Family Environmental Factors Research Articles

7956 Assessing Factors Influencing Polycystic Ovarian Syndrome Using Hybrid Multi-Criteria Decision Analysis

Abstract Disclosure: N.B. Trivedi: None. J. Amin: None. M. Patel: None. S. Patel: None. P. Rana: None. A. Rajani: None. V. Dave: None. Polycystic Ovarian Syndrome (PCOS) is a complex hormonal disorder having multifactorial origins. This study aims to apply Multi-Criteria Decision Analysis (MCDA) methods like Decision Making Trial and Evaluation Laboratory (DEMATEL) and Analytical Hierarchy Process (AHP) to prioritize factors influencing PCOS. In our study, 10 criteria impacting PCOS were identified through extensive literature review. AHP and DEMATEL were used via matrices, assessed by 13 experts. AHP determined relative importance/weights while DEMATEL assessed interconnectedness among criteria. AHP revealed that family history held the highest weight (0.22) while Insulin resistance held the lowest weight at 0.04. The results obtained from DEMATEL indicated that factors like obesity, insulin resistance, diet, psychological stress and sedentary lifestyle displayed higher D+R values, suggesting a strong influence on other factors; indicating their significant impact on the syndrome. The division of criteria into cause and effect groups based on D-R values revealed that family history, environmental factors, diet, sedentary lifestyle and psychological stress appear to be causative and sleep disturbances, low-grade inflammation, excess androgen and insulin resistance seem to be the consequences of PCOS. In AHP the criteria are treated as being independent to each other and their hierarchal order is determined. However, in realistic scenarios factors may have some sort of interdependency/relationship with one another. To identify that interdependency which AHP fails to focus on, DEMATEL was used. DEMATEL ensues that Insulin resistance along with obesity, sedentary lifestyle, and psychological stress show strong level of influence and interconnectedness, indicating a significant impact on the syndrome. However, insulin resistance, when treated as an independent criterion in AHP, displays lower weightage. In the end, improved PCOD treatment would come from targeted interventions and strategies that centre on the variables with a higher D+R value. When the criteria were considered independent of each other in AHP, highest weight is conferred to family history (despite of it having moderately low level of influence/interconnectedness on other criteria as ensued from DEMATEL) thus prompting more research in the direction of investigating genetic and familial factors associated with PCOS. This could consequently lead to early diagnosis and effective long term management. The combined methodology (DEMATEL+AHP) ensures comprehensive assessment of PCOS factors. Previous studies might have focused on individual factors separately or failed to adequately explore their interrelationships and relative importance. MCDA can be further employed in healthcare to assess conflicting treatment modalities, risk factors etc. for other multifactorial disorders. Presentation: 6/2/2024

The cumulative impact of clinical risk on brain networks and associations with executive function impairments in adolescents with congenital heart disease.

Patients with congenital heart disease (CHD) demonstrate altered structural brain network connectivity. However, there is large variability between reported results and little information is available to identify those patients at highest risk for brain alterations. Thus, we aimed to investigate if network connectivity measures were associated with the individual patient's cumulative load of clinical risk factors and with family-environmental factors in a cohort of adolescents with CHD. Further, we investigated associations with executive function impairments. In 53 adolescents with CHD who underwent open-heart surgery during infancy, and 75 healthy controls, diffusion magnetic resonance imaging and neuropsychological assessment was conducted at a mean age of 13.2 ± 1.3 years. Structural connectomes were constructed using constrained spherical deconvolution tractography. Graph theory and network-based statistics were applied to investigate network connectivity measures. A cumulative clinical risk (CCR) score was built by summing up binary risk factors (neonatal, cardiac, neurologic) based on clinically relevant thresholds. The role of family-environmental factors (parental education, parental mental health, and family function) was investigated. An age-adjusted executive function summary score was built from nine neuropsychological tests. While network integration and segregation were preserved in adolescents with CHD, they showed lower edge strength in a dense subnetwork. A higher CCR score was associated with lower network segregation, edge strength, and executive function performance. Edge strength was particularly reduced in a subnetwork including inter-frontal and fronto-parietal-thalamic connections. There was no association with family-environmental factors. Poorer executive functioning was associated with lower network integration and segregation. We demonstrated evidence for alterations of network connectivity strength in adolescents with CHD - particularly in those patients who face a cumulative exposure to multiple clinical risk factors over time. Quantifying the cumulative load of risk early in life may help to better predict trajectories of brain development in order to identify and support the most vulnerable patients as early as possible.

