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Fredriksen T, Marie Vatne T, Bjartveit Haukeland Y, Tudor M, Fjermestad KW. Siblings of children with chronic disorders: Family and relational factors as predictors of mental health. J Child Health Care 2023; 27:145-159. [PMID: 34727780 DOI: 10.1177/13674935211052157] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Siblings of children with chronic disorders are at increased risk of mental health problems. Predictors of siblings' mental health require further study to identify children in need of interventions and to design effective intervention programs. Siblings of children with chronic disorders (n = 107; M age = 11.5 years; SD = 2.1, 54.6% girls) and their parents (n = 199; 50.3% mothers) were included in a survey study. Siblings and parents completed questionnaires on mental health. Siblings completed questionnaires on parent-child communication, relationships with parents, and an adjustment measure on the sibling situation. Multiple linear regression analyses were applied to identify predictors of siblings' mental health. Sibling-reported relationship with parents was a significant predictor of sibling mental health reported by siblings, fathers, and mothers (R2 = 0.26 - R2 = 0.46). Siblings' adjustment was significantly associated with fathers' report of siblings' mental health (r = .36), but not mothers' report (r = .17). Siblings' relationships (d = 0.26) and communication (d = 0.33) with mothers were significantly better than with fathers. We conclude that the sibling-parent relationship is a significant factor in identifying siblings at risk and that family-based intervention programs should be developed.
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Affiliation(s)
- Trude Fredriksen
- Department of Psychiatry, 60516Innlandet Hospital Trust, Brumunddal, Norway
| | | | | | - Megan Tudor
- MIND Institue, University of California, Davis, Sacramento, CA, USA
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Petriti U, Dudman DC, Scosyrev E, Lopez-Leon S. Global prevalence of Rett syndrome: systematic review and meta-analysis. Syst Rev 2023; 12:5. [PMID: 36642718 PMCID: PMC9841621 DOI: 10.1186/s13643-023-02169-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 12/29/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Rett syndrome is a rare, severe neurodevelopmental disorder. Almost all cases occur in girls, in association with spontaneous (non-inherited) mutations involving the methyl-CpG-binding protein 2 gene located on the X chromosome. Diagnostic criteria for typical Rett syndrome require a period of regression, followed by recovery or stabilization, and fulfillment of all four main criteria (loss of purposeful hand skills, loss of spoken language, gait abnormalities, and stereotypic hand movements). Our objective was to estimate the prevalence of Rett syndrome in the general population, stratified by sex. METHODS We conducted a search of PubMed, Embase, Web of Science, Cochrane Library, LILACS, and LIVIVO to retrieve studies published in English between Jan. 1, 2000, and June 30, 2021. Pooled prevalence with a 95% confidence interval (CI) was estimated using a random-effects meta-analysis based on a generalized linear mixed model with a logit link. RESULTS Ten eligible studies were identified (all in females), with a combined sample size of 9.57 million women and 673 Rett syndrome cases. The pooled prevalence estimate (random effects) was 7.1 per 100,000 females (95% CI: 4.8, 10.5, heterogeneity p < 0.001). Despite greatly variable precision of estimation, all estimates were compatible with a prevalence range of approximately 5 to 10 cases per 100,000 females based on their respective 95% CIs. CONCLUSION These findings may facilitate planning of therapeutic trials in this indication in terms of target sample size and accrual times.
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Affiliation(s)
| | - Daniel C Dudman
- Former Rutgers University Ernest Mario School of Pharmacy, Piscataway, NJ, USA.,Former Quantitative Safety & Epidemiology, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Emil Scosyrev
- Quantitative Safety & Epidemiology, Novartis Pharmaceuticals Corporation, One Health Plaza, Building 339-1131, East Hanover, NJ, 07936-1080, USA
| | - Sandra Lopez-Leon
- Quantitative Safety & Epidemiology, Novartis Pharmaceuticals Corporation, One Health Plaza, Building 339-1131, East Hanover, NJ, 07936-1080, USA. .,Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, New Brunswick, NJ, USA.
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3
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Shively KB, Tassé MJ. Using a Delphi Process to Update the Nisonger Child Behavior Rating Form. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:455-472. [PMID: 36306412 DOI: 10.1352/1944-7558-127.6.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/28/2021] [Indexed: 06/16/2023]
Abstract
The Nisonger Child Behavior Rating Form (NCBRF) was developed to specifically screen psychopathology and problem behavior in children and adolescents with IDD. This study aimed to update the NCBRF to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and screen for the most prevalent psychopathologies that affect children and adolescents with IDD. The authors re-aligned the existing items to fit within a DSM-5 framework, and then used the Delphi method with a panel of experts in IDD to evaluate the NCBRF items. The revision process included deleting and revising existing items and formulating new items. We obtained a final item pool after three iterations. The Delphi process and resulting item pool are described in this article.
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Affiliation(s)
| | - Marc J Tassé
- Kelsey B. Shively and Marc J. Tassé, The Ohio State University
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4
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Takahashi H, Kato T. Effectiveness of dance/movement therapy in individuals with intellectual disability: a systematic review. BODY MOVEMENT AND DANCE IN PSYCHOTHERAPY 2022. [DOI: 10.1080/17432979.2022.2101528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Hideki Takahashi
- Human Health Science Department of Brain Function and Rehabilitation, School of Medicine Kyoto University, Kyoto, Japan
| | - Toshihiro Kato
- Human Health Science Department of Brain Function and Rehabilitation, School of Medicine Kyoto University, Kyoto, Japan
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5
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Briegel W. Psychiatric Comorbidities in 1p36 Deletion Syndrome and Their Treatment-A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212064. [PMID: 34831818 PMCID: PMC8619815 DOI: 10.3390/ijerph182212064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/03/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022]
Abstract
1p36 deletion syndrome represents the most common terminal deletion observed in humans. Major clinical findings comprise developmental delay/intellectual disability, poor or absent expressive language, congenital central muscular hypotonia, brain anomalies, brachydactyly/camptodactyly, short feet, and characteristic facial features like straight eyebrows, deep-set eyes, and midface hypoplasia. So far, there is very limited knowledge about comorbid psychiatric disorders and their effective treatment in this special population. To fill this gap, this case report presents an initially four-year-old girl with 1p36.33-1p36.32 deletion, moderate intellectual disability, insomnia, oppositional-defiant disorder and attention deficit/hyperactivity disorder covering a period of time of about 1.5 years comprising initial psychological/psychiatric assessment, subsequent day clinic/outpatient treatment (amongst others including off-label use of melatonin and methylphenidate as well as parent-child interaction therapy) and follow-up assessment. Follow-up results indicated good efficacy of melatonin and methylphenidate medication without any adverse effects. Multidisciplinarity in diagnosis and treatment are mandatory to meet needs of patients with complex genetic disorders like 1p36 deletion syndrome. Off-label use of melatonin (for insomnia) and methylphenidate (for attention deficit/hyperactivity disorder) should be considered in young children with 1p36 deletion syndrome if behavioral interventions are not sufficient.
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Affiliation(s)
- Wolfgang Briegel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Leopoldina Hospital, 97422 Schweinfurt, Germany; ; Tel.: +49-9721-720-3370
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany
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6
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Knott R, Johnson BP, Tiego J, Mellahn O, Finlay A, Kallady K, Kouspos M, Mohanakumar Sindhu VP, Hawi Z, Arnatkeviciute A, Chau T, Maron D, Mercieca EC, Furley K, Harris K, Williams K, Ure A, Fornito A, Gray K, Coghill D, Nicholson A, Phung D, Loth E, Mason L, Murphy D, Buitelaar J, Bellgrove MA. The Monash Autism-ADHD genetics and neurodevelopment (MAGNET) project design and methodologies: a dimensional approach to understanding neurobiological and genetic aetiology. Mol Autism 2021; 12:55. [PMID: 34353377 PMCID: PMC8340366 DOI: 10.1186/s13229-021-00457-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/05/2021] [Indexed: 11/20/2022] Open
Abstract
Background ASD and ADHD are prevalent neurodevelopmental disorders that frequently co-occur and have strong evidence for a degree of shared genetic aetiology. Behavioural and neurocognitive heterogeneity in ASD and ADHD has hampered attempts to map the underlying genetics and neurobiology, predict intervention response, and improve diagnostic accuracy. Moving away from categorical conceptualisations of psychopathology to a dimensional approach is anticipated to facilitate discovery of data-driven clusters and enhance our understanding of the neurobiological and genetic aetiology of these conditions. The Monash Autism-ADHD genetics and neurodevelopment (MAGNET) project is one of the first large-scale, family-based studies to take a truly transdiagnostic approach to ASD and ADHD. Using a comprehensive phenotyping protocol capturing dimensional traits central to ASD and ADHD, the MAGNET project aims to identify data-driven clusters across ADHD-ASD spectra using deep phenotyping of symptoms and behaviours; investigate the degree of familiality for different dimensional ASD-ADHD phenotypes and clusters; and map the neurocognitive, brain imaging, and genetic correlates of these data-driven symptom-based clusters. Methods The MAGNET project will recruit 1,200 families with children who are either typically developing, or who display elevated ASD, ADHD, or ASD-ADHD traits, in addition to affected and unaffected biological siblings of probands, and parents. All children will be comprehensively phenotyped for behavioural symptoms, comorbidities, neurocognitive and neuroimaging traits and genetics. Conclusion The MAGNET project will be the first large-scale family study to take a transdiagnostic approach to ASD-ADHD, utilising deep phenotyping across behavioural, neurocognitive, brain imaging and genetic measures. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-021-00457-3.
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Affiliation(s)
- Rachael Knott
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia.
| | - Beth P Johnson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Jeggan Tiego
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Olivia Mellahn
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Amy Finlay
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Kathryn Kallady
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Maria Kouspos
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Vishnu Priya Mohanakumar Sindhu
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Ziarih Hawi
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Aurina Arnatkeviciute
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Tracey Chau
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Dalia Maron
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Emily-Clare Mercieca
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Kirsten Furley
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Katrina Harris
- Department of Paediatrics, Monash University, Melbourne, VIC, 3800, Australia.,Department of Developmental Paediatrics, Monash Children's Hospital, 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Katrina Williams
- Department of Paediatrics, Monash University, Melbourne, VIC, 3800, Australia.,Department of Developmental Paediatrics, Monash Children's Hospital, 246 Clayton Rd, Clayton, VIC, 3168, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Alexandra Ure
- Department of Paediatrics, Monash University, Melbourne, VIC, 3800, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Department of Mental Health, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Neurodevelopment and Disability Research, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Kylie Gray
- Centre for Educational Development, Appraisal, and Research, University of Warwick, Coventry, CV4 7AL, UK.,Department of Psychiatry, School of Clinical Sciences, Monash University, 246 Clayton Rd, Melbourne, VIC, 3168, Australia
| | - David Coghill
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Mental Health, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Neurodevelopment and Disability Research, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Ann Nicholson
- Faculty of Information and Technology, Monash University, Melbourne, VIC, 3800, Australia
| | - Dinh Phung
- Faculty of Information and Technology, Monash University, Melbourne, VIC, 3800, Australia
| | - Eva Loth
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Luke Mason
- Centre for Brain and Cognitive Development, Birkbeck, University of London, Henry Welcome Building, Malet Street, London, WC1E 7HX, UK
| | - Declan Murphy
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
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Briegel W, Andritschky C. Psychological Adjustment of Children and Adolescents with 22q11.2 Deletion Syndrome and Their Mothers' Stress and Coping-A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052707. [PMID: 33800178 PMCID: PMC7967431 DOI: 10.3390/ijerph18052707] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/25/2021] [Accepted: 03/02/2021] [Indexed: 12/30/2022]
Abstract
At present, there is a lack of longitudinal studies on the psychological adjustment of both children and adolescents with 22q11.2 deletion syndrome (22q11.2DS) and their primary caregivers. To fill this gap, we performed a four-year follow-up study. Mothers filled out the Child Behavior Checklist 4–18, the Social Orientation of Parents with Handicapped Children questionnaire to assess maternal stress and coping strategies, and the Freiburger Personality Inventory-Revised—subscales strain and life satisfaction. Fifty-five subjects with 22q11.2DS (26 males and 29 females; age: M = 10.79 years, SD = 3.56 years) and their biological mothers (age: M = 40.84 years, SD = 4.68 years) were included in this study. Significantly higher levels of behavior problems than in the general population and an increase in these problems, especially internalizing ones, over time could be found. In contrast, maternal stress did not change significantly over time, but mothers demonstrated increased levels of strain and reduced life satisfaction at T2. Thus, careful monitoring as well as early and adequate interventions, if indicated, should be offered to families with a child with 22q11.2DS, not only for somatic complaints but also for problems with psychological adjustment.
