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Petrie DJ, Meeks KD, Fisher ZF, Geier CF. Associations between somatomotor-putamen resting state connectivity and obsessive-compulsive symptoms vary as a function of stress during early adolescence: Data from the ABCD study. Brain Res Bull 2024; 210:110934. [PMID: 38508468 DOI: 10.1016/j.brainresbull.2024.110934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/16/2024] [Accepted: 03/17/2024] [Indexed: 03/22/2024]
Abstract
Obsessive-compulsive symptoms (OCS) are relatively common during adolescence although most individuals do not meet diagnostic criteria for obsessive-compulsive disorder (OCD). Nonetheless, OCS during adolescence are associated with comorbid psychopathologies and behavioral problems. Heightened levels of environmental stress and greater functional connectivity between the somatomotor network and putamen have been previously associated with elevated OCS in OCD patients relative to healthy controls. However, the interaction of these factors within the same sample of individuals has been understudied. This study examined somatomotor-putamen resting state connectivity, stress, and their interaction on OCS in adolescents from 9-12 years of age. Participants (n = 6386) were drawn from the ABCD Study 4.0 release. Multilevel modeling was used to account for nesting in the data and to assess changes in OCS in this age range. Stress moderated the association between somatomotor-putamen connectivity and OCS (β = 0.35, S.E. = 0.13, p = 0.006). Participants who reported more stress than their average and had greater somatomotor-left putamen connectivity reported more OCS, whereas participants who reported less stress than their average and had greater somatomotor-left putamen connectivity reported less OCS. These data suggest that stress differentially affects the direction of association between somatomotor-putamen connectivity and OCS. Individual differences in the experience or perception of stress may contribute to more OCS in adolescents with greater somatomotor-putamen connectivity.
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Affiliation(s)
- Daniel J Petrie
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States; Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States.
| | - Kathleen D Meeks
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Zachary F Fisher
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Charles F Geier
- Department of Human Development and Family Science, University of Georgia, Athens, GA, United States
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Morgado F, Vandewouw MM, Hammill C, Kelley E, Crosbie J, Schachar R, Ayub M, Nicolson R, Georgiades S, Arnold P, Iaboni A, Kushki A, Taylor MJ, Anagnostou E, Lerch JP. Behaviour-correlated profiles of cerebellar-cerebral functional connectivity observed in independent neurodevelopmental disorder cohorts. Transl Psychiatry 2024; 14:173. [PMID: 38570480 PMCID: PMC10991387 DOI: 10.1038/s41398-024-02857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/05/2024] Open
Abstract
The cerebellum, through its connectivity with the cerebral cortex, plays an integral role in regulating cognitive and affective processes, and its dysregulation can result in neurodevelopmental disorder (NDD)-related behavioural deficits. Identifying cerebellar-cerebral functional connectivity (FC) profiles in children with NDDs can provide insight into common connectivity profiles and their correlation to NDD-related behaviours. 479 participants from the Province of Ontario Neurodevelopmental Disorders (POND) network (typically developing = 93, Autism Spectrum Disorder = 172, Attention Deficit/Hyperactivity Disorder = 161, Obsessive-Compulsive Disorder = 53, mean age = 12.2) underwent resting-state functional magnetic resonance imaging and behaviour testing (Social Communication Questionnaire, Toronto Obsessive-Compulsive Scale, and Child Behaviour Checklist - Attentional Problems Subscale). FC components maximally correlated to behaviour were identified using canonical correlation analysis. Results were then validated by repeating the investigation in 556 participants from an independent NDD cohort provided from a separate consortium (Healthy Brain Network (HBN)). Replication of canonical components was quantified by correlating the feature vectors between the two cohorts. The two cerebellar-cerebral FC components that replicated to the greatest extent were correlated to, respectively, obsessive-compulsive behaviour (behaviour feature vectors, rPOND-HBN = -0.97; FC feature vectors, rPOND-HBN = -0.68) and social communication deficit contrasted against attention deficit behaviour (behaviour feature vectors, rPOND-HBN = -0.99; FC feature vectors, rPOND-HBN = -0.78). The statistically stable (|z| > 1.96) features of the FC feature vectors, measured via bootstrap re-sampling, predominantly comprised of correlations between cerebellar attentional and control network regions and cerebral attentional, default mode, and control network regions. In both cohorts, spectral clustering on FC loading values resulted in subject clusters mixed across diagnostic categories, but no cluster was significantly enriched for any given diagnosis as measured via chi-squared test (p > 0.05). Overall, two behaviour-correlated components of cerebellar-cerebral functional connectivity were observed in two independent cohorts. This suggests the existence of generalizable cerebellar network differences that span across NDD diagnostic boundaries.
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Affiliation(s)
- Felipe Morgado
- Dept. Medical Biophysics, University of Toronto, Toronto, Canada.
- Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada.
| | - Marlee M Vandewouw
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Christopher Hammill
- Data Science & Advanced Analytics, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | | | - Jennifer Crosbie
- Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Russell Schachar
- Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Muhammad Ayub
- Department of Psychiatry, University College London, London, UK
| | - Robert Nicolson
- Department of Psychiatry, University of Western Ontario, London, Canada
- Lawson Research Institute, London, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Paul Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | - Alana Iaboni
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Azadeh Kushki
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Margot J Taylor
- Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Evdokia Anagnostou
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Jason P Lerch
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
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Rueppel M, Becker HC, Iturra-Mena A, Bilek EL, Monk CS, Phan KL, Fitzgerald KD. Obsessive-Compulsive Symptoms: Baseline Prevalence, Comorbidity, and Implications in a Clinically Anxious Pediatric Sample. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01658-y. [PMID: 38355854 DOI: 10.1007/s10578-023-01658-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 02/16/2024]
Abstract
Subclinical symptoms of obsessive-compulsive disorder (i.e., obsessive compulsive symptoms, or "OCS") cause functional impairment, including for youth without full-syndrome OCD. Further, despite high rates of OCS in youth with anxiety disorders, knowledge of OCS in the context of specific anxiety disorders is limited. The present study seeks to: (1) compare OCS in pediatric patients with anxiety disorders and healthy youth, (2) determine which categorical anxiety disorder(s) associate most with OCS, and (3) determine relationships between OCS with anxiety severity and impairment. Data on OCS, anxiety, and functional impairment were collected from 153 youth with anxiety disorders and 45 healthy controls, ages 7-17 years (M = 11.84, SD = 3.17). Findings indicated that patients had significantly more OCS than healthy controls. Among patients, GAD was a significant predictor of OCS as well as OCD risk. These results suggest that OCS should be a primary diagnostic and treatment consideration for youth who present in clinical settings with GAD.
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Affiliation(s)
- Meryl Rueppel
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, 10032, USA
- Department of Psychology, Fordham University, Bronx, NY, 10458, USA
| | - Hannah C Becker
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Ann Iturra-Mena
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Emily L Bilek
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Christopher S Monk
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, 43210, USA
| | - Kate D Fitzgerald
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032, USA.
- New York State Psychiatric Institute, New York, NY, 10032, USA.
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Uzun Cicek A, Ucuz I, Isık CM, Temelli G. Evaluation of cognitive disengagement syndrome in children with obsessive-compulsive disorder: Clinical implications. Clin Child Psychol Psychiatry 2023; 28:1449-1462. [PMID: 37073420 DOI: 10.1177/13591045231169137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Cognitive disengagement syndrome (CDS) has been found to be associated with internalizing symptoms. Yet, no study thus far has focused on whether there is an association between obsessive-compulsive disorder (OCD) and CDS. The purpose of this study is to examine the symptom frequency and clinical implications of CDS in children with OCD. The study included sixty-one children with OCD and sixty-six typically developing children. Children were evaluated by a semi-constructed diagnosis interview, Obsessive-Compulsive Inventory, Barkley Child Attention Scale, and Stroop test. The frequency of elevated symptoms of CDS, and total time, total error, and total correction scores of the Stroop test were significantly higher in the OCD group compared to the controls. Elevated CDS symptoms were significantly associated with higher OCD symptom prevalence and poorer performance on the Stroop Test. Moreover, poor insight, hoarding symptoms, mental compulsions, and ADHD comorbidity were significantly higher in those with elevated CDS symptoms than in those without CDS in the OCD group. The findings of this study provide clinical implications that CDS symptoms may contribute to deficits in attentional orientation, conceptual flexibility, and cognitive processing speed in OCD.
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Affiliation(s)
- Ayla Uzun Cicek
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Ilknur Ucuz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Cansu Mercan Isık
- Department of Child and Adolescent Psychiatry, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Gürkan Temelli
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, İnönü University, Malatya, Turkey
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Becker H, Liu Y, Hanna GL, Bilek E, Block SR, Hardee JE, Heitzeg MM, Pagliaccio D, Marsh R, Fitzgerald KD. Error-related brain activity associated with obsessive-compulsive symptoms in youth. Brain Behav 2023; 13:e2941. [PMID: 36919195 PMCID: PMC10097091 DOI: 10.1002/brb3.2941] [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] [Received: 07/23/2022] [Revised: 02/04/2023] [Accepted: 02/14/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Subclinical obsessive-compulsive symptoms (OCS) are common in children, and increase risk for later onset of obsessive-compulsive disorder (OCD). In pediatric patients with OCD, neuroimaging research implicates altered neural mechanisms for error-processing, but whether abnormal brain response occurs with subclinical OCS remains poorly understood. METHODS Using functional magnetic resonance imaging (fMRI), 113 youth (8-18 years; 45 female) from a community sample were scanned during an error-eliciting Go/No-Go task. OCS were assessed dimensionally using the obsessive-compulsive subscale of the Child Behavior Checklist. The association between OCS scores and error-related brain activity was examined at the whole-brain level. RESULTS Lower OCS scores associated with stronger response to errors in dorsal anterior cingulate cortex (dACC), caudate, putamen, thalamus, and occipital cortex. Additionally, lower OCS related to higher capacity for inhibitory control, as indexed by greater accuracy on No-Go trials during fMRI scanning. The relationship between lower OCS and better accuracy on No-Go trials was mediated by greater error-related dACC activity. CONCLUSIONS The inverse relationship between OCS and error-related activity in the dACC and extended cortical-striatal-thalamic circuitry may index an adaptive process by which subclinical OCS are minimized in youth. Further, these results identify an observable pattern of brain activity that tracks with subclinical OCS severity. Understanding the link between neural networks for error processing and the normal to abnormal range of OCS may pave the way for brain-based strategies to identify children who are more likely to develop OCD and enable the targeting of preventive strategies to reduce risk.
