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Children with ASD may present their parents with several challenges, most notably aggressive and destructive behaviors. Parents of children with ASD typically experience more stress, depressive and anxiety symptoms than other parents. Mindfulness-based interventions are reported to be effective in reducing parental stress along with improving the challenging behaviors of their children
The current review aimed to investigate if the use of mindfulness-based interventions is beneficial to reduce parental stress when caring for children with ASD.
The databases of PsycINFO and PubMED were used. The variables studied in this systematic review were Autism, Parental stress, and Mindfulness. Inclusion criteria were that all articles should be academic journals, and with a full text available in English during the last 20 years.
Compared to other behavioral approaches, mindfulness-based interventions showed statistically significant results in reducing the stress levels of parents as well as improving their children’s challenging behaviors.
Most of the studies in the current review indicated that mindfulness-based interventions are beneficial in improving the stress level of parents.
The objective of this study was to examine the association of different personality traits on severity of addiction indexes and patterns of drug use level, in a sample of adolescent psychiatric patients with Substance Use Disorders (SUD), based on the dimensional model of Personality Psychopathology Five (PSY-5) of the MMPI-A.
The Teen Addiction Severity Index (T-ASI), the MMPI-A, and an inventory of drug use pattern were administered to 73 psychiatric patients (M=16.0, SD=1.18 years old; 51% male).
Rho Spearman correlations showed significant associations between Disconstraint (DISC) and T-ASI indexes of drug and social problems (rho= .342, p= .003, and rho= .320, p= .006) and also between DISC in relation to level of cannabis use and other drugs than cocaine and amphetamines (rho= .334, p= .004, and rho= .274, p= .023). The dimension of Psychoticism (PSYC) and Aggressiveness (AGGR) showed slight association with cannabis use (rho= .236, p= .045, and rho= .247, p= .035). The Negative emotionality (NEGE) and Introversion (INTR) showed a moderate association with the T-ASI index of psychiatric problems (rho= .265, p=0.023, and rho=.256, p= .029) but not with drug problems.
The DISC trait could represent a good indicator of risk for drug related problems. High scores in PSYC and AGGR are slightly associated to increase level of cannabis use. While psychiatric complaints are associated with NEGE and INTR traits.
The use of psychiatric services has been associated with a wide range of clinical variables. However, information about the impact of adolescent personality pathology related to hospital admissions is limited.
To analyze the different combination of personality pathology associated to variables of psychiatric hospital admissions (number of admissions, total of days spent as psychiatric inpatient, average of days for admission, and number of admissions in a day care hospital).
The ICD-10 and DSM-IV modules of the semi-structured interview IPDE (International Personality Disorders Examination) were administered, in a sample of 107 adolescent psychiatric patients (M=15.8, SD=0.8 years old; age rank 15-17; 79% female).
Personality pathology group identified by the IPDE showed significantly higher number (p< .001) of psychiatric admissions (M=1.48) than no personality pathology group (M=0.57), but not significant higher number of admissions in a day care hospital. Psychotic patients showed the highest rate of admissions (M=2.88). In present sample, between 30% and 38% of all hospital admitted patients showed a Cluster B personality disorder (PD).The users of psychiatric inpatient services with a complex PD (two o more PD from different clusters) presents in average: 2-2.5 admissions, 34-53 total days spent as psychiatric inpatient, and 11-16 days on each admission.
Patients with psychotic disorders or complex PD were the highest users of inpatients services, but not of day care hospital admissions.
Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onset, using a large, international database.
The database includes 4037 patients with a diagnosis of bipolar I disorder, previously collected at 36 collection sites in 23 countries. Generalized estimating equations (GEE) were used to adjust the data for country median age, and in some models, birth cohort. Model-based clustering (mixture analysis) was then performed on the age of onset data using the residuals. Clinical variables in subgroups were compared.
There was a strong birth cohort effect. Without adjusting for the birth cohort, three subgroups were found by clustering. After adjusting for the birth cohort or when considering only those born after 1959, two subgroups were found. With results of either two or three subgroups, the youngest subgroup was more likely to have a family history of mood disorders and a first episode with depressed polarity. However, without adjusting for birth cohort (three subgroups), family history and polarity of the first episode could not be distinguished between the middle and oldest subgroups.
These results using international data confirm prior findings using single country data, that there are subgroups of bipolar I disorder based on the age of onset, and that there is a birth cohort effect. Including the birth cohort adjustment altered the number and characteristics of subgroups detected when clustering by age of onset. Further investigation is needed to determine if combining both approaches will identify subgroups that are more useful for research.