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Affiliation(s)
- Wolfgang Briegel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Leopoldina Hospital, 97422 Schweinfurt, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany;
- Correspondence: ; Tel.: +49-9721-720-3370
| | - Christoph Andritschky
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany;
- Department of Pneumology, Critical Care and Allergology, Lung Centre South-West, 88239 Wangen im Allgäu, Germany
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Bryant A, Guy J, Holmes J. The Strengths and Difficulties Questionnaire Predicts Concurrent Mental Health Difficulties in a Transdiagnostic Sample of Struggling Learners. Front Psychol 2020; 11:587821. [PMID: 33329246 PMCID: PMC7717974 DOI: 10.3389/fpsyg.2020.587821] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022] Open
Abstract
Children and adolescents with developmental problems are at increased risk of experiencing mental health problems. The Strengths and Difficulties Questionnaire (SDQ) is widely used as a screener for detecting mental health difficulties in these populations, but its use thus far has been restricted to groups of children with diagnosed disorders (e.g., ADHD). Transdiagnostic approaches, which focus on symptoms and soften or remove the boundaries between traditional categorical disorders, are increasingly adopted in research and practice. The aim of this study was to assess the potential of the SDQ to detect concurrent mental health problems in a transdiagnostic sample of children. The sample were referred by health and educational professionals for difficulties related to learning (N = 389). Some had one diagnosis, others had multiple, but many had no diagnoses. Parent-rated SDQ scores were significantly positively correlated with parent ratings of mental health difficulties on the Revised Child Anxiety and Depression Scale (RCADS). Ratings on the SDQ Emotion subscale significantly predicted the likelihood of having concurrent clinical anxiety and depression scores. Ratings on the Hyperactivity subscale predicted concurrent anxiety levels. These findings suggest the SDQ could be a valuable screening tool for identifying existing mental health difficulties in children recognized as struggling, as it can be in typically developing children and those with specific diagnoses.
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Affiliation(s)
- Annie Bryant
- Department of Clinical Psychology, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Jacalyn Guy
- Medical Research Council (MRC) Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Joni Holmes
- Medical Research Council (MRC) Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
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Buckley N, Glasson EJ, Chen W, Epstein A, Leonard H, Skoss R, Jacoby P, Blackmore AM, Srinivasjois R, Bourke J, Sanders RJ, Downs J. Prevalence estimates of mental health problems in children and adolescents with intellectual disability: A systematic review and meta-analysis. Aust N Z J Psychiatry 2020; 54:970-984. [PMID: 32475125 DOI: 10.1177/0004867420924101] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Children and adolescents with intellectual disability are at risk of developing psychiatric symptoms and disorders; yet, the estimates reported in the literature have been inconsistent, presenting a potential barrier for service planning and delivery. Sources of variability could arise from differences in measurement instruments as well as subgroup membership by severity of intellectual disability, gender and age. This systematic review aimed to address these gaps. METHOD MEDLINE and PsycINFO databases were searched from inception to 2018 and selected studies were reviewed. Studies were included if they reported point prevalence estimates of mental health symptomology or diagnoses in a general population of 6- to 21-year-old individuals with intellectual disability. The Joanna Briggs Institute Prevalence Critical Appraisal Checklist was applied to eligible papers to appraise their scientific strength. Pooled prevalence for mental health symptomology was determined using a random-effects meta-analysis. RESULTS A total of 19 studies were included, including 6151 children and adolescents. The pooled prevalence estimate captured by the Developmental Behaviour Checklist was 38% (95% confidence interval = [31, 46]), contrasting with 49% (95% confidence interval = [46, 51]) captured by the Child Behaviour Checklist; both rates were higher than a non-intellectual disability population. Severity of intellectual disability did not significantly influence the Developmental Behaviour Checklist risks. Insufficient data were available to conduct statistical analyses on the effects of age, gender and socioeconomic status. Of diagnosed psychiatric disorders, attention deficit/hyperactivity disorder (30%), conduct disorder (3-21%) and anxiety disorders (7-34%) were the most prevalent conditions. CONCLUSION This review consists of the largest sample hitherto evaluated. In the intellectual disability population, mental health comorbidities could be better detected by a symptom phenotype than a psychiatric diagnostic phenotype. Crucially, future research needs to address the effect of measurement validity in the intellectual disability population. Estimated prevalence rates were high compared to the general population, indicating the importance of systematic screening, case detection and appropriate management.
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Affiliation(s)
- Nicholas Buckley
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Emma J Glasson
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Wai Chen
- Mental Health Service, Fiona Stanley Hospital, Department of Health, Perth, WA, Australia.,Centre for Child and Adolescent Related Disorders, Graduate School of Education, The University of Western Australia, Perth, WA, Australia.,School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Current affiliations: Mental Health Service, Fiona Stanley Hospital, Department of Health, Perth, WA, Australia; School of Medicine, Notre Dame University, Fremantle, Perth, WA, Australia and College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia
| | - Amy Epstein
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Rachel Skoss
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Peter Jacoby
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Amanda Marie Blackmore
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.,Therapy and Other Health Services, Ability Centre, Perth, WA, Australia
| | | | - Jenny Bourke
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | | | - Jenny Downs
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
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Miller J, Perera B, Shankar R. Clinical guidance on pharmacotherapy for the treatment of attention-deficit hyperactivity disorder (ADHD) for people with intellectual disability. Expert Opin Pharmacother 2020; 21:1897-1913. [PMID: 32692263 DOI: 10.1080/14656566.2020.1790524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION ADHD causes significant distress and functional impairment in multiple domains of daily life. Therefore, diagnosis and treatment are important to improve the quality of life of people. The pharmacotherapy for ADHD is well established but needs systematic evaluation in Intellectual Disability (ID) populations. AREAS COVERED This paper reviews the ADHD pharmacological treatment in people with ID using the PRISMA guidance for scoping reviews to help identify the nature and strength of evidence. EXPERT OPINION In the last 20 years, seven randomized controlled trials have evaluated pharmacotherapies for ADHD in people with ID; five looking at methylphenidate. Generally, studies were underpowered; all but two had less than 25 participants. Of the two larger trials one was single blinded and therefore open to bias. Only two used a parallel-group method, the remainder were mostly short crossover trials; not ideal when measuring behavioral and psychological parameters which are long standing. The remaining evidence is made up of observational studies. Methylphenidate and atomoxetine, particularly at higher doses, have shown clear benefits in people with ID. Most people with ID tolerated ADHD medications well. Benefits were seen in behavioral and/or cognitive domains. The evidence base is limited, though promising, for dexamfetamine, clonidine, and guanfacine.
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Affiliation(s)
- Jonjo Miller
- Haringey Learning Disability Partnership, Barnet, Enfield and Haringey Mental Health NHS Trust , London, UK
| | - Bhathika Perera
- Haringey Learning Disability Partnership, Barnet, Enfield and Haringey Mental Health NHS Trust , London, UK
| | - Rohit Shankar
- Cornwall Partnership NHS Foundation Trust, Threemilestone Industrial Estate Truro , Truro, England, UK.,Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital Truro Cornwall , Truro, England, UK
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11
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Psychiatric Disorders and Distal 21q Deletion-A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093096. [PMID: 32365584 PMCID: PMC7246703 DOI: 10.3390/ijerph17093096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 11/17/2022]
Abstract
Partial deletion of chromosome 21q is a very rare genetic condition with highly variable phenotypic features including heart defects, high or cleft palate, brain malformations (e.g., cerebral atrophy), developmental delay and intellectual disability. So far, there is very limited knowledge about psychiatric disorders and their effective treatment in this special population. To fill this gap, the authors present the case of an initially five-year-old girl with distal deletion (del21q22.2) and comorbid oppositional defiant disorder (main psychiatric diagnosis) covering a period of time of almost four years comprising initial psychological/psychiatric assessment, subsequent treatment with Parent-Child Interaction Therapy (PCIT), and follow-up assessments. Post-intervention results including a 19-month follow-up indicated good overall efficacy of PCIT and high parental satisfaction with the treatment. This case report makes a substantial contribution to enhancing knowledge on psychiatric comorbidity and its effective treatment in patients with terminal 21q deletion. Moreover, it emphasizes the necessity of multidisciplinarity in diagnosis and treatment due to the variety of anomalies associated with 21q deletion. Regular screenings for psychiatric disorders and (if indicated) thorough psychological and psychiatric assessment seem to be reasonable in most affected children, as children with developmental delays are at increased risk of developing psychiatric disorders. As demonstrated with this case report, PCIT seems to be a good choice to effectively reduce disruptive behaviors in young children with partial deletion of chromosome 21q.
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Hemati Alamdarloo G, Majidi F. Feelings of hopelessness in mothers of children with neurodevelopmental disorders. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:485-494. [PMID: 35937174 PMCID: PMC9351562 DOI: 10.1080/20473869.2020.1736886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 06/15/2023]
Abstract
The aim of the present study was to compare feelings of hopelessness in mothers of children with neurodevelopmental disorders. The statistical population of the study included all mothers of children with neurodevelopmental disorders in Shiraz, Iran. The sample consisted of 150 mothers of children with neurodevelopmental disorders, including 50 mothers of children with autism spectrum disorder (ASD), 50 mothers of children with intellectual disability (ID), and 50 mothers of children with specific learning disorder (SLD) and they were selected by convenience sampling method. The data were collected during the years 2015-2016. The Beck Hopelessness Scale (BHS; Beck et al.) was used for measuring the feelings of hopelessness. The one-way ANOVA and MANOVA tests were used for the data analysis. The results showed that the feelings of hopelessness and the two subscales of feelings of hopelessness, i.e. negative expectations of the future and the loss of motivation in association with the future, in mothers of children with ASD were significantly higher than those of the other two groups of mothers. It was also observed that mothers of children with ID, compared to mothers of children with SLD, had higher levels of feelings of hopelessness, negative expectations of the future, and negative feelings in association with the future. Additionally, the findings revealed that mothers of children with ASD, compared to mothers of children with SLD, had higher levels of negative feelings in association with the future. Therefore, adopting preventive and intervention programs which can help mothers of children with neurodevelopmental disorders, especially mothers of children with ASD, to overcome their feelings of hopelessness are of great importance.