Family relationships and environmental factors of children in social vulnerability

This study sought to analyze the dynamics of family relationships and environmental factors in children in situations of social vulnerability and violence served by an educational institution. This is a descriptive-exploratory study, with eight families served by a non-governmental institution located in a municipality in the Southern Region of Brazil. Semi-structured interviews were applied to fathers, mothers and/or guardians for the analysis of the Comprehensive Assessment Synthesis Instruments (ISAC). The results showed averages close to 3.0 (from 1 to 5) in ISAC, which conceives situations in which there are strengths, but also vulnerabilities in families, especially socioeconomic factors. It was also identified difficulty in accessing health services, education, employment and adequate food. Therefore, health promotion actions should be encouraged, seeking to develop a culture of peace, reduce vulnerabilities and strengthen support networks.

Olfactory performance and odor liking are negatively associated with food neophobia in children aged between 3 and 9 years

BackgroundChild food neophobia, i.e., rejection or avoidance of novel foods at a young age, is a prevalent nutrition problem that affects the quality of children’s diet and impedes the development of healthy food preferences. Sensory sensitivity can relate to the degree of food neophobia, but previous studies rarely focused on the olfactory component of this problem in children.ObjectiveWe aimed to thoroughly examine the relationship between various aspects of olfactory sensitivity and food neophobia in children.Methods246 children aged between three and nine years took part in a food neophobia assessment as well as in a comprehensive, psychophysical olfactory testing.ResultsWe found that certain smell perception aspects such as lower odor liking, poorer odor identification ability as well as lower sensitivity to an unknown non-food odor all significantly predicted higher food neophobia in children. Among individual characteristics of either a child or a caregiver, only the child’s age significantly and positively predicted food neophobia. The exploratory model looking into the role of family environment factors predicting self-reported food neophobia in children revealed that food neophobia was associated with lower control given to a child in this child’s feeding process, as well as with a more frequent use of food as a reward in feeding.ConclusionsWe suggest that suppressed olfactory perception and performance can play a unique role in child nutritional difficulties. The study inspires further considerations of olfaction-engaging interventions to counteract food-neophobia in children.

Kebijakan Hukum Dalam Menghadapi Lesbian, Gay, Biseksual dan Transgender (LGBT) Sebagai Suatu Penyimpangan Perilaku di Indonesia

Deviant behavior in the form of Lesbian, Gay, Bisexual and Transgender (LGBT) seems unavoidable. This behavior can target children, teenagers and even adults. With this phenomenon, it has negative impacts on community life. The problem is getting stronger when the phenomenon is published through social media and television shows. At least there are perpetrators of LGBT couples and other LGBT actions in Indonesia. This study uses a research method that is a normative legal research type. In normative legal research, the data used is secondary data. The secondary data contains primary legal materials, secondary legal materials and tertiary legal materials. Then the materials that have been collected are analyzed using a statute approach and a case approach. This study answers a problem, namely first. The implications of LGBT behavioral deviations in Indonesia can have an impact on the health, social, education and security of the Indonesian state. The factors can be caused by internal factors originating from oneself and the family environment and external factors originating from the external environment and social media and television or community groups and second. In the provisions of the existing laws and regulations, there are limits for LGBT, although they are not regulated concretely and explicitly, and future regulations will regulate deviant behavior for LGBT groups who intentionally commit sexual harassment in public, but there is still a need for comprehensive regulations that regulate LGBT.