Poly-victims are described as subjects who experience extremely high levels of victimization. This condition is regularly associated with wide psychopathological distress. Children and adolescents are special risk collective for this type of victimization.
To describe and analyze more frequents mental health problems in adolescents with different levels of victimization.
A community sample of 895 adolescents (M = 15.7; SD = 1.3 years old) was subdivided into several groups taking as reference the number of victimizations suffered in the last year, obtained from the Juvenile Victimization Questionnaire. Resulting groups were as follows: those adolescents presenting no type of victimization, the group below average, a group above average and the group of poly-victimized adolescents. Mental health problems were identified with the Youth Self Report, analyzing specifically the DSM syndrome scales.
The group of poly-victimized adolescents presented more significant (p<.05) affective, anxious symptomatology with attention and behavior problems, post-traumatic and obssesive compulsive disturbances, even after Bonferroni's post-hoc contrast regarding the other groups. On the other hand, somatic and oppositional defiant problems were perceived with same intensity between the group above average and the poly-victimized group in front of the groups below victimizations average.
Poly-victimization in adolescents is associated to larger symptomatology patterns and mental health problems development.
Study of mental disorders phenomenology is a field increasingly developing. The Ecological Momentary Assessment (EMA) is a methodology that allows to capture mental microprocesses fluctuations in the moment they happen.
To explain the development of an application based on EMA methodology by using smartphones, for assessing several criteria of autism spectrum disorders in adolescents with Asperger syndrome.
The application assesses several contexts among them situational, personal contact, interests fields, communicative interaction, satisfaction level, and feelings. Additionally, it is applied a cognitive (WISC-IV) and psychopathological (ADOS-G, CBCL, STAI, CDI) assessment.
Preliminary results suggest that adolescents diagnosed with Asperger syndrome present a response rate of about 90%. They tend to spend more time with parents and tuthors taking care of them. They present anxiety peaks when they live together with groups of three or more persons. The activity mostly registered in their everyday life is resting. Besides, they regularly have a feeling that they understand the others and that are understood by the others when they communicate orally.
The Ecological Momentary Assessment can be a methodology very useful for understanding the daily dynamics of persons with Asperger syndrome. It is not intrusive and is very useful for the contents that provides to the clinician or researcher.
The presence of comorbid personality pathology with other psychiatric disorders, imposes a worse prognosis in the development of therapeutic intervention. Additionally, this construct is usually related to stigma effect in clinical settings. Information about this effect, associated with psychiatric disorders in adolescence, is limited and little recognized.
The clinical diagnosis of personality disorder in adolescence tends to be conservative and unspecific.
To examine the prevalence of personality disorder, and the involvement of stigma effect in adolescents with Axis I psychiatric disorders.
A sample of 100 patients with psychiatric disorders (M = 15.8, SD = 0.9 years, range 15-17, 70% women), were assessed and diagnosed for personality disorders in a mental health public centre.
The prevalence of PD identified by clinicians (12%), differs from the prevalence identified by the semi-structured interview (34–37%) showing a greater number (p < .001) of people affected. In the present sample most of the cases identified by clinicians are related to personality disorders (PD) not otherwise specified, while with the implementation of semi-structured interviews, most of the sample met criteria for Cluster B PDs. Additionally, 11% of the sample has dimensional pathological features (probable PD) without complying categorically the criteria for a full PD.
In clinical settings, a considerable proportion of adolescents with psychopathology meet features for PD, although few of them have a confirmed clinical diagnosis. Considerations about impact of the stigma are discussed.
Several studies have reported that immigrant adolescents suffer high rates of victimization. Polyvictimization was established as a well predictor of mental health problems. Many authors have highlighted the need to study immigrant adolescents’ community as they were immersed in a stressful process.
The aim is to assess multiple types of victimization (polyvictimization) and mental health problems among immigrants (first and second generation) in comparison to native adolescents.
The sample was composed of 296 adolescents (62.2% girls) aged 13-18 (M = 15.63; SD = 1.19) in Catalonia. Participants were distributed in three groups: native (50%), first (34%) and second (16%) generation immigrants. The Juvenile Victimization Questionnaire and the Youth Self Report were used to assess victimization experiences during the last year and psychological distress, respectively.
Immigrant and native adolescents were comparable in average of total victimizations and in different types of victimization. Nevertheless, significant differences were shown among first immigrant generation and natives in relation to child maltreatment (p = .005). Significant associations were found between multiple kinds of victimization and mental health problems. However, for first immigrant generation who had experienced multiple victimizations were more associated with internalizing symptoms, while victimized native adolescents were more associated with externalizing symptoms.
