Diagnosis and Epidemiology of Pediatric Psychiatric Disorders

2017 ◽  
Author(s):  
Elise B. Robinson ◽  
Benjamin M. Neale ◽  
Mark J. Daly
Keyword(s):  
Pervasive Developmental Disorders ◽  
Developmental Disorders ◽  
Autism Spectrum ◽  
Tic Disorders ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Diagnostic Categories ◽  
Severe Impairment ◽  
Substance Abuse Disorders ◽  
Definition Of

Pediatric psychiatric conditions are rising in estimated prevalence, and these disorders place an enormous burden on parents, educators, and the health care system. This rise in prevalence likely contains elements of diagnostic changes, greater awareness of these disorders, and true changes in incidence. It has been estimated that there is nearly a 50% lifetime childhood prevalence of one or more mood, anxiety, or behavioral disorders (excluding eating and substance abuse disorders) and that more than 20% of children meet the definition of severe impairment. This chapter focuses on epidemiology, heritability, and implied genetic architecture in representative pediatric neuropsychiatric conditions. We consider five major diagnostic categories and highlight major diagnosis within each, specifically, intellectual disability, pervasive developmental disorders (autism spectrum disorder [ASD]), hyperactive and inattentive behavior (attention deficit/hyperactivity disorder [ADHD]), obsessive compulsive disorder (OCD) and tic disorders (TD) (which includes Tourette Syndrome [TS] and other chronic tic disorders).

scholarly journals Obsessive-compulsive spectrum disorders

2003 ◽  
Vol 5 (3) ◽  
pp. 259-271
Keyword(s):  
Impulse Control ◽  
Body Dysmorphic Disorder ◽  
Patient Characteristics ◽  
Autism Spectrum ◽  
Sexual Compulsivity ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Diagnostic Categories ◽  
Spectrum Disorders ◽  
Fruitful Research

The obsessive-compulsive spectrum is an important concept referring to a number of disorders drawn from several diagnostic categories that share core obsessive-compulsive features. These disorders can be grouped by the focus of their symptoms: bodily preoccupation, impulse control, or neurological disorders. Although the disorders are clearly distinct from one another, they have intriguing similarities in phenomenology, etiology, pathophysiology, patient characteristics, and treatment response. In combination with the knowledge gained through many years of research on obsessive-compulsive disorder (OCD), the concept of a spectrum has generated much fruitful research on the spectrum disorders. It has become apparent that these disorders can also be viewed as being on a continuum of compulsivity to impulsivity, characterized by harm avoidance at the compulsive end and risk seeking at the impulsive end. The compulsive and impulsive disorders differ in systematic ways that are just beginning to be understood. Here, we review these concepts and several representative obsessive-compulsive spectrum disorders including both compulsive and impulsive disorders, as well as the three different symptom clusters: OCD, body dysmorphic disorder, pathological gambling, sexual compulsivity, and autism spectrum disorders.

Differential diagnosis of adolescent and adult pervasive developmental disorders/autism spectrum disorders (PDD/ASD): a not uncommon diagnostic dilemma

1999 ◽  
Vol 16 (4) ◽  
pp. 145-148 ◽  
Author(s):  
Michael Fitzgerald
Keyword(s):  
Autism Spectrum Disorders ◽  
Pervasive Developmental Disorders ◽  
Developmental Disorders ◽  
Specific Treatment ◽  
Autism Spectrum ◽  
Mental Illnesses ◽  
Diagnostic Categories ◽  
Core Deficit ◽  
Adult Psychiatry ◽  
Spectrum Disorders

