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PubMed1970

[Dyslexia].

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Child↗
PubMed1982

Prevention of children's psychosocial disorders: myth and substance.

A critical appraisal of primary prevention of children's psychosocial disorderrs indicates that our knowledge on this topic is limited and that there are few interventions of proven value. Nevertheless, there are possibilities for effective prevention. Myths associated with unwarranted claims for the value of prevention are reviewed in terms of unproven assumptions that: (1) prevention cuts costs; (2) prevention in childhood will improve adult health; (3) improved living standards will reduce mental illness; (4) sensible interventions can only be beneficial; (5) providing people with information leads to preventive action; (6) the main issue in prevention is implementing what we know; (7) the best approach is to tackle the basic cause; and (8) the crucial issue is to identify that one basic cause. Principles of causation are discussed and a model of causative influences is used to consider potentially effective primary prevention policies with respect to those directed at (a) individual predisposition; (b) ecologic factors; (c) influences on opportunity and situation; and (d) current stresses and strengths. It is concluded that a good deal is known about risk factors and the areas in which primary prevention might be effective, but that less is known concerning precisely how to intervene in orde to bring about the desired results. There is a potential for effective primary prevention but, so far, it remains largely unrealized.

Adolescent↗
PubMed1978

[Psychic disturbance in normal pressure hydrocephalus (author's transl)].

After reviewing the literature on psychic disturbance in normal pressure hydrocephalus, the author reports on 26 cases of CSF drainage. Impairment of memory and concentration were always present in normal pressure hydrocephalus; behaviour disorders were very frequent and characterized by both types of frontal behaviour; the mental picture also comprised difficulties of calculation, writing, visuoconstructive praxis and, less frequently, impaired speech and reading ability. CSF drainage brought clinical improvement in 73% of the cases. Disorders of consciousness, mental function and behaviour regressed generally progressively as soon as the operation had been performed. Two major factors affecting therapeutic efficacity appear to be the patient's age and the length of time between onset of the symptoms and start of therapy.

Adolescent↗
PubMed1997

Symptomatological characteristics distinguish between frontotemporal dementia and vascular dementia with a dominant frontal lobe syndrome.

OBJECTIVE: Our hypothesis was that patients with vascular dementia and a dominating frontal lobe syndrome have a symptomatology that reflects a more widespread lesion compared with patients with frontotemporal dementia. DESIGN: Patients with vascular dementia and a dominating frontal lobe syndrome (VAD-F; N = 11) were compared with regard to clinical symptoms and imaging features on CT scans of the brain with patients with frontotemporal dementia (FTD; N = 21). SETTING: A neuropsychiatric diagnostic ward. PATIENTS: Thirty-two inpatients, aged 48-78 years, with frontotemporal dementia or vascular dementia. MEASURES: Relatives were questioned about the initial symptoms. At the clinical investigation, mental and neurological symptoms and signs were recorded using the STEP method (stepwise comparative status analysis). CT scan features of the brain were evaluated by a trained neuroradiologist. The GBS-i (Gottfries-Bråne-Steen, intellectual variables) scale was used to measure the degree of dementia. RESULTS: At the onset of dementia, loss of memory (p < 0.001), sudden onset (p < 0.001), confusion (p < 0.05) and unspecified neurological signs (p < 0.05) had been significantly more frequent in the VAD-F group. At the time of the clinical investigation, lack of social awareness and presence of primitive reflexes were more frequent in the FTD group (p < 0.01 and p < 0.05, respectively) and visuospatial deficits more frequent in the VAD-F group (p < 0.05). CT of the brain showed that, apart from brain infarcts (present only in the VAD-F group), paraventricular leukoaraiosis was significantly more pronounced in the VAD-F group (p < 0.05). The groups did not differ with respect to age, age at onset or level of dementia. CONCLUSION: The findings support our hypothesis.

Age of Onset↗
PubMed2006

[Socio-emotional problems among hearing-impaired children--initial results of the German version of the Strengths and Difficulties Questionnaire (SDQ-D)].

OBJECTIVES: Many studies demonstrate the precariousness of hearing-impaired children's socio-emotional development and bring home the necessity of early and reliable diagnosis. The German version of the Strengths and Difficulties Questionnaire (SDQ-D) is a fairly new screening procedure examined here with a view to its usefulness in diagnosing hearing-impaired children. METHODS: The SDQ-D parent version was completed by 213 mothers and 213 fathers of hearing-impaired children within their families as part of a larger study on familial socialisation. The procedure's factorial structure and measurement accuracy were tested, and the prevalence rate of emotional and behavioural disorders was determined in comparison to the German standardization sample (Woerner et al., 2002a) in the context of other variables (age, sex, communicative competence, educational status). RESULTS: With the exception of the "Behaviour Disorders" scale, the SDQ-D factorial structure can be reproduced in a satisfactory manner. The same can be said for its measurement accuracy. The prevalence of behaviour disorders under the condition "Hearing Impairment" is clearly higher on almost all scales, as well as for the total problem score. Special attention should be paid to the scores in the fields "Emotional Problems" and "Peer Problems" because of their significant correlation to the children's age. CONCLUSIONS: The SDQ-D provides a valid yet economical screening procedure which can also be applied in the diagnosis of hearing-impaired children; children whose psychological development is especially endangered at an early age can be identified and referred for a more exact diagnosis and continuing counselling and therapy.