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Affiliation(s)
| | - Farzad Majidi
- Special Education Department, Shiraz University, Shiraz, Iran
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13
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Melby L, Indredavik MS, Løhaugen G, Brubakk AM, Skranes J, Vik T. Is there an association between full IQ score and mental health problems in young adults? A study with a convenience sample. BMC Psychol 2020; 8:7. [PMID: 32000845 PMCID: PMC6993501 DOI: 10.1186/s40359-020-0372-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 01/13/2020] [Indexed: 01/18/2023] Open
Abstract
Background Intelligence is the aggregate or global capacity of the individual to act purposefully, to think rationally and to deal effectively with the environment. Previous studies have shown that individuals with intellectual disability, IQ < 70, have increased risk of being diagnosed with one or more mental disorders. We wanted to investigate if this also applies to individuals with IQ between 70 and 85. Methods In this study, data was abstracted from a longitudinal follow-up study of individuals with low birth weight and a control group. In the present study, mental health of participants with borderline IQ, defined as a full IQ score 70–84, were compared with mental health of a reference group with full IQ scores ≥85. Mental health at age 19 was assessed using the Schedule for Affective Disorder and Schizophrenia for School-age Children Present and Lifetime (K-SADS P/L) whereby scores meeting the diagnostic criteria for a mental disorder were defined as having mental health problems. In addition the participants completed the ADHD-rating scale and the Autism Spectrum Quotient form (AQ). Logistic regression analyses were used to calculate odds ratio (OR) with 95% confidence intervals (CI) for high scores on the K-SADS. Results Thirty participants with borderline IQ and 146 controls were included. Sixteen (53%) of the participants with borderline IQ met the diagnostic criteria on the K-SADS for any diagnosis compared with 18 (12%) in the reference group (OR: 6.2; CI: 2.6–14.9). In particular the participants with borderline IQ had excess risk of ADHD and anxiety. These associations were slightly attenuated when adjusted for birth weight and parents’ socioeconomic status. Conclusions 53% of the participants with borderline IQ had increased risk for a research assessed psychiatric diagnosis compared to about one in ten in the reference group. The group with borderline IQ also had higher total scores and higher scores on some sub-scores included in the Autism Spectrum Quotient form. Our results points towards an increased vulnerability for mental illness in individuals with borderline low IQ. Trial registration The main study is recorded by the Regional Committee for Health Research Ethics in Mid-Norway (as project number 4.2005.2605).
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Affiliation(s)
- Linde Melby
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 6630, Tingvoll, Norway.
| | - Marit S Indredavik
- Child and Adolescent Psychiatry, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Gro Løhaugen
- Department of Pediatrics, Sørlandet Hospital Arendal, Arendal, Norway
| | - Ann Mari Brubakk
- Pediatrics, Department of Clinical and Molecular medicine, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Jon Skranes
- Department of Pediatrics, Sørlandet Hospital Arendal, Arendal, Norway.,Pediatrics, Department of Clinical and Molecular medicine, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Torstein Vik
- Pediatrics, Department of Clinical and Molecular medicine, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway.,St. Olavs Hospital, Trondheim, Norway
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14
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Tural Hesapcioglu S, Ceylan MF, Kasak M, Yavas CP. Psychiatric comorbidities of mild intellectual disability in children and adolescents in a clinical setting. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 67:151-157. [PMID: 34141408 PMCID: PMC8115543 DOI: 10.1080/20473869.2019.1634935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/17/2019] [Accepted: 06/16/2019] [Indexed: 06/12/2023]
Abstract
The aim of this study was to investigate the psychiatric disorders that accompany mild intellectual disability (ID) in school-aged children in a clinical setting. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version interview was conducted with the children with mild ID and their parents to diagnose any comorbid disorders. The mean age of the 111 children that fulfilled the study criteria was 12.09 ± 3.28 years, 59 of them (53.2%) were males, and 80.2% had at least one lifetime comorbid psychiatric diagnosis. Attention deficit hyperactivity disorder (64.9%), oppositional defiant disorder (21.6%), anxiety disorders (18.0%), were the most common comorbidities. The correlates of exhibiting comorbid psychiatric disorder were being male and irritability symptoms in the clinical history. Being aware of the comorbid psychiatric disorders and planning treatment strategies toward all of the diagnoses may help in the adaptation and rehabilitation of children with mild IDs.
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Affiliation(s)
- Selma Tural Hesapcioglu
- Faculty of Medicine, Child and Adolescent Psychiatry, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Mehmet Fatih Ceylan
- Faculty of Medicine, Child and Adolescent Psychiatry, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Meryem Kasak
- Faculty of Medicine, Child and Adolescent Psychiatry, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Cansu Pınar Yavas
- Faculty of Medicine, Child and Adolescent Psychiatry, Ankara Yildirim Beyazit University, Ankara, Turkey
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15
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Tassé MJ, Balboni G, Navas P, Luckasson R, Nygren MA, Belacchi C, Bonichini S, Reed GM, Kogan CS. Developing behavioural indicators for intellectual functioning and adaptive behaviour for ICD-11 disorders of intellectual development. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:386-407. [PMID: 30628126 DOI: 10.1111/jir.12582] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/31/2018] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND We present the work conducted to arrive at deriving behavioural indicators that could be used to guide clinical judgement in determining the presence and severity of deficits in intellectual functioning and adaptive behaviour for the purpose of making a diagnosis of disorders of intellectual development. METHODS An interdisciplinary expert panel provided guidance in developing behavioural indicators for intellectual functioning. A national dataset of adaptive behaviour on a sample of individuals with a diagnosis of intellectual disability was used to develop the behavioural indicators for the adaptive behaviour. The adaptive behaviour data were analysed using a cluster analysis procedure to define the different severity groupings by chronological age groups. RESULTS We present a series of tables containing behavioural indicators across the lifespan for intellectual functioning and adaptive behaviour, including conceptual, social and practical skills. These tables of behavioural indicators have been proposed for use in the clinical version of the 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11) to be published by the World Health Organization. CONCLUSIONS The proposed behavioural indicators for disorders of ID described in the present article and to be included in the ICD-11 Clinical Descriptions and Diagnostic Guidelines are put forth to assist professionals in making an informed clinical decision regarding an individual's level of intellectual functioning and adaptive behaviour for the purpose of making a determination about the presence and severity of disorders of ID.
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Affiliation(s)
- M J Tassé
- Nisonger Center & Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - G Balboni
- Department of Philosophy, Social and Human Sciences and Education, University of Perugia, Perugia, Italy
| | - P Navas
- INICO & Department of Personality, Assessment and Psychological Treatment, University of Salamanca, Salamanca, Spain
| | - R Luckasson
- Department of Special Education, University of New Mexico, Albuquerque, NM, USA
| | - M A Nygren
- American Association on Intellectual and Developmental Disabilities, Washington, DC, USA
| | - C Belacchi
- Department of Communication, Sciences Humanities and International Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - S Bonichini
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - G M Reed
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - C S Kogan
- School of Psychology, University of Ottawa, Ottawa, Canada
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16
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Li M, Yue W. VRK2, a Candidate Gene for Psychiatric and Neurological Disorders. MOLECULAR NEUROPSYCHIATRY 2018; 4:119-133. [PMID: 30643786 PMCID: PMC6323383 DOI: 10.1159/000493941] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 09/20/2018] [Indexed: 12/20/2022]
Abstract
Recent large-scale genetic approaches, such as genome-wide association studies, have identified multiple genetic variations that contribute to the risk of mental illnesses, among which single nucleotide polymorphisms (SNPs) within or near the vaccinia related kinase 2 (VRK2) gene have gained consistent support for their correlations with multiple psychiatric and neurological disorders including schizophrenia (SCZ), major depressive disorder (MDD), and genetic generalized epilepsy. For instance, the genetic variant rs1518395 in VRK2 showed genome-wide significant associations with SCZ (35,476 cases and 46,839 controls, p = 3.43 × 10-8) and MDD (130,620 cases and 347,620 controls, p = 4.32 × 10-12) in European populations. This SNP was also genome-wide significantly associated with SCZ in Han Chinese population (12,083 cases and 24,097 controls, p = 3.78 × 10-13), and all associations were in the same direction of allelic effects. These studies highlight the potential roles of VRK2 in the central nervous system, and this gene therefore might be a good candidate to investigate the shared genetic and molecular basis between SCZ and MDD, as it is one of the few genes known to show genome-wide significant associations with both illnesses. Furthermore, the VRK2 gene was found to be involved in multiple other congenital deficits related to the malfunction of neurodevelopment, adding further support for the involvement of this gene in the pathogenesis of these neurological and psychiatric illnesses. While the precise function of VRK2 in these conditions remains unclear, preliminary evidence suggests that it may affect neuronal proliferation and migration via interacting with multiple essential signaling pathways involving other susceptibility genes/proteins for psychiatric disorders. Here, we have reviewed the recent progress of genetic and molecular studies of VRK2, with an emphasis on its role in psychiatric illnesses and neurological functions. We believe that attention to this important gene is necessary, and further investigations of VRK2 may provide hints into the underlying mechanisms of SCZ and MDD.
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Affiliation(s)
- Ming Li
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Kunming, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Weihua Yue
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University) and National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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17
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Hyperkinetic disorder in a community service for people with intellectual disability. Ir J Psychol Med 2018; 38:177-181. [PMID: 30280680 DOI: 10.1017/ipm.2018.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND There appears to be a higher rate of prevalence of hyperkinetic disorder in the intellectual disability (ID) population, although there is a large variability in rates in previous studies. Hyperkinetic disorder can be a challenge to diagnose in a population with ID and can present a barrier to the development of the activities of daily living in an already vulnerable population. OBJECTIVES Our objective was to examine the point prevalence of hyperkinetic disorder in the ID population in a community ID service and also to determine the prevalence of hyperkinetic disorder based on the level of ID. METHODS A cross-sectional review of the Online Information Service 'OLIS' database was undertaken to establish the total number of patients with ID and those with comorbid hyperkinetic disorder. The overall point prevalence and prevalence based on the level of ID was calculated from the collected data. RESULTS The point prevalence of hyperkinetic disorder in the population with ID was similar to that found in studies in the general population at 3.1% in adults and 32.6% in children. When divided by the level of disability, the calculated point prevalence in both adults and children was highest in the population with mild ID and decreased as the level of disability increased. CONCLUSION This report contributes to previous research establishing the rates of hyperkinetic disorder in an ID population and establishes the point prevalence of hyperkinetic disorder in individuals diagnosed with ID in a clinical sample.