The failure to recognise the pervasive developmental disorders/autism spectrum disorders is probably not uncommon in adult psychiatry. Indeed some of the treatment-resistant chronic mental illnesses are due to the failure to make this diagnosis and apply more appropriate treatment.Patients with PDD/ASD cause considerable diagnostic difficulties in both inpatient and outpatient adolescent and adult psychiatry. Clinical experience suggests that patients with PDD/ASD in adulthood have been misdiagnosed as having schizophrenia resulting in inappropriate treatment. Mesibov and Handlan state that the diagnostic situation is complicated because the characteristics of autism are less pronounced in older clients. It is critical that an accurate diagnosis is given because of the specific treatment implications. In the past decade there have been considerable developments in our understanding of autism. The importance of bringing the developmental viewpoint into adult psychiatry is now highly relevant. Unfamiliar diagnostic categories now have to be considered by adolescent and adult psychiatrists. Grounds for the deletion of adult psychiatric disorders, eg. simple schizophrenia from ICD102 may exist. Instead PDD/ASD disorder may need to be considered.As the purpose of diagnosis is to ensure appropriate client management, it is essential that diagnostic criteria are continually reviewed in view of clinical observation and research developments. In this paper, diagnostic categories causing confusion are outlined, and that these are variants of the core deficit of autism is suggested. The major PDD/ASD diagnoses in adolescence and adulthood are listed below.Two of the following are required for the diagnosis of autism:

Understanding and Caring for the Child With Asperger Syndrome

2001 ◽  
Vol 17 (4) ◽  
pp. 178-184 ◽  
Author(s):  
Marcia Rubenstein Gardner
Keyword(s):  
Asperger Syndrome ◽  
Cognitive Abilities ◽  
Pervasive Developmental Disorders ◽  
Developmental Disorders ◽  
School Health ◽  
Autism Spectrum ◽  
Care Plan ◽  
Pragmatic Language ◽  
Management Support ◽  
Compulsive Disorder

Nurses in a variety of settings encounter children with the unfamiliar diagnosis of Asperger syndrome (AS). This disorder, which falls clinically along the autism spectrum, is receiving increasing attention because of its inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as one of the pervasive developmental disorders. The characteristic features of AS include deficits in social skills, atypical understanding of and use of pragmatic language, behavior problems, and a restricted set of interests. Cognitive abilities vary, and some children with AS have high intelligence. In addition, many children with AS have other conditions, such as attention deficit hyperactivity disorder, Tourette’s syndrome, obsessive-compulsive disorder, and depression. The disorder can result in significant functional difficulties in the home, school, and community contexts. A case study highlights the features of AS, and a related individualized school health care plan demonstrates the school nurse’s role in family and staff education, monitoring for comorbidities, behavioral management, medication management, support to family members, and referral.

scholarly journals Obsessive-compulsive disorder in children and adolescents

2014 ◽  
Vol 100 (5) ◽  
pp. 495-499 ◽  
Author(s):  
Georgina Krebs ◽  
Isobel Heyman
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Serotonin Reuptake ◽  
Current Knowledge ◽  
Autism Spectrum ◽  
Tic Disorders ◽  
Childhood And Adolescence ◽  
Behaviour Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cognitive Behaviour

Obsessive-compulsive disorder (OCD) in childhood and adolescence is an impairing condition, associated with a specific set of distressing symptoms incorporating repetitive, intrusive thoughts (obsessions) and distressing, time-consuming rituals (compulsions). This review considers current knowledge of causes and mechanisms underlying OCD, as well as assessment and treatment. Issues relating to differential diagnosis are summarised, including the challenges of distinguishing OCD from autism spectrum disorders and tic disorders in youth. The recommended treatments, namely cognitive behaviour therapy and serotonin reuptake inhibiting/selective serotonin reuptake inhibitor medications, are outlined along with the existing evidence-based and factors associated with treatment resistance. Finally, novel clinical developments that are emerging in the field and future directions for research are discussed.

scholarly journals The patterns of family genetic risk scores for eleven major psychiatric and substance use disorders in a Swedish national sample

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kenneth S. Kendler ◽  
Henrik Ohlsson ◽  
Jan Sundquist ◽  
Kristina Sundquist
Keyword(s):  
Genetic Risk ◽  
Molecular Genetic ◽  
National Sample ◽  
Autism Spectrum ◽  
Risk Scores ◽  
Pedigree Data ◽  
Obsessive Compulsive ◽  
Swedish Population ◽  
Compulsive Disorder ◽  
Genetic Risk Scores

