Bent, Stephen; Bertoglio, Kiah; Hendren, Robert L.
We conducted a systematic review to determine the safety and efficacy of omega-3 fatty acids for autistic spectrum disorder (ASD). Articles were identified by a search of MEDLINE, EMBASE, and the Cochrane Database using the terms autism or autistic and omega-3 fatty acids. The search identified 143 potential articles and six satisfied all…
L. Yu. Glukhova
Full Text Available The author represents the review of current scientific literature devoted to autistic epileptiform regression — the special form of autistic disorder, characterized by development of severe communicative disorders in children as a result of continuous prolonged epileptiform activity on EEG. This condition has been described by R.F. Tuchman and I. Rapin in 1997. The author describes the aspects of pathogenesis, clinical pictures and diagnostics of this disorder, including the peculiar anomalies on EEG (benign epileptiform patterns of childhood, with a high index of epileptiform activity, especially in the sleep. The especial attention is given to approaches to the treatment of autistic epileptiform regression. Efficacy of valproates, corticosteroid hormones and antiepileptic drugs of other groups is considered.
Parker, Sarah K; Schwartz, Benjamin; Todd, James; Pickering, Larry K
The issue of thimerosal-containing vaccines as a possible cause of autistic spectrum disorders (ASD) and neurodevelopmental disorders (NDDs) has been a controversial topic since 1999. Although most practitioners are familiar with the controversy, many are not familiar with the type or quality of evidence in published articles that have addressed this issue. To assess the quality of evidence assessing a potential association between thimerosal-containing vaccines and autism and evaluate whether that evidence suggests accepting or rejecting the hypothesis, we systematically reviewed published articles that report original data pertinent to the potential association between thimerosal-containing vaccines and ASD/NDDs. Articles for analysis were identified in the National Library of Medicine's Medline database using a PubMed search of the English-language literature for articles published between 1966 and 2004, using keywords thimerosal, thiomersal, mercury, methylmercury, or ethylmercury alone and combined with keywords autistic disorder, autistic spectrum disorder, and neurodevelopment. In addition, we used the "related links" option in PubMed and reviewed the reference sections in the identified articles. All original articles that evaluated an association between thimerosal-containing vaccines and ASD/NDDs or pharmacokinetics of ethylmercury in vaccines were included. Twelve publications that met the selection criteria were identified by the literature search: 10 epidemiologic studies and 2 pharmacokinetic studies of ethylmercury. The design and quality of the studies showed significant variation. The preponderance of epidemiologic evidence does not support an association between thimerosal-containing vaccines and ASD. Epidemiologic studies that support an association are of poor quality and cannot be interpreted. Pharmacokinetic studies suggest that the half-life of ethylmercury is significantly shorter when compared with methylmercury. Studies do not demonstrate
Sanders, Jane; Johnson, Katherine A.; Garavan, Hugh; Gill, Michael; Gallagher, Louise
Autistic spectrum disorders (ASD) are devastating neurodevelopmental disorders of unknown aetiology with characteristic deficits in social interaction, communication and behaviour. Individuals with ASD show deficits in executive function (EF), which are hypothesised to underlie core repetitive, stereotyped behaviours of autism. Neuroimaging…
OBJECTIVE: To review existing data on early signs of autistic spectrum disorders (ASD) and on how these disorders can be distinguished from other atypical patterns of development, and to describe a developmental surveillance approach that family physicians can use to ensure that children with these diagnoses are detected as early as possible. QUALITY OF EVIDENCE: MEDLINE was searched from January 1966 to July 2000 using the MeSH terms autistic disorder/diagnosis AND diagnosis, differential AND (infant OR child, preschool). Articles were selected based on relevance to developmental surveillance in primary care and on experimental design, with emphasis on prospective studies with systematic measurement procedures using up-to-date diagnostic criteria. MAIN MESSAGE: Autistic spectrum disorders are characterized by impairments in social interaction and verbal and nonverbal communication, and by preferences for repetitive interests and behaviours. Early signs that distinguish ASD from other atypical patterns of development include poor use of eye gaze, lack of gestures to direct other people's attention (particularly to show things of interest), diminished social responsiveness, and lack of age-appropriate play with toys (especially imaginative use of toys). Careful attention to parents' concerns and specific inquiry into and observation of how children interact, communicate, and play will help ensure that early signs are detected during regular health maintenance visits. CONCLUSION: Family physicians have an important role in early identification of children with ASD. Early diagnosis of these disorders is essential to ensure timely access to interventions known to improve outcomes for these children. PMID:11723598
Wulffaert, Josette; Van Berckelaer-Onnes, Ina A.; Scholte, Evert M.
According to the major classification systems it is not possible to diagnose a comorbid autistic disorder in persons with Rett syndrome. However, this is a controversial issue, and given the level of functioning of persons with Rett syndrome, the autistic disorder is expected to be present in a comparable proportion as in people with the same…
Aresti-Bartolome, Nuria; Garcia-Zapirain, Begonya
This study analyzes the technologies most widely used to work on areas affected by the Autistic Spectrum Disorder (ASD). Technologies can focus on the strengths and weaknesses of this disorder as they make it possible to create controlled environments, reducing the anxiety produced by real social situations. Extensive research has proven the efficiency of technologies as support tools for therapy and their acceptation by ASD sufferers and the people who are with them on a daily basis. This article is organized by the types of systems developed: virtual reality applications, telehealth systems, social robots and dedicated applications, all of which are classified by the areas they center on: communication, social learning and imitation skills and other ASD-associated conditions. 40.5% of the research conducted is found to be focused on communication as opposed to 37.8% focused on learning and social imitation skills and 21.6% which underlines problems associated with this disorder. Although most of the studies reveal how useful these tools are in therapy, they are generic tools for ASD sufferers in general, which means there is a lack of personalised tools to meet each person’s needs. PMID:25093654
Full Text Available This study analyzes the technologies most widely used to work on areas affected by the Autistic Spectrum Disorder (ASD. Technologies can focus on the strengths and weaknesses of this disorder as they make it possible to create controlled environments, reducing the anxiety produced by real social situations. Extensive research has proven the efficiency of technologies as support tools for therapy and their acceptation by ASD sufferers and the people who are with them on a daily basis. This article is organized by the types of systems developed: virtual reality applications, telehealth systems, social robots and dedicated applications, all of which are classified by the areas they center on: communication, social learning and imitation skills and other ASD-associated conditions. 40.5% of the research conducted is found to be focused on communication as opposed to 37.8% focused on learning and social imitation skills and 21.6% which underlines problems associated with this disorder. Although most of the studies reveal how useful these tools are in therapy, they are generic tools for ASD sufferers in general, which means there is a lack of personalised tools to meet each person’s needs.
Mercadante, M.T.; Gaag, R.J. van der; Schwartzman, J.S.
The category "Pervasive Developmental Disorders" includes autistic disorder, Asperger's syndrome, Rett's syndrome, childhood disintegrative disorder, and a residual category, named pervasive developmental disorder not otherwise specified. In this review, Rett's syndrome and childhood disintegrative
Autistic Spectrum Disorder (ASD) is a mental disorder that retards acquisition of linguistic, communication, cognitive, and social skills and abilities. Despite being diagnosed with ASD, some individuals exhibit outstanding scholastic, non-academic, and artistic capabilities, in such cases posing a challenging task for scientists to provide answers. In the last few years, ASD has been investigated by social and computational intelligence scientists utilizing advanced technologies such as machine learning to improve diagnostic timing, precision, and quality. Machine learning is a multidisciplinary research topic that employs intelligent techniques to discover useful concealed patterns, which are utilized in prediction to improve decision making. Machine learning techniques such as support vector machines, decision trees, logistic regressions, and others, have been applied to datasets related to autism in order to construct predictive models. These models claim to enhance the ability of clinicians to provide robust diagnoses and prognoses of ASD. However, studies concerning the use of machine learning in ASD diagnosis and treatment suffer from conceptual, implementation, and data issues such as the way diagnostic codes are used, the type of feature selection employed, the evaluation measures chosen, and class imbalances in data among others. A more serious claim in recent studies is the development of a new method for ASD diagnoses based on machine learning. This article critically analyses these recent investigative studies on autism, not only articulating the aforementioned issues in these studies but also recommending paths forward that enhance machine learning use in ASD with respect to conceptualization, implementation, and data. Future studies concerning machine learning in autism research are greatly benefitted by such proposals.
Full Text Available Children with autistic disorder (AD display atypical eye contact and struggle with the social imitation of eye contact. Impaired social imitation may be indicative of disruptions in motor learning processes. The application of specific motor learning principles, such as external feedback, may suggest which variables will result in positive change in eye contact. The study aimed to determine the effects of knowledge of performance (KP and knowledge of results (KR as types of feedback on the frequency and duration of elicited and spontaneous eye contact in children with AD. A two-phase multiple-probe, multi-treatment (cross-over, singleparticipant design with a withdrawal component was used. Mixed treatment effects were obtained. Overall effects suggest that KR results in the greatest positive change over a short period of time regarding frequency and duration for both elicited and spontaneous eye contact. This type of feedback seems to be the most effective for spontaneous eye contact. The provision of KP, after elicited and spontaneous eye contact, produced positive effects for duration only. The current Phase 1 evidence suggests that KR (which is goal-directed with fewer additional instructions may be more beneficial to children with AD. These findings are in accordance with the limb motor learning literature and may therefore support preliminary evidence for disrupted motor learning during eye contact imitation in children with AD.
Gomes, Erissandra; Pedroso, Fleming Salvador; Wagner, Mário Bernardes
auditory hypersensitivity in the autistic spectrum disorder has been described in the literature since the very first reports. However, this symptom has not been sufficiently explored, especially regarding possible causes, diagnosis and consequences. to study sensory-perceptual abnormalities in the autistic spectrum disorder, emphasizing auditory hypersensitivity and to discuss their effects in speech therapy based on the literature found until September 2007 in the following database: Scielo, Lilacs, Web of Science, and Medline. sensory-perceptual abnormalities are present in approximately 90% of individuals with autism; no theory has been found to explain this fact. Although the cause of auditory hypersensitivity remains unknown, it is the most common sensory-perceptual abnormality--its prevalence ranges between 15% to 100%. A few rare studies exist on behavioral, electroacoustic and electrophysiological hearing evaluation of autistic children; these studies discuss auditory hypersensitivity. The early diagnosis of this alteration is considered relevant for the possible identification of atypical sensorial markers, especially in hearing and for the better understanding of their impact on the development of communication in autistic individuals.
Aline Abreu e Andrade
Full Text Available Theory of mind is the people ability to understand their own mental states and the others. People with autism have significant deficit in this ability. The objective of this study was to conduct a systematic literature review about theory of mind studies conducted with relatives of people with autistic spectrum disorders. We used as databases BVS Medline, Web of Science, Academic Search Premier and Psy Articles in search of articles. Nine articles were selected and the results indicated inconclusive data on the existence of theory of mind deficits in relatives of people with autistic spectrum disorders. Thus, future studies are aimed to shed light on the topic.
Full Text Available The article presents a generalized overview of international approaches to the evaluation and formation of communication in children with autism spectrum disor ders (ASD. Described radicals communication disorders in children with ASD. Analyzed foreign approaches (Communication system for the exchange of images (PECS Lori Frost and Andrew Bondy; options piktogramme6ideogrammic communication (bliss6symbolism, Loeb system, a system of sign language; Program in Applied verbal behavior; a Method of facilitating communication (FC and others used for the development of communication in children with ASD and donditions underlying these approaches. Examined differences in focus for the development of communication in children with ASD in domestic and foreign schools. The main conditions for the development of communication in children with ASD described in the framework of cultural historical psychology and activity approach, ensuring the inclusion of children with ASD in education.
Background: Autistic disorder is a severe neuro-developmental disorder. In recent years, there has been an increased concern about the upsurge in the prevalence of autism. Psychiatrists and other clinicians have a pivotal role in its identification. Methods: This is a report of 2 cases of autistic disorder seen at a child and
Ashry, K. M.
Objective: To explore auditory function abnormalities and language disorder in autistic children. Twelve children with criteria of infantile autism were tested using Pure Tone Audiometry (PTA), Immitancemetry, Transient Evoked Otoacoustic Emission Test (TEOAE), Auditory Brainstem Response (ABR), Standardized Arabic Test of Early Language Development (for both receptive and expressive language). For comparison twlive normal children were chosen as control group. Statistically significant increase in hearing threshold level for the autistic children at low frequency region 250, 500 and 1000 Hz, significant reduction of the amplitude of TEOAE test and significant increase in wave I and V latency and I-V inter-peak latency at both RR 21.2 and 51.2 msec when compared to the control group. A positive correlation was found in this study between the changes in ABR latency and the severity of verbal disability. These resuts leed to the conclusion that Auditory dysfunction in autistic children can be verified through the presence of cochlear involvement and a delay in the brain stem transmission time in those patients. Disturbed verbal communication can be due to dysfunction in the auditory processing mechanisms
Kelmanson, I A
An association between sleep disorders and autistic spectrum disorders in children is considered. Characteristic variants of sleep disorders, including resistance to going to bed, frequent night awakenings, parasomnias, changes in sleep structure, primarily, the decrease in the percentage of rapid eye movement sleep, are presented. Attention is focused on the possibility of the direct relationship between sleep disturbance and the pathogenesis of autistic spectrum disorders. A role of pathological alterations in the production of neuromediators and morphological changes in the brain structures characteristic of autistic spectrum disorders in the genesis of sleep disorders in children is discussed. Possible non-pharmacological and pharmacological approaches are suggested.
Jones, Alice; Cork, Christine; Chowdhury, Uttom
As many as six in every 1000 children may be affected by an autistic spectrum disorder. The previous article of this two-part series discussed the distinction between autism, Asperger's syndrome and pervasive developmental disorder, and examined the assessment process. This article looks at potential differential diagnoses that must be considered, as well as conditions associated with autism. Many theories about the causes of autism have been suggested, including the MMR vaccine. Recent research has suggested that there is no link between the vaccine and autism. There is no cure for autism, but intervention and management techniques should be aimed at educating parents and carers about the disorder and behavioural interventions to aid the child's skills development.
Altgassen, A.M.; Kliegel, M.; Williams, T.I.
This study investigated the accuracy of musical pitch detection in children with autistic spectrum disorders as compared with typically developing children. Seventeen children on the autistic spectrum (Mage=9.34, SDage=1.12) and 13 typically developing, chronological age-matched children (Mage=9.13,
Robinson, Lee; Bond, Caroline
The most thoroughly researched topic in relation to autistic spectrum disorders (ASDs) is the evaluation of interventions. Educational psychology in the United Kingdom and Ireland is the most closely allied profession to school psychology in the United States. In considering what is published by and for the profession, it is important to include…
Nataf, Robert; Skorupka, Corinne; Amet, Lorene; Lam, Alain; Springbett, Anthea; Lathe, Richard
To address a possible environmental contribution to autism, we carried out a retrospective study on urinary porphyrin levels, a biomarker of environmental toxicity, in 269 children with neurodevelopmental and related disorders referred to a Paris clinic (2002-2004), including 106 with autistic disorder. Urinary porphyrin levels determined by high-performance liquid chromatography were compared between diagnostic groups including internal and external control groups. Coproporphyrin levels were elevated in children with autistic disorder relative to control groups. Elevation was maintained on normalization for age or to a control heme pathway metabolite (uroporphyrin) in the same samples. The elevation was significant (P < 0.001). Porphyrin levels were unchanged in Asperger's disorder, distinguishing it from autistic disorder. The atypical molecule precoproporphyrin, a specific indicator of heavy metal toxicity, was also elevated in autistic disorder (P < 0.001) but not significantly in Asperger's. A subgroup with autistic disorder was treated with oral dimercaptosuccinic acid (DMSA) with a view to heavy metal removal. Following DMSA there was a significant (P = 0.002) drop in urinary porphyrin excretion. These data implicate environmental toxicity in childhood autistic disorder
Autism and autistic spectrum disorders are still relatively poorly understood. This article outlines the results of new research into the prevalence of autism and into the causes of the condition and highlights implications for nurses from the findings.
Cortesi, Flavia; Giannotti, Flavia; Ivanenko, Anna; Johnson, Kyle
Children and adolescents with autistic spectrum disorders (ASD) suffer from sleep problems, particularly insomnia, at a higher rate than typically developing children, ranging from 40% to 80%. Sleep problems in ASD might occur as a result of complex interactions between biological, psychological, social/environmental, and family factors, including child rearing practices that are not conducive to good sleep. Interestingly, children with a history of developmental regression have a more disturbed sleep pattern than children without regression. Even though regulation of sleep in children with ASD is still poorly understood, circadian abnormalities in autism might be the result of genetic abnormalities related to melatonin synthesis and melatonin's role in modulating synaptic transmission. Recently a bifurcation of the sleep/wake cycle with increased sensitivity to external noise and short sleep duration causing irregular sleep onset and wake up times has been suggested. Identifying and treating sleep disorders may result not only in improved sleep, but also impact favorably on daytime behavior and family functioning. Several studies have also demonstrated effectiveness of behavioral interventions for sleep onset and maintenance problems in these populations. When behavioral interventions are not effective or lead only to a partial response, pharmacological treatment options should be considered. Studies of melatonin use in children with ASD provide evidence for its effectiveness and safety in the long run. The clinician assessing a child with an ASD should screen carefully for sleep disorders and make referrals as indicated. Copyright 2010 Elsevier B.V. All rights reserved.
Schoenberg, P.L.; David, A.S.
Biofeedback potentially provides non-invasive, effective psychophysiological interventions for psychiatric disorders. The encompassing purpose of this review was to establish how biofeedback interventions have been used to treat select psychiatric disorders [anxiety, autistic spectrum disorders,
Hassan, A.; Shafi, M.; Khattak, M.
This paper addresses UI (User Interface) designing based on multi-touch collaborative gesture recognition meant for ASD (Autism Spectrum Disorder) - affected children. The present user interfaces (in the context of behavioral interventions for Autism Spectrum disorder) are investigated in detail. Thorough comparison has been made among various groups of these UIs. Advantages and limitations of these interfaces are discussed and future directions for the design of such interfaces are suggested. (author)
Bilgic, Ayhan; Gurkan, Kagan; Turkoglu, Serhat; Akca, Omer Faruk; Kilic, Birim Gunay; Uslu, Runa
Iron deficiency (ID) causes negative outcomes on psychomotor and behavioral development of infants and young children. Children with autistic spectrum disorders (ASD) are under risk for ID and this condition may increase the severity of psychomotor and behavioral problems, some of which already inherently exist in these children. In the present…
Liss, Miriam; Saulnier, Celine; Fein, Deborah; Kinsbourne, Marcel
Individuals with autistic spectrum disorders (ASDs) often experience, describe and exhibit unusual patterns of sensation and attention. These anomalies have been hypothesized to result from overarousal and consequent overfocused attention. Parents of individuals with ASD rated items in three domains, "sensory overreactivity",…
Sweeten, Thayne L.; Posey, David J.; McDougle, Christopher J.
Previous research has identified a relationship between autistic disorder (autism) and specific congenital infections. Three cases of congenital or perinatal cytomegalovirus (CMV) infection occurring in association with autism are described. Hypothetical mechanisms relating congenital infection, such as CMV, to the development of autism are…
Geier, Mark R; Geier, David A
Autism is a neurodevelopmental disorder that according to the Centers for Disease Control and Prevention (CDC) affects 1 in 150 children in the United States. Autism is characterized by impairments in social relatedness and communication, repetitive behaviors, abnormal movements, and sensory dysfunction. Recently emerging evidence suggests that mercury, especially from childhood vaccines, appears to be a factor in the development of the autistic disorders, and that autistic children have higher than normal body-burdens of mercury. In considering mercury toxicity, it has previously been shown that testosterone significantly potentates mercury toxicity, whereas estrogen is protective. Examination of autistic children has shown that the severity of autistic disorders correlates with the amount of testosterone present in the amniotic fluid, and an examination of a case-series of autistic children has shown that some have plasma testosterone levels that were significantly elevated in comparison neurotypical control children. A review of some of the current biomedical therapies for autistics, such as glutathione and cysteine, chelation, secretin, and growth hormone, suggests that they may in fact lower testosterone levels. We put forward the medical hypothesis that autistic disorders, in fact, represents a form of testosterone mercury toxicity, and based upon this observation, one can design novel treatments for autistics directed towards higher testosterone levels in autistic children. We suggest a series of experiments that need to be conducted in order to evaluate the exact mechanisms for mercury-testosterone toxicity, and various types of clinical manipulations that may be employed to control testosterone levels. It is hoped by devising therapies that address the steroid hormone pathways, in addition to the current treatments that successful lower heavy metal body-burdens of mercury, will work synergistically to improve clinical outcomes. In light of the fact that
There are debates whether autistic disorder (autism) and Asperger's disorder are two distinct disorders. Moreover, interventional sensory occupational therapy should consider the clinical characteristics of patients. Already, commonalities and differences between Asperger's disorder and autistic disorder are not well studied. The aim of this study is to compare tactile sensory function of children with autistic disorder and children with Asperger's disorder. Tactile sensory function was compared between 36 children with autism and 19 children with Asperger's disorder. The two disorders were diagnosed based on Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision. The parent-reported Tactile Dysfunction Checklist was used to assess the three aspects of hypersensitivity, hyposensitivity, and poor tactile perception and discrimination. Developmental coordination was also assessed. Developmental coordination problems total score was not associated with group. The mean (standard deviation) score of tactile hyper-responsivity was not different between the groups. Tactile hyporesponsivity and poor tactile perception and discrimination scores were statistically higher in autistic disorder than Asperger's disorder group. These results for the first time indicated that at least some aspects of tactile perception can differentiate these two disorders. Children with autistic disorder have more tactile sensory seeking behaviors than children with Asperger's disorder. Moreover, the ability of children with autistic disorder for tactile discrimination and sensory perception is less than those with Asperger's disorder. Interventional sensory therapy in children with autistic disorder should have some characteristics that can be different and specific for children with Asperger's disorder. Formal intelligence quotient testing was not performed on all of the children evaluated, which is a limitation to this study. In some cases, a clinical estimation of
Objective There are debates whether autistic disorder (autism) and Asperger's disorder are two distinct disorders. Moreover, interventional sensory occupational therapy should consider the clinical characteristics of patients. Already, commonalities and differences between Asperger's disorder and autistic disorder are not well studied. The aim of this study is to compare tactile sensory function of children with autistic disorder and children with Asperger's disorder. Methods Tactile sensory function was compared between 36 children with autism and 19 children with Asperger's disorder. The two disorders were diagnosed based on Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision. The parent-reported Tactile Dysfunction Checklist was used to assess the three aspects of hypersensitivity, hyposensitivity, and poor tactile perception and discrimination. Developmental coordination was also assessed. Results Developmental coordination problems total score was not associated with group. The mean (standard deviation) score of tactile hyper-responsivity was not different between the groups. Tactile hyporesponsivity and poor tactile perception and discrimination scores were statistically higher in autistic disorder than Asperger's disorder group. Conclusion These results for the first time indicated that at least some aspects of tactile perception can differentiate these two disorders. Children with autistic disorder have more tactile sensory seeking behaviors than children with Asperger's disorder. Moreover, the ability of children with autistic disorder for tactile discrimination and sensory perception is less than those with Asperger's disorder. Interventional sensory therapy in children with autistic disorder should have some characteristics that can be different and specific for children with Asperger's disorder. Formal intelligence quotient testing was not performed on all of the children evaluated, which is a limitation to this study. In
Autistic disorders are categorized as neurodevelopmental disorders and are considered incurable. People with autistic disorders have issues on various fields of operation – one of those is also the occurrence of inappropriate behavioral patterns and the ability to communicate with the environment. Especially the occurrence of inappropriate behavioral patterns and the inability to communicate with the environment have a strong impact on the inclusion of people with autistic disorders in differ...
Kobayashi, R; Takenoshita, Y; Kobayashi, H; Kamijo, A; Funaba, K; Takarabe, M
To date, many researchers in Japan have assumed that the cause of autistic spectrum disorders is attributable to some disorder in the ability of the child. However, we have been working on the premise that autistic spectrum disorders are brought about by relationship disturbances in early infancy and have been attempting to validate this hypothesis through early intervention. We have examined the developmental process of affective communication in infants with autistic spectrum disorders. We have postulated that approach-avoidance motivational conflict (Richer) is the primary factor impeding the development of affective communication and have focused therapeutic intervention on this perspective. As a result, attachment behavior was markedly improved in children, but affective communication with their mothers was not. Examing the mothers' images of themselves in infancy in mother-infant psychotherapy, problems that the mothers had themselves in infacy with attachment behavior to their own mothers affected the mothers' internal representation of their children, leading to active evolution of mother-child interaction and development of affective communication between the mother and child. In this context, the basis and significance of the internal representation of both parties being determinants in the quality of mother-child communication are discussed. Our goal in early intervention is not the elevation of a child's linguistic-cognitive abilities, but the creation of a comforting relationship in which both parent and child can live securely, without strain.
van Steensel, F.J.A.; Bögels, S.M.; Perrin, S.
There is considerable evidence that children and adolescents with autistic spectrum disorders (ASD) are at increased risk of anxiety and anxiety disorders. However, it is less clear which of the specific DSM-IV anxiety disorders occur most in this population. The present study used meta-analytic
van Steensel, Francisca J. A.; Bogels, Susan M.; Perrin, Sean
There is considerable evidence that children and adolescents with autistic spectrum disorders (ASD) are at increased risk of anxiety and anxiety disorders. However, it is less clear which of the specific DSM-IV anxiety disorders occur most in this population. The present study used meta-analytic techniques to help clarify this issue. A systematic…
Sarnat, Haim; Samuel, Eli; Ashkenazi-Alfasi, Naomi; Peretz, Benjamin
to assess the dental status of young children with Autistic Syndrome Disorder (ASD) in order to allow better understanding of the dentist's role in treating these children. The ASD group consisted of 47 children diagnosed as ASD from three special kindergartens from three towns in Israel. The control group was 44 normally developed children from 4 kindergartens from 2 neighboring towns. Parents were asked to complete a questionnaire requesting the following: socio-demographic information, general medical condition, dental information (previous visit to a dentist, feeding habits, oral hygiene behavior, oral habits and the Vinland Adaptive Behavioral Scales (VABS). While in the control group there was no report of no brushing at all, among the ASD children 25% did not brush at all. Use of pacifier, fussy eating and eating problems were significantly more prevalent among the ASD group. In addition, the ASD children significantly preferred more salty, spicy and sweet foods than the control. There were more cariesfree children among the ASD group. In the ASD group, the ability to perform everyday life functions was slightly more than half of what is expected for age. autistic children have a relative age of one half, meaning they function at half the level of normally developed children at their chronological age, more eating problems and more persistent oral habits yet no correlation to dental health could be shown. Caries experience of autistic children was lower than in the control group, maintaining good oral hygiene is difficult for autistic children yet their gingival health was found to be good.
Zivoder, Ivana; Martic-Biocina, Sanja; Kosic, Ana Vodanovic; Bosak, Josipa
The aim of this paper is to describe neurofeedback (NFB) treatment in Autistic spectrum disorder (ASD) children. There is no specific cure for autism and therapeutic guidelines are directed to improve the quality of life of people with autism by reducing the symptoms and by increasing their functioning. Neurofeedback is a computerized method based on tracking electrical activity of the brain (EEG) and giving a feedback about it. The method has been developed in neurophysiological labs of scientific institutes in USA and has been used very successfully for over last 20 years. It has proven its efficacy in practise, but also in scientific and clinical research. During 2010 and 2011 neurofeedback treatment was administered to 10 children (N=10, 7 males and 3 females) age range 4 to 7 years which have been diagnosed as autistic spectrum disorder (highly functional) with an unspecific impairment of speech development and trouble communicating. An evaluation of treatment was done according to estimation of changes in functioning (parents, teachers and therapists' ratings and all other experts that were monitoring the child before, during and after the treatment) and tracking of changes in electrophysiology. The results have shown most changes in behaviour (less aggressive, more cooperation, better communication), attention span and sensory motor skills. According to the assessment of parents, teachers, therapists and other experts all children have accomplished a certain degree of improvement in the level of daily functioning. Our experiences in usage of neurofeedback in Autistic spectrum disorder (ASD) children confirmed previous data that this method can be applied to this category of patients.
Yamashita, Yushiro; Fujimoto, Chizu; Nakajima, Eisuke; Isagai, Takeo; Matsuishi, Toyojiro
We encountered seven children with symptomatic congenital cytomegalovirus (CMV) infection from 1988 to 1995, of whom two (28.6%) developed typical autistic disorder. Case 1: A boy born at 38 weeks' gestation with a birth weight of 3164 g showed generalized petechiae, hepatosplenomegaly, and positive serum CMV-specific IgM antibodies. He was profoundly deaf, mentally retarded, and exhibited a lack of eye contact, stereotyped repetitive play, and hyperactivity. Case 2: A boy delivered at 39 weeks gestation with a birthweight of 2912 g showed non-progressive dilatation of the lateral ventricles observed postnatally. CMV-specific IgM antibodies were positive and CMV-DNA in the urine was confirmed by PCR. The boy was mentally retarded but not deaf. He showed no interest in people and delayed speech development. Subependymal cysts were detected by cranial ultrasound after birth in both patients. This is the first report describing subependymal cysts and the later development of AD. Cranial magnetic resonance imaging revealed an abnormal intensity area in the periventricular white matter suggestive of disturbed myelination; however, no migration disorders were found in our patients. These findings suggest that the timing of injury to the developing brain by CMV may be in the third trimester in some patients with autistic disorder.
Ben Amor, Arwa; Halayem, Soumeyya; Touati, Maissa; Belhadj, Ahlem; Gouider, Riadh; Mrad, Ridha; Bouden, Asma
Background - Based on the recognized principles of assessment of autistic disorders, the child and adolescent psychiatry department in Razi Hospital developed an assessment unit with diagnostic as well as therapeutic roles. The aim of this work was to examine its functioning and to analyze the parents' perceptions about the unit services. Methods - We gathered the parental satisfaction about the unit by the means of a hetero-questionnaire. Results - Fifty-two parents of children evaluated within the unit were included. Patients had received the diagnosis of Autistic Disorder, Pervasive Developmental Disorders Not Otherwise Specified and Asperger Syndrome in accordance with DSM IV criteria, and than that of Autism Spectrum Disorder after DSM 5 publication. The overall satisfaction rate was 63%. Most parents (84.6%) rated the Psycho Educative Profile examination positively, 75% appreciated the neurological examination and the final report steps, 55.8% appreciated step of the Autism Diagnostic Interview revised and 42.3% the genetic exploration. 67% of the parents reported an improvement of their child following the evaluation. This improvement was attributed to the unit in 57.7% of cases. Parents whose children did not have associated disorders such as intellectual disability (p = 0.02), aggressive behavior (p = 0.04), affective disorder (p = 0.01) and sleep-related disorders (p = 0.03) were the most satisfied. Parents of children with epilepsy comorbidity were the least satisfied (p <10-3). 96% of parents suggested repeating the assessment once a year. Conclusion - Assessment units are based on international recommendations. However, it would be interesting to adapt assessments and orientation to the parents' expectations.
Pooni, Jyoti; Ninteman, Aafke; Bryant-Waugh, Rachel; Nicholls, Dasha; Mandy, William
To investigate whether young people (8-16 years) with an eating disorder have a higher prevalence of autism spectrum disorder (ASDs) and elevated autistic traits compared to typically developing (TD) peers. Twenty-two participants with early onset eating disorder (EOED) were assessed using standardized ASD measures and compared to IQ matched TD (n = 24) and ASD (n = 20) controls. An ASD diagnosis was no more common in EOED than in TD controls. However, repetitive and stereotyped behavior was more often observed in the EOED group and, compared to TD controls, there was a trend (p = .07) toward greater autistic social impairment in EOED. Whilst participants with EOED did not show increased ASD prevalence, they did have elevated autistic traits of clinical significance, particularly repetitive and stereotyped behavior. Further work is required to determine whether inflexibility and social difficulties in EOED have identical phenomenology and etiology to those seen in ASD. Copyright © 2012 Wiley Periodicals, Inc.
Tordjman, Sylvie; Anderson, George M; Pichard, Nadège; Charbuy, Henriette; Touitou, Yvan
Many studies in autistic disorder report sleep problems and altered circadian rhythms, suggesting abnormalities in melatonin physiology. Additionally, melatonin, a pineal gland hormone produced from serotonin, is of special interest in autistic disorder given reported alterations in central and peripheral serotonin neurobiology. Nocturnal urinary excretion of 6-sulphatoxymelatonin was measured by radioimmunoassay in groups of children and adolescents with autistic disorder (n = 49) and normal control individuals (n = 88) matched on age, sex, and Tanner stage of puberty. Nocturnal 6-sulphatoxymelatonin excretion rate was significantly and substantially lower in patients with autism than in normal controls (mean +/- SEM, .75 +/- .11 vs. 1.80 +/- .17 microg/hr, p =.0001), and was significantly negatively correlated with severity of autistic impairments in verbal communication and play (p autistic disorder, and to determine the utility of melatonin administration in individuals with autism.
Kawabe, Kentaro; Horiuchi, Fumie; Oka, Yasunori; Ueno, Shu-Ichi
Children with autism spectrum disorders (ASD), including autistic disorder, frequently suffer from comorbid sleep problems. An altered melatonin rhythm is considered to underlie the impairment in sleep onset and maintenance in ASD. We report three cases with autistic disorder in whom nocturnal symptoms improved with ramelteon, a selective melatonin receptor agonist. Insomnia and behavior, assessed using the Clinical Global Impression-Improvement Scale, improved in two cases with 2 mg ramelteon and in the third case with 8 mg ramelteon. Our findings demonstrate that ramelteon is effective not only for insomnia, but for behavioral problems as well, in patients with autistic disorder.
Full Text Available Children with autism spectrum disorders (ASD, including autistic disorder, frequently suffer from comorbid sleep problems. An altered melatonin rhythm is considered to underlie the impairment in sleep onset and maintenance in ASD. We report three cases with autistic disorder in whom nocturnal symptoms improved with ramelteon, a selective melatonin receptor agonist. Insomnia and behavior, assessed using the Clinical Global Impression-Improvement Scale, improved in two cases with 2 mg ramelteon and in the third case with 8 mg ramelteon. Our findings demonstrate that ramelteon is effective not only for insomnia, but for behavioral problems as well, in patients with autistic disorder.
Hatton, Sue; Tector, Angie
Finding suitable curriculum materials for Sexuality and Relationship Education for young people with autistic spectrum disorder can be a challenge for teaching staff. In this article, Sue Hatton and Angie Tector who both formerly worked at Coddington Court School discuss findings from their research project asking pupils with autistic spectrum…
VanderLaan, Doug P.; Leef, Jonathan H.; Wood, Hayley; Hughes, S. Kathleen; Zucker, Kenneth J.
Gender dysphoria (GD) and autism spectrum disorder (ASD) are associated. In 49 GD children (40 natal males), we examined ASD risk factors (i.e., birth weight, parental age, sibling sex ratio) in relation to autistic traits. Data were gathered on autistic traits, birth weight, parents' ages at birth, sibling sex ratio, gender nonconformity, age,…
The aim of this study was to clarify the features of mental development and autistic behavior in children with pervasive developmental disorders (PDD) from the viewpoint of remedial therapy. The Tokyo Child Development Schedule (TCDS) and the Tokyo Autistic Behavior Scale (TABS), designed to be completed by children's caregivers, were used. A…
Dardas, Latefa A; Ahmad, Muayyad M
A growing body of research has sought to examine issues associated with the Quality of Life (QoL) of parents of children with Autistic Disorder. However, no studies have examined the QoL of Arab parents whose parenting experience is expected to be substantially different from that of their western counterparts. Therefore, the purposes of this study were: (1) to examine differences in the QoL between fathers and mothers of children with Autistic Disorder in a sample from an Arab country, and (2) to examine the psychosocial correlates of the QoL of Arab parents of children with Autistic Disorder. Self-administered questionnaires on parents' QoL, stress, coping strategies, and demographic characteristics were completed by 184 parents of children with Autistic Disorder. The participants were recruited using the convenience sampling design. Fathers and mothers of children with Autistic Disorder showed no significant differences in their physical, psychological, social, and environmental health. Further, both parents showed almost similar bivariate correlations between the reported QoL levels and their parenting stress, coping strategies, and demographic characteristics. This is the first study to examine the QoL of parents of children with Autistic Disorder in the Arab world and, in doing so, it highlighted the distinct lack of research in this area. The QoL of Arab parents of children with Autistic Disorder crosses lines with their stress levels, coping strategies, demographic characteristics, and to some extent their cultural context. Copyright © 2013 Elsevier Ltd. All rights reserved.
Mohinderpal Chadha, Gagandeep; Kakodkar, Pradnya; Chaugule, Vishwas; Nimbalkar, Vidya
The objective of this study was to assess the oral hygiene practices, dietary pattern, dental caries status and needs of institutionalized autistic children. The sample consisted of 35 children (28 males and 7 females) in the age group of 5 to 10 years from two institutions in Maharashtra, India. The parents of the children were interviewed regarding oral hygiene practices of their respective ward and instructed to maintain a 4-day diet chart for their children. A clinical examination was conducted using WHO dentition status and treatment needs index and a simplified oral hygiene index for ages 4 to 6 years and 7 to 10 years (deciduous and mixed dentition) was used to assess the oral hygiene. The results of diet chart analysis according to Nizel AE and Papas AS score showed the 'at meal' sugar exposure close to nil, while the 'in between' meal sugar exposure was observed to be more than three times per day among maximum children. The oral hygiene status was poor with abundance of soft debris and fair calculus accumulation. The mean caries experience (deft) in these children was 6.4. The present study provided baseline data which has been used for planning a comprehensive oral health care program. How to cite this article: Chadha GM, Kakodkar P, Chaugule V, Nimbalkar V. Dental Survey of Institutionalized Children with Autistic Disorder. Int J Clin Pediatr Dent 2012;5(1):29-32.
Robert B Dudas
Full Text Available Both people with autism spectrum conditions (ASC and borderline personality disorder (BPD are significantly challenged in terms of understanding and responding to emotions and in interpersonal functioning.To compare ASC, BPD, and comorbid patients in terms of autistic traits, empathy, and systemizing.624 ASC, 23 BPD, and 16 comorbid (ASC+BPD patients, and 2,081 neurotypical controls (NC filled in the Autism Spectrum Quotient (AQ, the Empathy Quotient (EQ and the Systemizing Quotient-Revised (SQ-R.On the AQ, the comorbid group scored higher than the ASC group, who in turn scored higher than the BPD group, who scored higher than controls. On the EQ, we found the comorbid and ASC groups scored lower than the BPD group, who were not different from controls. Finally, on the SQ-R, we found the ASC and BPD group both scored higher than controls.Similar to ASC, BPD patients have elevated autistic traits and a strong drive to systemize, suggesting an overlap between BPD and ASC.
Dressler, Anastasia; Perelli, Valentina; Bozza, Margherita; Bargagna, Stefania
The autistic phenotype in Down syndrome (DS) is marked by a characteristic pattern of stereotypies, anxiety and social withdrawal. Our aim was to study adaptive behaviour in DS with and without autistic comorbidity using the Vineland Adaptive Behaviour Scales (VABS), the Childhood Autism Rating Scales (CARS) and the DSM IV-TR criteria. We assessed 24 individuals and established three groups: Down syndrome (DS), DS and autistic disorder (DS-AD), and autistic disorder (AD). The DS and DS-AD groups showed statistically significantly similar strengths on the VABS (in receptive and domestic skills). The DS and DS-AD subjects also showed similar strengths on the CARS (in imitation and relating), differing significantly from the AD group. The profile of adaptive functioning and symptoms in DS-AD seemed to be more similar to that found in DS than to the profile emerging in AD. We suggest that the comorbidity of austistic symptoms in DS hampered the acquisition of adaptive skills more than did the presence of DS alone.
Prior, M; Eisenmajer, R; Leekam, S; Wing, L; Gould, J; Ong, B; Dowe, D
Comprehensive data on the developmental history and current behaviours of a large sample of high-functioning individuals with diagnoses of autism, Asperger's syndrome, or other related disorder were collected via parent interviews. This provided the basis for a taxonomic analysis to search for subgroups. Most participants also completed theory of mind tasks. Three clusters or subgroups were obtained; these differed on theory of mind performance and on verbal abilities. Although subgroups were identified which bore some relationship to clinical differentiation of autistic, Asperger syndrome, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) cases, the nature of the differences between them appeared strongly related to ability variables. Examination of the kinds of behaviours that differentiated the groups suggested that a spectrum of autistic disorders on which children differ primarily in term of degrees of social and cognitive impairments could explain the findings.
Song, Dae Kwang; Sawada, Masayuki; Yokota, Shingo; Kuroda, Kenji; Uenishi, Hiroyuki; Kanazawa, Tetsufumi; Ogata, Hiroyuki; Ihara, Hiroshi; Nagai, Toshiro; Shimoda, Kazutaka
Prader-Willi syndrome (PWS) is a neuro-genetic disorder caused by the absence/loss of expression of one or more paternally expressed genes on chromosome 15 (q11-13). In this study, a comparative analysis of intelligence level and autistic traits was conducted between children with PWS (n = 30; 18 males, 12 females; age = 10.6 ± 2.8 years) and those with Asperger disorder (AD; n = 31; 24 males, 7 females; age = 10.5 ± 3.1 years). The children were compared by age group: lower elementary school age (6-8 years), upper elementary school age (9-12 years), and middle school age (13-15 years). As results, the intelligence levels of children with PWS were significantly lower than those with AD across all age groups. Autistic traits, assessed using the Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS), revealed that among elementary school age children, those with PWS had less prominent autistic traits than those with AD, however, among middle school age children, those with PWS and AD showed similar prominence. An analysis of the PARS subscale scores by age group showed that while the profiles of autistic traits for children with PWS differed from those of children with AD at elementary school age, the profiles showed no significant differences between the groups at middle school age. The findings suggest that autistic traits in PWS become gradually more prominent with increasing of age and that these autistic traits differ in their fundamental nature from those observed in AD. © 2014 Wiley Periodicals, Inc.
Full Text Available Background. User feedback is now an integral part of both clinical governance and service development, and it also provides a key route to engaging parents and children. Autistic spectrum disorders (ASDs can impact on all members of a family, and close working between parents and professionals is essential. Aim. To explore parental satisfaction rates and identify areas in need of improvement. Method. A postal survey was completed by parents whose children had been diagnosed with an ASD in the past 18 months in a Manchester Child and Adolescent Mental Health Service. The National Autism Plan for Children was used as a gold standard. Results. Parents were particularly satisfied with the way team members dealt with them and their children during appointments. However, the standard of written information provided about the condition, diagnosis, and support available could be improved. The findings show the benefits of receiving a diagnosis in the recommended timeframe. Discussion. We discuss ways of effectively using scarce resources.
Stigler, Kimberly A; Posey, David J; McDougle, Christopher J
The aim of this study was to report preliminary data on the effectiveness and tolerability of ramelteon for the treatment of insomnia in youth with autistic disorder (autism). Two youths, ages 7 and 18 years, with autism and significant insomnia characterized by problems with sleep onset and maintenance received an open-label trial of ramelteon (4-8 mg) over a duration of 16-18 weeks. Target symptoms of delayed sleep onset and/or frequent nocturnal awakening improved significantly, as determined by Clinical Global Impressions-Improvement (CGI-I) scale ratings of either "much improved" or "very much improved." Ramelteon was well tolerated. No daytime sedation was reported. This case report illustrates the potential effectiveness and tolerability of ramelteon for sleep disturbances in 2 patients with autism. Further research is needed to verify its safety, tolerability, and efficacy in children and adolescents with autism.
Westwood, Heather; Eisler, Ivan; Mandy, William; Leppanen, Jenni; Treasure, Janet; Tchanturia, Kate
Interest in the link between Autism Spectrum Disorder (ASD) and Anorexia Nervosa (AN) has led to estimates of the prevalence of autistic traits in AN. This systematic review and meta-analysis assessed the use of the Autism-Spectrum Quotient (AQ) or abbreviated version (AQ-10) to examine whether patients with AN have elevated levels of autistic…
Ming, Xue; Sun, Ye-Ming; Nachajon, Roberto V.; Brimacombe, Michael; Walters, Arthur S.
The prevalence of sleep related complaints is reported by questionnaire studies to be as high as 83.3% in children with autism spectrum disorders (ASD). Questionnaire studies report the presence of various parasomnia in ASD. However, no polysomnographic study reports non-REM parasomnias and only a single study reports REM related parasomnias in ASD. We investigated the prevalence and characteristics of sleep disorders by polysomnographic study and questionnaires in a cohort of 23 children with ASD and 23 age-matched children of a non-autistic comparison group. The results showed significantly more non-REM parasomnias in 14 children with ASD on polysomnograms (PSG) and 16 ASD children by questionnaire, a finding that was not associated with medication use, other comorbid medical or psychiatric disorders, or sleep disordered breathing. Of the 14 children with ASD who had PSG evidence of parasomnia, 11 of them had a history suggestive of parasomnia by questionnaire. There was a high sensitivity but a low specificity of parasomnia in ASD by questionnaire in predicting the presence of parasomnia in the PSG. Of the parasomnias recorded in the laboratory, 13 ASD children had Disorders of Partial Arousal, consistent with sleep terrors or confusional arousals. Furthermore, multiple episodes of partial arousal occurred in 11 of the 13 ASD children who had PSG evidence of Disorders of Partial Arousal. Of the 11 ASD children with multiple episodes of partial arousal, 6 ASD children had multiple partial arousals during both nights’ PSG study. Sleep architecture was abnormal in children with ASD, characterized by increased spontaneous arousals, prolonged REM latency and reduced REM percentage. These results suggest a high prevalence of parasomnia in this cohort of children with ASD and a careful history intake of symptoms compatible with parasomnia could be prudent to diagnose parasomnia in ASD children when performing a PSG is not possible. PMID:23818789
Arthur S. Walters
Full Text Available The prevalence of sleep related complaints is reported by questionnaire studies to be as high as 83.3% in children with autism spectrum disorders (ASD. Questionnaire studies report the presence of various parasomnia in ASD. However, no polysomnographic study reports non-REM parasomnias and only a single study reports REM related parasomnias in ASD. We investigated the prevalence and characteristics of sleep disorders by polysomnographic study and questionnaires in a cohort of 23 children with ASD and 23 age-matched children of a non-autistic comparison group. The results showed significantly more non-REM parasomnias in 14 children with ASD on polysomnograms (PSG and 16 ASD children by questionnaire, a finding that was not associated with medication use, other comorbid medical or psychiatric disorders, or sleep disordered breathing. Of the 14 children with ASD who had PSG evidence of parasomnia, 11 of them had a history suggestive of parasomnia by questionnaire. There was a high sensitivity but a low specificity of parasomnia in ASD by questionnaire in predicting the presence of parasomnia in the PSG. Of the parasomnias recorded in the laboratory, 13 ASD children had Disorders of Partial Arousal, consistent with sleep terrors or confusional arousals. Furthermore, multiple episodes of partial arousal occurred in 11 of the 13 ASD children who had PSG evidence of Disorders of Partial Arousal. Of the 11 ASD children with multiple episodes of partial arousal, 6 ASD children had multiple partial arousals during both nights’ PSG study. Sleep architecture was abnormal in children with ASD, characterized by increased spontaneous arousals, prolonged REM latency and reduced REM percentage. These results suggest a high prevalence of parasomnia in this cohort of children with ASD and a careful history intake of symptoms compatible with parasomnia could be prudent to diagnose parasomnia in ASD children when performing a PSG is not possible.
Nikolov, R; Jonker, Jacob Jan; Scahill, L
Autistic disorder and the group of related conditions defined as pervasive developmental disorders are chronic neurodevelopmental disorders starting in early childhood and affecting a significant number of children and families. Although the causes and much of the pathophysiology of the disorder
Parron, Carole; Da Fonseca, David; Santos, Andreia; Moore, David G.; Monfardini, Elisa; Deruelle, Christine
It is widely accepted that autistic children experience difficulties in processing and recognizing emotions. Most relevant studies have explored the perception of faces. However, context and bodily gestures are also sources from which we derive emotional meanings. We tested 23 autistic children and 23 typically developing control children on their…
Schultz Stephen T
Full Text Available Abstract Background Although Autistic Disorder is associated with several congenital conditions, the cause for most cases is unknown. The present study was undertaken to determine whether breastfeeding or the use of infant formula supplemented with docosahexaenoic acid and arachidonic acid is associated with Autistic Disorder. The hypothesis is that breastfeeding and use of infant formula supplemented with docosahexaenoic acid/arachidonic acid are protective for Autistic Disorder. Methods This is a case-control study using data from the Autism Internet Research Survey, an online parental survey conducted from February to April 2005 with results for 861 children with Autistic Disorder and 123 control children. The analyses were performed using logistic regression. Results Absence of breastfeeding when compared to breastfeeding for more than six months was significantly associated with an increase in the odds of having autistic disorder when all cases were considered (OR 2.48, 95% CI 1.42, 4.35 and after limiting cases to children with regression in development (OR 1.95, 95% CI 1.01, 3.78. Use of infant formula without docosahexaenoic acid and arachidonic acid supplementation versus exclusive breastfeeding was associated with a significant increase in the odds of autistic disorder when all cases were considered (OR 4.41, 95% CI 1.24, 15.7 and after limiting cases to children with regression in development (OR 12.96, 95% CI 1.27, 132. Conclusion The results of this preliminary study indicate that children who were not breastfed or were fed infant formula without docosahexaenoic acid/arachidonic acid supplementation were significantly more likely to have autistic disorder.
Mansour, Salma; Rozenblat, Vanja; Fuller-Tyszkiewicz, Matthew; Paganini, Chiara; Treasure, Janet; Krug, Isabel
The aim of the study was to assess the extent of overlap between autistic traits, body dissatisfaction and disordered eating and to explore the mediating effects of negative attitudes towards emotional expression and emotion dysregulation. The sample comprised 416 university students (82% females, 17-48 years [M=19.76, SD=3.85]), who completed an online questionnaire assessing eating attitudes and behaviours (including dieting, bulimia and oral control), body dissatisfaction, and autistic traits (including the Autism Quotient [AQ] and its related subscales as well as the Empathising Quotient). Attitudes towards emotional expression and emotion regulation were also assessed. Results revealed that eating pathology correlated highly with all AQ subscales, with the exception of the attention to detail subscale. However, there was no significant relationship between empathising and eating pathology. Path-analyses indicated that emotion dysregulation, but not negative attitudes towards emotional expression, was a significant mediator of the relationship between AQ, body dissatisfaction and eating pathology. Direct relationships were also obtained for the AQ-bulimia and the AQ-oral control paths. Prevention and early intervention programs for eating pathology would likely benefit from addressing abnormalities in emotion processes in individuals who score highly on measures of autistic traits. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Vishnu Rekha, C; Arangannal, P; Shahed, H
To assess the oral health status of autistic children in Chennai. Oral health status was assessed for 483 children with autism, solicited from special education schools, autistic child centres and therapy centres. Conditions assessed were plaque accumulation, gingival health, dental caries, malocclusion, developmental anomalies, oral injuries and restorations. Chi-square and Fisher's exact tests of significance were used to compare groups. Proportions test was used to compare the significance of the parameters between boys and girls. Autistic children with primary dentition showed significantly higher incidence of dental caries (24%), when compared to other oral conditions. Children with mixed dentition had more gingivitis (50%) and children with permanent dentition had more gingivitis (48.96%) and malocclusion (71.15%). All the oral conditions were seen more in boys than girls. Autistic children have significantly poor oral hygiene and higher incidence of malocclusion and dental caries when compared to other oral conditions.
McDougle, C J; Kresch, L E; Goodman, W K; Naylor, S T; Volkmar, F R; Cohen, D J; Price, L H
The purpose of this study was to investigate the types of repetitive thoughts and behavior demonstrated by adults with autistic disorder and compare them with those of age- and sex-matched adults with obsessive-compulsive disorder. Fifty consecutive patients admitted to the Yale Adult Pervasive Developmental Disorders (Autism) Clinic with a primary diagnosis of autistic disorder (DSM-III-R and DSM-IV) completed the symptom checklist of the Yale-Brown Obsessive Compulsive Scale. Types of current obsessions and compulsions were evaluated. The comparison group consisted of 50 age- and sex-matched adults with obsessive-compulsive disorder (without tics) (DSM-III-R and DSM-IV). Direct discriminant function analysis showed that the patients with autistic disorder could be distinguished from those with obsessive-compulsive disorder on the basis of the types of current repetitive thoughts and behavior that they demonstrated. Compared to the obsessive-compulsive group, the autistic patients were significantly less likely to experience thoughts with aggressive, contamination, sexual, religious, symmetry, and somatic content. Repetitive ordering; hoarding; telling or asking (trend); touching, tapping, or rubbing; and self-damaging or self-mutilating behavior occurred significantly more frequently in the autistic patients, whereas cleaning, checking, and counting behavior was less common in the autistic group than in the patients with obsessive-compulsive disorder. In addition, a specific subset of seven obsessive-compulsive variables from the Yale-Brown Obsessive Compulsive Scale symptom checklist was identified that reliably predicted membership in the autistic group. These results suggest that the repetitive thoughts and behavior characteristics of autism differ significantly from the obsessive-compulsive symptoms displayed by patients with obsessive-compulsive disorder. Future studies are warranted to assess the treatment response and neurobiological underpinnings of
Marcus, Ronald N.; Owen, Randall; Kamen, Lisa; Manos, George; McQuade, Robert D.; Carson, William H.; Aman, Michael G.
Objective: To evaluate the short-term efficacy and safety of aripiprazole in the treatment of irritability in children and adolescents with autistic disorder. Method: Two hundred eighteen children and adolescents (aged 6-17 years) with a diagnosis of autistic disorder, and with behaviors such as tantrums, aggression, self-injurious behavior, or a…
Martínez-Cayuelas, Elena; Ibáñez-Micó, Salvador; Ceán-Cabrera, Lourdes; Domingo-Jiménez, Rosario; Alarcón-Martínez, Helena; Martínez-Salcedo, Eduardo
Training in autistic spectrum disorders is crucial in order to achieve an early diagnosis. However, the number of papers describing this training is limited. This study describes this level of knowledge among paediatricians from tertiary care hospitals in different regions of Spain and detects areas that need improvement. A total of one hundred and fifty-seven (157) paediatricians working in tertiary healthcare hospitals located in three different regions in Spain consented to complete an online questionnaire divided in three sections (socio-demographic, knowledge about childhood autism, and opinion). Data were analysed using SPSS version 15. The total mean score of participating paediatricians in the questionnaire was 20.34 (± 2.43 SD) out of a total possible score of 23. Approximately two-thirds (65%) of paediatricians scored more or equal to the mean score. The knowledge gap was found to be higher with symptoms of repetitive behaviour patterns, concept of autism, and comorbidity, with no statistical significance. There were no differences in paediatrician scores within different socio-demographic groups. Just under two-thirds (64%) of paediatricians subscribed to the opinion that their own knowledge about autism is limited, and there is a significant lack of knowledge about facilities in every region. There is a sufficient level of knowledge about autism among paediatricians in tertiary healthcare, although a lack of awareness about the management of these patients, with poor coordination between the different specialists that are involved in their treatment. Efforts should focus on achieving a better coordination between these specialists, and update the knowledge gaps identified. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.
Full Text Available BACKGROUND: Parents, caregivers and mental health professionals have often reported violence and aggression in children or adolescents with autistic disorder. However, most of these observations derived from anecdotal reports, and studies on frequency and characterization of aggression in autism remain limited. Our objective was to better characterize and understand the different types of aggressive behaviors displayed by a large group of individuals with autism in different observational situations. METHODOLOGY/FINDINGS: The study was conducted on 74 children and adolescents with autism and 115 typically developing control individuals matched for sex, age and pubertal stage. Other-Injurious Behaviors (OIB were assessed in three observational situations (parents at home, two caregivers at day-care, a nurse and a child psychiatrist during blood drawing using validated scales. The frequency of OIB was significantly higher in individuals with autism compared to typically developing control individuals during the blood drawing (23% vs. 0%, P<0 .01. The parents observed significantly less OIB in their children than caregivers (34% vs. 58%, P<0.05. In addition, the most frequent concurrent behaviors occurring just before the appearance of OIB in individuals with autism were anxiety-related behaviors and excitation according to the parental as well as the caregiver observation. CONCLUSIONS/SIGNIFICANCE: The results suggest that in a stressful situation, such as the blood drawing, individuals with autism release their stress through behaviors such as OIB, whereas typically developing individuals regulate and express their stress through cognitive skills such as mental coping strategies, symbolization skills with representation and anticipation of the stressful situation, social interaction and verbal or non-verbal communication. The findings underline also the key role of the environment in assessing OIB and developing therapeutic perspectives, with an
Clinical and subclinical seizures occur frequently among children with autistic spectrum disorders. Electrographic status epilepticus in sleep, or continuous spike-wave in slow-wave sleep, is a typical feature of acquired epileptic aphasia and Landau-Kleffner syndrome. Seizures and epilepsy are more common among children with autistic spectrum disorder who experience language regression, especially those who experience language regression after the age of 2 years. Although the seizures associated with Landau-Kleffner syndrome and with acquired epileptic aphasia can be easily treated, improvement in language function often does not follow successful treatment of seizures. There are no published randomized clinical trials of treatments for Landau-Kleffner syndrome or for autistic language regression. Broad-spectrum antiepileptic drugs not associated with cognitive slowing are probably the treatment of choice for epilepsy among children with autistic spectrum disorder. Large multisite trials are needed to determine treatment efficacy among children with Landau-Kleffner syndrome and acquired epileptic aphasia and to establish whether there is a cause-effect relationship between electrographic status epilepticus in sleep or continuous spike-wave in slow-wave sleep and autistic language regression.