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18
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Tromans S, Chester V, Kiani R, Alexander R, Brugha T. The Prevalence of Autism Spectrum Disorders in Adult Psychiatric Inpatients: A Systematic Review. Clin Pract Epidemiol Ment Health 2018; 14:177-187. [PMID: 30197663 PMCID: PMC6118035 DOI: 10.2174/1745017901814010177] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/22/2018] [Accepted: 06/16/2018] [Indexed: 12/27/2022]
Abstract
Background: Whilst the prevalence of autism spectrum disorders in adults within the community setting is well-established, less is known about the prevalence among adults based within a psychiatric inpatient setting. Objective: To conduct a systematic literature review pertaining to the prevalence of autism spectrum disorders among the adult psychiatric inpatient population. Method: Eligibility criteria included: (a) investigation of the prevalence of autism spectrum disorders (b) adult psychiatric inpatient study population (c) published in English language. Electronic databases accessed included PubMed, Medline, CINAHL, PsycINFO and EMBASE. Additionally, the ancestry method was utilised for the references of eligible papers, as well as grey literature searches and consultation with experts in the field. Results: From the search, 4 studies were identified which satisfied the inclusion criteria, conducted in a variety of inpatient psychiatric settings, including secure forensic and intellectual disability units and a state psychiatric hospital. There were significant differences in methodological approaches, including the screening tests, diagnostic instruments and diagnostic criteria utilised. Autism spectrum disorder prevalence estimates varied considerably, from 2.4-9.9%. Conclusion: From the limited research data currently available, it appears that the prevalence of autism spectrum disorders is increased in inpatient psychiatric settings relative to the general population. There is a need for further high quality research in this patient group, to add to this limited evidence base, as well as in developing effective strategies to identify patients with a high likelihood of autism spectrum disorders within this setting.
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Affiliation(s)
- Samuel Tromans
- Department of Health Sciences, University of Leicester, Leicester, Leicestershire, United Kingdom.,Leicestershire Partnership NHS Trust, Leicester, Leicestershire, United Kingdom
| | - Verity Chester
- Priory Group, Norwich, Norfolk, United Kingdom.,Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Reza Kiani
- Department of Health Sciences, University of Leicester, Leicester, Leicestershire, United Kingdom.,Leicestershire Partnership NHS Trust, Leicester, Leicestershire, United Kingdom
| | - Regi Alexander
- Department of Health Sciences, University of Leicester, Leicester, Leicestershire, United Kingdom.,Hertfordshire Partnership University NHS Foundation Trust, Broadland Clinic & Astley Court, Norwich, United Kingdom
| | - Terry Brugha
- Department of Health Sciences, University of Leicester, Leicester, Leicestershire, United Kingdom.,Leicestershire Partnership NHS Trust, Leicester, Leicestershire, United Kingdom
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19
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Maïano C, Coutu S, Tracey D, Bouchard S, Lepage G, Morin AJS, Moullec G. Prevalence of anxiety and depressive disorders among youth with intellectual disabilities: A systematic review and meta-analysis. J Affect Disord 2018; 236:230-242. [PMID: 29751238 DOI: 10.1016/j.jad.2018.04.029] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/04/2018] [Accepted: 04/04/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND The purpose of this meta-analytic study was to determine the pooled prevalence estimates of anxiety and depressive disorders among children and adolescents with intellectual disabilities (ID) and to assess the extent to which these pooled prevalence rates differed according to studies' characteristics. METHOD A systematic literature search was performed in nine databases and 21 studies, published between 1975 and 2015, met the inclusion criteria. RESULTS The resulting pooled prevalence estimates of combined subtypes of anxiety and depressive disorders were respectively (a) 5.4% and 2.8% across samples; (b) 1.2% and 0.03% among children; and (c) 7.9% and 1.4% among adolescents. Pooled prevalence estimates for specific subtypes of anxiety disorders ranged from (a) 0.2% to 11.5% across samples; (b) 0.7% to 17.6% among children; and (c) 0.6% to 19.8% among adolescents. Pooled prevalence estimates of dysthymic disorder and major depressive disorder were respectively (a) 3.4% and 2.5% across samples; (b) 2.1% and 3.2% among children; and (c) 6.9% and 5.7% among adolescents. Finally, subgroup analyses showed significant variations in the pooled prevalence estimates of combined subtypes of anxiety disorders, obsessive-compulsive disorder, and generalized anxiety disorder; and combined subtypes of depressive disorders. LIMITATIONS The present findings of this meta-analysis should be interpreted with caution given several limitations related to the characteristics of the populations, diagnostic method and sampling method. CONCLUSION Findings provide recommendations for future studies investigating psychological disorders among youth with ID, as well as how clinicians and policy makers can improve diagnostic practices and support for youth with ID.
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Affiliation(s)
- Christophe Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Gatineau, Canada; Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada; Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montréal, Canada.
| | - Sylvain Coutu
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada
| | - Danielle Tracey
- School of Education, Western Sydney University, Sydney, Australia
| | - Stéphane Bouchard
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Gatineau, Canada; Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada
| | - Geneviève Lepage
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montréal, Canada
| | - Grégory Moullec
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada; School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, Canada; Research Center, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Nord-de-l'Île-de-Montréal, Montréal, Canada
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20
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Wright B, Williams C, Richardson G. Services for children with learning disabilities. PSYCHIATRIC BULLETIN 2018. [DOI: 10.1192/pb.bp.106.013656] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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21
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McClain MB, Hasty Mills AM, Murphy LE. Inattention and hyperactivity/impulsivity among children with attention-deficit/hyperactivity-disorder, autism spectrum disorder, and intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 70:175-184. [PMID: 28957735 DOI: 10.1016/j.ridd.2017.09.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 08/18/2017] [Accepted: 09/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and Intellectual Disability (ID) are common co-occurring neurodevelopmental disorders; however, limited research exists regarding the presentation and severity of overlapping symptomology, particularly inattention and hyperactivity/impulsivity, when a child is diagnosed with one of more of these neurodevelopmental disorders. AIMS As difficulties with inattention and hyperactivity/impulsivity are symptoms frequently associated with these disorders, the current study aims to determine the differences in the severity of inattention and hyperactivity/impulsivity in children diagnosed with ADHD, ASD, ID, and co-occurring diagnosis of ADHD/ID, ASD/ADHD, and ASD/ID. METHODS AND PROCEDURES Participants in the current study included 113 children between the ages of 6 and 11 who were diagnosed with ADHD, ASD, ID, ADHD/ID, ASD/ADHD, or ASD/ID. Two MANOVA analyses were used to compare these groups witih respsect to symptom (i.e., inattention, hyperactivity/impulsivity) severity. OUTCOMES AND RESULTS Results indicated that the majority of diagnostic groups experienced elevated levels of both inattention and hyperactivity/impulsivity. However, results yielded differences in inattention and hyperactivity/impulsivity severity. In addition, differences in measure sensitivity across behavioral instruments was found. CONCLUSIONS AND IMPLICATIONS Children with neurodevelopmental disorders often exhibit inattention and hyperactivity/impulsivity, particularly those with ADHD, ASD, ASD/ADHD, and ADHD/ID; therefore, differential diagnosis may be complicated due to similarities in ADHD symptom severity. However, intellectual abilities may be an important consideration for practitioners in the differential diagnosis process as children with ID and ASD/ID exhibited significantly less inattention and hyperactive/impulsive behaviors. Additionally, the use of multiple behavior rating measures in conjunction with other assessment procedures may help practitioners determine the most appropriate diagnosis.
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Affiliation(s)
- Maryellen Brunson McClain
- Utah State University, Emma Eccles Jones College of Education and Human Services, Department of Psychology, 2800 Old Main Hill, Logan, UT 84322, USA.
| | - Amber M Hasty Mills
- Glenwood Autism and Behavioral Health Center, 150 Glenwood Lane, Birmingham, AL, 35242, USA.
| | - Laura E Murphy
- University of Tennessee Health Science Center (UTHSC), Boling Center for Developmental Disabilities (BCDD) and UTHSC Department of Psychiatry, 711 Jefferson Avenue, Memphis, TN 38105, USA.
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22
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McKenzie K, Martin L, Ouellette-Kuntz H. Needles in the haystack: Using open-text fields to identify persons with intellectual and developmental disabilities in administrative home care data. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 69:85-95. [PMID: 28841496 DOI: 10.1016/j.ridd.2017.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/29/2017] [Accepted: 07/25/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Use of administrative health data to study populations of interest is becoming more common. Identifying individuals with intellectual and developmental disabilities (IDD) in existing databases can be challenging due to inconsistent definitions and terminologies of IDD over time and across sectors, and the inability to rely on etiologies of IDD as they are frequently unknown. AIMS To identify diagnoses related to IDD in an administrative database and create a cohort of persons with IDD. METHODS Open-text diagnostic entries related to IDD were identified in an Ontario home care database (2003-2015) and coded as being either acceptable (e.g. Down syndrome) or ambiguous (e.g. intellectually challenged). The cognitive and functional skills of the resulting groups were compared using logistic regressions and standardized differences, and their age distributions were compared to that of the general home care population. RESULTS Just under 1% of the home care population had a diagnostic entry related to IDD. Ambiguous terms were most commonly used (61%), and this group tended to be older and less impaired than the group with more acceptable terms used to describe their IDD. CONCLUSIONS Open-text diagnostic variables in administrative health records can be used to identify and study individuals with IDD. IMPLICATIONS Future work is needed to educate assessors on the importance of using standard, accepted terminology when recording diagnoses related to IDD.
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Affiliation(s)
- Katherine McKenzie
- Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7 B 5E1, Canada.
| | - Lynn Martin
- Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7 B 5E1, Canada.
| | - Hélène Ouellette-Kuntz
- Department of Public Health Sciences, Queen's University & Ongwanada, 191 Portsmouth Avenue, Kingston, Ontario, Kingston, K7 M 8A6, Canada.
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23
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Roording-Ragetlie S, Klip H, Buitelaar J, Slaats-Willemse D. Working memory training in children with neuropsychiatric disorders and mild to borderline intellectual functioning, the role of coaching; a double-blind randomized controlled trial. BMC Psychiatry 2017; 17:114. [PMID: 28351374 PMCID: PMC5371244 DOI: 10.1186/s12888-017-1274-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 03/17/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Working memory training (WMT) has been shown to offer therapeutic benefits to both patients with Attention-Deficit Hyperactivity Disorder (ADHD) and patients with mild to borderline Intellectual Disabilities (MBID; 60 < IQ < 85). However, robust evidence for transfer effects and treatment benefits of WMT over placebo training are lacking. Owing to the nature of double-blind research designs in RCTs, children have received non-specific coaching not based on their actual training performance. Active coaching based on individual training results (such as in clinical practice) might enhance the efficacy of Cogmed WMT. Furthermore, clinical experience and the general treatment approach to these vulnerable children has shown that the intensity and duration of WMT is often too stressful. This study therefore investigated the efficacy of a less intensive, but more prolonged Cogmed WMT (including active personalized coaching and feedback) in reducing behavioral symptoms and improving neurocognitive functioning and academic achievements in children with MBID and neuropsychiatric disorders. METHODS/DESIGN A double-blind RCT with children (age 10.0-13.11) with neuropsychiatric disorders (ADHD and/or autism spectrum disorder (ASD)) and MBID (IQ: 60 < IQ < 85). Two groups (each n = 26) will receive Cogmed WMT (version R/M) at home or at school for 8 weeks, 4 days a week, at 30 min a day. One group will receive active personalized coaching and feedback based on their actual individual performance during Cogmed training. The other group will only receive general non-personalized coaching (i.e. no receive personalized coaching and feedback). Both groups will undergo a neurocognitive assessment (working memory, executive functioning, academic achievements) before and after training and complete several questionnaires (behavioral problems, parenting style) with a 6 months follow-up. DISCUSSION This study will add to the literature since the role of coaching in Cogmed WMT has not been studied before. It will also provide opportunities to investigate an alternative version of WMT in a large group of vulnerable children, for whom few evidence-based treatments are available. Ultimately, this will allow us to advise mental health care professionals and special education schools about the use of this type of intervention for children with MBID and neuropsychiatric disorders. TRIAL REGISTRATION Dutch Trial Register. NTR5223 . Registration date 06-09-2015.
