recovery periods. Signal amplitude changes were expressed as percentage change from corresponding baseline. RESULTS: The magnitude of sympathetic discharge-induced attenuation of pulse arterial tonometry signal was significantly increased in children with sleep-disordered breathing during sigh maneuvers (74.1% +/- 10.7% change compared with 59.2% +/- 13.2% change in controls; P<.0001) and the cold pressor test (83.5% +/- 7.3% change compared with 74.1% +/- 11.4% change in controls; P=.039). Further, recovery kinetics in control children were faster than those of children with sleep-disordered breathing. CONCLUSION: Children with sleep-disordered breathing have altered autonomic nervous system regulation as evidenced by increased sympathetic vascular reactivity during wakefulness.

Adolescent↗
PubMed1984

Outpatient management of the suicidal child.

Susceptible children may become depressed and suicidal in response to stressful social factors including loss or separation from parents, parental abuse, neglect, rejection, pressure, or a chaotic, disorganized family environment. Psychological factors that predispose children to suicidal behavior include inadequate ego-defenses to cope with feelings engendered by the adverse environmental circumstances. Often these children relate poorly to others and are excessively dependent. Outpatient management is possible if the parents are able to be appropriately supportive and protective. Intensive psychotherapy is often necessary to modify a basic depressive outlook on life and to resolve inner conflict about self-worth. The suicidal child must be helped to give up perfectionistic attitudes and to alter aggressive responses to loss and disappointment. Work with parents is important, particularly when the child's suicidal state is reactive to inappropriate parental behavior. Antidepressant drugs may prove to be a useful adjunct.

Child↗
PubMed1989

Reliability and reactivity of self-recording by preschool children.

Reliability and reactivity are two important aspects of self-recording which have been studied in school-age children and adults. Little research on reliability and reactivity of self-recording by preschool children is available. The reliability of preschool children as recorders of their own behavior and whether reactive changes (or increases in behavior) occurred as a result of self-monitoring were evaluated. Two types of training in self-monitoring (didactic instruction vs guided practice) were received by two independent groups of 6 preschool children. Reliable self-recording for children ages 4 through 5 was not attained. Reactive changes in the recorded behavior were not observed.

Awareness↗
PubMed1982

The pattern of reactivated fetal erythropoiesis in bone marrow disorders of childhood.

The expression of fetal characteristics of erythropoiesis (haemoglobin F concentration, haemoglobin A2 concentration, haemoglobin F cells, globin chain synthesis, carboanhydrase isoenzyme B, hexokinase isoenzymes, erythrocyte membrane antigens of the iI- and the ABH-system) was examined in red cells of twelve patients with different bone marrow disorders (juvenile chronic myeloid leukaemia (JCML), erythroleukaemia (EL), acute myelogenous leukaemia (AML), aplastic anaemia (AA) and Diamond-Blackfan anaemia (DB)). In JCML and EL all red cell parameters studied appeared to be fetal including the distribution of hexokinase isoenzymes. No fetal signs could be found in red cells of patients with AML. In two patients with DB who were treated by transfusion no fetal erythropoiesis could be detected. In one patient with DB under cortisone treatment i-antigen, ABH-antigens, haemoglobin F concentration, globin chain synthesis and hexokinase isoenzyme distribution were of the fetal or mixed type. In patients with AA only slight elevations of haemoglobin F were detectable. The nearly total reversion to fetal erythropoiesis in JCML and EL seems to be a part of the disorder itself, whereas in the other disorders the reactivation of fetal erythropoiesis could be the result of an erythropoietic stress.

Adolescent↗
PubMed1991

Mortality and morbidity from respiratory diseases in childhood in The Netherlands, 1980-1987.