Physical activity and depression during the COVID-19 pandemic in Australia: A twin study

Background and aimsLow levels of physical activity (PA) have been associated with depression. However, shared familial (genetic and environmental) factors might confound this association, given PA and depression tend to cluster in families. We investigated the association between levels of PA and depression symptoms during the COVID-19 pandemic, and then controlled for shared familial factors by design, and assessed if being in lockdown modified this association. MethodsWe applied within-individual and within-pair regression models to questionnaire data from adult same-sex twin pair members of Twins Research Australia collected between August and November 2020. Depression score was measured using the Depression, Anxiety and Stress Scale (DASS-21), and PA levels and changes since the onset of the pandemic were self-reported. Adjusted models included body-mass-index, sleep adequacy, smoking, and alcohol consumption. ResultsThe sample of 1148 twins was predominantly female (80%) and had a mean age of 52.5 (Standard Deviation = 15.7). Reduced PA was associated with higher depression scores (β = 1.22, 95% Confidence Interval: 0.70–1.73, P < 0.001) in the adjusted within-individual model, but evidence of a within-pair association was weak. Lockdown status was an effect modifier (P = 0.006); relative to the co-twin, increased PA was associated with lower depression scores for those not in lockdown but higher scores for those in lockdown. ConclusionShared familial factors play a role in the association between PA and depression. Health interventions and educational campaigns for families rather than just individuals might be better suited to improve mental health outcomes, especially when opportunities for PA and exercise are limited.

Program Everyday Untuk Mengembangkan Akhlak Mulia Anak Usia 5-6 Tahun

The everyday program is one of the habituation programs that is carried out every day to develop children's noble character but, in its implementation there are still some children who do not concentrate, play, and talk to themselves. The purpose of the research is to describe, find out the inhibiting and encouraging factors, and find out the impact of the everyday program to develop noble morals. The method used is qualitative with a case study approach. The results of this study concluded that the description of the everyday program is a program of habituation to read short letters in tartil interspersed with the cultivation of morning aqidah which aims to make children have a basic Islamic religion and recognize short letters from an early age. This program is a superior activity that is supported by the safari dhuha program, the Friday clean program, and environmental love activities. Supporting factors of this program include educators, evaluation, reward and punishment, motivation, follow-up, and infrastructure. While the inhibiting factors include the community environment, family environment, and internal factors. The impact of the everyday program is to increase love for the Qur'an, increase the skill of reading the Qur'an, especially in tajweed, increase faith in Allah SWT by worshiping, and have an impact on noble character because children are always accustomed to doing good things such as attitude, speech, and actions so that they can make good traits and character for children.

Pengaruh Moderasi Beragama Terhadap Prilaku Keagamaan Generasi Z

The role of religious moderation is very important in the school environment, because school is the place where students spend most of their time and receive a lot of influence from peers and teachers. In a multicultural environment such as at SMP Negeri 04 Kualuh Hulu, religious moderation can help students develop mutual respect and understanding of existing differences. This research aims to explore the influence of religious moderation on the religious behavior of generation Z at SMP Negeri 04 Kualuh Hulu. The research method used is field research with a descriptive qualitative approach. The analysis technique applied is Descriptive Analysis which provides a complete and orderly picture of the research object. Data was collected through observation and interviews with primary data sources in the form of three teachers and three students, as well as secondary data from previous studies. The research results show that students' understanding of religious moderation at SMP Negeri 04 Kualuh Hulu is quite diverse. Some students understand and apply the concept of religious moderation well, while others still show extreme or apathetic tendencies. The implementation of religious moderation in this school helps some students develop attitudes of tolerance and mutual respect, but there are still challenges in implementing it as a whole. Family environmental factors and the influence of social media also influence students' understanding and behavior regarding religious moderation. Therefore, further efforts and collaboration between schools and parents are needed to increase understanding and implementation of religious moderation among students.