Emanuele, Enzo; Boso, Marianna; Brondino, Natascia; Pietra, Stefania; Barale, Francesco; Ucelli di Nemi, Stefania; Politi, Pierluigi
High mobility group box 1 (HMGB1) is a highly conserved, ubiquitous protein that functions as an activator for inducing the immune response and can be released from neurons after glutamate excitotoxicity. The objective of the present study was to measure serum levels of HMGB1 in patients with autistic disorder and to study their relationship with clinical characteristics. We enrolled 22 adult patients with autistic disorder (mean age: 28.1+/-7.7 years) and 28 age- and gender-matched healthy controls (mean age: 28.7+/-8.1 years). Serum levels of HMGB1 were measured by enzyme-linked immunosorbent assay (ELISA). Compared with healthy subjects, serum levels of HMGB1 were significantly higher in patients with autistic disorder (10.8+/-2.6 ng/mL versus 5.6+/-2.5 ng/mL, respectively, P<0.001). After adjustment for potential confounders, serum HMGB1 levels were independently associated with their domain A scores in the Autism Diagnostic Interview-Revised, which reflects their impairments in social interaction. These results suggest that HMGB1 levels may be affected in autistic disorder. Increased HMGB1 may be a biological correlate of the impaired reciprocal social interactions in this neurodevelopmental disorder. Copyright 2010 Elsevier Inc. All rights reserved.
Battaglia, Agatino; Carey, John C
Studies addressing etiologic yield in childhood developmental disabilities have mainly looked at individuals with developmental delay/mental retardation. The few studies addressing the question of etiologic yield in patients with pervasive developmental disorders (PDDs) had a major drawback, in that the enrolled subjects were diagnosed as having the autistic spectrum disorders based only on history and clinical examination, and/or on unspecified instruments. In addition, only some of these patients underwent a complete laboratory evaluation. To investigate the etiologic yield of PDDs, we undertook a large prospective study on subjects selected according to very strict criteria and diagnosed as having PDD based on the present "gold standard" (ADI-R and ADOS-G), and a clinical diagnosis made by a child psychiatrist. Eighty-five (85) patients with PDD and their first degree relatives participated in this study. These patients were selected from a sample of 236 subjects who had received a clinical diagnosis of PDD at the Stella Maris Institute between March 2002 and 2005. Selection criteria for entering the study were: (1) a diagnosis of PDD (with exclusion of the Rett syndrome) confirmed after the administration of the ADI-R (autism diagnostic interview-revised) and the ADOS-G (autism diagnostic observation schedule-generic). In addition, a clinical diagnosis was made by the child psychiatrist, on the basis of presence or absence of DSM-IV symptoms of autism; (2) chronological age between 4 and 18 years; (3) IQ>30; (4) availability of both biologic parents. Patients, 65/85 (76.5%), had autism, 18/85 (21.2%) had PDD-NOS, and the remaining 2/85 (2.3%) had Asperger syndrome. Ages varied between 4 years 2 months and 12 years 5 months (mean 7.6 years), and there was a marked male preponderance (68/85). All subjects underwent various laboratory studies and neuroimaging. With respect to possible etiologic determination, a detailed history and physical examination in this
Bhaumik, Sabyasachi; Tyrer, Freya; Barrett, Mary; Tin, Nyunt; McGrother, Catherine W; Kiani, Reza
It is often difficult to determine the triad of impairments and whether autistic features are the consequence of intellectual impairment or autism spectrum disorders in people with intellectual disability (ID). The aim of the current study was to investigate the relationship between carer-reported autistic traits and independent diagnoses of autism spectrum disorders (ASD). Data were collected on carers' subjective report of autistic traits and clinical diagnoses of ASD. Of 1145 adults with ID identified, 220 (19%) individuals had a diagnosis of ASD, and 778 (68%) individuals had at least one autistic trait. Optimal sensitivity and specificity were achieved with two or more autistic traits (sensitivity 63%; specificity 79%) and the positive predictive value increased substantially as the number of autistic traits increased. However, a significant proportion of individuals with ID who did not have a diagnosis of ASD also displayed autistic traits. Our findings suggest that in the absence of other measures, the presence of autistic traits can serve as a useful proxy measure for ASD in research (and/or clinical settings). However, although information on autistic traits may help healthcare practitioners to identify people with possible ASD, it cannot be used alone to make a formal diagnosis. 2010 Elsevier Ltd. All rights reserved.
Brewster, Stephanie; Coleyshaw, Liz
The importance of active participation in leisure activities for everybody is identified by Carr (2004) but issues around leisure in the lives of children with disabilities have received little recognition. The experience of children/young people (henceforth referred to simply as children, for brevity) with autistic spectrum disorders (ASD) in…
Embregts, P.; van Nieuwenhuijzen, M.
Background: Children with autistic spectrum disorders (ASD) and mild to borderline intellectual disability (ID) have less adaptive behaviour and more behaviour problems than children with mild to borderline ID. Social information processing appears to be an important mechanism in the explanation of the socially inadequate behaviour of children…
Embregts, P.J.C.M.; Nieuwenhuijzen, M. van
Background - Children with autistic spectrum disorders (ASD) and mild to borderline intellectual disability (ID) have less adaptive behaviour and more behaviour problems than children with mild to borderline ID. Social information processing appears to be an important mechanism in the explanation of
Ross, Penelope; Cuskelly, Monica
Background: Siblings of children with autistic spectrum disorder (ASD) express more problem behaviours and experience more difficulties in their relationships than do children in families where all children are developing typically. We know little about what contributes to these difficulties. Method: Mothers of a child with ASD completed the…
Melogno, Sergio; D'Ardia, Caterina; Pinto, Maria Antonietta; Levi, Gabriel
This article presents case studies on metaphor comprehension in two boys with high-functioning autistic spectrum disorder, aged 9;1 (9 years, 1 month) and 8;11. The participants were assessed twice, before and after an intervention program aimed at improving their social skills. The focus of the article is on the specific patterns exhibited by…
Dietz, C.; Swinkels, S.H.N.; Buitelaar, J.K.; Daalen, E. van; Engeland, H.M. van
AIM: To investigate cognitive development in preschool-age children diagnosed with Autistic Spectrum Disorder (ASD; N = 39) compared with that of children diagnosed with mental retardation (MR; N = 14) and normally developing children (NC; N = 36). METHOD: In a prospective longitudinal study,
Hare, Dougal Julian; Chapman, Melanie; Fraser, Janelle; Gore, Sarah; Burton, Mark
A survey of service providers for people with learning disabilities in the Manchester (England) region identified a total of 174 people with either a confirmed or a suspected autistic spectrum disorder. Discussion of current and historical factors in estimating incidence suggests that the usual 10% of service users represents the lowest estimate…
Autistic spectrum disorder (ASD) is characterized by stereotyped\\/obsessional behaviours and social and communicative deficits. However, there is significant variability in the clinical phenotype; for example, people with autism exhibit language delay whereas those with Asperger syndrome do not. It remains unclear whether localized differences in brain anatomy are associated with variation in the clinical phenotype.
Hartley, S. L.; Sikora, D. M.; McCoy, R.
Background: Children with Autistic Disorder (AD) evidence more co-occurring maladaptive behaviours than their typically developing peers and peers with intellectual disability because of other aetiologies. The present study investigated the prevalence of Clinically Significant maladaptive behaviours during early childhood and identified at-risk…
King, Diane; Dockrell, Julie E.; Stuart, Morag
Background: Children with autistic spectrum disorder (ASD) are known to have difficulties in narrative language and especially with use of evaluative enrichment devices. However, little is known about their production of event narratives. Aims: To establish if children with ASD differ from typically developing peers in their production of general…
Branigan, Holly P.; Tosi, Alessia; Gillespie-Smith, Karri
It is well established that adults converge on common referring expressions in dialogue, and that such lexical alignment is important for successful and rewarding communication. The authors show that children with an autistic spectrum disorder (ASD) and chronological- and verbal-age-matched typically developing (TD) children also show spontaneous…
This descriptive action research experience with case study procedures examined the use of best practices paired with assistive technologies as interventions to individualize fiction reading instruction for a high-functioning elementary student, JB (pseudonym), diagnosed with autistic spectrum disorder. JB's instructional, reading goals were to…
Postorino, Valentina; Scahill, Lawrence; De Peppo, Lavinia; Fatta, Laura Maria; Zanna, Valeria; Castiglioni, Maria Chiara; Gillespie, Scott; Vicari, Stefano; Mazzone, Luigi
This study aimed to examine the presence of Autism Spectrum Disorder (ASD) in a sample of female adolescents with Anorexia Nervosa (AN) during the acute phase of illness. We also compare the level of autistic traits, social perception skills and obsessive-compulsive symptoms in four groups: AN, ASD, and two gender- and age-matched control groups.…
Matsuishi, Toyojiro; Yamashita, Yushiro; Ohtani, Yasuyo; Ornitz, Edward; Kuriya, Norikazu; Murakami, Yoshihiko; Fukuda, Seiichi; Hashimoto, Takeo; Yamashita, Fumio
Analysis of the incidence of autistic disorder (AD) among 5,271 children in a neonatal intensive care unit in Japan found that 18 children were later diagnosed with AD, an incidence more than twice as high as previously reported. Children with AD had a significantly higher history of the meconium aspiration syndrome than the controls. (Author/DB)
Full Text Available Abstract Autistic Spectrum Disorders (ASDs are a set of complex developmental disabilities defined by impairment in social interaction and communication, as well as by restricted interests or repetitive behaviors. Neuroimaging studies have substantially advanced our understanding of the neural mechanisms that underlie the core symptoms of ASDs. Nevertheless, a number of challenges still remain in the application of neuroimaging techniques to the study of ASDs. We review three major conceptual and methodological challenges that complicate the interpretation of findings from neuroimaging studies in ASDs, and that future imaging studies should address through improved designs. These include: (1 identification and implementation of tasks that more specifically target the neural processes of interest, while avoiding the confusion that the symptoms of ASD may impose on both the performance of the task and the detection of brain activations; (2 the inconsistency that disease heterogeneity in persons with ASD can generate on research findings, particularly heterogeneity of symptoms, symptom severity, differences in IQ, total brain volume, and psychiatric comorbidity; and (3 the problems with interpretation of findings from cross-sectional studies of persons with ASD across differing age groups. Failure to address these challenges will continue to hinder our ability to distinguish findings that outline the causes of ASDs from brain processes that represent downstream or compensatory responses to the presence of the disease. Here we propose strategies to address these issues: 1 the use of simple and elementary tasks, that are easier to understand for autistic subjects; 2 the scanning of a more homogenous group of persons with ASDs, preferably at younger age; 3 the performance of longitudinal studies, that may provide more straight forward and reliable results. We believe that this would allow for a better understanding of both the central pathogenic
Kurita, Hiroshi; Koyama, Tomonori; Setoya, Yutaro; Shimizu, Kaoru; Osada, Hirokazu
In order to test clinical validity of DSM-IV childhood disintegrative disorder (CDD), 10 CDD children (mean age = 8.2 years, SD = 3.8; 7 male and 3 female) and 30 age- and gender-matched children with DSM-IV autistic disorder (AD) with speech loss (SL) (ADSL) were compared on 24 variables not directly related to CDD criteria. Compared with the ADSL children, the CDD children showed fearfulness significantly more frequently during the period of SL; displayed epilepsy significantly more frequently and stereotypy significantly more prominently at first visit on average about 6 years after SL; and had significantly less uneven intellectual profile at first visit to support the validity of CDD to a certain extent. No significant difference in the retardation level at first visit between the two groups suggested no worse short-term outcome in CDD than ADSL, although a long-term prospective study to compare them from infancy is needed.
Albizzati, A; Morè, L; Di Candia, D; Saccani, M; Lenti, C
Autism is a neurological-psychiatric disease. In the last 20 years we witnessed a strong increase of autism diagnoses. To explain this increase, some scientists put forward the hypothesis that heavy metal intoxication may be one of the causes of autism. The origin of such an intoxication was hypothesised to be vaccines containing thimerosal as antimicrobic preservative. This preservative is mainly made up of mercury. The aim of our research was to investigate the correlation between autism and high biological concentrations of heavy metals. Seventeen autistic patients, between 6 and 16 years old (average: 11.52 DS: 3.20) (15 males and 2 females), were investigated, as well as 20 non autistic subjects from neuropsychiatric service between 6 and 16 years (average: 10.41 DS: 3.20) (15 males and 2 females). In both groups blood, urine and hair samples were analysed trough means of a semiquantitative analysis of heavy metal dosing. The metals analysed were Lead, mercury, cadmium and aluminium, since their build-up may give both neurological and psychiatric symptoms. The comparison of the mean values of the concentrations between the groups, performed with ANOVA test, has shown no statistically relevant differences. There wasn't correlation between autism and heavy metal concentration.
Vojinovic, Dina; Brison, Nathalie; Ahmad, Shahzad; Noens, Ilse; Pappa, Irene; Karssen, Lennart C; Tiemeier, Henning; van Duijn, Cornelia M; Peeters, Hilde; Amin, Najaf
Autism spectrum disorder (ASD) is a highly heritable neurodevelopmental disorder with a complex genetic architecture. To identify genetic variants underlying ASD, we performed single-variant and gene-based genome-wide association studies using a dense genotyping array containing over 2.3 million single-nucleotide variants in a discovery sample of 160 families with at least one child affected with non-syndromic ASD using a binary (ASD yes/no) phenotype and a quantitative autistic trait. Replication of the top findings was performed in Psychiatric Genomics Consortium and Erasmus Rucphen Family (ERF) cohort study. Significant association of quantitative autistic trait was observed with the TTC25 gene at 17q21.2 (effect size=10.2, P-value=3.4 × 10 -7 ) in the gene-based analysis. The gene also showed nominally significant association in the cohort-based ERF study (effect=1.75, P-value=0.05). Meta-analysis of discovery and replication improved the association signal (P-value meta =1.5 × 10 -8 ). No genome-wide significant signal was observed in the single-variant analysis of either the binary ASD phenotype or the quantitative autistic trait. Our study has identified a novel gene TTC25 to be associated with quantitative autistic trait in patients with ASD. The replication of association in a cohort-based study and the effect estimate suggest that variants in TTC25 may also be relevant for broader ASD phenotype in the general population. TTC25 is overexpressed in frontal cortex and testis and is known to be involved in cilium movement and thus an interesting candidate gene for autistic trait.
Full Text Available Autism is one of disorders from the autism spectrum, besides Asperger syndrome, atypical autism and pervasive developmental disorder not otherwise specified. They are classified as mental disorders as being manifested by a wide range of cognitive, emotional and neurobehavioural abnormalities. Key categorical characteristics of the disorder are clear impairments of the development of the child’s socialisation, understanding and production of verbal and non-verbal communication and restricted and repetitive patterns of behaviour. Demarcation boundaries are not clear, neither within the very group of the disorders from the autistic spectrum, nor with respect to the autistic behavioural features in the general population. For this reason, the term spectrum points out the significance of the dimensional assessment of autistic disorders, which will most likely be the basis of the new diagnostic classification of the disorders belonging to the current group of pervasive developmental disorders in the new DSM-V classification. The understanding, as well as the prevalence of the autistic spectrum disorders has changed drastically in the last four decades. From the previous 4 per 10,000 people, today’s prevalence estimates range from 0.6 to around 1%, and the increase of prevalence cannot be explained solely by better recognition on the part of experts and parents or by wider diagnostic criteria. The general conclusion is that the autistic spectrum disorders are no longer rare conditions and that the approach aimed at acknowledging the warning that this is an urgent public health problem is completely justified.
Blanken, Laura M E; Dass, Alena; Alvares, Gail; van der Ende, Jan; Schoemaker, Nikita K; El Marroun, Hanan; Hickey, Martha; Pennell, Craig; White, Scott; Maybery, Murray T; Dissanayake, Cheryl; Jaddoe, Vincent W V; Verhulst, Frank C; Tiemeier, Henning; McIntosh, Will; White, Tonya; Whitehouse, Andrew
Altered trajectories of brain growth are often reported in Autism Spectrum Disorder (ASD), particularly during the first year of life. However, less is known about prenatal head growth trajectories, and no study has examined the relation with postnatal autistic symptom severity. The current study prospectively examined the association between fetal head growth and the spectrum of autistic symptom severity in two large population-based cohorts, including a sample of individuals with clinically diagnosed ASD. This study included 3,820 children from two longitudinal prenatal cohorts in The Netherlands and Australia, comprising 60 individuals with a confirmed diagnosis of ASD. Latent growth curve models were used to examine the relationship between fetal head circumference measured at three different time points and autistic traits measured in postnatal life using either the Social Responsiveness Scale or the Autism-Spectrum Quotient. While lower initial prenatal HC was weakly associated with increasing autistic traits in the Dutch cohort, this relationship was not observed in the Australian cohort, nor when the two cohorts were analysed together. No differences in prenatal head growth were found between individuals with ASD and controls. This large population-based study identified no consistent association across two cohorts between prenatal head growth and postnatal autistic traits. Our mixed findings suggest that further research in this area is needed. Autism Res 2018, 11: 602-612. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. It is not known whether different patterns of postnatal brain growth in Autism Spectrum Disorder (ASD) also occurs prenatally. We examined fetal head growth and autistic symptoms in two large groups from The Netherlands and Australia. Lower initial prenatal head circumference was associated with autistic traits in the Dutch, but not the Australian, group. No differences
Background Autism is a neurological disorder that limits communication, socialization, and participation of children in symbolic play. Sensory processing disorders are common characteristics (45% to 96%) of children with pervasive development disorders, including. Sleep disorders are also more prevalent in autistic children than in normal children. Objectives This study aimed to investigate the relationship between sensory process...
Laura de Magistris
Full Text Available Purpose. Immune system of some autistic patients could be abnormally triggered by gluten/casein assumption. The prevalence of antibodies to gliadin and milk proteins in autistic children with paired/impaired intestinal permeability and under dietary regimen either regular or restricted is reported. Methods. 162 ASDs and 44 healthy children were investigated for intestinal permeability, tissue-transglutaminase (tTG, anti-endomysium antibodies (EMA-IgA, and total mucosal IgA to exclude celiac disease; HLA-DQ2/-DQ8 haplotypes; total systemic antibodies (IgA, IgG, and IgE; specific systemic antibodies: α-gliadin (AGA-IgA and IgG, deamidated–gliadin-peptide (DGP-IgA and IgG, total specific gliadin IgG (all fractions: α, β, γ, and ω, β-lactoglobulin IgG, α-lactalbumin IgG, casein IgG; and milk IgE, casein IgE, gluten IgE, -lactoglobulin IgE, and α-lactalbumin IgE. Results. AGA-IgG and DPG-IgG titers resulted to be higher in ASDs compared to controls and are only partially influenced by diet regimen. Casein IgG titers resulted to be more frequently and significantly higher in ASDs than in controls. Intestinal permeability was increased in 25.6% of ASDs compared to 2.3% of healthy children. Systemic antibodies production was not influenced by paired/impaired intestinal permeability. Conclusions. Immune system of a subgroup of ASDs is triggered by gluten and casein; this could be related either to AGA, DPG, and Casein IgG elevated production or to impaired intestinal barrier function.
Efstratopoulou, Maria; Janssen, Rianne; Simons, Johan
The study was designed to investigate the discriminant validity of the Motor Behavior Checklist (MBC) for distinguishing four group of children independently classified with Attention-Deficit/Hyperactivity Disorder, (ADHD; N = 22), Conduct Disorder (CD; N = 17), Learning Disabilities (LD; N = 24) and Autistic Spectrum Disorders (ASD; N = 20).…
Full Text Available Autistic spectrum disorder (ASD is a developmental disability of the central nervous system with rapid worsening. A subset of patients also has mitochondrial dysfunction leading to increased sensitivity to various anesthetic agents. Rarely, gene mutation in these patients results in homocysteinemia which causes higher incidences of thromboembolism, hypoglycemia, and seizures. Anesthetic management of ASD with homocysteinemia and refractory seizures has not been previously reported.
Ridley, Julie; Hunter, Susan; Infusion Co-operative
This study, commissioned to inform The same as you? National Implementation Group, looked at what employment support there is in Scotland for people with learning disabilities and/or autistic spectrum disorders (ASD) and identified good practice. The research surveyed providers of employment support, looked at the literature on best practice, gathered\\ud opinions about barriers and key issues, and explored experiences and views of supported employees, their families and employers.
Konstantareas, M M; Lunsky, Y J
Thirty-one individuals, 15 with autistic disorder and 16 with developmental delay, male and female, were asked to select from a series of drawings depicting sexually relevant activities and to define them. In addition they were asked to describe their sexual experiences, attitudes, and interests, using a semistructured interview format. Ability to select through pointing out sexually relevant body parts or activities was not different by level of functioning, group, or gender. There were differences in providing a sociosexual label, however, with better performance for those with developmental delay and for the higher functioning. No differences were evident for sexual experiences, likely because of the considerable variability across subjects and types of activity, with some individuals reporting very many and others very few. As to attitudes, individuals with autistic disorder endorsed more sexual activities than those with developmental delay. Higher knowledge of sexuality terms and activities was inversely related to their endorsement. Literalness and perseveration were evident in the responses of some, primarily those with autistic disorder. Results are discussed for their relevance to the reliability and validity of information on sexual awareness among the developmentally disabled. Suggestions for future research are offered.
Singh, Vijendra K
Autism causes incapacitating neurologic problems in children that last a lifetime. The author of this article previously hypothesized that autism may be caused by autoimmunity to the brain, possibly triggered by a viral infection. This article is a summary of laboratory findings to date plus new data in support of an autoimmune pathogenesis for autism. Autoimmune markers were analyzed in the sera of autistic and normal children, but the cerebrospinal fluid (CSF) of some autistic children was also analyzed. Laboratory procedures included enzyme-linked immunosorbent assay and protein immunoblotting assay. Autoimmunity was demonstrated by the presence of brain autoantibodies, abnormal viral serology, brain and viral antibodies in CSF, a positive correlation between brain autoantibodies and viral serology, elevated levels of proinflammatory cytokines and acute-phase reactants, and a positive response to immunotherapy. Many autistic children harbored brain myelin basic protein autoantibodies and elevated levels of antibodies to measles virus and measles-mumps-rubella (MMR) vaccine. Measles might be etiologically linked to autism because measles and MMR antibodies (a viral marker) correlated positively to brain autoantibodies (an autoimmune marker)--salient features that characterize autoimmune pathology in autism. Autistic children also showed elevated levels of acute-phase reactants--a marker of systemic inflammation. The scientific evidence is quite credible for our autoimmune hypothesis, leading to the identification of autoimmune autistic disorder (AAD) as a major subset of autism. AAD can be identified by immune tests to determine immune problems before administering immunotherapy. The author has advanced a speculative neuroautoimmune (NAI) model for autism, in which virus-induced autoimmunity is a key player. The latter should be targeted by immunotherapy to help children with autism.
Mukaddes, Nahit Motavalli; Abali, Osman; Gurkan, Kagan
Recently, atypical antipsychotic treatments have been used in children with autistic disorder (AD). However, data on safety and efficacy of atypical antipsychotic agents in autistic children are limited. In this open, prospective trial, subjects were treated with risperidone for six weeks. Nineteen children (12 male, 7 female) aged 4 to 8 years were started on 0.5 mg daily with individual titration to a maximum of 1.5 mg daily. Behavioural assessments were completed by Conner's parent 10-item index, AD symptom checklist and CGI-Global improvement. Statistically significant improvement was observed in mean total scores of Conner's parent 10-item index from baseline to the end of study (pchildren were considered responders. Statistically significant improvement was also found in some aspects of social contact, impulsive-aggression and repetitive, ritualistic behaviour based on assessment with the AD-symptom checklist. Weight gain and increase in night-time sleep were the most frequent side effects.
Full Text Available We report the case of a Moroccan boy with mental retardation, hyperactivity, epilepsy, developmental problems and behavioural disorders. Cytogenetic analysis showed the presence of a supernumerary marker chromosome. Molecular cytogenetics allowed us to determine the marker as an inverted duplication of chromosome 15. It is the first case of a Moroccan patient with tetrasomy 15q in which fluorescence in situ hybridization (FISH enabled us to specify the diagnosis. Interestingly, this patient has an infantile autism with cytogenetic abnormalities on chromosomal region 15q11-q13 as reported in patients with Autistic Disorder.
Kurita, Hiroshi; Nakayasu, Nobuo
This paper presents a case report of a young adult Japanese male with infantile autism who also met diagnostic criteria for seasonal affective disorder and trichotillomania (compulsive hair pulling). The case report deals with difficulties in diagnosing mood disorder in such individuals, potential treatment effectiveness of valproic acid, and…
Posey, D J; Guenin, K D; Kohn, A E; Swiezy, N B; McDougle, C J
The aim of this study was to conduct a naturalistic, open-label examination of the efficacy and tolerability of mirtazapine (a medication with both serotonergic and noradrenergic properties) in the treatment of associated symptoms of autism and other pervasive developmental disorders (PDDs). Twenty-six subjects (5 females, 21 males; ages 3.8 to 23.5 years; mean age 10.1 +/- 4.8 years) with PDDs (20 with autistic disorder, 1 with Asperger's disorder, 1 with Rett's disorder, and 4 with PDDs not otherwise specified were treated with open-label mirtazapine (dose range, 7.5-45 mg daily; mean 30.3 +/- 12.6 mg daily). Twenty had comorbid mental retardation, and 17 were taking concomitant psychotropic medications. At endpoint, subjects' primary caregivers were interviewed using the Clinical Global Impressions (CGI) scale, the Aberrant Behavior Checklist, and a side-effect checklist. Twenty-five of 26 subjects completed at least 4 weeks of treatment (mean 150 +/- 103 days). Nine of 26 subjects (34.6%) were judged responders ("much improved" or "very much improved" on the CGI) based on improvement in a variety of symptoms including aggression, self-injury, irritability, hyperactivity, anxiety, depression, and insomnia. Mirtazapine did not improve core symptoms of social or communication impairment. Adverse effects were minimal and included increased appetite, irritability, and transient sedation. Mirtazapine was well tolerated but showed only modest effectiveness for treating the associated symptoms of autistic disorder and other PDDs.
Full Text Available A number of studies have assessed ages of parents of children with autistic spectrum disorders (ASD, and reported both maternal and paternal age effects. Here we assess relationships with grandparental ages.We compared the parental and grandparental ages of children in the population-based Avon Longitudinal Study of Parents and Children (ALSPAC, according to their scores in regard to 4 autistic trait measures and whether they had been given a diagnosis of ASD. Mean maternal and paternal ages of ASD cases were raised, but this appears to be secondary to a maternal grandmother age effect (P = 0.006: OR = 1.66[95%CI 1.16, 2.37] for each 10-year increase in the grandmother's age at the birth of the mother. Trait measures also revealed an association between the maternal grandmother's age and the major autistic trait-the Coherence Scale (regression coefficient b = 0.142, [95%CI = 0.057, 0.228]P = 0.001. After allowing for confounders the effect size increased to b = 0.217[95%CI 0.125, 0.308](P<0.001 for each 10 year increase in age.Although the relationship between maternal grandmother's age and ASD and a major autistic trait was unexpected, there is some biological plausibility, for the maternal side at least, given that the timing of female meiosis I permits direct effects on the grandchild's genome during the grandmother's pregnancy. An alternative explanation is the meiotic mismatch methylation (3 M hypothesis, presented here for the first time. Nevertheless the findings should be treated as hypothesis generating pending corroborative results from other studies.
Ohan, Jeneva L.; Ellefson, Sarah E.; Corrigan, Patrick W.
In the DSM-5, "Asperger's Disorder" was incorporated into "Autistic Spectrum Disorder" (ASD). One key concern in this change has been that the ASD label will increase negative attitudes relative to the Asperger's label. To test this, we asked 465 American adults to read a vignette describing a child with autistic symptoms that…
Akhondzadeh, Shahin; Tajdar, Hamid; Mohammadi, Mohammad-Reza; Mohammadi, Mohammad; Nouroozinejad, Gholam-Hossein; Shabstari, Omid L.; Ghelichnia, Hossein-Ali
It has been reported that autism is a hypoglutamatergic disorder. Therefore, it was of interest to assess the efficacy of piracetam, a positive modulator of AMPA-sensitive glutamate receptors in autistic disorder. About 40 children between the ages three and 11 years (inclusive) with a DSM IV clinical diagnosis of autism and who were outpatients…
Hassan, Tamer H.; Abdelrahman, Hadeel M.; Fattah, Nelly R. Abdel; El-Masry, Nagda M.; Hashim, Haitham M.; El-Gerby, Khaled M.; Fattah, Nermin R. Abdel
Despite of the great efforts that move forward to clarify the pathophysiologic mechanisms in autism, the cause of this disorder, however, remains largely unknown. There is an increasing body of literature concerning neurochemical contributions to the pathophysiology of autism. We aimed to determine blood and brain levels of glutamate in children…
Early, Maureen C; Erickson, Craig A; Wink, Logan K; McDougle, Christopher J; Scott, Eric L
This paper highlights clinical challenges faced when diagnosing and then treating an individual presenting to a child and adolescent psychiatry clinic because of unwelcome comments he made to female peers about their feet. Novel use of exposure therapy helped him effectively decrease his comments from 1 to 2 times per month to once every 6 months. Conceptualizing this case as the individual's failed attempts toward relationships with females instead of sexual harassment led to diminution of problematic behavior. Implications for diagnosis and treatment of individuals with Autistic Disorder displaying problematic behaviors are presented.
Full Text Available The purpose of this paper is to outline the findings of a pilot study, which compares drawings of typically developed preschool children and children with autistic spectrum disorders in the same age. In the study the Goodenough-Harris Drawing Test (GHDT (1926; 1963 was used. In this study, the auto-portraits of children from two groups were analyzed concerning such categories as line, size, colour, details. For this the statistical analysis of variance was used. The results of the study show that there are no statistically significant differences in the drawings of studied groups according to the categories line, size, colour, details.
Carton, Amelia Myri; Smith, Alastair D
Previous research demonstrates a genetic and behavioural link between eating disorders and autism spectrum disorders, and a recent study (Coombs et al. in Br J Clin Psychol 50:326-338, 2011) extends this link to typical populations, showing a positive correlation between behaviours in typically developing children. The purpose of the present study was to examine whether this relationship continues beyond development, by studying the link between behaviours in a non-clinical adult population. We examined associations between performance on measures relating to autistic traits and disordered eating. Undergraduate students, equally balanced by gender and by subject studied (i.e. humanity or science), completed three tasks: to measure autistic traits, participants were administered the Embedded Figures Test (EFT) and the Autism-Spectrum Quotient (AQ). Eating disorder symptomatology was measured by the Eating Attitudes Test (Eat-26). Our data revealed a significant positive correlation between scores on the AQ and Eat-26. Multiple linear regressions showed that higher scores on the AQ were particularly associated with higher scores on the Bulimia & Food Preoccupation subscale of the Eat-26. EFT performance was positively related to behaviours associated with autism and eating disorders, although not reliably so. These data support the broader link between autistic traits and disordered eating in the non-clinical population, and demonstrate that it extends into adulthood (a time at which autistic behaviours can decrease). This work carries implications for the development of cognitive therapies for people with eating disorders.
Full Text Available Background Autism is a neurological disorder that limits communication, socialization, and participation of children in symbolic play. Sensory processing disorders are common characteristics (45% to 96% of children with pervasive development disorders, including. Sleep disorders are also more prevalent in autistic children than in normal children. Objectives This study aimed to investigate the relationship between sensory processing disorders and sleep disturbances in school-aged autistic children. Patients and Methods This study is quantitative, observational, and cross-sectional. 35 school-aged autistic children in Shiraz, Iran were selected using cluster sampling. A demographic questionnaire, short sensory profile (SSP, and the sleep disturbance scale for children (SDSC were used. The Pearson correlation coefficient and Pearson chi-square were used during data analysis. Results Results shows that autistic children show clear differences from normal function (74.3%, possible differences with normal function (20%, and normal function (5.7% in their total sensory processing scores. 95.3% of autistic children had some degrees of abnormal sensory processing disorder. Also, 68.6% of the participants suffered from sleep disorders. However, there was no relationship between sensory processing disorders and sleep disturbances in children with autism (P value = 0.83. Also, there was no correlation between the subscales of sensory processing disorders and the subscales of sleep disturbances. Conclusions The results showed that despite the simultaneous high prevalence of sleep disturbances and sensory processing disorders in children with autism, there isn’t a significant relationship between the two conditions among these children.
Galán, Carmen; Sánchez, Soledad; Franco, Lourdes; Bravo, Rafael; Rivero, Montserrat; Rodríguez, Ana Beatriz; Barriga, Carmen
Theintake of foods rich in tryptophan produces beneficial effects on sleep. Themajority of children with neurological disorders like autistic spectrum disorder(ASD), cerebral palsy or attention deficit hyperactivity disorder (ADHD) havesleep problems. To evaluate the effect of tryptophan-enriched cereal intake onsleep of children with neurological disorders. Involving 7 children with ASD, 9children with cerebral palsy and 6 children with ADHD. They carried a wrist actimeterto record activity....
Groen, Yvonne; Wijers, Albertus A.; Mulder, Lambertus J. M.; Waggeveld, Brenda; Minderaa, Ruud B.; Althaus, Monika
Objective: Performance monitoring was investigated in typically developing (TD) children, children with Autistic Spectrum Disorder (ASD), and Methylphenidate (Mph)-treated and medication-free children with Attention Deficit Hyperactivity Disorder (ADHD). Methods: Subjects performed a feedback-based
Miano, Silvia; Ferri, Raffaele
Insomnia is the predominant sleep concern in children with autistic spectrum disorder (ASD), and its nature is most likely multifactorial, with neurochemical (abnormalities in serotonergic transmission or melatonin levels), psychiatric (anxiety), and behavioral (poor sleep habits) etiological factors involved. Children with ASD experience sleep problems similar to those of typically developing children, although the prevalence is markedly higher, occurring in 44-83% of school-aged children with ASD. Caregivers usually report that insomnia is the most frequent sleep disorder, described as disorders of initiating and maintaining sleep, restless sleep, bedtime resistance, co-sleeping, alterations of sleep hygiene, and early awakenings in the morning. Many actigraphic studies have added information on sleep disorders, confirming the questionnaire findings in the majority of cases. There are relatively few polysomnographic data for ASD, compared with questionnaire studies, and most of these studies reported a reduction in total sleep time and more undifferentiated sleep in the youngest patients. These findings were associated with several sleep microstructure alterations during rapid eye movement (REM) sleep, and with non-REM (NREM) sleep microstructure changes that appeared to be related to cognitive impairment rather than to the autistic core. Moreover, few data about other less frequent sleep disorders, such as periodic limb movements disorder and obstructive sleep apnea syndrome, bruxism, and the influence of epilepsy and EEG abnormalities, are available. Both pharmacologic and behavioral interventions have been suggested for the treatment of sleep problems in autistic children. The most common types of behavioral interventions are complete extinction (removing reinforcement to reduce a behavior) and various forms of graduated extinction. Melatonin has shown promising results in the treatment of insomnia in children with ASD. Although controlled studies are limited
Full Text Available This study has been designed to explore CAM used in the management of Autistic spectrum disorder (ASD in Mauritius. Parents and/or legal guardians of individuals with ASD were surveyed. Effectiveness, method of use, possible side-effects, reasons behind using CAM, source of recommendation, and beliefs behind the cause of ASD were studied. Out of the 23 individuals with ASD recruited, 73.9% presented with a formal diagnosis of autistic disorder while 26.1% had only traits of autism. Educational techniques (13.6%, prescribed drugs (35.6%, speech therapy interventions (15.3%, occupational therapy interventions (22.0%, and applied behavioural analysis (13.6% were used by the individuals with ASD as common therapies. Eighteen different types CAM interventions were used by the subjects. The most used therapies were omega-3 (6.6%, vitamins (7.9%, music therapies (9.2%, sensory integration therapy (7.9%, spiritual healing (14.5%, hippotherapy (7.9%, and hydrotherapy (6.6%. The use of CAM is in common use among ASD patients. [J Complement Med Res 2017; 6(4.000: 420-428
Garstang, J; Wallis, M
Melatonin is often used for autistic children with sleep disorders, despite a lack of published evidence in this population. A randomized, placebo-controlled double-blind crossover trial of melatonin was undertaken in 11 children with autistic spectrum disorder (ASD). Seven children completed the trial. Sleep latency was 2.6 h [95% confidence intervals (CI) 2.28-2.93] baseline, 1.91 h (95% CI 1.78-2.03) with placebo and 1.06 h (95% CI 0.98-1.13) with melatonin. Wakings per night were 0.35 (95% CI 0.18-0.53) baseline, 0.26 (95% CI 0.20-0.34) with placebo and 0.08 (95% CI 0.04-0.12) with melatonin. Total sleep duration was 8.05 h (95% CI 7.65-8.44) baseline, 8.75 h (95% CI 8.56-8.98) with placebo and 9.84 h (95% CI 9.68-9.99) with melatonin. Although the study was small owing to recruitment difficulties, it still provides evidence of effectiveness of melatonin in children with sleep difficulties and ASD, which we predict a larger study would confirm.
Bejerot, S; Mörtberg, E
Social phobia and obsessive-compulsive disorder (OCD) share several similarities: both are categorized as anxiety disorders, avoidant personality disorder and depression are common in both, they have a similar age of onset and course, and both disorders respond to treatments with serotonin reuptake inhibitors and cognitive behavioural therapy. However, OCD and social phobia differ in respect to their relation to autism spectrum disorders (ASD; i.e. Asperger's syndrome, autism, pervasive disorder not otherwise specified). Findings that suggest a link between OCD and ASD have no parallel in social phobia. Moreover, obsessive-compulsive, paranoid and schizotypal personality disorders are prevalent in OCD and in ASD, but not in social phobia. Individuals with ASD are known to be frequent targets of bullying. We hypothesised that individuals with autistic traits would have been frequent targets for bullies during their childhood, as opposed to people without such traits. Adult patients with social phobia (n = 63) or OCD (n = 65) were assessed regarding autistic traits, and interviewed about being bullied at school. A reference group (n = 551) responded to questions about being bullied. There was a significant difference in the prevalence of being bullied between OCD (50%), social phobia patients (20%) and the reference group (27%). Autistic traits were more common in OCD than in social phobia. A history of being bullied was related to autistic traits among patients. Falling victim to bullying is not a random event. Autistic traits, i.e. low social skills, may be a predictor of being bullied in school. The high rate of bullying victims in persons who later develop OCD is suggested to be related to the overlap between OCD and ASD. Copyright 2009 S. Karger AG, Basel.
Efstratopoulou, Maria; Janssen, Rianne; Simons, Johan
The study was designed to investigate the discriminant validity of the Motor Behavior Checklist (MBC) for distinguishing four group of children independently classified with Attention-Deficit/Hyperactivity Disorder, (ADHD; N=22), Conduct Disorder (CD; N=17), Learning Disabilities (LD; N=24) and Autistic Spectrum Disorders (ASD; N=20). Physical education teachers used the MBC for children to rate their pupils based on their motor related behaviors. A multivariate analysis revealed significant differences among the groups on different problem scales. The results indicated that the MBC for children may be effective in discriminating children with similar disruptive behaviors (e.g., ADHD, CD) and autistic disorders, based on their motor behavior characteristics, but not children with Learning Disabilities (LD), when used by physical education teachers in school settings. Copyright © 2011 Elsevier Ltd. All rights reserved.
Children with autistic spectrum disorders (ASD) characteristically display a lack of shared attention behaviours and the lack of these behaviours impacts on their ability to develop social interactions and relationships with others. Steve Solomons, assistant headteacher at Rectory Paddock School and Research Unit in the London Borough of Bromley,…
Trajkovski, Vladimir; Petlichkovski, Aleksandar; Efinska-Mladenovska, Olivija; Trajkov, Dejan; Arsov, Todor; Strezova, Ana; Ajdinski, Ljubomir; Spiroski, Mirko
Specific IgA, IgG, and IgE antibodies to food antigens in 35 participants with autistic disorder and 21 of their siblings in the Republic of Macedonia were examined. Statistically significant higher plasma concentration of IgA antibodies against alpha-lactalbumin, beta-lactoglobulin, casein, and gliadin were found in the children with autistic…
Dardas, Latefa A.; Ahmad, Muayyad M.
The World Health Organization's Quality of Life Questionnaire-BREF (WHOQOL-BREF) has been used in many studies that target parents of children with Autistic Disorder. However, the measure has yet to be validated and adapted to this sample group whose daily experiences are considered substantially different from those of parents of children…
Herrera, Gerardo; Alcantud, Francisco; Jordan, Rita; Blanquer, Amparo; Labajo, Gabriel; De Pablo, Cristina
Difficulties in understanding symbolism have been documented as characteristic of autistic spectrum disorders (ASDs). In general, virtual reality (VR) environments offer a set of potential advantages for educational intervention in ASD. In particular, VR offers the advantage, for teaching pretend play and for understanding imagination, of it being…
Senel, Hatice Gunayer
Use of complementary and alternative medicine (CAM) treatments have been increasing for children with autistic spectrum disorder (ASD). In this study, 38 Turkish parents of children with ASD were surveyed related with their use of CAM treatments, experiences, and views for each treatment. They mentioned "Vitamins and minerals",…
Stephen J. Sheinkopf
Full Text Available Psychophysiology studies of heart rate and heart rate variability can be employed to study regulatory processes in children with autism. The objective of this study was to test for differences in respiratory sinus arrhythmia (RSA; a measure of heart rate variability and to examine the relationship between physiologic responses and measures of social behavior. Participants included 2- to 6-year-old children with Autistic Disorder and children without autism. Heart rate and RSA were derived from ECG recordings made during a baseline period and then a stranger approach paradigm. Social and adaptive behavior was assessed by parent report. Groups did not differ in mean heart rate or RSA at baseline or in response to social challenge. However, children with autism were more likely to show a physiologic response to intrusive portions of the stranger approach than to less intrusive portions of this procedure. Nonautistic children were equally likely to respond to intrusive and less intrusive social events. Within the autistic group, physiologic response to the intrusive stranger approach corresponded to higher ratings of social adaptive behaviors. These results suggest that physiologic responses to social challenge may help understand differences in social behavioral outcomes in children with autism.
Full Text Available Xiaosong Bu, De Wu, Xiaomei Lu, Li Yang, Xiaoyan Xu, Juan Wang, Jiulai Tang Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China Abstract: Autistic spectrum disorder (ASD is a neurodevelopmental disorder and has a high prevalence in children. Recently, mitochondrial oxidative stress has been proposed to be associated with ASD. Besides, SIRT1/PGC-1α signaling plays an important role in combating oxidative stress. In this study, we sought to determine the role of SIRT1/PGC-1α signaling in the ASD lymphoblastoid cell lines (LCLs. In this study, the mRNA and protein expressions of SIRT1/PGC-1α axis genes were assessed in 35 children with ASD and 35 healthy controls (matched for age, gender, and IQ. An immortalized LCL was established by transforming lymphocytes with Epstein–Barr virus. Next, we used ASD LCLs and control LCLs to detect SIRT1/PGC-1α axis genes expression and oxidative damage. Finally, the effect of overexpression of PGC-1α on oxidative injury in the ASD LCLs was determined. SIRT1/PGC-1α axis genes expression was downregulated at RNA and protein levels in ASD patients and LCLs. Besides, the translocation of cytochrome c and DIABLO from mitochondria to the cytosol was found in the ASD LCLs. Moreover, the intracellular reactive oxygen species (ROS and mitochondrial ROS and cell apoptosis were increased in the ASD LCLs. However, overexpression of PGC-1α upregulated the SIRT1/PGC-1α axis genes expression and reduced cytochrome c and DIABLO release in the ASD LCLs. Also, overexpression of PGC-1α reduced the ROS generation and cell apoptosis in the ASD LCLs. Overexpression of PGC-1α could reduce the oxidative injury in the ASD LCLs, and PGC-1α may act as a target for treatment. Keywords: autistic spectrum disorder, PGC-1α, SIRT1, mitochondria, oxidative stress
Control of psychomotor agitation and aggressive behavior in patients with autistic disorder: a retrospective chart review Controle da agitação psicomotora e agressividade em pacientes com autismo: estudo retrospectivo de revisão de prontuário
Camila Marinho Novaes
Full Text Available OBJECTIVE: To evaluate the efficacy of pharmacotherapy on the symptoms of psychomotor agitation and aggressive behavior in a sample of patients with autistic spectrum disorder. METHOD: The charts of all patients with a diagnosis of autistic spectrum disorder, receiving care for psychomotor agitation and/or aggressive behavior in two psychiatric outpatient departments between 2001 and 2006, were reviewed. The Clinical Global Impression-Severity and -Improvement scales (CGI-S and CGI-I were applied to the data retrieved from the charts. RESULTS: The majority of the 26 patients included were treated with second-generation antipsychotics. A positive, statistically significant correlation was found between the implementation of pharmacotherapy and a reduction in CGI-S scores (pOBJETIVO: Avaliar a eficácia do tratamento farmacológico dos sintomas de agitação psicomotora e agressividade em amostra de pacientes com transtorno do espectro autista. MÉTODO: Foram revisados os prontuários de pacientes com diagnóstico de transtorno do espectro autista que procuraram atendimento por apresentarem agitação psicomotora e/ou heteroagressividade, atendidos entre 2001 e 2006, em dois ambulatórios de psiquiatria. Para avaliação da evolução dos pacientes aplicou-se às informações do prontuário a escala de Impressão Clínica Global Sintomas (ICG-S e a Impressão Clínica Global Melhora (ICG-M. RESULTADOS: A maioria dos 26 pacientes estava em tratamento com antipsicóticos de segunda geração. Houve correlação positiva e estatisticamente significativa entre a introdução do tratamento farmacológico e a redução nos escores da ICG-S (p<0,05. A evolução do tratamento farmacológico foi melhor para os pacientes sem retardo mental do que para aqueles com retardo mental (p<0,05. A maioria dos pacientes que obteve melhora clínica com o tratamento participava de ao menos uma intervenção auxiliar ao tratamento principal (p<0,05. CONCLUSÃO: Os
This research investigated the effects of improvisational music therapy on joint attention behaviours in children with autistic spectrum disorder. The study was designed to look at these behaviours in two different conditions, improvisational music therapy and free play, and use both standardized...... tools and DVD analysis of sessions to evaluate changes in joint attention behaviours. A repeated measures, within subject comparison design was used and children were randomly assigned in to two groups; group 1 had music therapy first, and then free play later. Group 2 vice versa. Sessions were divided...... joint attention behaviours in children than free play. The most clinically relevant and important findings were that children displayed markedly more and longer events of ‘eye contact’ ‘joy’ ‘emotional synchronicity’ and ‘initiation of engagement’ spontaneously in improvisational music therapy than free...
Miano, Silvia; Bruni, Oliviero; Elia, Maurizio; Trovato, Alessia; Smerieri, Arianna; Verrillo, Elisabetta; Roccella, Michele; Terzano, Mario G; Ferri, Raffaele
To evaluate sleep in children with autistic spectrum disorder (ASD) by means of sleep questionnaires and polysomnography; moreover, to analyze their cyclic alternating pattern (CAP). Thirty-one patients with ASD (28 males, 3 females, aged 3.7-19 years) and age-matched normal controls were included. ASD children were evaluated by a standard sleep questionnaire that consisted of 45 items in a Likert-type scale covering several areas of sleep disorders and by overnight polysomnography in the sleep laboratory after one adaptation night. The questionnaire results showed that parents of ASD children reported a high prevalence of disorders of initiating and maintaining sleep, enuresis, repetitive behavior when falling asleep, and daytime sleepiness. Polysomnographically, ASD children showed reduced time in bed, total sleep time, sleep period time and rapid eye movement (REM) latency. ASD subjects had a CAP rate during slow-wave sleep (SWS) lower than normal controls, together with a lower percentage of A1 subtypes. ASD children questionnaires showed a higher percentage of disorders of initiating and maintaining sleep than normal controls; this was not completely confirmed by sleep staging. CAP measures showed subtle alterations of NREM sleep which could be detected with an appropriate methodology of analysis. The reduction of A1 subtypes during SWS might play a role in the impairment of cognitive functioning in these subjects.
Eliasen, Marie; Tolstrup, Janne S; Nybo Andersen, Anne-Marie
To examine whether maternal alcohol intake, including binge drinking (intake > or =5 drinks, equivalent to 60 g pure ethanol on a single occasion), is associated with autistic spectrum disorders (ASD) and infantile autism....
Desjardins, S; Doyen, C; Contejean, Y; Kaye, K; Paubel, P
CLINICAL BACKGROUND: Autism is a developmental disorder that is usually diagnosed in early childhood. According to ICD-10 criteria, autism can be characterized by delays in language skills, by impaired social interaction, verbal or non-verbal communication and by repetitive, stereotyped or severely restricted activities and interests. The causes of autism are not yet elucidated, but both genetics and environment seem to play a role in 10 to 25% of autism cases. Several biochemical abnormalities, such as impairment of serotoninergic, catecholinergic, dopaminergic, and opioid systems have been reported. Autism therapies are designed to treat symptoms, and medication can be associated with psychoeducational and environmental interventions. Generally, the medications that are currently used are not intended for autism, and must be used with caution and selected according to the type and intensity of symptoms. The most common medication consists of psychotropic therapies by administration of dopaminergic and/or serotoninergic receptor antagonists (haloperidol, risperidone, clomipramine). Several drugs, such as anxiolytics (buspirone), mood stabilisers (lithium, sodium valproate), vitamins (vitamins B6, B12) or opioid antagonists (naltrexone) can be prescribed, in second intention, in cases of severe behavioural disorders. The prescription of opioid antagonists is based on the possible implication of an opioid system disorder observed in some cases. Nevertheless, several clinical studies reveal its variable effectiveness. Naltrexone is a competitive antagonist of opioid receptors OPRM1, OPRD1 and OPRK1. In France, this drug is prescribed for treating opioid and alcohol dependence. Moreover, several studies describe naltrexone as a possible treatment of autistic children in cases of developmental disorder and hyperactivity. In the Child and Adolescent Psychopathology Department of Sainte-Anne's Hospital, autistic children benefit from a multidisciplinary treatment program
Mehrazad-Saber, Zahra; Kheirouri, Sorayya; Noorazar, Seyyed-Gholamreza
Sleep disorders are frequently reported in autistic patients. Evidences suggest that increased oxidative stress and reduced antioxidants may play a major role in the pathogenesis of these disorders. Carnosine acts as an antioxidant, antitoxic and neuroprotective agent. The aim of this trial study was to examine the effects of carnosine supplementation on the sleep disorders and severity of autism core symptoms in autistic patients. In this double-blind, randomized clinical trial, 43 autistic patients (31 boys and 12 girls; aged 4 to 16 years) were divided into two groups of carnosine and control that received 500 mg of carnosine and 500 mg of placebo per day for two months, respectively. Sleep disorders was measured using Children's Sleep Habits Questionnaires. Gilliam Autism Rating Scale 2 was used to assess the effects of carnosine supplementation on the autism severity. Carnosine supplementation did not change anthropometric indices (p>0.05) and showed no effect on autism severity (p>0.05), whereas it significantly reduced sleep duration (p=0.04), parasomnias (p=0.02) and total sleep disorders score by 7.59% (p=0.006) when compared with the control group. The results suggest that carnosine supplementation could be effective in improving sleep disturbances, in particular sleep duration and parasomnias subscales. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Full Text Available Shared genetic and environmental risk factors have been identified for autistic spectrum disorders (ASD and schizophrenia. Social interaction, communication, emotion processing, sensorimotor gating and executive function are disrupted in both, stimulating debate about whether these are related conditions. Brain imaging studies constitute an informative and expanding resource to determine whether brain structural phenotype of these disorders is distinct or overlapping. We aimed to synthesize existing datasets characterizing ASD and schizophrenia within a common framework, to quantify their structural similarities. In a novel modification of Anatomical Likelihood Estimation (ALE, 313 foci were extracted from 25 voxel-based studies comprising 660 participants (308 ASD, 352 first-episode schizophrenia and 801 controls. The results revealed that, compared to controls, lower grey matter volumes within limbic-striato-thalamic circuitry were common to ASD and schizophrenia. Unique features of each disorder included lower grey matter volume in amygdala, caudate, frontal and medial gyrus for schizophrenia and putamen for autism. Thus, in terms of brain volumetrics, ASD and schizophrenia have a clear degree of overlap that may reflect shared etiological mechanisms. However, the distinctive neuroanatomy also mapped in each condition raises the question about how this is arrived in the context of common etiological pressures.
Chabrol, Henri; Raynal, Patrick
The co-occurrence of Autism Spectrum Disorder (ASD) and Borderline Personality Disorder (BPD) is not rare and has been linked to increased suicidality. Despite this significant comorbidity between ASD and BPD, no study had examined the co-occurrence of autistic traits and borderline personality disorder traits in the general population. The aim of the present study was to examine the co-occurrence of autistic and borderline traits in a non-clinical sample of young adults and its influence on the levels of suicidal ideation and depressive symptomatology. Participants were 474 college students who completed self-report questionnaires. Data were analysed using correlation and cluster analyses. Borderline personality traits and autistic traits were weakly correlated. However, cluster analysis yielded four groups: a low traits group, a borderline traits group, an autistic traits group, and a group characterized by high levels of both traits. Cluster analysis revealed that autistic and borderline traits can co-occur in a significant proportion of young adults. The high autistic and borderline traits group constituted 17% of the total sample and had higher level of suicidal ideation than the borderline traits group, despite similar levels of depressive symptoms. This result suggests that the higher suicidality observed in patients with comorbid ASD and BPD may extent to non-clinical individuals with high levels of co-occurrent autistic and borderline traits. Copyright © 2018 Elsevier Inc. All rights reserved.
Distinguishing and Improving Mouse Behavior With Educational Computer Games in Young Children With Autistic Spectrum Disorder or Attention Deficit/Hyperactivity Disorder : An Executive Function-Based Interpretation
Koning - Veenstra ,de Baukje; van Geert, Paul L. C.; van der Meulen, Bieuwe F.
In this exploratory multiple case study, it is examined how a computer game focused on improving ineffective learning behavior can be used as a tool to assess, improve, and study real-time mouse behavior (MB) in different types of children: 18 children (3.86.3 years) with Autistic Spectrum Disorder
Distinguishing and Improving Mouse Behavior with Educational Computer Games in Young Children with Autistic Spectrum Disorder or Attention Deficit/Hyperactivity Disorder: An Executive Function-Based Interpretation
Veenstra, Baukje; van Geert, Paul L. C.; van der Meulen, Bieuwe F.
In this exploratory multiple case study, it is examined how a computer game focused on improving ineffective learning behavior can be used as a tool to assess, improve, and study real-time mouse behavior (MB) in different types of children: 18 children (3.8-6.3 years) with Autistic Spectrum Disorder (ASD), Attention Deficit/Hyperactivity Disorder…
Buitelaar, J K; van der Wees, M; Swaab-Barneveld, H; van der Gaag, R J
The hypothesis was tested that weak theory of mind (ToM) and/or emotion recognition (ER) abilities are specific to subjects with autism. Differences in ToM and ER performance were examined between autistic (n = 20), pervasive developmental disorder-not otherwise specified (PDD-NOS) (n = 20), psychiatric control (n = 20), and normal children (n = 20). The clinical groups were matched person-to-person on age and verbal IQ. We used tasks for the matching and the context recognition of emotional expressions, and a set of first- and second-order ToM tasks. Autistic and PDD-NOS children could not be significantly differentiated from each other, nor could they be differentiated from the psychiatric controls with a diagnosis of ADHD (n = 9). The psychiatric controls with conduct disorder or dysthymia performed about as well as normal children. The variance in second-order ToM performance contributed most to differences between diagnostic groups.