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Affiliation(s)
- Hannah Becker
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yanni Liu
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily Bilek
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Jillian E Hardee
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Addiction Research Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Mary M Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Addiction Research Center, University of Michigan, Ann Arbor, Michigan, USA
| | - David Pagliaccio
- New York State Psychiatric Institute, Columbia University, New York, New York, USA
| | - Rachel Marsh
- New York State Psychiatric Institute, Columbia University, New York, New York, USA
| | - Kate D Fitzgerald
- New York State Psychiatric Institute, Columbia University, New York, New York, USA
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6
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Early Identification and Intervention in Pediatric Obsessive-Compulsive Disorder. Brain Sci 2023; 13:brainsci13030399. [PMID: 36979207 PMCID: PMC10046131 DOI: 10.3390/brainsci13030399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/19/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by persistent thoughts with subsequent repetitive behaviors. Interventions that are effective for adult OCD cannot simply be generalized to pediatric OCD, since OCD in children and adolescents usually has a different clinical presentation, etiology and course from adult OCD. Delayed and inadequate treatment is associated with a worse prognosis, making the need for early identification and intervention in pediatric OCD very urgent. In this paper, we reflected on the current constraints that make early interventions for pediatric OCD unpromoted and reviewed the approaches with potential application for early identification and early intervention in pediatric OCD, categorized by three-level prevention stages corresponding to a clinical staging model. Since the etiology of pediatric OCD is still unclear, primary prevention is most lacking, and early interventions for pediatric OCD are currently focused on the secondary prevention stage, which aims to prevent the conversion of obsessive-compulsive symptoms into full-blown OCD; tertiary prevention mostly focuses on the alleviation of mild to moderate OCD, while interventions for co-morbidities are still in their infancy. We closed by considering the important research questions on this topic.
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Wu X, Yu G, Zhang K, Feng J, Zhang J, Sahakian BJ, Robbins TW. Symptom-Based Profiling and Multimodal Neuroimaging of a Large Preteenage Population Identifies Distinct Obsessive-Compulsive Disorder-like Subtypes With Neurocognitive Differences. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1078-1089. [PMID: 34224907 DOI: 10.1016/j.bpsc.2021.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/06/2021] [Accepted: 06/21/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is characterized by both internalizing (anxiety) and externalizing (compulsivity) symptoms. Currently, little is known about their interrelationships and their relative contributions to disease heterogeneity. Our goal is to resolve affective and cognitive symptom heterogeneity related to internalized and externalized symptom dimensions by determining subtypes of children with OCD symptoms, and to identify any corresponding neural differences. METHODS A total of 1269 children with OCD symptoms screened using the Child Behavior Checklist Obsessive-Compulsive Symptom scale and 3987 matched control subjects were obtained from the Adolescent Brain Cognitive Development (ABCD) Study. Consensus hierarchical clustering was used to cluster children with OCD symptoms into distinct subtypes. Ten neurocognitive task scores and 20 Child Behavior Checklist syndrome scales were used to characterize cognitive/behavioral differences. Gray matter volume, fractional anisotropy of major white matter fiber tracts, and functional connectivity among networks were used in case-control studies. RESULTS We identified two subgroups with contrasting patterns in internalized and externalized dimensions. Group 1 showed compulsive thoughts and repeated acts but relatively low anxiety symptoms, whereas group 2 exhibited higher anxiety and perfectionism and relatively low repetitive behavior. Only group 1 had significant cognitive impairments and gray matter volume reductions in the bilateral inferior parietal lobe, precentral gyrus, and precuneus gyrus, and had white matter tract fractional anisotropy reductions in the corticostriatal fasciculus. CONCLUSIONS Children with OCD symptoms are heterogeneous at the level of symptom clustering and its underlying neural basis. Two subgroups represent distinct patterns of externalizing and internalizing symptoms, suggesting that anxiety is not its major predisposing factor. These results may have implications for the nosology and treatment of preteenage OCD.