AbstractTo clarify the structure of genetic risks for 11 major psychiatric disorders, we calculated, from morbidity risks for disorders in 1st–5th degree relatives controlling for cohabitation effects, in the Swedish population born between 1932 and 1995 (n = 5,830,014), the family genetic risk scores (FGRS) for major depression (MD), anxiety disorders (AD), obsessive-compulsive disorder (OCD), bipolar disorder (BD), schizophrenia (SZ), bulimia (BUL), anorexia nervosa (AN), alcohol use disorder (AUD), drug use disorder (DUD), ADHD, and autism-spectrum disorder (ASD). For all affected individuals, we calculated their mean standardized FGRS for each disorder. The patterns of FGRS were quite similar for MD and AD, and for AUD and DUD, but substantially less similar for BUL and AN, BD and SZ, and ADHD and ASD. While OCD had high levels of FGRS for MD and AD, the overall FGRS profile differed considerably from MD and AD. ADHD FGRS scores were substantially elevated in AUD and DUD. FGRS scores for BD, OCD, AN, ASD, ADHD, and especially SZ were relatively disorder-specific while genetic risk for MD and AD had more generalized effects. The levels of FGRS for BMI, coronary artery disease, and educational attainment across our disorders replicated prior associations found using molecular genetic methods. All diagnostic categories examined had elevated FGRS for many disorders producing, for each condition, an informative FGRS profile. Using a novel method which approximates, from pedigree data, aggregate genetic risk, we have replicated and extended prior insights into the structure of genetic risk factors for key psychiatric illnesses.

Bipolar disorder and comorbid obsessive-compulsive disorder is associated with higher rates of anxiety and impulse control disorders

2010 ◽  
Vol 22 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Cilly Klüger Issler ◽  
Emel Serap Monkul ◽  
José Antonio de Mello Siqueira Amaral ◽  
Renata Sayuri Tamada ◽  
Roseli Gedanke Shavitt ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Obsessive Compulsive Disorder ◽  
Impulse Control ◽  
Severe Form ◽  
Impulse Control Disorders ◽  
Tic Disorders ◽  
Obsessive Compulsive ◽  
Residual Symptoms ◽  
Compulsive Disorder ◽  
Depressive Episodes

Issler CK, Monkul ES, Amaral JAMS, Tamada RS, Shavitt RG, Miguel EC, Lafer B. Bipolar disorder and comorbid obsessive-compulsive disorder is associated with higher rates of anxiety and impulse control disorders.Objective:Although bipolar disorder (BD) with comorbid obsessive-compulsive disorder (OCD) is highly prevalent, few controlled studies have assessed this comorbidity. The objective of this study was to investigate the clinical characteristics and expression of comorbid disorders in female BD patients with OCD.Method:We assessed clinically stable female outpatients with BD: 15 with comorbid OCD (BD+OCD group) and 15 without (BD/no-OCD group). All were submitted to the Structured Clinical Interview for DSM-IV, with additional modules for the diagnosis of kleptomania, trichotillomania, pathological gambling, onychophagia and skin picking.Results:The BD+OCD patients presented more chronic episodes, residual symptoms and previous depressive episodes than the BD/no-OCD patients. Of the BD+OCD patients, 86% had a history of treatment-emergent mania, compared with only 40% of the BD/no-OCD patients. The following were more prevalent in the BD+OCD patients than the BD/no-OCD patients: any anxiety disorder other than OCD; impulse control disorders; eating disorders; and tic disorders.Conclusion:Female BD patients with OCD may represent a more severe form of disorder than those without OCD, having more depressive episodes and residual symptoms, and being at a higher risk for treatment-emergent mania, as well as presenting a greater anxiety and impulse control disorder burden.

Surgery and Radiosurgery in Autism: A Retrospective Study in 10 Patients

2021 ◽  
pp. 1-10
Author(s):  
Cristina V. Torres ◽  
Nuria Martínez ◽  
Marcos Ríos-Lago ◽  
Monica Lara ◽  
Juan Alvarez-Linera ◽  
...  
Keyword(s):  
Autism Spectrum ◽  
Obsessive Compulsive ◽  
Behavioural Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Compulsive Disorder ◽  
Radiofrequency Lesions