Long-term effects of litter characteristics on reproduction in female cavies (Cavia aperea)

In mammals, birth mass is an important predictor of early growth and survival. Within litters, heavier siblings are usually able to outcompete smaller siblings and gain more resources, thereby often permanently shaping phenotypic development. Early body size and growth are particularly important for later fitness. Only few studies investigated if and how differences within the early family environment contribute to long-term variation in fitness among individuals. We quantified if initial differences in size translate to size differences in adulthood and whether birth mass, relative size within the litter, litter size or the litter sex-ratio affect maturation and reproductive output of female wild cavies (Cavia aperea). Initial differences in mass were maintained until animals reached maximum adult mass at two years of age. Heavier sisters matured earlier and invested more into their first litter than smaller sisters, presumably because smaller sisters invested more into their own growth during the first pregnancy. Growing up in mixed-sexed litters in comparison to female-only litters slowed down maturation in smaller but not the heaviest female within a litter and had no effect on female reproductive effort. Variation in reproduction of multiparous females was to a lesser extent explained by the initial relative size of siblings. Offspring survival to independence was high but slightly lower when mothers had been born as smaller sisters. Our results demonstrate that factors of the early family environment not only affect immediate offspring development but lead to long-term fitness consequences.

Factors Associated with Bullying in Adolescents: a Literature Review

Background: Bullying is deliberate and repeated aggressive behavior toward another person in which there is a real or perceived power imbalance, and the victim of bullying feels vulnerable and powerless to protect himself. Objective: To determine the factors associated with bullying in adolescents. Methods: This article is a literature review of research articles conducted by summarizing and analyzing related articles. The search method used three electronic databases, namely Science Direct, Willey, and Pubmed with the keywords bullying, adolescent, factors and mental health. The inclusion criteria for writing were free English articles for the last 5 years, adolescent research samples, quantitative research, full text articles, relevant related articles, and original articles. Results: There were nine articles that met the inclusion criteria. The findings showed that there are various factors associated with bullying in adolescents. Conclusion: This study found that bullying in adolescents is influenced by individual, family, peer, and school environment factors. A holistic approach with interventions at multiple levels is needed to create a safe and supportive environment for students.

Study of the Relationship Between Students' Biology Learning Outcomes and Students’ Family Environment

Purpose of the study: The purpose of this study was to analyze the relationship between students' biology learning outcomes and their family environment. This study also aims to identify family environmental factors that contribute to students' biology learning achievement. Methodology: This research is a quantitative research with descriptive method. The population in this is XI science at Public High School 2 Bengkulu, 40 students, and parents of each student is 40 people. The sample was taken using saturated sampling technique. The research instrument used family environment questionnaire, observation, and documentation and data analysis techniques used were descriptive statistics and inferential statistics. Main Findings: The results of the analysis show that the family environment has a significant influence on the learning outcomes of class XI science students in the inferential statistical analysis with the F test showing that the calculated F value is greater than the F table, which means that the relationship between the family environment and student learning outcomes is significant. The average results of the family environment are the moderate category, while student learning outcomes are in the very high category. Novelty/Originality of this study: This research focuses on class XI science students, offering a special understanding of how the family environment relationships learning outcomes in biology at a critical educational stage. This can provide in-depth insight into the factors that relationship academic performance at the upper secondary education level. Seeing the relationship of the family environment on biology learning outcomes.

Study of The Concept of Vocational Guidance and Counseling in Vocational Schools

The concept of vocational guidance and counseling in vocational high schools (SMK) plays a crucial role in shaping the future of students. A recent study conducted at SMKS Teknologi YPL Lirik aimed to explore the general overview of guidance and counseling implementation, the steps taken by school principals and teachers, and the challenges faced in this aspect. Using a qualitative descriptive approach, the researchers directly collected data through interviews, documentation, and involving key stakeholders such as the school principal, vice principal of student affairs, subject teachers, class advisors, guidance counselors, and students. The gathered data was then analyzed through a process of reduction and interpreted qualitatively to draw conclusions. According to the interviews conducted with school officials, it was revealed that the current guidance and counseling practices at SMKS Teknologi YPL Lirik are inadequate. This is evident from the students' behavior, which tends to be naughty or undisciplined due to family or community environmental factors. To achieve holistic character education through guidance and counseling, the school must establish good cooperation with parents, maintain direct communication with them in case of any issues at school, and find solutions collaboratively to foster positive character growth in both the family and school environments. In conclusion, the study emphasizes the importance of enhancing guidance and counseling practices in vocational high schools to better support students in their personal and academic development. By addressing challenges and strengthening collaboration between school stakeholders, SMKS Teknologi YPL Lirik can create a more conducive environment for students to thrive and succeed in their vocational endeavors.

