Pervasive Developmental Disorders Patients Research Articles

Prescription trends in children with pervasive developmental disorders: a claims data-based study in Japan.

The only drug approved for pervasive developmental disorders (PDD) in Japan is pimozide. Several psychotropic drugs are also prescribed for offlabel use in Japan, but details regarding their prescription and use are largely unknown. The purpose of this study was to clarify the use of drug treatment in Japanese children with PDD. Data were extracted from claims data from the Japan Medical Data Center for children younger than 18 years of age who were newly diagnosed with PDD (International Classification of Diseases version 10 codes: F84) from 2005 to 2010 (total of 3276 patients as of 2010). The prescription rates were presented as the percentage of PDD patients who were prescribed each drug. Prior to 2010, the prescription rates for atypical antipsychotics, other antipsychotics, psychostimulants, all other central nervous system drugs, anticovnvulsants, non-barbiturates, and Parkinson's disease/syndrome drugs significantly increased among the Anatomical Therapeutic Chemical classifications defined as the "nervous system" (trend P≤0.02). The prescription rate for risperidone consistently increased, reaching 6.9% in 2010 (trend P<0.0001), the highest rate of the surveyed drugs among the antipsychotics. The prescription rate for aripiprazole also increased (trend P<0.0001), reaching 1.9% in 2010. The prescription rate for pimozide showed no annual changes, with a low rate of 0.4% in 2010. Compared with pimozide, the prescription rates for risperidone, aripiprazole and other psychotropic drugs have increased. Because safety data for these drugs in Japanese children are sparse, there is a need for future safety evaluations of these drugs in Japanese children.

Incidence of aberrant behaviors in children with pervasive developmental disorders

Objective To evaluate the incidence of four aberrant behaviors in patients with pervasive developmental disorders(PDDs). Methods The abnormal behaviors during the last month in 138 PDDs patients were assessed with Aberrant Behavior Checklist and Conners Index of Hyperactivity. Results The incidence of aberrant behaviors was 61.6% for hyperactivity, 81.9% for stereotyped behaviors, 13.77% for self-injury, and 58.70% for irritability in PDDs patients.The occurance of irritability in autism patients was higher than that of asperger syndrome(AS) patients(χ2=5.623, P=0.018). Conclusion Stereotyped behaviors, hyperactivity and irritability are common in children with PDDs. Autism patients are more likely to exhibit irritability behaviors than AS patients. Key words: Pervasive developmental disorders; Hyperactivity; Stereotyped behaviors; Self-injury; Irritability

発達障害におけるイメージの曖昧さ ロールシャッハ・テストにおける「不確定反応」から

発達障害におけるイメージの曖昧さ ロールシャッハ・テストにおける「不確定反応」から

Psychiatric family history of pervasive developmental disorder patients in a child psychiatric unit

Psychiatric family history of pervasive developmental disorder patients in a child psychiatric unit

Observational study on reason for first referral and final diagnosis of pervasive developmental disorder patients in a child psychiatric unit

Observational study on reason for first referral and final diagnosis of pervasive developmental disorder patients in a child psychiatric unit

Validation of an interview-based rating scale developed in Japan for pervasive developmental disorders

The pervasive developmental disorders (PDDs) Autism Society Japan Rating Scale (PARS), an interview-based instrument for evaluating PDDs, has been developed in Japan with the aim of providing a method that (1) can be used to evaluate PDD symptoms and related support needs and (2) is simpler and easier than the currently used “gold standard” instruments such as the Autism Diagnostic Interview-Revised (ADI-R). We examined the reliability and validity of PARS on the basis of data from 572 participants (277 PDD patients and 295 nonclinical controls). Inter-rater reliability was sufficient at both the item and scale level. Factor analysis extracted four subscales, for which internal consistency was found to be high. The sub and total scores of PARS showed correlations with the domain and total scores of ADI-R, in line with theoretical prediction, indicating the convergent validity of PARS. A receiver operating characteristic analysis showed that PARS has good discriminative validity in differentiating between PDD patients and nonclinical controls, regardless of intellectual capacity. Considering that PARS can be easily implemented by professionals with appropriate knowledge regarding PDDs, PARS may be superior to the existing instruments in terms of cost performance.

Multi‐channel near‐infrared spectroscopy shows reduced activation in the prefrontal cortex during facial expression processing in pervasive developmental disorder

The purpose of the present study was to investigate whether individuals with pervasive developmental disorders (PDD) show differential activation during an emotional activation task compared with age- and sex-matched controls, by measuring changes in the concentration of oxygenated (oxyHb) and deoxygenated (deoxyHb) hemoglobin, using near-infrared spectroscopy (NIRS). Fourteen patients with PDD and 14 age- and sex-matched healthy controls participated in the study. The relative changes of concentrations of oxyHb and deoxyHb were measured on NIRS during an implicit processing task of fearful expression using Japanese standard faces. PDD patients had significantly reduced oxyHb changes in the prefrontal cortex (PFC) compared to healthy controls. PFC dysfunction may exist in PDD.