Curtin, Suzanne; Vouloumanos, Athena
We examined whether infants' preference for speech at 12 months is associated with autistic-like behaviors at 18 months in infants who are at increased risk for autism spectrum disorder (ASD) because they have an older sibling diagnosed with ASD and in low-risk infants. Only low-risk infants listened significantly longer to speech than to…
Andr?s-Roqueta, Clara; Katsos, Napoleon
Pragmatic skills enable children to produce and comprehend words and sentences in ways that are appropriate to the conversational context. While structural language is known to vary widely in children with Autistic Spectrum Disorders (ASD), pragmatic language has been claimed to be consistently impaired within this population, and has been considered a hallmark of ASD (Volden and Phillips, 2010). Specially, people with ASD frequently demonstrate unusual or inappropriate conversational behavio...
Clarke, Dave F; Roberts, Wendy; Daraksan, Mina; Dupuis, Annie; McCabe, Jane; Wood, Halyey; Snead, O Carter; Weiss, Shelly K
It is well documented that children with autistic spectrum disorder (ASD) have an increased prevalence of seizures; however, studies have not been done to evaluate the prevalence of ASD in children with epilepsy. This comorbidity is important to define as early diagnosis and intervention in some children with ASD has been shown to improve outcome. Children with epilepsy seen in a tertiary care epilepsy clinic were evaluated using validated autism screening questionnaires (ASQ). In addition, questions about sleep-related disorders, behavior, seizure characteristics, antiepileptic agents, and body mass index (BMI) were requested. An attempt was then made to determine if there was a correlation between the factors identified and ASD. Of the 107 questionnaires returned, 97 ASQ's were properly completed and used in this study. Approximately 32% of children fit the ASQ criteria for having ASD. Most children had not been previously diagnosed. Worst behavior and daytime sleepiness was seen in those at greater risk (p children at risk of having ASD. Though confirmatory diagnostic evaluations are needed, this questionnaire-based study suggests that children with epilepsy are at greater risk of having ASD, and illustrates the need for more clinical vigilance. Behavioral difficulties and daytime sleepiness identified in these children could potentially affect their ability to learn. It is of interest that the age of seizure onset identified in those at greater risk corresponds with the approximate age of regression identified in some children with ASD.
Ekinci, Ozalp; Arman, Ayşe Rodopman; Işik, Uğur; Bez, Yasin; Berkem, Meral
Our aim was to examine the characteristics of EEG findings and epilepsy in autistic spectrum disorders (ASD) and the associated clinical and familial risk factors. Fifty-seven children (86% male) with ASD, mean age 82+/-36.2 months, were included in the study. Thirty-nine (68.4%) children had the diagnosis of autism, 15 (26.3%) had Pervasive Developmental Disorder Not Otherwise Specified, and 3 (5.3%) had high-functioning autism. One hour of sleep and/or awake EEG recordings was obtained for each child. All patients were evaluated with respect to clinical and familial characteristics and with the Childhood Autism Rating Scale, the Autism Behavior Checklist, and the Aberrant Behavior Checklist. The frequency of interictal epileptiform EEG abnormalities (IIEAs) was 24.6% (n=14), and the frequency of epilepsy was 14.2% (n=8). IIEAs were associated with a diagnosis of epilepsy (P=0.0001), Childhood Autism Rating Scale Activity scores (P=0.047), and a history of asthma and allergy (P=0.044). Epilepsy was associated with a family history of epilepsy (P=0.049) and psychiatric problems in the mother during pregnancy (P=0.0026). Future studies with larger samples will help to clarify the possible associations of epilepsy/IIEAs with asthma/allergy, hyperactivity, and familial factors in ASD. (c) 2009 Elsevier Inc. All rights reserved.
There are no treatments for the core symptoms of autistic spectrum disorder (ASD), but there is now more knowledge on emerging mechanisms and on mechanism-based therapies. In autism there are altered synapses: genes affected are commonly related to synaptic and immune function. Dysregulation of activity-dependent signaling networks may have a key role the etiology of autism. There is an over-activation of IGF-AKT-mTor in autism spectrum disorders. Morphological and electro-physiological defects of the cerebellum are linked to system-wide ASD-like behavior defects. The molecular basis for a cerebellar contribution has been demonstrated in a mouse model. These have led to a potential mechanism-based use of drug targets and mouse models. Neurotrophic factors are potential candidates for the treatment. Insulin-like growth factor-1 (IGF-1) is altered in autism. It reduces neuro-inflammation: by causing changes of cytokines such as IL-6 and microglial function. IGF-1 reduces the defects in the synapse. It alleviates NMDA-induced neurotoxicity via the IGF-AKT-mTor pathway in microglia. IGF-1 may rescue function in Rett syndrome and ASD caused by changes of the SCHANK3 gene. There are recently pilot studies of the treatment of Rett syndrome and of SCHANK3 gene deficiency syndromes. The FDA has granted Orphan drug designations for Fragile X syndrome, SCHANK3 gene deficiency syndrome and Rett syndrome. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
Milačić-Vidojević, Ivona; Gligorović, Milica; Dragojević, Nada
Family members experience stigma via their connection with the affected member. Family stigma contains stereotypes of blame, shame and contamination. To establish the tendency towards stigmatization of family members of a person with autistic spectrum disorders (ASD) by a sample of the general public of Belgrade. The sample encompassed 181 participants, of various ages and levels of education, and of different, self-assessed levels of knowledge about autism. The structure of stigmatization of family members of a person with ASD was explored applying the Family Stigma Questionnaire (FSQ) and the Level of Familiarity Questionnaire (LFQ). Analysis of the obtained results established that scores indicating the tendency towards stigmatization were most pronounced for variables connected to blame for deterioration of the condition of the person with autism, contamination of the individual family members by the condition, and to feeling pity for family members of a person with ASD. Statistically significant differences were established when the FSQ scores stigmatizing parents and siblings were compared. Significant differences in stigmatizing stereotypes were established according to gender and level of education, and according to the self-assessment of knowledge about autism and the level of previous contact to persons with mental disorders. Anti-stigma programmes are important especially bearing in mind that participants who self-evaluated as having the least knowledge about ASD demonstrated the highest tendency towards stigmatizing the parents of a person suffering from ASD, and those of lower education demonstrated the highest tendency towards stigmatizing the family members.
Hellzen, Ove; Asplund, Kenneth
To illuminate the meaning of being a carer for a person with a severe autistic disorder. Carers working with people with severe autism are occasionally exposed to residents' self-injurious behaviours and violent actions and at time residents appear resistant to all forms of treatment. A qualitative case study was conducted. Six Swedish carers enrolled nurses (ENs), working on a special ward in a nursing home were interviewed about their lived experiences when caring for an individual with a severe autistic disorder. Narrative interviews were conducted and interpreted using a phenomenological-hermeneutic method inspired by Paul Ricoeur. Two themes were formulated which describe the carers' reality and their dream of an ideal. This ideal described carers' experiences of being trapped in a segmented and isolated care reality and their longing to achieve a sense of wholeness. The findings were interpreted and reflected on in the light of a framework inspired by the German philosopher Karl Jaspers in order to achieve a deeper understanding of the text. In their desperation, the carers used their empirical knowledge based on scientific knowledge, which could be understood as a substitute for their vision of a consolating wholeness. This paper shows that searching for a substitute to consolation seems to be an important aspect of the meaning of being a carer for a person with a severe autistic disorder.
Georgiades, Stelios; Szatmari, Peter; Zwaigenbaum, Lonnie; Bryson, Susan; Brian, Jessica; Roberts, Wendy; Smith, Isabel; Vaillancourt, Tracy; Roncadin, Caroline; Garon, Nancy
The presence of autistic-like traits in relatives of individuals with autism spectrum disorder (ASD) is well recognized, but, to our knowledge, the emergence of these traits early in development has not been studied. To prospectively investigate the emergence of autistic-like traits in unaffected (no ASD diagnosis) infant siblings of probands diagnosed as having ASD. Two groups of children unaffected with ASD were assessed prospectively-siblings of probands diagnosed as having ASD (high risk [HR]) and control subjects with no family history of ASD (low risk [LR]). Scores on a measure of autistic-like traits at 12 months of age were used in a cluster analysis of the entire sample. A prospective study of infant siblings of probands with ASD from 3 diagnostic centers in Canada. The study included 170 HR and 90 LR children, none of whom was diagnosed as having ASD at age 3 years. The Autism Observation Scale for Infants was used to measure autistic-like traits and derive clusters at 12 months of age. Clusters were compared on ASD symptoms, cognitive abilities, and social-emotional difficulties at age 3 years. Two clusters were identified. Cluster 1 (n = 37; 14.2% of total sample) had significantly higher levels of autistic-like traits compared with cluster 2. Within cluster 1, 33 children came from the siblings (19.4% of HR group) and only 4 came from the control subjects (4.5% of LR group). At age 3 years, children from cluster 1 had more social-communication impairment (effect size > 0.70; P autism phenotype by 12 months of age in approximately 19% of HR siblings who did not meet ASD diagnostic criteria at age 3 years.
Wiggs, Luci; Stores, Gregory
The present study sought to describe the profile of sleep disturbance reported in children with autistic spectrum disorders (ASDs) and to document any sleep disorders underlying reports of sleeplessness. Sixty-nine children aged 5 to 16 years (mean 9 years 4 months, SD 2 years 7 months; 14 females) with an ASD were assessed by detailed sleep histories taken from parents, the Simonds and Parraga Sleep Questionnaire, a 2-week sleep diary, and actigraphs worn by the child for five nights. Parent-reported sleeplessness featured prominently (64%). Sleep disorders underlying the sleeplessness were most commonly behavioural (i.e. to do with inappropriate sleep-related behaviours), although sleep-wake cycle disorders and anxiety-related problems were also seen. In addition, the sleeplessness patterns of a large minority of children could not be classified by conventional diagnostic criteria. Sleep patterns measured objectively did not differ between those children with or without reported sleeplessness, but the sleep quality of all children seemed to be compromised compared with normal values.
Conclusions: It was possible for autistic children to relieve social barriers by implementing psychodrama training, then to improve the social cognitive ability and enhance the social function of the autistic children. These results provided basic Clinical implications for exploring a new intervention technique to reduce autistic symptom severity.
Øien, Roald; Eisemann, Martin R.
Parents of children with Autism spectrum disorders often report elevated levels of stress, depression and anxiety compared to parents of children with other developmental disorders. The present study investigated experiences of mothers of children with autistic disorder, both boys and girls. The results show that mothers report problems related to…
Hakim Shoushtari, Mitra; Ghalebandi, Mirfarhad; Tavasoli, Azita; Pourshams, Maryam
Objective Kleine-Levin syndrome (KLS) is a rare disorder with an unknown etiology. Autism spectrum disorder is characterized by various degrees of impairment in social communication, repetitive behavior and restricted interests. Only four patients of KLS with autistic spectrum disorder (ASD) have been reported so far. This report presents an 8-year-old girl with history of autistic disorder and epilepsy that superimposed KLS. Because of the rarity of KLS and related studies did not address whether autism accounts for a primary or secondary cause, the area required attention further studies.
Full Text Available Introduction: This study aimed to examine the role of prenatal stressful events in mothers of children and adolescents with autistic disorder (AD. Methods: This case-control study was conducted in 2014. A total number of 115 children and adolescents with AD were selected by convenience method from the autism rehabilitation centers in Tabriz, Iran. Moreover, 112 typically developing (TD children and adolescents were selected from public schools using a random clustering method. Two groups were matched in terms of mother's and child's age and mother's educational level. The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS semi-structured diagnostic interview was used to evaluate the presence of psychiatric disorders. The diagnosis of AD was made based on the DSM-IV criteria during separate diagnostic interviews by two child and adolescent psychiatrists. The life stressful events’ inventory was used to assess the presence of stressful events during pregnancy. Results: According to Fisher's exact test, the frequency of stressful life events including failure to achieve life goals, high debt, frequent marital conflict, conflict with spouse's family, changes in sleeping habits, and sexual difficulties in the mothers of AD children during pregnancy was significantly higher than the mothers of TD children. Also, mothers of AD children reported significantly higher frequency for the positive stressful life events including the major job progress, starting or finishing education, change of education, location, and summer vacation during pregnancy. Conclusion: Some stressful life events in mothers during pregnancy may be considered as risk factors for developing AD in their children. Further researches are needed to establish the results of this study.
Norbury, Courtenay Frazier; Brock, Jon; Cragg, Lucy; Einav, Shiri; Griffiths, Helen; Nation, Kate
Investigations using eye-tracking have reported reduced fixations to salient social cues such as eyes when participants with autism spectrum disorders (ASD) view social scenes. However, these studies have not distinguished different cognitive phenotypes. The eye-movements of 28 teenagers with ASD and 18 typically developing peers were recorded as they watched videos of peers interacting in familiar situations. Within ASD, we contrasted the viewing patterns of those with and without language impairments. The proportion of time spent viewing eyes, mouths and other scene details was calculated, as was latency of first fixation to eyes. Finally, the association between viewing patterns and social-communicative competence was measured. Individuals with ASD and age-appropriate language abilities spent significantly less time viewing eyes and were slower to fixate the eyes than typically developing peers. In contrast, there were no differences in viewing patterns between those with language impairments and typically developing peers. Eye-movement patterns were not associated with social outcomes for either language phenotype. However, increased fixations to the mouth were associated with greater communicative competence across the autistic spectrum. Attention to both eyes and mouths is important for language development and communicative competence. Differences in fixation time to eyes may not be sufficient to disrupt social competence in daily interactions. A multiple cognitive deficit model of ASD, incorporating different language phenotypes, is advocated.
Srisawasdi, Pornpen; Vanwong, Natchaya; Hongkaew, Yaowaluck; Puangpetch, Apichaya; Vanavanan, Somlak; Intachak, Boontarika; Ngamsamut, Nattawat; Limsila, Penkhae; Sukasem, Chonlaphat; Kroll, Martin H
To evaluate the influence of dose and duration of risperidone treatment on cardiovascular and diabetes risk biomarkers in children and adolescents with autistic spectrum disorders (ASDs). In this cross-sectional analysis, a total of 168 ASDs patients (89% male) treated with a risperidone-based regimen for ≥12months were included. Blood samples were analyzed for glucose and lipid metabolic markers, adiponectin, leptin, prolactin, cortisol and high sensitive C-reactive protein. The mean concentrations of glucose, insulin, prolactin and leptin and HOMA-IR significantly rose with risperidone dosage (all PRisperidone treatment disturbed glucose homeostasis and endocrine regulation (particularly leptin) in children and adolescents with ASDs, in a dose- and duration-dependent manner, being suggestive of leptin and insulin resistance mechanisms. Metabolic adverse effects, especially development of type 2 diabetes mellitus should be closely monitored, particularly in individuals receiving high doses and/or long-term risperidone treatment. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Rashid, Barnaly; Blanken, Laura M E; Muetzel, Ryan L; Miller, Robyn; Damaraju, Eswar; Arbabshirani, Mohammad R; Erhardt, Erik B; Verhulst, Frank C; van der Lugt, Aad; Jaddoe, Vincent W V; Tiemeier, Henning; White, Tonya; Calhoun, Vince
Recent advances in neuroimaging techniques have provided significant insights into developmental trajectories of human brain function. Characterizations of typical neurodevelopment provide a framework for understanding altered neurodevelopment, including differences in brain function related to developmental disorders and psychopathology. Historically, most functional connectivity studies of typical and atypical development operate under the assumption that connectivity remains static over time. We hypothesized that relaxing stationarity assumptions would reveal novel features of both typical brain development related to children on the autism spectrum. We employed a "chronnectomic" (recurring, time-varying patterns of connectivity) approach to evaluate transient states of connectivity using resting-state functional MRI in a population-based sample of 774 6- to 10-year-old children. Dynamic connectivity was evaluated using a sliding-window approach, and revealed four transient states. Internetwork connectivity increased with age in modularized dynamic states, illustrating an important pattern of connectivity in the developing brain. Furthermore, we demonstrated that higher levels of autistic traits and ASD diagnosis were associated with longer dwell times in a globally disconnected state. These results provide a roadmap to the chronnectomic organization of the developing brain and suggest that characteristics of functional brain connectivity are related to children on the autism spectrum. © 2018 Wiley Periodicals, Inc.
Humphreys, Joanna S; Gringras, Paul; Blair, Peter S; Scott, Nicola; Henderson, John; Fleming, Peter J; Emond, Alan M
To investigate longitudinal sleep patterns in children with autistic spectrum disorders (ASDs). Prospective longitudinal study using Avon Longitudinal Study of Parents and Children, an English cohort born in 1991-1992. Parental reports of sleep duration were collected by questionnaires at 8 time points from 6 months to 11 years. Children with an ASD diagnosis at age 11 years (n=73) were identified from health and education records. From aged 30 months to 11 years old, children with ASD slept for 17-43 min less each day than contemporary controls. No significant difference in total sleep duration was found in infancy, but from 30 months of age children with ASD slept less than their peers, a difference that remained significant after adjusting for sex, ethnicity, high parity and epilepsy. The reduction in total sleep was wholly due to changes in night rather than daytime sleep duration. Night-time sleep duration was shortened by later bedtimes and earlier waking times. Frequent waking (3 or more times a night) was also evident among the children with ASD from 30 months of age. Age-specific decreases of >1SD within individuals in sleep duration across adjacent time points was a predictor of ASD between 18 months and 30 months of age (p=0.04) and from 30 months to 42 months (p=0.02). Sleep duration in children with ASD is reduced from 30 months of age and persists until adolescence.
Petersen, Andrea Klunder; Ahmad, Ausaf; Shafiq, Mustafa; Brown-Kipphut, Brigette; Fong, Chin-To; Anwar Iqbal, M
Deletions on the distal portion of the long arm of chromosome 1 result in complex and highly variable clinical phenotypes which include intellectual disability, autism, seizures, microcephaly/craniofacial dysmorphology, corpus callosal agenesis/hypogenesis, cardiac and genital anomalies, hand and foot abnormalities and short stature. Genotype-phenotype correlation reported a minimum region of 2 Mb at 1q43-q44. We report on a 3 ½ year old male patient diagnosed with autistic disorder who has social withdrawal, eating problems, repetitive stereotypic behaviors including self-injurious head banging and hair pulling, and no seizures, anxiety, or mood swings. Array comparative genomic hybridization (aCGH) showed an interstitial deletion of 473 kb at 1q43 region (239,412,391-239,885,394; NCBI build37/hg19) harboring only CHRM3 (Acetylcholine Receptor, Muscarinic, 3; OMIM: 118494). Recently, another case with a de novo interstitial deletion of 911 kb at 1q43 encompassing three genes including CHRM3 was reported. The M3 muscarinic receptor influences a multitude of central and peripheral nervous system processes via its interaction with acetylcholine and may be an important modulator of behavior, learning and memory. We propose CHRM3 as a candidate gene responsible for our patient's specific phenotype as well as the overlapping phenotypic features of other patients with 1q43 or 1q43-q44 deletions. Copyright © 2013. Published by Elsevier Masson SAS.
Perry, Anat; Levy-Gigi, Einat; Richter-Levin, Gal; Shamay-Tsoory, Simone G
An inherent feature of social interactions is the use of social space or interpersonal distance-the space between one individual and another. Because social deficits are core symptoms of Autistic Spectrum Disorder (ASD), we hypothesized that individuals on this spectrum will exhibit abnormal interpersonal distance preferences. The literature on interpersonal distance in ASD is not conclusive. While some studies show preferences for closer distances among this group, others show preferences for farther distances than controls. A common symptom of ASD that may explain the variance in responses to interpersonal distance in this population is social anxiety (SA), which has been shown to correlate with interpersonal distance preferences. In the current study, we investigated interpersonal distance preferences in a group of individuals with ASD using both behavioral and ERP measures. We found greater variance in interpersonal distance preferences in the ASD group than in the control group. Furthermore, we showed that this variance can be explained by differences in SA level and can be predicted by the N1 amplitude, an early ERP component related to attention and discrimination processes. These results hint at the early sensory and attentional processes that may be affecting higher social behaviors, both in subclinical and in clinical populations.
Blaurock-Busch, Eleonor; Amin, Omnia R; Rabah, Thanaa
General information: Autism is a severe developmental disorder which involves social withdrawal, communication deficits, and stereotypic/repetitive behavior. The pathophysiological etiologies which precipitate autism symptoms remain elusive and controversial in many cases, but both genetic and environmental factors (and their interactions) have been implicated. While autism is considered multicausal, environmental factors have received significant attention. International discussion has ocused on neurotoxins such as mercury and lead, suggesting that these and other toxic metals contribute to the development of the disorder. An epidemiological study released in 2006 (Palmer et al.) linking Toxic Release Inventory (TRI) data on mercury to special education data in Texas reported a 61% increase in autism prevalence rates (or 17% adjusted) per 1000 pounds of mercury released into the environment (1). We attempted to further evaluate whether exposure to variable environmental contributes to the genesis of autistic spectrum disorder, and thus is a factor increasing the risk for developing autism symptoms in utero or in early childhood. The purpose of this study is to examine possible environmental risk factors and sources of exposure to mercury and other heavy metals in children with autism spectrum disorder versus controls. Through laboratory diagnostics we are able to distinguish between present and past exposure (i.e. hair analysis measurements reflect past exposure), urinary excretion levels of unprovoked urine represent immediate exposure. By assessing a spectrum of trace elements and heavy metals in hair and urine of both autistic and control groups, we focused on the participants≈ past and present exposure. The participants were 25 Autistic Spectrum Disorder (ASD) children (22 boys and 3 girls) between the age of 3 and 9 years. They were either diagnosed previously by other psychiatrist, psychologist, and developmental pediatrician or suspected by their parents
Emanuele, Enzo; Colombo, Roberto; Martinelli, Valentina; Brondino, Natascia; Marini, Mara; Boso, Marianna; Barale, Francesco; Politi, Pierluigi
Previous studies have suggested that the endogeneous psychotomimetic molecule bufotenine (N-N-dimethyl-5-idroxytryptamine) may play a role in the pathogenesis of severe mental disorders. The potential association of bufotenine with the clinical features of autism and schizophrenia is not entirely understood. In this study, we measured urinary levels of bufotenine in subjects with autistic spectrum disorder (ASD), schizophrenia and healthy comparison subjects free of psychiatric symptoms. We also sought to assess whether urine concentrations of this molecule may be associated with the clinical characteristics of psychiatric patients. Urine bufotenine levels were measured using a high-performance liquid chromatography-mass spectrometry (HPLC-MS) assay in young adults with severe ASD (n=15), patients with schizophrenia (n=15), and healthy control subjects (n=18). The Vineland Adaptive Behavior Scale was used to measure adaptive behaviors in ASD individuals. The Brief Psychiatric Rating Scale (BPRS) was used for patients with schizophrenia. Urine bufotenine levels were significantly higher in ASD subjects (3.30 +/- 0.49 microg/L, p<0.05) and patients with schizophrenia (4.39 +/- 0.43 microg/L, p<0.001) compared with controls (1.53 +/- 0.30 microg/L). Among patients with ASD, there was a significant positive correlation between urine bufotenine and hyperactivity scores on the Vineland Adaptive Behavior Scale (r=0.479, p<0.05). No other associations were detected. Our results indicate that elevated urine levels of the endogeneous psychotomimetic molecule bufotenine may play a role in ASD and schizophrenia, and can be correlated with hyperactivity scores in autism.
Reid, David B
Despite volumes of published studies supporting the efficacy of hypnosis for ego-strengthening, performance, and physical and psychological disorders, the precise nature of hypnosis, and in particular, the neurobiological underpinnings of trance-phenomenon, remains tenuous at best. With his empathic involvement theory of hypnosis, Wickramasekera II (2015) brings us closer to an understanding of the elusive nature of hypnotic processes by proposing a bridging of two long-standing and seemingly incongruent theories of hypnosis (i.e., neodissociative versus socio-cognitive). Borrowing from neuroscientific studies of empathy, the empathic involvement theory maintains that empathy, beyond any other human dynamic (including emotions, behavior, personality, and imagination), facilitates and enhances hypnotic experiences for both recipient and provider alike. By the same token, one can reasonably infer from the empathic involvement theory that non-empathic individuals are less likely to benefit from hypnosis. With this perspective in mind, the empathic involvement theory's identification of empathy as an apparent "Holy Grail" of the neural underpinnings and precise nature of hypnosis may be challenged on a number of grounds. Individuals with autistic spectrum disorder, especially those suffering from alexithymia, have been identified as empathy deficient, and therefore according to the empathic involvement theory would be classified as "low-hypnotizable," yet empirical studies, albeit limited in number, suggest otherwise. Furthermore, hypnotic inductions of audience volunteers by stage hypnotists challenge the empathic involvement theory's supposition that empathy is a required component of hypnosis. It is this author's contention that empathy is a beneficial, though not essential, element of successful hypnosis.
Obrenovich, Mark E; Shola, Dorjee; Schroedel, Kathleen; Agrahari, Aditya; Lonsdale, Derrick
Although there has been much research into autism or autistic spectrum disorder (ASD), there is room for considerable conjecture regarding the etiology of these developmental brain disorders. ASD is marked by a complex interaction between environmental factors and genetic predisposition, including epistasis. This manuscript argues that changes in oxidative metabolism, thiamine homeostasis, heavy metal deposition and cellular immunity have a role in the etiopathogenesis of autism and ASD. Recent findings from our group and others provide evidence for abnormal thiol metabolism, marked by significant alteration in the deposition of several trace heavy metal species. Together with these, we find differences in thiamine homeostasis in ASD patients, which can be corrected by supplementation. We hypothesize that altered thiol metabolism from heavy metal toxicity, one of the key mechanisms for oxidative stress production, may be responsible for the biochemical alterations in transketolase, dysautonomia and abnormal thiamine homeostasis. Although it is unknown why these particular metals accumulate, we suspect that children with ASD and forms of autism may have particular trouble excreting thiol-toxic heavy metal species, many of which exist as divalent cations. We maintain mercury accumulation is evidence of altered clearance. Together with concomitant oxidative stress, these findings may offer an intriguing component or possible mechanism for oxidative stress-mediated neurodegeneration in ASD patients. Regardless of the exact cause, these factors may be more important to the etiology of this symptomatically diverse disease spectrum. Here, we offer insight into new avenues of exploration as well as the development of novel treatment approaches for these growing and devastating diseases.
Investigation of the Association Between Motor Stereotypy Behavior With Fundamental Movement Skills, Adaptive Functioning, and Autistic Spectrum Disorder Symptomology in Children With Intellectual Disabilities.
Powell, Joanne L; Pringle, Lydia; Greig, Matt
Motor stereotypy behaviors are patterned, coordinated, repetitive behaviors that are particularly evident in those with an autistic spectrum disorder and intellectual disabilities. The extent to which motor stereotypy behavior severity is associated with motor skills and maladaptive behavior, measures of adaptive functioning, along with fundamental movement skills and degree of autistic spectrum disorder symptomology is assessed in this preliminary report. Twelve participants, aged 7 to 16 years, with a reported motor stereotypy behavior and either mild or severe intellectual disability comprising developmental or global delay took part in the study. Spearman rho correlational analysis showed that severity of motor stereotypy behavior was significantly positively correlated with autistic spectrum disorder symptomology ( P = .008) and maladaptive behavior ( P = .008) but not fundamental movement skills ( P > .05). An increase in fundamental movement skills score was associated with a decrease in autistic spectrum disorder symptomology ( P = .01) and an increase in motor skills ( P = .002). This study provides evidence showing a significant relationship between motor stereotypy behavior severity with degree of autistic spectrum disorder symptomology and maladaptive behavior.
Murray, Aja L; Booth, Tom; McKenzie, Karen; Kuenssberg, Renate; O'Donnell, Michael
It is common to administer measures of autistic traits to those without autism spectrum disorders (ASDs) with, for example, the aim of understanding autistic personality characteristics in non-autistic individuals. Little research has examined the extent to which measures of autistic traits actually measure the same traits in the same way across those with and without an ASD. We addressed this question using a multi-group confirmatory factor invariance analysis of the Autism Quotient Short Form (AQ-S: Hoekstra et al. in J Autism Dev Disord 41(5):589-596, 2011) across those with (n = 148) and without (n = 168) ASD. Metric variance (equality of factor loadings), but not scalar invariance (equality of thresholds), held suggesting that the AQ-S measures the same latent traits in both groups, but with a bias in the manner in which trait levels are estimated. We, therefore, argue that the AQ-S can be used to investigate possible causes and consequences of autistic traits in both groups separately, but caution is due when combining or comparing levels of autistic traits across the two groups.
Siniscalco, Dario; Sapone, Anna; Giordano, Catia; Cirillo, Alessandra; de Magistris, Laura; Rossi, Francesco; Fasano, Alessio; Bradstreet, James Jeffrey; Maione, Sabatino; Antonucci, Nicola
Autistic disorders (ADs) are heterogeneous neurodevelopmental disorders arised by the interaction of genes and environmental factors. Dysfunctions in social interaction and communication skills, repetitive and stereotypic verbal and non-verbal behaviours are common features of ADs. There are no defined mechanisms of pathogenesis, rendering…
Almansour, Mohammed A; Alateeq, Mohammed A; Alzahrani, Mansour K; Algeffari, Metab A; Alhomaidan, Homaidan T
To evaluate the presence of depression and anxiety in parents/caregivers of autistic spectral disorder (ASD) children, and to identify associated factors. In this retrospective cohort study carried out between July and December 2011, parents/caregivers of at least one child diagnosed with an ASD (cases group), were recruited through the Saudi Charitable Society of Autism Families and the Autism Clinic in the Pediatric out-patient clinic in King Fahad National Guard Hospital, King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. The parents/caregivers of a normally developed child (control group) were recruited from the Well Child Clinic at King Abdulaziz Medical City, Riyadh. We used a self-reported questionnaire containing questions on demographic data, as well as the Arabic version of the hospital anxiety and depression scale. The study included 100 parents/caregivers, 50 cases and 50 controls. More than 50% of the control group was in the age group 26-30 years (56%), while 42% of cases were in the age group 31-35 years. Time lapsed since autism diagnosis was over 3 years in one-third of cases. Twenty-two percent of cases, and only 2% of control parents/caregivers had a history of psychiatric problems (p=0.002). Both the mean depression score, and the mean anxiety score was significantly higher among cases when compared with controls, pAutism is associated with burden and stress for parents/caregivers of the affected child. The demands placed by the disability contribute to a higher overall incidence of depression and anxiety among parents/caregivers.
Chiang, Huey-Ling; Kao, Wei-Chih; Chou, Mei-Chun; Chou, Wen-June; Chiu, Yen-Nan; Wu, Yu-Yu; Gau, Susan Shur-Fen
School dysfunction is observed in youths with autism spectrum disorder (ASD), but the factors moderating their school dysfunction have not been well explored. This study investigated school functions in youths with ASD in Taiwan, stratified by personal characteristics including demographics, ASD subtypes, intelligence profiles, and the presence of attention-deficit hyperactivity disorder (ADHD). We recruited 160 youths (aged 6-18 years, 87.5% boys) with a clinical diagnosis of ASD and 160 age and gender-matched typically developing (TD) youths. Their parents received a semi-structured psychiatric interview for their ASD and ADHD diagnoses and reported their school functions. Youths with ASD were further grouped into low-functioning autism (LFA, ASD with intellectual disability and developmental language delay, n = 44), high-functioning autism (HFA, ASD with no intellectual disability, n = 55) and Asperger's syndrome (AS, ASD with neither language delay nor intellectual disability, n = 61). Compared to TD, ASD had worse school functions in the domains of academic performance, attitude toward schoolwork, social interaction, and behavioral problems except for no academic differences from TD in HFA and ASD without ADHD. Subgroup analysis revealed that HFA and AS had better academic performance but showed worse attitude toward school than LFA. Comorbidity of ADHD negatively impacted all domains of school functions. Besides autistic and ADHD symptoms, oppositional symptoms, lower intelligence, older age, and female gender in youths also predicted school dysfunction. Although youths with ASD have school dysfunction in several domains, this study specifically addresses the role of intelligence and comorbid ADHD on their school dysfunction. Autism Res 2018. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Impaired school functions varied in ASD youths with different characteristics. Youths with autism spectrum disorder (ASD) encounter
There is consensus about the disorders that comprise the autistic spectrum, with autistic disorder, Asperger's disorder, and PDD-NOS as the most typical examples and Rett's disorder and disintegrative disorder as the other components. Important controversies regarding the precise definitions of
Full Text Available BACKGROUND: The clinical relevance of MR scanning in children with autism is still an open question and must be considered in light of the evolution of this technology. MRI was judged to be of insufficient value to be included in the standard clinical evaluation of autism according to the guidelines of the American Academy of Neurology and Child Neurology Society in 2000. However, this statement was based on results obtained from small samples of patients and, more importantly, included mostly insufficient MRI sequences. Our main objective was to evaluate the prevalence of brain abnormalities in a large group of children with a non-syndromic autistic disorder (AD using T1, T2 and FLAIR MRI sequences. METHODOLOGY: MRI inspection of 77 children and adolescents with non-syndromic AD (mean age 7.4+/-3.6 was performed. All met the DSM-IV and ADI -R criteria for autism. Based on recommended clinical and biological screenings, we excluded patients with infectious, metabolic or genetic diseases, seizures or any other neurological symptoms. Identical MRI inspections of 77 children (mean age 7.0+/-4.2 without AD, developmental or neurological disorders were also performed. All MRIs were acquired with a 1.5-T Signa GE (3-D T1-FSPGR, T2, FLAIR coronal and axial sequences. Two neuroradiologists independently inspected cortical and sub-cortical regions. MRIs were reported to be normal, abnormal or uninterpretable. PRINCIPAL FINDINGS: MRIs were judged as uninterpretable in 10% (8/77 of the cases. In 48% of the children (33/69 patients, abnormalities were reported. Three predominant abnormalities were observed, including white matter signal abnormalities (19/69, major dilated Virchow-Robin spaces (12/69 and temporal lobe abnormalities (20/69. In all, 52% of the MRIs were interpreted as normal (36/69 patients. CONCLUSIONS: An unexpectedly high rate of MRI abnormalities was found in the first large series of clinical MRI investigations in non-syndromic autism
Full Text Available Abnormalities in melatonin physiology may be involved or closely linked to the pathophysiology and behavioral expression of autistic disorder, given its role in neurodevelopment and reports of sleep-wake rhythm disturbances, decreased nocturnal melatonin production, and beneficial therapeutic effects of melatonin in individuals with autism. In addition, melatonin, as a pineal gland hormone produced from serotonin, is of special interest in autistic disorder given reported alterations in central and peripheral serotonin neurobiology. More specifically, the role of melatonin in the ontogenetic establishment of circadian rhythms and the synchronization of peripheral oscillators opens interesting perspectives to ascertain better the mechanisms underlying the significant relationship found between lower nocturnal melatonin excretion and increased severity of autistic social communication impairments, especially for verbal communication and social imitative play. In this article, first we review the studies on melatonin levels and the treatment studies of melatonin in autistic disorder. Then, we discuss the relationships between melatonin and autistic behavioral impairments with regard to social communication (verbal and non-verbal communication, social interaction, and repetitive behaviors or interests with difficulties adapting to change. In conclusion, we emphasize that randomized clinical trials in autism spectrum disorders are warranted to establish potential therapeutic efficacy of melatonin for social communication impairments and stereotyped behaviors or interests.
Kent, Justine M; Hough, David; Singh, Jaskaran; Karcher, Keith; Pandina, Gahan
The purpose of this study was to evaluate the long-term safety and efficacy of risperidone in treating irritability and related behaviors in children and adolescents with autistic disorders. In this 6 month (26 week) open-label extension (OLE) study, patients (5-17 years of age, who completed the previous fixed-dose, 6 week, double-blind [DB] phase) were flexibly dosed with risperidone based on body weight. The maximum allowed dose was 1.25 mg/day for those weighing 20 to sleep visual analog scale (24.6). All groups showed additional improvement in efficacy scale scores during the OLE. During this OLE, safety findings with risperidone treatment (maximum weight-based dose of 1.25 mg/day or 1.75 mg/day) were consistent with those observed in the DB phase, and with the current safety information for risperidone in autistic, psychiatric, and behavioral disorders. Patients experienced some additional improvement in irritability and related behaviors. This phase-4 study is registered at ClinicalTrials.gov (NCT00576732).
Guerini, Franca R; Bolognesi, Elisabetta; Chiappedi, Matteo; Ripamonti, Enrico; Ghezzo, Alessandro; Zanette, Michela; Sotgiu, Stefano; Mensi, Maria Martina; Carta, Alessandra; Canevini, Maria Paola; Zanzottera, Milena; Agliardi, Cristina; Costa, Andrea S; Balottin, Umberto; Clerici, Mario
Different isoforms of HLA-G protein are endowed with a differential ability to induce allogenic tolerance during pregnancy. As prenatal immune activation is suggested to play a role in the onset of autistic spectrum disorders (ASD), we evaluated HLA G*01:01-*01:06 allelic polymorphism in a cohort of Italian children affected by ASD (N=111) their mothers (N=81), and their healthy siblings (N=39). DNA sequencing analysis of HLA-G exon 2, 3 and 4 was used to obtain HLA-G allelic frequencies; alleles distribution was compared with that of two control groups of Caucasoid couples of multiparous women and their partners from Brazil and Denmark. HLA-G distribution was significantly different in ASD children compared to both control groups (Brazilian p c =1×10 -4 ; Danish p c =1×10 -3 ). Since HLA-G distribution was similar in the two control groups, their data were pooled. Results indicated that HLA-G*01:01 was significantly less frequent (p c =1×10 -4 ; OR:0.5, 95%CI: 0.3-0.7) whereas HLA-G*01:05N was significantly more frequent (p c =2×10 -3 ; OR:7.3, 95%CI: 2.4-26.6) in ASD children compared to combined controls. Finally, no clear pattern emerged when HLA-G allelic distribution was analyzed in healthy sibs. Notably, HLA-G allelic distribution found in ASD mothers was similar to that observed in the control subgroup of women with recurrent miscarriages, whilst it was significantly different compared to women without miscarriages (p c =6×10 -4 df=12). Since HLA-G*01:01 is associated with the elicitation of KIR-mediated tolerogenic responses and HLA-G*01:05N correlates with NK cells activation, results herein indicate that an immune activating milieu during pregnancy is more likely observed in association with the development of ASD, similarly to what occurs in women with recurrent miscarriages. Copyright © 2017 Elsevier Inc. All rights reserved.
Øien, Roald; Eisemann, Martin R
Parents of children with Autism spectrum disorders often report elevated levels of stress, depression and anxiety compared to parents of children with other developmental disorders. The present study investigated experiences of mothers of children with autistic disorder, both boys and girls. The results show that mothers report problems related to communication, behavior and interests of their child, which impact their quality of life. There were also differences between boys and girls.
Doyen, C; Mighiu, D; Kaye, K; Colineaux, C; Beaumanoir, C; Mouraeff, Y; Rieu, C; Paubel, P; Contejean, Y
Over the last 20 years, melatonin, a pineal hormone synthesized from serotonin, has been implicated in various studies on the autism spectrum disorder (ASD) and altered melatonin levels were detected in subgroups of subjects with ASD. Its effect on sleep disturbances got the attention of clinicians and several investigations were carried out to determine the usefulness and safety of melatonin administration in this disorder. Hypotheses were also raised regarding the possibility that the dysfunctional synthesis and secretion of melatonin detected in subgroups of subjects with ASD may increase the risk as well the severity of ASD. The purpose of this paper is to review our pharmacokinetic knowledge on melatonin and present results from recent studies on sleep disorders in autism, their treatment with melatonin and the impact of melatonin prescription in children with ASD evaluated in a Diagnostic Center for Autism Spectrum Disorder in Paris, France.
Suzuki, Mayo; Tachimori, Hisateru; Saito, Mari; Koyama, Tomonori; Kurita, Hiroshi
This study aimed to compile a screening scale for high-functioning pervasive developmental disorders (PDD), using the Tokyo Child Development Schedule (TCDS) and Tokyo Autistic Behavior Scale (TABS). The 72 participants (IQ greater than or equal to 70) were divided into 3 groups after IQ matching depending on their diagnoses: i.e., PDD,…
López, José María; Moreno-Rodríguez, Ricardo; Alcover, Carlos-María; Garrote, Inmaculada; Sánchez, Sergio
Individuals with Autistic Spectrum Disorder (ASD) present learning difficulties and limited performance of social skills, besides lower motor skills performance in comparison with their peers. Owing to these difficulties, most of children with ASD are at risk of social exclusion or a poor inclusion due to their behavior, mainly playing with other…
Tonge, Bruce; Brereton, Avril; Kiomall, Melissa; Mackinnon, Andrew; Rinehart, Nicole J.
Aim: To determine the effect of parent education on adaptive behaviour, autism symptoms and cognitive/language skills of young children with autistic disorder. Method: A randomised group comparison design involving a parent education and counselling intervention and a parent education and behaviour management intervention to control for parent…
Hamilton, Antonia F. de C.; Brindley, Rachel M.; Frith, Uta
The motor mirror neuron system supports imitation and goal understanding in typical adults. Recently, it has been proposed that a deficit in this mirror neuron system might contribute to poor imitation performance in children with autistic spectrum disorders (ASD) and might be a cause of poor social abilities in these children. We aimed to test…
Grey, Ian M.; Bruton, Cora; Honan, Rita; McGuinness, Roisin; Daly, Michael
The purpose of this study was to determine the effects of a cooperative learning (CL) intervention on the levels of social and task engagement of a child with autistic spectrum disorder (ASD) conducted in a mainstream class setting and a child with ASD implemented in a special needs class setting. The target children were two 8-year-old boys…
Kadak, Muhammed Tayyib; Demirel, Omer Faruk; Yavuz, Mesut; Demir, Türkay
Research findings debate about features of broad autism phenotype. In this study, we tested whether parents of children with autism have problems recognizing emotional facial expression and the contribution of such an impairment to the broad phenotype of autism. Seventy-two parents of children with autistic spectrum disorder and 38 parents of control group participated in the study. Broad autism features was measured with Autism Quotient (AQ). Recognition of Emotional Face Expression Test was assessed with the Emotion Recognition Test, consisting a set of photographs from Ekman & Friesen's. In a two-tailed analysis of variance of AQ, there was a significant difference for social skills (F(1, 106)=6.095; p<.05). Analyses of variance revealed significant difference in the recognition of happy, surprised and neutral expressions (F(1, 106)=4.068, p=.046; F(1, 106)=4.068, p=.046; F(1, 106)=6.064, p=.016). According to our findings, social impairment could be considered a characteristic feature of BAP. ASD parents had difficulty recognizing neutral expressions, suggesting that ASD parents may have impaired recognition of ambiguous expressions as do autistic children. Copyright © 2014 Elsevier Inc. All rights reserved.
Robert, Cyrille; Pasquier, Laurent; Cohen, David; Fradin, Mélanie; Canitano, Roberto; Damaj, Léna; Odent, Sylvie; Tordjman, Sylvie
Progress in epidemiological, molecular and clinical genetics with the development of new techniques has improved knowledge on genetic syndromes associated with autism spectrum disorder (ASD). The objective of this article is to show the diversity of genetic disorders associated with ASD (based on an extensive review of single-gene disorders, copy number variants, and other chromosomal disorders), and consequently to propose a hierarchical diagnostic strategy with a stepwise evaluation, helping general practitioners/pediatricians and child psychiatrists to collaborate with geneticists and neuropediatricians, in order to search for genetic disorders associated with ASD. The first step is a clinical investigation involving: (i) a child psychiatric and psychological evaluation confirming autism diagnosis from different observational sources and assessing autism severity; (ii) a neuropediatric evaluation examining neurological symptoms and developmental milestones; and (iii) a genetic evaluation searching for dysmorphic features and malformations. The second step involves laboratory and if necessary neuroimaging and EEG studies oriented by clinical results based on clinical genetic and neuropediatric examinations. The identification of genetic disorders associated with ASD has practical implications for diagnostic strategies, early detection or prevention of co-morbidity, specific treatment and follow up, and genetic counseling. PMID:28287497
Full Text Available Background The study was carried out within the research “Reading comprehension – typical development and its risks”. The article contains data from a component study focused on 4th grade students with autism spectrum disorder (ASD who were incorporated into a group of readers with reading comprehension development risks. The main aim was to establish whether variable results in children’s reading and comprehension tests relate to the level of understanding of social relations. Participants and procedure We tested 20 students with ASD in two phases: T1 and T2. Each phase consisted of 2 individual sessions. Under the leadership of a research assistant, during each of these sessions a student would carry out the test focused on general intellectual skills, language skills, reading, and reading comprehension. For students with autistic spectrum disorder the Strange Stories test was added in order to ascertain the level of social relations understanding. Results The results in reading and reading comprehension tests among students with ASD varied significantly. Based on a correlation analysis it was found that the Strange Stories results substantially correlate with tests focused on reading, text comprehension and language skill levels. Conclusions Our research proved the following: the Strange Stories test results show that the level to which an individual is able to understand social relations and social behavior is significantly related to his/her ability to comprehend a text. Consequently, this can influence his/her learning skills as well as the quality of life in society. Cultivation of social abilities, social communication and understanding of social situations and relations is therefore necessary for compensation of autistic spectrum disorder expressions.
BLAUROCK-BUSCH, Eleonor; AMIN, Omnia R.; RABAH, Thanaa
ABSTRACT General information: Autism is a severe developmental disorder which involves social withdrawal, communication deficits, and stereotypic/repetitive behavior. The pathophysiological etiologies which precipitate autism symptoms remain elusive and controversial in many cases, but both genetic and environmental factors (and their interactions) have been implicated. While autism is considered multicausal, environmental factors have received significant attention. International discussion has ocused on neurotoxins such as mercury and lead, suggesting that these and other toxic metals contribute to the development of the disorder. An epidemiological study released in 2006 (Palmer et al.) linking Toxic Release Inventory (TRI) data on mercury to special education data in Texas reported a 61% increase in autism prevalence rates (or 17% adjusted) per 1000 pounds of mercury released into the environment (1). We attempted to further evaluate whether exposure to variable environmental contributes to the genesis of autistic spectrum disorder, and thus is a factor increasing the risk for developing autism symptoms in utero or in early childhood. Purpose: The purpose of this study is to examine possible environmental risk factors and sources of exposure to mercury and other heavy metals in children with autism spectrum disorder versus controls. Through laboratory diagnostics we are able to distinguish between present and past exposure (i.e. hair analysis measurements reflect past exposure), urinary excretion levels of unprovoked urine represent immediate exposure. By assessing a spectrum of trace elements and heavy metals in hair and urine of both autistic and control groups, we focused on the participants≈ past and present exposure. Methodology: The participants were 25 Autistic Spectrum Disorder (ASD) children (22 boys and 3 girls) between the age of 3 and 9 years. They were either diagnosed previously by other psychiatrist, psychologist, and developmental pediatrician
Ella, Bruno; Ghorayeb, Imad; Burbaud, Pierre; Guehl, Dominique
Bruxism is an abnormal repetitive movement disorder characterized by jaw clenching and tooth gnashing or grinding. It is classified into two overlapping types: awake bruxism (AB) and sleep bruxism (SB). Theories on factors causing bruxism are a matter of controversy, but a line of evidence suggests that it may to some extent be linked to basal ganglia dysfunction although so far, this topic has received little attention. The purpose of this article was to review cases of bruxism reported in various movement disorders. The biomedical literature was searched for publications reporting the association of bruxism with various types of movement disorders. As a whole, very few series were found, and most papers corresponded to clinical reports. In Parkinsonian syndromes, AB was rarely reported, but seems to be exacerbated by medical treatment, whereas SB is mainly observed during non-REM sleep, as in restless leg syndrome. AB is occasionally reported in Huntington's disease, primary dystonia, and secondary dystonia; however, its highest incidence and severity is reported in syndromes combining stereotypies and cognitive impairment, such as Rett's syndrome (97%), Down syndrome (42%), and autistic spectrum disorders (32%). Taken as a whole, AB seems to be more frequent in hyperkinetic movement disorders, notably those with stereotypies, and is influenced by anxiety, suggesting an involvement of the limbic part of the basal ganglia in its pathophysiology. © 2016 by the American College of Prosthodontists.
Emerson, Eric; Blacher, Jan; Einfeld, Stewart; Hatton, Chris; Robertson, Janet; Stancliffe, Roger J
We investigated the association between exposure to environmental risks in early childhood and the prevalence and persistence of conduct difficulties (CD) in children with intellectual disability (ID) who did not have autistic spectrum disorder (ASD), children with ASD and typically developing (TD) children. Results indicated that: (1) exposure to risk was associated with elevated prevalence of CD at age three and, for TD children and children with ID, increased risk of CD persisting to ages five and seven; (2) at all levels of risk, children with ASD were more likely to show persistent CD than other children; (3) children with ID were no more likely to show persistent CD than TD children at low levels of exposure to environmental risk. Copyright © 2014 Elsevier Ltd. All rights reserved.
Lee, Seunghoon; Won, Jinyoung; Park, Sookyoung; Lee, Sang-Rae; Chang, Kyu-Tae; Kim, Joo-Heon; Hong, Yonggeun
[Purpose] The purpose of the present review is to discuss recent published articles in the understanding of efficacy of interventional exercise on autistic Fragile X syndrome (FXS) with special emphasis on its significance in clinical application in patients. [Methods] This review article was identified scientifically and/or clinically relevant articles from PubMed that directly/indirectly met the inclusion criteria. [Results] Mutation of fragile X mental retardation 1 ( fmr1 ) gene on the X chromosome is related with loss of fragile X mental retardation protein (FMRP) that affecting physiological and behavioral abnormalities. Autistic FXS individuals exhibit disturbed sleep and altered circadian behavior. Although the underlying molecular mechanisms are not been fully explored, interventional exercise in autistic FXS has been clinically used for the treatment of physiological and behavioral abnormalities as well as psychiatric disorder in autistic FXS. [Conclusion] This review describes beneficial efficacy of interventional exercise and its controversy in patients with autistic FXS. This review also provides interventional strategies for clinicians and scientists that the way of neurophysiological approaches according to the level of physical and behavioral abnormalities.
Hough, David; Singh, Jaskaran; Karcher, Keith; Pandina, Gahan
Abstract Objective: The purpose of this study was to evaluate the long-term safety and efficacy of risperidone in treating irritability and related behaviors in children and adolescents with autistic disorders. Methods: In this 6 month (26 week) open-label extension (OLE) study, patients (5–17 years of age, who completed the previous fixed-dose, 6 week, double-blind [DB] phase) were flexibly dosed with risperidone based on body weight. The maximum allowed dose was 1.25 mg/day for those weighing 20 to risperidone's safety; efficacy was assessed as a secondary end-point. Results: Fifty-six (71%) out of 79 enrolled patients completed the OLE; the most common discontinuations were for insufficient response (7 [9%]) or adverse events (AE) (5 [6%]). The most common (≥5% frequency in the total group) AEs were increased appetite (11% [n=9]); increased weight and vomiting (9% [n=7] each); sedation, pyrexia, and upper respiratory tract infection (8% [n=6] each); nasopharyngitis (6% [n=5]); and somnolence and fatigue (5% [n=4] each). Extrapyramidal AEs were reported in 6 (8%) patients. Increase in mean weight (11–15%) and body mass index (5–10%) occurred; one patient discontinued because of weight increase. One potentially prolactin-related AE (irregular menstruation) was reported. The risperidone high-dose group had the greatest mean improvement in sleep visual analog scale (24.6). All groups showed additional improvement in efficacy scale scores during the OLE. Conclusions: During this OLE, safety findings with risperidone treatment (maximum weight-based dose of 1.25 mg/day or 1.75 mg/day) were consistent with those observed in the DB phase, and with the current safety information for risperidone in autistic, psychiatric, and behavioral disorders. Patients experienced some additional improvement in irritability and related behaviors. Clinical Trials Registry: This phase-4 study is registered at ClinicalTrials.gov (NCT00576732). PMID:24350813
Freitag, Christine M; Agelopoulos, Konstantin; Huy, Ellen; Rothermundt, Matthias; Krakowitzky, Petra; Meyer, Jobst; Deckert, Jürgen; von Gontard, Alexander; Hohoff, Christa
Autism spectrum disorders (ASDs) are heterogeneous disorders presenting with increased rates of anxiety. The adenosine A(2A) receptor gene (ADORA2A) is associated with panic disorder and is located on chromosome 22q11.23. Its gene product, the adenosine A(2A) receptor, is strongly expressed in the caudate nucleus, which also is involved in ASD. As autistic symptoms are increased in individuals with 22q11.2 deletion syndrome, and large 22q11.2 deletions and duplications have been observed in ASD individuals, in this study, 98 individuals with ASD and 234 control individuals were genotyped for eight single-nucleotide polymorphisms in ADORA2A. Nominal association with the disorder was observed for rs2236624-CC, and phenotypic variability in ASD symptoms was influenced by rs3761422, rs5751876 and rs35320474. In addition, association of ADORA2A variants with anxiety was replicated for individuals with ASD. Findings point toward a possible mediating role of ADORA2A variants on phenotypic expression in ASD that need to be replicated in a larger sample.
Vijay Kumar Ambaldhage
Full Text Available For maintenance of the health of an individual, taste sensation is very important. It is an important sensation that serves to assess the nutritious content of food, support oral intake, and prevent ingestion of potentially toxic substances. Disturbances in the perception of taste can lead to loss of appetite, causing malnutrition and thus distressing both the physical and psychological well-being of the patient. Oral physicians are often the first clinicians who hear complaints about alteration in taste from the patients. In spite of the effect of taste changes on health, literature on the diagnosis, pathogenesis, and precise treatment of taste disorders are less. Taste changes may lead patients to seek inappropriate dental treatments. Proper diagnosis of the etiology is the foremost step in the treatment of taste disorders. Thus, it is important that dental clinicians to be familiar with the various causes and proper management of taste changes. In this article, we have reviewed related articles focusing on taste disorders and their management, to provide a quick sketch for the clinicians. A detailed search was performed to identify the systematic reviews and research articles on taste disorders, using PUBMED and Cochrane. All the authors independently extracted data for analysis and review. Ultimately, 26 articles underwent a full text review. In conclusion, the research to date certainly offers us valid management strategies for taste disorders. Meanwhile, practical strategies with the highest success are needed for further intervention.
Ohan, Jeneva L; Ellefson, Sarah E; Corrigan, Patrick W
In the DSM-5, 'Asperger's Disorder' was incorporated into 'Autistic Spectrum Disorder' (ASD). One key concern in this change has been that the ASD label will increase negative attitudes relative to the Asperger's label. To test this, we asked 465 American adults to read a vignette describing a child with autistic symptoms that included an ASD label, an Asperger's label, or no label, and rate their stigma and treatment attitudes (help-seeking and perceived effectiveness). Contrary to predictions, label did not impact stigma. Label did impact treatment attitudes, with greater help-seeking and perceived treatment effectiveness for both Asperger's and ASD labels. In sum, concern that the ASD label will increase negative perceptions, at least amongst the general public, is not supported.
