Other Psychiatric Disorders Research Articles

Screening for Pediatric Obsessive-Compulsive Disorder Using the Obsessive-Compulsive Inventory-Child Version.

The study assessed the ability of the Obsessive-Compulsive Inventory-Child Version (OCI-CV) to detect pediatric obsessive-compulsive disorder (OCD) using receiver operating characteristic analyses. The sample consisted of 114 cases with current OCD, 340 cases with other psychiatric disorders (OPD), and 301 healthy controls (HC) ages 7 to 18years. All 755 participants were assessed with two semi-structured interviews and seven rating scales. In a comparison of current OCD cases and all other participants, the optimal OCI-CV cut-score was 11 with an area under the curve (AUC) of .88. In a comparison of current OCD cases and OPD cases, the optimal OCI-CV cut-score was 11 with an AUC of .82. In a comparison of current OCD cases and HC, the optimal OCI-CV cut-score was 10 with an AUC of .94. The results indicate that the OCI-CV provides an effective screen for pediatric OCD using empirically derived cut-scores.

Clinical Practice Guidelines for the management of Dissociative disorders in children and adolescents.

Clinical Practice Guidelines for the management of Dissociative disorders in children and adolescents.

EMOTIONAL AVAILABILITY IN EARLY MOTHER-CHILD INTERACTIONS FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS, OTHER PSYCHIATRIC DISORDERS, AND DEVELOPMENTAL DELAY.

Emotional availability (EA) is a method to assess early parent-child dyadic interactions for emotional awareness, perception, experience, and expression between child and parent that describe global relational quality (Z. Biringen & M. Easterbrooks, 2012). The current study aimed to examine the effects of an infant's diagnosis of autism spectrum disorders (ASDs), other psychiatric disorders (OPD), and developmental delay (DD) on the maternal EA Scale (EAS; Z. Biringen & M. Easterbrooks, 2012; Z. Biringen, J.L. Robinson, & R.N. Emde, 2000) scores and the relative contributions of infant's age, gender, diagnosis, developmental level, and maternal education on EAS scores in a clinical Turkish sample. Three hundred forty-five infant-mother dyads participated in this study. Results of the research indicated that EAS adult scores were associated with maternal education and infant's diagnosis whereas child scores were associated with infant's age, diagnosis, and developmental level. Infants' involvement and responsiveness to the mother were lower in the group with ASD. Children with OPD, particularly when their mothers have lower education, might be at increased risk of having problems in parent-child interactions. Young ASD subjects with developmental delay are in greatest need of support to increase reactions toward their mother. These findings underscore the importance of using all of the EA dimensions rather than only one measure on children in high-risk populations.

Repensando el concepto de adicciones: pasos hacia la patología dual

Resumen Diversos estudios epidemiológicos, desde los años 1980, han demostrado la existencia de importantes asociaciones estadísticas que evidencian la elevada prevalencia de la co-ocurrencia entre los Trastornos por Consumo de Sustancias (TCS) con Otros Trastornos Psiquiátricos (OTP), misma que oscila entre el 20% y 50% en población general y entre el 40% y 80% en población clínica. Asimismo los estudios epidemiológicos sugieren que en más de 80% de los casos los OTP iniciaron antes de la aparición de los TCS, de tal forma que las personas con OTP presentan hasta 3 veces más probabilidad de desarrollar TCS posteriormente.

Mujeres con patología dual: características clínicas y de tratamiento

Introducción: las mujeres con trastornos por consumo de sustancias (TCS) presentan mayor prevalencia de patología dual (PD) en comparación a los hombres con la misma condición, entendiendo la PD como la concurrencia de TCS con otros trastornos psiquiátricos (OTP). Esta relación genera consecuencias negativas en la severidad de la sintomatología y en el tratamiento de ambas condiciones. Objetivo: analizar las características clínicas e historia de tratamiento de mujeres con PD. Método: evaluación clínica psiquiátrica de mujeres que recibían atención en dos centros residenciales. Se compararon las características y trastornos en función de los tratamientos previos, utilizando GEE para determinar las diferencias de las prescripciones de medicamentos en el tiempo. Resultados: se analizaron los datos de 100 pacientes mujeres, de las cuales 30 dijeron no haber recibido tratamientos previos y menos de 20% reportó padecimientos médicos de importancia. Las pacientes con trastorno límite de la personalidad presentaron una tercera parte de la probabilidad de reportar tratamientos previos con respecto a las pacientes sin esta condición (OR = .33; IC 95% .13-.84). Se encontraron diferencias significativas a través del tiempo en antidepresivos (17.6% vs 41.8%; p