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Affiliation(s)
- Sammy Roording-Ragetlie
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands. .,Karakter Child and Adolescent Psychiatry, Utrechtseweg 320, 6862 BC, Oosterbeek, The Netherlands.
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
| | - Jan Buitelaar
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands ,Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands ,0000000122931605grid.5590.9Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Dorine Slaats-Willemse
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands ,Department of Psychiatry, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Tonnsen BL, Boan AD, Bradley CC, Charles J, Cohen A, Carpenter LA. Prevalence of Autism Spectrum Disorders Among Children With Intellectual Disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 121:487-500. [PMID: 27802102 DOI: 10.1352/1944-7558-121.6.487] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Autism spectrum disorders (ASD) often co-occur with intellectual disability (ID) and are associated with poorer psychosocial and family-related outcomes than ID alone. The present study examined the prevalence, stability, and characteristics of ASD estimates in 2,208 children with ASD and ID identified through the South Carolina Autism and Developmental Disabilities Network. The prevalence of ASD in ID was 18.04%, relative to ASD rates of 0.60%-1.11% reported in the general South Carolina population. Compared to children with ASD alone, those with comorbid ID exhibited increased symptom severity and distinct DSM-IV-TR profiles. Further work is needed to determine whether current screening, diagnostic, and treatment practices adequately address the unique needs of children and families affected by comorbid ASD and ID diagnoses.
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Affiliation(s)
- Bridgette L Tonnsen
- Bridgette L. Tonnsen, Department of Psychological Sciences, Purdue University; Andrea Boan, Catherine Bradley, and Jane Charles, Department of Developmental and Behavioral Pediatrics, Medical University of South Carolina; Amy Cohen, Department of Psychology, University of Illinois at Urbana-Champaign; and Laura A. Carpenter, Department of Developmental and Behavioral Pediatrics, Medical University of South Carolina
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Yousefichaijan P, Sharafkhah M, Rafiei M, Salehi B. Attention-deficit/hyperactivity disorder in children with overactive bladder; a case-control study. J Renal Inj Prev 2016; 5:193-9. [PMID: 27689122 PMCID: PMC5039988 DOI: 10.15171/jrip.2016.41] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 08/03/2016] [Indexed: 11/30/2022] Open
Abstract
Introduction: Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood psychiatric disorder. This disorder is more prevalent in some chronic diseases.
Objectives: To investigate ADHD in children with overactive bladder.
Patients and Methods: A number of 92 children with overactive bladder and 92 healthy children without overactive bladder (age range of both groups 5 to 12 years old) were included in this study as case and control groups, respectively. Participants were selected from children who had referred to a pediatric clinic in Arak city, Iran. ADHD types (inattentive, hyperactive-impulsive, and mixed) were diagnosed by Conner’s Parent Rating Scale and Diagnostic and Statistical Manual of Mental Disorders IV-TR (DSM-IV-TR) criteria. Data were analyzed by chi-square and t tests.
Results: In both groups, 51 children (27.7%) had ADHD. The prevalence of ADHD in the case group (33 cases, 35.9%) was significantly higher than the control group (18 cases, 19.6%) (P = 0.021). Inattentive ADHD was observed in 22 participants (23.9%) of the case group and nine participants of the control group (9.7%) (P = 0.047). Despite this significant difference, three (3.2%) and four (4.3%) children were affected by hyperactive-impulsive ADHD (P = 0.73), and eight (8.6%) and five (5.4%) children were affected by mixed ADHD (P = 0.42) in the case and control groups, respectively.
Conclusion: ADHD bladder is significantly more common in children with overactive bladder than healthy children. The observed correlation between ADHD and overactive bladder makes psychological counseling mandatory in children with overactive bladder.
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Affiliation(s)
| | - Mojtaba Sharafkhah
- Students Research Committee, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Rafiei
- Department of Biostatistics and Epidemiology, Arak University of Medical Sciences, Arak, Iran
| | - Bahman Salehi
- Department of Psychiatry, School of Medicine, Arak University of Medical Sciences, Arak, Iran
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Cohen SR, Zeedyk S, Tipton LA, Rodas NV, Blacher J. Fathers of children with or without ID: understanding long-term psychological symptoms. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:295-307. [PMID: 26708718 PMCID: PMC4925317 DOI: 10.1111/jir.12232] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 09/03/2015] [Accepted: 09/07/2015] [Indexed: 05/25/2023]
Abstract
BACKGROUND Researchers have primarily relied on mother report to understand the parenting contexts of rearing children with intellectual disabilities. Fathers are increasingly being considered as equally important reporters of their child's behaviours, as they have unique and independent relationships with their children. The purpose of this study was to understand how one source of stress - reports of child behaviour problems - along with spousal support related to parenting tasks, associated with fathers' reports of psychological symptoms over time. METHOD One hundred eighty-two father participants completed measures of child behaviour problems, spousal support and psychological symptoms. Growth curve modelling was employed to examine paternal psychological symptoms over the child's developmental trajectory. RESULTS Fathers' reports of child behaviour problems predicted initial levels of paternal psychological symptoms but did not predict change in paternal psychological symptoms over time. Spousal support further reduced initial levels of paternal psychological symptoms. CONCLUSIONS Child behaviour problems are more important than disability status in predicting father's psychological symptoms. Spousal support predicts paternal psychological symptoms and can be viewed as an additional resource for fathers. Implications for research and practice are discussed.
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The co-occurrence of mental disorders in children and adolescents with intellectual disability/intellectual developmental disorder. Curr Opin Psychiatry 2016; 29:95-102. [PMID: 26779862 PMCID: PMC4814928 DOI: 10.1097/yco.0000000000000236] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW The study summarizes supportive epidemiological data regarding the true co-occurrence (comorbidity) and course of mental disorders in children with intellectual disability/intellectual developmental disorders (ID/IDD) across the lifespan. RECENT FINDINGS Published studies involving representative populations of children and adolescents with ID/IDD have demonstrated a three to four-fold increase in prevalence of co-occurring mental disorders. The effect of age, sex, and severity (mild, moderate, severe, and profound) and socioeconomic status on prevalence is currently not clearly understood. To date there are no prevalence estimates of co-occurring mental disorders in youth identified using the new DSM-5 (and proposed ICD-11) definition of ID/IDD using measures of intellectual functions and deficits in adaptive functioning with various severity levels defined on the basis of adaptive functioning, and not intellectual quotient scores. SUMMARY The true relationship between two forms of morbidity remains complex and causal relationships that may be true for one disorder may not apply to another. The new conceptualization of ID/IDD offers a developmentally better informed psychobiological approach that can help distinguish co-occurrence of mental disorders within the neurodevelopmental section with onset during the developmental period as well as the later onset of other mental disorders.
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Yousefichaijan P, Sharafkhah M, Rafeie M, Salehi B. Obsessive Compulsive Inventory-Child Version (OCV-CI) to Evaluate Obsessive Compulsive Disorder in Children With Early Stages of Chronic Kidney Disease: A Case Control Study. Nephrourol Mon 2016; 8:e34017. [PMID: 26981501 PMCID: PMC4779309 DOI: 10.5812/numonthly.34017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 11/14/2015] [Accepted: 11/28/2015] [Indexed: 11/29/2022] Open
Abstract
Background: Chronic kidney disease (CKD) is a common medical condition among children and obsessive-compulsive disorder (OCD) is a frequent, chronic, costly, and disabling disorder among them. Objectives: The aim of this study was to investigate obsessive-compulsive disorder (OCD) in children with early stages of CKD, and to compare it with the occurrence of OCD in healthy children. Patients and Methods: In this case-control study, we evaluated 160 children aged 7 to 17 years old who were visited in the pediatric clinics of Amir-Kabir hospital, Arak, Iran. The control group consisted of 80 healthy children and the case group included 80 children with Stage 1 to 3 CKD. The ages and sex of the children in the two groups were matched. OCD in children was evaluated using the obsessive compulsive inventory-child version (OCI-CV). Results: The mean scores of doubting/checking (case: 3.52 ± 2.54, control: 2.5 ± 2.32, P = 0.007) and ordering (case: 2.59 ± 1.81, control: 1.5 ± 2.56, P = 0.005) in the children with CKD was significantly higher than in the healthy ones. Moreover, the mean total scores for the OCI-CV of the children with CKD at 15.32 ± 7.69 was significantly higher than the scores of the healthy ones at 11.12 ± 2.54 (P = 0.021). There was a significant correlation between the CKD duration and doubting/checking (P = 0.004, correlation coefficient (CC): 0.4), obsessing (P = 0.06, CC: 0.02), washing (P = 0.031, CC: 0.8), ordering (P = 0.001, CC: 0.2), and the total scores of the OCI-CV questionnaire (P = 0.04, CC: 0.4). Conclusions: The risk of OCD in children with CKD is significantly higher than that in healthy children. Although the results seem to suggest that psychiatric intervention can be helpful in treating OCD in children with CKD, further investigation into the medical condition is required so as to obtain more definitive conclusions.
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Affiliation(s)
- Parsa Yousefichaijan
- Department of Pediatrics, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran
| | - Mojtaba Sharafkhah
- Students Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran
- Corresponding author: Mojtaba Sharafkhah, Students Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran. Tel: +98-9119180298, Fax: +98-8633133193, E-mail:
| | - Mohammad Rafeie
- Department of Biostatistics and Epidemiology, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran
| | - Bahman Salehi
- Department of Psychiatry, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran
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Kok L, van der Waa A, Klip H, Staal W. The effectiveness of psychosocial interventions for children with a psychiatric disorder and mild intellectual disability to borderline intellectual functioning: A systematic literature review and meta-analysis. Clin Child Psychol Psychiatry 2016; 21:156-71. [PMID: 25633367 DOI: 10.1177/1359104514567579] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with intellectual disability frequently have difficulties in adapting to their environment. The extent of the experienced problems does not only depend on cognitive functioning but is influenced by other factors, such as the presence of a psychiatric disorder or other brain disorders, or adverse environmental factors. Several epidemiological studies show that children with intellectual disabilities are at an increased risk to develop psychiatric disorders. This is also true for youth with a mild intellectual disability and even those with borderline intellectual functioning (mild to borderline intellectual disability (MBID)). Psychiatric disorders are often overlooked because behavioral problems are rather attributed to the intellectual disability. Consequently, effective psychiatric interventions, which are needed to improve the level of functioning, are not applied. This review aimed to systematically evaluate the currently available, qualitatively sound research concerning the effectiveness of psychosocial interventions, specifically directed at psychiatric disorders in children with MBID. Assessed for eligibility were 1409 unique reports, and the review ultimately included only 12 reports. Review of the results and meta-analyses showed that the majority of studies suffer from multiple limitations and that methodological variations between studies are extensive. This possibly reflects the high variance of factors that may be involved in MBID. It will be important in future research to address multi-causality.