National mortality and hospitalization data from the Netherlands were analysed for asthma (International Classification of Diseases) (ICD 493), acute bronchi(oli)tis (ICD 466), pneumonia and influenza (ICD 480-487), and other chronic obstructive pulmonary diseases (ICD 490 + 491 + 492 + 496) in children aged 0-14 yrs for 1980-1987. No trends were seen in the mortality in age groups 0-4 yrs and 5-14 yrs, which actually concerned small numbers. In general a tendency towards increasing hospital admission rates for respiratory diseases was observed in both sexes in age groups 0-4 yrs and 5-9 yrs but not in age group 10-14 yrs, and significant increases were found for asthma in males and females aged 0-4 yrs and in males aged 5-9 yrs, and for acute bronchitis in females aged 5-9 yrs. Hospital admission rates in the Netherlands for asthma appeared to be low compared to other countries. The average length of stay, however, for both asthma and the other respiratory diseases was substantial though declining. Clinical information is required on possible causal factors of the apparent need for hospitalization for reactive airway disorders in young children, and on the management of asthma in particular.

Adolescent↗
PubMed1986

Antibodies to peptidoglycan in juvenile onset ankylosing spondylitis and pauciarticular onset juvenile arthritis associated with chronic iridocyclitis.

Using an indirect enzyme linked immunosorbent assay, antibodies of the IgG class to Streptococcus pyogenes group A peptidoglycan-polysaccharide polymers (PG-GSP) were measured in the sera of 37 patients with juvenile onset ankylosing spondylitis (JAS), 22 with pauciarticular onset juvenile arthritis associated with chronic iridocyclitis and 20 healthy children. Mean antibody activity, measured in arbitrary units, was of 184 U in JAS and 250 U in chronic iridocyclitis (p = NS). The results in both groups differed significantly from those found in healthy children (p less than 0.001 and p less than 0.01, respectively). This suggests either a possible role of bacterial cell wall products in the pathogenesis of these disorders or a state of immune reactivity to PG-GSP in these children.

Antibodies↗
PubMedDate not supplied

[The cortical reactions during sensory and motor activities in healthy children and adults and in depression patients].

Studying the visual perception by means of EP recording in the visual and motor cortical areas and cortical reactions during hand movements revealed resemblance of these reactions in children to those in patients with endogenous (cyclophrenia and low-progredient schizophrenia) depressive disorders. In perception, the latency of the early and middle EP components was reduced. An increase in reactivity of the right hemisphere and ipsilateral reactions were induced by the movement.

Adult↗
PubMed1993

[Temperament, psychological development and psychopathology. Correlations, explanatory models and forms of intervention].

A return to temperamental concepts characterizes contemporary child psychology in the United States. The word "temperament" refers to early developing differences in reactivity and behavioral style. Temperament research focuses on the origins, the stability, the dimensionality and the psychopathological significance of such differences. This article especially emphasizes the latter. Associations between temperament and psychopathology are noted. Chess' and Thomas' goodness of fit-model is presented as an explanatory model for these associations. According to this model, behavior disorders result from an incompatibility between the normal variations of child and environment. The applicability of this model in clinical and educational settings is then outlined. Finally, the author considers the contribution of temperament research to established paradigms in developmental psychopathology.

Child↗
PubMed2004

Increased oxidative stress and altered activities of erythrocyte free radical scavenging enzymes in autism.

There is great evidence in recent years that oxygen free radicals play an important role in the pathophysiology of many neuropsychiatric disorders. The present study was performed to assess the changes in red blood cells thiobarbituric acid-reactive substances (TBARS) levels, and superoxide dismutase (SOD), catalase (CAT), adenosine deaminase (ADA) and xanthine oxidase (XO) activities in patients with autism (n = 27) compared to age- and sex-matched normal controls (n = 26). In the autistic group, increased TBARS levels (p < 0.001) and XO (p < 0.001) and SOD (p < 0.001) activity, decreased CAT (p < 0.001) activity and unchanged ADA activity were detected. It is proposed that antioxidant status may be changed in autism and this new situation may induce lipid peroxidation. These findings indicated a possible role of increased oxidative stress and altered enzymatic antioxidants, both of which may be relevant to the pathophysiology of autism.

Adenosine Deaminase↗
PubMed1998

Myasthenia gravis with alopecia totalis.

