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Hypothalamic-pituitary-adrenal axis functioning in offspring of parents with a major affective disorder: a meta-analytic review. 父母患有重度情感障碍的后代的下丘脑-垂体-肾上腺轴功能:荟萃分析综述。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-29 DOI: 10.1007/s00787-024-02553-0
Lisa Serravalle, Florencia Trespalacios, Mark A Ellenbogen

Because the offspring of parents with an affective disorder (OAD) are at high risk for developing mental disorders, and persons with an affective disorder (AD) show dysfunctional hypothalamic-pituitary-adrenal (HPA) axis activity, changes in HPA functioning in OAD might be an etiological risk factor that precedes the development of ADs. The primary aim of the meta-analysis was to quantitatively summarize the existing data on different indices of diurnal cortisol in the OAD. The secondary aim was to explore potential moderators of this relation. Following PRISMA guidelines, we included 26 studies (3052 offspring) on diurnal cortisol in our meta-analysis after an initial screening of 3408 articles. Intercept-only and meta-regression models were computed using the robust variance estimation method. Analyses examining mean cortisol levels at discrete timepoints, total cortisol output, and the cortisol rise in response to awakening (CAR) were conducted separately. The results demonstrated that the OAD had higher mean levels of cortisol at different timepoints throughout the day compared to controls (Hedge's g = 0.21). There was evidence of publication bias in studies examining CAR, such that effect sizes were positively biased. The present findings are consistent with a meta-analysis showing elevated cortisol in youth having an AD. Notable limitations across studies include the method of cortisol measurement and assessment of ADs. Altogether, these results highlight the fact that increased cortisol levels may act as a potential neuroendocrine antecedent and/or risk factor for the development of ADs among high risk youth.

由于患有情感障碍(OAD)的父母的后代患精神疾病的风险很高,而情感障碍(AD)患者表现出下丘脑-垂体-肾上腺(HPA)轴活动失调,因此,OAD 患者 HPA 功能的变化可能是 ADs 发病前的一个致病风险因素。荟萃分析的主要目的是定量总结有关 OAD 中不同昼皮质醇指数的现有数据。次要目的是探索这种关系的潜在调节因素。按照 PRISMA 指南,我们在初步筛选了 3408 篇文章后,将 26 项有关昼皮质醇的研究(3052 名后代)纳入了荟萃分析。我们使用稳健方差估计法计算了纯截距模型和元回归模型。对离散时间点的平均皮质醇水平、皮质醇总输出量和皮质醇对觉醒反应的上升(CAR)分别进行了分析。结果表明,与对照组相比,OAD 在全天不同时间点的皮质醇平均水平更高(Hedge's g = 0.21)。有证据表明,在研究 CAR 的研究中存在发表偏倚,因此效应大小存在正偏倚。本研究结果与一项荟萃分析结果一致,后者显示患有注意力缺失症的青少年皮质醇升高。各项研究的显著局限性包括皮质醇测量方法和注意力缺失评估。总之,这些结果突出表明,皮质醇水平升高可能是高危青少年罹患注意力缺失症的潜在神经内分泌先兆和/或风险因素。
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引用次数: 0
The developmental course of adolescent paranoia: a longitudinal analysis of the interacting role of mistrust and general psychopathology. 青少年妄想症的发展过程:对不信任和一般精神病理学相互作用的纵向分析。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-29 DOI: 10.1007/s00787-024-02563-y
Gennaro Catone, Vincenzo Paolo Senese, Antonio Pascotto, Simone Pisano, Matthew R Broome

Paranoia is the erroneous idea that people are targeting you for harm, and the cognitive model suggests that symptoms increase with emotional and relational distress. A factor potentially associated with paranoia is mistrust, a milder form of suspiciousness. This study investigated the longitudinal course of non-clinical paranoia in a sample of 739 students (age range 10-12 at baseline assessment, 12-14 at second assessment) using data from the Social Mistrust Scale (SMS) and the paranoia subscale of the Specific Psychotic Experiences Questionnaire (SPEQ). Prevalence of mistrustful and high paranoia children was 14.6 and 15% respectively. Independently, baseline internalizing symptoms (b = 0.241, p < 0.001) and mistrust (b = 0.240, p < 0.001) longitudinally predict paranoia after controlling for confounders. The interaction of mistrust and internalizing symptoms at T1 increases the possibility of the onset of paranoia at T2. Therefore, the effect of mistrust on paranoia is more marked when internalizing symptoms are higher. Our results confirm the role of mistrust as a factor involved in the developmental trajectory of paranoia in adolescence, enhanced by the presence of internalizing symptoms. The implications of these results are both theoretical and clinical, as they add developmental information to the cognitive model of paranoia and suggests the assessment and clinical management of mistrust and internalizing symptoms in youth may be useful with the aim of reducing the risk of psychotic experiences.