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Affiliation(s)
- Lidwien Kok
- Department of Mild Intellectual Disabilities, Karakter Child and Adolescent Psychiatry, The Netherlands
| | - Anne van der Waa
- Department of Mild Intellectual Disabilities, Karakter Child and Adolescent Psychiatry, The Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry University Centre, The Netherlands
| | - Wouter Staal
- Karakter Child and Adolescent Psychiatry University Centre, The Netherlands Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, The Netherlands
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Abstract
Purpose
– A wealth of research on autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD) has led to increased understanding and identification of each of these developmental disorders. Existing literature has sparked controversial discussions regarding whether aspects of ASD and ADHD predispose individuals to criminality. The purpose of this paper is to explore the link between these conditions and offending.
Design/methodology/approach
– A review of the literature on ASD, ADHD and offending was undertaken. This paper looks at the particular focus of the literature on the involvement of individuals with ADHD and ASD within the criminal justice system.
Findings
– There is some evidence of a link between ADHD and criminality. However, the relationship between ASD and offending is a little more difficult to ascertain. Complicating this further is the relatively unexplored subject of comorbid ASD/ADHD and criminal behaviour. This paper found that additional cognitive deficits and conduct problems are associated with comorbid ASD/ADHD, highlighting the need for further research and development of interventions.
Originality/value
– This paper seeks to examine whether predictions can be made with regards to what offending behaviour may look like in an individual with comorbid ASD/ADHD. This paper reviews the literature on offending in relation to both disorders to examine whether predictions can be made with regards to what the offending behaviour of an individual with ASD and ADHD may look like.
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Androschuk A, Al-Jabri B, Bolduc FV. From Learning to Memory: What Flies Can Tell Us about Intellectual Disability Treatment. Front Psychiatry 2015; 6:85. [PMID: 26089803 PMCID: PMC4453272 DOI: 10.3389/fpsyt.2015.00085] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 05/19/2015] [Indexed: 01/13/2023] Open
Abstract
Intellectual disability (ID), previously known as mental retardation, affects 3% of the population and remains without pharmacological treatment. ID is characterized by impaired general mental abilities associated with defects in adaptive function in which onset occurs before 18 years of age. Genetic factors are increasing and being recognized as the causes of severe ID due to increased use of genome-wide screening tools. Unfortunately drug discovery for treatment of ID has not followed the same pace as gene discovery, leaving clinicians, patients, and families without the ability to ameliorate symptoms. Despite this, several model organisms have proven valuable in developing and screening candidate drugs. One such model organism is the fruit fly Drosophila. First, we review the current understanding of memory in human and its model in Drosophila. Second, we describe key signaling pathways involved in ID and memory such as the cyclic adenosine 3',5'-monophosphate (cAMP)-cAMP response element binding protein (CREB) pathway, the regulation of protein synthesis, the role of receptors and anchoring proteins, the role of neuronal proliferation, and finally the role of neurotransmitters. Third, we characterize the types of memory defects found in patients with ID. Finally, we discuss how important insights gained from Drosophila learning and memory could be translated in clinical research to lead to better treatment development.
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Affiliation(s)
- Alaura Androschuk
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Basma Al-Jabri
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Francois V. Bolduc
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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Yousefichaijan P, Sharafkhah M, Vazirian S, Seyedzadeh A, Rafeie M, Salehi B, Amiri M, Ebrahimimonfared M. Attention-deficit/hyperactivity disorder in children undergoing peritoneal dialysis. Nephrourol Mon 2015; 7:e24427. [PMID: 25830120 PMCID: PMC4363907 DOI: 10.5812/numonthly.24427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/10/2014] [Accepted: 11/15/2014] [Indexed: 11/16/2022] Open
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood psychiatric disorder. This disorder is more prevalent in some chronic disease. Objectives: The aim of this study was to investigate ADHD in children with end-stage renal disease (ESRD) undergoing continuous ambulatory peritoneal dialysis (CAPD) and to compare the results with those of healthy children. Patients and Methods: This case-control study was conducted for six months (December 22, 2013 to June 21, 2014) on five to 16-year-old children, visiting the Pediatric Dialysis Unit of Amirkabir Hospital, Arak, Iran, and Taleghani Hospital, Kermanshah, Iran. A total of 100 children with ESRD who had undergone CAPD for at least six months and 100 healthy children were included in this study as case and control groups, respectively. ADHD was diagnosed by Conner's Parent Rating Scale-48 (CPRS-48) and DSM-IV-TR criteria, and was confirmed through consultation by psychologist. Data were analyzed by Binomial test in SPSS 18. Results: The ADHD inattentive type was observed in 16 cases (16%) with CAPD and five controls (5%) (P = 0.01). Moreover, ADHD hyperactive-impulsive type was observed in 27 cases (27%) with CAPD and seven controls (9%) (P = 0.002). Despite these significant differences, no children were diagnosed with ADHD combined type among all subjects. Conclusions: Inattentive type and hyperactive-impulsive type of ADHD are more prevalent in children with ESRD undergoing CAPD. Therefore screening methods for ADHD is necessary in these patients.
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Affiliation(s)
- Parsa Yousefichaijan
- Department of Pediatric Nephrology, Arak University of Medical Sciences, Arak, IR Iran
| | - Mojtaba Sharafkhah
- Students Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran
- Corresponding author: Mojtaba Sharafkhah, Students Research Committee, School of Medicine, Arak University of Medical Sciences, Zip Code: 3819693345, Arak, IR Iran. Tel: +98-9119180298, Fax: +98-8633133193, E-mail:
| | - Shams Vazirian
- Department of Pediatric Nephrology, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Abolhasan Seyedzadeh
- Department of Pediatric Nephrology, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Mohammad Rafeie
- Department of Biostatistics and Epidemiology, Arak University of Medical Sciences, Arak, IR Iran
| | - Bahman Salehi
- Department of Psychiatry, Arak University of Medical Sciences, Arak, IR Iran
| | - Mohammad Amiri
- Department of Emergency Medicine, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran
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Reardon TC, Gray KM, Melvin GA. Anxiety disorders in children and adolescents with intellectual disability: Prevalence and assessment. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:175-190. [PMID: 25462478 DOI: 10.1016/j.ridd.2014.10.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 10/02/2014] [Indexed: 06/04/2023]
Abstract
Children and adolescents with intellectual disability are known to experience mental health disorders, but anxiety disorders in this population have received relatively little attention. Firstly, this paper provides a review of published studies reporting prevalence rates of anxiety disorders in children and adolescents with intellectual disability. Secondly, the paper reviews measures of anxiety that have been evaluated in children/adolescents with intellectual disability, and details the associated psychometric properties. Seven studies reporting prevalence rates of anxiety disorders in this population were identified, with reported rates varying from 3% to 22%. Two-one studies evaluating a measure of anxiety in a sample of children/adolescents with intellectual disability were identified. While these studies indicate that several measures show promise, further evaluation studies are needed; particularly those that evaluate the capacity of measures to screen for anxiety disorders, not only measure symptoms.
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Affiliation(s)
- Tessa C Reardon
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Australia
| | - Kylie M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Australia.
| | - Glenn A Melvin
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Australia
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Aman MG, Smith T, Arnold LE, Corbett-Dick P, Tumuluru R, Hollway JA, Hyman SL, Mendoza-Burcham M, Pan X, Mruzek DW, Lecavalier L, Levato L, Silverman LB, Handen B. A review of atomoxetine effects in young people with developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1412-24. [PMID: 24732041 PMCID: PMC4532325 DOI: 10.1016/j.ridd.2014.03.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 02/25/2014] [Accepted: 03/06/2014] [Indexed: 06/03/2023]
Abstract
UNLABELLED This review summarizes the pharmacokinetic characteristics, pharmacodynamic properties, common side effects, and clinical advantages and disadvantages associated with atomoxetine (ATX) treatment in typically developing children and adults with ADHD. Then the clinical research to date in developmental disabilities (DD), including autism spectrum disorders (ASD), is summarized and reviewed. Of the 11 relevant reports available, only two were placebo-controlled randomized clinical trials, and both focused on a single DD population (ASD). All trials but one indicated clinical improvement in ADHD symptoms with ATX, although it was difficult to judge the magnitude and validity of reported improvement in the absence of placebo controls. Effects of ATX on co-occurring behavioral and cognitive symptoms were much less consistent. Appetite decrease, nausea, and irritability were the most common adverse events reported among children with DD; clinicians should be aware that, as with stimulants, irritability appears to occur much more commonly in persons with DD than in typically developing individuals. Splitting the dose initially, starting below the recommended starting dose, and titrating slowly may prevent or ameliorate side effects. Patience is needed for the slow build-up of benefit. CONCLUSIONS ATX holds promise for managing ADHD symptoms in DD, but properly controlled, randomized clinical trials of atomoxetine in intellectual disability and ASD are sorely needed. Clinicians and researchers should be vigilant for the emergence of irritability with ATX treatment. Effects of ATX on cognition in DD are virtually unstudied.