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Affiliation(s)
- Xinran Wu
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Gechang Yu
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Kai Zhang
- School of Computer Science and Technology, East China Normal University, Shanghai, China
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Shanghai Center for Mathematical Sciences, Shanghai, China; Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China; Department of Computer Science, University of Warwick, Coventry, United Kingdom
| | - Jie Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.
| | - Barbara J Sahakian
- Departments of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W Robbins
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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8
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Efe A, Kaba D, Canlı M, Temeltürk RD. Impact of Attention-Deficit/Hyperactivity Disorder Comorbidity on Phenomenology and Treatment Outcomes of Pediatric Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol 2022; 32:337-348. [PMID: 35905054 DOI: 10.1089/cap.2022.0007] [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: 11/12/2022]
Abstract
Objective: This study, with a case-control design, investigates the impact of attention-deficit/hyperactivity disorder (ADHD) comorbidity on the phenomenology and treatment outcomes in a clinical sample of pediatric obsessive-compulsive disorder (OCD). Methods: The data were derived from an evaluation of the sociodemographic and clinical characteristics of 364 children with OCD who were regularly followed up over a 4-year period. Between-group analyses of psychiatric scales were used to compare patients with ADHD comorbidity (n = 144, 39.5%) with their ADHD-free opponents. The clinical course and treatment outcomes of each patient were evaluated based on 4-year clinical follow-up data. Results: Substantial clinical variations in pediatric OCD caused by ADHD comorbidity were identified, including a male preponderance, higher rates of concurrent conduct problems, tic disorders, and learning disabilities, as well as prolonged symptom and treatment durations accompanied by poor response to first-line treatments and higher rates of treatment resistance. Contrary to previous findings, ADHD comorbidity had no impact on the age of OCD onset, and the severity of OCD symptoms was lower in ADHD. With ADHD comorbidity, the OCD symptom course tended to be chronically stable, which may have resulted in complaints persisting into adulthood. In ADHD-free patients, contamination, doubt, religious, somatic obsessions, and cleaning were all more common than in those with ADHD. There was a positive correlation between compulsion scores and the severity of ADHD symptoms, which may be related to increased compulsive coping in ADHD. Impulsivity or compulsivity dominance in the symptom presentation of OCD-ADHD comorbidity may determine phenomenological distinctions such as whether concurrent traits are more prone to tics, conduct problems, or internalizing problems. The primordial associations for clinical characteristics, which were independently associated with ADHD comorbidity, were adjusted using multivariate logistic regression analysis. Clinical variables such as being male, absence of cleaning compulsion, the existence of concurrent conduct problems, tic disorders, and dyslexia, as well as longer treatment duration and poorer treatment response, were all independent predictors of ADHD comorbidity. With an 80.8% accurate classification and relatively fine goodness-of-fit model, the regression model consisting of those predictors had good predictiveness for ADHD comorbidity (R2 = 0.543). Conclusions: The close association between pediatric OCD, ADHD, and tic disorders can be defined as a specific subtype of pediatric OCD, characterized by more conduct problems, a chronically stable course of OCD symptoms, and poorer treatment outcomes. Correlational analyses in a longitudinal design and the inclusion of an impulsivity scale would be beneficial for further research to interpret the impulsivity-related correlates in the findings on tic and conduct problems.
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Affiliation(s)
- Ayşegül Efe
- Department of Child and Adolescent Psychiatry, Dr. Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Duygu Kaba
- Department of Child and Adolescent Psychiatry, Başkent University, Medical Faculty, Ankara, Turkey
| | - Merve Canlı
- Department of Child and Adolescent Psychiatry, Dr. Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Rahime Duygu Temeltürk
- Department of Child and Adolescent Psychiatry, Ankara University, Medical Faculty, Ankara, Turkey
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Şimşek MK, Seçer İ. Developing and Examining the Effectiveness of a Cognitive Behavioral Therapy-Based Psychoeducation Practice for Reducing Obsessive-Compulsive Symptoms in Adolescents: A Mixed-Methods Study With a Turkish Sample. Front Psychol 2022; 13:805035. [PMID: 35330724 PMCID: PMC8940527 DOI: 10.3389/fpsyg.2022.805035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
This study developed a cognitive behavioral therapy (CBT)-based psychoeducation practice aimed at reducing obsessive-compulsive symptom levels in adolescents in Turkey and tested its effectiveness with a mixed-methods study. After the study was constructed as a pretest-posttest control group experimental application consisting of qualitative stages. The experimental application of the study was carried out with high school students in Turkey. In the sampling process, the schools, where the study will be carried out, were determined with the cluster sampling method. The experimental and control groups were formed with 30 students with high obsessive-compulsive disorder (OCD) symptoms from these schools, and the developed CBT-based psychoeducation practice was applied to the experimental group for 12 weeks. Quantitative data were collected through the "Child Version of the Obsessive-Compulsive Inventory," and normality analysis, t-test for dependent samples, and Single Factor Analysis of Covariance were used. Qualitative data of the study were collected through document review, session evaluation forms, and semi-structured interview protocol; content and descriptive analysis techniques were used in the analysis. It was concluded that the developed CBT-based psychoeducation application was an effective approach in reducing OCD symptoms in the Turkish adolescent sample, except for the neutralizing dimension. It was also determined that the findings obtained from the analysis during the application and the interviews after the application are parallel with the findings obtained by quantitative methods, and the qualitative and quantitative findings adequately explained the quantitative documents findings.