Family Environmental Risk and Perceived Stress in Adolescent Depressive Symptoms: A Network Analysis.

This study, grounded in the Process-Person-Context-Time framework, investigates the complex interplay of family environmental factors and their influence on adolescent depressive symptoms, focusing on the role of 'perceived stress'. Using network analysis, we examined data from 735 junior high students (52.1% female adolescents) from three provinces in China (Jiangsu, Shandong, and Henan), with an average age of 13.81 ± 0.92 years, ranging from 12 to 16 years, exploring the relationships between depressive symptoms, perceived stress, and seven family risk factors. The analysis identified three distinct communities. The incorporation of perceived stress led to its integration into a community that included depressive symptoms, parental restrictive monitoring, and family economic strain. Perceived stress emerged as the strongest predictor of depressive symptoms, surpassing parental restrictive monitoring. Furthermore, it overtook depressive symptoms as the node with the strongest bridging connection within its community. These findings underscore the importance of interventions targeting both family conditions and the internal processing of these stressors by adolescents, especially in challenging family environments, to mitigate the risk of depression and promote resilience.

Tinjauan Faktor Penyebab Daya Tangkap Rendah pada Siswa dalam Proses Pembelajaran di SMP Negeri 35 Medan

In a teaching and learning process, the level of understanding of a student is very important to the learning material delivered by the teacher in order to achieve the success of the teaching and learning process. If students are unable to understand or find it difficult to understand the material delivered by the teacher, the teaching and learning process will be slightly hampered. Therefore, the student's ability to catch is very important in the teaching and learning process in order to achieve good learning objectives. In this research, the method used is qualitative method. Qualitative methods involve data collection through observation interviews, and document analysis. As for the results of research that has been conducted at SMP Negeri 35 Medan in class VIII-3, there are inhibiting factors that result in low catchability in students such as physical factors, school environment factors and family environment factors.

Long-Term Risk of Type 2 Diabetes After Preterm Delivery or Hypertensive Disorders of Pregnancy.

To examine long-term diabetes risk after preterm delivery or hypertensive disorders of pregnancy in a large population-based cohort. This retrospective cohort study included all women with a singleton delivery in Sweden during 1973-2015 and no preexisting diabetes mellitus. Participants were followed up for development of type 2 diabetes identified from nationwide outpatient and inpatient diagnoses through 2018. Cox regression was used to compute hazard ratios (HRs) for the association between preterm delivery or hypertensive disorders of pregnancy and type 2 diabetes with adjustment for gestational diabetes and other maternal factors. Co-sibling analyses assessed for confounding by shared familial (genetic or environmental) factors. Overall, 2,184,417 women were included. Within 10 years after delivery, adjusted HRs for type 2 diabetes associated with specific pregnancy outcomes were as follows: any preterm delivery (before 37 weeks of gestation), 1.96 (95% CI, 1.83-2.09); extremely preterm delivery (22-27 weeks), 2.53 (95% CI, 2.03-3.16); and hypertensive disorders of pregnancy, 1.52 (95% CI, 1.43-1.63). All HRs remained significantly elevated (1.1-1.7-fold) 30-46 years after delivery. These findings were largely unexplained by shared familial factors. In this large national cohort, preterm delivery and hypertensive disorders of pregnancy were associated with increased risk for type 2 diabetes up to 46 years later. Women with these pregnancy complications are candidates for early preventive actions and long-term monitoring for type 2 diabetes.

