Adolescents In Middle-income Countries Research Articles

Irritability in an open-door pediatric psychiatric emergency service in a middle-income country

BackgroundIrritability is a main reason for referral of a child to a pediatric emergency. Few psychiatric services are dedicated to care for children and adolescents in middle income countries. Thus, there is not a clear picture about the real needs of an emergency unit to optimize the service's demands. This study aims to describe a sociodemographic profile of children and adolescents in a psychiatric emergency service due to complaints of irritability. MethodsIn total, 2,255 medical records were reviewed from patients referred within a year at an emergency department of a mental health service for children and adolescents. Patients with and without irritability were compared in terms of sociodemographic features, psychiatric complaints and associated somatic and psychiatric disorders. ResultsAbout 30% of youths attending at this service had irritability. Most were boys (67%) with an average age of 12.6 years (±3.9). Irritability was associated with a diagnosis of mood disorder, attention deficit hyperactivity disorder and oppositional defiant disorder. LimitationsThere are concerns about the setting in which data was collected, since it might have some time restrictions and data imprecision. ConclusionIrritability was a frequent complaint taking children and adolescents to the emergency department. This symptom co-occurs with several psychiatric disorders. These findings support the trans-nosographic view of irritability, in particular its co-occurrence with neurodevelopmental disorders.

Associations of changes in BMI and body fat percentage with demographic and socioeconomic factors: the ELANA middle school cohort.

Adolescent weight and fat gain is determined by multiple factors. This study examined the association between changes in body fat indicators, excessive weight and fat gain, and sociodemographic factors among Brazilian adolescents over a 4-year period. Body mass index (BMI) and body fat percentage (BFP) of 809 middle school students (mean age: 11.8 ± 1.15 years) were evaluated annually, from 2010 to 2013. Linear mixed effects models were used to assess the trajectories of BMI and BFP in both boys and girls according to the type of school attended (public or private) and skin colour. General estimating equations logistic regression analyses were performed to investigate associations between sociodemographic variables and the development of overweight or high BFP. Girls from private schools (p = 0.003) and white boys (p = 0.041) experienced bigger increases in BMI, as compared to girls from public schools and black/brown boys, respectively. White boys also had an increased chance of presenting excessive weight (OR = 3.28; CI 95%: 1.13-9.52) and BFP (OR = 3.32; CI 95%: 1.38-8.01) gain than black/brown boys. Conversely, white girls were less likely to present excessive body fat gain when compared to black/brown girls (OR = 0.42; CI 95%: 0.18-0.96). Adolescents who experienced better socioeconomic conditions, especially boys, were more likely to have greater increases in body fat indicators. Our findings contribute to the better understanding of BMI trajectories and body composition changes during puberty, as well as demonstrates the relationship between socioeconomic variables and adiposity indicators among adolescents in middle-income countries.