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Affiliation(s)
| | - İsmail Seçer
- Faculty of Education, Counseling and Guidance, Atatürk University, Erzurum, Turkey
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10
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Cui Y, Chu J, Li Y, Li Y. The Behavioral and Emotional Profile of Pediatric Tourette Syndrome Based on CBCL in a Chinese Sample. Front Psychiatry 2022; 13:784753. [PMID: 35280165 PMCID: PMC8907575 DOI: 10.3389/fpsyt.2022.784753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder that has a unique status of a quintessentially neuropsychiatric condition at the interface of neurology (movement disorder) and psychiatry (behavioral/emotional condition). However, the behavioral and emotional profile has seemed to be neglected in the literature thus far. This study aimed to investigate the behavioral and emotional profile of TS. METHODS A total of 124 patients aged 6-16 years with TS were included in this study, including age- and sex-matched health control, attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and major depressive disorder (MDD) groups. The Child Behavior Checklist (CBCL) was used to screen the behavioral and emotional profile of the TS and other compared groups. The Yale Global Tic Severity Scale (YGTSS) was used to assess TS tic severity. Analysis of variance (ANOVA) was used to investigate the difference between the TS and other compared groups. RESULTS The results showed that the eight factors of the CBCL had no association with motor tics, vocal tics, or tic severity (p > 0.05). However, positive correlations were identified between functional impairments (subscales of YGTSS) and thought problems (TP) and rule-breaking behavior (RBB). Based on the eight-factor profile of the CBCL, TS showed a similar profile to MDD but different from ADHD and OCD, which showed similar profiles. CONCLUSIONS Based on the assessment of the CBCL of TS, it was found that "pure" TS might show fewer behavioral and emotional problems than OCD, ADHD, and MDD. Similar behavioral and emotional profiles were identified between TS and MDD, but not OCD and ADHD. More attention needs to be paid to the thought problems and rule break problems in the CBCL in the screening stage, which might have a potential influence on the functional impairments of TS.
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Affiliation(s)
- Yonghua Cui
- Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jiahui Chu
- Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yanlin Li
- Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ying Li
- Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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11
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Developmental Trajectories of Pediatric Obsessive-Compulsive Symptoms. Res Child Adolesc Psychopathol 2021; 49:1635-1648. [PMID: 34236586 DOI: 10.1007/s10802-020-00742-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 10/20/2022]
Abstract
Children who experience obsessive-compulsive symptoms (OCS) may be at risk for developing Obsessive-Compulsive Disorder (OCD). The current study aimed to investigate developmental trajectories of OCS, as well as possible predictors, within a community-based sample of children. Children (N = 1147) from the longitudinal NICHD Study of Early Child Care and Youth Development (SECCYD) were assessed for OCS, via the Child Behavioral Checklist - Obsessive-Compulsive Scale (OCS-8), eight times between Pre-Kindergarten (54 months; Pre-K) and High School (15 years of age; HS.) Participants were recruited within the United States and included only maternal caregivers. Preliminary analyses indicated that approximately 3% of the sample was above the diagnostic cutoff score on the OCS-8 at the High School time-point. Latent growth models tested symptom trajectories. Findings demonstrated three groups of OCS trajectories. Most children fell within a low symptomatology group (the No Peak group) with low OCS across all time points. Two additional OCS trajectories were also demonstrated: Pre-K Peak (high to low OCS across time) and HS Peak (low to high OCS across time). Both higher attention problems and greater depression/anxiety symptoms at the Pre-K time point predicted children's membership in the Pre-K Peak or HS Peak groups compared to the No Peak group. Membership within the HS Peak group predicted a high likelihood of children's OCS being above previously established cutoff scores for an OCD diagnosis at age 15 years. Membership within either the Pre-K Peak or No Peak groups predicted a low likelihood. This study provides new evidence for the existence of different developmental trajectories for youth with OCS. From a clinical perspective, these results may have important implications when considering the identification and early intervention of childhood OCS and OCD within the community.