Paroxysmal EEG abnormalities and epilepsy in pervasive developmental disorders: Follow-up study until adolescence and beyond

This study examined paroxysmal abnormalities and epilepsy in EEG for individuals with pervasive developmental disorders (PDD) in two parts: first with a large number of subjects ( n = 1624); and second with extracted subjects followed from ⩽5 years into adolescence and beyond ( n = 92). Many paroxysms in PDD patients in their childhood tended to appear at various sites and the same held for paroxysms at the time of epilepsy onset. However, in adolescence and beyond, paroxysms in the frontal region prevailed as those appearing at sites other than the frontal region tended to disappear. The same held for paroxysms at the time of epilepsy onset. These paroxysms in the frontal area characteristic of PDD were named “Paroxysms at F.” It was suggested that functional abnormality in the frontal region exists in PDD through paroxysmal EEG abnormalities and epilepsy.

Measuring language development in pervasive developmental disorders (PDD) and non-PDD children

Background Impairments in language and related socialcommunication skills can be found in children with pervasivedevelopmental disorders (POD) and other developmentallanguage disorders (non-POD). These conditions lead to decisionof enrolling children with language disorders to speech therapydespite that it is not the therapy of choice for POD.Objectives To explore the differences in receptive language, verbal expressive language, and non-verbal expressive language between PDD and non-POD childrenMethods A cross sectional study was performed in October2008 to January 2009. Questionnaire using the MacArthurcommunicative development inventory (CDI) was filled byparents whose children were PDD and non-PDD patients aged 1to 3 years old. The diagnosis ofPDD was based on the diagnosticand statistical manual IV.Results A total of 42 PDD and 42 non-POD subjects wereevaluated. There was significant difference between PDD and nonPOD in receptive language [P= 0.01 (95% CI -170.63 to -24.33)in 12 to 24 month-old subjects and P&lt; 0.01 (95% CI -158.28to -92.99) in &gt; 24 to 36 month-old subjects] and non-verbalexpressive language [P= 0.01 (95% CI -20.96 to -1.96) in 12 to24 month-old subjects and P&lt; 0.01 (95% CI -22.65 to -10.5) in&gt; 24 to 36 month-old subjects]. Verbal expressive language wasnot significantly different between POD and non-POD childrenage 1 to 3 year-old.Conclusions PDD children are more likely to have a delay inreceptive language and non-verbal expressive language compare to non-POD children. Verbal expressive language can not be used to differentiate POD and non-POD children.

Relationship of hypersensitivity to anxiety and depression in children with high‐functioning pervasive developmental disorders

Sensory-perceptual abnormalities, which include hyper- and hyposensitivity, have been identified by numerous researchers as prevalent in individuals with pervasive developmental disorders (PDD). Hypersensitivity has a greater impact on PDD patients' daily lives than hyposensitivity. The purpose of the present study was to clarify the relationship of hypersensitivity to anxiety, depression and other psychopathology in children with PDD. Sixty-four children were divided into a hypersensitivity group (HG; n = 43) and a non-hypersensitivity group (non-HG; n = 21), and compared for anxiety, depression and other psychopathology on the Child Behavior Checklist (CBCL), State-Trait Anxiety Inventory for Children (STAIC) and Children's Depression Inventory (CDI). The HG group had significantly higher scores than the non-HG group in Total, Internalizing, and Somatic complaints on the CBCL. On STAIC, the mean sore of Total Score, State Score and Trait Score in the HG group tended to be higher than in the non-HG group, but the difference was not significant. The score on the CDI in the HG group was significantly higher than that in the non-HG group. PDD children with hypersensitivity have more serious psychopathologies, especially internalizing symptoms including depression.

Variability in spatial normalization of pediatric and adult brain images

Objective Normalization of brain images is a necessity for group comparisons of source analyses based on realistic head models. In this paper we compared the outcome of a linear registration method for brain images of psychiatric and control groups of different ages in order to assess the relative adequacy of normalization in such diverse groups. Methods Magnetic Resonance images (MRI) of the brains of pediatric and adolescent subjects (mean ages 19 and 10.5 years) with a pervasive developmental disorder (PDD) and their healthy controls were included. A simple voxel-wise test of the group variances in image intensities was performed to evaluate regional differences in registration quality. Dipole analysis of visual P1 was performed to establish whether source locations were comparable across groups. Results Significant differences between pediatric groups were found in white matter and thalamic regions of the brain. For all other group-wise comparisons, differences were confined to skull and neck regions. Dipole locations were found to be more anteriorly located in the adolescent groups. Conclusions The normalization procedure used in this paper is based on a brain template of normal adult brains from a restricted age group, and the results show that the use of this method in pediatric groups is less adequate. The method seems suitable for use in psychiatric groups. Also, the generators of visual P1 in PDD patients were found to be comparable to controls. Significance The results suggest that this existing normalization method can be used in diverse populations, but is less suitable for pediatric images.