Myasthenia gravis was diagnosed on the basis of a positive Tensilon test in a 4-year-old male child with alopecia totalis. His scalp hair and eyebrows had began to disappear at the age of 10 months. No other physical abnormalities such as motor paralysis, were seen except for left ptosis and alopecia totalis. His serum titer of anti-acetylcholine receptor antibody was elevated. No immune system abnormalities (C3, C4, CH50, C-reactive protein, antinuclear antibody or lymphocyte function disorders) were detected. Although alopecia areata and alopecia totalis are sometimes present in adults with autoimmune diseases and myasthenia gravis, this association is rare in children. The present case represents the youngest patient with myasthenia gravis associated with alopecia totalis.

Alopecia↗
PubMedDate not supplied

Acute juvenile pityriasis rubra pilaris: a superantigen mediated disease?

Juvenile acute pityriasis rubra pilaris (JAPRP) is a form of pityriasis rubra pilaris (PRP) with particular clinical characteristics and course. It is usually preceded by an infectious condition. We report a boy, initially thought to have Kawasaki disease, and subsequently diagnosed as having JAPRP, who made a satisfactory recovery. In this case, prior antibiotic treatment made it impossible to show the presence of any microorganism. However, the clinical characteristics of these patients and the similarities with other disorders involving the skin that are mediated by superantigens led us to think that these antigens may be involved in the development of this disease. Also, in view of the obvious differences between JAPRP and the other PRP, we suggest that, in the future this disorder may be considered a separate entity as a reactive exanthem.

Acute Disease↗
PubMedDate not supplied

Protean manifestations of mitochondrial diseases: a minireview.

PURPOSE: Mitochondrial abnormalities are major causes of human disease. Pearson syndrome illustrates many features of abnormal mitochondrial function and genetics. DESIGN: Mitochondria from adenosine triphosphate (ATP) via five multienzyme complexes of the electron transport chain and oxidative phosphorylation, composed from a blend of nuclear and mitochondrial gene products. Mitochondrial DNA (mtDNA) is small (16.6 kb), encoding some subunits of these complexes as well as transfer RNA (tRNA) and ribosomal RNA, but is replicated and transcribed by nuclear encoded polymerases. Multiple copies of mtDNA are passed on to progeny cells via the cytoplasm, accounting for maternal inheritance. Normal and mutant mtDNA can coexist within the same cell (heteroplasmy); when the proportion of mutant mtDNA exceeds a threshold, cellular function is impaired, resulting in disease. RESULTS AND CONCLUSIONS: MtDNA abnormalities include point mutations, deletions, and depletion. Point mutations in an enzyme subunit cause a specific disorder, whereas point mutations in the tRNAs result in general impairment of protein synthesis and are associated with a variety of disorders. Large mtDNA deletions, initially described in Kearns-Sayre syndrome (KSS), were found soon thereafter in Pearson syndrome. Survivors of Pearson syndrome have gone on to develop KSS. A whole spectrum of disease forms, ranging from isolated sideroblastic anemia to combined Pearson and KSS, are associated with deletions of mtDNA. Diagnosis of mitochondrial disorders depends on clinical suspicion, enhanced by evidence of abnormal mitochondrial structure, number, and/or function. Effective treatment for mitochondrial disorders is very limited, including correction of the metabolic milieu, activation of enzyme activity by drugs or cofactors, and removal of reactive oxygen species.

Child↗
PubMed2006

Reaction to background stimulation of preschool children who do and do not stutter.

UNLABELLED: This study investigated the maintenance of attention and adaptation to background stimuli of preschool children who do (CWS) and do not stutter (CWNS). Participants were 13 monolingual, Standard American English speaking, 3-5-year-old CWS and 14 CWNS. Results indicated that CWS were significantly more apt than CWNS to attend to or look at changes in background stimuli, although there were no significant differences between groups in duration and latency of these looks. Findings suggest that preschool CWS are more reactive to, distracted by, and slower to adapt and habituate to environmental stimuli than their CWNS counterparts. LEARNING OUTCOMES: The reader should be able to: (1) recognize the temperamental differences between CWS and CWNS, (2) define attention reactivity and regulation, (3) explain how attention reactivity and regulation are associated with preschool stuttering, and (4) understand recent empirical evidence relating reactivity and regulation to preschool stuttering.

Attention↗