Nah, Yong-Hwee; Young, Robyn L; Brewer, Neil; Berlingeri, Genna
The Autism Detection in Early Childhood (ADEC; Young, 2007) was developed as a Level 2 clinician-administered autistic disorder (AD) screening tool that was time-efficient, suitable for children under 3 years, easy to administer, and suitable for persons with minimal training and experience with AD. A best estimate clinical Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) diagnosis of AD was made for 70 children using all available information and assessment results, except for the ADEC data. A screening study compared these children on the ADEC with 57 children with other developmental disorders and 64 typically developing children. Results indicated high internal consistency (α = .91). Interrater reliability and test-retest reliability of the ADEC were also adequate. ADEC scores reliably discriminated different diagnostic groups after controlling for nonverbal IQ and Vineland Adaptive Behavior Composite scores. Construct validity (using exploratory factor analysis) and concurrent validity using performance on the Autism Diagnostic Observation Schedule (Lord et al., 2000), the Autism Diagnostic Interview-Revised (Le Couteur, Lord, & Rutter, 2003), and DSM-IV-TR criteria were also demonstrated. Signal detection analysis identified the optimal ADEC cutoff score, with the ADEC identifying all children who had an AD (N = 70, sensitivity = 1.0) but overincluding children with other disabilities (N = 13, specificity ranging from .74 to .90). Together, the reliability and validity data indicate that the ADEC has potential to be established as a suitable and efficient screening tool for infants with AD. 2014 APA
Autism spectrum disorders (ASD) are neurodevelopmental disorders associated with disturbances in communication, social interactions, cognition and affect. ASD are also accompanied by complex movement disorders, including ataxia. A special focus of recent research in this area is made on the striatum and the cerebellum, two structures known not only to control movement but also to be involved in cognitive functions such as memory and language. Dysfunction within the motor system may be associated with abnormal movements in ASD that are translated into ataxia, abnormal pattern of righting, gait sequencing, development of walking, and hand positioning. This line of study may generate new knowledge and understanding of motor symptoms associated with ASD and aims to deliver fresh perspectives for early diagnosis and therapeutic strategies against ASD. Despite the relative paucity of research in this area (compared to the social, linguistic, and behavioural disturbances in ASD), there is evidence that the frontostriatal motor system and/or the cerebellar motor systems may be the site of dysfunction in ASD. Indeed, the cerebellum seems to be essential in the development of basic social capabilities, communication, repetitive/restrictive behaviors, and motor and cognitive behaviors that are all impaired in ASD. Cerebellar neuropathology including cerebellar hypoplasia and reduced cerebellar Purkinje cell numbers are the most consistent neuropathologies linked to ASD. The functional state of the cerebellum and its impact on brain function in ASD is the focus of this review. This review starts by recapitulating historical findings pointing towards an implication of the cerebellum, and to a lesser extent the basal ganglia structures, in TSA. We then detail the structure/function of the cerebellum at the regional and cellular levels before describing human and animal findings indicating a role of the cerebellum and basal ganglia in ASD. Several studies have attempted to
Irwanto; Rehatta, Nancy Margarita; Hartini, Sri; Takada, Satoshi
Sleep problems are associated with problems of cognitive functioning, learning, attention and school performance. It has been found that sleep problems are highly prevalent in children with Autistic spectrum disorders (ASD), with rates ranging from 40% to 80%. We aimed to identify the prevalence of sleep problems on children with ASD in Indonesia and Japan. A cross-sectional study was conducted in Surabaya, Indonesia and Kobe, Japan. Children aged 4 -10 years old were enrolled using stratified cluster sampling. Children's Sleep Habits Questionnaire-Abbreviated (CSHQ-A) was used in this research to assess the sleep problems, consisted of 22 questions (NICHD SECCYD-Wisconsin). Data were analyzed with Mann-Whitney U test to compare the CSHQ-A scores between Indonesian and Japanese children, while the proportion of sleep problems was evaluated by chi-square test with 95% confidence interval. Fifty children with ASD were included in this study, 25 children from Kobe, Japan and 25 children from Surabaya, Indonesia. The prevalence of sleep problems on children with ASD was 60% (15 children) in Indonesia and 16% (4 children) in Japan respectively. There were significant differences in total waking during the night and in morning wake for the CSHQ-A between children from Indonesia and Japan (psleep problems on children with ASD was higher in children from Indonesia than from Japan.
Dickinson, Kathleen; Place, Maurice
Problems with social functioning are a major area of difficulty for children with autism. Such problems have the potential to exert a negative influence on several aspects of the children's functioning, including their ability to access education. This study looked to examine if a computer-based activity program could improve the social functioning of these children. Using a pooled subject design, 100 children with autistic spectrum disorder were randomly allocated, controlling where possible for age and gender, to either an intervention or a control group. The children in the intervention group were encouraged to use the Nintendo (Kyoto, Japan) Wii™ and the software package "Mario & Sonic at the Olympics" in addition to their routine school physical education classes over a 9-month period. The control group attended only the routine physical education classes. After 1 year, analysis of the changes in the scores of teacher-completed measures of social functioning showed that boys in the intervention group had made statistically significant improvement in their functioning when compared with controls. The number of girls in the study was too small for any change to reach statistical significance. This type of intervention appears to have potential as a mechanism to produce improvement in the social functioning, at least of boys, as part of a physical education program.
Full Text Available O transtorno autista e o grupo de condições relacionadas definidas como transtornos invasivos do desenvolvimento são transtornos de neurodesenvolvimento crônicos que começam na infância precoce e afetam um número significativo de crianças e suas famílias. Ainda que as causas e muito da fisiopatologia do transtorno sejam desconhecidas, em anos recentes, vários tratamentos medicamentosos disponíveis têm sido identificados como contendo a promessa de aliviar alguns dos comportamentos mal-adaptativos mais comprometedores associados aos transtornos invasivos do desenvolvimento. No entanto, esses tratamentos não enfocam os sintomas nucleares da enfermidade e, geralmente, seus efeitos colaterais excedem os benefícios. Portanto, há uma necessidade substancial de novas medicações que sejam mais seguras e mais eficazes em tratar os sintomas comportamentais do autismo. O objetivo desta revisão é o de destacar as farmacoterapias correntes disponíveis e aquelas emergentes e que tenham potencial de melhorar as opções de tratamento de pacientes com transtornos invasivos do desenvolvimento.Autistic disorder and the group of related conditions defined as pervasive developmental disorders are chronic neurodevelopmental disorders starting in early childhood and affecting a significant number of children and families. Although the causes and much of the pathophysiology of the disorder remain unknown, in recent years a number of available medication treatments have been identified as holding promise in alleviating some of the most disabling maladaptive behaviors, associated with pervasive developmental disorders. However these treatments do not address the core symptoms of the disease and oftentimes their side effects outweigh their benefits. Therefore there is substantial need for new medications that are safer and more effective in addressing the behavior symptoms of autism. The aim of this review is to highlight the available current
Anketell, Pamela M; Saunders, Kathryn J; Gallagher, Stephen; Bailey, Clare; Little, Julie-Anne
Autistic Spectrum Disorder (ASD) is a common neurodevelopmental disorder characterised by impairment of communication, social interaction and repetitive behaviours. Only a small number of studies have investigated fundamental clinical measures of vision including refractive error. The aim of this study was to describe the refractive profile of a population of children with ASD compared to typically developing (TD) children. Refractive error was assessed using the Shin-Nippon NVision-K 5001 open-field autorefractor following the instillation of cyclopentolate hydrochloride 1% eye drops. A total of 128 participants with ASD (mean age 10.9 ± 3.3 years) and 206 typically developing participants (11.5 ± 3.1 years) were recruited. There was no significant difference in median refractive error, either by spherical equivalent or most ametropic meridian between the ASD and TD groups (Spherical equivalent, Mann-Whitney U307 = 1.15, p = 0.25; Most Ametropic Meridian, U305 = 0.52, p = 0.60). Median refractive astigmatism was -0.50DC (range 0.00 to -3.50DC) for the ASD group and -0.50DC (Range 0.00 to -2.25DC) for the TD group. Magnitude and prevalence of refractive astigmatism (defined as astigmatism ≥1.00DC) was significantly greater in the ASD group compared to the typically developing group (ASD 26%, TD 8%, magnitude U305 = 3.86, p = 0.0001; prevalence (χ12=17.71 , p refractive profile of a population of European Caucasian children with ASD compared to a TD population of children. Unlike other neurodevelopmental conditions, there was no increased prevalence of spherical refractive errors in ASD but astigmatic errors were significantly greater in magnitude and prevalence. This highlights the need to examine refractive errors in this population. © 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.
Cooper, Miriam; Thapar, Anita; Jones, Derek K.
Traits of autism spectrum disorder (ASD) in children with attention-deficit/hyperactivity disorder (ADHD) have previously been found to index clinical severity. This study examined the association of ASD traits with diffusion parameters in adolescent males with ADHD (n = 17), and also compared WM microstructure relative to controls (n = 17).…
Amin, Noor A.; Oweini, Ahmad
The purpose of this case study was to determine the effectiveness of a combined intervention in remediating the social skills in a first-grader with a disorder from the autism spectrum disorders (ASDs). The researcher also aimed to identify the changes observed during the intervention period. The combined intervention consisted of reading…
Lawson, Rebecca P; Aylward, Jessica; Roiser, Jonathan P; Rees, Geraint
Perceptual constancy strongly relies on adaptive gain control mechanisms, which shift perception as a function of recent sensory history. Here we examined the extent to which individual differences in magnitude of adaptation aftereffects for social and non-social directional cues are related to autistic traits and sensory sensitivity in healthy participants (Experiment 1); and also whether adaptation for social and non-social directional cues is differentially impacted in adults with Autism Spectrum Disorder (ASD) relative to neurotypical (NT) controls (Experiment 2). In Experiment 1, individuals with lower susceptibility to adaptation aftereffects, i.e. more 'veridical' perception, showed higher levels of autistic traits across social and non-social stimuli. Furthermore, adaptation aftereffects were predictive of sensory sensitivity. In Experiment 2, only adaptation to eye-gaze was diminished in adults with ASD, and this was related to difficulties categorizing eye-gaze direction at baseline. Autism Diagnostic Observation Schedule (ADOS) scores negatively predicted lower adaptation for social (head and eye-gaze direction) but not non-social (chair) stimuli. These results suggest that the relationship between adaptation and the broad socio-cognitive processing style captured by 'autistic traits' may be relatively domain-general, but in adults with ASD diminished adaptation is only apparent where processing is most severely impacted, such as the perception of social attention cues. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available So far no standardized screening instrument for autism spectrum disorders for adults has been developed in Poland. The main aim of the study was to explore the properties of the Polish version of the Autism-Spectrum Quotient (AQ, especially its reliability and discriminating power. The second purpose was to establish whether the pattern of sex and area of study differences in the amount of autistic traits found in other countries also exist in Poland. The groups in the study included students (n = 2819, adults with ASD (n = 60 and a non-clinical sample (n = 60 matched with the ASD group for age, sex, education and place of residence. The Polish version of AQ proved to be reliable, although--as in studies conducted in other countries--the internal consistency coefficients for subscales (with exception for social skill were low. ASD diagnosis was the most powerful determinant of AQ scores. Sex differences in autistic traits and a relationship between autistic traits and area of study were found.
Delli, Konstantina; Reichart, Peter A.; Bornstein, Michael M.; Livas, Christos
Objectives: This article reviews the present literature on the issues encountered while coping with children with autistic spectrum disorder from the dental perspective. The autistic patient profile and external factors affecting the oral health status of this patient population are discussed upon the existing body of evidence. Material and Methods: The MEDLINE database was searched using the terms ?Autistic Disorder?, ?Behaviour Control/methods?, ?Child?, ?Dental care for disabled?, ?Educati...
Jou, Roger J; Minshew, Nancy J; Keshavan, Matcheri S; Hardan, Antonio Y
The validity of Asperger disorder as a distinct syndrome from autism is unclear partly because of the paucity of differentiating neurobiological evidence. Frontal lobe cortical folding between these disorders was compared using the gyrification index. Twenty-three boys underwent structural magnetic resonance imaging: 6 with high-functioning autism, 9 with Asperger disorder, and 8 controls. Using the first coronal slice anterior to the corpus callosum, total and outer cortical contours were traced to calculate the gyrification index. This index was also calculated for superior and inferior regions to examine dorsolateral prefrontal and orbitofrontal cortices, respectively. Analysis of variance revealed differences in the left inferior gyrification index, which was higher in the autism group compared with Asperger and control groups. There were no differences in age, intelligence quotient, and brain volume. These preliminary findings suggest that cortical folding may be abnormally high in the frontal lobe in autism but not Asperger disorder, suggesting distinct frontal lobe neuropathology.
Ishitobi, Makoto; Kawatani, Masao; Asano, Mizuki; Kosaka, Hirotaka; Goto, Takashi; Hiratani, Michio; Wada, Yuji
Bipolar disorder (BD) has been linked with the manifestation of catatonia in subjects with autism spectrum disorders (ASD). Idiopathic basal ganglia calcification (IBGC) is characterized by movement disorders and various neuropsychiatric disturbances including mood disorder. We present a patient with ASD and IBGC who developed catatonia presenting with prominent dystonic feature caused by comorbid BD, which was treated effectively with quetiapine. In addition to considering the possibility of neurodegenerative disease, careful psychiatric interventions are important to avoid overlooking treatable catatonia associated with BD in cases of ASD presenting with both prominent dystonic features and apparent fluctuation of the mood state. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
Jou, Roger J.; Minshew, Nancy J.; Keshavan, Matcheri S.; Hardan, Antonio Y.
The validity of Asperger disorder as a distinct syndrome from autism is unclear partly due to the paucity of differentiating neurobiological evidence. Frontal lobe cortical folding between these disorders was compared using the gyrification index. Twenty-three boys underwent structural magnetic resonance imaging: six with high-functioning autism, nine with Asperger disorder, and eight controls. Using the first coronal slice anterior to the corpus callosum, total and outer cortical contours were traced to calculate the gyrification index. This index was also calculated for superior and inferior regions to examine dorsolateral prefrontal and orbitofrontal cortices, respectively. Analysis of variance revealed differences in the left inferior gyrification index, which was higher in the autism group compared to Asperger and control groups. There were no differences in age, intelligence quotient, and brain volume. These preliminary findings suggest that cortical folding may be abnormally high in the frontal lobe in autism but not Asperger disorder, suggesting distinct frontal lobe neuropathology. PMID:20413799
Brewer, Rebecca; Biotti, Federica; Catmur, Caroline; Press, Clare; Happé, Francesca; Cook, Richard; Bird, Geoffrey
The difficulties encountered by individuals with autism spectrum disorder (ASD) when interacting with neurotypical (NT, i.e. nonautistic) individuals are usually attributed to failure to recognize the emotions and mental states of their NT interaction partner. It is also possible, however, that at least some of the difficulty is due to a failure of NT individuals to read the mental and emotional states of ASD interaction partners. Previous research has frequently observed deficits of typical facial emotion recognition in individuals with ASD, suggesting atypical representations of emotional expressions. Relatively little research, however, has investigated the ability of individuals with ASD to produce recognizable emotional expressions, and thus, whether NT individuals can recognize autistic emotional expressions. The few studies which have investigated this have used only NT observers, making it impossible to determine whether atypical representations are shared among individuals with ASD, or idiosyncratic. This study investigated NT and ASD participants' ability to recognize emotional expressions produced by NT and ASD posers. Three posing conditions were included, to determine whether potential group differences are due to atypical cognitive representations of emotion, impaired understanding of the communicative value of expressions, or poor proprioceptive feedback. Results indicated that ASD expressions were recognized less well than NT expressions, and that this is likely due to a genuine deficit in the representation of typical emotional expressions in this population. Further, ASD expressions were equally poorly recognized by NT individuals and those with ASD, implicating idiosyncratic, rather than common, atypical representations of emotional expressions in ASD. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.
Conti, Eugenia; Calderoni, Sara; Marchi, Viviana; Muratori, Filippo; Cioni, Giovanni; Guzzetta, Andrea
There is overwhelming evidence that autism spectrum disorder (ASD) is related to altered brain connectivity. While these alterations are starting to be well characterized in subjects where the clinical picture is fully expressed, less is known on their earlier developmental course. In the present study we systematically reviewed current knowledge on structural connectivity in ASD infants and toddlers. We searched PubMed and Medline databases for all English language papers, published from year 2000, exploring structural connectivity in populations of infants and toddlers whose mean age was below 30 months. Of the 264 papers extracted, four were found to be eligible and were reviewed. Three of the four selected studies reported higher fractional anisotropy values in subjects with ASD compared to controls within commissural fibers, projections fibers, and association fibers, suggesting brain hyper-connectivity in the earliest phases of the disorder. Similar conclusions emerged from the other diffusion parameters assessed. These findings are reversed to what is generally found in studies exploring older patient groups and suggest a developmental course characterized by a shift toward hypo-connectivity starting at a time between two and four years of age.
Lortie, Melissa; Proulx-Bégin, Léa; Saint-Amour, Dave; Cousineau, Dominique; Théoret, Hugo; Lepage, Jean-François
There is debate whether social impairments in autism spectrum disorder (ASD) are truly domain-specific, or if they reflect generalized deficits in lower-level cognitive processes. To solve this issue, we used auditory-evoked EEG responses to assess novelty detection (MMN component) and involuntary attentional orientation (P3 component) induced by…
Wolters, Lidewij H.; de Haan, Else; Hogendoorn, Sanne M.; Boer, Frits; Prins, Pier J. M.
Clinical consensus exists on the recommendation to add medication to cognitive behavioral therapy (CBT) for children with moderate to severe obsessive compulsive disorder (OCD). However, it has never been examined if CBT monotherapy indeed is less effective for this subgroup. In addition, CBT is
Antshel, Kevin M.; Aneja, Alka; Strunge, Leslie; Peebles, Jena; Fremont, Wanda P.; Stallone, Kimberly; AbdulSabur, Nuria; Higgins, Anne Marie; Shprintzen, Robert J.; Kates, Wendy R.
The extent to which the phenotype of children comorbid for velocardiofacial syndrome (VCFS) and autism spectrum disorders (ASD) differs from that of VCFS-only has not been studied. The sample consisted of 41 children (20 females) with VCFS, ranging in age from 6.5 years to 15.8 years. Eight children with VCFS met formal DSM-IV diagnostic criteria…
Da Fonseca, David; Santos, Andreia; Bastard-Rosset, Delphine; Rondan, Cecilie; Poinso, Francois; Deruelle, Christine
The aim of the present study was to determine whether children with autism spectrum disorders (ASD) are able to recognize facial expressions of emotion and objects missing on the basis of contextual cues. While most of these studies focused on facial emotion recognition, here we examined the ability to extract emotional information on the basis…
Norbury, Courtenay Frazier; Brock, Jon; Cragg, Lucy; Einav, Shiri; Griffiths, Helen; Nation, Kate
Background: Investigations using eye-tracking have reported reduced fixations to salient social cues such as eyes when participants with autism spectrum disorders (ASD) view social scenes. However, these studies have not distinguished different cognitive phenotypes. Methods: The eye-movements of 28 teenagers with ASD and 18 typically developing…
Garofoli, Francesca; Lombardi, Giuseppina; Orcesi, Simona; Pisoni, Camilla; Mazzucchelli, Iolanda; Angelini, Micol; Balottin, Umberto; Stronati, Mauro
The aim of this retrospective study, with prospective data collection, was to correlate congenital cytomegalovirus (CMV) infection with autism spectrum disorder (ASD) and to define its prevalence. Seventy proven congenitally-infected infants, born between 2007 and 2012, were referred to our centre for CMV diagnosis and follow-up, which consisted…
Cook, Edwin H., Jr.; And Others
Forty-two parents of children with autistic disorder, 15 children with autistic disorder, 17 siblings of children with autistic disorder, and 12 unrelated normal controls were studied for binding characteristics of their immunoglobulins. Results did not support the hypothesis that two specific autoantibodies are characteristic of autism.…
Full Text Available The ketogenic diet (KGD has been recognized as an effective treatment for individuals with glucose transporter 1 (GLUT1 and pyruvate dehydrogenase (PDH deficiencies as well as with epilepsy. More recently, its use has been advocated in a number of neurological disorders prompting a newfound interest in its possible therapeutic use in Autism Spectrum Disorders (ASD. One study and one case report indicated that children with ASD treated with a KGD showed decreased seizure frequencies and exhibited behavioral improvements (i.e., improved learning abilities and social skills. The KGD could benefit individuals with ASD affected with epileptic episodes as well those with either PDH or mild RC (respiratory chain Complex deficiencies. Given that the mechanism of action of the KGD is not fully understood, caution should be exercised in ASD cases lacking a careful biochemical and metabolic characterization to avoid deleterious side effects or refractory outcomes.
Grayson, Dennis R; Guidotti, Alessandro
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that is characterized by a wide range of cognitive and behavioral abnormalities. Genetic research has identified large numbers of genes that contribute to ASD phenotypes. There is compelling evidence that environmental factors contribute to ASD through influences that differentially impact the brain through epigenetic mechanisms. Both genetic mutations and epigenetic influences alter gene expression in different cell types of the brain. Mutations impact the expression of large numbers of genes and also have downstream consequences depending on specific pathways associated with the mutation. Environmental factors impact the expression of sets of genes by altering methylation/hydroxymethylation patterns, local histone modification patterns and chromatin remodeling. Herein, we discuss recent developments in the research of ASD with a focus on epigenetic pathways as a complement to current genetic screening.
Sacco, Roberto; Gabriele, Stefano; Persico, Antonio M
Macrocephaly and brain overgrowth have been associated with autism spectrum disorder. We performed a systematic review and meta-analysis to provide an overall estimate of effect size and statistical significance for both head circumference and total brain volume in autism. Our literature search strategy identified 261 and 391 records, respectively; 27 studies defining percentages of macrocephalic patients and 44 structural brain imaging studies providing total brain volumes for patients and controls were included in our meta-analyses. Head circumference was significantly larger in autistic compared to control individuals, with 822/5225 (15.7%) autistic individuals displaying macrocephaly. Structural brain imaging studies measuring brain volume estimated effect size. The effect size is higher in low functioning autistics compared to high functioning and ASD individuals. Brain overgrowth was recorded in 142/1558 (9.1%) autistic patients. Finally, we found a significant interaction between age and total brain volume, resulting in larger head circumference and brain size during early childhood. Our results provide conclusive effect sizes and prevalence rates for macrocephaly and brain overgrowth in autism, confirm the variation of abnormal brain growth with age, and support the inclusion of this endophenotype in multi-biomarker diagnostic panels for clinical use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Rudra, Alokananda; Belmonte, Matthew K; Soni, Parmeet Kaur; Banerjee, Saoni; Mukerji, Shaneel; Chakrabarti, Bhismadev
Despite housing ∼18% of the world's population, India does not yet have an estimate of prevalence of autism. This study was carried out to estimate the prevalence of autism in a selected population of school-children in India. N = 11,849 children (mean age = 5.9 [SD = 1.3], 39.5% females) were selected from various school types from three boroughs in Kolkata, India. Parents/caregivers and teachers filled in the social and communication disorders checklist (SCDC). Children meeting cutoff on parent-reported SCDC were followed up with the social communication questionnaire (SCQ). SCQ-positive children were administered the autism diagnostic observation schedule (ADOS). Teacher report on SCDC was available on all 11,849 children. Parent-report SCDC scores were obtained for 5,947 children. Mean scores on teacher SCDC were significantly lower than parent SCDC. Out of 1,247 SCDC-positive children, 882 answered the SCQ, of whom 124 met the cutoff score of 15. Six of these children met criteria for autism, autism spectrum disorder (ASD), or broader autism spectrum on the ADOS. The weighted estimate of supra-threshold SCQ scores was 3.54% (CI: 2.88-4.3%). The weighted prevalence estimate of positive scores (for broader autism spectrum + ASD + autism) was 0.23% (0.07-0.46%). As ∼20% children in this state are known to be out of the school system, and ASD prevalence is likely to be higher in this group, this estimate is likely to represent the lower-bound of the true prevalence. This study provides preliminary data on the prevalence of broader-spectrum autism and supra-threshold autistic traits in a population sample of school children in Eastern India. Autism Res 2017, 10: 1597-1605. ©2017 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research. © 2017 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.
Morozov S.A.Morozova T.I.
Full Text Available Children with autism spectrum disorders are considered a highly heterogeneous group by clinical signs, which makes it impossible to develop a common method of correctional and educational development for them. In this article, results of an analysis of clinical, psychological and pedagogic polymorphism in autism spectrum disorders are shown, emphasized are its main components and basic consequences necessary for organizing education. Results are viewed in the context of the principle of variability in education. A dual structure of variability in education of autistic children has been discovered. Shortly reviewed are some topical problems of correctional education process for autism spectrum disorders
Garofoli, Francesca; Lombardi, Giuseppina; Orcesi, Simona; Pisoni, Camilla; Mazzucchelli, Iolanda; Angelini, Micol; Balottin, Umberto; Stronati, Mauro
The aim of this retrospective study, with prospective data collection, was to correlate congenital cytomegalovirus (CMV) infection with autism spectrum disorder (ASD) and to define its prevalence. Seventy proven congenitally-infected infants, born between 2007 and 2012, were referred to our centre for CMV diagnosis and follow-up, which consisted of a consolidated protocol allowing an early evaluation of autism. We considered four children 2-year old, two of whom, at the age of 3, were diagnosed with ASD demonstrating a 2-3 fold higher prevalence (2.86%), than that in general Italian population (0.66-1.36%).Our protocol enabled us to make the earliest diagnosis and highlight the role of the virus among other causes of autism, which may be a long term sequela of congenital CMV.
Cukier, Sebastián H
Autism constitutes one of the most investigated disorders in child psychiatry. The heterogeneous clinical phenomena that characterize it have been exhaustibly described along the last 62 years. Multiple aetiological hypothesis, neuropsychological theories and physiopathological mechanisms, sometimes complementary and other times mutually exclusive, and different descriptions of neurobiological alterations that resulted, in general, of low replicability, have attempted to account for the marked variability of its manifestations. An integration of these different levels of analysis results even harder than the comprehension of each of them separately. In this article the author revises the three aspects considered the most characteristic of the syndrome (social interaction, communication and flexibility) and tries to integrate its clinical manifestations with some neuropsychological variables and the neurobiological substrates.
Vanderkerken, Lien; Heyvaert, Mieke; Maes, Bea; Onghena, Patrick
Vocal challenging behavior (VCB) forms a common problem in individuals with autistic disorder. Since VCB is associated with negative outcomes for the individual and his or her environment, it is important to know how to manage this type of CB. To evaluate the effectiveness of several psychosocial interventions applied to decrease VCB in individuals with autistic disorder, we conducted a meta-analysis of single-case experiments (SCEs). Fifty-two SCEs, including 74 participants, were combined using a multilevel meta-analysis. The overall treatment effect was large and statistically significant. However, the effect varied significantly over the included studies and participants. Examining this variance, evidence was found for a moderator effect of VCB type and intervention type, with, on average, the largest effects for interventions used to reduce VCB including stereotypical VCB and for interventions containing both antecedent and consequence components. Age, gender, primary treatment setting, publication year, and study quality did not significantly moderate the intervention effect. Copyright © 2013 Elsevier Ltd. All rights reserved.
Richard E. Frye
Full Text Available Treatments targeting metabolic abnormalities in children with autism are limited. Previously we reported that a nutritional treatment significantly improved glutathione metabolism in children with autistic disorder. In this study we evaluated changes in adaptive behaviors in this cohort and determined whether such changes are related to changes in glutathione metabolism. Thirty-seven children diagnosed with autistic disorder and abnormal glutathione and methylation metabolism were treated with twice weekly 75 µg/Kg methylcobalamin and twice daily 400 µg folinic acid for 3 months in an open-label fashion. The Vineland Adaptive Behavior Scale (VABS and glutathione redox metabolites were measured at baseline and at the end of the treatment period. Over the treatment period, all VABS subscales significantly improved with an average effect size of 0.59, and an average improvement in skills of 7.7 months. A greater improvement in glutathione redox status was associated with a greater improvement in expressive communication, personal and domestic daily living skills, and interpersonal, play-leisure, and coping social skills. Age, gender, and history of regression did not influence treatment response. The significant behavioral improvements observed and the relationship between these improvements to glutathione redox status suggest that nutritional interventions targeting redox metabolism may benefit some children with autism.
Frye, Richard E; Melnyk, Stepan; Fuchs, George; Reid, Tyra; Jernigan, Stefanie; Pavliv, Oleksandra; Hubanks, Amanda; Gaylor, David W; Walters, Laura; James, S Jill
Treatments targeting metabolic abnormalities in children with autism are limited. Previously we reported that a nutritional treatment significantly improved glutathione metabolism in children with autistic disorder. In this study we evaluated changes in adaptive behaviors in this cohort and determined whether such changes are related to changes in glutathione metabolism. Thirty-seven children diagnosed with autistic disorder and abnormal glutathione and methylation metabolism were treated with twice weekly 75 µg/Kg methylcobalamin and twice daily 400 µg folinic acid for 3 months in an open-label fashion. The Vineland Adaptive Behavior Scale (VABS) and glutathione redox metabolites were measured at baseline and at the end of the treatment period. Over the treatment period, all VABS subscales significantly improved with an average effect size of 0.59, and an average improvement in skills of 7.7 months. A greater improvement in glutathione redox status was associated with a greater improvement in expressive communication, personal and domestic daily living skills, and interpersonal, play-leisure, and coping social skills. Age, gender, and history of regression did not influence treatment response. The significant behavioral improvements observed and the relationship between these improvements to glutathione redox status suggest that nutritional interventions targeting redox metabolism may benefit some children with autism.
Botbol, Michel; Cabon, Philippe; Kermarrec, Solenn; Tordjman, Sylvie
Biological rhythms are crucial phenomena that are perfect examples of the adaptation of organisms to their environment. A considerable amount of work has described different types of biological rhythms (from circadian to ultradian), individual differences in their patterns and the complexity of their regulation. In particular, the regulation and maturation of the sleep-wake cycle have been thoroughly studied. Its desynchronization, both endogenous and exogenous, is now well understood, as are its consequences for cognitive impairments and health problems. From a completely different perspective, psychoanalysts have shown a growing interest in the rhythms of psychic life. This interest extends beyond the original focus of psychoanalysis on dreams and the sleep-wake cycle, incorporating central theoretical and practical psychoanalytic issues related to the core functioning of the psychic life: the rhythmic structures of drive dynamics, intersubjective developmental processes and psychic containment functions. Psychopathological and biological approaches to the study of infantile autism reveal the importance of specific biological and psychological rhythmic disturbances in this disorder. Considering data and hypotheses from both perspectives, this paper proposes an integrative approach to the study of these rhythmic disturbances and offers an etiopathogenic hypothesis based on this integrative approach. Copyright © 2013 Elsevier Ltd. All rights reserved.
Stephen W Porges
Full Text Available Auditory hypersensitivities are a common feature of autism spectrum disorder (ASD. In the present study the effectiveness of a novel intervention, the Listening Project Protocol (LPP was evaluated in two trials conducted with children diagnosed with ASD. LPP was developed to reduce auditory hypersensitivities. LPP is based on a theoretical neural exercise model that uses computer altered acoustic stimulation to recruit the neural regulation of middle ear muscles. Features of the intervention stimuli were informed by basic research in speech and hearing sciences that has identified the specific acoustic frequencies necessary to understand speech, which must pass through middle ear structures before being processed by other components of the auditory system. LPP was hypothesized to reduce auditory hypersensitivities by increasing the neural tone to the middle ear muscles to functionally dampen competing sounds in frequencies lower than human speech. The trials demonstrated that LPP, when contrasted to control conditions, selectively reduced auditory hypersensitivities. These findings are consistent with the Polyvagal Theory, which emphasizes the role of the middle ear muscles in social communication.
Full Text Available Introduction: Prevalence of autism spectrum disorders (ASD worldwide shows a significant rise. Screening and early diagnosis are extremely important and provide a possibility for an early intervention. Objectives: This study is a part of validation process for a Serbian translation of Modified Checklist for Autism in Toddlers, Revised with Follow-up (MCHAT- R/F. Another aim was to analyse the risk factors which are associated with the development of ASD. Methods: The study included parents of toddlers aged 16 to 30 months during a well-child care visits in Dom zdravlja Savski venac and parents of toddlers sent to see a psychiatrist in Institute for mental health (IMH. Children were screened using the M-CHATR/ F. Results: The study included 65 toddlers. The ones screened in Dom zdravlja were placed in a low-risk group, and others who were referred to IMH were classified as high-risk group. Comparing these two groups no statistically significant difference was found in terms of children's age or parents' age at birth. Statistically significant difference was found in terms of gestational week at birth, and significantly higher incidence of pregnancy complications in high-risk group. Conclusion: Further investigation should completely examine the psychometric characteristics of M-CHAT, but the preliminary findings show that M-CHAT can detect many cases of ASD during a routine pediatrician examination. Some prenatal and perinatal factors such as pregnancy complications and gestational age at birth can lead to increased risk of developing ASD.
Porges, Stephen W; Bazhenova, Olga V; Bal, Elgiz; Carlson, Nancy; Sorokin, Yevgeniya; Heilman, Keri J; Cook, Edwin H; Lewis, Gregory F
Auditory hypersensitivities are a common feature of autism spectrum disorder (ASD). In the present study, the effectiveness of a novel intervention, the listening project protocol (LPP), was evaluated in two trials conducted with children diagnosed with ASD. LPP was developed to reduce auditory hypersensitivities. LPP is based on a theoretical "neural exercise" model that uses computer altered acoustic stimulation to recruit the neural regulation of middle ear muscles. Features of the intervention stimuli were informed by basic research in speech and hearing sciences that has identified the specific acoustic frequencies necessary to understand speech, which must pass through middle ear structures before being processed by other components of the auditory system. LPP was hypothesized to reduce auditory hypersensitivities by increasing the neural tone to the middle ear muscles to functionally dampen competing sounds in frequencies lower than human speech. The trials demonstrated that LPP, when contrasted to control conditions, selectively reduced auditory hypersensitivities. These findings are consistent with the polyvagal theory, which emphasizes the role of the middle ear muscles in social communication.
Rohmani Nur Indah
Full Text Available This research focuses on the semantics acquisition of a child with language delay diagnosed as autistic spectrum disorder (ASD. The research problem is on how the child acquired the ability to comprehend meaning. It aims at answering the questions on how the child identified lexical meanings and how he labeled targeted lexicons of his first language. The approach employed in this research is descriptive qualitative to get adequate explanation on a specific language phenomenon, namely semantics acquisition. Its design is case study with the type neo-ethnographic. As the data collection method, it uses participant observation of longitudinal study considering that the research subject has familial relation with the researcher. The data analysis shows that the semantic acquisition of the research subject has complexity in vocabulary enrichment. The research subject often performs echolalic speech when he is asked to identify or label certain object given. The typical idiosyncratic speech is shown by the unique feature of limited syllable and prosody. In general, his ability to identify lexical meanings is far exceeding his ability to label objects. He also has sensitivity to perceive the non-verbal symbol performed by the people he knows well. The use of verbal language supported by non-verbal language facilitates his perception. He finds it difficult to comprehend the lexicons having similar sound as he assumes that one lexicon represents one object which typically belongs to concrete object. In addition, the ability of the research subject in labeling objects cannot be developed easily because of his difficulty in expressing ideas through words. To pronounce the words correctly, he shows high anxiety by lowering down his speech. In selecting the lexicon he also finds it hard to use pronoun, to label homonyms and to apply both polysemy and hyponym. Accordingly, he tends to communicate only to fulfill his needs by asking things, asking the
Sommer, Monika; Döhnel, Katrin; Jarvers, Irina; Blaas, Lore; Singer, Manuela; Nöth, Victoria; Schuwerk, Tobias; Rupprecht, Rainer
A central diagnostic criteria for autism spectrum disorder (ASD) is the qualitative impairment in reciprocal social interaction and a prominent hypotheses that tried to explain this impairment is the Theory of Mind (ToM) deficit hypotheses. On a behavioral level the critical test for having a ToM, the understanding of false beliefs (FB), is often used for testing ToM abilities in individuals with ASD. Investigating the neural underpinnings several neuroimaging studies revealed a network of areas involved in FB reasoning in neurotypical individuals. For ASD individuals the neural correlates of false belief processing are largely unknown. Using functional magnetic resonance imaging and an adapted unexpected transfer task, that makes it possible to distinguish between the computation of diverging beliefs and the selection of a belief-associated response, we investigated a group of adult high-functioning individuals with ASD (N = 15) and an age and IQ matched group of neurotypical adults (NT; N = 15). On the behavioral level we found no group differences. On the neural level, results were two-fold: In the story phase, in which participants had to compute whether the character's belief is congruent or incongruent to their own belief, there were no differences between neurotypical participants and those diagnosed with ASD. But, in the subsequent question phase, participants with ASD showed increased activity in the bilateral anterior prefrontal cortex, the left posterior frontal cortex, the left superior temporal gyrus, and the left temporoparietal area. These results suggest that during the story phase in which the participants processed observable actions the neural correlates do not differ between adult individuals with ASD and NT individuals. But in the question phase in which participants had to infer an unobservable mental state results revealed neural differences between the two groups. Possibly, these subtle neural processing differences may contribute to the
Stanley-Cary, Chloe; Rinehart, Nicole; Tonge, Bruce; White, Owen; Fielding, Joanne
It remains unclear whether autism and Asperger's disorder (AD) exist on a symptom continuum or are separate disorders with discrete neurobiological underpinnings. In addition to impairments in communication and social cognition, motor deficits constitute a significant clinical feature in both disorders. It has been suggested that motor deficits and in particular the integrity of cerebellar modulation of movement may differentiate these disorders. We used a simple volitional saccade task to comprehensively profile the integrity of voluntary ocular motor behaviour in individuals with high functioning autism (HFA) or AD, and included measures sensitive to cerebellar dysfunction. We tested three groups of age-matched young males with normal intelligence (full scale, verbal, and performance IQ estimates >70) aged between 11 and 19 years; nine with AD, eight with HFA, and ten normally developing males as the comparison group. Overall, the metrics and dynamics of the voluntary saccades produced in this task were preserved in the AD group. In contrast, the HFA group demonstrated relatively preserved mean measures of ocular motricity with cerebellar-like deficits demonstrated in increased variability on measures of response time, final eye position, and movement dynamics. These deficits were considered to be consistent with reduced cerebellar online adaptation of movement. The results support the notion that the integrity of cerebellar modulation of movement may be different in AD and HFA, suggesting potentially differential neurobiological substrates may underpin these complex disorders.
Pervasive Developmental Disorders (PPD) refers to the group of disorders characterised by delayed or inappropriate development of multiple basic functions including socialisation, communication, behaviour and cognitive functioning. The term „autistic spectrum disorders” was established as a result of the magnitude of the intensity of symptoms and their proportions observed in all types of pervasive developmental disorders. Asperger’s Syndrome (AS) remains the most controversial diagnosis in t...
Halsey, N A; Hyman, S L
Parents and physicians are understandably concerned about the causes and treatment of autism, a devastating disease that affects the entire family. Although much has been learned about autism, there are many gaps in our knowledge about what causes the disorder and how it can be prevented. Autistic symptoms occur along a spectrum, often referred to as autistic spectrum disorder (ASD). Concern has been raised about a possible association between measles-mumps-rubella (MMR) vaccine and inflammatory bowel disease (IBD) and ASD, especially autism with regression. Also, increased requests for educational services related to ASD have raised concerns about possible increases in the incidence of ASD. On June 12-13, 2000, the American Academy of Pediatrics (AAP) convened a conference titled "New Challenges in Childhood Immunizations" in Oak Brook, Illinois. At this conference, parents, practitioners, and scientists presented information and research on MMR vaccine and ASD. Attendees included representatives from select AAP committees and sections as well as federal and other organizations that address related issues. The multidisciplinary panel of experts reviewed data on what is known about the pathogenesis, epidemiology, and genetics of ASD and the available data on hypothesized associations with IBD, measles, and MMR vaccine. Supplemental information was requested from authors who have proposed the hypotheses and other experts in relevant areas. Autism is a complex disorder of uncertain and probably multiple etiologies. Genetic predisposition to ASD may involve as many as 10 genes. Many experts believe that the abnormal brain development in autism occurs before 30 weeks' gestation in most instances. In utero rubella is a known cause of autism. Animal model data support the biologic plausibility that exposure to yet unrecognized infectious or other environmental agents could cause ASD. Several factors may contribute to apparent increases in incidence of ASD in recent years
Title: Developmental coordination disorder - literature review Objectives: The theoretical part talks about developmental coordination disorder, its diagnosis, investigations, etiology and division during the different ages of the child. The practical part compares the studies relating to atypical development of motor skills in children with developmental coordination disorder. In diploma thesis was often used shortcut CKP and DCD, depending on the source from which it was drawn. DCD is the E...
Omega-3 and Omega-6 Polyunsaturated Fatty Acid Levels and Correlations with Symptoms in Children with Attention Deficit Hyperactivity Disorder, Autistic Spectrum Disorder and Typically Developing Controls.
Full Text Available There is evidence that children with Attention Deficit Hyperactivity Disorder (ADHD and Autistic Spectrum Disorder (ASD have lower omega-3 polyunsaturated fatty acid (n-3 PUFA levels compared with controls and conflicting evidence regarding omega-6 (n-6 PUFA levels.This study investigated whether erythrocyte n-3 PUFAs eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA were lower and n-6 PUFA arachidonic acid (AA higher in children with ADHD, ASD and controls, and whether lower n-3 and higher n-6 PUFAs correlated with poorer scores on the Australian Twin Behaviour Rating Scale (ATBRS; ADHD symptoms and Test of Variable Attention (TOVA in children with ADHD, and Childhood Autism Rating Scale (CARS in children with ASD.Assessments and blood samples of 565 children aged 3-17 years with ADHD (n = 401, ASD (n = 85 or controls (n = 79 were analysed. One-way ANOVAs with Tukey's post-hoc analysis investigated differences in PUFA levels between groups and Pearson's correlations investigated correlations between PUFA levels and ATBRS, TOVA and CARS scores.Children with ADHD and ASD had lower DHA, EPA and AA, higher AA/EPA ratio and lower n-3/n-6 than controls (P<0.001 except AA between ADHD and controls: P = 0.047. Children with ASD had lower DHA, EPA and AA than children with ADHD (P<0.001 for all comparisons. ATBRS scores correlated negatively with EPA (r = -.294, P<0.001, DHA (r = -.424, P<0.001, n-3/n-6 (r = -.477, P<0.001 and positively with AA/EPA (r = .222, P <.01. TOVA scores correlated positively with DHA (r = .610, P<0.001, EPA (r = .418, P<0.001 AA (r = .199, P<0.001, and n-3/n-6 (r = .509, P<0.001 and negatively with AA/EPA (r = -.243, P<0.001. CARS scores correlated significantly with DHA (r = .328, P = 0.002, EPA (r = -.225, P = 0.038 and AA (r = .251, P = 0.021.Children with ADHD and ASD had low levels of EPA, DHA and AA and high ratio of n-6/n-3 PUFAs and these correlated significantly with symptoms. Future research should further
Luschekina, E A; Strelets, V B
Autism, like schizophrenia, are heterogeneous diseases, which are directed by both genetic factors and external influences in the early stages of development. Knowledge about the similarities and differences of these disorders can help early diagnosis and treatment. Patients with autism have specific cognitive difficulties in social relations. They are characterized by impairment of social interaction, communication and behavioral flexibility. The severity of the delay the development of autistic children, clinical and psychological indicators is correlated with an increase in the high frequency of spontaneous EEG activity. Cognitive task in autistic children, unlike normal persons, does not lead to a significant restructuring of high-frequency EEG activity, which may be a violation of the reaction mechanism to external stimuli and behavioral disorders. Abnormality in high-frequency components of EEG reactivity on cognitive task, the perception of human faces and visual illusions as well as the inadequate system of mirror neurons, can be considered common mechanisms underlying disorders of autism and schizophrenia. These general mechanisms may be considered as related to violation of the inhibition-exitation balance, controlled via GABA-transmission and NMDA-receptors. A multidimensional study of patterns of disontogenesis in autism, in addition to detailing the clinical picture of disease and rehabilitation activities, allows us to clear the fundamental understanding of the brain.
Lesinskiene, Sigita; Pūras, Dainius; Kajokiene, Asta; Senina, Julija
Due to the behavioral and communication difficulties autistic children need individualized approaches providing them medical help. Aspects of nursing of autistic children were not investigated in our country. Thirty seven mothers of autistic children and 74 mothers of children without developmental disorders (control group) were interviewed orally and filled the questionnaire. The age of children was 3-12 years old. The aim of the research was to analyze peculiarities of behavior, communication and social adaptation of children with autism disorder together with troubles they face in medical services (outpatient and inpatient), and prepare practical recommendations to the pediatric and mental health nurses. It appeared that families with autistic children come across the great difficulties in various areas of the daily life. Autistic children tended to have severe behavioral and emotional difficulties while being examined by the medical staff. Adaptation difficulties in medical services were very prominent, especially at the in-patient departments (unpredictable and impulsive behavior, anxiety, decrease of appetite, sleep disturbances). Possibilities of home visit of the nurses are underestimated and could provide more useful and constructive help to the families. The data showed existing difficulties for the pediatric nurses and medical staff to establish good contact with the autistic children and their parents and lack of knowledge about the children with pervasive developmental disorders and their needs. Practical recommendations are provided.
de Kluiver, H.; Buizer-Voskamp, J.E.; Dolan, C.V.; Boomsma, D.I.
We review the hypotheses concerning the association between the paternal age at childbearing and childhood psychiatric disorders (autism spectrum- and attention deficit/hyperactive disorder) and adult disorders (schizophrenia, bipolar-, obsessive-compulsive-, and major depressive disorder) based on
Wang, Jia; Fu, Kuang; Chen, Lei; Duan, Xujun; Guo, Xiaonan; Chen, Heng; Wu, Qiong; Xia, Wei; Wu, Lijie; Chen, Huafu
Autism spectrum disorder (ASD) has been widely recognized as a complex neurodevelopmental disorder. A large number of neuroimaging studies suggest abnormalities in brain structure and function of patients with ASD, but there is still no consistent conclusion. We sought to investigate both of the structural and functional brain changes in 3-7-year-old children with ASD compared with typically developing controls (TDs), and to assess whether these alterations are associated with autistic behavioral symptoms. Firstly, we applied an optimized method of voxel-based morphometry (VBM) analysis on structural magnetic resonance imaging (sMRI) data to assess the differences of gray matter volume (GMV) between 31 autistic boys aged 3-7 and 31 age- and handness-matched male TDs. Secondly, we used clusters with between-group differences as seed regions to generate intrinsic functional connectivity maps based on resting-state functional connectivity magnetic resonance imaging (rs-fcMRI) in order to evaluate the functional impairments induced by structural alterations. Brain-behavior correlations were assessed among GMV, functional connectivity and symptom severity in children with ASD. VBM analyses revealed increased GMV in left superior temporal gyrus (STG) and left postcentral gyrus (PCG) in ASD children, comparing with TDs. Using left PCG as a seed region, ASD children displayed significantly higher positive connectivity with right angular gyrus (AG) and greater negative connectivity with right superior parietal gyrus (SPG) and right superior occipital gyrus (SOG), which were associated with the severity of symptoms in social interaction, communication and self-care ability. We suggest that stronger functional connectivity between left PCG and right AG, SPG, and SOG detected in young boys with ASD may serve as important indicators of disease severity. Our study provided preliminary functional evidence that may underlie impaired higher-order multisensory integration in ASD
Full Text Available Autism spectrum disorder (ASD has been widely recognized as a complex neurodevelopmental disorder. A large number of neuroimaging studies suggest abnormalities in brain structure and function of patients with ASD, but there is still no consistent conclusion. We sought to investigate both of the structural and functional brain changes in 3–7-year-old children with ASD compared with typically developing controls (TDs, and to assess whether these alterations are associated with autistic behavioral symptoms. Firstly, we applied an optimized method of voxel-based morphometry (VBM analysis on structural magnetic resonance imaging (sMRI data to assess the differences of gray matter volume (GMV between 31 autistic boys aged 3–7 and 31 age- and handness-matched male TDs. Secondly, we used clusters with between-group differences as seed regions to generate intrinsic functional connectivity maps based on resting-state functional connectivity magnetic resonance imaging (rs-fcMRI in order to evaluate the functional impairments induced by structural alterations. Brain-behavior correlations were assessed among GMV, functional connectivity and symptom severity in children with ASD. VBM analyses revealed increased GMV in left superior temporal gyrus (STG and left postcentral gyrus (PCG in ASD children, comparing with TDs. Using left PCG as a seed region, ASD children displayed significantly higher positive connectivity with right angular gyrus (AG and greater negative connectivity with right superior parietal gyrus (SPG and right superior occipital gyrus (SOG, which were associated with the severity of symptoms in social interaction, communication and self-care ability. We suggest that stronger functional connectivity between left PCG and right AG, SPG, and SOG detected in young boys with ASD may serve as important indicators of disease severity. Our study provided preliminary functional evidence that may underlie impaired higher-order multisensory
Deonna, Thierry; Roulet-Perez, Eliane
Early-onset acquired epileptic aphasia (Landau-Kleffner syndrome) may present as a developmental language disturbance and the affected child may also exhibit autistic features. Landau-Kleffner is now seen as the rare and severe end of a spectrum of cognitive-behavioural symptoms that can be seen in idiopathic (genetic) focal epilepsies of childhood, the benign end being the more frequent typical rolandic epilepsy. Several recent studies show that many children with rolandic epilepsy have minor developmental cognitive and behavioural problems and that some undergo a deterioration (usually temporary) in these domains, the so-called "atypical" forms of the syndrome. The severity and type of deterioration correlate with the site and spread of the epileptic spikes recorded on the electroencephalogram within the perisylvian region, and continuous spike-waves during sleep (CSWS) frequently occur during this period of the epileptic disorder. Some of these children have more severe preexisting communicative and language developmental disorders. If early stagnation or regression occurs in these domains, it presumably reflects epileptic activity in networks outside the perisylvian area, i.e. those involved in social cognition and emotions. Longitudinal studies will be necessary to find out if and how much the bioelectrical abnormalities play a causal role in these subgroup of children with both various degrees of language and autistic regression and features of idiopathic focal epilepsy. One has to remember that it took nearly 40 years to fully acknowledge the epileptic origin of aphasia in Landau-Kleffner syndrome and the milder acquired cognitive problems in rolandic epilepsies. Copyright © 2010 Elsevier B.V. All rights reserved.
Delli, Konstantina; Reichart, Peter A; Bornstein, Michael M; Livas, Christos
Objectives: This article reviews the present literature on the issues encountered while coping with children with autistic spectrum disorder from the dental perspective. The autistic patient profile and external factors affecting the oral health status of this patient population are discussed upon
Cahn, R.W.; Johnson, W.L.
Four types of phase transformation that involve the conversion of crystalline phases into more disordered forms are reviewed: melting, disordering of superlattices, amorphization by diffusion between crystalline phases, and irradation amorphization. In the review emphasis is placed on evidence for the heterogeneous nucleation of the product phases; in this connection, the role of surfaces, antiphase domain boundaries, dislocations, vacancies, and grain boundaries is specifically discussed. All of these features have been either observed, or hypothesized, to play a role as heterogeneous nucleation sites in one or more of the four transformations. An attempt is made to draw parallels between nucleation mechanisms in the various processes
Dou, Yanmei; Yang, Xiaoxu; Li, Ziyi; Wang, Sheng; Zhang, Zheng; Ye, Adam Yongxin; Yan, Linlin; Yang, Changhong; Wu, Qixi; Li, Jiarui; Zhao, Boxun; Huang, August Yue; Wei, Liping
The roles and characteristics of postzygotic single-nucleotide mosaicisms (pSNMs) in autism spectrum disorders (ASDs) remain unclear. In this study of the whole exomes of 2,361 families in the Simons Simplex Collection, we identified 1,248 putative pSNMs in children and 285 de novo SNPs in children with detectable parental mosaicism. Ultra-deep amplicon resequencing suggested a validation rate of 51%. Analyses of validated pSNMs revealed that missense/loss-of-function (LoF) pSNMs with a high mutant allele fraction (MAF≥ 0.2) contributed to ASD diagnoses (P = 0.022, odds ratio [OR] = 5.25), whereas missense/LoF pSNMs with a low MAF (MAF<0.2) contributed to autistic traits in male non-ASD siblings (P = 0.033). LoF pSNMs in parents were less likely to be transmitted to offspring than neutral pSNMs (P = 0.037), and missense/LoF pSNMs in parents with a low MAF were transmitted more to probands than to siblings (P = 0.016, OR = 1.45). We estimated that pSNMs in probands or de novo mutations inherited from parental pSNMs increased the risk of ASD by approximately 6%. Adding pSNMs into the transmission and de novo association test model revealed 13 new ASD risk genes. These results expand the existing repertoire of genes involved in ASD and shed new light on the contribution of genomic mosaicisms to ASD diagnoses and autistic traits. © 2017 The Authors. Human Mutation published by Wiley Periodicals, Inc.
Findling, Robert L; Mankoski, Raymond; Timko, Karen; Lears, Katherine; McCartney, Theresa; McQuade, Robert D; Eudicone, James M; Amatniek, Joan; Marcus, Ronald N; Sheehan, John J
To evaluate the efficacy and safety of aripiprazole versus placebo in preventing relapse of irritability symptoms associated with autistic disorder in pediatric patients. This multicenter, double-blind, randomized, placebo-controlled, relapse-prevention trial enrolled patients (6-17 years) who met the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DMS-IV-TR) criteria for autistic disorder and who also had serious behavioral problems (ie, tantrums, aggression, self-injurious behavior, or a combination of these behavioral problems) between March 2011 and June 2012. In phase 1, single-blind aripiprazole was flexibly dosed (2-15 mg/d) for 13-26 weeks. Patients with a stable response (≥ 25% decrease in Aberrant Behavior Checklist-irritability subscale score and a rating of "much improved" or "very much improved" on the Clinical Global Impressions-Improvement scale) for 12 consecutive weeks were randomized into phase 2 to continue aripiprazole or switch to placebo. Treatment was continued until relapse or up to 16 weeks. The primary end point was time from randomization to relapse. Eighty-five patients were randomized in phase 2. The difference in time to relapse between aripiprazole and placebo was not statistically significant (P = .097). Kaplan-Meier relapse rates at week 16 were 35% for aripiprazole and 52% for placebo (hazard ratio [HR] = 0.57; number needed to treat [NNT] = 6). The most common adverse events during phase 1 were weight increase (25.2%), somnolence (14.8%), and vomiting (14.2%); and, during phase 2 (aripiprazole vs placebo), they were upper respiratory tract infection (10.3% vs 2.3%), constipation (5.1% vs 0%), and movement disorder (5.1% vs 0%). In this study, there was no statistically significant difference between aripiprazole and placebo in time to relapse during maintenance therapy. However, the HR and NNT suggest some patients will benefit from maintenance treatment. Patients receiving
Rahman, Mustafizur; Ferdous, S. M.; Ahmed, Syed Ishtiaque; Anwar, Anika
Purpose: Speech disorder is one of the most common problems found with autistic children. The purpose of this paper is to investigate the introduction of computer-based interactive games along with the traditional therapies in order to help improve the speech of autistic children. Design/methodology/approach: From analysis of the works of Ivar…
Transtornos invasivos do desenvolvimento não-autísticos: síndrome de Rett, transtorno desintegrativo da infância e transtornos invasivos do desenvolvimento sem outra especificação Non-autistic pervasive developmental disorders: Rett syndrome, disintegrative disorder and pervasive developmental disorder not otherwise specified
Marcos T Mercadante
Full Text Available A categoria "transtorno invasivos do desenvolvimento" inclui o autismo, a síndrome de Asperger, a síndrome de Rett, o transtorno desintegrativo da infância e uma categoria residual denominada transtornos invasivos do desenvolvimento sem outra especificação. Nesta revisão, a síndrome de Rett e o transtorno desintegrativo da infância, que são categorias bem definidas, serão discutidas, assim como as categorias não tão bem definidas que foram incluídas no grupo transtornos invasivos do desenvolvimento sem outra especificação. Diferentes propostas de categorização têm sido feitas, algumas baseadas em abordagem fenomenológica descritiva, outras baseadas em outras perspectivas teóricas, tais como a neuropsicologia. As propostas atuais são apresentadas e discutidas, seguidas por avaliações críticas sobre as vantagens e desvantagens desses conceitos.The category "Pervasive Developmental Disorders" includes autistic disorder, Asperger's syndrome, Rett's syndrome, childhood disintegrative disorder, and a residual category, named pervasive developmental disorder not otherwise specified. In this review, Rett's syndrome and childhood disintegrative disorder, which are well-defined categories, will be discussed, as well as the not well defined categories that have been included in the Pervasive Developmental Disorder Not Otherwise Specified group. Different proposals of categorization have been created, some of which based on descriptive phenomenological approach, and others based upon other theoretical perspectives, such as neuropsychology. Current proposals are presented and discussed, followed by critical appraisals on the clinical advantages and disadvantages of these concepts.
Al Mochamant Iosif-Grigorios
Full Text Available Dental treatment of patients with Autism Spectrum Disorders (ASD can be complicated because of the presence of behavioural unpredictability. This article reviews the present literature on the issues dealt with children with autistic spectrum disorder from the dental perspective. The prevalence of autism is rising worldwide. Consequently, dentists will find an increasing number of such children in their routine practice, whose treatment will require special considerations in their dental management. Knowledge regarding the oral health status of autistic children is essential for the paediatric dentists. Negative behaviour toward dental treatment was very clear in autistic children. Self-inflicting trauma/habits were observed in autistic children. It was concluded that the autistic children do not have a higher dental caries score compared to that of normal children. Their oral hygiene was fair; however, they exhibited more debris deposits than normal children.