妄想症是一种错误的想法,认为别人正在以你为伤害目标,认知模式表明,症状会随着情绪和关系困扰的增加而加重。与妄想症潜在相关的一个因素是不信任,这是一种较温和的多疑形式。本研究使用社会不信任量表(SMS)和特殊精神病经历问卷(SPEQ)中的妄想症分量表的数据,调查了 739 名学生(基线评估时年龄在 10-12 岁之间,第二次评估时年龄在 12-14 岁之间)非临床妄想症的纵向发展过程。不信任和高度偏执儿童的患病率分别为 14.6%和 15%。另外,基线内化症状(b = 0.241,p
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引用次数: 0
Reply: the inclusion of methylphenidate in the WHO list of essential medicines is endorsed by millions of people with ADHD. 答复:将哌醋甲酯列入世卫组织基本药物清单得到了数百万多动症患者的认可。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-28 DOI: 10.1007/s00787-024-02570-z
Samuele Cortese, David Coghill, Joerg M Fegert, Gregory W Mattingly, Luis A Rohde, Ian C K Wong, Stephen V Faraone
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引用次数: 0
Risk factor patterns define social anxiety subtypes in adolescents with brain and clinical feature differences. 青少年社交焦虑亚型的风险因素模式与大脑和临床特征的差异。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-28 DOI: 10.1007/s00787-024-02548-x
Yinzhi Kang, Qingfeng Li, Wenjing Liu, Yang Hu, Zhen Liu, Shuqi Xie, Changminghao Ma, Lei Zhang, Xiaochen Zhang, Zhishan Hu, Yue Ding, Wenhong Cheng, Zhi Yang

Social anxiety disorder (SAD) is one of the most common psychiatric disorders in adolescents. The heterogeneity of both symptoms and etiology is an essential source of difficulties in the treatment and prevention of SAD. The study aimed to identify subtypes of adolescent SAD based on etiology-related phenotype dimensions and examine symptom and brain associations of the subtypes. We used a deeply phenotyped sample (47 phenotype subscales from 13 measures) of adolescents with SAD (n = 196) and healthy controls (n = 109) to extract etiology-relevant risk factors, based on which we identified subtypes of SAD. We compared the subtypes on clinical characteristics and brain morphometrics and functional connectivity, and examined subtype-specific links between risk factors, brain aberrance, and clinical characteristics. We identified six etiology-relevant risk factors and two subtypes of adolescent SAD. One subtype showed mainly elevated negative emotionality trait and coping style and diminished positive emotionality trait and coping style, while the other additionally had significantly high environmental risk factors, more severe impairments in social functioning, and significant abnormalities in brain structure and function. There were subtype-specific links between the risk factor profiles, brain aberrance, and clinical characteristics. The finding suggests two etiology-based subtypes of adolescent SAD, providing novel insights to the diversity of pathological pathways and precise intervention strategies.

社交焦虑症(SAD)是青少年最常见的精神疾病之一。症状和病因的异质性是导致 SAD 治疗和预防困难的重要原因。本研究旨在根据病因相关的表型维度确定青少年 SAD 的亚型,并研究亚型的症状和大脑关联。我们对患有 SAD 的青少年(196 人)和健康对照组(109 人)进行了深度表型抽样(13 项测量中的 47 个表型子量表),提取了与病因相关的风险因素,并在此基础上确定了 SAD 的亚型。我们比较了这些亚型的临床特征、大脑形态计量学和功能连接,并研究了风险因素、大脑畸变和临床特征之间的亚型特异性联系。我们发现了六种与病因相关的风险因素和两种青少年 SAD 亚型。其中一种亚型主要表现为消极情绪特质和应对方式的升高,以及积极情绪特质和应对方式的降低,而另一种亚型则具有明显的高环境风险因素、更严重的社会功能障碍以及大脑结构和功能的显著异常。风险因素特征、大脑异常和临床特征之间存在亚型特异性联系。研究结果表明,青少年 SAD 有两种基于病因的亚型,为病理途径的多样性和精确干预策略提供了新的见解。
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引用次数: 0
Actigraphy-assessed sleep duration and quality and executive function in a sample of typically developing preschoolers. 在一个发育正常的学龄前儿童样本中,对睡眠时间和质量以及执行功能进行动觉仪评估。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-27 DOI: 10.1007/s00787-024-02558-9
Llanos Merín, Marta Nieto, Lucía Sánchez-Arias, Laura Ros, José Miguel Latorre