<b><i>Introduction:</i></b> A subgroup of patients with autism spectrum disorder (ASD) show self or heteroaggression, dyscontrol episodes, and others are of obsessive-compulsive disorder (OCD) profile; some of them are resistant to medical and behavioural treatment. We describe the long-term outcome in a group of these patients, treated with radiofrequency brain lesions or combined stereotactic surgery and Gamma Knife (GK) radiosurgery. <b><i>Methods:</i></b> We reviewed the medical records of 10 ASD patients with pathological aggressiveness and OCD, who had undergone radiofrequency lesions and/or radiosurgery with GK in our institution. <b><i>Results:</i></b> The 10 patients had a significant reduction of their symptoms (PCQ 39.9 and 33, OAS 11.8 and 5, CYBOCS-ASD 30.4 and 20), preoperatively and in the last follow-up, respectively; <i>p</i> &#x3c; 0.005 (in all cases), although all but 2 needed more than 1 treatment to maintain this improvement. <b><i>Conclusions:</i></b> We observed a marked improvement in behaviour, quality of life, and relationship with the environment in all our 10 patients after the lesioning treatments, without long-lasting side effects.

scholarly journals The Impact of MNRI Therapy on the Levels of Neurotransmitters Associated with Inflammatory Processes

2020 ◽  
Vol 21 (4) ◽  
pp. 1358 ◽  
Author(s):  
Tatiana V. Tatarinova ◽  
Trina Deiss ◽  
Lorri Franckle ◽  
Susan Beaven ◽  
Jeffrey Davis
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Emotional Regulation ◽  
Cognitive Skills ◽  
Developmental Disorders ◽  
Negative Impact ◽  
Autism Spectrum ◽  
Post Traumatic Stress ◽  
Compulsive Disorder ◽  
The Impact

The neurotransmitter levels of representatives from five different diagnosis groups were tested before and after participation in the MNRI®—Masgutova Neurosensorimotor Reflex Intervention. The purpose of this study was to ascertain neurological impact on (1) Developmental disorders, (2) Anxiety disorders/OCD (Obsessive Compulsive Disorder), PTSD (Post-Traumatic Stress disorder), (3) Palsy/Seizure disorders, (4) ADD/ADHD (Attention Deficit Disorder/Attention Deficit Disorder Hyperactive Disorder), and (5) ASD (Autism Spectrum Disorder) disorders. Each participant had a form of neurological dysregulation and typical symptoms respective to their diagnosis. These diagnoses have a severe negative impact on the quality of life, immunity, stress coping, cognitive skills, and social assimilation. This study showed a trend towards optimization and normalization of neurological and immunological functioning, thus supporting the claim that the MNRI method is an effective non-pharmacological neuromodulation treatment of neurological disorders. The effects of MNRI on inflammation have not yet been assessed. The resulting post-MNRI changes in participants’ neurotransmitters show significant adjustments in the regulation of the neurotransmitter resulting in being calmer, a decrease of hypervigilance, an increase in stress resilience, behavioral and emotional regulation improvements, a more positive emotional state, and greater control of cognitive processes. In this paper, we demonstrate that the MNRI approach is an intervention that reduces inflammation. It is also likely to reduce oxidative stress and encourage homeostasis of excitatory neurotransmitters. MNRI may facilitate neurodevelopment, build stress resiliency, neuroplasticity, and optimal learning opportunity. There have been no reported side effects of MNRI treatments.

scholarly journals Neural Substrates of the Drift-Diffusion Model in Brain Disorders

2022 ◽  
Vol 15 ◽  
Author(s):  
Ankur Gupta ◽  
Rohini Bansal ◽  
Hany Alashwal ◽  
Anil Safak Kacar ◽  
Fuat Balci ◽  
...  
Keyword(s):  
Diffusion Model ◽  
Response Times ◽  
Autism Spectrum ◽  
Brain Disorders ◽  
Functional Impairments ◽  
Drift Diffusion Model ◽  
Drift Diffusion ◽  
Obsessive Compulsive ◽  
Theoretical Understanding ◽  
Compulsive Disorder

Many studies on the drift-diffusion model (DDM) explain decision-making based on a unified analysis of both accuracy and response times. This review provides an in-depth account of the recent advances in DDM research which ground different DDM parameters on several brain areas, including the cortex and basal ganglia. Furthermore, we discuss the changes in DDM parameters due to structural and functional impairments in several clinical disorders, including Parkinson's disease, Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorders, Obsessive-Compulsive Disorder (OCD), and schizophrenia. This review thus uses DDM to provide a theoretical understanding of different brain disorders.

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