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Affiliation(s)
- Michael G Aman
- The Nisonger Center UCEDD, Ohio State University, McCampbell Hall, 1581 Dodd Dr., Columbus, OH 43210, United States.
| | - Tristram Smith
- Division of Neurodevelopmental and Behavioral Pediatrics at the University of Rochester, Box 671, 601 Elmwood Avenue, Rochester, NY 14642, United States
| | - L Eugene Arnold
- The Nisonger Center UCEDD, Ohio State University, McCampbell Hall, 1581 Dodd Dr., Columbus, OH 43210, United States
| | - Patricia Corbett-Dick
- Division of Neurodevelopmental and Behavioral Pediatrics at the University of Rochester, Box 671, 601 Elmwood Avenue, Rochester, NY 14642, United States
| | - Rameshwari Tumuluru
- Department of Psychiatry at the Western Psychiatric Institute and Clinic, Thomas Detre Hall, 3811 O'Hara Street, Pittsburgh, PA 15213, United States
| | - Jill A Hollway
- The Nisonger Center UCEDD, Ohio State University, McCampbell Hall, 1581 Dodd Dr., Columbus, OH 43210, United States
| | - Susan L Hyman
- Division of Neurodevelopmental and Behavioral Pediatrics at the University of Rochester, Box 671, 601 Elmwood Avenue, Rochester, NY 14642, United States
| | - Marissa Mendoza-Burcham
- Department of Psychiatry at the Western Psychiatric Institute and Clinic, Thomas Detre Hall, 3811 O'Hara Street, Pittsburgh, PA 15213, United States
| | - Xueliang Pan
- Center for Biostatistics, Ohio State University, 2012 Kenny Road, Columbus, OH 43221, United States
| | - Daniel W Mruzek
- Division of Neurodevelopmental and Behavioral Pediatrics at the University of Rochester, Box 671, 601 Elmwood Avenue, Rochester, NY 14642, United States
| | - Luc Lecavalier
- The Nisonger Center UCEDD, Ohio State University, McCampbell Hall, 1581 Dodd Dr., Columbus, OH 43210, United States
| | - Lynne Levato
- Division of Neurodevelopmental and Behavioral Pediatrics at the University of Rochester, Box 671, 601 Elmwood Avenue, Rochester, NY 14642, United States
| | - Laura B Silverman
- Division of Neurodevelopmental and Behavioral Pediatrics at the University of Rochester, Box 671, 601 Elmwood Avenue, Rochester, NY 14642, United States
| | - Benjamin Handen
- Department of Psychiatry at the Western Psychiatric Institute and Clinic, Thomas Detre Hall, 3811 O'Hara Street, Pittsburgh, PA 15213, United States
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Alfieri P, Piccini G, Caciolo C, Perrino F, Gambardella ML, Mallardi M, Cesarini L, Leoni C, Leone D, Fossati C, Selicorni A, Digilio MC, Tartaglia M, Mercuri E, Zampino G, Vicari S. Behavioral profile in RASopathies. Am J Med Genet A 2014; 164A:934-42. [PMID: 24458522 DOI: 10.1002/ajmg.a.36374] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 10/20/2013] [Indexed: 01/22/2023]
Abstract
Here, we describe neurobehavioral features in patients with RASopathies (i.e., Noonan syndrome, LEOPARD syndrome, Costello syndrome, and cardiofaciocutaneous syndrome), developmental disorders caused by mutations in genes coding transducers participating in the RAS-MAPK signaling cascade. Parents of 70 individuals with a RASopathy were asked to fill out the following questionnaires: Child Behavior Checklist (CBCL), Social Communication Questionnaire version lifetime (SCQ-L), and Modified Checklist for Autism in toddlers (M-CHAT). Data analysis indicated high rates of internalizing (37%) and externalizing problems (31%) on CBCL. Scores over the cut-off were documented in 64% of patients with cardiofaciocutaneous syndrome, 44% with Costello syndrome, and 12% with Noonan syndrome on SCQ-L/M-CHAT. Our findings indicate that mutations promoting dysregulation of the RAS-MAPK cascade mark an increased psychopathological risk and highlight that autistic-like behavior could be underdiagnosed in patients with RASopathies.
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Affiliation(s)
- Paolo Alfieri
- Dipartimento di Neuroscienze, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Ahuja A, Martin J, Langley K, Thapar A. Intellectual disability in children with attention deficit hyperactivity disorder. J Pediatr 2013; 163:890-5.e1. [PMID: 23608559 PMCID: PMC4078221 DOI: 10.1016/j.jpeds.2013.02.043] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 01/09/2013] [Accepted: 02/22/2013] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine whether children with attention deficit hyperactivity disorder (ADHD) and mild intellectual disability (ID) are a clinically distinct ADHD subgroup. STUDY DESIGN This was a cross-sectional study comparing clinical characteristics (ADHD subtypes, total number of symptoms, and rates of common comorbidities) between children with ADHD and mild ID and those with ADHD and IQ test scores >70, and also between children with ADHD and ID and a general population sample of children with ID alone. The sample comprised a clinical sample of children with ADHD with ID (n = 97) and without ID (n = 874) and a general population sample of children with ID and without ADHD (n = 58). RESULTS After correcting for multiple statistical tests, no differences were found between the 2 ADHD groups on any measure except the presence of conduct disorder (CD) symptoms and diagnoses. Children with ADHD and ID had higher rates of both (OR, 2.38; 95% CI, 1.71-3.32 and OR, 2.69; 95% CI, 1.69-4.28, respectively). Furthermore, children with ADHD and ID had significantly higher rates of oppositional defiant disorder (OR, 5.54; 95% CI, 2.86-10.75) and CD (OR, 13.66; 95% CI, 3.25-57.42) symptoms and a higher incidence of oppositional defiant disorder diagnoses (OR, 30.99; 95% CI, 6.38-150.39) compared with children with ID without ADHD. CONCLUSION Children with ADHD and mild ID appear to be clinically typical of children with ADHD except for more conduct problems. This finding has implications for clinicians treating these children in terms of acknowledging the presence and impact of ADHD symptoms above and beyond ID and dealing with a comorbid CD.
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Affiliation(s)
- Alka Ahuja
- Ty Bryn Unit, St Cadocs Hospital, Newport, United Kingdom,Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Joanna Martin
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom,Medical Research Council Center for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Kate Langley
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom,Medical Research Council Center for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, United Kingdom,Reprint requests: Kate Langley, PhD, Cardiff University School of Medicine, Department of Psychological Medicine, 4th Floor Main Building, Heath Park, Cardiff CF14 4XN, UK.
| | - Anita Thapar
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom,Medical Research Council Center for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, United Kingdom
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The coexistence of psychiatric disorders and intellectual disability in children aged 3-18 years in the barwani district, India. ISRN PSYCHIATRY 2013; 2013:875873. [PMID: 23738223 PMCID: PMC3664507 DOI: 10.1155/2013/875873] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 04/11/2013] [Indexed: 11/17/2022]
Abstract
Background. The coexistence of psychiatric disorders in people with intellectual disability (ID) is common. This study determined the prevalence of psychiatric disorders in children with ID in Barwani, India. Method. A total of 262 children with ID were evaluated for psychiatric disorders using the diagnostic criteria outlined in the International Classification of Diseases (ICD-10). Results. Psychiatric disorders appeared in study participants at the following rates: attention deficit hyperactivity disorder (ADHD), 6.5%; autism, 4.2%; anxiety, 2.7%; bipolar disorder, 1.1%; delusional disorder, 0.8%; depression, 2.3%; obsessive-compulsive disorder, 0.8%; schizophrenia, 1.9%; enuresis, 10.3%; epilepsy, 23.7%; and behavioral problems, 80.9%. The prevalence of psychiatric disorders was statistically higher in severely intellectually disabled children (IQ ≤ 49) than mildly intellectually disabled children (IQ ≥ 50). Conclusions. There is a higher prevalence of psychiatric disorders in children with ID when their IQ ≤ 49 compared with ID children whose IQ ≥ 50.
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38
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Mathiassen B, Brøndbo PH, Waterloo K, Martinussen M, Eriksen M, Hanssen-Bauer K, Kvernmo S. IQ as a moderator of outcome in severity of children's mental health status after treatment in outpatient clinics. Child Adolesc Psychiatry Ment Health 2012; 6:22. [PMID: 22676055 PMCID: PMC3464132 DOI: 10.1186/1753-2000-6-22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 06/07/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Psychotherapy is an effective treatment for mental health disorders, but even with the most efficacious treatment, many patients do not experience improvement. Moderator analysis can identify the conditions under which treatment is effective or whether there are factors that can attenuate the effects of treatment. METHODS In this study, linear mixed model analysis was used to examine whether the Full Scale IQ (FSIQ), Performance IQ (PIQ) and Verbal IQ (VIQ) on the Wechsler Intelligence Scale for Children - Third Edition, moderated outcomes in general functioning and symptom load. A total of 132 patients treated at three outpatient child and adolescent mental health services (CAMHS) were assessed at three different time points. The Children's Global Assessment Scale (CGAS) and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were used to measure the severity of impairments in general functioning and symptom load. IQ was assessed at the start of treatment. RESULTS Moderator analysis revealed that the FSIQ × time interaction predicted changes in CGAS scores (p < .01), and that the PIQ × time interaction predicted changes in HoNOSCA scores (p < .05). The slopes and intercepts in HoNOSCA scores covaried negatively and significantly (p < .05). The same pattern was not detected for the CGAS scores (p = .08). CONCLUSIONS FISQ and PIQ moderated change in general functioning and symptom load, respectively. This implies that patients with higher IQ scores had a steeper improvement slope than those with lower scores. The patients with the highest initial symptom loads showed the greatest improvement, this pattern was not found in the improvement of general functioning.
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Affiliation(s)
- Børge Mathiassen
- Departments of Child and Adolescent Psychiatry, Division of Child and Adolescent Health, University Hospital of North-Norway, P,O, Box 19,, 9038, Tromsø, Norway.
| | - Per Håkan Brøndbo
- Departments of Child and Adolescent Psychiatry, Division of Child and Adolescent Health, University Hospital of North-Norway, P.O. Box 19,, 9038, Tromsø, Norway
| | - Knut Waterloo
- Departments of Child and Adolescent Psychiatry, Division of Child and Adolescent Health, University Hospital of North-Norway, P.O. Box 19,, 9038, Tromsø, Norway,Division of Neurology, University Hospital of North-Norway, P.O. Box 19, , 9038, Tromsø, Norway
| | - Monica Martinussen
- RKBU-North, Faculty of Health Sciences, University of Tromsø, 9037, Tromsø, Norway
| | - Mads Eriksen
- Alta Child and Adolescent Mental Health Service, Finnmark Hospital Trust, P.O. Box 1294, 9505, Alta, Norway
| | - Ketil Hanssen-Bauer
- Department of Research and Development, Division of Mental Health Services, Akershus University Hospital, 1478, Lørenskog, Norway,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, P.O. Box 4623, Nydalen, 0405, Oslo, Norway
| | - Siv Kvernmo
- Departments of Child and Adolescent Psychiatry, Division of Child and Adolescent Health, University Hospital of North-Norway, P.O. Box 19,, 9038, Tromsø, Norway,Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, 9037, Tromsø, Norway
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39
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Ramstad K, Jahnsen R, Skjeldal OH, Diseth TH. Mental health, health related quality of life and recurrent musculoskeletal pain in children with cerebral palsy 8-18 years old. Disabil Rehabil 2012; 34:1589-95. [PMID: 22352294 DOI: 10.3109/09638288.2012.656794] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To extend knowledge on mental health with children's self-report and explore mental health and health related quality of life (HRQL) in a context of recurrent musculoskeletal pain in cerebral palsy (CP). METHOD Eighty-three participants, mean age 14.2 ± 2.8 years, were assessed with clinical examination, interview and questionnaires. Gross motor function was GMFCS level I 42%, level II 42%, level III 12% and level IV-V 5%. Children self-reported mental health on SDQ (Strengths and Difficulty Questionnaire), HRQL on PedsQL (Pediatric Quality of Life), and pain on CHQ (Child Health Questionnaire). Mothers proxy-reported on the same questionnaires and reported own mental health on GHQ (General Health Questionnaire). RESULTS Both self-reported mental health and HRQL was better than proxy-reported. Recurrent musculoskeletal pain was associated with more mental health problems and reduced HRQL in self-reports, but not in proxy-reports. CONCLUSIONS In CP, the importance of child-report on mental health and HRQL when possible, in addition to parent proxy-report, cannot be overstated. Close co-operation between (re)habilitation and child psychiatry is urgent. Further research on self-reported mental health and impact of mental health problems is warranted together with a focus on the impact of recurrent musculoskeletal pain on participation.