Screening for ASD with the Korean CBCL/1½–5

To test the Child Behavior Checklist's (CBCL/1½-5) ability to screen for autism spectrum disorders (ASD), we studied Korean preschoolers: 46 with ASD, 111 with developmental delay (DD), 71 with other psychiatric disorders (OPD), and 228 non-referred (NR). The ASD group scored significantly higher than the other groups on the Withdrawn and DSM-Pervasive Developmental Problems (DSM-PDP) scales as well as attaining higher scores (p < .001) on seven items reflecting ASD. With a T ≥ 65 cutpoint on the DSM-PDP scale, sensitivity was 80 % for identifying ASD relative to the other three groups, but specificity varied across groups: NR = 87 %, OPD = 55 %, DD = 60 %, replicating in a non-Western sample results from previous studies. Results suggested that the CBCL/1½-5 performs best in Level 1 screening, namely differentiating children with ASD from children in the general population.

Gender and injuries predict stimulant medication use.

The purpose of this article was to examine whether injuries in early childhood and gender predict prescriptions of stimulant medication in three groups of children: With attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and other psychiatric disorders (OPD). This was a population-based study with prospective and complete follow-up of children with ADHD (n=11,553), ASD (n=9698), and OPD (n=48,468), of whom 61%, 16%, and 3%, respectively, were treated with stimulants. For all 69,719 individual children data on psychiatric diagnoses, injuries, and drug prescriptions were obtained from national registers and merged. Having sustained an injury before 5 years of age increased the likelihood of later stimulant treatment, in children with ADHD (odds ratio [OR]=1.09; 95% confidence interval [CI]=1.01-1.21), ASD (OR=1.19; 95% CI=1.02-1.40), and OPD (OR=1.24; 95% CI=1.08-1.42), with each injury increasing the likelihood by 3%, 10%, and 7%, respectively. Head injury did not increase the likelihood of later stimulant treatment. Within each of the three groups, ADHD, ASD, and OPD boys were more likely than girls to receive stimulant medication, OR=1.17 (95% CI=1.07-1.28); OR=1.71 (95% CI=1.47-2.01), and OR=2.41 (95% CI=2.16-2.71), respectively. To our knowledge, this is the first prospective study assessing early life predictors of later ADHD medication in children with a psychiatric disorder, taken from a national cohort with complete follow-up of all cases. We found that the number of injuries prior to diagnosis was associated with initiation of stimulant treatment in all three groups of patients. In addition, male gender predicted treatment with ADHD medications. Our results suggest that the number of injuries early in life prior to diagnosis is associated with stimulant treatment, and may serve as a proxy for the level of later severity of ADHD symptoms, as it is universally associated with pharmacological treatment for ADHD.

The relation between ADHD and ANS-CNS integration

Background: Attention deficit hyperactivity disorder (ADHD) was long considered to be limited to children and adolescents, but it is now known that ADHD symptoms may persist into adulthood. It is plausible that the etiology of ADHD is not one-dimensional, but instead involves various neuroanatomical and neurochemical systems, with the causes of the main abnormalities believed to be catecholaminergic. Iodine-123-labeled meta-iodobenzylguanidine (123I-MIBG) is a physiological analogue of norepinephrine (NE). To the best of our knowledge, there are no reports about the abnormalities of MIBG scintigraphy in patients with ADHD. The cases presented are male adult patients with different comorbid psychiatric disorders. Case presentation: The cases presented are male adult patients with different psychiatric disorders. Case 1 was a 52-year-old male residential construction foreman, who had been diagnosed with acute schizophrenia-like psychotic disorder. 123I-MIBG planar and SPECTs of the studies were performed at 20 min (early phase) and 3 h (late phase) after intravenous injection of 111 MBq. Planar images were processed to determine the heart (H) to mediastinum (M) ratio (H/M). The early and late H/M ratios were 1.22 and 1.07, respectively. Case 2 was a 52-year-old male civil servant who was diagnosed with adjustment disorder. The early and late H/M ratios were 1.98 and 2.08, respectively. Conclusion: Clinical studies make it clear that symptoms of ADHD are more heterogenous and subtle in adults than children. Adult ADHD is significantly commorbid with wide range of other 12-month disorders. MIBG imaging can be useful to diagnose patients with preexisting psychiatric disorders and ADHD. It might be possible to diagnose objectively though the psychiatric statuses resemble or coexist with other psychiatric disorders. Needless to say, further research is important.