Affective Symptoms↗
PubMed1990

Dementia and depression in elders with mental retardation: a pilot study.

A preliminary investigation of cognitive decline and depressive symptomatology is presented with older adults who have mental retardation. A series of different assessment instruments are reviewed and tested in a pilot study. A review of dementia and depression with respect to elders with mental retardation is presented to place the study in perspective. Findings reveal decreasing cognitive ability is associated with higher rates of observed depression and reported behavioral problems. Trends suggested those more elderly displayed more depressive behaviors, psychotropic medication was a common treatment, and cognitive decline was associated with lower initial intellectual levels. Dementia and depression is a complicated symptom complex to identify in aging adults with mental retardation.

Activities of Daily Living↗
PubMed1980

Psychosocial and psychosomatic diagnoses in primary care of children.

In this study in seven primary care facilities the proportion of children recognized as having behavioral, educational, or social problems was much higher than generally assumed. Although there was great variability among the facilities, at least 5% and as many as 15% of children seen in one year were diagnosed as having these problems in all but the hospital teaching facilities. The prevalence was even higher among children from poor families. The variability among facilities was much less for psychosomatic problems, which were diagnosed in 8% to 10% of the children. For both psychosocial and psychosomatic types of problems, but especially for psychosocial ones, the proportion of visits with the diagnoses was much lower than the proportion of children with them, so that these problems engendered fewer visits for their management than might have been expected from their frequency in the population. However, available evidence suggests that individuals with unresolved psychosocial problems make more than their share of visits for other diagnoses. The findings of this study have implications for the content of educational programs for primary care practitioners, for the organization of primary care practice, and for the current debate over policy concerning reimbursement and benefit packages.

Adolescent↗
PubMed1973

Psychiatric nurse as therapist.

Under supervision five nurse-therapists have treated phobic patients as successfully as have psychiatrists and psychologists using similar psychological treatments in comparable psychiatric populations. Nurses have also had good results in other neurotic disorders. Intensive training is required. Nurse-therapists find their work rewarding, but the present Salmon gradings make no provision for their advancement should they retain their clinical function. Results suggest that the use of selected psychiatric nurses as skilled therapists can ease the current critical shortage of treatment personnel in psychiatry.

Abreaction↗
PubMed2000

The impact of dental anxiety on daily living.

AIM: To explore the impact of dental anxiety on daily living. METHOD: Twenty people attending a dental sedation clinic completed the Modified Dental Anxiety Scale, and were interviewed privately using a reflexive, in-depth technique. All interviews were audio-tape recorded and transcribed. The transcripts were analysed to identify the impact of dental anxiety upon the participants' daily lives. Twenty-five per cent of the qualitative data was reviewed by an independent researcher to ensure the reliability of the analysis. RESULTS: The mean age of participants was 41 years (range 23 to 60). The mean MDAS score was 21.5 (range 14 to 25). Five main impacts of dental anxiety were identified: physiological; cognitive; behavioural; health; and social. Subsumed under these broad categories were: the fright response; a vast array of negative thoughts, feelings and fears; avoidance behaviour and behaviours related to eating, oral hygiene, and self-medication; and other manifestations of anxiety in the dental environment including muscular tension, crying and aggression were all identified. Dental anxiety was also found to disturb sleep and to have a profound affect socially, interfering with work and personal relationships. CONCLUSION: The impact that dental anxiety can have on people's lives is wide-ranging and dynamic.

Activities of Daily Living↗
PubMed1992

Development of conduct problems and peer rejection in preschool children: a social systems analysis.

The development of impulsive-aggressive problem behavior and peer rejection was examined in sixty 4- to 5-year-old boys from low-income family backgrounds. Children's sociometric status and behavioral adjustment were assessed longitudinally at the beginning and end of the preschool year, and related to measures of peer interaction at three different points in time. Boys identified as socially rejected and aggressive in the beginning of the year were highly likely to be identified as such at the end of the year. Early in the preschool year, these children contributed to their own rejection by initiating socially aversive exchanges with peers. Although peers clearly perceived these problems, they did not reciprocate with counteraggression at first. However, as time passed, peers began to actively victimize these children, and most of the aggression on the part of victims became reactive in nature. Thus, the current findings strongly support a transactional model of the development of early peer rejection and conduct problems.

Aggression↗