Yaylaci, Ferhat; Miral, Suha
Aim of this study was to compare children diagnosed with Pervasive Developmental Disorder (PDD) according to DSM-IV-TR and DSM-5 diagnostic systems. One hundred fifty children aged between 3 and 15 years diagnosed with PDD by DSM-IV-TR were included. PDD symptoms were reviewed through psychiatric assessment based on DSM-IV-TR and DSM-5 criteria. Clinical severity was determined using Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). A statistically significant decrease (19.3 %) was detected in the diagnostic ratio with DSM-5. Age and symptom severity differed significantly between those who were and were not diagnosed with PDD using DSM-5. B4 criteria in DSM-5 was most common criterion. Results indicate that individuals diagnosed with PDD by DSM-IV-TR criteria may not be diagnosed using DSM-5 criteria.
Global methylation profiling of lymphoblastoid cell lines reveals epigenetic contributions to autism spectrum disorders and a novel autism candidate gene, RORA, whose protein product is reduced in autistic brain
Nguyen, AnhThu; Rauch, Tibor A.; Pfeifer, Gerd P.; Hu, Valerie W.
Autism is currently considered a multigene disorder with epigenetic influences. To investigate the contribution of DNA methylation to autism spectrum disorders, we have recently completed large-scale methylation profiling by CpG island microarray analysis of lymphoblastoid cell lines derived from monozygotic twins discordant for diagnosis of autism and their nonautistic siblings. Methylation profiling revealed many candidate genes differentially methylated between discordant MZ twins as well as between both twins and nonautistic siblings. Bioinformatics analysis of the differentially methylated genes demonstrated enrichment for high-level functions including gene transcription, nervous system development, cell death/survival, and other biological processes implicated in autism. The methylation status of 2 of these candidate genes, BCL-2 and retinoic acid-related orphan receptor alpha (RORA), was further confirmed by bisulfite sequencing and methylation-specific PCR, respectively. Immunohistochemical analyses of tissue arrays containing slices of the cerebellum and frontal cortex of autistic and age- and sex-matched control subjects revealed decreased expression of RORA and BCL-2 proteins in the autistic brain. Our data thus confirm the role of epigenetic regulation of gene expression via differential DNA methylation in idiopathic autism, and furthermore link molecular changes in a peripheral cell model with brain pathobiology in autism.—Nguyen, A., Rauch, T. A., Pfeifer, G. P., Hu, V. W. Global methylation profiling of lymphoblastoid cell lines reveals epigenetic contributions to autism spectrum disorders and a novel autism candidate gene, RORA, whose protein product is reduced in autistic brain. PMID:20375269
Minhas, Ayesha; Vajaratkar, Vivek; Divan, Gauri; Hamdani, Syed Usman; Leadbitter, Kathy; Taylor, Carol; Aldred, Catherine; Tariq, Ahmareen; Tariq, Mahjabeen; Cardoza, Percy; Green, Jonathan; Patel, Vikram; Rahman, Atif
Autism spectrum disorder (ASD) affects about 1.4% of the population in South Asia but very few have access to any form of health care service. The objective of this study was to explore the beliefs and practices related to the care of children with ASD to inform strategies for intervention. In Pakistan, primary data were collected through in-depth interviews of parents (N = 15), while in India a narrative review of existing studies was conducted. The results show that the burden of care is almost entirely on the mother, leading to high levels of stress. Poor awareness of the condition in both family members and front-line health-providers leads to delay in recognition and appropriate management. There is considerable stigma and discrimination affecting children with autism and their families. Specialist services are rare, concentrated in urban areas, and inaccessible to the majority. Strategies for intervention should include building community and family support networks to provide respite to the main carer. In the absence of specialists, community members such as community health workers, traditional practitioners and even motivated family members could be trained in recognizing and providing evidence-based interventions. Such task-shifting strategies should be accompanied by campaigns to raise awareness so greater inclusivity can be achieved.
Yan, W L; Guan, X Y; Green, E D; Nicolson, R; Yap, T K; Zhang, J; Jacobsen, L K; Krasnewich, D M; Kumra, S; Lenane, M C; Gochman, P; Damschroder-Williams, P J; Esterling, L E; Long, R T; Martin, B M; Sidransky, E; Rapoport, J L; Ginns, E I
Childhood-onset schizophrenia (COS) is defined by the development of first psychotic symptoms by age 12. While recruiting patients with COS refractory to conventional treatments for a trial of atypical antipsychotic drugs, we discovered a unique case who has a familial t(1;7)(p22;q21) reciprocal translocation and onset of psychosis at age 9. The patient also has symptoms of autistic disorder, which are usually transient before the first psychotic episode among 40-50% of the childhood schizophrenics but has persisted in him even after the remission of psychosis. Cosegregating with the translocation, among the carriers in the family available for the study, are other significant psychopathologies, including alcohol/drug abuse, severe impulsivity, and paranoid personality and language delay. This case may provide a model for understanding the genetic basis of schizophrenia or autism. Here we report the progress toward characterization of genomic organization across the translocation breakpoint at 7q21. The polymorphic markers, D7S630/D7S492 and D7S2410/D7S646, immediately flanking the breakpoint, may be useful for further confirming the genetic linkage for schizophrenia or autism in this region. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:749-753, 2000. Published 2000 Wiley-Liss, Inc.
Metsu, Sofie; Rainger, Jacqueline K; Debacker, Kim; Bernhard, Birgitta; Rooms, Liesbeth; Grafodatskaya, Daria; Weksberg, Rosanna; Fombonne, Eric; Taylor, Martin S; Scherer, Stephen W; Kooy, R Frank; FitzPatrick, David R
We report de novo occurrence of the 7p11.2 folate-sensitive fragile site FRA7A in a male with an autistic spectrum disorder (ASD) due to a CGG-repeat expansion mutation (∼450 repeats) in a 5' intron of ZNF713. This expanded allele showed hypermethylation of the adjacent CpG island with reduced ZNF713 expression observed in a proband-derived lymphoblastoid cell line (LCL). His unaffected mother carried an unmethylated premutation (85 repeats). This CGG-repeat showed length polymorphism in control samples (five to 22 repeats). In a second unrelated family, three siblings with ASD and their unaffected father were found to carry FRA7A premutations, which were partially or mosaically methylated. In one of the affected siblings, mitotic instability of the premutation was observed. ZNF713 expression in LCLs in this family was increased in three of these four premutation carriers. A firm link cannot yet be established between ASD and the repeat expansion mutation but plausible pathogenic mechanisms are discussed. © 2014 WILEY PERIODICALS, INC.
O'Reilly, Michelle; Karim, Khalid; Lester, Jessica Nina
Autistic spectrum disorder (ASD) is a life-long condition. In recent years, there has been a rise in the number of children diagnosed with ASD and a greater recognition that parents need clear, accessible information communicated through different modalities. The objective of this research was to explore the views of stakeholders regarding their information needs, current information modalities and the perceived barriers and complexities of information. Three focus groups with the same stakeholders were conducted with a range of individuals from a variety of backgrounds, all of whom had a personal and/or professional interest in ASD. The same stakeholders were included in all three groups to promote depth of analysis and to facilitate rapport. All focus groups were audio-recorded, transcribed and analysed using thematic analysis. Three main issues were identified, including (1) the value of particular information sources; (2) the vulnerability of families and (3) the need for validated evidence. It was concluded, therefore, that information should be available through a multitude of modalities, accounting for the educational ability and economic status of families. The information should also be communicated in an accessible style, should be presented as trustworthy and clinical professionals may play a key role in translating information. Such information also needs to account for practical problems inherent to having a child with ASD, including time constraints and fatigue. © The Author(s) 2014.
Rodriguez-Porcel, Federico; Green, Donald; Khatri, Nidhi; Harris, Sharonda Swilley; May, Warren L; Lin, Rick C S; Paul, Ian A
We have demonstrated that neonatal exposure to selective serotonin reuptake inhibitors has lasting effects on behavior and serotonergic neurons in Long Evans rats. Hyperserotoninemia and altered sensory processing are reported in autistic spectrum disorders (ASD). We hypothesized that early life exposure to SSRIs alters sensory processing, disrupts responses to novelty, and impairs social interactions in a manner similar to that observed in ASD. Male and female Long-Evans rat pups were administered citalopram, buproprion, fluoxetine, or saline from postnatal day (P) 8-21. Rats were tested for response to a novel tone before weaning (P25). Later, rats were tested 2× for response to a novel object (P39), and to a novel conspecific (P78, P101). In addition, rats were assessed for juvenile play behaviors (P32-P34) and later, we assessed sexual response to an estrus female in male rats (P153-184). Antidepressant exposure increased freezing after tone, diminished novel object exploration, and reduced conspecific interaction up to 3× compared to saline exposed rats. Juvenile play was profoundly reduced in antidepressant-exposed males when compared to saline exposed groups. Exposure to the SSRIs, but not bupropion disrupted male sexual behaviors. Moreover, specific male responses to female proceptive behaviors were disrupted in SSRI, but not bupropion exposed rats. We conclude that neonatal exposure to antidepressants in rats results in sensory and social abnormalities that parallel many of those reported in ASD. Copyright © 2011 Wiley-Liss, Inc.
Full Text Available OBJECTIVE: To verify if the clinical behavior of auditory hypersensitivity, reported in interviews with parents/caregivers and therapists/teachers of 46 children and teenagers suffering from autistic spectrum disorder, correspond to audiological findings. METHOD: The clinical diagnosis for auditory hypersensitivity was investigated by means of an interview. Subsequently, a test of the acoustic stapedial reflex was conducted, and responses to intense acoustic stimulus in open field were observed. RESULTS: Of the 46 subjects, 11 (23.9% were clinically diagnosed as oversensitive to sound and only 2 showed discomfort when exposed to intense acoustic stimulus in open field. There was no statistically significant difference for the test of the ipsilateral acoustic stapedial reflex between the groups. CONCLUSION: Behavioral manifestations to sounds are not associated to hypersensitivity of the auditory pathways, but instead these are associated to difficulties in the upper processing, involving systems that usually are impaired in autistic spectrum patients, such as the limbic system.OBJETIVO: Verificar se o comportamento clínico de hipersensibilidade auditiva, relatado nas entrevistas com os pais/cuidadores e terapeutas/professores de crianças e adolescentes com transtorno do espectro autista, corresponde aos achados audiológicos. MÉTODO: O diagnóstico clínico para a hipersensibilidade auditiva foi investigado a partir do protocolo de entrevista. Após, foi utilizada a pesquisa do reflexo acústico estapédico e observadas as reações ao estímulo sonoro intenso em campo aberto. RESULTADOS: Dos 46 sujeitos, 11 (23,9% foram diagnosticados clinicamente como hipersensíveis ao som, e somente 2 demonstraram desconforto quando expostos ao estímulo sonoro intenso em campo aberto. Não houve diferença estatisticamente significante para a pesquisa do reflexo acústico estapédico ipsilateral entre os grupos. CONCLUSÃO: As manifesta
Full Text Available Abstract Background The TPH2 gene encodes the enzyme responsible for serotonin (5-HT synthesis in the Central Nervous System (CNS. Stereotypic and repetitive behaviors are influenced by 5-HT, and initial studies report an association of TPH2 alleles with childhood-onset obsessive-compulsive disorder (OCD and with autism. GLO1 encodes glyoxalase I, the enzyme which detoxifies α-oxoaldehydes such as methylglyoxal in all living cells. The A111E GLO1 protein variant, encoded by SNP C419A, was identifed in autopsied autistic brains and proposed to act as an autism susceptibility factor. Hyperserotoninemia, macrocephaly, and peptiduria represent some of the best-characterized endophenotypes in autism research. Methods Family-based and case-control association studies were performed on clinical samples drawn from 312 simplex and 29 multiplex families including 371 non-syndromic autistic patients and 156 unaffected siblings, as well as on 171 controls. TPH2 SNPs rs4570625 and rs4565946 were genotyped using the TaqMan assay; GLO1 SNP C419A was genotyped by PCR and allele-specific restriction digest. Family-based association analyses were performed by TDT and FBAT, case-control by χ2, endophenotypic analyses for 5-HT blood levels, cranial circumference and urinary peptide excretion rates by ANOVA and FBAT. Results TPH2 alleles and haplotypes are not significantly associated in our sample with autism (rs4570625: TDT P = 0.27, and FBAT P = 0.35; rs4565946: TDT P = 0.45, and FBAT P = 0.55; haplotype P = 0.84, with any endophenotype, or with the presence/absence of prominent repetitive and stereotyped behaviors (motor stereotypies: P = 0.81 and 0.84, verbal stereotypies: P = 0.38 and 0.73 for rs4570625 and rs4565946, respectively. Also GLO1 alleles display no association with autism (191 patients vs 171 controls, P = 0.36; TDT P = 0.79, and FBAT P = 0.37, but unaffected siblings seemingly carry a protective gene variant marked by the A419 allele (TDT P
Raevuori, Anu; Keski-Rahkonen, Anna; Hoek, Hans W.
Purpose of review Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males. Recent findings Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th
Renato P. Munhoz
Full Text Available Movement disorders (MD encompass acute and chronic diseases characterized by involuntary movements and/or loss of control or efficiency in voluntary movements. In this review, we covered situations in which the main manifestations are MDs that pose significant risks for acute morbidity and mortality. The authors examine literature data on the most relevant MD emergencies, including those related to Parkinson's disease, acute drug reactions (acute dystonia, neuroleptic malignant syndrome, serotonergic syndrome and malignant hyperthermia, acute exacerbation of chronic MD (status dystonicus, hemiballism and stiff-person syndrome, highlighting clinical presentation, demographics, diagnosis and management.
Huke, Vanessa; Turk, Jeremy; Saeidi, Saeideh; Kent, Andy; Morgan, John F
Empirical research addressing cognitive processing deficits in eating disorders has noted an overlap with autism spectrum disorders. We conducted a systematic review investigating the prevalence of autism spectrum disorder in its entirety in eating disordered populations. A comprehensive search for relevant studies was performed on five electronic databases. Studies were not included if solely focused on specific traits of autism spectrum disorders, for instance, theory of mind, set shifting or central coherence. Titles, abstracts and full texts were screened by two members of the research team independently. Quantitative studies published in English were included. A total of eight studies were found to fit the inclusion criteria. Results showed significantly raised prevalence rates of autism spectrum disorder in eating disorder populations compared with those in healthy control participants. This discovery has clinical implications and may assist in deciphering poor responses to conventional treatment, facilitating new psychological interventions for eating disorders. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
Rossignol, Daniel A.; Frye, Richard E.
Aim: The aim of this study was to investigate melatonin-related findings in autism spectrum disorders (ASD), including autistic disorder, Asperger syndrome, Rett syndrome, and pervasive developmental disorders, not otherwise specified. Method: Comprehensive searches were conducted in the PubMed, Google Scholar, CINAHL, EMBASE, Scopus, and ERIC…
We describe the cases of 2 autistic children with ophthalmic and systemic manifestations of vitamin A deficiency due to food faddism. Although vitamin A deficiency is common in the developing world, reports in developed societies are rare. Our patients presented over a 1-year period. The patients were 14 and 13 years old at the time of presentation and were both found to have marked features of vitamin A deficiency related to unusual dietary habits. Anterior segment signs of xerophthalmia were present in both patients. In addition, patient 1 showed evidence of a rod-predominant retinopathy, which resolved with vitamin A supplementation. Due to its rare occurrence, hypovitaminosis A must be highlighted and anticipated in this cohort.
Béhérec, L; Quilici, G; Rosier, A; Gerardin, P; Campion, D; Guillin, O
Pervasive developmental disorders (PDD) are neurodevelepmental disorders that are characterized by severe deficits in socialisation and communication, and the existence of repetitive and stereotyped interests and behaviours. It is estimated more than 60/100,000 children are suffering from PDD. Comorbid disorders are common in people with PDD, including intellectual deficiency, symptoms of attention deficit-hyperactivity, aggression and disruption, and pervasive repetitive behaviours or thoughts. These symptoms have a negative impact on the outcome and quality of life of the patients and their caregivers. The first-line management of comorbid disorders in PDD is behavioural intervention, but sometimes this is not sufficient, and the use of pharmacological treatment is needed. We conducted a review of studies of medical treatments used in patients with PDD to establish which treatments show good evidence of efficacy in PDD. We used the Medline database and the following keywords "pervasive development disorders" or "autism spectrum disorders" or "autistic disorder" and "therapy" or "treatment". The treatments that showed the best efficacy on irritability in well-designed studies are second generation antipsychotics, risperidone and aripiprazole. Some studies indicate that haloperidol is efficient as well, but the very high frequency of extra-pyramidal effects limits its use. Methylphenidate has shown some efficacy on impulsivity and hyperactivity in randomised placebo-controlled studies. First data concerning atomoxetine are promising but better-designed studies are needed. Selective serotonin re-uptake inhibitors: fluvoxamine and fluoxetine have shown some efficacy in the treatment of serious and pervasive repetitive behaviours. Alpha-adrenergic treatments, clonidine and guanfacine, can help in the management of disruptive behaviours in patients with PDD. Data concerning naltrexone are contradictory, indeed many case reports of its efficacy on aggressive (mostly
Physiological responses to social and nonsocial stimuli in neurotypical adults with high and low levels of autistic traits: implications for understanding nonsocial drive in autism spectrum disorders.
Singleton, Clarence J; Ashwin, Chris; Brosnan, Mark
Researchers have suggested that the two primary cognitive features of autism spectrum disorder (ASD), a drive toward nonsocial processing and a reduced drive toward social processing, may be unrelated to each other in the neurotypical (NT) population and may therefore require separate explanations. Drive toward types of processing may be related to physiological arousal to categories of stimuli, such as social (e.g., faces) or nonsocial (e.g., trains). This study investigated how autistic traits in an NT population might relate to differences in physiological responses to nonsocial compared with social stimuli. NT participants were recruited to examine these differences in those with high vs. low degrees of ASD traits. Forty-six participants (21 male, 25 female) completed the Autism Spectrum Quotient (AQ) to measure ASD traits before viewing a series of 24 images while skin conductance response (SCR) was recorded. Images included six nonsocial, six social, six face-like cartoons, and six nonsocial (relating to participants' personal interests). Analysis revealed that those with a higher AQ had significantly greater SCR arousal to nonsocial stimuli than those with a low AQ, and the higher the AQ, the greater the difference between SCR arousal to nonsocial and social stimuli. This is the first study to identify the relationship between AQ and physiological response to nonsocial stimuli, and a relationship between physiological response to both social and nonsocial stimuli, suggesting that physiological response may underlie the atypical drive toward nonsocial processing seen in ASD, and that at the physiological level at least the social and nonsocial in ASD may be related to one another. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.
Hasanzadeh, Elmira; Mohammadi, Mohammad-Reza; Ghanizadeh, Ahmad; Rezazadeh, Shams-Ali; Tabrizi, Mina; Rezaei, Farzin; Akhondzadeh, Shahin
"Ginkgo biloba" has been reported to affect the neurotransmitter system and to have antioxidant properties that could impact the pathogenesis of Autism Spectrum Disorder. Based on these studies, we decided to assess the effectiveness of "Ginkgo biloba" extract (Ginko T.D., Tolidaru, Iran) as an adjunctive agent to risperidone in the treatment of…
Erickson, Craig A.; Wink, Logan K.; Early, Maureen C.; Stiegelmeyer, Elizabeth; Mathieu-Frasier, Lauren; Patrick, Vanessa; McDougle, Christopher J.
Rationale: An excitatory/inhibitory (E:I) imbalance marked by enhanced glutamate and deficient gamma-aminobutyric acid (GABA) neurotransmission may contribute to the pathophysiology of autism spectrum disorders (ASD). Objectives: We report on the first single-blind placebo lead-in trial of acamprosate, a drug with putative mechanisms restoring E:I…
Full Text Available Autism spectrum disorders (ASDs comprise a distinct entity of neurodevelopmental disorders with a strong genetic component. Despite the identification of several candidate genes and causative genomic copy number variations (CNVs, the majority of ASD cases still remain unresolved. We have applied microarray-based comparative genomic hybridization (array-CGH using Agilent 400K custom array in the first Cyprus population screening for identification of ASD-associated CNVs. A cohort of 50 ASD patients (G1, their parents (G2, 50 ethnically matched normal controls (G3, and 80 normal individuals having children with various developmental and neurological conditions (G4 were tested. As a result, 14 patients were found to carry 20 potentially causative aberrations, two of which were de novo. Comparison of the four population groups revealed an increased rate of rare disease-associated variants in normal parents of children with autism. The above data provided additional evidence, supporting the complexity of ASD aetiology in comparison to other developmental disorders involving cognitive impairment. Furthermore, we have demonstrated the rationale of a more targeted approach combining accurate clinical description with high-resolution population-oriented genomic screening for defining the role of CNVs in autism and identifying meaningful associations on the molecular level.
Coombs, Elizabeth; Brosnan, Mark; Bryant-Waugh, Rachel; Skevington, Suzanne M
OBJECTIVE. Female adults with a diagnosis of anorexia nervosa (AN) have been found to score higher than healthy controls on a questionnaire that measures characteristics associated with Autism Spectrum Disorders (ASD). This research investigated the relationship between eating disorder (ED) and ASD symptomatology in a non-clinical sample, with an additional focus on prenatal testosterone (pT) levels. DESIGN. A cross-sectional research design was used. The selected age group of both males and females allowed for a focus on early onset of ED symptomatology in both sexes. METHODS. Self-reported questionnaire data from the Eating Attitudes Test (EAT-26) and the Autism Spectrum Quotient (AQ) were collected from 132 schoolchildren (61 boys, 71 girls) aged 11 to 14, with no recorded psychiatric diagnoses. Digit ratio (2D:4D) measures to index levels of pT exposure were also obtained. RESULTS. A significant relationship between levels of ED symptomatology and ASD symptomatology was identified. Particularly strong relationships were identified between the EAT-26 and the attention to detail and communication subscales of the AQ. Few relationships were found for digit ratios. CONCLUSION. The results extend previous research from a sample with a diagnosis of AN to a non-clinical population. Those registering higher levels of ED symptomatology also reported higher levels of attention to detail and communication difficulties associated with ASD. ©2010 The British Psychological Society.
Howlin, Patricia; Karpf, Janne
Increasingly, recent research has identified relatively high rates of autistic types of symptoms in a variety of genetic conditions, such as fragile X (Turk and Graham, 1997), tuberous sclerosis (Bolton and Griffiths, 1997), Angelman syndrome (Trillingsgaard and Ostergaard, this issue) and others (see Gillberg and Coleman, 2000). Detailed…
Agius, May M; Vance, Margaret
Few studies have compared the efficacy of the Picture Exchange Communication System (PECS) and iPads used as speech generating devices (SGDs), and none have targeted preschoolers. This study compares the relative efficacy of PECS and an iPad/SGD with three preschool-aged children with autism spectrum disorder and limited functional speech who lived in Malta. The study utilized an adapted alternating treatment design embedded in a multiple baseline design, with requesting of reinforcers as the dependent variable. Visual analysis of the results indicated that all participants required more prompted trials and sessions for the iPad/SGD condition. All participants learned a three step navigational sequence on the iPad. Participant preference probes were inconclusive and were not linked to speed of acquisition of requesting skills. Results suggest that both PECS and an iPad could be appropriate for teaching requesting skills to beginning communicators.
Malow, Beth A.
The purpose of this review article is to describe the clinical data linking autism with sleep and epilepsy and to discuss the impact of treating sleep disorders in children with autism either with or without coexisting epileptic seizures. Studies are presented to support the view that sleep is abnormal in individuals with autistic spectrum…
Hasanzadeh, Elmira; Mohammadi, Mohammad-Reza; Ghanizadeh, Ahmad; Rezazadeh, Shams-Ali; Tabrizi, Mina; Rezaei, Farzin; Akhondzadeh, Shahin
Ginkgo biloba has been reported to affect the neurotransmitter system and to have antioxidant properties that could impact the pathogenesis of Autism Spectrum Disorder. Based on these studies, we decided to assess the effectiveness of Ginkgo biloba extract (Ginko T.D., Tolidaru, Iran) as an adjunctive agent to risperidone in the treatment of autism. Forty-seven outpatients with a DSM-IV-TR diagnosis of autism ages between 4 and 12 years were assigned to this double blinded clinical trial and were randomly divided into two groups. One group received risperidone plus Ginko T.D and the other received risperidone plus placebo. The dose of risperidone was 1-3 mg/day and the dose of Ginko T.D. was 80 mg/day for patients under 30 kg and 120 mg/day for patients above 30 kg. Patients were assessed using Aberrant Behavior Checklist-Community (ABC-C) rating scale and the side effect check list every 2 weeks until the endpoint. None of the 5 subscales of ABC-C rating scale showed significant differences between the two groups. Incidents of side effects were not significantly different between the two groups. Adding Ginkgo biloba to risperidone did not affect the treatment outcome of ADs. Nevertheless, further observations are needed to confirm this result.
Capone, George T; Goyal, Parag; Grados, Marco; Smith, Brandon; Kammann, Heather
We report on an open-label, naturalistic study using risperidone to treat disruptive behaviors and self-injury in children with Down syndrome, severe intellectual disability, and comorbid autism spectrum disorders (DS+ASDs). We hypothesized that hyperactivity and disruptive behaviors would improve in response to risperidone treatment consistent with previous studies of children with ASD. Subjects were children (mean age, 7.8 +/- 2.6 years), consisting of 20 males and three females identified through our outpatient Down Syndrome Clinic between 2000 and 2004. Using the Aberrant Behavior Checklist as the primary outcome measure, all five subscales showed significant improvement following risperidone treatment. The mean duration of treatment was 95.8 +/- 16.8 days, and mean total daily dose was 0.66 +/- 0.28 mg/day. The Hyperactivity, Stereotypy, and Lethargy subscale scores showed the most significant reduction (p Children with disruptive behavior and self-injury showed the greatest improvement. Sleep quality improved for 88% of subjects with preexisting sleep disturbance. Subjects for whom a follow-up weight was available showed a mean weight increase of 2.8 +/- 1.5 kg during the treatment period. These findings support our clinical impression of improvement on important target behaviors such as aggression, disruptiveness, self-injury, stereotypy, and social withdrawal. Low-dose risperidone appears to be well tolerated in children with DS+ASD, although concerns about weight gain and metabolic alterations may limit its usefulness over the long term in some children.
Full Text Available Carla J Rash,1 Jeremiah Weinstock,2 Ryan Van Patten2 1Calhoun Cardiology Center – Behavioral Health, UConn Health, Farmington, CT, USA; 2Department of Psychology, Saint Louis University, St Louis, MO, USA Abstract: In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, gambling disorder was recategorized from the “Impulse Control Disorder” section to the newly expanded “Substance-related and Addictive Disorders” section. With this move, gambling disorder has become the first recognized nonsubstance behavioral addiction, implying many shared features between gambling disorder and substance use disorders. This review examines these similarities, as well as differences, between gambling and substance-related disorders. Diagnostic criteria, comorbidity, genetic and physiological underpinnings, and treatment approaches are discussed. Keywords: pathological gambling, problem gambling, behavioral addiction, transdiagnostic factors, addiction syndrome
Jivraj, Jamil; Sacrey, Lori-Ann; Newton, Amanda; Nicholas, David; Zwaigenbaum, Lonnie
Participatory research aims to increase the relevance and broaden the implementation of health research by involving those affected by the outcomes of health studies. Few studies within the field of neurodevelopmental disorders, particularly autism spectrum disorders, have involved autistic individuals as partners. This study sought to identify and characterize published participatory research partnerships between researchers and individuals with autism spectrum disorder or other neurodevelopmental disorders and examine the influence of participatory research partnerships on the research process and reported study outcomes. A search of databases and review of gray literature identified seven studies that described participatory research partnerships between academic researchers and individuals with autism spectrum disorder or other neurodevelopmental disorders. A comparative analysis of the studies revealed two key themes: (1) variations in the participatory research design and (2) limitations during the reporting of the depth of the partner's involvement. Both themes potentially limit the application and generalizability of the findings. The results of the review are discussed in relation to the use of evaluative frameworks for such participatory research studies to determine the potential benefits of participatory research partnerships within the neurodevelopmental and autism spectrum disorder populations. © The Author(s) 2014.
Background The objectives of this study were to explore associations between autistic traits and self-reported clinical symptoms in a population with anorexia nervosa (AN). Experimental and self-report evidence reveals similarities between AN and autism spectrum condition (ASC) populations in socio-emotional and cognitive domains; this includes difficulties with empathy, set-shifting and global processing. Focusing on these similarities may lead to better tailored interventions for both conditions. Methods A cross-sectional independent-groups design was employed. Participants with AN (n = 66) and typical controls (n = 66) completed self-report questionnaires including the Short (10-Item) Version Autism Spectrum Quotient (AQ-10) questionnaire (the first time this has been implemented in this population), the Eating Disorder Examination Questionnaire, the Hospital Anxiety and Depression Scale and the Work and Social Adjustment Scale. Group differences and the relationship between autistic traits and other questionnaire measures were investigated. Results The AN group had a significantly higher AQ-10 total score and a greater proportion scored above the clinical cut-off than the control group. Seven out of ten AQ-10 items significantly discriminated between groups. In the AN group, levels of autistic traits correlated with a greater self-reported anxiety and depression and a lower ability to maintain close relationships; however, eating disorder symptoms were not associated with autistic traits. Conclusions Women with anorexia possess a greater number of autistic traits than typical women. AQ-10 items that discriminated between groups related to ‘bigger picture’ (global) thinking, inflexibility of thinking and problems with social interactions, suggesting that autistic traits may exacerbate factors that maintain the eating disorder rather than cause the eating disorder directly. Using screening instruments may improve understanding of patients’ problems, leading
Kuroda, Miho; Wakabayashi, Akio; Uchiyama, Tokio; Yoshida, Yuko; Koyama, Tomonori; Kamio, Yoko
Deficits in understanding the mental state of others ("mind-reading") have been well documented in individuals with pervasive developmental disorders (PDD). However, it is unclear whether this deficit in social cognition differs between the subgroups of PDD defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text…
Full Text Available This work includes a review of the literature to analyze the effectiveness of the TEACCH intervention, as well as the effect of this intervention on the level of parental and teachers’ stress of children with autism spectrum disorder (ASD. Considering the inclusion criteria, a total of 14 studies were analyzed. Regardless of the context of intervention, all the studies revealed developmental abilities improvements and a reduction in autistic symptoms and maladaptative behaviors. In 11 of the 14 studies, statistically significant improvements were obtained. As for the effect of the TEACCH intervention in the level of the parents or teachers stress, out of the 7 studies that evaluated stress, 5 of them obtained a significant decrease between Pre and Post measurements. Considering these results, TEACCH intervention could be effective not only improving the child’s development, but also enhancing the adults’ level of well-being.
Yaylaci, Ferhat; Miral, Suha
Aim of this study was to compare children diagnosed with Pervasive Developmental Disorder (PDD) according to DSM-IV-TR and DSM-5 diagnostic systems. One hundred fifty children aged between 3 and 15 years diagnosed with PDD by DSM-IV-TR were included. PDD symptoms were reviewed through psychiatric assessment based on DSM-IV-TR and DSM-5 criteria.…
However, relatively few studies have been carried out on the relationship of emotional factors to diseases of the oral mucosa. So, here is an article which tries to briefly review the psychosomatic (stress related disorders related to the oral cavity.
Curtis, Luke T; Patel, Kalpana
The purpose of this study was to concisely review the available literature of nutritional and environmental factors on autistic spectrum and attention deficit hyperactivity disorder (ADHD). Review of journal articles found on the PubMed database and from information from several conference proceedings. Many, but not all, studies link exposure to toxins such as mercury, lead, pesticides, and in utero smoking exposure to higher levels of autism and/or ADHD. Some studies have reported many nutritional deficiencies in autism/ADHD patients. Numerous studies have reported that supplemental nutrients such as omega-3 fatty acids, vitamins, zinc, magnesium, and phytochemicals may provide moderate benefits to autism/ADHD patients. Avoidance of food allergens, food chemicals, and chelation therapy may also provide some relief to autism/ADHD patients. Autistic spectrum disorders and ADHD are complicated conditions in which nutritional and environmental factors play major roles. Larger studies are needed to determine optimum multifactorial treatment plans involving nutrition, environmental control,medication, and behavioral/education/speech/physical therapies.
Abstract This review aims to critically analyse the literature which considers the relationship between the media’s portrayal of the ‘ideal body image’ and adolescent eating disorders. Currently within Western society, the media endorses a thin-ideal for females and a lean, muscular-ideal for males. A critical review was chosen to deconstruct the evident debate within the literature as to whether the media is solely to blame for eating disorder development or whether other risk fact...
Tsai, Luke Y.
This review focuses on identifying up-to-date number of publications that compared DSM-IV/ICD-10 Asperger's disorder (AspD) to Autistic Disorder/High-functioning Autism (AD/HFA). One hundred and twenty-eight publications were identified through an extensive search of major electronic databases and journals. Based on more than 90 clinical…
Latzer, Yael; Witztum, Eliezer; Stein, Daniel
Israel presents a unique opportunity to study the role of socio-cultural parameters in the development of mental disturbances because of the exceptional diversity of the Israeli society. In the present review, we aimed to analyse the current state of disordered eating in Israel by means of an extensive literature review. The following are the main findings of our review: The frequency of maladaptive eating among female and male Israeli Jewish adolescents is higher in comparison to many other Westernized countries. Among different Jewish sub-populations, Kibbutz women have been found until recently to show higher rates of disordered eating in comparison to other Israeli samples. Recent studies show no such difference between Kibbutz members and the general Israeli population. No clear-cut findings emerge with respect to the influence of immigration and degree of Jewish religious affiliation on the occurrence of disordered eating. In contrast, disordered eating is less prevalent in Israeli-Arabs compared with Israeli-Jews. Moreover, diverse Israeli-Arab groups show different rates of disordered eating. We discuss the high rate of disordered eating in Israeli youth in light of Israel being a culture in transition that is constantly exposed to the risk of terrorism. The changes in the rates of disordered eating in the Kibbutzim are discussed in light of the dramatic societal changes occurring in these communities within a relatively brief period of time. The low rates of disordered eating in Israeli-Arabs reflect the traditional non-Westernized characteristics of their society, whereas the differences between diverse Arab sub-populations depend upon the degree of exposure to Westernized influences and the presence of conflicts between modern and traditional values. (c) 2008 John Wiley & Sons, Ltd and Eating Disorders Association.
Nader, Anne-Marie; Courchesne, Valérie; Dawson, Michelle; Soulières, Isabelle
Wechsler Intelligence Scale for Children (WISC) is widely used to estimate autistic intelligence (Joseph in The neuropsychology of autism. Oxford University Press, Oxford, 2011; Goldstein et al. in "Assessment of autism spectrum disorders." Guilford Press, New York, 2008; Mottron in "J Autism Dev Disord" 34(1):19-27, 2004).…
Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Autism spectrum disorders (ASDs include autistic disorder, Asperger’s disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. DESIGN AND SETTING: Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI; this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/magnesium and SSRI for children. CONCLUSION: Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence. Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed.
Stepan, L; Shaw, C-K L; Oue, S
Temporomandibular disorder poses a diagnostic challenge to otolaryngologists as orofacial pain, headache and otology symptoms are very common in temporomandibular disorder, and mimic a number of otolaryngological conditions. Missed diagnosis of temporomandibular disorder can lead to unnecessary investigation and treatment, resulting in further patient suffering. To review the current literature and propose management pathways for otolaryngologists to correctly differentiate temporomandibular disorder from other otolaryngological conditions, and to initiate effective treatment for temporomandibular disorder in collaboration with other health professionals. A systematic review using PubMed and Medline databases was conducted, and data on temporomandibular disorder in conjunction with otolaryngological symptoms were collected for analysis. Of 4155 potential studies, 33 were retrieved for detailed evaluation and 12 met the study criteria. There are questionnaires, examination techniques and radiological investigations presented in the literature to assist with distinguishing between otolaryngological causes of symptoms and temporomandibular disorder. Simple treatment can be initiated by the otolaryngologist. Initial temporomandibular disorder treatment steps can be undertaken by the otolaryngologist, with consideration of referral to dentists, oral and maxillofacial surgeons, or physiotherapists if simple pharmacological treatment or temporomandibular disorder exercise fails.
Autism Spectrum Disorder (ASD); Autism; Autistic Disorder; Asperger's Disorder; Asperger's; Pediatric Autism; Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS); Pervasive Child Development Disorder
Mohammad Reza Khakzad
Full Text Available Background: Despite many efforts, the etiology of autism remains unknown. Food allergy has been suggested as a pathogenic factor in Autism Spectrum Disorder (ASD. Our aim in this study was to determine whether food allergy could be considered as a risk factor for autistic children. Methods: Thirty-nine autistic children were examined by the skin prick test (SPT, and total serum IgE was evaluated by ELISA. SPTs were performed for egg whites, oranges, peanuts, tomatoes, tuna fish, walnuts, aubergines, melons, grapes, and cow milk. Parents and teachers were then asked to exclude these items from the childrens’ diets for six months. After the treatment period, the autistic children who tested positive for food allergies were re-assessed by a standard questionnaire to obtain further information about their medical histories. Results: Three of the study’s 39 autistic children (7.7% tested positive on the SPT. Total serum IgE levels were elevated in 56.4% of the subjects (mean=164±24.5, cut-off >155 IU/ml. The results showed a decreased mean in the childrens’ autistic behaviors on the Children Autism Rating Scale (CARS after both eight weeks and six months; however, this decrease was not statistically significant. Conclusion: Food allergy may play a role in the pathophysiology of autism. We conclude that avoidance of certain foods benefits the behavior of autistic children.
Raevuori, Anu; Keski-Rahkonen, Anna; Hoek, Hans W
Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males. Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition has outlined more sex-neutral diagnostic criteria for eating disorders. Data of socioeconomic factors, prenatal influences, clinical characteristics, assessment, and mortality for eating disorders have been reported independently for males. Unlike in females, higher parental education showed no association with eating disorders in males, but twin or triplet status and lower gestational age at birth had an independent association with anorexia nervosa in males. Contrary to earlier suggestions, no differences in eating disorder symptoms such as binging, vomiting, or laxative abuse were observed between the sexes. Yet, males tended to score lower on eating disorder symptom measures than females. High rates of premorbid overweight and higher BMIs at various stages of eating disorders have been confirmed repeatedly. Higher age and lower BMI at admission, and restrictive anorexia nervosa subtype predicted fatal outcome for anorexia nervosa in males. Contemporary research provides grounds for improved recognition, diagnosis, and treatment for males suffering from eating disorders.
Full Text Available Children with autism have a high rate of irritability and aggressive symptoms. Irritability or self-injurious behavior can result in significant harm to those affected, as well as to marked distress for their families. This paper provides a literature review regarding the efficacy and tolerability of pharmacotherapy for the treatment of irritability in autistic children. Although antipsychotics have not yet been approved for the treatment of autistic children by many countries, they are often used to reduce symptoms of behavioral problems, including irritability, aggression, hyperactivity, and panic. However, among antipsychotics, the Food and Drug Administration has approved only risperidone and aripiprazole to treat irritability in autism. Among atypical antipsychotics, olanzapine and quetiapine are limited in their use for autism spectrum disorders in children because of high incidences of weight gain and sedation. In comparison, aripiprazole and ziprasidone cause less weight gain and sedation. However, potential QTc interval prolongation with ziprasidone has been reported. Contrary to ziprasidone, no changes were evident in the QT interval in any of the trials for aripiprazole. However, head-to-head comparison studies are needed to support that aripiprazole may be a promising drug that can be used to treat irritability in autistic children. On the other hand, risperidone has the greatest amount of evidence supporting it, including randomized controlled trials; thus, its efficacy and tolerability has been established in comparison with other agents. Further studies with risperidone as a control drug are needed.
Keen, David A.
Superionic conductors are materials which exhibit exceptionally high ionic conductivity whilst in the solid state. The manner in which certain structures accommodate superionic conduction has preoccupied many scientists throughout the latter part of the last century, beginning with the early debate about the disordered structure of the superionic α-phase of silver iodide. In this review, the key methods that have been used to deduce structural disorder in superionic conductors are described, and the important results summarized. The review focuses on simple archetypal systems, since these have dominated the literature, concentrating on more recent work and including emerging methodologies for deducing structural disorder. In most cases, the interpretation of diffuse scattering, as observed in scattering measurements, has played a crucial role in the understanding of these highly disordered systems and this is considered in some detail.
Ung, E K
Anorexia nervosa, bulimia and binge-eating disorder are the three best recognised eating disorders. Eating disorders have been reported to affect some 1 to 3% of adolescent females in the West. Increasing reports from Asia suggest that it is no longer possible to view these illnesses as 'Western' diseases. Eating disorders are the third most common serious medical disorder in female adolescents, after asthma and depression. It poses a tremendous burden for individuals, families and society. Historical and current studies on eating disorders in Singapore are reviewed, and discussed in the light of available regional and worldwide research. Studies on anorexia nervosa and bulimia in Singapore were identified through a MEDLINE search (from 1979). Information from these studies were supplemented with relevant local monographs on eating disorders. Reports of eating disorders have increased over recent years in the local literature. The psychopathology of eating disorders in Singapore is very similar to that described in the Western literature, and in the two main current classification systems. Body dissatisfaction is prevalent among Singaporean Chinese schoolgirls and female undergraduates, with rates not dissimilar to the West. There is a link between 'Westernisation' (based on English being spoken as the main language at home) and body dissatisfaction.
Hamza, M; Halayem, S; Mrad, R; Bourgou, S; Charfi, F; Belhadj, A
The etiology of autism spectrum disorders (ASD) is complex and multifactorial, and the roles of genetic and environmental factors in its emergence have been well documented. Current research tends to indicate that these two factors act in a synergistic manner. The processes underlying this interaction are still poorly known, but epigenetic modifications could be the mediator in the gene/environment interface. The epigenetic mechanisms have been implicated in susceptibility to stress and also in the pathogenesis of psychiatric disorders including depression and schizophrenia. Currently, several studies focus on the consideration of the etiological role of epigenetic regulation in ASD. The object of this review is to present a summary of current knowledge of an epigenetic hypothesis in ASD, outlining the recent findings in this field. Using Pubmed, we did a systematic review of the literature researching words such as: autism spectrum disorders, epigenetics, DNA methylation and histone modification. Epigenetic refers to the molecular process modulating gene expression without changes in the DNA sequence. The most studied epigenetic mechanisms are those that alter the chromatin structure including DNA methylation of cytosine residues in CpG dinucleotides and post-translational histone modifications. In ASD several arguments support the epigenetic hypothesis. In fact, there is a frequent association between ASD and genetic diseases whose epigenetic etiologies are recognized. A disturbance in the expression of genes involved in the epigenetic regulation has also been described in this disorder. Some studies have demonstrated changes in the DNA methylation of several autism candidate genes including the gene encoding the oxytocin receptor (OXTR), the RELN and the SHANK3 genes. Beyond the analysis of candidate genes, recent epigenome-wide association studies have investigated the methylation level of several other genes and showed hypomethylation of the whole DNA in brain
Autism is a neurodevelopmental disorder for which a number of genetic, environmental, and nutritional causes have been proposed. Glyphosate is used widely as a crop desiccant and as an herbicide in fields of genetically modified foods that are glyphosate resistant. Several researchers have proposed that it may be a cause of autism, based on epidemiological data that correlates increased usage of glyphosate with an increased autism rate. The current study was intended to determine if excessive glyphosate was present in the triplets and their parents and to evaluate biochemical findings for the family to determine the potential effects of its presence. The author performed a case study with the cooperation of the parents and the attending physician. The study took place at The Great Plains Laboratory, Inc (Lenexa, KS, USA). Participants were triplets, 2 male children and 1 female, and their parents. The 2 male children had autism, whereas the female had a possible seizure disorder. All 3 had elevated urinary glyphosate, and all of the triplets and their mother had elevated values of succinic acid or tiglylglycine, which are indicators of mitochondrial dysfunction. The participants received a diet of organic food only. The study performed organic acids, glyphosate, toxic chemicals and tiglylglycine, and creatinine testing of the participants' urine. The 2 male triplets with autism had abnormalities on at least 1 organic acids test, including elevated phenolic compounds such as 4-cresol, 3-[3-hydroxyphenyl]-3-hydroxypropionic acid and 4-hydroxyphenylacetic acid, which have been previously associated with Clostridia bacteria and autism. The female, who was suspected of having a seizure disorder but not autism, did not have elevated phenolic compounds but did have a significantly elevated value of the metabolite tiglylglycine, a marker for mitochondrial dysfunction and/or mutations. One male triplet was retested postintervention and was found to have a markedly lower
DeNigris, Danielle; Brooks, Patricia J.; Obeid, Rita; Alarcon, Maria; Shane-Simpson, Christina; Gillespie-Lynch, Kristen
Reduced cognitive empathy may put autistic people at risk for bullying. We compared interpretations of bullying provided by 22 autistic and 15 non-autistic college students. Autistic (and non-autistic) students reported less severe bullying in college relative to earlier in development. Chronic bullying was associated with improvements in…
Bora, E; Pantelis, C
Impairment in social cognition is an established finding in autism spectrum disorders (ASD). Emerging evidence suggests that attention-deficit/hyperactivity disorder (ADHD) might be also associated with deficits in theory of mind (ToM) and emotion recognition. However, there are inconsistent findings, and it has been debatable whether such deficits persist beyond childhood and how similar social cognitive deficits are in ADHD v. ASD. We conducted a meta-analysis of social cognition, including emotion recognition and ToM, studies in ADHD compared with healthy controls and ASD. The current meta-analysis involved 44 studies comparing ADHD (n = 1999) with healthy controls (n = 1725) and 17 studies comparing ADHD (n = 772) with ASD (n = 710). Facial and vocal emotion recognition (d = 0.40-0.44) and ToM (d = 0.43) abilities were significantly impaired in ADHD. The most robust facial emotion recognition deficits were evident in anger and fear. Social cognitive deficits were either very subtle (emotion recognition) or non-significant (ToM) in adults with ADHD. Deficits in social cognition, especially ToM, were significantly more pronounced in ASD compared with ADHD. General cognitive impairment has contributed to social cognitive deficits in ADHD. Performance of individuals with ADHD on social cognition lies intermediate between ASD and healthy controls. However, developmental trajectories of social cognition probably differ between ADHD and ASD as social cognitive deficits in ADHD might be improving with age in most individuals. There is a need for studies investigating a potential subtype of ADHD with persistent social cognitive deficits and exploring longitudinal changes in social cognition during development.
Hering, Eli; Epstein, Rachel; Elroy, Sarit; Iancu, Daisy R.; Zelnik, Nathanel
This study compared data on sleep disturbances of 22 autistic children obtained by questionnaires with data obtained with actigraphy. Questionnaire responses indicated that autistic children had an earlier morning awakening time and multiple and early night arousals; actigraphic monitoring, however, showed their sleep patterns were normal except…
This paper deals with autistic syntax and its expressions both in the fully fledged autistic structure and in the autistic zones of other personality structures. The musical notion of the organ point serves as a point of departure in an attempt to describe how autistic syntax transforms what was meant to constitute the substrate for linguistic…
Bauer, Stephanie; Kindermann, Sally Sophie; Moessner, Markus
Eating disorders are severe mental illnesses that are challenging to treat and often follow a chronic course. They are associated with immense impairment on the psychological, physical, interpersonal, and social level as well as signifi cant direct and indirect cost. Therefore, prevention and early intervention are of utmost importance. Based on a qualitative literature review, we summarized the empirical evidence for the effi cacy of universal and selective prevention of eating disorders. Programs available in German and/or English were included in the review. In addition to research on effi cacy and effectiveness, the areas of implementation, dissemination, and reach were identifi ed as key issues for future studies. Furthermore, more research is needed on the relationship of cost, benefi t, and risks of eating disorder prevention.
Martins, Regina Helena Garcia; Pereira, Eny Regina Bóia Neves; Hidalgo, Caio Bosque; Tavares, Elaine Lara Mendes
Voice disorders are very prevalent among teachers and consequences are serious. Although the literature is extensive, there are differences in the concepts and methodology related to voice problems; most studies are restricted to analyzing the responses of teachers to questionnaires and only a few studies include vocal assessments and videolaryngoscopic examinations to obtain a definitive diagnosis. To review demographic studies related to vocal disorders in teachers to analyze the diverse methodologies, the prevalence rates pointed out by the authors, the main risk factors, the most prevalent laryngeal lesions, and the repercussions of dysphonias on professional activities. The available literature (from 1997 to 2013) was narratively reviewed based on Medline, PubMed, Lilacs, SciELO, and Cochrane library databases. Excluded were articles that specifically analyzed treatment modalities and those that did not make their abstracts available in those databases. The keywords included were teacher, dysphonia, voice disorders, professional voice. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Robinson, Stephanie; Curwen, Tracey; Ryan, Thomas G.
This review includes empirical peer-reviewed articles which support the examination of Asperger's Disorder and co-morbid disorders, as well as an analysis of how adolescents with Asperger's Disorder transition to adulthood. Although the focus was on Asperger's Disorder, some studies include Autism Spectrum Disorder samples. It was found that…
Weinbrecht, Anna; Schulze, Lars; Boettcher, Johanna; Renneberg, Babette
This review focuses on recent research on diagnostic aspects, etiology, and treatment of avoidant personality disorder (AVPD). Current studies stress the close relation between AVPD and social anxiety disorder, the influence of genetic factors in the development of AVPD, and the relative stability of symptoms. Treatment approaches should target the pervasive patterns of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Empirical evidence for cognitive-behavior and schema therapy is promising. Few other therapeutic approaches have been developed, but until now, these have only been investigated in case studies. We conclude that AVPD qualifies as a neglected disorder and that more research specifically on avoidant personality disorder symptoms and its treatment is needed.
Sleep problems are very common among psychiatric patients. Borderline personality disorder, as a common and severe mental disorder, is associated with different types of sleep disturbances, such as disturbances of sleep continuity, altered REM sleep regulation and nightmares. These disturbances are the result of interaction of the personality traits, concomitant and comorbid diseases and environmental factors. Despite the high prevalence of sleep related disorders in BPD patients, this aspect of BPD is still neglected in clinical and research settings. To date there has been little agreement on sleep characteristics of BPD among different studies, and presence of some uncontrolled confounding factors, make interpretation of the results difficult. However, it seems that appropriate diagnosis and treatment of sleep disorders in BPD patients might lead to better outcome. This article aimed to review the current literature of sleep studies in BPD. Some recommendations and suggestions were made for future researches in this field. Copyright © 2013 Elsevier B.V. All rights reserved.
Ali, Shahid; Jabeen, Shagufta; Pate, Rebecca J; Shahid, Marwah; Chinala, Sandhya; Nathani, Milankumar; Shah, Rida
In this article, the authors accentuate the signs and symptoms of conversion disorder and the significance of clinical judgment and expertise in order to reach the right diagnosis. The authors review the literature and provide information on the etiology, prevalence, diagnostic criteria, and the treatment methods currently employed in the management of conversion disorder. Of note, the advancements of neuropsychology and brain imaging have led to emergence of a relatively sophisticated picture of the neuroscientific psychopathology of complex mental illnesses, including conversion disorder. The available evidence suggests new methods with which to test hypotheses about the neural circuits underlying conversion symptoms. In context of this, the authors also explore the neurobiological understanding of conversion disorder.
Glenn, Andrea L; Johnson, Alexandria K; Raine, Adrian
The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) classification of antisocial personality disorder (ASPD) describes individuals who engage in repetitive irresponsible, delinquent, and criminal behavior. The diagnosis is highly controversial, with many researchers and clinicians arguing that the category is too heterogeneous, overinclusive, and demonstrates considerable overlap with other disorders. This review focuses on recent studies that have improved our understanding of the characteristics of individuals who fit the ASPD definition by exploring how subtypes differ and how comorbid conditions influence the presentation of ASPD. In addition, we discuss research on the etiology of ASPD that has identified genetic and environmental factors that may contribute to the development and persistence of antisocial behavior, and brain imaging research that has improved our understanding of the relationships between ASPD and other psychopathology. Finally, we discuss promising preliminary research on treatment for this disorder.
Pina-Camacho, Laura; Villero, Sonia; Boada, Leticia; Fraguas, David; Janssen, Joost; Mayoral, Maria; Llorente, Cloe; Arango, Celso; Parellada, Mara
This systematic review aims to determine whether or not structural magnetic resonance imaging (sMRI) data support the DSM-5 proposal of an autism spectrum disorder (ASD) diagnostic category, and whether or not classical DSM-IV autistic disorder (AD) and Asperger syndrome (AS) categories should be subsumed into it. The most replicated sMRI findings…
Adler, Benjamin A; Wink, Logan K; Early, Maureen; Shaffer, Rebecca; Minshawi, Noha; McDougle, Christopher J; Erickson, Craig A
Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define drug-refractory aggression, self-injurious behavior, and severe tantrums in people with autism spectrum disorders as behavioral symptoms requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of three psychotropic drugs targeting the symptom cluster, one of which was risperidone or aripiprazole. We reviewed the medical records of individuals of all ages referred to our clinic for autism spectrum disorder diagnostic evaluation, as well as pharmacotherapy follow-up notes for all people meeting autism spectrum disorder criteria, for drug-refractory symptoms. Among 250 consecutively referred individuals, 135 met autism spectrum disorder and enrollment criteria, and 53 of these individuals met drug-refractory symptom criteria. Factors associated with drug-refractory symptoms included age 12 years or older (p disorder (p = 0.0139), and presence of intellectual disability (p = 0.0273). This pilot report underscores the significance of drug-refractory aggression, self-injurious behavior, and severe tantrums; suggests the need for future study clarifying factors related to symptom development; and identifies the need for focused treatment study of this impairing symptom domain. © The Author(s) 2014.
Iniciativas de comunicação na interação entre crianças com distúrbios do espectro autístico e suas mães: análise pragmática Communication initiatives in the interaction among children with autistic spectrum disorders and their mothers: pragmatic analysis
Maria Cláudia Brito
Full Text Available OBJETIVOS: investigar as iniciativas de comunicação na interação entre crianças com distúrbios do espectro autístico (DEA e suas mães, por meio de uma análise pragmática. MÉTODO: cinco crianças com DEA, de ambos os gêneros, idades entre cinco e 12 anos juntamente com suas mães. O grupo controle constou de cinco crianças com desenvolvimento normal, pareadas com as crianças com DEA de acordo com gênero e idade e suas respectivas mães, totalizando 20 participantes. Para a caracterização da amostra foram utilizadas uma Ficha informativa e a Escala de Avaliação de Traços Autísticos. Cada díade foi filmada por 30 minutos durante as interações lúdicas, analisadas a partir do Protocolo de Pragmática. Este instrumento avalia as iniciativas de comunicação, meios e funções comunicativas expressas. Os dados foram tratados estatisticamente (p PURPOSE: to investigate the communication initiatives among children with autistic spectrum disorders and their mothers, employing a pragmatic analysis. METHOD: five children with autistic spectrum disorders, both genders, ages ranging between five and 12-year and their mothers. The control group comprised 5 children with normal development, paired with children with autistic spectrum disorders, according to gender and age and their respective mothers, totaling 20 participants. For the characterization of the sample, an Information Form and a Scale for the Assessment of Autistic Behavior were employed. Each dyad was filmed for 30 minutes during ludic interactions and analyzed according to the Pragmatic Protocol. This instrument evaluates communication initiatives, means and communicative functions. Data were analyzed statistically (p < 0.05; non-parametric tests of Wilcoxon and Mann-Whitney were employed. RESULTS: statistically significant differences were observed between the communicative initiatives of children with autistic spectrum disorders and their mothers, when compared to the
The serotonin transporter promoter length polymorphism (5-hydroxytryptamine transporter length polymorphism; 5-HTTLPR) has long been implicated in autism and other psychiatric disorders. The use of selective serotonin reuptake inhibitors (SSRIs) has a positive effect on treating some symptoms of autism. The effects of these drugs vary in individuals because of the presence of the S or L allele of 5-HTTLPR. Studies performed on various autistic populations have found different allele frequencies for the L and S alleles. Allele frequencies and genotypes of the South African autistic populations (African, mixed, and Caucasian) were compared with matching South African ethnic control populations. The *S/*S genotype was found to be highly significantly associated with all the South African autistic ethnic populations. In the South African African population the *S/*S genotype was present in 7 (33%) of the autistic individuals but in none of the control subjects, yielding infinitely large odds of developing autism. The odds of developing autism with the *S/*S genotype compared to the *L/*L genotype increased 10.15-fold in the South African mixed group and 2.74-fold in the South African Caucasian population. The allele frequency of the South African autistic population was also compared with studies of other autistic populations around the world, and highly significant differences were found with the Japanese, Korean, and Indian population groups. The difference was not significant for the French, German, Israeli, Portuguese, and American groups. This is the first South African study of autistic individuals of different ethnic backgrounds that shows significant differences in allele and genotype frequencies of 5-HTTLPR. The results of this study open new avenues for investigating the role of transmission of the L and S alleles in families with autism in South Africa.