Child Behavior Check List 1½–5 as a tool to identify toddlers with Autism Spectrum Disorders: A case-control study

Tools to identify toddlers with autism in clinical settings have been recently developed. This study evaluated the sensitivity and specificity of the Child Behavior Check List 1½-5 (CBCL 1½-5) in the detection of toddlers subsequently diagnosed with an Autism Spectrum Disorder (ASD), ages 18-36 months. The CBCL of 47 children with ASD were compared to the CBCL of 47 toddlers with Other Psychiatric Disorders (OPD) as well as the CBCL of 47 toddlers with Typical Development (TD) in a case control study. One-way analysis of variance (ANOVA) and logistic regression with odds ratio (OR) analyses were performed. In order to establish the optimal threshold able to discriminate children with ASD from children with OPD and TD, Receiver Operating Characteristic (ROC) analyses were performed. One-way ANOVA revealed significant differences between the three groups. Logistic regression analysis showed that the Withdrawn and the Pervasive Developmental Problems (PDP) subscales can recognize toddlers subsequently identified as ASD from both children with TD (p<0.001) and OPD (p<0.001). ROC analyses showed very high sensitivity and specificity for the PDP (0.98 and 0.91) and Withdrawn (0.92 and 0.97) subscales when ASD was compared to TD. Sensitivity and specificity of Withdrawn (0.90 and 0.83) and PDP (0.85 and 0.83) remained high when comparing ASD versus OPD. In conclusion, the CBCL 1½-5 seemed to be able to identify toddlers subsequently diagnosed with ASD from children with TD and OPD. Its high sensitivity and specificity, coupled with its efficiency in terms of time and cost, suggest this broadband tool should be tested in a pilot screening survey of toddlers in the general population.

Validation of the Spanish Center for Epidemiological Studies Depression and Zung Self-Rating Depression Scales: A Comparative Validation Study

BackgroundDepressive disorders are leading contributors to burden of disease in developing countries. Research aiming to improve their diagnosis and treatment is fundamental in these settings, and psychometric tools are widely used instruments to support mental health research. Our aim is to validate and compare the psychometric properties of the Spanish versions of the Center for Epidemiological Studies Depression Scale (CES-D) and the Zung Self-Rating Depression Scale (ZSDS).Methodology/Principal FindingsA Spanish version of the CES-D was revised by 5 native Spanish speaking psychiatrists using as reference the English version. A locally standardized Spanish version of the ZSDS was used. These Spanish versions were administered to 70 patients with a clinical diagnosis of DSM-IV Major Depressive Episode (MDE), 63 without major depression but with clinical diagnosis of other psychiatric disorders (OPD), and 61 with no evidence of psychiatric disorders (NEP). For both scales, Cronbach's alpha (C-α) and Hierarchical McDonald Omega for polychoric variables (MD-Ω) were estimated; and receiver operating characteristics (ROC) analysis performed. For the CES-D and ZSDS scales, C-α was 0.93 and 0.89 respectively, while MD-Ω was 0.90 and 0.75 respectively. The area under the ROC curve in MDE+OPD was 0.83 for CES-D and 0.84 for ZSDS; and in MDE+NEP was 0.98 for CES-D and 0.96 for ZSDS. Cut-off scores (co) for the highest proportions of correctly classified (cc) individuals among MDE+OPD were ≥29 for CES-D (sensitivity (ss) = 77.1/specificity (sp) = 79.4%/(cc) = 78.2%) and ≥47 for ZSDS (ss = 85.7%/sp = 71.4%/cc = 78.9%). In the MDE+NEP, co were ≥24 for the CES-D (ss = 91.4%/sp = 96.7%/cc = 93.9%) and ≥45 for the ZSDS (ss = 91.4%/sp = 91.8%/cc = 91.6%).ConclusionSpanish versions of the CES-D and ZSDS are valid instruments to detect depression in clinical settings and could be useful for both epidemiological research and primary clinical settings in settings similar as those of public hospitals in Lima, Peru.