Integrasi Psikologi Pendidikan dan Analisis Kesalahan Bahasa dalam Peningkatan Kualitas Pembelajaran

This study aims to explore how the integration of educational psychology and error analysis in language can improve the quality of learning. Through a systematic literature review (SLR) approach, this research examines various relevant studies to identify effective methods for enhancing students' learning interest and reducing language errors. The results show that game-based learning design can increase students' learning interest by 330%, and the implementation of an independent curriculum has a positive impact on producing skilled and creative generations. The empowerment of pedagogical competence based on reflective capabilities and training in phenomenon-based learning methods have also proven effective in improving the quality of learning interactions. These findings emphasize the importance of teacher training in information technology and innovative teaching methodologies, as well as the development of information systems that support better educational administration. The integration of educational psychology and language error analysis not only improves student learning outcomes but also prepares them to compete globally. Further research is needed to optimize the use of technology and family environmental factors in supporting students' learning processes.

Dynamics of the experience of sexual violence and its impact on girls in Ogan Komering Ulu Regency

The aim of this research is to obtain an overview of the dynamics of the experience of sexual violence and its impact on children in Ogan Komering Ulu Regency. This research method uses qualitative research with a descriptive phenomenological approach. The number of informants was five main informants and six supporting informants. The main informants are children who have experienced sexual violence and supporting informants, parents or guardians, people closest to them who are trusted by the informants and officers from the Women's Empowerment and Child Protection Service. The results of research on the dynamics of the experience of sexual violence in children show that all perpetrators come from familial abuse which is accompanied by physical and psychological pressure. Factors that influence the occurrence of sexual violence in children are family factors, environmental factors, cultural factors and individual factors. The impact of sexual violence that arises is pain in the body, fear of seeing items related to the perpetrator, despair and shame about the environment. Health workers can disseminate reproductive health education on how to prevent sexual violence to parents to reduce the rate of sexual violence against children so that a child-friendly city program can be realized.

It doesn't matter if I feel obliged as long as I enjoy it: The associations between organized leisure-time activities and adolescents' mental health and wellbeing.

There is a consensus that adolescents' participation in organized leisure-time activities (OLTAs) is pro-developmental and beneficial for youth mental health. While enjoyment in OLTA is commonly regarded as positive, the role of obligation in the context of adolescents' OLTA has been scarcely researched. The present study investigated how these theoretically contradictory experiences (enjoyment and/or obligation) in OLTA participation relate to adolescents' wellbeing and incidence of psychological complaints accounting for their possible co-occurrence. A nationally representative sample of 14,128 eleven-fifteen-year-old adolescents (49.7% girls) drawn from the Czech 2021/2022 Health Behaviour in School-aged Children cross-sectional study was used. A series of multivariate regression analyses assessed how perceptions of obligation and enjoyment in OLTA related to wellbeing and occurrence of psychological complaints. A person-centered approach derived groups of respondents on the basis of their perceptions of obligation and enjoyment. Regression analyses, controlled for sociodemographic and family environment factors, and dimensions of OLTA participation, indicated that adolescents enjoying their OLTA displayed more favourable mental wellbeing reports. In contrast, perceptions of obligation were only weakly associated with more frequent psychological complaints and not at all with wellbeing, unless adolescents also reported the lack of enjoyment. Enjoyment in OLTA plays a pivotal role in the association between OLTA participation and mental health, whereas the role of obligation is far less pronounced. In fact, if adolescents do not enjoy their participation, but feel obliged to participate, their self-assessed mental wellbeing is comparable to their peers not participating in OLTA at all.