Antineuronal antibodies in autistic children: relation to blood mercury. INTRODUCTION. Autism is a severe neurodevelopmental disorder characterized by impaired communication, social interaction and imagination that is often accompanied by repetitive and stereotyped behavior1. It develops before the 36 month of age.
Background: Autism is a behaviorally defined neurodevelopmental disorder of unknown etiology. Objective: To assess serum copper and ceruloplasmin levels in Egyptian autistic children patients. Subjects and methods: 40 participants have been subjected to thorough history taking, complete clinical examination, ...
Background: It was recently suggested that autism, a severe neurodevelopmental disorder, may involve an autoimmune pathogenesis. Mercury (Hg) is a potential risk factor for autoimmunity in autistic children. Objective: We sought to investigate the expression of antineuronal antibodies, as an index of autoimmunity to brain ...
Al-Farsi, Yahya M.; Al-Sharbati, Marwan M.; Waly, Mostafa I.; Al-Farsi, Omar A.; Al Shafaee, Mohammed A.; Deth, Richard C.
To assess prevalence of malnutrition indicators among preschool children with autism spectrum disorder (ASD) a cross-sectional study was conducted among 128 Omani autistic children 3-5 years of age. Based on standardized z-scores, the overall prevalence of malnutrition was 9.2 per 100 preschool ASD children (95% CI 4.1, 11.6). The most common type…
Roberts, Andrea L; Koenen, Karestan C; Lyall, Kristen; Robinson, Elise B; Weisskopf, Marc G
Persons with autistic traits may be at elevated risk for interpersonal victimization across the life course. Children with high levels of autistic traits may be targeted for abuse, and deficits in social awareness may increase risk of interpersonal victimization. Additionally, persons with autistic traits may be at elevated risk of posttraumatic stress disorder (PTSD) symptoms subsequent to trauma. We examined retrospectively reported prevalence of childhood abuse, trauma victimization and PTSD symptoms by autistic traits among adult women in a population-based longitudinal cohort, the Nurses' Health Study II (N=1,077). Autistic traits were measured by the 65-item Social Responsiveness Scale. We estimated odds ratios (OR) for childhood sexual and physical/emotional abuse and PTSD symptoms by quintiles of autistic traits. We examined possible mediation of PTSD risk by abuse and trauma type. Women in the highest versus lowest quintile of autistic traits were more likely to have been sexually abused (40.1% versus 26.7%), physically/emotionally abused (23.9% versus 14.3%), mugged (17.1% versus 10.1%), pressured into sexual contact (25.4% versus 15.6%) and have high PTSD symptoms (10.7% versus 4.5%). Odds of PTSD were elevated in women in the top three quintiles of autistic traits compared with the reference group (OR range=1.4 to 1.9). Childhood abuse exposure partly accounted for elevated risk of PTSD in women with autistic traits. We identify for the first time an association between autistic traits, childhood abuse, trauma victimization, and PTSD. Levels of autistic traits that are highly prevalent in the general population are associated with abuse, trauma and PTSD. Copyright © 2015 Elsevier Ltd. All rights reserved.
Holttum, J R; Lubetsky, M J; Eastman, L E
The coexistence of trichotillomania and autistic disorder has rarely been reported in psychiatric literature. The current study describes successful treatment of trichotillomania in a young autistic girl, using combined clomipramine and behavioral therapy. Neither behavioral therapy, clomipramine, methylphenidate, buspirone, nor naltrexone was effective in monotherapeutic trials. We postulate a synergistic effect of combined treatment with clomipramine and behavioral therapy, suggesting that both pharmacological and behavioral treatment of hair pulling may be necessary for many patients. This model is consistent with the extant literature and suggests that future clinical trials of clomipramine for trichotillomania, in both developmentally disabled and normal subjects, must evaluate this multimodal approach.
McConachie, Helen; Diggle, Tim
Recent estimates concerning the prevalence of autism spectrum disorder (ASD) suggest that at least one in 200 children is affected. This group of children and families have important service needs. The involvement of parents in implementing intervention strategies designed to help their autistic children has long been accepted as helpful. The potential benefits are increased skills and reduced stress for parents as well as children. This research review focused on interventions for children aged 1-6 years, and was carried out using systematic methodology: a comprehensive search of psychological, educational and biomedical databases, as well as bibliographies and reference lists of key articles, contact with experts in the field, and hand search of key journals. Only studies which involved a concurrent element of control were included. The review found very few studies that had adequate research design from which to draw conclusions about the effectiveness of parent-implemented early intervention. Both randomized and controlled studies tended to suggest that parent training leads to improved child communicative behaviour, increased maternal knowledge of autism, enhanced maternal communication style and parent child interaction, and reduced maternal depression. It seems that parent training can successfully contribute to intervention for young children with ASD. However, the review highlights the need for improved research in this area.
Adler, Benjamin A.; Wink, Logan K.; Early, Maureen; Shaffer, Rebecca; Minshawi, Noha; McDougle, Christopher J.; Erickson, Craig A.
Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define…
Burney, K.; Bradley, M.; Lyburn, I.; Hopkins, R.; Buckley, A.; Rye, A.
Posttransplant lymphoproliferative disorder (PTLD) is a serious and potentially fatal complication after solid organ and haemopoietic stem cell transplantation. The frequency of PTLD varies with the type of organ transplant but overall it affects 2-10% of all solid organ transplant recipients. Most cases develop within 1 year after the transplant, although occasional cases present 5-10 years later. Posttransplant lymphoproliferative disorder is clinically and pathologically heterogeneous - the majority are of the non-Hodgkin's lymphoma type, whereas Hodgkin's lymphoma arising after transplantation is rare. We have retrospectively reviewed patients with a histological diagnosis of PTLD after a solid organ transplant. We present the imaging features and a clinical review of this condition. Early diagnosis of PTLD may alter the management and outcome of the disease. The radiologist can play a vital role in establishing the diagnosis by imaging features supplemented with percutaneous biopsy and also in monitoring the disease response to treatment
Francisco ALCANTUD MARÍN
Full Text Available Published data on the prevalence of autism spectrum disorders point to a significant increase in this indicator. This increase is being studied in numerous publications of analysis, meta-analysis and systematic reviews. The prevalence indicates the proportion of people who suffer at a given time or are diagnosed with a disease. The consequences of the increasing prevalence are relevant from the point of health, social and educational, but especially relevant when as is the case, the cause of the disorder is unknown. It is in this sense that the prevalence study gains importance in order to delimit various circumstances that may give clues to the possible cause or causes that generate disorder. This article reviews studies, summarizes the last data, and reflects on them and possible causes that justify the increased reporting. It looks like these epidemiological indicators can or are influenced by possible methodological flaws behind, which can explain the variations between studies and others. It concludes by stating the need population studies and monitoring that allows us to know the reality of the evolution of these disorders in order to provide reliable information to those responsible for the institutions involved in the detection and treatment of ASD.
Domes, Gregor; Spenthof, Ines; Radtke, Martina; Isaksson, Alexandra; Normann, Claus; Heinrichs, Markus
Difficulties in social interaction are characteristic for depressive disorders and one of the cardinal symptoms of Autism Spectrum Disorders (ASD). It has been proposed that chronically depressed persons have profoundly impaired empathic abilities in comparison to episodically depressed persons, and that specifically they exhibit a deficit in cognitive empathy, but not in affective empathy, a pattern also reported in ASD. This study aimed to explore autistic traits and empathy deficits in chronic depression, and identify specific differences to episodic depression. Autistic traits and multimodal empathy were assessed in chronically depressed patients (n=59), episodically depressed patients (n=40), and a healthy control group (n=55) using standardized questionnaires. Regardless of the disorder's chronicity, depressed patients exhibited higher levels of autistic traits and lower levels of perspective-taking than healthy controls. Chronically depressed patients reported significantly higher impairment in social skills and higher levels of personal distress in social interactions than episodic patients. Our results suggest that patients with chronic depression share two distinct characteristics, namely lower levels of social skills and higher levels of distress in tense social situations than patients with episodic depression. Future studies will need to determine whether the elevated autistic traits in chronic depression are specific to chronic depression, or represent the general tendency to withdraw from social situations. We conclude that chronically depressed patients are not specifically impaired in understanding another person's state of mind, but are unable to deal with another person's suffering or negative affective state. Copyright © 2016 Elsevier B.V. All rights reserved.
Abidullah, Mohammed; Gaddikeri, Kavitha; Raghoji, Swetha; Ravishankar T, Shilpa
Leukoplakias are oral white lesions that have not been diagnosed as any other specific disease. They are grouped under premalignant lesions, now redesignated as potentially malignant disorders. Their significance lies in the fact that they have propensity for malignant transformation at a higher rate when compared to other oral lesions. This article reviews aetiology, epidemiology, clinical characteristics, histopathologic features, malignant potential and treatment of oral leukoplakia. PMID:25302287
Full Text Available The article presents a detailed review on epidemiology, pathogenesis and interrelation of serotonin neuromedia-tor metabolism in the central nervous system in state of chronic pain and depression. It has been demonstrated that neurophysiological conditions serve as psychological defense of an individual. That mechanism has been proved to «transform» serious emotions onto the inner level (body and it assists in the development of psychosomatic disorders — chronic pain syndrome
Finkenauer, C.; Pollmann, M.M.H.; Begeer, S.; Kerkhof, P.
Individuals with autism spectrum disorders or autistic traits may profit from Internet and computer-mediated interactions, but there is concern about their Internet use becoming compulsive. This study investigated the link between autistic traits and Internet use in a 2-wave longitudinal study with
Finkenauer, Catrin; Pollmann, Monique M. H.; Begeer, Sander; Kerkhof, Peter
Individuals with autism spectrum disorders or autistic traits may profit from Internet and computer-mediated interactions, but there is concern about their Internet use becoming compulsive. This study investigated the link between autistic traits and Internet use in a 2-wave longitudinal study with a non-clinical community sample (n = 390). As…
Appart, A; Lange, A-K; Sievert, I; Bihain, F; Tordeurs, D
This paper exposes the complexity and discrete characteristic of the adjustment disorder with reference to its clinical and scientific diagnosis. Even though the disorder occurs in frequent clinical circumstances after important life events, such as mobbing, burn-out, unemployment, divorce or separation, pregnancy denial, surgical operation or cancer, the adjustment disorder is often not considered in the diagnosis since better known disorders with similar symptoms prevail, such as major depression and anxiety disorder. Ten years ago, Bottéro had already noticed that the adjustment disorder diagnosis remained rather uncommon with reference to patients he was working with while Langlois assimilated this disorder with an invisible diagnosis. In order to maximize the data collection, we used the article review below and challenged their surveys and results: National Center for Biotechnology Information (NBCI - Pubmed) for international articles and Cairn.info for French literature. Moreover, we targeted the following keywords on the search engine and used articles, which had been published from 1 February 1975 to 31 January 2015: "adjustment", "adjustment disorder" and the French translation "trouble de l'adaptation". One hundred and ninety-one articles matched our search criteria. However, after a closer analysis, solely 105 articles were selected as being of interest. Many articles were excluded since they were related to non-psychiatric fields induced by the term "adaptation". Indeed, the number of corresponding articles found for the adjustment disorder literally pointed-out the lack of existing literature on that topic in comparison to more known disorders such as anxiety disorder (2661 articles) or major depression (5481 articles). This represents up to 50 times more articles in comparison to the number of articles we found on adjustment disorder and up to 20 times more articles for the eating disorder (1994), although the prevalence is not significantly
Full Text Available Gabriel C Quintero Florida State University – Republic of Panama, Panama City, Panama Abstract: The present review is an overview of previous experimental work on biopsychological aspects of gambling disorder. It includes the topics 1 gambling disorder from the neuroimaging and electroencephalography (EEG perspective, 2 cognitive, executive functioning, and neuropsychological aspects of gambling disorder, and 3 rodent models of gambling disorder. Penalties and losses in gambling can differ in terms of brain activity. Also, specific patterns of brain activity, brain anatomical traits, EEG responses, and cognitive and executive performance can discriminate pathological gamblers from nonpathological gamblers. Also, pathological gamblers can display dysfunction in such brain areas as the insula, frontal lobe, and orbitofrontal cortex. Pathological gambling is a heterogeneous disorder that can vary depending on the severity of cognition, the style of gambling (strategic or not, the prospect of recovery, proneness to relapse, and proneness to treatment withdrawal. Finally, based on rodent models of gambling, the appropriateness of gambling decision is influenced by the presence of cues, the activity of dopamine receptors, and the activity of some brain areas (infralimbic, prelimbic, or rostral agranular insular cortex. Pathological gamblers differed in terms of frontoparietal brain activation compared to nonpathological gamblers (if winning or losing a game. Pathological gamblers had dysfunctional EEG activity. The severity of gambling was linked to the magnification and content of cognitive distortions. The insula was fundamental in the distortion of cognitions linked to result analysis during gambling activity. Keywords: pathological gambling, biopsychology, human, rodent
Al-Mosalem, O A; El-Ansary, A; Attas, O; Al-Ayadhi, L
Energy metabolism is usually manipulated in many neurodegenerative diseases. Autism is considered a definable systemic disorder resulting in a number of diverse factors that may affect the brain development and functions both pre and post natal. The increased prevalence of autism will have enormous future public implications and has stimulated intense research into potential etiologic factors. This study aims to establish a connection between autism and the deterioration accompanied it, especially in the brain cognitive areas through a postulation of energy manipulation. The biochemical changes in activities of enzymes and pathways that participate in the production of ATP as the most important high-energy compound needed by the human brain were measured in Saudi autistic children. Na(+)/K(+)ATPase, ectonucleotidases (NTPDases) (ADPase and ATPase) and creatine kinase (CK), were assessed in plasma of 30 Saudi autistic patients and compared to 30 age-matching control samples. In addition, adenosine mono, di and trinucleotides (ATP, ADP, and AMP) were measured calorimetrically in the red blood cells of both groups and the adenylate energy charge (AEC) was calculated. Moreover, lactate concentration in plasma of both groups was monitored. The obtained data recorded 148.77% and 72.35% higher activities of Na(+)/K(+)ATPase and CK respectively in autistic patients which prove the impairment of energy metabolism in these children compared to age and sex matching healthy controls. While ADPase was significantly higher in autistic patients, ATPase were non-significantly elevated compared to control. In spite of the significant increase of Na(+)/K(+)ATPase activity in autistic patients, there was no significant difference in the levels of ATP, ADP, and AMP in both groups and the calculated AEC values were 0.814+/-0.094 and 0.806+/-0.081 for autistic and control groups respectively. The unchanged AEC value in autistic patients was easily correlated with the induced activity of
Skewes, Joshua; Jegindø, Else-Marie Elmholdt; Gebauer, Line
Autistic people are better at perceiving details. Major theories explain this in terms of bottom-up sensory mechanisms, or in terms of top-down cognitive biases. Recently, it has become possible to link these theories within a common framework. This framework assumes that perception is implicit....... In this preliminary study, we compared these models using groups with high and low autistic trait scores (AQ). We found evidence supporting the cognitive bias model, and no evidence for the enhanced sensory precision model....
Alunos com distúrbios do espectro autístico em interação com professores na educação inclusiva: descrição de habilidades pragmáticas Students with autistic spectrum disorders in the interaction with teachers in inclusive education: description of pragmatic skills
Maria Claudia Brito
Full Text Available OBJETIVO: Investigar as habilidades pragmáticas de alunos com distúrbios do espectro autístico durante a interação com suas professoras em salas comuns de escolas públicas. MÉTODOS: Participaram 14 alunos com distúrbios do espectro autístico, de ambos os gêneros, com idade entre três e oito anos (média=5,9; DP=1,8. Como parte do procedimento, foram realizadas filmagens em situações de sala de aula e para análise dos aspectos pragmáticos da comunicação dos participantes, foi utilizado o Protocolo de Pragmática. Os resultados foram tratados estatisticamente (pPURPOSE: To investigate the pragmatic skills of students with autistic spectrum disorders during interaction with their teachers, in regular classrooms of public schools. METHODS: Fourteen students with autistic spectrum disorders, both male and female, with ages between three and eight years (mean=5.9; SD=1.8, participated in the study. As part of the procedure, classroom situations were filmed for the analysis of the children's pragmatic aspects of communication, using the Pragmatic Protocol. Data were statistically analyzed using Wilcoxon, Friedman, Kruskal-Wallis, and Spearman tests, with a significance level of p<0.05 and, in some cases, p<0.01. RESULTS: In average, the number of communicative acts expressed per minute by the teachers (3.4 acts/minute was superior (p<0.05 to the number presented by the students with autistic spectrum disorders (2.7 acts/minute. The students demonstrated prevalence in the use of the gestural communication mean, with an average of 36.2 occurrences, and of less interactive communicative functions, with an average of 24.1 occurrences. Moreover, there was positive correlation between students' and teachers' acts/minute (p=0.01. It was also observed that age and level of education did not present correlations with communication establishment in the dyads. CONCLUSION: It was possible to identify deficits and abilities of students with
Stevenson, Jennifer L; Lindley, Caitlin E; Murlo, Nicole
Autistic individuals often struggle developmentally, even in areas that are not explicit diagnostic criteria, such as motor skills. This study explored the relation between early motor skills, assessed retrospectively, and current pragmatic language skills. Caregivers of neurotypical and autistic children, matched on gender and age, completed assessments of their child's early motor development and current language abilities. Early motor skills were correlated with later pragmatic language skills, and autistic children exhibited fewer motor skills than neurotypical children. In fact, motor skills were a better predictor of an autism spectrum diagnosis than were scores on a measure of current pragmatic language. These results highlight the important role of motor skills in autism spectrum disorders.
Xie, Zizhen; Chen, Fei; Li, William A; Geng, Xiaokun; Li, Changhong; Meng, Xiaomei; Feng, Yan; Liu, Wei; Yu, Fengchun
Sleep disorders are a group of conditions that affect the ability to sleep well on a regular basis and cause significant impairments in social and occupational functions. Although currently approved medications are efficacious, they are far from satisfactory. Benzodiazepines, antidepressants, antihistamines and anxiolytics have the potential for dependence and addiction. Moreover, some of these medications can gradually impair cognition. Melatonin (N-acetyl-5-methoxytryptamine) is an endogenous hormone produced by the pineal gland and released exclusively at night. Exogenous melatonin supplementation is well tolerated and has no obvious short- or long-term adverse effects. Melatonin has been shown to synchronize the circadian rhythms, and improve the onset, duration and quality of sleep. It is centrally involved in anti-oxidation, circadian rhythmicity maintenance, sleep regulation and neuronal survival. This narrative review aims to provide a comprehensive overview of various therapeutic functions of melatonin in insomnia, sleep-related breathing disorders, hypersomnolence, circadian rhythm sleep-wake disorders and parasomnias. Melatonin offers an alternative treatment to the currently available pharmaceutical therapies for sleep disorders with significantly less side effects.
Liew, Shi Min; Thevaraja, Nishta; Hong, Ryan Y.; Magiati, Iliana
The high prevalence of anxiety symptoms in individuals with autism spectrum disorders has now been well documented. There is also a positive relationship between autistic traits and anxiety symptoms in unselected samples and individuals with anxiety disorders have more autistic traits compared to those without. Less is known, however, regarding…
Robles, David T; Romm, Sharon; Combs, Heidi; Olson, Jonathan; Kirby, Phil
There are several unique psychiatric disorders that are likely to present to a dermatologist because of their accompanying skin complaints. Delusions of parasitosis (DP) is a fixed, false belief of parasitic infestation that may lead patients to compulsively self-mutilate while attempting to remove the non-existent parasites. Morgellons disease is a controversial condition characterized by a fixed belief that fibers that are imbedded or extruding from the skin; this condition is likely in the spectrum of DP. Body dysmorphic disorder (BDD) is a preoccupation with an imagined defect in appearance that causes significant distress and is associated with time consuming rituals, isolation, depression, and increased risk of suicide. Olfactory reference syndrome (ORS) is a preoccupation with body odor leading to the stigmata of shame, embarrassment, and social isolation. This brief review examines each of these conditions and their management because any one of them may present to a dermatologist.
Full Text Available AimGonadal hormones are essential for reproductive function, but can act on neural and other organ systems, and are probably the cause of the large majority of known sex differences in function and disease. The aim of this review is to provide evidence for this hypothesis in relation to eye disorders and to retinopathies in particular.MethodsEpidemiological studies and research articles were reviewed.ResultsAnalysis of the biological basis for a relationship between eye diseases and hormones showed that estrogen, androgen, and progesterone receptors are present throughout the eye and that these steroids are locally produced in ocular tissues. Sex hormones can have a neuroprotective action on the retina and modulate ocular blood flow. There are differences between the male and the female retina; moreover, sex hormones can influence the development (or not of certain disorders. For example, exposure to endogenous estrogens, depending on age at menarche and menopause and number of pregnancies, and exposure to exogenous estrogens, as in hormone replacement therapy and use of oral contraceptives, appear to protect against age-related macular degeneration (both drusenoid and neurovascular types, whereas exogenous testosterone therapy is a risk factor for central serous chorioretinopathy. Macular hole is more common among women than men, particularly in postmenopausal women probably owing to the sudden drop in estrogen production in later middle age. Progestin therapy appears to ameliorate the course of retinitis pigmentosa. Diabetic retinopathy, a complication of diabetes, may be more common among men than women.ConclusionWe observed a correlation between many retinopathies and sex, probably as a result of the protective effect some gonadal hormones may exert against the development of certain disorders. This may have ramifications for the use of hormone therapy in the treatment of eye disease and of retinal disorders in particular.
Woods, Douglas W.; Miltenberger, Raymond G.
This paper first reviews four classes of habit disorders in children: motor and vocal tics, nervous habits, stuttering, and Tourette's disorder. It then describes the habit reversal procedure and reviews the literature on its use and variations to treat each of the four classes of habit disorders. Emphasis is on simplified versions of the original…
Arora, Manu; Praharaj, Samir Kumar; Sarkhel, Sujit; Sinha, Vinod Kumar
Asperger disorder was first described in 1944 by the Austrian pediatrician, Hans Asperger. It was introduced as a separate diagnostic category from autistic disorder in DSM-IV and ICD-10. The pattern of comorbidity in Asperger disorder is different from autistic disorder, with a higher level of psychosis, violent behavior, anxiety, and mood disorders. We present three cases of Asperger disorder diagnosed for the first time in adulthood, with psychosis being the predominant reason for the referral. In each case, the psychosis improved with antipsychotic treatment, although core autistic symptoms remained the same.
Gras, A; Amad, A; Thomas, P; Jardri, R
Hallucinations constitute understudied symptoms in borderline personality disorders (BPD), which can be observed in about 30% of the patients, essentially in the auditory modality. Most of these experiences are transitory, triggered by intermittent stressors, but chronicity remains a major cause of concern. In order to better circumscribe hallucinations in BPD, we summarized the literature on this particular phenomenon. We conducted a review using Medline, Scopus and Google Scholar databases up to March 2013, using the following keywords combinations: "borderline personality disorder", "hallucinat*" and "psychotic symptoms". Papers were included in the review if they were published in an English or French language peer-reviewed journal; the study enrolled patients with BPD; and the diagnosis was made according to the Diagnostic and Statistical Manual (DSM) criteria. Fifteen studies published between 1985 and 2012, merging a total of 635 patients, were retained. The hallucinatory experiences observed in BPD appeared phenomenologically similar to those described in the schizophrenia spectrum in terms of vividness, duration, spatial localization, beliefs about malevolence or omnipotence. Conversely, the hallucinatory content appeared more negative and potentially more distressful. Crucially, this literature search also revealed that these symptoms have long been regarded as "pseudo-hallucinations" (or "hallucination-like symptoms"). This concept was judged of poor scientific validity, inducing stigma for BPD patients in that it casts doubt on the authenticity of these experiences while disqualifying the related distress. This situation points out that research should focus more on understanding hallucinations in BPD than questioning their existence. Interestingly, recent comorbidity studies reopened a 40-year debate on the potential links that may exist between BPD and psychosis. Initially considered as a para-psychotic disorder, BPD was effectively redefined as an
Rengit, Ashy C.; McKowen, James W.; O'Brien, Julie; Howe, Yamini J.; McDougle, Christopher J.
There is limited literature available on the comorbidity between autism spectrum disorder (ASD) and substance use disorder (SUD). This paper reviews existing literature and exemplifies the challenges of treating this population with a case report of an adult male with ASD and DSM-5 alcohol use disorder. This review and case study seeks to…
Full Text Available Intellectual disability is a term used when a person has certain limitations in mental functioning and skills. Autism is a group of developmental brain disorders, collectively called autism spectrum disorder (ASD. Teenagers with learning and physical disabilities are more likely to have menstrual problems compared to the general populations. The parents of a 12-year-old girl with autism spectrum disorder and intellectual disability referred to the coroner due to her numerous problems of puberty (menstruation including: poor hygiene and polluting herself and the environment, not allowing to put or change the pads and changes in mood and physical health prior period, requested for the surgery (hysterectomy. In legal medicine organization after reviewing the medical records, physical exams and medical consultations with a gynecologist and psychiatric, surgery was not accepted. Hysterectomy (surgery due to the age of the child, either physically or morally is not recommended. The use of hormone replacement therapy has side effects such as osteoporosis. In these cases, it seems noninvasive methods (behavioral therapy and learning care skills under the welfare experts is also more effective and morally.
Aneta Michalska; Natalia Szejko; Andrzej Jakubczyk; Marcin Wojnar
Aim. The aim of this paper was to characterise nonspecific eating disorders (other than anorexia nervosa and bulimia nervosa). Method. The Medline database was searched for articles on nonspecific eating disorders. The following disorders were described: binge eating disorder (BED), pica, rumination disorder, avoidant/restrictive food intake disorder, night eating syndrome (NES), sleep-related eating disorder (SRED), bigorexia, orthorexia, focusing on diagnosis, symptoms, assessment, comorbid...
Karaklic, D; Bungener, C
Borderline personality disorder (BPD) is a serious mental disorder associated with severe emotional, behavioral, cognitive and interpersonal dysfunction, extensive functional impairment and frequent self-destructive behaviour, including deliberate self-harm and suicidal behaviour. For quite some time, BPD has been viewed as a chronic disorder and borderline patients as extremely difficult to treat, doomed to a life of misery. However, those views are changing and there is an increasing recognition that BPD has a far more benign course than previously thought. The purpose of this study is to show how those views changed over time by reviewing longitudinal studies of the course of BPD. We have reviewed the literature published from 1968 to March 2009, using the following key words: borderline personality disorder, outcome, follow-up studies with some additional references. The aim of the longitudinal studies conducted prior to the DSM definition of BPD criteria was to determine whether borderline patients could become psychotic over time, but no such evidence was found even though their functioning was at a relatively low level. The studies conducted after the introduction of BPD in the DSM in 1980 tested the stability and the specificity of BPD diagnosis, concluding that the criteria were relatively stable in the short run since the majority of patients continued to meet them at the follow-up assessments. However, those studies had many methodological drawbacks which limited their generalizability such as small sample sizes, high attrition rates, the absence of comparison groups, etc. Four retrospective studies of the 15-year outcome of borderline patients obtained virtually identical results despite methodological differences, showing that the global functioning of borderline patients improved substantially over time with mean scores of the GAF scale falling within a mild range of impairment. One 27-year retrospective study showed that borderline patients continued
González Rodríguez, Julia
Autism Spectrum Disorder (ASD) is a condition that affects people’s ability to interact, communicate and behave properly. This dissertation explains the main traits of this disorder in order to raise awareness of the special needs that Autistic people have. In addition to this, it is also the aim of this paper to provide the readers with a teaching project for the “English as a Foreign Language” classroom that meets not only the Autistic students’ requirements, but also the non-Autistic child...
Stratton, Kathleen; Gable, Alicia; McCormick, Marie C
In this report, the Immunization Safety Review committee examines the hypothesis of whether or not the use of vaccines containing the preservative thimerosal can cause neurodevelopmental disorders (NDDs...
Michalska, Aneta; Szejko, Natalia; Jakubczyk, Andrzej; Wojnar, Marcin
The aim of this paper was to characterise nonspecific eating disorders (other than anorexia nervosa and bulimia nervosa). The Medline database was searched for articles on nonspecific eating disorders. The following disorders were described: binge eating disorder (BED), pica, rumination disorder, avoidant/restrictive food intake disorder, night eating syndrome (NES), sleep-related eating disorder (SRED), bigorexia, orthorexia, focusing on diagnosis, symptoms, assessment, comorbidities, clinical implications and treatment. All of the included disorders may have dangerous consequences, both somatic and psychological. They are often comorbid with other psychiatric disorders. Approximately a few percent of general population can be diagnosed with each disorder, from 0.5-4.7% (SRED) to about 7% (orthorexia). With the growing literature on the subject and changes in DSM-5, clinicians recognise and treat those disorders more often. More studies have to be conducted in order to differentiate disorders and treat or prevent them appropriately.
Mohammad Reza MOHAMMADI; Maryam SALMANIAN; Shahin AKHONDZADEH
How to Cite this Article: Mohammadi MR, Salmanian M, Akhondzadeh Sh. Autism Spectrum Disorders in Iran. Iranian Journal of Child Neurology2011;5(4):1-9.ObjectiveAutistic disorder, Asperger syndrome, and PDD-Not Otherwise Specified are subsets of autism spectrum disorders (ASDs), which are characterized by impairments in social communication and stereotyped behavior. This article reviews the prevalence, etiology, diagnosis, and treatment of ASDs in Iran.Materials & MethodsWe searched PubMe...
Anxiety disorders are the most prevalent psychiatric disorders. There is a high comorbidity between anxiety (especially generalized anxiety disorders or panic disorders) and depressive disorders or between anxiety disorders, which renders treatment more complex. Current guidelines do not recommend benzodiazepines as first-line treatments due to their potential side effects. Selective serotonin reuptake inhibitors and selective serotonin norepinephrine reuptake inhibitors are recommended as fi...
Gerlach, G; Loeber, S; Herpertz, S
Studies demonstrate an association between personality traits and obesity as well as their prognostic influence on weight course. In contrast, only few studies have investigated the association between personality disorders (PDs) and obesity. The present review summarizes through a comprehensive and critical evaluation the results of 68 studies identified by database research (PubMed and PsycINFO) covering the last 35 years that investigated the association between PDs, overweight and obesity as well as the predictive value of PDs for the development of obesity and the effectiveness of weight reduction treatments. Adults with any PD have a higher risk of obesity. In the female general population, there is an association between avoidant or antisocial PD and severe obesity. Further, women with paranoid or schizotypal PD have a higher risk of obesity. Clinical studies including foremost female participants showed a higher comorbidity of PDs, especially borderline PD and avoidant PD, in binge-eating disorder. Regarding both genders, patients with PD show less treatment success in conservative weight-loss treatment programmes for obesity than patients without PD. In prevention and conservative weight-loss treatment strategies, more care should be taken to address the special needs of patients with comorbid PDs. © 2016 World Obesity.
Malacarne, Alberto; Spierings, Egilius L H; Lu, Chao; Maloney, George E
Persistent dentoalveolar pain of idiopathic origin represents a diagnostic challenge for the dentist and physician alike. Disagreement on taxonomy and diagnostic criteria presents a significant limit to the advancement of research in the field. Patients struggle with a lack of knowledge by dental and medical professionals, diagnostic delays, and unnecessary treatments. A PubMed search was performed as of January 1, 2017 by using the terms atypical odontalgia, phantom tooth pain, persistent idiopathic facial pain, painful posttraumatic trigeminal neuropathy, idiopathic toothache, persistent dentoalveolar pain disorder, nonodontogenic tooth pain, and continuous neuropathic orofacial pain. Three hundred forty-five abstracts were screened, and 128 articles that were pertinent to the topic went through full-text reading. Case reports and narrative reviews constitute the majority of available literature. Several retrospective case-control studies investigated the clinical characteristics, pathophysiology, and diagnostic processes. Treatment strategies were evaluated in only 7 open-label and 2 randomized controlled trials. Persistent dentoalveolar pain disorder is likely neuropathic in origin, but pathophysiological mechanisms to explain the onset and persistence of the pain are still far from understood. A correct diagnosis should be established before treatments are performed. Researchers should reach an agreement on the diagnostic criteria to enable a coherent research path to better understand the condition and reduce patient suffering. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Singh, Vijendra K; Hanson, Jeff
Allergic autoimmune reaction after exposure to heavy metals such as mercury may play a causal role in autism, a developmental disorder of the central nervous system. As metallothionein (MT) is the primary metal-detoxifying protein in the body, we conducted a study of the MT protein and antibodies to metallothionein (anti-MT) in normal and autistic children whose exposure to mercury was only from thimerosal-containing vaccines. Laboratory analysis by immunoassays revealed that the serum level of MT did not significantly differ between normal and autistic children. Furthermore, autistic children harboured normal levels of anti-MT, including antibodies to isoform MT-I (anti-MT-I) and MT-II (anti-MT-II), without any significant difference between normal and autistic children. Our findings indicate that because autistic children have a normal profile of MT and anti-MT, the mercury-induced autoimmunity to MT may not be implicated in the pathogenesis of autism.
Maule, John; Stanworth, Kirstie; Pellicano, Elizabeth; Franklin, Anna
It has been suggested that attenuated adaptation to visual stimuli in autism is the result of atypical perceptual priors (e.g., Pellicano and Burr in "Trends Cogn Sci" 16(10):504-510, 2012. doi:10.1016/j.tics.2012.08.009). This study investigated adaptation to color in autistic adults, measuring both strength of afterimage and the…
Since 1979 we have performed CT examinations on 132 autistic children. Neurological diagnosis of the lesion was established by Dr. Segawa's group. On the CT of many autistic children, we found a small low density change located in the anterior wall of the temporal horn, or localized dilatation of the inferior horn near the damaged brain. We reviewed 96 of these patients who all had the obvious low density changes, or localized irregular dilatations in the anterior wall of the temporal horn. By measuring the distance of damage from the midline, we divided the 96 cases into two groups. Group 1 consisted of those with damage located laterally more than 30 mm line from the midline. Group 2 consisted of those with damage medially to the 30 mm line from the midline. Those cases with a large lesion both laterally and medially of the 30 mm line were categorized into group 1. In the adult brain the lateral border of the amygdaloid nucleus was never located laterally more than 30 mm from the midline. Laterally over the 30 mm line there were two marked fiber systems running near the anterior wall of the temporal horn: the fiber of the anterior commissure and the uncinate fascicle. Group 1 consisted of 62 patients and group 2 of 34 patients. The majority of the two group patients were pure autism children. This suggested that the main lesion in autism was in the amygdala. (author)
Anxiety disorders are the most prevalent psychiatric disorders. There is a high comorbidity between anxiety (especially generalized anxiety disorders or panic disorders) and depressive disorders or between anxiety disorders, which renders treatment more complex. Current guidelines do not recommend benzodiazepines as first-line treatments due to their potential side effects. Selective serotonin reuptake inhibitors and selective serotonin norepinephrine reuptake inhibitors are recommended as first-line treatments. Psychotherapy, in association with pharmacotherapy, is associated with better efficacy. Finally, a bio-psycho-social model is hypothesized in anxiety disorders.
Rash CJ; Weinstock J; Van Patten R
Carla J Rash,1 Jeremiah Weinstock,2 Ryan Van Patten2 1Calhoun Cardiology Center – Behavioral Health, UConn Health, Farmington, CT, USA; 2Department of Psychology, Saint Louis University, St Louis, MO, USA Abstract: In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder was recategorized from the “Impulse Control Disorder” section to the newly expanded “Substance-related and Addictive Disorders&r...
Epidemiological studies show that anxiety disorders are highly prevalent and an important cause of functional impairment; they constitute the most frequent menial disorders in the community. Phobias are the most common with the highest rates for simple phobia and agoraphobia. Panic disorder (PD) and obsessive-compulsive disorder (OCD) are less frequent (2% lifetime prevalence), and there are discordant results for social phobia (SP) (2%-16%) and generalized anxiety disorder (GAD) (3%-30%). Th...
Matson, Johnny L.; Worley, Julie A.; Kozlowski, Alison M.; Chung, Kyong-Mee; Jung, Woohyun; Yang, Jae-won
Symptoms of Autism Spectrum Disorders are universally accepted; however, the reported severity of symptoms may be sensitive to cultural differences. Therefore, the aim of the current study was to examine the differences in reported symptoms of appropriate and inappropriate social skills between children and adolescents from South Korea (SK) and…
Jansen, Sofie; Bhangu, Jaspreet; de Rooij, Sophia; Daams, Joost; Kenny, Rose Anne; van der Velde, Nathalie
Objective: Cardiovascular disorders are recognized as risk factors for falls in older adults. The aim of this systematic review was to identify cardiovascular disorders that are associated with falls, thus providing angles for optimization of fall-preventive care. Design: Systematic review. Data
Grant, Jon E; Odlaug, Brian L; Chamberlain, Sam
Gambling disorder affects 0.4 to 1.6% of adults worldwide, and is highly comorbid with other mental health disorders. This article provides a concise primer on the neural and psychological underpinnings of gambling disorder based on a selective review of the literature. Gambling disorder is associated with dysfunction across multiple cognitive domains which can be considered in terms of impulsivity and compulsivity. Neuroimaging data suggest structural and functional abnormalities of networks...
Epidemiological studies show that anxiety disorders are highly prevalent and an important cause of functional impairment; they constitute the most frequent menial disorders in the community. Phobias are the most common with the highest rates for simple phobia and agoraphobia. Panic disorder (PD) and obsessive-compulsive disorder (OCD) are less frequent (2% lifetime prevalence), and there are discordant results for social phobia (SP) (2%-16%) and generalized anxiety disorder (GAD) (3%-30%). These studies underline the importance of an accurate definition of disorders using unambiguous diagnostic and assessment criteria. The boundaries between anxiety disorders are often ill defined and cases may vary widely according to the definition applied. Simple phobia, agoraphobia, and GAD are more common in vmrnen, while there is no gender différence for SP, PD, and OCD, Anxiety disorders are more common in separated, divorced, and widowed subjects; their prevalence is highest in subjects aged 25 to 44 years and lowest in subjects aged >65 years. The age of onset of the different types of anxiety disorders varies widely: phobic disorders begin early in life, whereas PD occurs in young adulthood. Clinical - rather than epidemiological - studies have examined risk factors such as life events, childhood experiences, and familial factors. Anxiety disorders have a chronic and persistent course, and are frequently comorbid with other anxiety disorders, depressive disorders, and substance abuse. Anxiety disorders most frequently precede depressive disorders or substance abuse, Comorbid diagnoses may influence risk factors like functional impairment and quality of life. It remains unclear whether certain anxiety disorders (eg, PD) are risk factors for suicide. The comorbidity of anxiety disorders has important implications for assessment and treatment and the risk factors should be explored. The etiology, natural history, and outcome of these disorders need to be further addressed
Modesto J. Romero-López
Full Text Available In this paper we review the idea of dissociation, dissociative disorders and their relationship with the processes of consciousness. We will deal specifically with multiple personality disorder and posttraumatic stress disorder. Both polarize the discussion of diagnostic categories with dissociative symptoms. This review compares the initial ideas (one century old with the current scenario and emerging trends in research, which are relating cognitive processes and dissociative phenomena and disorders from a neuroscientific approach. We discuss the ideas on dissociation, hypnosis and suicide associated with these disorders. There seems to be a lack of consensus as to the nature of dissociation with theoretical, empirical and clinical implications.
Background Glutathione has a wide range of functions; it is an endogenous anti-oxidant and plays a key role in the maintenance of intracellular redox balance and detoxification of xenobiotics. Several studies have indicated that children with autism spectrum disorders may have altered glutathione metabolism which could play a key role in the condition. Methods A systematic literature review and meta-analysis was conducted of studies examining metabolites, interventions and/or genes of the glutathione metabolism pathways i.e. the γ-glutamyl cycle and trans-sulphuration pathway in autism spectrum disorders. Results Thirty nine studies were included in the review comprising an in vitro study, thirty two metabolite and/or co-factor studies, six intervention studies and six studies with genetic data as well as eight studies examining enzyme activity. Conclusions The review found evidence for the involvement of the γ-glutamyl cycle and trans-sulphuration pathway in autistic disorder is sufficiently consistent, particularly with respect to the glutathione redox ratio, to warrant further investigation to determine the significance in relation to clinical outcomes. Large, well designed intervention studies that link metabolites, cofactors and genes of the γ-glutamyl cycle and trans-sulphuration pathway with objective behavioural outcomes in children with autism spectrum disorders are required. Future risk factor analysis should include consideration of multiple nutritional status and metabolite biomarkers of pathways linked with the γ-glutamyl cycle and the interaction of genotype in relation to these factors. PMID:22524510
Main Penelope AE
Full Text Available Abstract Background Glutathione has a wide range of functions; it is an endogenous anti-oxidant and plays a key role in the maintenance of intracellular redox balance and detoxification of xenobiotics. Several studies have indicated that children with autism spectrum disorders may have altered glutathione metabolism which could play a key role in the condition. Methods A systematic literature review and meta-analysis was conducted of studies examining metabolites, interventions and/or genes of the glutathione metabolism pathways i.e. the γ-glutamyl cycle and trans-sulphuration pathway in autism spectrum disorders. Results Thirty nine studies were included in the review comprising an in vitro study, thirty two metabolite and/or co-factor studies, six intervention studies and six studies with genetic data as well as eight studies examining enzyme activity. Conclusions The review found evidence for the involvement of the γ-glutamyl cycle and trans-sulphuration pathway in autistic disorder is sufficiently consistent, particularly with respect to the glutathione redox ratio, to warrant further investigation to determine the significance in relation to clinical outcomes. Large, well designed intervention studies that link metabolites, cofactors and genes of the γ-glutamyl cycle and trans-sulphuration pathway with objective behavioural outcomes in children with autism spectrum disorders are required. Future risk factor analysis should include consideration of multiple nutritional status and metabolite biomarkers of pathways linked with the γ-glutamyl cycle and the interaction of genotype in relation to these factors.
Sedgewick, Felicity; Hill, Vivian; Yates, Rhiannon; Pickering, Leanne; Pellicano, Elizabeth
This mixed-methods study examined gender differences in the social motivation and friendship experiences of adolescent boys and girls with autism relative to those without autism, all educated within special education settings. Autistic girls showed similar social motivation and friendship quality to non-autistic girls, while autistic boys…
Cederlöf, Martin; Pettersson, Erik; Sariaslan, Amir; Larsson, Henrik; Östberg, Per; Kelleher, Ian; Långström, Niklas; Gumpert, Clara Hellner; Lundström, Sebastian; Lichtenstein, Paul
Studies suggest associations between childhood autistic traits and adolescent psychotic experiences. However, recent research suggests that a general neuropsychiatric problems factor predicts adverse outcomes better than specific diagnostic entities. To examine if the alleged association between autistic traits and psychotic experiences could rather be explained by a general neuropsychiatric problems factor comprising symptoms of ADHD, tic disorder, developmental coordination disorder, and learning disorder, we conducted a prospective cohort study based on the Child and Adolescent Twin Study in Sweden. In addition, we examined the genetic and environmental influences on the associations. A total of 9,282 twins with data on childhood autistic traits and other neuropsychiatric problems, and follow-up data on psychotic experiences at ages 15 and/or 18 years were included. First, psychotic experiences were regressed on autistic traits and second, the general neuropsychiatric problems factor was added to the model. Auditory hallucinations were analyzed separately from the other psychotic experiences. Finally, twin analyses were employed to disentangle genetic from environmental influences in the observed associations. Replicating prior research, significant associations were found between autistic traits in childhood and auditory hallucinations at ages 15 and 18. However, after controlling for the general neuropsychiatric problems factor, the associations between autistic traits and auditory hallucinations disappeared, whereas the association between the general neuropsychiatric problems factor and auditory hallucinations persisted after controlling for autistic traits. Twin analyses revealed that the association between the general neuropsychiatric problems factor and auditory hallucinations was driven by shared genetic influences. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
Full Text Available Patients with temporomandibular disorders (TMD frecuently present psychological and psychiatric problems. These patients often show increased somatization, depression, anxiety, stress reaction and catastrophism, wich plays a role in the predisposition, initiation and perpetuation of TMD and treatment response. This review presents thaerapeutic options that compromise the psychological axis of patients with TMD, wich primarily seek to reduce the anxiety and the emotional stress present, modify different perceptions of pain and coping. There are different posibilities, within wich are: patient education, identifying situations that increase the tension to avoid them, teaching relaxation techniques such as biofeedback, hipnosis and yoga. As for psychological treatment, the most common for chronic orofacial pain is cognitive behavioral therapy (CBT. The appropriate and effective psychological intervention can reduce TMD pain, decreasing the probability that the symptoms become more complex. Within psychological treatment options for TMD, conservative standard treatment (education, self-instruction, avoidance of painful movements, soft diet, even the shortest, may be sufficient in the short term for most patients with TMD, especially in cases of acute conditions. The addition of CBT, by a specialist, gives coping skills that will add to the effectiveness, especially in chronic cases, obtaining better results in the long term.
Shi, Limin; Du, Xixun; Jiang, Hong; Xie, Junxia
Ghrelin, the endogenous ligand of the growth hormone secretagogue receptor 1a (GHS-R1a), is a gut-derived, orexigenic peptide hormone that primarily regulates growth hormone secretion, food intake, and energy homeostasis. With the wide expression of GHS-R1a in extra-hypothalamic regions, the physiological role of ghrelin is more extensive than solely its involvement in metabolic function. Ghrelin has been shown to be involved in numerous higher brain functions, such as memory, reward, mood, and sleep. Some of these functions are disrupted in neurodegenerative disorders, including Parkinson's disease (PD), Alzheimer's disease (AD), and Huntington's disease (HD). This link between ghrelin and these neurodegenerative diseases is supported by numerous studies. This review aims to provide a comprehensive overview of the most recent evidence of the novel neuromodulatory role of ghrelin in PD, AD, and HD. Moreover, the changes in circulating and/or central ghrelin levels that are associated with disease progression are also postulated to be a biomarker for clinical diagnosis and therapy.
Hargens, Trent A; Kaleth, Anthony S; Edwards, Elizabeth S; Butner, Katrina L
Decreased sleep duration and quality is associated with an increase in body weight and adiposity. Insomnia, obstructive sleep apnea, and restless legs syndrome are three of the most prevalent types of sleep disorder that lead to an increased risk for numerous chronic health conditions. Various studies have examined the impact of these sleep disorders on obesity, and are an important link in understanding the relationship between sleep disorders and chronic disease. Physical activity and exercise are important prognostic tools in obesity and chronic disease, and numerous studies have explored the relationship between obesity, sleep disorders, and exercise. As such, this review will examine the relationship between sleep disorders and obesity. In addition, how sleep disorders may impact the exercise response and how exercise may impact patient outcomes with regard to sleep disorders will also be reviewed.
Hewedi Doaa H
Full Text Available Abstract Background Autism is a disorder of early childhood characterized by social impairment, communication abnormalities and stereotyped behaviors. The hypothalamic-pituitary-adrenocortical (HPA axis deserves special attention, since it is the basis for emotions and social interactions that are affected in autism. Aim To assess basal and stimulated plasma cortisol, and adrenocorticotropic hormone (ACTH levels in autistic children and their relationship to disease characteristics. Methods Fifty autistic children were studied in comparison to 50 healthy age-, sex- and pubertal stage- matched children. All subjects were subjected to clinical evaluation and measurement of plasma cortisol (basal and stimulated and ACTH. In addition, electroencephalography (EEG and intelligence quotient (IQ assessment were done for all autistic children. Results Sixteen% of autistic patients had high ACTH, 10% had low basal cortisol and 10% did not show adequate cortisol response to ACTH stimulation. Autistic patients had lower basal (p = 0.032 and stimulated cortisol (p = 0.04 and higher ACTH (p = 0.01 than controls. Childhood Autism Rating Scale (CARS score correlated positively with ACTH (r = 0.71, p = 0.02 and negatively with each of basal (r = -0.64, p = 0.04 and stimulated cortisol (r = -0.88, p Conclusions The observed hormonal changes may be due to a dysfunction in the HPA axis in autistic individuals. Further studies are warranted regarding the role of HPA axis dysfunction in the pathogenesis of autism.
Bölte, Sven; Poustka, Fritz
Autism and schizophrenia are considered to be substantially influenced by genetic factors. The endophenotype of both disorders probably also includes deficits in affect perception. The objective of this study was to examine the capacity to detect facially expressed emotion in autistic and schizophrenic subjects, their parents and siblings. Thirty-five subjects with autism and 102 of their relatives, 21 schizophrenic subjects and 46 relatives from simplex (one child affected) and multiplex (more than one child affected) families, as well as an unaffected control sample consisting of 22 probands completed a 50-item computer-based test to assess the ability to recognize basic emotions. The autistic subjects showed a poorer performance on the facial recognition test than did the schizophrenic and the unaffected individuals. In addition, there was a tendency for subjects from multiplex families with autistic loading to score lower on the test than individuals from simplex families with autistic loading. Schizophrenic subjects and their relatives as well as siblings and parents of autistic subjects did not differ from the sample of unaffected subjects in their ability to judge facial affect. Findings corroborate the assumption that emotion detection deficits are part of the endophenotype of autism. In families with autistic children, the extent of facial recognition deficits probably indexes an elevation in familial burden. It seems unlikely that problems in emotion perception form a consistent part of the endophenotype of schizophrenia or the broader phenotype in relatives of patients with psychosis or autism.
Tchanturia, Kate; Larsson, Emma; Adamson, James
The current study aimed to evaluate group Cognitive remediation therapy (CRT) inpatients with Anorexia Nervosa (AN). We aimed to examine the treatment response of group CRT in AN patients with high or low levels of autistic traits. Thirty-five in patients with an AN diagnosis received group CRT intervention for 6 sessions in a national eating disorder unit. All participants completed self-report questionnaires on thinking styles and motivation before and after the intervention. Patients with low autistic traits had statistically significant medium size effect improvements in self-reported thinking style scales as well as confidence (ability) to change. Patients with high autistic traits showed no statistically significant improvements in any outcome measure. The brief group format CRT intervention improves self-reported cognitive and motivational aspects in people with AN without autistic traits. For patients with higher autistic traits brief group CRT does not improve self-reported cognitive style or motivation. This finding suggests that brief group format CRT might not be the best suited format for individuals with elevated autistic traits and individual or more tailored CRT should be explored.
Tic disorders are neurodevelopmental disorders of childhood associated with psychiatric comorbidity and academic problems. Estimating the prevalence and understanding the epidemiology of tic disorders is more complex than was once thought. Until fairly recently, tic disorders were thought to be rare, but today tics are believed to be the most common movement disorder, with 0.2-46.3% of schoolchildren experiencing tics during their lifetime. Tentative explanations for differing prevalence estimates include the multidimensional nature of tics with a varied and heterogeneous presentation, and the use of different epidemiological methods and study designs. Literature review and analysis of methodological issues pertinent to epidemiological studies of tic disorders. Epidemiological studies of tic disorders were reviewed, and the main elements of epidemiological studies, including sample selection, case ascertainment strategy, definition of tic disorders, and the degree of coverage of the eligible population (i.e., the response rate) were examined. In order to improve the quality of epidemiological studies of tic disorders, a number of recommendations were made, including but not limited to a review of the diagnostic criteria for tic disorders, and inclusion of new tic disorder categories for those with tics of secondary etiology.
Full Text Available Introduction: Tic disorders are neurodevelopmental disorders of childhood associated with psychiatric comorbidity and academic problems. Estimating the prevalence and understanding the epidemiology of tic disorders is more complex than was once thought. Until fairly recently, tic disorders were thought to be rare, but today tics are believed to be the most common movement disorder, with 0.2–46.3% of schoolchildren experiencing tics during their lifetime. Tentative explanations for differing prevalence estimates include the multidimensional nature of tics with a varied and heterogeneous presentation, and the use of different epidemiological methods and study designs. Methods: Literature review and analysis of methodological issues pertinent to epidemiological studies of tic disorders. Results: Epidemiological studies of tic disorders were reviewed, and the main elements of epidemiological studies, including sample selection, case ascertainment strategy, definition of tic disorders, and the degree of coverage of the eligible population (i.e., the response rate were examined. Discussion: In order to improve the quality of epidemiological studies of tic disorders, a number of recommendations were made, including but not limited to a review of the diagnostic criteria for tic disorders, and inclusion of new tic disorder categories for those with tics of secondary etiology.
Full Text Available High proportions of autistic children suffer from gastrointestinal (GI disorders, implying a link between autism and abnormalities in gut microbial functions. Increasing evidence from recent high-throughput sequencing analyses indicates that disturbances in composition and diversity of gut microbiome are associated with various disease conditions. However, microbiome-level studies on autism are limited and mostly focused on pathogenic bacteria. Therefore, here we aimed to define systemic changes in gut microbiome associated with autism and autism-related GI problems. We recruited 20 neurotypical and 20 autistic children accompanied by a survey of both autistic severity and GI symptoms. By pyrosequencing the V2/V3 regions in bacterial 16S rDNA from fecal DNA samples, we compared gut microbiomes of GI symptom-free neurotypical children with those of autistic children mostly presenting GI symptoms. Unexpectedly, the presence of autistic symptoms, rather than the severity of GI symptoms, was associated with less diverse gut microbiomes. Further, rigorous statistical tests with multiple testing corrections showed significantly lower abundances of the genera Prevotella, Coprococcus, and unclassified Veillonellaceae in autistic samples. These are intriguingly versatile carbohydrate-degrading and/or fermenting bacteria, suggesting a potential influence of unusual diet patterns observed in autistic children. However, multivariate analyses showed that autism-related changes in both overall diversity and individual genus abundances were correlated with the presence of autistic symptoms but not with their diet patterns. Taken together, autism and accompanying GI symptoms were characterized by distinct and less diverse gut microbial compositions with lower levels of Prevotella, Coprococcus, and unclassified Veillonellaceae.
Tsilioni, I; Dodman, N; Petra, A I; Taliou, A; Francis, K; Moon-Fanelli, A; Shuster, L; Theoharides, T C
Autism spectrum disorders (ASD) are neurodevelopmental disorders characterized by defects in communication and social interactions, as well as stereotypic behaviors. Symptoms typically worsen with anxiety and stress. ASD occur in early childhood, often present with regression and have a prevalence of 1 out of 68 children. The lack of distinct pathogenesis or any objective biomarkers or reliable animal models hampers our understanding and treatment of ASD. Neurotensin (NT) and corticotropin-releasing hormone (CRH) are secreted under stress in various tissues, and have proinflammatory actions. We had previously shown that NT augments the ability of CRH to increase mast cell (MC)-dependent skin vascular permeability in rodents. CRH also induced NT receptor gene and protein expression in MCs, which have been implicated in ASD. Here we report that serum of ASD children (4-10 years old) has significantly higher NT and CRH levels as compared with normotypic controls. Moreover, there is a statistically significant correlation between the number of children with gastrointestinal symptoms and high serum NT levels. In Bull Terriers that exhibit a behavioral phenotype similar to the clinical presentation of ASD, NT and CRH levels are also significantly elevated, as compared with unaffected dogs of the same breed. Further investigation of serum NT and CRH, as well as characterization of this putative canine breed could provide useful insights into the pathogenesis, diagnosis and treatment of ASD.
Peters, Brenda; Forlin, Chris
It is possible that many benefits may be found for all concerned in education and child development in understanding how knowledge of the brain and its development can inform early years practice. This article, written by Brenda Peters and Chris Forlin, both from the Hong Kong Institute of Education, reviews literature based on neuroscience to…
Korbivcher, Celia Fix
This article examines the implications of the proposal of autistic transformations within the general context of Bion's theory of Transformations. The aim is to confirm the coherence of this proposal of autistic transformations within the overall structure of Bion's theory of Transformations. She examines the relation between emotional links and their negatives, particularly -K. She questions in which of the dimensions of the mind the autistic phenomena are located, the relation between autistic phenomena and beta elements, and where to place them in the Grid. The author tries to form metapsychological support for the incorporation of the autistic area in Bion's theory of Transformations. She argues that, despite the incongruence and imprecision of this incorporation, such autistic phenomena cannot be excluded from the complexus of the human mind and should therefore be accounted for in Bion's transformations. She discusses the idea that the theory of transformations includes the field of the neurosis and psychosis and deals with emotions, whereas the autistic area is dominated by sensations. The author asks how to add the autistic area to Bion's theory. Clinical material of a child for whom the non-psychotic part of the personality predominates and who presents autistic nuclei provides material for the discussion. Copyright © 2013 Institute of Psychoanalysis.