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Affiliation(s)
- Kjersti Ramstad
- Department of Clinical Neuroscience, Division of Women and Children, Oslo University Hospital, Norway.
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40
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Hassiotis A, Turk J. Mental Health Needs in Adolescents with Intellectual Disabilities: Cross-Sectional Survey of a Service Sample. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2012; 25:252-61. [DOI: 10.1111/j.1468-3148.2011.00662.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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41
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Niccols A, Milligan K, Chisholm V, Atkinson L. Maternal sensitivity and overt aggression in young children with Down syndrome. Brain Cogn 2011; 77:153-8. [DOI: 10.1016/j.bandc.2011.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 06/28/2011] [Indexed: 11/26/2022]
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42
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[Psychopathology in youths with intellectual disabilities--prevalence and prevention]. Prax Kinderpsychol Kinderpsychiatr 2011; 60:510-26. [PMID: 21991670 DOI: 10.13109/prkk.2011.60.7.intro] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A survey of epidemiological findings suggests a significantly increased level of emotional and behavioural problems in children and youth with intellectual disabilities. Some biological and social factors are presented which contribute to this elevated risk for psychopathology. Assessment and intervention planning needs to acknowledge genetic dispositions, and limitations of the capacity of information processing which characterise children with intellectual disabilities. Early intervention may help to prevent emotional and behavioural problems by supporting a positive parent-child relationship, increasing the parents' educational competence and assisting preschool teachers in supporting positive relationships with peers, and promoting social competence.
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43
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Ekstein S, Glick B, Weill M, Kay B, Berger I. Down syndrome and attention-deficit/hyperactivity disorder (ADHD). J Child Neurol 2011; 26:1290-5. [PMID: 21628698 DOI: 10.1177/0883073811405201] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Clinicians might minimize the prevalence of behavioral disorders among mentally retarded people. Decreased attention, hyperactivity, and impulsivity are frequently reported in children with Down syndrome, yet the exact prevalence of attention-deficit/hyperactivity disorder (ADHD) has not been clearly estimated in this population. The objective of this study was to estimate the prevalence of ADHD in children with Down syndrome and to emphasize the possible relationship between ADHD symptoms and the level of mental retardation and common medical comorbidity. In this study, the prevalence of ADHD among Down syndrome children was very high, reaching 43.9%. No significant correlation was found between ADHD symptoms and the level of mental retardation, but significant correlation was found with ophthalmologic problems. We conclude that children with Down syndrome are at increased risk for ADHD. When evaluating children with Down syndrome for attention deficits, psychiatric comorbidity as well as medical problems should be carefully taken into consideration.
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Affiliation(s)
- Sivan Ekstein
- Pediatric Neurology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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44
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Poon KK. The activities and participation of adolescents with autism spectrum disorders in Singapore: findings from an ICF-based instrument. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:790-800. [PMID: 21375640 DOI: 10.1111/j.1365-2788.2011.01397.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND This study sought to describe the activities and participation of adolescents with autism spectrum disorders (ASD) in Singapore and to examine the suitability of the Activity and Participation component of the International Classification of Functioning, Disability and Health for achieving this purpose. This information may guide the development of intervention programmes for adolescents and adults as well as the provision of a means to document meaningful outcomes. METHODS Parents of 20 adolescents with ASD attending special schools in Singapore were interviewed using the Vineland Adaptive Behavioural Scales - Second Edition and the Activities and Participation Rating Scale (APRS), which was developed for this study. RESULTS The adolescents with ASD were rated to have more difficulties with participation than with the engagement of activities. Individual domain analyses indicate no difficulties with mobility and mild difficulties with self-care. The performance of general tasks and demands were rated as less problematic than domestic, major life areas, communication and interpersonal interactions. The adolescents with ASD were rated to have more difficulties in communication and community environments than in at home. In addition, analysis of associations between the APRS and Vineland Adaptive Behavioural Scales - Second Edition reveal a pattern of strong relationships between sub-tests. CONCLUSION This study highlights the imperative for researchers and practitioners alike to develop a focus on strengths, generalisation and the quality of life of adolescents with ASD. The APRS also shows promise in helping document outcomes for adolescents with ASD in Asia and further development of this instrument is needed.
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Affiliation(s)
- K K Poon
- National Institute of Education, Nanyang Technological University, Singapore.
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45
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Oeseburg B, Dijkstra GJ, Groothoff JW, Reijneveld SA, Jansen DEMC. Prevalence of chronic health conditions in children with intellectual disability: a systematic literature review. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2011; 49:59-85. [PMID: 21446871 DOI: 10.1352/1934-9556-49.2.59] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A systematic review of the prevalence rates of chronic health conditions in populations of children with intellectual disability was provided. We identified 2,994 relevant studies by searching Medline, Cinahl, and PsycINFO databases from 1996 to 2008. We included the 31 studies that had sufficient methodological quality. The 6 most prevalent chronic health conditions in children with intellectual disability were epilepsy (22.0/100), cerebral palsy (19.8/100), any anxiety disorder (17.1/100), oppositional defiant disorder (12.4/100), Down syndrome (11.0/100), and autistic disorder (10.1/100). The reported prevalence rates of chronic health conditions in this population was much higher than in the general population. However, both the number of studies that were included and the number of chronic health conditions they reported about were limited. There is an urgent need for better evidence on the prevalence of chronic health conditions among children with intellectual disability.
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Affiliation(s)
- Barth Oeseburg
- Department of Health Sciences, University of Groningen, Groningen, the Netherlands.
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Hässler F, Reis O. Pharmacotherapy of disruptive behavior in mentally retarded subjects: A review of the current literature. ACTA ACUST UNITED AC 2011; 16:265-72. [PMID: 20981765 DOI: 10.1002/ddrr.119] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The review presented here describes the state of the art of pharmacological treatment of aggression in subjects with mental retardation (MR) summing up results for both, children and adults. In general, psychopharmacological treatment of disruptive behavior in individuals with MR is similar to the treatment in subjects without MR. Compared to individuals without MR medication should "start lower and go slower." For children and adults results were similar but were obtained by somewhat different medications. There is evidence for the conventional antipsychotic zuclopenthixol having positive effects on disruptive behavior. Most studies described the atypical antipsychotic risperidone to control severe self-injurious behavior and other behavior problems in a variety of diagnoses. Anticonvulsants, antidepressants, and anxiolytic medications are reported as effective as well for the treatment of individuals with disruptive behavior. Aggression-related behavior often gets treated with stimulants or with stimulants combined with atypical neuroleptics.
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Affiliation(s)
- Frank Hässler
- Department of Child and Adolescent Neuropsychiatry, University of Rostock, Rostock, Germany.
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Reilly C, Holland N. Symptoms of Attention Deficit Hyperactivity Disorder in Children and Adults with Intellectual Disability: A Review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2011. [DOI: 10.1111/j.1468-3148.2010.00607.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Taggart L, Taylor D, McCrum-Gardner E. Individual, life events, family and socio-economic factors associated with young people with intellectual disability and with and without behavioural/emotional problems. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2010; 14:267-288. [PMID: 21285121 DOI: 10.1177/1744629510390449] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The aim of this study was to compare a range of individual, life events, family and socio-economic factors associated with young people with intellectual disabilities and with and without behavioural/emotional problems. Teachers in 16 schools in one region of the UK completed a postal questionnaire on 249 young people with intellectual disabilities aged between 11 and 19 years. There were two groups: 155 young people with behavioural/emotional issues, and 94 without. Using a binary logistic regression analysis, a number of individual, life events, family and socio-economic risk factors were found to be significantly associated with emotional/behavioural problems. The results are discussed alongside findings from other studies. The importance of a multidimensional assessment is highlighted, as well as the interdependent nature of the risk factors.
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Fernández-Jaén A, Fernández-Mayoralas DM, Calleja Pérez B, Muñoz Jareño N, Campos Díaz MDR. Atomoxetine for attention deficit hyperactivity disorder in mental retardation. Pediatr Neurol 2010; 43:341-7. [PMID: 20933178 DOI: 10.1016/j.pediatrneurol.2010.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Revised: 05/12/2010] [Accepted: 06/07/2010] [Indexed: 11/16/2022]
Abstract
The study objective was to assess the efficacy and tolerability of atomoxetine in the treatment of attention deficit hyperactivity disorder symptoms in patients with mental retardation. In a 16-week, open-label, prospective study, 48 children with mental retardation and attention deficit hyperactivity disorder were recruited; the patients received atomoxetine, with a single final dose of 1.2 mg/kg per day reached at 3 weeks. The measure of efficacy was scores on Clinical Global Impression Severity scale (CGI-S), Conners, and Attention Deficit Hyperactivity Disorder Rating Scale ADHDRS-IV. A statistically significant difference was documented between the mean CGI-S scores before and after treatment: baseline CGI-S = 5.31 (S.D. = 0.85); post-treatment CGI-S = 4.13 (S.D. = 0.97), with a difference of 1.18 points (S.D. = 0.84) and a 95% confidence interval for the difference of 0.92-1.43 (P < 0.001). A statistically significant reduction (P < 0.01) was observed with respect to all the variables of the ADHDRS-IV and Conners scales. Slightly less than one third of the patients (31%) presented adverse events, the majority of which were mild, with irritability being the most frequent event. Atomoxetine appears to be to useful in improving attention deficit hyperactivity disorder symptoms in mentally retarded patients. Larger, randomized, controlled, double-blind studies are required to confirm the efficacy observed in this first study.
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Affiliation(s)
- Alberto Fernández-Jaén
- Neuropediatrics Section, Quiron University Hospital, C/ Diego de Velázquez 1,Pozuelo de Alarcón, Madrid, Spain.
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Baker BL, Neece CL, Fenning RM, Crnic KA, Blacher J. Mental disorders in five-year-old children with or without developmental delay: focus on ADHD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2010; 39:492-505. [PMID: 20589561 DOI: 10.1080/15374416.2010.486321] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Epidemiological studies of children and adolescents with intellectual disability have found 30 to 50% exhibiting clinically significant behavior problems. Few studies, however, have assessed young children, included a cognitively typical comparison group, assessed for specific disorders, and/or studied family correlates of diagnosis. We assessed 236 5-year-old children--95 with developmental delay (DD) and 141 with typical development--for clinical diagnoses using a structured interview. Every disorder assessed was more prevalent in the DD group. The percent of children meeting criteria for Attention Deficit Hyperactivity Disorder (ADHD) most highly differentiated the two groups (ratio = 3.21:1). There was high stability from externalizing behavior problems at age 3 to ADHD diagnoses at age 5 in both groups. In regression analyses, parenting stress at child age 3 related to later ADHD diagnosis in both groups and maternal scaffolding (sensitive teaching) also predicted ADHD in the DD group.
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Affiliation(s)
- Bruce L Baker
- Department of Psychology, University of California, Los Angeles, 90095, USA.
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