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Pavone P, Ceccarelli M, Marino S, Caruso D, Falsaperla R, Berretta M, Rullo EV, Nunnari G. SARS-CoV-2 related paediatric acute-onset neuropsychiatric syndrome. THE LANCET CHILD & ADOLESCENT HEALTH 2021; 5:e19-e21. [PMID: 33961798 PMCID: PMC8096321 DOI: 10.1016/s2352-4642(21)00135-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Piero Pavone
- Section of Paediatrics and Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Manuela Ceccarelli
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, Unit of Infectious Diseases, University of Messina, Messina 98124, Italy
| | - Silvia Marino
- Unit of Paediatrics and Paediatric Emergency, Paediatric COVID-19 Centre, Azienda Ospedaliera Universitaria Policlinico, Presidio Ospedaliero San Marco, University of Catania, Catania, Italy
| | - Daniela Caruso
- Postgraduate Training Programme in Paediatrics, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Raffaele Falsaperla
- Neonatal Intensive Care Unit, Neonatal COVID-19 Centre, Azienda Ospedaliera Universitaria Policlinico, Presidio Ospedaliero San Marco, University of Catania, Catania, Italy
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina 98124, Italy
| | - Emmanuele Venanzi Rullo
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina 98124, Italy.
| | - Giuseppe Nunnari
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina 98124, Italy
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Pagliaccio D, Durham K, Fitzgerald KD, Marsh R. Obsessive-Compulsive Symptoms Among Children in the Adolescent Brain and Cognitive Development Study: Clinical, Cognitive, and Brain Connectivity Correlates. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:399-409. [PMID: 33495121 PMCID: PMC8035161 DOI: 10.1016/j.bpsc.2020.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/01/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Childhood obsessive-compulsive symptoms (OCSs) are common and can be an early risk marker for obsessive-compulsive disorder. The Adolescent Brain and Cognitive Development (ABCD) Study provides a unique opportunity to characterize OCSs in a large normative sample of school-age children and to explore corticostriatal and task-control circuits implicated in pediatric obsessive-compulsive disorder. METHODS The ABCD Study acquired data from 9- and 10-year-olds (N = 11,876). Linear mixed-effects models probed associations between OCSs (Child Behavior Checklist) and cognition (NIH Toolbox), brain structure (subcortical volume, cortical thickness), white matter (diffusion tensor imaging), and resting-state functional connectivity. RESULTS OCS scores showed good psychometric properties and high prevalence, and they were related to familial/parental factors, including family conflict. Higher OCS scores related to better cognitive performance (β = .06, t9966.60 = 6.28, p < .001, ηp2= .01), particularly verbal, when controlling for attention-deficit/hyperactivity disorder, which related to worse performance. OCSs did not significantly relate to brain structure but did relate to lower superior corticostriatal tract fractional anisotropy (β = -.03, t = -3.07, p = .002, ηp2= .02). Higher OCS scores were related to altered functional connectivity, including weaker connectivity within the dorsal attention network (β = -.04, t7262.87 = -3.71, p < .001, ηp2= .002) and weaker dorsal attention-default mode anticorrelation (β = .04, t7251.95 = 3.94, p < .001, ηp2 = .002). Dorsal attention-default mode connectivity predicted OCS scores at 1 year (β = -.04, t2407.61 = -2.23, p = .03, ηp2 = .03). CONCLUSIONS OCSs are common and may persist throughout childhood. Corticostriatal connectivity and attention network connectivity are likely mechanisms in the subclinical-to-clinical spectrum of OCSs. Understanding correlates and mechanisms of OCSs may elucidate their role in childhood psychiatric risk and suggest potential utility of neuroimaging, e.g., dorsal attention-default mode connectivity, for identifying children at increased risk for obsessive-compulsive disorder.
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Affiliation(s)
- David Pagliaccio
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
| | - Katherine Durham
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Kate D Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Rachel Marsh
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
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Ravagnani Salto AB, Santoro ML, Hoexter MQ, Jackowski AP, Pan PM, Rosário MC, Belangero SI, Alvarenga PG, Doretto VF, Fumo AMT, Batistuzzo MC, Macul Ferreira de Barros P, Timpano KR, Ota VK, Rohde LA, Miguel EC, Leckman JF, Zugman A. Obsessive-Compulsive Symptoms, Polygenic Risk Score, and Thalamic Development in Children From the Brazilian High-Risk Cohort for Mental Conditions (BHRCS). Front Psychiatry 2021; 12:673595. [PMID: 34163385 PMCID: PMC8215160 DOI: 10.3389/fpsyt.2021.673595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Thalamic volume measures have been linked to obsessive-compulsive disorder (OCD) in children and adolescents. However, it is unclear if alterations in thalamic volumes occur before or after symptom onset and if there is a relation to the presence of sub-clinical obsessive-compulsive symptoms (OCS). Here, we explore the relationship between OCS and the rate of thalamic volume change in a cohort of children and youth at high risk to develop a mental disorder. A secondary aim was to determine if there is a relationship between OCS and the individual's OCD polygenic risk score (OCD-PRS) and between the rate of thalamic volume change and the OCD-PRS. Methods: The sample included 378 children enrolled in the longitudinal Brazilian High-Risk Cohort for Mental Conditions. Participants were assessed for OCS and the symmetrized percent change (SPC) of thalamic volume across two time-points separated by 3 years, along with the OCD-PRS. Zero-altered negative binomial models were used to analyze the relationship between OCS and thalamic SPC. Multiple linear regressions were used to examine the relationship between thalamic SPC and OCD-PRS. Results: A significant relationship between OCS and the right thalamus SPC (p = 0.042) was found. There was no significant relationship between changes in thalamic volume SPC and OCD-PRS. Conclusions: The findings suggest that changes in the right thalamic volume over the course of 3 years in children may be associated to OCS. Future studies are needed to confirm these results and further characterize the specific nature of OCS symptoms associated with thalamic volumes.