García-Peñas, J J
It is still not known whether epilepsy or subclinical epileptiform activity can generate autistic regression in children with pervasive development disorder (PDD) in a similar manner to the way linguistic and neurocognitive regression are produced in patients with Landau-Kleffner syndrome and electrical status epilepticus during slow-wave sleep (ESES). Data on the use of different antiepileptic drugs (AED) in Landau-Kleffner syndrome and in ESES is contradictory, but it has been proved that courses of polytherapy clearly have a harmful effect. It has been suggested that the suppression of subclinical epileptiform activity by the early use of AED can revert the disorders affecting behaviour, cognition and language in these patients. Nevertheless, few studies have been conducted to examine the influence of AED therapy on the clinical course of children with PDD and autistic regression and evidence of epileptiform activity in video-EEG-polygraph recordings during sleep. Cases of complete recovery or significant improvement following the use of AED such as valproate, ethosuximide, clobazam, oxcarbazepine, sulthiame, levetiracetam, topiramate or lamotrigine have been reported. Moreover, striking and sustained improvements have been reported with courses of corticoids or ACTH. Yet, we still do not know whether the natural history of PDD with autistic regression is linked to the persistence of epileptiform anomalies in the video-EEG-polygraph recordings or not, and it is therefore difficult to draw conclusions about whether early AED therapy should be established in these patients. In our own clinical experience, lamotrigine has proved to be a good therapeutic alternative for the treatment of patients with autistic regression and paroxysmal anomalies in the EEG recordings, and offers a suitable balance between effectiveness and safety.
Post-traumatic stress disorder is highly prevalent among individuals who suffer from opioid use disorder. Compared to individuals with opioid use disorder alone, those with post-traumatic stress disorder have a worse course of illness, occupational functioning, and physical health. The neurobiological pathways underlying each disorder overlap substantially, and there are multiple pathways through which these disorders may interact. This narrative review explores evidence underpinning 3 explanatory perspectives on comorbid post-traumatic stress disorder and opioid use disorder: The opioid susceptibility model (a.k.a.: the Self-Medication Hypothesis), the post-traumatic stress disorder susceptibility model, and the common factors model. Diagnostic implications, treatment implications, and directions for future research are discussed.
Chen, Kuan-Lin; Lin, Chien-Ho; Yu, Tzu-Ying; Huang, Chien-Yu; Chen, Ying-Dar
This study aimed to compare symptoms of autism spectrum disorder using the Childhood Autism Rating Scale (CARS) and the Social Responsiveness Scale (SRS™-2) and to investigate their influencing factors. The diagnostic agreement was 92.7%, but with a fair Kappa value (0.247). Children's verbal comprehension was related to the CARS scores, and no variables were related to the SRS™-2 scores. Generally, significant small correlations were found between the two measures in children with normal or borderline to below average verbal comprehension (rs = 0.32 ~ 0.49, p < .005), but not in those with impaired verbal comprehension. The CARS and the SRS™-2 may contain different explicit behaviors and collect different perspectives (i.e., those of caregivers and professionals). Therefore, they appear to complement each other.
Nowakowski, Matilda E; McFarlane, Traci; Cassin, Stephanie
Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.e., restricting food intake, bingeing, and/or purging) as a way to avoid or cope with their feelings. The current critical review synthesizes the literature on alexithymia and eating disorders and examines alexithymia levels across eating disorders (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified), the role of alexithymia in binge eating disorder, and the influence of alexithymia on the development of eating disorders as well as treatment outcome. The clinical implications of the research conducted to date and directions for future research are discussed.
Delli, Konstantina; Reichart, Peter A; Bornstein, Michael M; Livas, Christos
This article reviews the present literature on the issues encountered while coping with children with autistic spectrum disorder from the dental perspective. The autistic patient profile and external factors affecting the oral health status of this patient population are discussed upon the existing body of evidence. The MEDLINE database was searched using the terms 'Autistic Disorder', 'Behaviour Control/methods', 'Child', 'Dental care for disabled', 'Education', 'Oral Health', and 'Pediatric Dentistry' to locate related articles published up to January 2013. Most of the relevant studies indicate poor oral hygiene whereas they are inconclusive regarding the caries incidence in autistic individuals. Undergraduate dental education appears to determine the competence of dental professionals to treat developmentally disabled children and account partly for compromised access to dental care. Dental management of an autistic child requires in-depth understanding of the background of the autism and available behavioural guidance theories. The dental professional should be flexible to modify the treatment approach according to the individual patient needs.
Buitelaar, J K; van der Wees, M; Swaab-Barneveld, H; van der Gaag, R J
This study was designed to examine the developmental and cognitive correlates of theory of mind (ToM) and emotion recognition ability in children with autism (N = 20), with pervasive developmental disorder-not otherwise specified (PDD-NOS) (N = 20), and in psychiatric control children (N = 20). The diagnostic groups were person-to-person matched on age and verbal IQ. The age of the children was between 8 and 18 years; their Full Scale IQ was at least 65. The test battery included tasks for the matching and the context recognition of emotional expressions, and a set of first- and second-order ToM tasks. The relationships between composite domain scores and the subjects' age, Verbal IQ, Performance IQ, verbal memory, visual memory, and gender were examined in bivariate and multivariate analyses. Further, the subjects who reliably and consistently passed the tasks of a domain and those who could not were compared on developmental and cognitive characteristics. Overall, the results of the various analyses converged and indicated that verbal memory, Performance IQ, age and gender were the best predictors of social cognitive ability.
Full Text Available Mutations in the X-linked genes neuroligin 3 (NLGN3 and neuroligin 4X (NLGN4X were first implicated in the pathogenesis of X-linked autism in Swedish families. However, reports of mutations in these genes in autism spectrum disorder (ASD patients from various ethnic backgrounds present conflicting results regarding the etiology of ASD, possibly because of genetic heterogeneity and/or differences in their ethnic background. Additional mutation screening study on another ethnic background could help to clarify the relevance of the genes to ASD. We scanned the entire coding regions of NLGN3 and NLGN4X in 62 Japanese patients with ASD by polymerase chain reaction-high-resolution melting curve and direct sequencing analyses. Four synonymous substitutions, one in NLGN3 and three in NLGN4X, were identified in four of the 62 patients. These substitutions were not present in 278 control X-chromosomes from unrelated Japanese individuals and were not registered in the database of Single Nucleotide Polymorphisms build 132 or in the Japanese Single Nucleotide Polymorphisms database, indicating that they were novel and specific to ASD. Though further analysis is necessary to determine the physiological and clinical importance of such substitutions, the possibility of the relevance of both synonymous and nonsynonymous substitutions with the etiology of ASD should be considered.
Idol, Jacquelyn R; Addington, Anjene M; Long, Robert T; Rapoport, Judith L; Green, Eric D
We characterized a t(1;7)(p22;q21) reciprocal translocation in a patient with childhood-onset schizophrenia (COS) and autism using genome mapping and sequencing methods. Based on genomic maps of human chromosome 7 and fluorescence in situ hybridization (FISH) studies, we delimited the region of 7q21 harboring the translocation breakpoint to a approximately 16-kb interval. A cosmid containing the translocation-associated 1:7 junction on der(1) was isolated and sequenced, revealing the positions on chromosomes 1 and 7, respectively, where the translocation occurred. PCR-based studies enabled the isolation and sequencing of the reciprocal 7:1 junction on der(7). No currently recognized gene on either chromosome appears to be disrupted by the translocation. We further found no evidence for copy-number differences in the genomic regions flanking the translocation junctions in the patient. Our efforts provide sequence-based information about a schizophrenia/autism-associated translocation, and may facilitate future studies investigating the genetic bases of these disorders.
Full Text Available Abstract Background Autism is a neurodevelopmental disorder characterized by impairments in social interaction, verbal communication and repetitive behaviors. To date the etiology of this disorder is poorly understood. Studies suggest that astrocytes play critical roles in neural plasticity by detecting neuronal activity and modulating neuronal networks. Recently, a number of studies suggested that an abnormal function of glia/astrocytes may be involved in the development of autism. However, there is yet no direct evidence showing how astrocytes develop in the brain of autistic individuals. Methods Study subjects include brain tissue from autistic subjects, BTBR T + tfJ (BTBR and Neuroligin (NL-3 knock-down mice. Western blot analysis, Immunohistochemistry and confocal microscopy studies have be used to examine the density and morphology of astrocytes, as well as Wnt and β-catenin protein expression. Results In this study, we demonstrate that the astrocytes in autisitcsubjects exhibit significantly reduced branching processes, total branching length and cell body sizes. We also detected an astrocytosis in the frontal cortex of autistic subjects. In addition, we found that the astrocytes in the brain of an NL3 knockdown mouse exhibited similar alterations to what we found in the autistic brain. Furthermore, we detected that both Wnt and β-catenin proteins are decreased in the frontal cortex of autistic subjects. Wnt/β-catenin pathway has been suggested to be involved in the regulation of astrocyte development. Conclusions Our findings imply that defects in astrocytes could impair neuronal plasticity and partially contribute to the development of autistic-like behaviors in both humans and mice. The alteration of Wnt/β-catenin pathway in the brain of autistic subjects may contribute to the changes of astrocytes.
surgical procedures in bipolar disorder have generated mixed results. It should be noted that most studies had been conducted during the 1950's and 1960's. In a more recent study with a 7 year follow-up, it was found that limbic leucotomy did not significantly improve mania symptoms in bipolar disorder as compared to ...
BLACK, DONALD W
Compulsive buying disorder (CBD) is characterized by excessive shopping cognitions and buying behavior that leads to distress or impairment. Found worldwide, the disorder has a lifetime prevalence of 5.8% in the US general population. Most subjects studied clinically are women (~80%), though this gender difference may be artifactual. Subjects with CBD report a preoccupation with shopping, prepurchase tension or anxiety, and a sense of relief following the purchase. CBD is associated with significant psychiatric comorbidity, particularly mood and anxiety disorders, substance use disorders, eating disorders, and other disorders of impulse control. The majority of persons with CBD appear to meet criteria for an Axis II disorder, although there is no special "shopping" personality. Compulsive shopping tends to run in families, and these families are filled with mood and substance use disorders. There are no standard treatments. Psychopharmacologic treatment studies are being actively pursued, and group cognitive-behavioral models have been developed and are promising. Debtors Anonymous, simplicity circles, bibliotherapy, financial counseling, and marital therapy may also play a role in the management of CBD. PMID:17342214
Schuurmans, J.; van Balkom, A.J.L.M.
Anxiety disorders are a major clinical problem in late life; estimated prevalence rates vary from 6% to 10%, and the disease impact is considerable and equal to that of depression. However, anxiety disorders often remain undetected and untreated in older adults. This discrepancy may be accounted for
Black, Donald W
Compulsive buying disorder (CBD) is characterized by excessive shopping cognitions and buying behavior that leads to distress or impairment. Found worldwide, the disorder has a lifetime prevalence of 5.8% in the US general population. Most subjects studied clinically are women (~80%), though this gender difference may be artifactual. Subjects with CBD report a preoccupation with shopping, prepurchase tension or anxiety, and a sense of relief following the purchase. CBD is associated with significant psychiatric comorbidity, particularly mood and anxiety disorders, substance use disorders, eating disorders, and other disorders of impulse control. The majority of persons with CBD appear to meet criteria for an Axis II disorder, although there is no special "shopping" personality. Compulsive shopping tends to run in families, and these families are filled with mood and substance use disorders. There are no standard treatments. Psychopharmacologic treatment studies are being actively pursued, and group cognitive-behavioral models have been developed and are promising. Debtors Anonymous, simplicity circles, bibliotherapy, financial counseling, and marital therapy may also play a role in the management of CBD.
Beauchamp, Marshall T; Lundgren, Jennifer D
Bright light therapy is a noninvasive biological intervention for disorders with nonnormative circadian features. Eating disorders, particularly those with binge-eating and night-eating features, have documented nonnormative circadian eating and mood patterns, suggesting that bright light therapy may be an efficacious stand-alone or adjunctive intervention. The purpose of this systematic literature review, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, was (1) to evaluate the state of the empirical treatment outcome literature on bright light therapy for eating disorders and (2) to explore the timing of eating behavior, mood, and sleep-related symptom change so as to understand potential mechanisms of bright light therapy action in the context of eating disorder treatment. A comprehensive literature search using PsycInfo and PubMed/MEDLINE was conducted in April 2016 with no date restrictions to identify studies published using bright light therapy as a treatment for eating disorders. Keywords included combinations of terms describing disordered eating (eating disorder, anorexia nervosa, bulimia nervosa, binge eating, binge, eating behavior, eating, and night eating) and the use of bright light therapy (bright light therapy, light therapy, phototherapy). After excluding duplicates, 34 articles were reviewed for inclusion. 14 published studies of bright light therapy for eating disorders met inclusion criteria (included participants with an eating disorder/disordered-eating behaviors; presented as a case study, case series, open-label clinical trial, or randomized/nonrandomized controlled trial; written in English; and published and available by the time of manuscript review). Results suggest that bright light therapy is potentially effective at improving both disordered-eating behavior and mood acutely, although the timing of symptom response and the duration of treatment effects remain unknown. Future research should
van der Windt, D A; van der Heijden, G J; van den Berg, S G; ter Riet, G; de Winter, A F; Bouter, L M
BACKGROUND: Ultrasound therapy is used frequently to reduce pain and related disability, mainly by physiotherapists. The objective of this review was to evaluate the effectiveness of ultrasound therapy in the treatment of musculoskeletal disorders. METHODS: Published reports of randomized clinical
Book Review: Generalized Anxiety Disorder Across the Lifespan: An Integrative Approach. ME Portman. Abstract. Michael E. Portman: Publisher: New York: Springer, 2009. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
Hoek, HW; van Hoeken, D
Objective: To review the literature on the incidence and prevalence of eating disorders. Methods: We searched Medline using several key terms relating to epidemiology and eating disorders and we checked the reference lists of the articles that we found. Special attention has been paid to
Soares, Célia; Fernandes, Natália; Morgado, Pedro
At present, no treatment recommendations can be made for compulsive buying disorder. Recent studies have found evidence for the efficacy of psychotherapeutic options, but less is known regarding the best pharmacologic treatment. The purpose of this review is to present and analyze the available published evidence on the pharmacological treatment of compulsive buying disorder. To achieve this, we conducted a review of studies focusing on the pharmacological treatment of compulsive buying by se...
In the philosophy of well-being, there is hardly anything written on the lives of people with autism or on the question whether existing philosophical theories of well-being are suited for understanding how well the lives of autistic persons are going. This paper tries to make some progress towards filling this gap. I start by giving a concise account of autism, which highlights the huge heterogeneity among autistics. I discuss some basic features of autism, ask whether there are good reasons why we would need an account of well-being specifically for autistics and what philosophical well-being research could learn from being informed by autistic experiences and phenomenology. I then investigate to what extent the capability approach gives us a helpful theory of well-being for autistics, and what looking through an autism-lens can contribute to the further development of the capabilitarian well-being. In particular, I show that some capabilities that are crucially relevant for autistics are also relevant for the lives of non-autistic people. The final part of the paper looks at an important difficulty in using the capabilitarian account of well-being for autistics, namely: should the normative focus be on achievements (functionings) or real opportunities (capabilities)? Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Rakofsky, Jeffrey J; Dunlop, Boadie W
To review the evidence for treating anxiety in patients with bipolar disorder. A literature search from 1950 to week 1 of August 2009 was conducted via OVID and the National Institutes of Health's clinical trials online databases. Search terms included anxiety, anxiety disorders, bipolar disorder, panic disorder, generalized anxiety disorder, social phobia, social anxiety, obsessive compulsive disorder, specific phobia, posttraumatic stress disorder, and treatment. Reference lists of identified articles were also searched. Fourteen treatment studies that included patients with bipolar disorder with either a syndrome-defined anxiety disorder or nonspecific anxiety were selected. Sample size, bipolar disorder subtype, comorbid anxiety disorders, baseline anxiety, treatment interventions, and outcome measurements were extracted. The majority of studies focus on treating anxiety disorders and nonspecific anxiety occurring during bipolar mood episodes. Studies of syndrome-defined anxiety disorders reveal that risperidone monotherapy did not separate from placebo and that olanzapine was superior to lamotrigine when used to augment lithium treatment. A study using open-label divalproex sodium and an uncontrolled study of group cognitive-behavioral therapy both suggest some benefit from these treatments in patients with bipolar disorder with panic disorder. Studies of nonspecific anxiety reveal some benefit for divalproex, quetiapine, olanzapine, and olanzapine-fluoxetine combination. Weaker evidence supports the use of Mindfulness-Based Cognitive Therapy, and observational studies suggest potential efficacy for gabapentin and valproate. Nonspecific anxiety symptoms occurring during a mood episode improve with treatment of the mood disturbance, though divalproex may be the mood stabilizer of choice for anxious patients with bipolar disorder. Given their reduced risk for manic induction and episode cycling, psychotherapy, benzodiazepines, and certain atypical antipsychotics
Chaudhary, Ujwal; Hall, Michael; Gutierrez, Anibal; Messinger, Daniel; Rey, Gustavo; Godavarty, Anuradha
Autism is a socio-communication brain development disorder. It is marked by degeneration in the ability to respond to joint attention skill task, from as early as 12 to 18 months of age. This trait is used to distinguish autistic from nonautistic. In this study Near infrared spectroscopy (NIRS) is being applied for the first time to study the difference in activation and connectivity in the frontal cortex of typically developing (TD) and autistic children between 4-8 years of age in response to joint attention task. The optical measurements are acquired in real time from frontal cortex using Imagent (ISS Inc.) - a frequency domain based NIRS system in response to video clips which engenders a feeling of joint attention experience in the subjects. A block design consisting of 5 blocks of following sequence 30 sec joint attention clip (J), 30 sec non-joint attention clip (NJ) and 30 sec rest condition is used. Preliminary results from TD child shows difference in brain activation (in terms of oxy-hemoglobin, HbO) during joint attention interaction compared to the nonjoint interaction and rest. Similar activation study did not reveal significant differences in HbO across the stimuli in, unlike in an autistic child. Extensive studies are carried out to validate the initial observations from both brain activation as well as connectivity analysis. The result has significant implication for research in neural pathways associated with autism that can be mapped using NIRS.
Rossignol, Daniel A; Rossignol, Lanier W
Autism is a neurodevelopmental disorder that currently affects as many as 1 out of 166 children in the United States. Recent research has discovered that some autistic individuals have decreased cerebral perfusion, evidence of neuroinflammation, and increased markers of oxidative stress. Multiple independent single photon emission computed tomography (SPECT) and positron emission tomography (PET) research studies have revealed hypoperfusion to several areas of the autistic brain, most notably the temporal regions and areas specifically related to language comprehension and auditory processing. Several studies show that diminished blood flow to these areas correlates with many of the clinical features associated with autism including repetitive, self-stimulatory and stereotypical behaviors, and impairments in communication, sensory perception, and social interaction. Hyperbaric oxygen therapy (HBOT) has been used with clinical success in several cerebral hypoperfusion syndromes including cerebral palsy, fetal alcohol syndrome, closed head injury, and stroke. HBOT can compensate for decreased blood flow by increasing the oxygen content of plasma and body tissues and can even normalize oxygen levels in ischemic tissue. In addition, animal studies have shown that HBOT has potent anti-inflammatory effects and reduces oxidative stress. Furthermore, recent evidence demonstrates that HBOT mobilizes stem cells from human bone marrow, which may aid recovery in neurodegenerative diseases. Based upon these findings, it is hypothesized that HBOT will improve symptoms in autistic individuals. A retrospective case series is presented that supports this hypothesis.
Compulsive buying disorder (CBD) refers to the chronic purchasing of unneeded or unwanted items, causing significant negative consequences. There are no established criteria for CBD, and operational definitions have relied on similarities with OCD, substance use disorders, and impulse control disorders. Compulsive buying disorder is common, affecting 5.8% of the general population, according to one study. Typically, CBD has early onset, frequent comorbidities, and a chronic course. The etiology of CBD is unknown, with biological, psychological and sociocultural factors proposed as likely contributors. Treatment data are limited and suggest addressing comorbid conditions and considering cognitive behavioral therapy, financial and family counseling, selective serotonin reuptake inhibitors, and naltrexone, among other possible interventions, to target CBD. Beyond treatment, educational, legislative and family-based public policy initiatives can likely help individuals with CBD and other excessive spenders.
BLACK, DONALD W
Compulsive buying disorder (CBD) is characterized by excessive shopping cognitions and buying behavior that leads to distress or impairment. Found worldwide, the disorder has a lifetime prevalence of 5.8% in the US general population. Most subjects studied clinically are women (~80%), though this gender difference may be artifactual. Subjects with CBD report a preoccupation with shopping, prepurchase tension or anxiety, and a sense of relief following the purchase. CBD is as...
Interpretation & conclusions: A review of Indian literature on cannabis use and its association with psychiatric disorders indicates a high co-prevalence of psychotic disorders, especially in vulnerable individuals as well as high rates of co-occurrence of other psychiatric comorbidities. However, there is limited focus on exploring the aetiological association between cannabis use and psychiatric disorders; understanding the neurobiology of this association and management-related issues.
Burke, J.D.; Loeber, R.; Birmaher, B.
Objective: To review empirical findings on oppositional defiant disorder (ODD) and conduct disorder (CD). Method: Selected summaries of the literature over the past decade are presented. Results: Research on ODD and CD during the past decade has addressed the complexity involved in identifying the
The primary objective of this review of literature was to examine the relationship of eating disorders and disordered eating among female collegiate athletes. Since the institution of Title IX in 1972, the Educational Amendment to the Civil Rights Act of 1964, female participation in sports has been consistently rising at all levels of…
Bowden, David J; Kilburn-Toppin, Fleur; Scoffings, Daniel J
Eating disorders are a major challenge for health professionals, with many patients receiving ineffective care due to underdiagnosis or poor compliance with treatment. The incidence of eating disorders is increasing worldwide, producing an increasing burden on healthcare systems, and they most often affect young patients, with significant long-term complications. The effects of long-term malnutrition manifest in almost every organ system, and many can be detected radiologically, even without overt clinical findings. Musculoskeletal complications including osteoporosis result in a high incidence of insufficiency fractures, with long-term implications for bone health and growth, while respiratory complications are often recognized late due to disordered physiologic responses to infection. Gastrointestinal complications are numerous and in extreme cases may result in fatal outcomes after acute gastric dilatation and rupture subsequent to binge eating. In patients with severely disordered eating, in particular anorexia nervosa, marked derangement of electrolyte levels may result in refeeding syndrome, which requires emergent management. Recognition of such complications is critical to effective patient care and requires radiologists to be aware of the spectrum of imaging abnormalities that may be seen. Since many patients are reluctant to disclose their underlying condition, radiologists also play a critical role in identifying previously undiagnosed eating disorders. ©RSNA, 2013.
Great interest in herbal medicine as a potential source of phytopharmaceuticals has created the need to review common factors responsible for major diseases and body disorders. This review shows one such common factor in inflammation and the role herbal medicine can play. Traditional medicinal herbal remedies in the ...
Foulkes, Lucy; Bird, Geoffrey; Gökçen, Elif; McCrory, Eamon; Viding, Essi
According to the social motivation hypothesis of autism, individuals with high levels of autistic traits experience reduced levels of reward from social interactions. However, empirical evidence to date has been mixed, with some studies reporting lower levels of social reward in individuals with Autism Spectrum Disorder (ASD), and others finding no difference when compared to typically developing controls. Alexithymia, a subclinical condition associated with the reduced ability to identify and describe one’s own emotions, has been found to account for other affective difficulties observed inconsistently in individuals with ASD. The current study used a nonclinical sample (N = 472) to explore the associations between autistic traits and the value of six types of social reward, as measured by the Social Reward Questionnaire. In addition, we measured alexithymia to assess if this accounted for associations between autistic traits and social reward. There were three main findings. Firstly, higher levels of autistic traits were associated with significantly less enjoyment of admiration and sociability, and adding alexithymia to these models did not account for any additional variance. Secondly, both autistic traits and alexithymia were uniquely associated with reduced levels of enjoyment of prosocial interactions and sexual relationships. Thirdly, autistic traits were associated with higher levels of enjoyment of passivity and negative social potency, but these associations were no longer significant once alexithymia was taken into account, suggesting that co-occurring alexithymia accounted for these apparent associations. Overall, the current findings provide a novel and more nuanced picture of the relationship between autistic traits and social reward. PMID:25853670
Harris, Jonathan M.; Best, Catherine S.; Moffat, Vivien J.; Spencer, Michael D.; Philip, Ruth C. M.; Power, Michael J.; Johnstone, Eve C.
Cognitive performance and the relationship between theory of mind (TOM), weak central coherence and executive function were investigated in a cohort of young people with additional learning needs. Participants were categorized by social communication questionnaire score into groups of 10 individuals within the autistic spectrum disorder (ASD)…
Polderman, T.J.C.; Hoekstra, R.A.; Vinkhuyzen, A.A.E.; Sullivan, P.F.; van der Sluis, S.; Posthuma, D.
Background Attention deficit hyperactivity disorder (ADHD) symptoms and autistic traits often occur together. The pattern and etiology of co-occurrence are largely unknown, particularly in adults. This study investigated the co-occurrence between both traits in detail, and subsequently examined the
Hallett, Victoria; Ronald, Angelica; Rijsdijk, Fruhling; Happe, Francesca
Internalizing difficulties are prevalent in children with autism spectrum disorders (ASD), yet little is known about the underlying cause of this comorbidity. It is also unclear which types of autistic-like and internalizing difficulties are most strongly associated. The current study investigated the phenotypic and etiological associations…
Robinson, Elise B.; Munir, Kerim; Munafo, Marcus R.; Hughes, Michael; McCormick, Marie C.; Koenen, Karestan C.
Objective: This study investigated the developmental course of autistic traits in a nationally representative sample of subjects 7 to 13 years of age. Method: The parents of 6,539 children in the Avon Longitudinal Study of Parents and Children completed the Social and Communication Disorders Checklist at ages 7, 10, and 13. The phenotypic…
Gregory, B. L.; Plaisted-Grant, K. C.
A high Autism-Spectrum Quotient (AQ) score (Baron-Cohen et al. in "J Autism Dev Disord" 31(1):5-17, 2001) is increasingly used as a proxy in empirical studies of perceptual mechanisms in autism. Several investigations have assessed perception in non-autistic people measured for AQ, claiming the same relationship exists between…
Freeth, Megan; Sheppard, Elizabeth; Ramachandran, Rajani; Milne, Elizabeth
The disorder of autism is widely recognised throughout the world. However, the diagnostic criteria and theories of autism are based on research predominantly conducted in Western cultures. Here we compare the expression of autistic traits in a sample of neurotypical individuals from one Western culture (UK) and two Eastern cultures (India and…
Jones, Kristen J.; Block, Martin E.
Autism is a brain disorder that affects a person's social, communication, and behavioral skills. Social deficits are noted by the child's lack of interest or inability to interact with peers and family members. This article highlights some of the successful methods and techniques used to include an autistic middle school child in a general…
Conclusion: HBOT is a treatment that has recently become quite popular in the autism spectrum disorder (ASD community. Its benefits cross a wide range of autistic traits as: improved language, increased awareness, behavior and socialization by affecting the pathophysiological findings in autism.
Levin, Rivka L; Rawana, Jennine S
Attention-deficit/hyperactivity disorder (ADHD) and eating disorders are common and concerning mental health disorders. There is both empirical and theoretical support for an association between ADHD and eating disorders or disordered eating. This systematic review aims to summarize the extant literature on the comorbidity of ADHD and eating disorders across the lifespan, including the influences of sex, age, eating disorder diagnosis, and potential mediators. A total of 37 peer-reviewed studies on diagnosed ADHD and eating disturbances were identified through key research databases. Twenty-six studies supported a strong empirical association between ADHD and eating disorders or disordered eating. The systematic review findings suggest that children with ADHD are at risk for disordered eating, while adolescents, emerging adults, and adults are at risk for both eating disorders and disordered eating. Methodological considerations, future research, and clinical implications are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.
Keywords: Males; Eating disorders; Age of onset and presentation; Body dissatisfaction; Weight control; Comorbidity; Sexual orientation; Social class; Socio-cultural ... result(ing) in out-of-control eating episodes, or binges, often followed by ... The DSM-IV-TR is a useful tool to use insofar as clinicians around the world are ...
El Ghoch, Marwan; Soave, Fabio; Calugi, Simona; Dalle Grave, Riccardo
Background: Eating disorders are health problems that are particularly prevalent in adolescents and young adults. They are associated with considerable physical health and psychosocial morbidity, and increased risk of mortality. We set out to conduct a systematic review to determine their effect on physical fitness in the general population and on sport performance in athletes. Methods/Design: A systematic review of the relevant peer-reviewed literature was performed. For inclusion, articles ...
Tavares, Hermano; Lobo, Daniela Sabbatini S; Fuentes, Daniel; Black, Donald W
Compulsive buying disorder was first described as a psychiatric syndrome in the early twentieth century. Its classification remains elusive, and investigators have debated its potential relationship to mood, substance use, obsessive-compulsive, and impulse control disorders. The objective of this study is to present a review of compulsive buying disorder and present a case vignette. Two databases were reviewed (Medline and PsycINFO) in search for articles published in the last 40 years. Selected terms included oniomania, compulsive buying, and compulsive shopping. Other relevant articles were also identified through reference lists. Compulsive buying disorder is a prevalent and chronic condition that is found worldwide, sharing commonalities with impulse control disorders. In clinical samples, women make up more than 80% of subjects. Its etiology is unknown, but neurobiologic and genetic mechanisms have been proposed. The disorder is highly comorbid with mood, substance use, eating and impulse control disorders. Treatment recommendations derived from the literature and clinical experience suggest that problem shoppers can benefit from psychosocial interventions. Cognitive-behavioral group models appear promising. Medication trials have reported mixed results. The identification and treatment of psychiatric comorbidity is also a key aspect of treatment. In order to determine the validity of compulsive buying disorder, future work should focus on psychopathology and neurobiological findings unique to the syndrome.
Full Text Available Trent A Hargens,1 Anthony S Kaleth,2 Elizabeth S Edwards,1 Katrina L Butner31Department of Kinesiology, James Madison University, Harrisonburg, VA, USA; 2Department of Kinesiology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA; 3Laboratory for Health and Exercise Science, Department of Human Nutrition, Food and Exercise, Virginia Tech, Blacksburg, VA, USAAbstract: Decreased sleep duration and quality is associated with an increase in body weight and adiposity. Insomnia, obstructive sleep apnea, and restless legs syndrome are three of the most prevalent types of sleep disorder that lead to an increased risk for numerous chronic health conditions. Various studies have examined the impact of these sleep disorders on obesity, and are an important link in understanding the relationship between sleep disorders and chronic disease. Physical activity and exercise are important prognostic tools in obesity and chronic disease, and numerous studies have explored the relationship between obesity, sleep disorders, and exercise. As such, this review will examine the relationship between sleep disorders and obesity. In addition, how sleep disorders may impact the exercise response and how exercise may impact patient outcomes with regard to sleep disorders will also be reviewed.Keywords: obesity, sleep disorders, obstructive sleep apnea, insomnia
Dixon, P M; Dacre, I
Equine dentistry is a very important but until recently rather neglected area of equine practice, with many horses suffering from undiagnosed, painful dental disorders. A thorough clinical examination using a full mouth speculum is a pre-requisite to performing any equine dental procedure. Common incisor disorders include: prolonged retention of deciduous incisors, supernumerary incisors and overjet--the latter usually accompanied by cheek teeth (CT) overgrowths. Overjet can be surgically corrected, but perhaps should not be in breeding animals. In younger horses, traumatically fractured incisors with pulpar exposure may survive by laying down tertiary dentine. Loss or maleruption of incisors can cause uneven occlusal wear that can affect mastication. Idiopathic fractures and apical infection of incisors are rare. The main disorder of canine teeth is the development of calculus of the lower canines, and occasionally, developmental displacements and traumatic fractures. The main indications for extraction of "wolf teeth" (Triadan 05s) are the presence of displaced or enlarged wolf teeth, or their presence in the mandible. Developmental abnormalities of the CT include; rostral positioning of the upper CT rows in relation to the lower CT rows--with resultant development of focal overgrowths on the upper 06s and the lower 11s. Displaced CT develop overgrowths on unopposed aspects of the teeth and also develop periodontal disease in the inevitable abnormal spaces (diastemata) that are present between displaced and normal teeth. Diastemata of the CT due to excessive developmental spacing between the CT or to inadequate compression of the CT rows is a common but under diagnosed problem in many horses and causes very painful periodontal disease and quidding. Supernumerary CT mainly occur at the caudal aspect of the CT rows and periodontal disease commonly occurs around these teeth. Eruption disorders of CT include prolonged retention of remnants of deciduous CT ("caps
Tetley, Amanda; Moghaddam, Nima G; Dawson, David L; Rennoldson, Mike
This article systematically reviewed studies of parental bonding in people with eating disorders. MEDLINE, PsychINFO, EMBASE and CINAHL were searched to identify studies that compared parental bonding in people diagnosed with an eating disorder relative to non-clinical controls. Twenty-four studies were identified. Women with eating disorders typically reported lower parental care and higher parental protection compared to non-clinical, but not psychiatric, controls. Interestingly, a modest number of studies found that these relationships were mediated by avoidant problem solving style and several schemas from the Young Schema Questionnaire (YSQ; Schmidt, Joiner, Young, & Telch, 1995). While there are methodological limitations associated with the reviewed studies, they do offer some support for the proposal that difficulties in parent-child relationships predispose women to eating disorders and other psychiatric diagnoses. © 2013.
Egan, Anna M; Dreyer, Meredith L; Odar, Cathleen C; Beckwith, Malia; Garrison, Carol B
The purpose of this study was to identify rates of overweight and obesity in young children with autism spectrum disorders (ASD) and factors related to overweight. Retrospective chart reviews were conducted for 273 children with ASD [i.e., autistic disorder, Asperger's disorder, pervasive developmental disorder not otherwise specified (PDD-NOS)] after receiving outpatient services with a developmental pediatrician or the developmental team at a children's hospital. Information on child demographics, height and weight, medications prescribed, and adaptive functioning was collected from charts. Rates of overweight and obesity in children with ASD were found to be above nationally representative prevalence estimates for children. Among children with autistic disorder, 17.16% had a body mass index (BMI) percentile in the overweight range and 21.89% had a BMI percentile in the obese range. For children with Asperger's disorder/PDD-NOS, 12.50% were considered overweight and 10.58% were considered obese. Neither psychotropic medications prescribed nor adaptive functioning was found to be related to whether the child was overweight or obese. Children with ASD are at risk for overweight and obesity, and children with autistic disorder are at greater risk for weight problems than children with Asperger's disorder/PDD-NOS. Further research is needed to identify factors related to overweight in children with ASD.
Pomian, Andrzej; Lisik, Wojciech; Kosieradzki, Maciej; Barcz, Ewa
Overweight and obesity are becoming a worldwide health problem associated with numerous co-morbidities. National costs of obesity and pelvic flor disorders have been rising since the 1950s across the world. Obesity is thought to have a very strong effect on pelvic floor disorders, and, considering the high prevalence of both problems worldwide, it is of utmost importance to evaluate the association between these pathologies as well as the impact of obesity on treatment efficacy. This review i...
Connor, Daniel F; Steeber, Jennifer; McBurnett, Keith
Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder with significant functional impairment. ADHD is frequently complicated by oppositional symptoms, which are difficult to separate from comorbidity with oppositional defiant disorder, conduct disorder, and aggressive symptoms. This review addresses the impact of oppositional symptoms on ADHD, disease course, functional impairment, clinical management, and treatment response. Oppositional defiant disorder or conduct disorder may be comorbid in more than half of ADHD cases and are more common with the combined than with the inattentive ADHD subtype. Comorbid symptoms of oppositional defiant disorder and conduct disorder in patients with ADHD can have a significant impact on the course and prognosis for these patients and may lead to differential treatment response to both behavioral and pharmacologic treatments. Assessment of oppositional symptoms is an essential part of ADHD screening and diagnosis and should include parental, as well as educator, input. Although clinical evidence remains limited, some stimulant and nonstimulant medications have shown effectiveness in treating both core ADHD symptoms and oppositional symptoms. Oppositional symptoms are a key consideration in ADHD management, although the optimum approach to treating ADHD complicated by such symptoms remains unclear. Future research should focus on the efficacy and safety of various behavioral and medication regimens, as well as longitudinal studies to further clarify the relationships between ADHD, oppositional defiant disorder, and conduct disorder.
Juliana Lourenço Araújo Veras
Full Text Available Objective: This paper offers a systematic review of the literature on eating disorders and the relationship with suicidal behavior. Methods: Searches were performed in the Medline, Lilacs, Adolec and Pubmed databases for articles published between 2003 and 2014. Results: Anorexia nervosa was the most often cited eating disorder in the articles selected. In cases of bulimia nervosa, suicide attempts and self-aggression were more frequent among those who use multiple compensation behaviors. Behavior disorders, emotional disorders and chemical dependency were described as risk factors in all publications. Conclusion: Despite the small number of studies performing an in-depth investigation into the relationship between eating disorder and suicidal behavior, the concomitant presence of these conditions places the health of patients at greater risk.
Cardoso, Carla; Montenegro, Melaine Luz
The aim of this study was to identify variations from different language therapy processes times in two groups of children with autistic spectrum disorders. 8 subjects, from 3 to 17 years old, participated of this study and they were divided in two groups: Group 1: 4 subjects, in language therapy for 12 months, with therapist change after 6 months; Group 2: 4 subjects, also in language therapy for 12 months, but without therapist change in this period. Data was collected from two videotapes recordings: initial and final and all the recordings had fifteen minutes of duration. The analysis was done according to the criteria proposed by Fernandes (2004a), for functional evaluation of language and the statistical analysis were done with the Wilcoxon signed ranks test and the Mann-Whitney test, with 5% of significance. The results showed no difference between the two groups. This outcome may be related to the small size of the groups or to the duration of the study. Nevertheless, a better functional profile of communication was noted on group 2, with had no therapist change. This outcome was represented by the improving of the communicational acts and the use of the communicative space, it was also noted an increasing of the utilization of the verbal mean and decreasing of the vocal mean, besides a greater utilization of the more interactive functions.
Singh, Shalini; Balhara, Yatan Pal Singh
Cannabis is a widely used illicit drug and its use is often associated with co-occurring psychiatric disorders. This systematic review was aimed to provide information on the published Indian studies on co-occurring cannabis use disorders and psychiatric disorders. An electronic search of available Indian literature using relevant search terms was carried out in May 2015 and 52 articles in English language published from India were included in the current review. Studies on cannabis and associated psychotic disorders (n=16) chiefly described acute episodes with predominant positive symptoms, following cannabis use. Some studies (n=6) observed an overall increased prevalence of all psychiatric disorders and symptoms owing to cannabis use, while others (n=14) elaborated on high rates of substance use in those with psychiatric disorders. The effect of cannabis use on cognitive function was the focus of some of the Indian studies (n=7). All these studies barring one had all male subjects, and a single study described the service delivery model for those with dual diagnosis disorders in India. Most of the research used cross-sectional observational design and focussed on treatment-seeking population. A review of Indian literature on cannabis use and its association with psychiatric disorders indicates a high co-prevalence of psychotic disorders, especially in vulnerable individuals as well as high rates of co-occurrence of other psychiatric comorbidities. However, there is limited focus on exploring the aetiological association between cannabis use and psychiatric disorders; understanding the neurobiology of this association and management-related issues.
Sigman, Marian; Mundy, Peter
Demonstrates that young autistic children suffer from deficits in social understanding and symbolic representations of other individuals. Data suggest that the core deficit appears to lie at the intersection of representational abilities and social experiences. (RWB)
Scrandis, Debra A
Women with bipolar disorder may benefit from continuation of their medications during pregnancy, but there may be risks to the fetus associated with some of these medications. This article examines the evidence relating to the effect of bipolar disorder and pharmacologic treatments for bipolar disorder on pregnancy outcomes. MEDLINE, CINAHL, ProQuest Dissertation & Theses, and the Cochrane Database of Systematic Reviews were searched for English-language studies published between 2000 and 2017, excluding case reports and integrative reviews. Twenty articles that met inclusion criteria were included in this review. Women with bipolar disorder have a higher risk for pregnancy complications and congenital abnormalities than do women without bipolar disorder. In addition, illness relapse can occur if psychotropic medications are discontinued. There are limited data to recommend discontinuing lithium, lamotrigine, or carbamazepine during pregnancy. Valproic acid is not recommended during pregnancy due to increased odds of neural tube defects associated with its use. Atypical antipsychotics are used more frequently during pregnancy, with mixed evidence regarding an association between these agents and congenital malformations or preterm birth. The knowledge of benefits and risks of bipolar disorder and its treatment can help women and health care providers make individualized decisions. Prenatal care providers can discuss the evidence about safety of medications used to treat bipolar disorder with women in collaboration with their mental health care providers. In addition, women being treated for bipolar disorder require close monitoring for depressive and manic/hypomanic episodes that impact pregnancy outcomes. © 2017 by the American College of Nurse-Midwives.
De Crescenzo, F; Lennox, A; Gibson, J C; Cordey, J H; Stockton, S; Cowen, P J; Quested, D J
Melatonin has been widely studied in the treatment of sleep disorders and evidence is accumulating on a possible role for melatonin influencing mood. Our aim was to determine the efficacy and acceptability of melatonin for mood disorders. We conducted a comprehensive systematic review of randomized clinical trials on patients with mood disorders, comparing melatonin to placebo. Eight clinical trials were included; one study in bipolar, three in unipolar depression and four in seasonal affective disorder. We have only a small study on patients with bipolar disorder, while we have more studies testing melatonin as an augmentation strategy for depressive episodes in major depressive disorder and seasonal affective disorder. The acceptability and tolerability were good. We analyzed data from three trials on depressive episodes and found that the evidence for an effect of melatonin in improving mood symptoms is not significant (SMD = 0.37; 95% CI [-0.05, 0.37]; P = 0.09). The small sample size and the differences in methodology of the trials suggest that our results are based on data deriving from investigations occurring early in this field of study. There is no evidence for an effect of melatonin on mood disorders, but the results are not conclusive and justify further research. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.e., restricting food intake, bingeing, and/or purging) as a way to avoid or cope with their feelings. The current critical review synthesizes the literature on alexithymia and eating disorders and examines alexithymia levels across eating disorders (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified), the role of alexithymia in binge eating disorder, and the influence of alexithymia on the development of eating disorders as well as treatment outcome. The clinical implications of the research conducted to date and directions for future research are discussed. PMID:24999402
Donno, R. E.
There is increasing evidence that a proportion of children with Conduct Disorder may have unidentified Autistic Spectrum Disorder (Gilchrist et al., 2001 Gilmour, Hill, Place & Skuse, 2004). This paper considers the argument that a subgroup of children with Autistic Spectrum Disorder are undetected and subsumed under Conduct Disorder or similar descriptors. Diagnostic criteria are described and issues relevant to Conduct Disorder discussed. This is followed by an examination of the similariti...
Fazel, Seena; Wolf, Achim; Geddes, John R
To examine the risk of suicide and suicide attempts in prisoners with bipolar disorder and other psychiatric disorders compared with prisoners without psychiatric disorders. We conducted a systematic review and meta-analysis of observational studies comparing suicide outcomes in prisoners with bipolar disorder and other psychiatric disorders to other prisoners. Five studies reported the risk of suicidal outcomes in prisoners with bipolar disorder compared with other prisoners, with a random effects pooled odds ratio of 2.4 (95% confidence interval: 1.6-3.7; I(2) = 0%). This appeared to be lower than the risk of suicidal outcomes for all psychiatric disorders and for depression, specifically, and, in meta-regression, significantly lower (p = 0.03) than for schizophrenia-spectrum disorders. Although bipolar disorder is associated with suicide and non-fatal suicidal behavior in prisoners, further research is necessary to confirm any associations and mediating mechanisms. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available Case histories of a mother and her two children are reported. The mother was a recovered alcoholic. She and her two children, both of whom had symptoms that are typical of autistic spectrum disorder, had dysautonomia. All had intermittently abnormal erythrocyte transketolase studies indicating abnormal thiamine pyrophosphate homeostasis. Both children had unusual concentrations of urinary arsenic. All had symptomatic improvement with diet restriction and supplementary vitamin therapy but quickly relapsed after ingestion of sugar, milk, or wheat. The stress of a heavy metal burden, superimposed on existing genetic or epigenetic risk factors, may be important in the etiology of autism spectrum disorder when in combination. Dysautonomia has been associated with several diseases, including autism, without a common etiology. It is hypothesized that oxidative stress results in loss of cellular energy and causes retardation of hard wiring of the brain in infancy, affecting limbic system control of the autonomic nervous system.
Castro, Thais; Castro, Alberto; Lima, David
Children with autism often have difficulties in learning the social skills and norms of peer social interaction, which severely affect and limit their social lives. Aiming at addressing this issue, through design, we developed a digital-analogue model playground to help them understand and cope...... behaviour. Our design artefact was evaluated in a rehabilitation clinic for autistic children and demonstrates promising potential for digital-analogue devices as useful resources training peer social interaction. Our findings document that digital-analogue design devices can facilitate the development...... with the socially difficult situations experienced when they go to a physical playground to interact with peers. Based on therapists and parents' insights, we created the model playground with built in collaborative protocols providing immediate feedback to the children in terms of acceptable and unacceptable...
AIMS – This study reviews literature on comorbidity of drug use disorders (DUD) and eating disorders (ED). The article updates knowledge on the occurrence of comorbidity of these diagnoses. METHODS – The databases Embase, Medline and PsycInfo were searched for studies published between 1990 and May 2011, with combinations of the terms ’eating disorder’, ’substance-related disorder’, ’drug dependence’, ’drug abuse’, ’drug addiction’ and ’substance abuse’. This generated altogether ...
Norman, R J; Clark, A M
Obesity has significant consequences for the reproductive system, depending upon the amount and distribution of body fat. Epidemiological evidence clearly shows that being overweight contributes to menstrual disorders, infertility, miscarriage, poor pregnancy outcome, impaired fetal well-being and diabetes mellitus. Central adiposity is particularly important in clinical sequelae associated with an increased body mass index. The advent of assisted reproduction highlights the problems of being overweight, and the use of gonadotrophins in ovulation induction and in vitro fertilization is more difficult when the subject is overweight. Weight loss has marked effects on improving the menstrual cycle and promoting spontaneous ovulation and fertility. Results indicate that fertility is improved through exercise and sensible eating patterns when conducted in a group environment. The mechanisms for this are unclear but may be associated with changes in sensitivity to insulin.
Lund, Crick; Brooke-Sumner, Carrie; Baingana, Florence; Baron, Emily Claire; Breuer, Erica; Chandra, Prabha; Haushofer, Johannes; Herrman, Helen; Jordans, Mark; Kieling, Christian; Medina-Mora, Maria Elena; Morgan, Ellen; Omigbodun, Olayinka; Tol, Wietse; Patel, Vikram; Saxena, Shekhar
Mental health has been included in the UN Sustainable Development Goals. However, uncertainty exists about the extent to which the major social determinants of mental disorders are addressed by these goals. The aim of this study was to develop a conceptual framework for the social determinants of mental disorders that is aligned with the Sustainable Development Goals, to use this framework to systematically review evidence regarding these social determinants, and to identify potential mechanisms and targets for interventions. We did a systematic review of reviews using a conceptual framework comprising demographic, economic, neighbourhood, environmental events, and social and culture domains. We included 289 articles in the final Review. This study sheds new light on how the Sustainable Development Goals are relevant for addressing the social determinants of mental disorders, and how these goals could be optimised to prevent mental disorders. Copyright © 2018 Elsevier Ltd. All rights reserved.
Grzadzinski, Rebecca; Di Martino, Adriana; Brady, Emily; Mairena, Maria Angeles; O'Neale, Matthew; Petkova, Eva; Lord, Catherine; Castellanos, F. Xavier
We examined to what extent increased parent reports of autistic traits in some children with Attention Deficit Hyperactivity Disorder (ADHD) are the result of ADHD-related symptoms or qualitatively similar to the core characteristics of autism spectrum disorders (ASD). Results confirm the presence of a subgroup of children with ADHD and elevated ratings of core ASD traits (ADHD+) not accounted for by ADHD or behavioral symptoms. Further, analyses revealed greater oppositional behaviors, but n...
Ryu, Young Hoon; Lee, Jong Doo; Yoon, Pyeong Ho; Kim, Dong Ik; Jeon, Tae Joo; Shin, Yee Jin; Lee, Byung Hee; Shin, Hyung Cheol
Neuroimaging findings of autism has been the subjects of continuing investigation. Because previous study had not demonstrated consistent and specific neuroimaging findings of autism and most studies comprised adults and school-aged children, we performed a retrospective review in search of common functional and structural abnormalities in pre-school aged autistic children using Tc-99m ECD brain SPECT and MRI and compared them with age-matched children with nonautistic pervasive developmental disorders (PDD). 58 children between 3 and 8 years of age infantile autism (n=37) and non-autistic PDD (n=21) were performed Tc-99m ECD brain SPECT and MRI. Diagnosis of autism and non-autistic PDD was based on the criteria of DSM-IV and Childhood Autism Rating Scale (CARS). Of the 37 autistic patients, 32 revealed decreased perfusion of cerebellar hemisphere, followed by hypoperfusion of thalami (n=30), parietal cortex (n=16), temporal cortex (n=12). Of those 21 PDD patients, 14 patients showed hypoperfusion of the thalami and 10 patients showed temporal hypoperfusion. However, cerebellar hemispheric (n=8) and parietal (n=1) hypoperfusion was infrequently seen. All autistic and nonautistic PDD patients had normal MRI scan. Cerebellar hemispheric and parietal hypoperfusion on brain SPECT showed statistically significant correlation with CARS. Cerebellar hemispheric and parietal hypoperfusion is significantly frequently noted in autistic patients although they had normal MRI and SPECT may be useful and more sensitive modality in reflecting pathophysiology of autism as evidenced by previous MRI and postmortem studies. Thalamic and temporal hypoperfusion can be seen in both autistic and nonautistic patients and further studies are necessary to determine the significance of the thalamic hypoperfusion
Ryu, Young Hoon; Lee, Jong Doo; Yoon, Pyeong Ho; Kim, Dong Ik; Jeon, Tae Joo; Shin, Yee Jin; Lee, Byung Hee; Shin, Hyung Cheol [College of Medecine, Soonchunhyang Univ., Chonan (Korea, Republic of)
Neuroimaging findings of autism has been the subjects of continuing investigation. Because previous study had not demonstrated consistent and specific neuroimaging findings of autism and most studies comprised adults and school-aged children, we performed a retrospective review in search of common functional and structural abnormalities in pre-school aged autistic children using Tc-99m ECD brain SPECT and MRI and compared them with age-matched children with nonautistic pervasive developmental disorders (PDD). 58 children between 3 and 8 years of age infantile autism (n=37) and non-autistic PDD (n=21) were performed Tc-99m ECD brain SPECT and MRI. Diagnosis of autism and non-autistic PDD was based on the criteria of DSM-IV and Childhood Autism Rating Scale (CARS). Of the 37 autistic patients, 32 revealed decreased perfusion of cerebellar hemisphere, followed by hypoperfusion of thalami (n=30), parietal cortex (n=16), temporal cortex (n=12). Of those 21 PDD patients, 14 patients showed hypoperfusion of the thalami and 10 patients showed temporal hypoperfusion. However, cerebellar hemispheric (n=8) and parietal (n=1) hypoperfusion was infrequently seen. All autistic and nonautistic PDD patients had normal MRI scan. Cerebellar hemispheric and parietal hypoperfusion on brain SPECT showed statistically significant correlation with CARS. Cerebellar hemispheric and parietal hypoperfusion is significantly frequently noted in autistic patients although they had normal MRI and SPECT may be useful and more sensitive modality in reflecting pathophysiology of autism as evidenced by previous MRI and postmortem studies. Thalamic and temporal hypoperfusion can be seen in both autistic and nonautistic patients and further studies are necessary to determine the significance of the thalamic hypoperfusion.
Mariana Rodrigues Poubel Alves
Full Text Available Objective: To conduct a review of the literature on the possible neuropsychological deficits present in patients with panic disorder. Methods: We performed a systematic review and search of the PubMed, ISI and PsycInfo scientific databases, with no time limits, using the following key words: cognitive, function, panic, and disorder. Of the 971 articles found, 25 were selected and 17 were included in this review. The inclusion criterion was at least one neuropsychological assessment task in patients with panic disorder. Results: The number of publications has grown gradually, especially those assessing executive functions, corresponding to the neurobiological model most widely accepted. Of all the functions evaluated, these patients had lower performance in memory tasks and higher performance in affective processing tasks related to the disorder. However, these data require further investigation due to the high rate of comorbidities, the small sample sizes of the included studies and little standardization of instruments used. Conclusion: The results showed a greater occurrence of deficits in memory and enhanced affective processing related to panic disorder.
Berkman, Nancy D; Lohr, Kathleen N; Bulik, Cynthia M
The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center systematically reviewed evidence on factors associated with outcomes among individuals with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) and whether outcomes differed by sociodemographic characteristics. We searched electronic databases including MEDLINE and reviewed studies published from 1980 to September, 2005, in all languages against a priori inclusion/exclusion criteria and focused on eating, psychiatric or psychological, or biomarker outcomes. At followup, individuals with AN were more likely than comparisons to be depressed, have Asperger's syndrome and autism spectrum disorders, and suffer from anxiety disorders including obsessive-compulsive disorders. Mortality risk was significantly higher than what would be expected in the population and the risk of suicide was particularly pronounced. The only consistent factor across studies relating to worse BN outcomes was depression. A substantial proportion of individuals continue to suffer from eating disorders over time but BN was not associated with increased mortality risk. Data were insufficient to draw conclusions concerning factors associated with BED outcomes. Across disorders, little to no data were available to compare results based on sociodemographic characteristics. The strength of the bodies of literature was moderate for factors associated with AN and BN outcomes and weak for BED.
Vardaxi, Chrysoula Ch; Gonda, Xenia; Fountoulakis, Konstantinos N
Life events play a central role in the development of psychiatric disorders and impact course and outcome. We present a systematic review of the literature on the relationship of life events with the onset and long-term course of schizoaffective disorder. MEDLINE was searched with the combination of the key words: 'life events' plus 'schizoaffective'. The PRISMA method was followed in the review process. From the identified 66 papers only 12 were considered to be of relevance to the current study and 6 more papers were identified by inspecting the reference lists of the identified papers. There are very few studies focusing on the role of life events in schizoaffective disorder indicating insufficient data concerning the relationship of life events with onset and long-term course of schizoaffective disorder. Reported effects are not generic but concern specific events like the loss of mother, and females seem to be more vulnerable. Patients with schizoaffective disorder manifest high rates of PTSD. The literature on life events with the development and course of schizoaffective disorder is limited and precludes solid conclusions. Copyright © 2017 Elsevier B.V. All rights reserved.
Colin D Steer
Full Text Available It is increasingly recognised that traits associated with autism reflect a spectrum with no clear boundary between typical and atypical behaviour. Dimensional traits are needed to investigate the broader autism phenotype.Ninety-three individual measures reflecting components of social, communication and repetitive behaviours characterising autistic spectrum disorder (ASD were identified between the ages of 6 months and 9 years from the ALSPAC database. Using missing value imputation, data for 13,138 children were analysed. Factor analysis suggested the existence of 7 factors explaining 85% of the variance. The factors were labelled: verbal ability, language acquisition, social understanding, semantic-pragmatic skills, repetitive-stereotyped behaviour, articulation and social inhibition. Four factors (1, 3, 5 and 7 were specific to ASD being more strongly associated with this phenotype than other co-morbid conditions while other factors were more associated with learning difficulties and specific language impairment. Nevertheless, all 7 factors contributed independently to the explanation of ASD (p<0.001. Exploration of putative genetic causal factors such as variants in the CNTNAP2 gene showed a varying pattern of associations with these traits. An alternative predictive model of ASD was derived using four individual measures: the coherence subscale of the Children's Communication Checklist (9y, the Social and Communication Disorders Checklist (91 m, repetitive behaviour (69 m and the sociability subscale of the Emotionality Activity and Sociability measure (38 m. Although univarably these traits performed better than some factors, their combined explanations of ASD were similar (R(2 = 0.48.These results support the fractional nature of ASD with different aetiological origins for these components despite pleiotropic genetic effects being observed. These traits are likely to be useful in the exploration of ASD.