Results emphasized the importance to assess victimization experiences which were suffered by adolescents, and also suggested that polyvictimization will be associated differently depend on the migration status group of the adolescents with mental health problems.
Often, children with autism spectrum disorder (ASD) can present deficits for acquiring superior level of theory of mind (ToM) in the detection of false beliefs o blunder situations. The objective of this study is to assess 51 subjects with a primary education level (18 with ASD compared to 33 control subjects) comparing ToM level by using the test of Faux Pas test by Baron-Cohen et al. (1999) in two groups divided in 2 layers by age of 7 and 11 years. Results showed significant differences in this construct (ToM) between control group and ASD group only at the age of 11 years (z-score = 2.26; P = .023), but not at the age of 7 years (z-score = 1.89; P = .062). This suggests that ToM's superior capacity acquires greater expression and maturity towards late childhood, just before transition to adolescence stage.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Bullying at school and victimization problems in adolescence have a negative impact in personal identity development specifically in mental health field.
To analyze coping profiles used in a communitarian adolescents sample in relation to victimization among peers and controlling the other victimization subtypes.
From Barcelona Metropolitan area, 1031 adolescents between 12 and 20 years old participated (37.5% boys; 15.7% foreigners). The different coping strategies were assessed with adolescent coping orientation for problem experiences test and the victimization types with juvenile victimization questionnaire.
A 46.2% of adolescents suffered a victimization event by peers in the last year. As victimization level by peers advance, it presents an increase of unproductive coping strategies (P < .001; d-Cohen = 0.92). Regularly women score higher than men in low and moderate victimization groups (P < .05). However, when it reaches the highest expression (higher risk profile), unproductive strategies use in both genders is very similar and significant differences disappear. The results show that avoidant coping type is associated with a higher rate of victimization by peers. Positive relationship between previous victimization in other areas and peer victimization rate was found.
It is of high importance to develop and strengthen coping psychoeducation programs centered in solving this problem and struggling against victimization consequences by peers in adolescence. Due to that, increase of this victimization type is very related to the use of unproductive strategies use and therefore a coping by avoiding the problem.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
To compare functional endoscopic sinus surgery with a combined approach (functional endoscopic sinus surgery plus Caldwell–Luc procedure) for the treatment of paediatric antrochoanal polyp, in terms of antrochoanal polyp recurrence and safety.
This retrospective case series comprises 27 paediatric patients with recurrent antrochoanal polyp, treated from January 2010 to January 2018.
The average age of the patients at the time of diagnosis was 10.4 ± 2.49 years. The recurrence rate after functional endoscopic sinus surgery alone was 72.9 per cent, compared with 12.5 per cent after functional endoscopic sinus surgery plus the Caldwell–Luc procedure (p < 0.00001). No complications were reported during surgery or follow up.
The correct identification of the origin of the antrochoanal polyp and an adequate returning of maxillary ventilation by widening the ostium can prevent recurrences. Although functional endoscopic sinus surgery continues to be the ‘gold standard’ for antrochoanal polyp treatment, in cases of revision surgery, a combined approach could ensure the complete removal of the polyp through the two openings.
Urban slum environments in the tropics are conducive to the proliferation and the spread of rodent-borne zoonotic pathogens to humans. Calodium hepaticum (Brancroft, 1893) is a zoonotic nematode known to infect a variety of mammalian hosts, including humans. Norway rats (Rattus norvegicus) are considered the most important mammalian host of C. hepaticum and are therefore a potentially useful species to inform estimates of the risk to humans living in urban slum environments. There is a lack of studies systematically evaluating the role of demographic and environmental factors that influence both carriage and intensity of infection of C. hepaticum in rodents from urban slum areas within tropical regions. Carriage and the intensity of infection of C. hepaticum were studied in 402 Norway rats over a 2-year period in an urban slum in Salvador, Brazil. Overall, prevalence in Norway rats was 83% (337/402). Independent risk factors for C. hepaticum carriage in R. norvegicus were age and valley of capture. Of those infected the proportion with gross liver involvement (i.e. >75% of the liver affected, a proxy for a high level intensity of infection), was low (8%, 26/337). Sixty soil samples were collected from ten locations to estimate levels of environmental contamination and provide information on the potential risk to humans of contracting C. hepaticum from the environment. Sixty percent (6/10) of the sites were contaminated with C. hepaticum. High carriage levels of C. hepaticum within Norway rats and sub-standard living conditions within slum areas may increase the risk to humans of exposure to the infective eggs of C. hepaticum. This study supports the need for further studies to assess whether humans are becoming infected within this community and whether C. hepaticum is posing a significant risk to human health.