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Affiliation(s)
| | - Marcos L Santoro
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Marcelo Q Hoexter
- Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Andrea Parolin Jackowski
- Laboratory of Integrative Neuroscience, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Pedro M Pan
- Laboratory of Integrative Neuroscience, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maria Conceição Rosário
- Laboratory of Integrative Neuroscience, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sintia I Belangero
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, São Paulo, Brazil.,Laboratory of Integrative Neuroscience, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Pedro Gomes Alvarenga
- Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Victoria Fogaça Doretto
- Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Afonso Mazine Tiago Fumo
- Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, Brazil
| | | | - Kiara R Timpano
- Department of Psychology, University of Miami, Coral Gables, FL, United States
| | - Vanessa K Ota
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luis Augusto Rohde
- Attention-Deficit/Hyperactivity Disorder and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | | | - James F Leckman
- Yale Child Study Centre, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - André Zugman
- Laboratory of Integrative Neuroscience, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
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15
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Blanco-Vieira T, Hoexter MQ, Batistuzzo MC, Alvarenga P, Szejko N, Fumo AMT, Miguel EC, do Rosário MC. Association Between Obsessive-Compulsive Symptom Dimensions in Mothers and Psychopathology in Their Children. Front Psychiatry 2021; 12:674261. [PMID: 34262490 PMCID: PMC8273307 DOI: 10.3389/fpsyt.2021.674261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/06/2021] [Indexed: 12/21/2022] Open
Abstract
Background: The non-clinical presentation of obsessive-compulsive symptoms (OCS) in women may impact not only their daily lives and well-being but also increase the risk for emotional and behavioral problems in their children. This study aims to investigate the OCS dimension distribution in a large sample of mothers from a cohort of school age children and the association between these OCS dimensions with their own psychopathology, and with the presence of OCS and other psychopathology in their children. Method: Our final sample consisted of 2,511 mother-children dyads recruited from the elementary schools of two large cities. Throughout multiple regression analysis, we examined the correlations between demographic and clinical variables of mothers assessed by the Mini International Psychiatric Interview (MINI) and the Dimensional Yale-Brown Obsessive-Compulsive Scale-Short Version (DY-BOCS-SV) with children's psychopathology status reported by the Child Behavior Checklist (CBCL). Results: The overall prevalence of mothers who reported experiencing at least one OCS was 40% (N = 1,004). "Aggression/violence" was the most frequent symptom dimension (32.2%), followed by the "symmetry/ordering" (16.4%) and the "sexual/religious" dimensions (13.8%). There was a significant correlation between the presence of OCS and maternal psychopathology in general (p < 0.001, r = 0.397). Not only the presence but also the severity of the mother's OCS were strongly correlated to the total (p < 0.001), internalizing (p < 0.001), externalizing (p < 0.001), and OCS subscale scores (p < 0.001) on the CBCL. Conclusion: OCS dimensions are highly prevalent in women. Presence and severity of maternal OCS are related to children's psychopathology and behavioral problems.
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Affiliation(s)
- Thiago Blanco-Vieira
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Marcelo Queiroz Hoexter
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil.,Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, Brazil
| | - Pedro Alvarenga
- Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Sírio-Libanês Hospital, São Paulo, Brazil
| | - Natalia Szejko
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States.,Department of Neurology, Medical University of Warsaw, Warsaw, Poland.,Department of Bioethics, Medical University of Warsaw, Warsaw, Poland
| | - Afonso Mazine Tiago Fumo
- Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Hospital Central da Beira, Beira, Mozambique
| | - Eurípedes C Miguel
- Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Maria Conceição do Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
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16
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Macul Ferreira de Barros P, do Rosário MC, Szejko N, Polga N, Requena GDL, Ravagnani B, Fatori D, Batistuzzo MC, Hoexter MQ, Rohde LA, Polanczyk GV, Leckman JF, Miguel EC, de Alvarenga PG. Risk factors for obsessive-compulsive symptoms. Follow-up of a community-based youth cohort. Eur Child Adolesc Psychiatry 2021; 30:89-104. [PMID: 32076869 DOI: 10.1007/s00787-020-01495-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 02/07/2020] [Indexed: 12/19/2022]
Abstract
Environmental factors are at least as important as genetic factors for the development of obsessive-compulsive symptoms (OCS), but the identification of such factors remain a research priority. Our study aimed to investigate the association between a broad scope of potential risk factors and OCS in a large community cohort of children and adolescents. We evaluated 1877 participants and their caregivers at baseline and after 3 years to assess various demographic, prenatal, perinatal, childhood adversity, and psychopathological factors. Mean age at baseline was 10.2 years (SD 1.9) and mean age at follow-up was 13.4 years (SD 1.9). Reports of OCS at baseline and follow-up were analyzed using latent variable models. At preliminary regression analysis, 15 parameters were significantly associated with higher OCS scores at follow-up. At subsequent regression analysis, we found that eight of these parameters remained significantly associated with higher follow-up OCS scores while being controlled by each other and by baseline OCS scores. The significant predictors of follow-up OCS were: lower socioeconomic status (p = 0.033); lower intelligence quotient (p = 0.013); lower age (p < 0.001); higher maternal stress level during pregnancy (p = 0.028); absence of breastfeeding (p = 0.017); parental baseline OCS (p = 0.038); youth baseline anxiety disorder (p = 0.023); and youth baseline OCS scores (p < 0.001). These findings may better inform clinicians and policymakers engaged in the mental health assessment and prevention in children and adolescents.