Bipolar Disorders in Mentally Retarded Persons With Pervasive Developmental Disorders

To examine clinical features of mentally retarded patients with pervasive developmental disorders (PDD) with a comorbid bipolar disorder, 23 PDD patients (mean age = 23.5 years, SD = 4.2) with an episode satisfying modified DSM-IV criteria for manic/hypomanic episode (PDD-B), and 23 age, sex, diagnosis, and retardation matched control PDD patients without a mood episode (PDD-C) were compared on 26 variables (e.g., family history, development, autistic symptoms, epilepsy). Although many of the variables did not show a significant difference, autistic symptoms tended to be more severe in the PDD-B than PDD-C patients, and epilepsy tended to occur earlier in 14 PDD-C than 13 PDD-B patients. Twenty two of the 23 PDD-B patients had taken mood stabilizers clinically judged effective. Bipolar disorders are not rare and are diagnosable in mentally retarded PDD patients with modified DSM-IV criteria consisting of items observable by others, and their treatment by mood stabilizers seems worthy for further research.

Symptoms related to ADHD observed in patients with pervasive developmental disorder

To elucidate attention-deficit/hyperactivity disorder (ADHD)-related factors observed in high-function pervasive developmental disorder (PDD) and their impact on daily life, we classified high-function PDD patients according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for ADHD with the exception of the exclusion criteria (coexistence with PDD), and studied the relationship between ADHD-related aspects and daily behavior problems using the Child Behavior Checklist (CBCL). The subjects were divided into two groups: Group 1, eight patients less than 6 years of age; and Group II, eight patients 6 years of age and older. Six patients in Group II met the criteria for ADHD. Five of them were classified as having the predominantly inattentive type of ADHD, and the remaining patient exhibited the combined type. However, no patient in Group I met the criteria for ADHD, suggesting the low sensitivity of the DSM-IV criteria for assessing the inattentiveness of preschoolers. The analyses of the correlation between corresponding items in the DSM-IV criteria and CBCL scores suggested that ADHD-related symptoms in high-function PDD patients have an impact on their daily lives.

Clinical and genetic relationships between autism‐pervasive developmental disorder and Tourette syndrome: A study of 19 cases

Children with autism or pervasive developmental disorder (PDD) and Tourette syndrome (TS) share a number of symptoms. Forty-one cases have been reported in which PDD patients subsequently developed TS. We term this PDD----TS. We describe an additional 16 such patients plus 3 families where a close relative of a TS proband had autism. There was a high frequency of alcoholism, drug abuse, obsessive-compulsive, and other behavior disorders in the relatives of these patients. This frequency was virtually identical to that observed in relatives of individuals with TS only. We suggest there is an intimate genetic, neuropathologic relatedness between some cases of PDD and TS. Many observations have led us to suggest that the genetic defect in TS may be a mutation of tryptophan oxygenase and that TS is inherited as a semidominant semirecessive trait, i.e., homozygosity for a common gene which shows some expression in the heterozygous state. We propose that some types of PDD are inherited in the same fashion and by the same gene. This would explain the similarity of symptoms, frequent evolution of PDD into TS, the apparent recessive inheritance of PDD despite no increase in consanguinity, the high frequency of behavior problems in the relatives of PDD----TS patients and the serotonin abnormalities.

A Comparison of Breastfeeding Rates among Children with Pervasive Developmental Disorder, and Controls

The breastfeeding rates for 50 children with pervasive developmental disorder (PDD) from North Dakota's roster of PDD patients were compared with the national average and with the rates for a control group matched for age, sex, and IQ. In addition, the breastfeeding rates for the normal siblings of the PDD and control groups were compared with the national average to help determine whether the lower breastfeeding rate among PDD patients was a function of parenting practices. The breastfeeding rates for the PDD and control groups were not significantly different from each other, but both were significantly lower than the national average. The breastfeeding rate for the normal siblings of PDD children was almost identical to the national average, but the rate for the siblings of the matched control group was significantly lower than the national average. These results are discussed in terms of hypotheses regarding the early parent-child interactions and characteristics in the families of PDD children.