The CBCL 1.5–5 and the identification of preschoolers with autism in Italy

To study the potential use of child behaviour checklist (CBCL) 1.5-5 scales for the early identification of preschoolers at risk of autism. CBCL scores of three groups of preschoolers were compared: (1) an experimental group of 101 preschoolers with autism spectrum disorder (ASD); (2) a control group of 95 preschoolers with other psychiatric disorders (OPD); (3) a control group of 117 preschoolers with typical development (TD). One-way analysis of variance (ANOVA), logistic regression with odds ratio (OR) and receiver operating characteristic (ROC) analyses were performed. ANOVA revealed that ASD and OPD had significantly higher scores in almost all CBCL scales than TD. ASD presented significantly higher scores than OPD on Withdrawn, Attention Problems and Pervasive Developmental Problems (PDP) scales. Logistic regression analysis demonstrated that these same CBCL scales have validity in predicting the presence of an ASD towards both TD and OPD. ROC analysis indicated high sensitivity and specificity for PDP (0.85 and 0.90) and Withdrawn (0.89 and 0.92) scales when ASD is compared to TD. Specificity (0.60 for PDP and 0.65 for Withdrawn) decreases when comparing ASD and OPD CONCLUSIONS: The PDP and Withdrawn scales have a good predictive validity so that they could be proposed as a first-level tool to identify preschoolers at risk of autism in primary care settings. Problems regarding the lower specificity when comparing ASD v. OPD are discussed.

Premorbid IQ and adult schizophrenia spectrum disorder: Verbal Performance subtests

The present prospective high-risk study examined associations between childhood scores on five Wechsler Intelligence Scale for Children (WISC) subtests (vocabulary, similarities, block design, object assembly, and mazes) and later development of schizophrenia spectrum disorders (SSD). The sample comprised 244 high-risk or control children who were administered the WISC subtests at age 10 to 13 years in 1972. Adult psychiatric data were gathered from psychiatric interviews in 1992–93 and from the Danish Psychiatric Central Register in 2007. Thirty-two participants had developed SSD, 79 other psychiatric disorders (OPD), and 133 had no diagnosis (ND). The SSD group obtained lower scores than the ND group on all subtests and IQs, but when adjusted for sex and parental social status only significantly lower scores on similarities, object assembly, mazes, and total IQ. Compared with the ND group, the OPD group obtained significantly lower scores on similarities, vocabulary, verbal IQ, and total IQ. The only significant difference between the SSD and OPD groups was on object assembly (OPD performed at the level of ND). The results suggest a premorbid deficit in general intelligence in individuals who later develop SSD. The results for the OPD group support recent studies demonstrating that premorbid IQ deficits may characterize a wide range of psychiatric disorders.

Sex influences on shared risk factors for bulimia nervosa and other psychiatric disorders.

The examination of opposite-sex and same-sex dizygotic twins allows us to explore the sex-specific comorbidity of psychiatric disorders. To date, this question has not been explored in eating disorders. To determine whether sex influences shared risk factors between bulimia nervosa (BN) and other forms of psychopathology. The study examines associations between BN and other forms of psychopathology in twin pairs using interview and survey reports. Twins from the Virginia population-based twin registry. Male-female dizygotic twins (N = 1192 pairs), mean (SD) age 36.6 (8.9) years, and female-female dizygotic twins (N = 467 pairs), mean (SD) age 36.0 (7.6) years. Lifetime psychiatric disorders as diagnosed by a structured psychiatric interview, including major depression, anxiety disorders, and substance abuse and dependence. Also, continuous measures of body mass index and personality, including neuroticism and novelty seeking. Significant within-person associations existed for women between BN and higher body mass index, neuroticism, novelty seeking, and all lifetime psychopathology. Results from this study suggest the presence of either familial or nonfamilial shared risk factors between BN and generalized anxiety disorder, neuroticism, psychoactive substance use, novelty seeking, major depression, and panic disorder. The shared risk factors between BN and generalized anxiety disorder and BN and novelty seeking were only present in men. Evidence supports the existence of a sex-specific manifestation of familial liability with respect to BN and generalized anxiety disorder and BN and novelty seeking.