Adverse Pregnancy Outcomes and Long-Term Mortality in Women

Women with adverse pregnancy outcomes, such as preterm delivery or preeclampsia, have higher future risks of cardiometabolic disorders; however, little is known about their long-term mortality risks. A better understanding of such risks is needed to facilitate early identification of high-risk women and preventive actions. To determine long-term mortality risks associated with 5 major adverse pregnancy outcomes in a large population-based cohort of women. This national cohort study in Sweden used the Swedish Medical Birth Register, containing prenatal and birth information for nearly all deliveries in Sweden since 1973, to identify women who had a singleton delivery during 1973 to 2015. All 2 195 667 such women with information for pregnancy duration and infant birth weight were included in the study. Data were analyzed from March to September 2023. Adverse pregnancy outcomes (preterm delivery, small for gestational age, preeclampsia, other hypertensive disorders, and gestational diabetes), identified from nationwide birth records. All-cause and cause-specific mortality through December 31, 2018. Cox regression was used to compute hazard ratios (HRs) for mortality associated with specific adverse pregnancy outcomes, adjusted for other maternal factors. Cosibling analyses assessed for confounding by shared familial (genetic or environmental) factors. In 56 million person-years of follow-up to a median (IQR) age of 52 (42-61) years, 88 055 women (4%) died (median [IQR] age at death, 59 [50-67] years). All 5 adverse pregnancy outcomes were independently associated with increased mortality. Across the entire follow-up (≤46 years after delivery), adjusted HRs for all-cause mortality associated with specific adverse pregnancy outcomes were as follows: gestational diabetes, 1.52 (95% CI, 1.46-1.58); preterm delivery, 1.41 (95% CI, 1.37-1.44); small for gestational age, 1.30 (95% CI, 1.28-1.32); other hypertensive disorders, 1.27 (95% CI, 1.19-1.37); and preeclampsia, 1.13 (95% CI, 1.10-1.16). All HRs remained significantly elevated even 30 to 46 years after delivery. These effect sizes were only partially (0%-45%) reduced after controlling for shared familial factors in cosibling analyses. Women who experienced multiple adverse pregnancy outcomes had further increases in risk. Several major causes of death were identified, including cardiovascular and respiratory disorders and diabetes. In this large national cohort study, women who experienced any of 5 major adverse pregnancy outcomes had increased mortality risks that remained elevated more than 40 years later. Women with adverse pregnancy outcomes need early preventive evaluation and long-term follow-up for detection and treatment of chronic disorders associated with premature mortality.

Treatment Resistant Early-Onset Schizophrenia: A Tale of Two Siblings

IntroductionEarly-Onset Schizophrenia (EOS) is a rare and severe form of schizophrenia that begins in childhood and it is often associated with genetic risk factors, poorer prognosis, and increased treatment resistance compared to adult-onset schizophrenia (Hatzimanolis et al. Eur Psychiatry 2020;63(1):e44). This case report presents two siblings diagnosed with EOS and treated at the same inpatient clinic in different years.ObjectivesThe aim is offering a perspective on the clinical characteristics, genetic and enviromental implications, and treatment challenges of two siblings with EOS and seeking to enhance understanding of EOS’s complexity, particularly in the context of treatment resistance.MethodsA comprehensive retrospective review of the siblings’ all medical records was conducted, focusing on their psychiatric history, symptoms, treatment trials, and responses of treatment. Both cases’ current clinical situations were evaluated cross-sectionally.ResultsOlder sibling: 19 year-old male, was diagnosed with EOS following the onset of symptoms as social withdrawal, negativism and suspiciousness at the age of 14. He referred to the inpatient clinic with the cause of drug intake refusal. Risperidone treatment started but there was no significant response. Risperidone to olanzapine switch made and clinical remission observed. After his discharge, 4 more hospitalisations in 5 years needed due to low socioeconomic status, parental neglect and him having no insight and stopped taking his medications repeatedly. Several depot form antipsychotic injections started to prevent recurrent hospitalisation. Despite that he needed several hospitalisations to adult psychiatry inpatient clinics.Younger sibling: 14 year-old female, were diagnosed with EOS following the symptoms as auditory hallucinations, suspiciousness, disorganised speech and behaviours at the age of 13. She referred to the same inpatient clinic with suicidal risk after 2 years of his brother’s last hospital stay. She responded good to olanzapine treatment like her brother’s, during her first stay. After 2 weeks of her discharge, her psychotic symptoms started again with no specific reason. Second hospitalisation needed due to her homicidal and suicidal risk. Clozapine and aripipirazole treatment started and she discharged in partial remission. She is being followed in outpatient clinic, with low functioning.ConclusionsDespite trials of multiple antipsychotic medications and adjunctive treatments, both siblings demonstrated significant treatment resistance. These sibling cases underscore the complexity and challenges in managing EOS, particularly when it presents with treatment resistance. The shared familial environment and potential genetic factors demand further investigation to elucidate the pathogenesis of EOS and optimize therapeutic approaches.Disclosure of InterestNone Declared