Interventions including physical exercise may help improve the outcomes of late-life major depression, but few studies are available.
To investigate whether augmenting sertraline therapy with physical exercise leads to better outcomes of late-life major depression.
Primary care patients (>65 years) with major depression were randomised to 24 weeks of higher-intensity, progressive aerobic exercise plus sertraline (S+PAE), lower-intensity, non-progressive exercise plus sertraline (S+NPE) and sertraline alone. The primary outcome was remission (a score of $10 on the Hamilton Rating Scale for Depression).
A total of 121 patients were included. At study end, 45% of participants in the sertraline group, 73% of those in the S+NPE group and 81% of those in the S+PAE group achieved remission (P = 0.001). A shorter time to remission was observed in the S+PAE group than in the sertraline-only group.
Physical exercise may be a safe and effective augmentation to antidepressant therapy in late-life major depression.
Presso il Centro di Diagnosi Prenatale all'Università Cattolica del Sacro Cuore di Roma, sono state osservate 95 pazienti con gravidanza complicata da idrope fetale non immunologica. Nove pazienti presentavano una gravidanza gemellare. La sopravvivenza dei 95 feti osservati è stata del 27.7%. Nessun feto gemellare idropico è sopravvissuto. Nei 9 casi di gravidanza gemellare è stato possibile diagnosticare ecograficamente una placenta monocoriale in 6 casi e monoamniotica in 3 casi. La causa dell'idrope fetale è stata riferita in 3 casi a trasfusione feto-fetale; in 2 casi a cardiopatia fetale ed 1 caso a malformazione genito-urinaria e 3 casi di n.d.d. La morte del feto idropico è avvenuta tra la 21a e la 35a settimana di gravidanza. Dei feti gemellari non idropici la sopravvivenza è stata del 57.1% (4 su 7).
Otto delle gravidanze gemellari sono state osservate prima del 1988, epoca in cui nella nostra Istituzione, non era possibile un approccio diagnostico e terapeutico intrava-scolare mediante cordocentesi. Tale possibilità diagnostica e terapeutica può con molta probabilità migliorare la sopravvivenza dei feti idropici nelle gravidanze gemellari come avvenuta nelle gravidanze singole, dove è passata dal 25% (1980-88) al 36.8% (1988-93).
This study investigated the influence of soil factors on the structure, richness and distribution of woody Cerrado species within the National Forest of Paraopeba, Minas Gerais State, Brazil. Individuals with basal stem circumference ≥ 10 cm were sampled in five plots of 20 × 100 m. The study was conducted in five environments with different physiognomies and types of soils. A total of 132 species were recorded. The species with the greatest importance values varied between different areas, as did structure. Canonical correspondence analysis ordination showed three different groups closely related to soil fertility and Al levels. These relations were also confirmed by Pearson’s correlation where richness was positively related to pH, K, Ca, Mg and P and negatively to Al. The basal area was positively correlated with levels of P, Mg, Ca and T (base saturation) and negatively with Al, also using Pearson’s correlation. Likewise, density was positively correlated with Mg and negatively with Al. The analysis shows that soil fertility and the concentration of Al are two of the most important factors responsible for structural and floristic variation and for differentiating dystrophic and mesotrophic Cerradão.
Determining age is an important step when assessing growth, mortality, and yield of
cultivated and wild populations, but studies linking shell growth marks in the pearl
oyster Pteria sterna with the age of individuals are lacking. Thirty
juveniles (20.0 ± 1.2 mm shell height), collected from a winter spatfall, were marked with
the fluorochrome calcein and kept in the field in culture containers. After day 16, the
juveniles were cleaned and their shells cut along the sagittal axis to determine
periodicity of micro growth bands formed in the inner shell layers and to estimate age.
During this trial, fluorescent calcein marking succeeded in individuals larger than 20 mm
shell height; these formed an average of 15 micro growth bands over the 16 days,
representing 1 band per day. The marker created a wide fluorescent band containing three
micro growth marks, suggesting that calcein was incorporated into the shell over the first
three days. The use of calcein was found to be an accurate method for validating the micro
growth band frequency of formation in P. sterna juveniles, which in turn
can help to estimate age.