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Affiliation(s)
| | - Maria Conceição do Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Natalia Szejko
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland.,Department of Bioethics, Medical University of Warsaw, Warsaw, Poland
| | - Natália Polga
- Graduate Program in Psychology, Federal University of São Paulo, Santos, Brazil
| | - Guaraci de Lima Requena
- Department of Statistics, Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | - Beatriz Ravagnani
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | - Daniel Fatori
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | - Marcelo Camargo Batistuzzo
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | - Marcelo Queiroz Hoexter
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | - Luis Augusto Rohde
- Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Guilherme Vanoni Polanczyk
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | | | - Eurípedes Constantino Miguel
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | - Pedro Gomes de Alvarenga
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
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17
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Cirillo A, Diniz E, Gadelha A, Asevedo E, Axelrud LK, Miguel EC, Rohde LA, Bressan RA, Pan P, Mari JDJ. Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries. ACTA ACUST UNITED AC 2020; 42:442-448. [PMID: 32267341 PMCID: PMC7430393 DOI: 10.1590/1516-4446-2019-0761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 12/01/2019] [Indexed: 12/21/2022]
Abstract
Objective: Population neuroscience is an emerging field that combines epidemiology and neuroscience to study how genes and the environment shape typical and atypical brain functioning. The objective of this study was to review key studies on population neuroscience from low- and middle-income countries (LMICs) and to identify potential gaps vis-à-vis studies conducted in high-income countries. Methods: We conducted a systematic review to search for longitudinal cohort studies investigating the development of psychiatric disorders in children and adolescents in LMICs. We performed an electronic search in the EMBASE and MEDLINE databases from inception to July 5th, 2019. Results: We found six cohorts from four countries that met our search criteria: three cohorts from Brazil, one from China, one from South Africa, and one from Mauritius. Relevant examples of findings from these studies are reported. Conclusion: Our results demonstrate the impact of the valuable science output these cohort designs promote, allowing LMICs to have a share in frontline global psychiatry research. National and international funding agencies should invest in LMIC population neuroscience in order to promote replication and generalization of research from high-income countries.
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Affiliation(s)
| | - Elton Diniz
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ary Gadelha
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Elson Asevedo
- Global Mental Health Program, Columbia University, New York, NY, USA
| | - Luiza K Axelrud
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Eurípedes C Miguel
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Luis Augusto Rohde
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Rodrigo A Bressan
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Pedro Pan
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jair de J Mari
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Nazeer A, Latif F, Mondal A, Azeem MW, Greydanus DE. Obsessive-compulsive disorder in children and adolescents: epidemiology, diagnosis and management. Transl Pediatr 2020; 9:S76-S93. [PMID: 32206586 PMCID: PMC7082239 DOI: 10.21037/tp.2019.10.02] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) can be found in about 4% of the general population and is characterized by various compulsions and obsessions that interfere with the person's quality of life from a mild to severe degree. The following discussion reflects on current concepts in this condition, including its epidemiology and etiologic underpinnings (behavioral, neurological, immunological, gastroenterological, as well as genetic). The interplay of PANS and PANDAS are included in this review. In addition, the core concepts of OCD diagnosis, differential diagnosis, and co-morbidities are considered. It is stressed that the quality of life for persons with pediatric OCD as well as for family members can be quite limited and challenged. Thus, principles of management are presented as a guide to improve the quality of life for these persons as much as possible.
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Affiliation(s)
- Ahsan Nazeer
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Sidra Medicine, Doha, Qatar
| | - Finza Latif
- Division of Psychiatry and Behavioral Sciences, George Washington University, Children's National Medical Center, Washington, DC, USA
| | - Aisha Mondal
- Division of Psychiatry and Behavioral Sciences, George Washington University, Children's National Medical Center, Washington, DC, USA
| | | | - Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
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