Hyseni, Fjola; Blanken, Laura M E; Muetzel, Ryan; Verhulst, Frank C; Tiemeier, Henning; White, Tonya
Clinical studies of children with autism spectrum disorder (ASD) provide evidence for poorer neuropsychological performance within specific domains compared to age, gender, and sometimes IQ-matched controls. Since recent evidence suggests that autistic symptoms form a spectrum that extends into the general population, it was our goal to evaluate the nature of the relationship between autistic traits and neuropsychological performance across the continuum in the general population. We examined neuropsychological performance across five different domains in 1019 6-to-10-year-old children participating in a population-based study of child development. Autistic traits were assessed when the children were 6 years of age using the Social Responsiveness Scale and ASD diagnoses were obtained via medical records. Neuropsychological functioning was measured using the NEPSY-II-NL and included the domains of attention and executive function, memory and learning, sensorimotor functioning, language, and visuospatial functioning. We found that children with higher autistic traits showed significantly lower neuropsychological performance in all domains investigated and that this association remained even after excluding children with the highest autistic traits or confirmed ASD. When comparing 41 children with confirmed ASD diagnosis to typically developing controls, children with ASD showed significantly lower neuropsychological performance across all domains. Taken together, our results suggest that children with both ASD and subclinical autistic traits have lower neuropsychological performance. Thus, this may provide an understanding of why some children without an ASD diagnosis may require some additional assistance within academic settings.
Barttfeld, Pablo; Amoruso, Lucía; Ais, Joaquín; Cukier, Sebastián; Bavassi, Luz; Tomio, Ailin; Manes, Facundo; Ibanez, Agustín; Sigman, Mariano
The dimensional approach to autism spectrum disorder (ASD) considers ASD as the extreme of a dimension traversing through the entire population. We explored the potential utility of electroencephalography (EEG) functional connectivity as a biomarker. We hypothesized that individual differences in autistic traits of typical subjects would involve a long-range connectivity diminution within the delta band. Resting-state EEG functional connectivity was measured for 74 neurotypical subjects. All participants also provided a questionnaire (Social Responsiveness Scale, SRS) that was completed by an informant who knows the participant in social settings. We conducted multivariate regression between the SRS score and functional connectivity in all EEG frequency bands. We explored modulations of network graph metrics characterizing the optimality of a network using the SRS score. Our results show a decay in functional connectivity mainly within the delta and theta bands (the lower part of the EEG spectrum) associated with an increasing number of autistic traits. When inspecting the impact of autistic traits on the global organization of the functional network, we found that the optimal properties of the network are inversely related to the number of autistic traits, suggesting that the autistic dimension, throughout the entire population, modulates the efficiency of functional brain networks. EEG functional connectivity at low frequencies and its associated network properties may be associated with some autistic traits in the general population.
External factors impact on the hormones and enzymes which trigger development of metabolic disorders. The aim of this review was to highlight major hormonal and enzymatic factors that differentially predispose males and females to obesity, diabetes mellitus and hypertension. The research was a literaturebased ...
Sanger, Dixie D.; And Others
The review, intended to provide speech-language pathologists and special educators with an awareness of genetics and specific syndromes involving speech, language, and hearing components, discusses basic etiologies of abnormal development and selected syndromes (such as Down's and Klinefelter's) that include communication disorders. (CL)
Eigsti, Inge-Marie; de Marchena, Ashley B.; Schuh, Jillian M.; Kelley, Elizabeth
This paper reviews the complex literature on language acquisition in the autism spectrum disorders (ASD). Because of the high degree of interest in ASD in the past decade, the field has been changing rapidly, with progress in both basic science and applied clinical areas. In addition, psycholinguistically-trained researchers have increasingly…
Squizzato, A.; Gerdes, V. E. A.; Ageno, W.; Büller, H. R.
Endocrine disorders can influence the haemostatic balance. Abnormal coagulation test results have been observed in patients with abnormal hormone levels. Also unprovoked bleeding or thrombotic events have been associated with endocrine disease. The aim of the present review is to summarise the
Weber, M. A.; Kleijn, M. H.; Langendam, M.; Limpens, J.; Heineman, M. J.; Roovers, J. P.
Objective The decline in available oestrogen after menopause is a possible etiological factor in pelvic floor disorders like vaginal atrophy (VA), urinary incontinence (UI), overactive bladder (OAB) and pelvic organ prolapse (POP). This systematic review will examine the evidence for local oestrogen
Sjarif, D. R.; Ploos van Amstel, J. K.; Duran, M.; Beemer, F. A.; Poll-The, B. T.
Glycerol kinase deficiency (GKD) is an X-linked recessive disorder. There are two types. an isolated form and a complex form. We review the clinical, biochemical and molecular genetic features of GKD. The clinical and biochemical phenotype of isolated GKD may vary from a life-threatening childhood
Despite increased records of the incidence of both Anorexia Nervosa and Bulimia Nervosa in females over the last 50 years, the awareness of these disorders in males remains low. This has been attributed to bias and inaccuracy in diagnosis, stigma, and reluctance among males to seek treatment. This paper reviews the ...
Rothbart, Rachel; Stein, Dan J
Individuals affected by trichotillomania (TTM) (hair-pulling disorder) consciously or non-consciously pull out their own body hair. The disorder has recently been incorporated into a chapter entitled, 'Obsessive-Compulsive and Related Disorders' in the diagnostic and statistical manual of mental disorders, fifth edition. The review describes the literature currently available on the pharmacotherapy for TTM, including both randomized controlled trials and open-label trials of pharmacotherapy for TTM in adults or children. Early work focused on the serotonin reuptake inhibitors; however, the majority of the trials have been negative. There is a small body of evidence focused on pharmacotherapy for TTM. In future, larger trials are required to expand on the preliminary evidence available for N-acetylcysteine, olanzapine and dronabinol in recent trials.
Nautiyal, Katherine M; Okuda, Mayumi; Hen, Rene; Blanco, Carlos
Gambling disorder (GD), previously called pathological gambling and classified as an impulse control disorder in DSM-III and DSM-IV, has recently been reclassified as an addictive disorder in the DSM-5. It is widely recognized as an important public health problem associated with substantial personal and social costs, high rates of psychiatric comorbidity, poor physical health, and elevated suicide rates. A number of risk factors have been identified, including some genetic polymorphisms. Animal models have been developed in order to study the underlying neural basis of GD. Here, we discuss recent advances in our understanding of the risk factors, disease course, and pathophysiology. A focus on a phenotype-based dissection of the disorder is included in which known neural correlates from animal and human studies are reviewed. Finally, current treatment approaches are discussed, as well as future directions for GD research. © 2017 New York Academy of Sciences.
Ida F. Dancyger
Full Text Available This review examines the literature during the past 10 years about suicide risk and suicide during adolescence and young adulthood of individuals with eating disorders. Epidemiological surveys are summarized, including suicide rates, parasuicidal behaviors, associated risk factors, and comorbid psychopathology. Critical implications for the comprehensive assessment and treatment planning, including safety considerations, are discussed. Two clinical cases of women with long-standing eating disorders are described to highlight both the pragmatic considerations and the complex clinical challenges of working with patients with eating disorders who become suicidal. The potentially life-threatening issues of safety have not received sufficient attention, neither in the medical literature nor by the treating clinicians. All health care professionals who are treating patients with an eating disorder must be keenly aware of the serious risks of suicidal behavior and of suicide in this population.
Araujo, Daniele Marano Rocha; Santos, Giovana Fonseca da Silva; Nardi, Antonio Egídio
The purpose of this systematic literature review is to examine previous studies that investigated the relation between depression and binge eating disorder (BED). Medline/PubMed published data from 1980 through 2006 was tracked using the following keywords: "binge eating disorder and depression", "periodic binge eating and depression", "binge eating disorder" and "periodic binge eating". The findings of 14 studies were successfully highlighted: one cohort, four cross-sectional and nine case-control studies. Most studies (7/14) were conducted in the United States, with missing data varying between 2.3 and 44.32%, and seven studies emphasizing the most important variables. The majority of the studies (10/14) showed an association between depression and binge eating disorder, but carefully designed studies are required to minimize the limitations found in these studies.
Full Text Available Objectives: The purpose of the present study was to investigate the effectiveness of cognitive-behavior education on decreasing deterministic thinking in mothers of children with autism spectrum disorders. Methods: Participants were 24 mothers of autistic children who were referred to counseling centers of Tehran and their children’s disorder had been diagnosed at least by a psychiatrist and a counselor. They were randomly selected and assigned into control and experimental groups. Measurement tool was Deterministic Thinking Questionnaire and both groups answered it before and after education and the answers were analyzed by analysis of covariance. Results: The results indicated that cognitive-behavior education decreased deterministic thinking among mothers of autistic children, it decreased four sub scale of deterministic thinking: interaction with others, absolute thinking, prediction of future, and negative events (P<0.05 as well. Discussions: By learning cognitive and behavioral techniques, parents of children with autism can reach higher level of psychological well-being and it is likely that these cognitive-behavioral skills would have a positive impact on general life satisfaction of mothers of children with autism.
El Ghoch, Marwan; Soave, Fabio; Calugi, Simona; Dalle Grave, Riccardo
Eating disorders are health problems that are particularly prevalent in adolescents and young adults. They are associated with considerable physical health and psychosocial morbidity, and increased risk of mortality. We set out to conduct a systematic review to determine their effect on physical fitness in the general population and on sport performance in athletes. A systematic review of the relevant peer-reviewed literature was performed. For inclusion, articles retrieved from PubMed had to be published in English between 1977 and 2013. Wherever possible, methods and reporting adhere to the guidelines outlined in the PRISMA statement. Some additional studies were retrieved from among those cited in the reference lists of included studies and from non-electronic databases. Literature searches, study selection, method and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Of the 1183 articles retrieved, twenty-nine studies met the inclusion criteria and were consequently analysed. The available data indicate that eating disorders have a negative effect on physical fitness and sport performance by causing low energy availability, excessive loss of fat and lean mass, dehydration, and electrolyte disturbance. Although the paucity of the available data mean that findings to date should be interpreted with caution, the information collated in this review has several practical implications. First, eating disorders have a negative effect on both physical fitness and sport performance. Second athletics coaches should be targeted for education about the risk factors of eating disorders, as deterioration in sport performance in athletes, particularly if they are underweight or show other signs of an eating disorder, may indicate the need for medical intervention. However, future studies are needed, especially to assess the direct effect of eating disorders on sport performance.
El Ghoch, Marwan; Soave, Fabio; Calugi, Simona; Dalle Grave, Riccardo
Background: Eating disorders are health problems that are particularly prevalent in adolescents and young adults. They are associated with considerable physical health and psychosocial morbidity, and increased risk of mortality. We set out to conduct a systematic review to determine their effect on physical fitness in the general population and on sport performance in athletes. Methods/Design: A systematic review of the relevant peer-reviewed literature was performed. For inclusion, articles retrieved from PubMed had to be published in English between 1977 and 2013. Wherever possible, methods and reporting adhere to the guidelines outlined in the PRISMA statement. Some additional studies were retrieved from among those cited in the reference lists of included studies and from non-electronic databases. Literature searches, study selection, method and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Results: Of the 1183 articles retrieved, twenty-nine studies met the inclusion criteria and were consequently analysed. The available data indicate that eating disorders have a negative effect on physical fitness and sport performance by causing low energy availability, excessive loss of fat and lean mass, dehydration, and electrolyte disturbance. Discussion: Although the paucity of the available data mean that findings to date should be interpreted with caution, the information collated in this review has several practical implications. First, eating disorders have a negative effect on both physical fitness and sport performance. Second athletics coaches should be targeted for education about the risk factors of eating disorders, as deterioration in sport performance in athletes, particularly if they are underweight or show other signs of an eating disorder, may indicate the need for medical intervention. However, future studies are needed, especially to assess the direct effect of eating disorders on
Marwan El Ghoch
Full Text Available Background: Eating disorders are health problems that are particularly prevalent in adolescents and young adults. They are associated with considerable physical health and psychosocial morbidity, and increased risk of mortality. We set out to conduct a systematic review to determine their effect on physical fitness in the general population and on sport performance in athletes. Methods/Design: A systematic review of the relevant peer-reviewed literature was performed. For inclusion, articles retrieved from PubMed had to be published in English between 1977 and 2013. Wherever possible, methods and reporting adhere to the guidelines outlined in the PRISMA statement. Some additional studies were retrieved from among those cited in the reference lists of included studies and from non-electronic databases. Literature searches, study selection, method and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Results: Of the 1183 articles retrieved, twenty-nine studies met the inclusion criteria and were consequently analysed. The available data indicate that eating disorders have a negative effect on physical fitness and sport performance by causing low energy availability, excessive loss of fat and lean mass, dehydration, and electrolyte disturbance. Discussion: Although the paucity of the available data mean that findings to date should be interpreted with caution, the information collated in this review has several practical implications. First, eating disorders have a negative effect on both physical fitness and sport performance. Second athletics coaches should be targeted for education about the risk factors of eating disorders, as deterioration in sport performance in athletes, particularly if they are underweight or show other signs of an eating disorder, may indicate the need for medical intervention. However, future studies are needed, especially to assess the direct effect of
Forsberg, S; Lock, J
Perfectionism is a potentially maladaptive personality trait implicated in a number of psychopathologies. As our understanding of the construct perfectionism has shifted from more unidimensionally focused conceptualizations to multidimensional ones, our ability to assess its bearing on various disorders has grown. One particular area in which perfectionism appears to play an important role is among eating disorder patients. The personalities of both those with anorexia nervosa (AN) and bulimia nervosa (BN) are thought to be intrinsically perfectionistic, which suggests a need to understand the role perfectionism plays in the development, course and outcome of these disorders. There is also an increased focus on perfectionism among athletes and its relationship to the higher prevalence of eating disorders in this group. With the institution of Title IX in the United States (which prohibited sex discrimination in higher educational settings) the participation of women in various sports has increased exponentially and with it concerns about their well-being in a milieu where a risk for menstrual irregularities, osteoporosis and eating disorders (the female athlete triad) are common. However, conflicting data suggests that athletics may be a protective factor in the development of eating disorders on the one hand, or it may be a risk factor on the other. Thus, it has become important to examine other variables, such as perfectionism, that may influence the outcome, one way or another. This review examines the current evidence about the relations between perfectionism, athletics and eating disorders.
Paranoid Personality Disorder (PPD) has historically been neglected by science out of proportion to its prevalence or its association with negative clinical outcomes. This review provides an update on what is known about PPD regarding its prevalence, demographics, comorbidity, biological mechanism, risk factors, and relationship to psychotic disorders. PPD has long been the subject of a rich and prescient theoretical literature which has provided a surprisingly coherent account of the psychological mechanism of non-delusional paranoia. Available data indicate that PPD has a close relationship with childhood trauma and social stress. Descriptive data on a sample of 115 individuals with Paranoid Personality Disorder is examined in comparison with a group of individuals with Borderline Personality Disorder. The descriptive data largely confirm previously identified relationships between Paranoid Personality Disorder and childhood trauma, violence, and race. We identify important similarities to and differences from Borderline Personality Disorder. PPD continues to be an important construct in the clinic and the laboratory. Available data lead to a reconsideration of the disorder as more closely related to trauma than to schizophrenia.
Raevuori, Anu; Linna, Milla S; Keski-Rahkonen, Anna
The objective of this descriptive review is to summarize the current scientific evidence on various prenatal and perinatal exposures affecting later development of eating disorders among offspring. Studies were searched from PubMed database with the following keywords: eating disorders and disordered eating and anorexia nervosa and bulimia nervosa and binge eating disorder and prenatal exposure delayed effects and maternal exposure and perinatology. A comprehensive manual search, including search from the reference list of included articles, was also performed. The attributable risk for prenatal and perinatal factors in anorexia nervosa (AN) is 3.6%. Numerous prenatal and perinatal factors have been associated with offspring AN, but only prematurity has been replicated in different samples. The risk of bulimia nervosa (BN) in offspring has attracted less study, and despite varying positive associations, there are no replicated findings. Higher prenatal testosterone may protect against the development of a range of disordered eating symptoms, although studies are not consistent. Evidence in support of an effect of prenatal and perinatal factors on eating disorders or disordered eating in offspring is conflicting. If present, the overall effect appears to be relatively small, and it is likely that the early risk factors operate in conjunction with other biological, genetic, and/or environmental risk factors to bring on eating pathology. Genetically sensitive designs, such as sibling and twin studies, are needed to disentangle the different types of risk factors and ensure that prenatal/perinatal effects are "causal" rather than indications of genetic risk. © 2014 Wiley Periodicals, Inc.
Poole, Norman A; Wuerz, Axel; Agrawal, Niruj
The value of drug interviews in the treatment of conversion disorder is at present unknown. To review all the available papers published in English that report on the use of drug interviews for treating conversion/dissociative disorder. Databases (including EMBASE, MEDLINE and PsycINFO) were searched from 1920 to 2009. Selected publications had to report on the use of drug interviews in people diagnosed with a conversion/dissociative disorder. Qualitative and quantitative data were extracted. Predictors of a positive response were ascertained using meta-analytic techniques. Fifty-five papers meeting inclusion criteria were identified. No studies compared the intervention with a suitable control group. However, two studies reported high response rates when drug interview was used in individuals with treatment-resistant conversion disorder. In the meta-analysis, the use of suggestion and occurrence of emotional catharsis during the interview were positively associated with recovery. Combining two medications and comorbid psychiatric disorder were negatively associated with recovery. The evidence for effectiveness of drug interviews is of poor quality but it may be of benefit in the treatment of acute and treatment-resistant conversion disorder. A proactive approach during the interview, making suggestions the individual will respond, could influence outcome. Comorbid psychiatric disorder should be treated conventionally. Experimental studies to determine efficacy are required.
Tasca, Giorgio A; Balfour, Louise
Attachment insecurity may confer risk for developing an eating disorder. We describe domains of attachment functioning that are relevant to eating disorders including: affect regulation, interpersonal style, coherence of mind, and reflective functioning. Research since 2000 on attachment and eating disorders related to these domains is reviewed. We searched MedLine/Pubmed and PsycINFO from January 2000 to February 2014 and kept articles that: were empirical, included adults with a diagnosed eating disorder, and used a standard attachment measure. We retained 50 relevant studies. Compared to controls, those with eating disorders had higher levels of attachment insecurity and disorganized mental states. Lower reflective functioning was specifically associated with anorexia nervosa. Attachment anxiety was associated with eating disorder symptom severity, and this relationship may be mediated by perfectionism and affect regulation strategies. Type of attachment insecurity had specific negative impacts on psychotherapy processes and outcomes, such that higher attachment avoidance may lead to dropping out and higher attachment anxiety may lead to poorer treatment outcomes. Research to date suggests a possible relationship between attachment insecurity and risk for an eating disorder. More research is needed that uses attachment interviews, and longitudinal and case control designs. Clinicians can assess attachment insecurity to help inform therapeutic stances and interventions. © 2014 Wiley Periodicals, Inc.
T M Rajan
Full Text Available Background: Inconsistent evidence exists regarding the strength, direction, and moderators in the relationship between obesity and psychiatric disorders. Aim: This study aims to summarize the evidence on the association between psychiatric illness and obesity with particular attention to the strength and direction of association and also the possible moderators in each postulated link. Materials and Methods: Systematic electronic searches of MEDLINE through PubMed, ScienceDirect, PsycINFO, and Google Scholar were carried out from inception till October 2016. Generated abstracts were screened for eligibility to be included in the review. Study designs that evaluated the strength of relationship between obesity and psychiatric disorders were included in the study. Quality assessment of included studies was done using the Newcastle–Ottawa checklist tool. Results: From a total of 2424 search results, 21 eligible articles were identified and reviewed. These included studies on obesity and depression (n = 15, obesity and anxiety (four and one each on obesity and personality disorders, eating disorder (ED, attention deficit hyperactivity disorder, and alcohol use. Maximal evidence existed for the association between depression and obesity with longitudinal studies demonstrating a bidirectional link between the two conditions. The odds ratios (ORs were similar for developing depression in obesity (OR: 1.21–5.8 and vice versa (OR: 1.18–3.76 with a stronger association observed in women. For anxiety disorders, evidence was mostly cross-sectional, and associations were of modest magnitude (OR: 1.27–1.40. Among other disorders, obesity, and EDs appear to have a close link (OR: 4.5. Alcohol use appears to be a risk factor for obesity and not vice versa but only among women (OR: 3.84. Conclusion: Obesity and depression have a significant and bidirectional association. Evidence is modest for anxiety disorders and inadequate for other psychiatric
Rajan, T M; Menon, V
Inconsistent evidence exists regarding the strength, direction, and moderators in the relationship between obesity and psychiatric disorders. This study aims to summarize the evidence on the association between psychiatric illness and obesity with particular attention to the strength and direction of association and also the possible moderators in each postulated link. Systematic electronic searches of MEDLINE through PubMed, ScienceDirect, PsycINFO, and Google Scholar were carried out from inception till October 2016. Generated abstracts were screened for eligibility to be included in the review. Study designs that evaluated the strength of relationship between obesity and psychiatric disorders were included in the study. Quality assessment of included studies was done using the Newcastle-Ottawa checklist tool. From a total of 2424 search results, 21 eligible articles were identified and reviewed. These included studies on obesity and depression (n = 15), obesity and anxiety (four) and one each on obesity and personality disorders, eating disorder (ED), attention deficit hyperactivity disorder, and alcohol use. Maximal evidence existed for the association between depression and obesity with longitudinal studies demonstrating a bidirectional link between the two conditions. The odds ratios (ORs) were similar for developing depression in obesity (OR: 1.21-5.8) and vice versa (OR: 1.18-3.76) with a stronger association observed in women. For anxiety disorders, evidence was mostly cross-sectional, and associations were of modest magnitude (OR: 1.27-1.40). Among other disorders, obesity, and EDs appear to have a close link (OR: 4.5). Alcohol use appears to be a risk factor for obesity and not vice versa but only among women (OR: 3.84). Obesity and depression have a significant and bidirectional association. Evidence is modest for anxiety disorders and inadequate for other psychiatric conditions. Gender appears to be an important mediator in these relationships.
Kang, Joon Young; Kim, Ryunhyung; Kim, Hyunsun; Kang, Yeonjune; Hahn, Susan; Fu, Zhengrui; Khalid, Mamoon I; Schenck, Enja; Thesen, Thomas
The prevalence of autism spectrum disorder (ASD) has risen significantly in the last ten years, and today, roughly 1 in 68 children has been diagnosed. One hallmark set of symptoms in this disorder are stereotypical motor movements. These repetitive movements may include spinning, body-rocking, or hand-flapping, amongst others. Despite the growing number of individuals affected by autism, an effective, accurate method of automatically quantifying such movements remains unavailable. This has negative implications for assessing the outcome of ASD intervention and drug studies. Here we present a novel approach to detecting autistic symptoms using the Microsoft Kinect v.2 to objectively and automatically quantify autistic body movements. The Kinect camera was used to film 12 actors performing three separate stereotypical motor movements each. Visual Gesture Builder (VGB) was implemented to analyze the skeletal structures in these recordings using a machine learning approach. In addition, movement detection was hard-coded in Matlab. Manual grading was used to confirm the validity and reliability of VGB and Matlab analysis. We found that both methods were able to detect autistic body movements with high probability. The machine learning approach yielded highest detection rates, supporting its use in automatically quantifying complex autistic behaviors with multi-dimensional input.
Ide, Masakazu; Wada, Makoto
In a rubber hand illusion (RHI) task, synchronous brush stroking of a rubber hand and a participant's hidden hand induces body ownership of the rubber hand. The effects of spatial distances and temporal lags on the RHI have been extensively examined; however, the effect of periodicity of the stimuli on illusory body ownership has not been examined. Meanwhile, the occurrence of RHI tends to be weak in individuals with autism-spectrum disorders (ASD) and high autistic traits. Preference for stimulus having regularity of tempo is generally observed in individuals with ASD, and thus, periodic stimulation might be more effective to elicit the body ownership illusion in individuals with high autistic traits. Hence, we investigated whether stimulus periodicity influenced RHI as well as its association with participant's autistic traits. Brush strokes were applied to a participant's own hand and the rubber hand periodically (2 s) or non-periodically (1-3 s), either synchronously or asynchronously. Two blocks were performed in each condition. We found that periodic stimulation enhanced the spatial updating of tactile sensation induced by RHI in the subsequent block in participants with high autistic traits, whereas both periodic and non-periodic stimulation strongly elicited RHI in blocks 1 and 2. These results indicate that the periodicity of stimulation has different effects based on an individual's autistic traits. Since individuals with ASD are known to sustain their focus on interoceptive sensations (heartbeats), a periodic stimulation that is potentially correlated with heartbeats might be effective to enhance the visuotactile integration during RHI in individuals with high autistic traits.
Barlow, J H; Ellard, D R; Hainsworth, J M; Jones, F R; Fisher, A
To review current evidence for the clinical and cost-effectiveness of self-management interventions for panic disorder, phobias and obsessive-compulsive disorder (OCD). Papers were identified through computerized searches of databases for the years between 1995 and 2003, manual searches and personal contacts. Only randomized-controlled trials were reviewed. Ten studies were identified (one OCD, five panic disorder, four phobias). Effective self-management interventions included cognitive-behavioural therapy (CBT) and exposure to the trigger stimuli for phobias and panic disorders. All involved homework. There was evidence of effectiveness in terms of improved symptoms and psychological wellbeing when compared with standard care, waiting list or relaxation. Brief interventions and computer-based interventions were effective for most participants. In terms of quality, studies were mainly based on small samples, lacked long-term follow-up, and failed to address cost-effectiveness. Despite the limitations of reviewed studies, there appears to be sufficient evidence to warrant greater exploration of self-management in these disorders. Copyright 2005 Blackwell Munksgaard.
Lélis, Ana Luíza P A; Cardoso, Maria Vera L M; Hall, Wendy A
Sleep disorders are more prevalent in children with cerebral palsy. The review aimed to identify and synthesize information about the nature of sleep disorders and their related factors in children with cerebral palsy. We performed an electronic search by using the search terms sleep/child*, and sleep/cerebral palsy in the following databases: Latin American literature on health sciences, SCOPUS, medical publications, cumulative index to nursing and allied health literature, psycinfo, worldcat, web of science, and the Cochrane library. The selection criteria were studies: available in Portuguese, English or Spanish and published between 2004 and 2014, with results addressing sleep disorders in children (ages 0-18 y) with a diagnosis of cerebral palsy. 36,361 abstracts were identified. Of those, 37 papers were selected, and 25 excluded. Twelve papers were incorporated in the study sample: eight quantitative studies, three reviews, and one case study. Eleven types of sleep disorders were identified, such as difficult morning awakening, insomnia, nightmares, difficulties in initiating and maintaining nighttime sleep (night waking), and sleep anxiety. Twenty-one factors were linked to sleep disorders, which we classified as intrinsic factors associated with common comorbidities accompanying cerebral palsy, and extrinsic aspects, specifically environmental and socio-familial variables, and clinical-surgical and pharmacological interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.
There is considerable controversy about the role of child sexual abuse in the etiology of anxiety disorders. Although a growing number of research studies have been published, these have produced inconsistent results and conclusions regarding the nature of the associations between child sexual abuse and the various forms of anxiety problems as well as the potential effects of third variables, such as moderators, mediators, or confounders. This article provides a systematic review of the several reviews that have investigated the literature on the role of child sexual abuse in the etiology of anxiety disorders. Seven databases were searched, supplemented with hand search of reference lists from retrieved papers. Four meta-analyses, including 3,214,482 subjects from 171 studies, were analyzed. There is evidence that child sexual abuse is a significant, although general and nonspecific, risk factor for anxiety disorders, especially posttraumatic stress disorder, regardless of gender of the victim and severity of abuse. Additional biological or psychosocial risk factors (such as alterations in brain structure or function, information processing biases, parental anxiety disorders, family dysfunction, and other forms of child abuse) may interact with child sexual abuse or act independently to cause anxiety disorders in victims in abuse survivors. However, child sexual abuse may sometimes confer additional risk of developing anxiety disorders either as a distal and indirect cause or as a proximal and direct cause. Child sexual abuse should be considered one of the several risk factors for anxiety disorders and included in multifactorial etiological models for anxiety disorders.
Pallanti, Stefano; Lassi, Stefano; La Malfa, Giampaolo; Campigli, Marco; Di Rubbo, Roberto; Paolini, Giulia; Cesarali, Valentina
Pervasive Developmental Disorders (PDD) are chronic, lifelong disorders for which there is as yet no effective cure, and medical management remains a challenge for clinicians. The current report describes two patients affected by autistic disorder with associated gastrointestinal symptoms. They received multiple doses of intravenous secretin for a six-month period and were assessed with several specific outcome measures to evaluate drug effect. The administration of secretin led to some significant and lasting improvement in only one case. Gastroesophageal reflux may contribute to some of the behavioural problems and explain the effect of secretin since its suppressive effect on gastric secretion is well known. It is also true that autistic children with gastroesophageal reflux and a higher IQ could constitute a subtype which responds to secretin administration and that could be labelled as a "gastrointestinal subtype".
Perich, Tania; Ussher, Jane; Meade, Tanya
Menopause may be a time of increased mood symptoms for some women. This systematic review aimed to examine the severity of symptoms and prevalence of mood changes in women with bipolar disorder during peri-menopause and post-menopause. A systematic review was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The two primary outcomes assessed were relapse rates and symptom severity during menopause. Databases searched were MEDLINE, EMBASE, PsychInfo, CINAHL and SCOPUS from January 1980 until December 2016. Nine studies, including a total of 273 participants diagnosed with bipolar disorder and who reported menopause, were included in the narrative synthesis. Menopause was reported to be associated with increased symptoms overall, and with depression in particular (range of 46%-91%). The collection of self-reported retrospective data was the most commonly used method to record menopause status. The impact of menopause on illness course for women with bipolar disorder is largely under-explored. Preliminary evidence suggests that it may be associated with increased bipolar symptoms. Further work is needed to explore how menopause may interact with bipolar disorder over time and the nature of these symptom changes, and if and how menopause may differ from other reproductive stages. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Oren M. Weiner
Full Text Available Measurement of sleep microarchitecture and neural oscillations is an increasingly popular technique for quantifying EEG sleep activity. Many studies have examined sleep spindle oscillations in sleep-disordered adults; however reviews of this literature are scarce. As such, our overarching aim was to critically review experimental studies examining sleep spindle activity between adults with and without different sleep disorders. Articles were obtained using a systematic methodology with a priori criteria. Thirty-seven studies meeting final inclusion criteria were reviewed, with studies grouped across three categories: insomnia, hypersomnias, and sleep-related movement disorders (including parasomnias. Studies of patients with insomnia and sleep-disordered breathing were more abundant relative to other diagnoses. All studies were cross-sectional. Studies were largely inconsistent regarding spindle activity differences between clinical and nonclinical groups, with some reporting greater or less activity, while many others reported no group differences. Stark inconsistencies in sample characteristics (e.g., age range and diagnostic criteria and methods of analysis (e.g., spindle bandwidth selection, visual detection versus digital filtering, absolute versus relative spectral power, and NREM2 versus NREM3 suggest a need for greater use of event-based detection methods and increased research standardization. Hypotheses regarding the clinical and empirical implications of these findings, and suggestions for potential future studies, are also discussed.
Herrema, Renske; Garland, Deborah; Osborne, Malcolm; Freeston, Mark; Honey, Emma; Rodgers, Jacqui
Family members are often the primary caregiver for autistic adults and this responsibility may impact on the carer’s wellbeing and quality of life. 109 family members of autistic adults completed an online survey assessing their wellbeing relating to their caring role for their autistic relative. Family members who were supporting an autistic relative with co-occurring mental health difficulties and who they reported as unprepared for the future, self-reported higher levels of worry, depressi...
Simpson, Heather A; Jung, Leah; Murphy, Tanya K
Tic disorders impact quality of life, but when they are co-occurring with attention-deficit/hyperactivity disorder, the combined impact takes a toll on psychosocial functioning and adds another layer of complexity to treatment approaches. A review of the current literature supports evidence of a unique relationship between comorbid attention-deficit/hyperactivity disorder and tic disorders, emphasizing the intricate phenotype and impairment associated with these co-occurring conditions. The complexity of these symptoms requires careful diagnosis and appropriate treatment as determined by the level of impairment and can include pharmacotherapy, behavioral interventions, or a combination of therapies. To achieve the greatest benefits in improving quality of life and eliminating further comorbidity, an ideal treatment plan would include a comprehensive evaluation as well as a hierarchical treatment approach involving education of the child, family, and teachers; careful medication management; and cognitive and behavioral training.
Dalsgaard, Søren; Madsen, Anders G.; Bikic, Aida
This paper presents an overview of the history of the studies of mental health problems and substance use disorder (SUD) and the neurobiology and etiology of attention-deficit hyperactivity disorder (ADHD) and SUD. Additionally, we review the literature on the associations between ADHD and SUD......, the association between stimulant treatment in patients with ADHD and the risk of SUD and the guidelines for clinical assessment and treatment of adolescents with ADHD and comorbid SUD. There is substantial evidence suggesting that patients with ADHD are at increased risk of SUD, and that comorbid conduct...
Hazari, Nandita; Kate, Natasha; Grover, Sandeep
Tardive syndromes (TS) arise from long term exposure to dopamine receptor blocking agents. Clozapine has been considered to have low risk of causing new onset TS and is considered as a treatment option in patients with TS. This review evaluates the usefulness of clozapine in patients with TS and occasional reports of clozapine causing TS. Electronic searches were carried out using the search engines of PUBMED, Science direct and Google Scholar databases. All reports describing use of clozapine in management of TS, monitoring of TS while on clozapine and onset of TS after initiation of clozapine were identified. Fifteen trials and 28 case series/case reports describe the use of clozapine in TS. Most of these reports show that clozapine is useful in patients with TS, in the dose range of 200-300 mg/day and the beneficial effect is seen within 4-12 weeks of initiation. One case series and two case reports described clozapine withdrawal emergent dyskinesias suggesting a masking role of clozapine. One trial, three case series and two case reports describe beneficial effects of clozapine on long standing neurological syndromes. There is relatively less literature (2 trials and 15 case series/reports) describing the emergence of TS with clozapine. Evidence of beneficial effects of clozapine in TS is greater than its role in causation/worsening of TS. Hence, clozapine should be considered in symptomatic patients who develop TS while receiving other antipsychotics. Further research on mechanism of TS and clozapine effect on TS is required. Copyright © 2013 Elsevier B.V. All rights reserved.
Bárbara R. Ferreira
Full Text Available Objective: To compile data on Tourette's syndrome (TS, tics and associated disorders.Methods: A systematic review of the literature was conducted using the 5S levels of organization of healthcare research evidence (systems, summaries, synopses, syntheses, studies, based on the model described by Haynes. The search keywords were Tourette, tics and comorbidity, which were cross-referenced. Studies provided by publishers and articles being processed on July 31, 2013, were also included.Results: Of all studies retrieved during the search, 64 were selected because they analyzed the epidemiology, clinical features and etiopathogenesis of TS and its comorbidities. TS is classified as a hyperkinetic movement disorder, and at least 90% of the patients have neuropsychiatric comorbidities, of which attention deficit hyperactivity and obsessive-compulsive disorders are the most common. The syndrome is clinically heterogeneous and has been associated with a dysfunction of cortico-striatal-thalamic-cortical circuits involving various neurotransmitters. Although its genetic etiology has been widely studied, other factors may be important to understand this syndrome and its associated disorders.Conclusions: TS is a neurodevelopmental disorder that results from the impact of stress factors on a vulnerable biological substrate during the critical periods of neurodevelopment. The study of TS and its comorbidities may contribute, at different levels, to the understanding of several neuropsychiatric disorders of clinical and therapeutic relevance.
Kronfol, Ziad; Zakaria Khalil, Mostafa; Kumar, Pankaj; Suhre, Karsten; Karam, Elie; McInnis, Melvin
Bipolar disorders are common psychiatric disorders that affect 1-5% of the population worldwide. Major advances in the epidemiology, pathophysiology, and treatment of the disorders have recently occurred. The majority of published reports, however, originate from the Western hemisphere, mostly Europe and the United States. There is a shortage of data from the Arab world on bipolar disorders. In an era of globalization and rapid communication, it is not clear to what extent research findings pertaining to one part of the world are by necessity applicable to other parts. Psychiatric disorders are known to be affected by the culture in which they occur, and knowledge of variations in illness presentation in different ethnic groups is also increasing. However, knowledge of variations affecting Arab populations remains quite limited. This paper provides a critical review of the literature on bipolar affective disorders in the Arab world, pointing to major gaps in knowledge and future opportunities to fill these gaps. © 2015 New York Academy of Sciences.
Lyvia Christina Camarotto Battiston Rodrigues
Full Text Available OBJETIVO: Analisar a atribuição de estados mentais no discurso de crianças pertencentes aos Distúrbios do Espectro Autístico e verificar a modificação no vocabulário e extensão frasal desses, após período de terapia fonoaudiológica. MÉTODOS: Foram colhidas amostras de fala da avaliação fonoaudiológica inicial, após seis meses e um ano de terapia fonoaudiológica, registradas nos prontuários de cinco crianças com autismo infantil e cinco com síndrome de Asperger para caracterização do desempenho verbal e da habilidade de atribuição de estados mentais de cada criança. Considerando-se apenas as emissões espontâneas, foram verificadas as palavras pertencentes às classes substantivo e verbo e classificadas como termos que referem estados físicos e mentais. A comparação entre os três momentos foi realizada por meio da avaliação da significância entre as medianas das amostras obtidas (teste da mediana, com diferença significativa ao nível de 10%. RESULTADOS: Verificou-se aumento no número de palavras emitidas e também no número de palavras por frase emitida entre os períodos de avaliação e após um ano de terapia fonoaudiológica para crianças com autismo infantil. Não foram encontradas diferenças para a atribuição de verbos de estados físicos e mentais e substantivos de estados mentais para ambos os grupos, sendo observada diminuição na emissão de substantivos de estados físicos no grupo autismo infantil. CONCLUSÃO: A atribuição de estados mentais aumentou após período de intervenção terapêutica fonoaudiológica, porém, sem diferença significativa, verificando-se aumento no comportamento verbal de crianças com autismo infantil.PURPOSE: To analyze the attribution of mental states in the speech of children within the Autistic Spectrum Disorders, and verify the modification in their vocabulary and phrasal extension, after a period of speech-language therapy. METHODS: Speech samples from the
Otte, Julie L; Carpenter, Janet S; Manchanda, Shalini; Rand, Kevin L; Skaar, Todd C; Weaver, Michael; Chernyak, Yelena; Zhong, Xin; Igega, Christele; Landis, Carol
Although sleep is vital to all human functioning and poor sleep is a known problem in cancer, it is unclear whether the overall prevalence of the various types of sleep disorders in cancer is known. The purpose of this systematic literature review was to evaluate if the prevalence of sleep disorders could be ascertained from the current body of literature regarding sleep in cancer. This was a critical and systematic review of peer-reviewed, English-language, original articles published from 1980 through 15 October 2013, identified using electronic search engines, a set of key words, and prespecified inclusion and exclusion criteria. Information from 254 full-text, English-language articles was abstracted onto a paper checklist by one reviewer, with a second reviewer randomly verifying 50% (k = 99%). All abstracted data were entered into an electronic database, verified for accuracy, and analyzed using descriptive statistics and frequencies in SPSS (v.20) (North Castle, NY). Studies of sleep and cancer focus on specific types of symptoms of poor sleep, and there are no published prevalence studies that focus on underlying sleep disorders. Challenging the current paradigm of the way sleep is studied in cancer could produce better clinical screening tools for use in oncology clinics leading to better triaging of patients with sleep complaints to sleep specialists, and overall improvement in sleep quality. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Otte, Julie L; Carpenter, Janet S; Manchanda, Shalini; Rand, Kevin L; Skaar, Todd C; Weaver, Michael; Chernyak, Yelena; Zhong, Xin; Igega, Christele; Landis, Carol
Although sleep is vital to all human functioning and poor sleep is a known problem in cancer, it is unclear whether the overall prevalence of the various types of sleep disorders in cancer is known. The purpose of this systematic literature review was to evaluate if the prevalence of sleep disorders could be ascertained from the current body of literature regarding sleep in cancer. This was a critical and systematic review of peer-reviewed, English-language, original articles published from 1980 through 15 October 2013, identified using electronic search engines, a set of key words, and prespecified inclusion and exclusion criteria. Information from 254 full-text, English-language articles was abstracted onto a paper checklist by one reviewer, with a second reviewer randomly verifying 50% (k = 99%). All abstracted data were entered into an electronic database, verified for accuracy, and analyzed using descriptive statistics and frequencies in SPSS (v.20) (North Castle, NY). Studies of sleep and cancer focus on specific types of symptoms of poor sleep, and there are no published prevalence studies that focus on underlying sleep disorders. Challenging the current paradigm of the way sleep is studied in cancer could produce better clinical screening tools for use in oncology clinics leading to better triaging of patients with sleep complaints to sleep specialists, and overall improvement in sleep quality
After World War II, traumatic after effects often caused persistent sleep disorders for Holocaust survivors (HSs). This is a review of studies reporting on sleep disturbances and nightmares (as primary or secondary outcomes) among HSs between 1939 and 2015, conducted in various countries and contexts (clinical settings, pension claims, community surveys, sleep laboratories). Most studies revealed various sleep disturbances among HSs. Some studies found those disturbances in the absence of clinical disorders. Both men and women reported similar frequencies of sleep disturbances, although posttraumatic stress disorder and depression were more frequent in women. Sleep laboratory studies provided the single most direct and detailed sources of information. Findings included a) long-standing changes in sleep architecture, for example, decreased rapid eye movement (REM) sleep, and b) contrasting patterns of dreaming and recall among better versus poorly adjusted survivors. These results are of importance to both HSs and their families and for medical and mental health professionals.
Paulus, Frank W; Ohmann, Susanne; von Gontard, Alexander; Popow, Christian
Internet gaming disorder (IGD) is a serious disorder leading to and maintaining pertinent personal and social impairment. IGD has to be considered in view of heterogeneous and incomplete concepts. We therefore reviewed the scientific literature on IGD to provide an overview focusing on definitions, symptoms, prevalence, and aetiology. We systematically reviewed the databases ERIC, PsyARTICLES, PsycINFO, PSYNDEX, and PubMed for the period January 1991 to August 2016, and additionally identified secondary references. The proposed definition in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition provides a good starting point for diagnosing IGD but entails some disadvantages. Developing IGD requires several interacting internal factors such as deficient self, mood and reward regulation, problems of decision-making, and external factors such as deficient family background and social skills. In addition, specific game-related factors may promote IGD. Summarizing aetiological knowledge, we suggest an integrated model of IGD elucidating the interplay of internal and external factors. So far, the concept of IGD and the pathways leading to it are not entirely clear. In particular, long-term follow-up studies are missing. IGD should be understood as an endangering disorder with a complex psychosocial background. In representative samples of children and adolescents, on average, 2% are affected by Internet gaming disorder (IGD). The mean prevalences (overall, clinical samples included) reach 5.5%. Definitions are heterogeneous and the relationship with substance-related addictions is inconsistent. Many aetiological factors are related to the development and maintenance of IGD. This review presents an integrated model of IGD, delineating the interplay of these factors. This article's abstract has been translated into Spanish and Portuguese. Follow the links from the abstract to view the translations. © 2018 Mac Keith Press.
Mahn, Heather Mciver; Lordly, Daphne
The diet industry and media have a powerful influence over women, leading many to believe that they must modify their appearance for societal acceptance. Dietetics, as one of many predominantly female professions, may be particularly vulnerable to these pressures. An integrative review process was used to examine eating disorders and disordered eating within the dietetics profession with the aim to both synthesize existing data and develop questions for future research. Seventeen articles were reviewed using broad search terms and dates because of the dearth of available literature. Given nutrition programs and dietetic practice often involve significant exposure to food, ideas and opinions about food, weight, and its place in health and dietetic practice researchers were compelled to ask "why". Findings were organized under 3 categories including thinness ideology, implications of food and body associated with nutrition or dietetic education, and establishment of a continuum. This review serves as a platform to inspire future research in an understudied but important topic related to dietetic education and practice. Minimally as a profession, baseline data need to be collected to understand the prevalence of disordered eating and eating disorders along the continuum of practice in Canada.
Abbate-Daga, Giovanni; Marzola, Enrica; Amianto, Federico; Fassino, Secondo
To comprehensively review the existing literature on the effectiveness of psychodynamic psychotherapies in eating disorders (EDs) and to stimulate both debate and research on this topic. Online and hand searches were conducted to identify papers published between 1980 and 2015 on psychodynamic treatments delivered to adults with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). A total of 47 studies were finally included in this review. Fifteen studies were available for AN, 9 for BN, 12 for BED, and 11 for samples with mixed diagnoses. Several methodological flaws emerged, but overall psychodynamic interventions showed promising results at the end of treatment and follow-up, when available. The body of literature on psychodynamic treatments is sparse and sometimes methodologically questionable; nevertheless, current data provide support to the effectiveness of these interventions, particularly for AN. However, both a defined approach (focus, themes, and techniques) and randomized controlled trials (RCTs) are warranted to clarify the effectiveness of psychodynamic psychotherapies.
Yang, Jennifer H; Baskin, Laurence S; DiSandro, Michael
Many concerns have been raised regarding the treatment and long-term outcome of infants born with complex genital anomalies. Debate among clinicians, psychologists, ethicists, and patient advocate groups regarding the optimal management of these individuals is ongoing. Although determining the most appropriate gender is a difficult task, this review will help clarify some of the issues at hand. A literature review which addresses the challenges of advising families about gender identity in infants and children with disorders of sex development. The evidence for endocrine effects on neurobiological development with regard to sexual behavior is compelling, although the existing outcome studies are largely anecdotal and somewhat contradictory. Gender assignment in infants born with a disorder of sex development remains only one of the many difficult decisions faced by both the treatment team and the family. Improved long-term follow-up of these patients will provide much needed feedback on previous and contemporary management. 2010 Elsevier Inc. All rights reserved.
Lowe, Hilary; Henry, Lucy; Müller, Lisa-Maria; Joffe, Victoria L
Language disorder and associated vocabulary difficulties can persist into adolescence, and can impact on long-term life outcomes. Previous reviews have shown that a variety of intervention techniques can successfully enhance students' vocabulary skills; however, none has investigated vocabulary intervention specifically for adolescents with language disorder. To carry out a systematic review of the literature on vocabulary interventions for adolescents with language disorder. A systematic search of 14 databases and other sources yielded 1320 studies, of which 13 met inclusion criteria. Inclusion criteria were: intervention effectiveness studies with a focus on enhancing oral receptive and/or expressive vocabulary skills in the study's aims; participants in the age range 11;0-16;11 with receptive and/or expressive language difficulties of any aetiology. There was a high degree of diversity between studies. Types of intervention included: semantic intervention (four studies); comparison of phonological versus semantic intervention (two); and combined phonological-semantic intervention (seven). The strongest evidence for effectiveness was found with a combined phonological-semantic approach. The evidence suggested a potential for all models of delivery to be helpful (individual, small group and whole class). Tentative evidence is emerging for the effectiveness of a phonological-semantic approach in enhancing the vocabulary skills of adolescents who have language disorder. Future research needs to refine and develop the methodologies used in this diverse group of studies in order to replicate their findings and to build consensus. © 2017 Royal College of Speech and Language Therapists.
Karen M. O’Callaghan
Full Text Available This narrative systematic review evaluates growing evidence of an association between low maternal vitamin D status and increased risk of hypertensive disorders. The inclusion of interventional, observational, and dietary studies on vitamin D and all hypertensive disorders of pregnancy is a novel aspect of this review, providing a unique contribution to an intensively-researched area that still lacks a definitive conclusion. To date, trial evidence supports a protective effect of combined vitamin D and calcium supplementation against preeclampsia. Conflicting data for an association of vitamin D with gestational hypertensive disorders in observational studies arises from a number of sources, including large heterogeneity between study designs, lack of adherence to standardized perinatal outcome definitions, variable quality of analytical data for 25-hydroxyvitamin D (25(OHD, and inconsistent data reporting of vitamin D status. While evidence does appear to lean towards an increased risk of gestational hypertensive disorders at 25(OHD concentrations <50 nmol/L, caution should be exercised with dosing in trials, given the lack of data on long-term safety. The possibility that a fairly narrow target range for circulating 25(OHD for achievement of clinically-relevant improvements requires further exploration. As hypertension alone, and not preeclampsia specifically, limits intrauterine growth, evaluation of the relationship between vitamin D status and all terms of hypertension in pregnancy is a clinically relevant area for research and should be prioritised in future randomised trials.
Soares, Célia; Fernandes, Natália; Morgado, Pedro
At present, no treatment recommendations can be made for compulsive buying disorder. Recent studies have found evidence for the efficacy of psychotherapeutic options, but less is known regarding the best pharmacologic treatment. The purpose of this review is to present and analyze the available published evidence on the pharmacological treatment of compulsive buying disorder. To achieve this, we conducted a review of studies focusing on the pharmacological treatment of compulsive buying by searching the PubMed/MEDLINE database. Selection criteria were applied, and 21 studies were identified. Pharmacological classes reported included antidepressants, mood stabilizers, opioid antagonists, second-generation antipsychotics, and N-methyl-D-aspartate receptor antagonists. We found only placebo-controlled trials for fluvoxamine; none showed effectiveness against placebo. Three open-label trials reported clinical improvement with citalopram; one was followed by a double-blind discontinuation. Escitalopram was effective in an open-label trial but did not show efficacy in the double-blind phase. Memantine was identified as effective in a pilot open-label study. Fluoxetine, bupropion, nortriptyline, clomipramine, topiramate and naltrexone were only reported to be effective in clinical cases. According to the available literature, there is no evidence to propose a specific pharmacologic agent for compulsive buying disorder. Future research is required for a better understanding of both pathogenesis and treatment of this disorder.
Stea, Jonathan N; Hodgins, David C
This review presents the theoretical model, evidence base, and theoretical and methodological issues for seven treatment approaches to gambling disorders: 1) psychoanalytic and psychodynamic treatments, 2) Gamblers Anonymous, 3) behavioural treatments, 4) cognitive and cognitive-behavioural therapies, 5) brief, motivational, and self-directed interventions, 6) pharmacotherapies, and 7) family therapy approaches. Throughout the review, broader clinical and research issues are also discussed, including barriers to treatment-seeking, controlled gambling versus abstinence as a treatment goal, comorbidity, and the evaluation of treatment efficacy and effectiveness.
Dancyger, Ida F.; Fornari, Victor M.
This review examines the literature during the past 10 years about suicide risk and suicide during adolescence and young adulthood of individuals with eating disorders. Epidemiological surveys are summarized, including suicide rates, parasuicidal behaviors, associated risk factors, and comorbid psychopathology. Critical implications for the comprehensive assessment and treatment planning, including safety considerations, are discussed. Two clinical cases of women with long-standing eating dis...
Bauset, S.M. (Salvador M.); Zazpe, I. (Itziar); Mari-Sanchis, A. (Amelia); Llopis-Gonzalez, A. (Agustín); Suarez-Varela, M.M. (María M.)
Autism spectrum disorders are characterized by difficulties with reciprocal social interactions and restricted patterns of behavior and interest; one of these characteristic behaviors is food selectivity. The objective of this study was to perform a systematic review of the literature published between 1970 and 2013 concerning this eating behavior. The articles identified were analyzed in terms of sample size, study design, and criteria for assessment and intervention, as well as the results,...
Witcher, Patricia M; Chez, Bonnie Flood; Baird, Suzanne McMurtry
Hypertension predisposes the woman and fetus to adverse outcomes during the pregnancy and postpartum. The risk for maternal complications and neonatal morbidity associated with the necessity of preterm birth extends beyond the postpartum and postnatal period. A comprehensive review of the multisystem effects of hypertensive disorders and underlying pathophysiology is provided to support the role of prompt identification of and management of acute complications of hypertension.
Dingemans, Alexandra; Danner, Unna; Parks, Melissa
The purpose of the present review is to provide a summary of the research findings on emotion regulation in Binge Eating Disorder (BED). Negative emotions and maladaptive emotion regulation strategies play a role in the onset and maintenance of binge eating in BED. Anger and sadness, along with negative emotions related to interpersonal experiences (i.e., disappointment, being hurt or loneliness), seem to be particularly relevant. Individuals with BED have a tendency to suppress and ruminate ...
Preeti Devnani; Racheal Fernandes
Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, ...
Maras, K. L.; Bowler, D. M.
Autism spectrum disorder (ASD) is estimated to affect around 1% of the population, and is characterised by impairments in social interaction, communication, and behavioural flexibility. A number of risk factors indicate that individuals with ASD may become victims or witnesses of crimes. In addition to their social and communication deficits, people with ASD also have very specific memory problems, which impacts on their abilities to recall eyewitnessed events. We begin this review with an ov...
O'Toole, Mia Skytte; Pedersen, Anders Degn
the causal relationship between these constructs. Knowledge from such studies is important in order to improve the understanding of why SAD is such a disabling disorder, both educationally and interpersonally, and could assist in the planning and evaluation of psychotherapeutic treatment. Read More: http...... number of 698 adult patients with SAD. The review revealed indication for decreased performance regarding visual scanning and visuoconstructional ability as well as some indication for verbal memory difficulties. Conclusion: The impact of possible confounding variables on the neuropsychological...
Full Text Available Disordered optical fibers show novel waveguiding properties that can be used for various device applications, such as beam-multiplexed optical communications and endoscopic image transport. The strong transverse scattering from the transversely disordered optical fibers results in transversely confined beams that can freely propagate in the longitudinal direction, similar to conventional optical fibers, with the advantage that any point in the cross section of the fiber can be used for beam transport. For beam multiplexing and imaging applications, it is highly desirable to make the localized beam radius as small as possible. This requires large refractive index differences between the materials that define the random features in the disordered fiber. Here, disordered glass-air fibers are briefly reviewed, where randomly placed airholes in a glass matrix provide the sufficiently large refractive index difference of 0.5 for strong random transverse scattering. The main future challenge for the fabrication of an optimally disordered glass-air fibers is to increase the fill-fraction of airholes to nearly 50% for maximum beam confinement.
Poppe, I; Simons, A; Glazemakers, I; Van West, D
The incidence of anorexia nervosa (AN) in adolescents has increased significantly in recent years. In several studies and in the media it has been suggested that AN has recently become more prevalent in the pre-adolescence. In view of the impact that an eating disorder can have on a child, it is important to diagnose and start treating the illness as early as possible. To review the literature on the characteristics and susceptibilities of patients with eating disorders because this information can be important for early diagnosis, prevention and identification of susceptibilities to early-onset eating disorders. We searched the literature for articles relating to early-onset eating disorders. We based our search on PubMed and on related relevant articles listed in the references. We selected 34 relevant articles published between 1987 and 2014. The literature lists characteristics and susceptibilities at various levels. Many types of factors are involved; examples of 'biological' factors are prior streptococcal infection, previous consultations with GP and a patients medical history; psychological factors include comorbidity, temperament, a particular personality profile, maturation-anxiety; environmental factors such as family history, family functioning and/or stressful events can play a role in the development of eating disorders. CONCLUSION The literature indicates that the early development of AN in children is related to a complex combination of etiological factors. However, there is a need for more research into this group of patients.
Naskar, Subrata; Victor, Robin; Nath, Kamal; Sengupta, Chiradeep
Due to explosive growth in technology and internet usage in the last few years, internet gaming disorder (IGD) has manifested as rapidly growing public health problem mainly affecting the teen and preteen population worldwide. It has a negative impact upon physical, psychological, social, and occupational functioning of the affected individual, often leading to severe consequences. It was only recently that it has been recognized as a separate diagnosable disorder in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. Not much data is available regarding the exact prevalence and the various sociodemographic, clinical, and other risk factors to identify the individuals vulnerable to develop this disorder, especially in the developing countries such as India. According to a recent report, India ranks 22 nd in the list of highest revenue-generating countries from gaming-related businesses, thus highlighting the magnitude of risk faced by Indian population. The aim of this review is to provide an insight about the disorder to identify the risk factors and clinical features, to understand the effect of IGD upon the psychological and physical health with a special focus on neural changes, and to provide information on the various upcoming preventive and treatment strategies.
Renauld, Stéphanie; Mohamed-Saïd, Lyakout; Macoir, Joël
Although cognitive impairments are common in patients with multiple sclerosis (MS), language impairments are not well defined. The goal of this review was to examine the presence and nature of language disorders associated with MS. A search of PubMed and PsycINFO databases was conducted using combinations of the following terms: language disorders, language pathology, language impairment, multiple sclerosis, communication, language and speech. Studies were chosen based on the original language of the text, year of publication, peer-review status and specificity of the results regarding language and communication disorders. This review covers 30 articles from 13 countries. The studies involved patients with different types of MS. Various language impairments were reported in MS. However, since the methods used in the studies varied widely, it is difficult to draw any conclusions thus far. Given the various cognitive deficits in MS, it is expected that higher language abilities would be affected. This aspect should be investigated in future studies. Copyright Â© 2016 Elsevier B.V. All rights reserved.