Sleep is essential for cognitive development and brain maturation during early childhood. Studies focused on preschool populations using objective measures of sleep are still scarce. The objective of this study was to examine the associations between objective measures of sleep duration and quality with executive functioning in a 133 non-clinical sample of Spanish participants (Mage = 60.33 months, SD = 9.04; ages 41-77 months; 51.1% girls). Sleep was assessed for five weeknights using actigraphy; Shape School task was applied to assess inhibition and cognitive flexibility; and Word Span task was used to assess working memory. The results revealed that relation between sleep and executive functioning was significant for inhibition and working memory. Preschoolers with higher sleep efficiency showed better results in executive functioning tasks after controlling for the effect of age. Additionally, age and sleep duration and quality variables were predictive of inhibition, working memory, and cognitive flexibility. These results suggest that the different dimensions of sleep could play an important role in the development of executive functions during preschool age. Therefore, improving sleep could lead to an improvement in children's executive functioning in both clinical and educational contexts.

睡眠对幼儿期的认知发展和大脑成熟至关重要。针对学龄前儿童使用客观睡眠测量方法进行的研究仍然很少。本研究的目的是在133名非临床样本的西班牙参与者(年龄=60.33个月,标准差=9.04;年龄41-77个月;51.1%为女孩)中,研究睡眠时间和质量的客观测量与执行功能之间的关联。研究人员使用行为记录仪评估了五个周夜的睡眠情况;使用 "形状学校 "任务评估了抑制和认知灵活性;使用 "单词跨度 "任务评估了工作记忆。结果显示,在抑制和工作记忆方面,睡眠与执行功能的关系显著。在控制了年龄的影响后,睡眠效率较高的学龄前儿童在执行功能任务中表现得更好。此外,年龄、睡眠时间和质量变量对抑制、工作记忆和认知灵活性也有预测作用。这些结果表明,睡眠的不同维度可能在学龄前儿童执行功能的发展中发挥重要作用。因此,在临床和教育方面,改善睡眠可提高儿童的执行功能。
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引用次数: 0
An examination of sociodemographic and clinical factors influencing help-seeking attitudes and behaviors among adolescents with mental health problems. 研究影响有心理健康问题的青少年求助态度和行为的社会人口和临床因素。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-27 DOI: 10.1007/s00787-024-02568-7
Marialuisa Cavelti, Noemi Anne Ruppen, Silvano Sele, Markus Moessner, Stephanie Bauer, Katja Becker, Jennifer Krämer, Heike Eschenbeck, Christine Rummel-Kluge, Rainer Thomasius, Silke Diestelkamp, Vera Gillé, Sabrina Baldofski, Julian Koenig, Michael Kaess

This study investigated sociodemographic and clinical factors influencing help-seeking attitudes and behavior among adolescents with mental health problems. As part of the ProHEAD ("Promoting Help-seeking using E-technology for ADolescents") consortium a school-based, online assessment of sociodemographic information, psychopathology, risk-taking and self-harming behavior, help-seeking attitudes and behavior, and barriers to help-seeking was conducted in adolescents aged ≥ 12 years recruited from randomly selected schools in five regions of Germany. Linear regression analyses with the LMG formula were performed to explore predictors of help-seeking attitudes and behavior and assess their relative importance. Nine thousand five hundred and nine participants (95.5%) completed the online assessment (mean age: 15.1 years, 58.6% female). In total, 1606 participants (16.9%) showed relevant mental health problems (e.g., depressive and eating disorder symptoms, alcohol problems, and thoughts of self-harming behavior). Among them, 895 (55.7%) reported having sought help (lifetime), with higher rates for informal (n = 842, 52.4%) compared to professional (n = 380, 23.7%) sources. High help-seeking propensity emerged as the most important factor contributing to professional help-seeking, followed by elevated levels of psychopathology and perceived barriers, with sociodemographic factors being less impactful. Psychopathological severity also outweighed sociodemographic factors in predicting negative help-seeking attitudes. These findings indicate that attitudes towards seeking professional help, perceived barriers, and psychopathology severity critically influence limited adolescent help-seeking behavior. This emphasizes the need for initiatives that promote help-seeking, reduce negative attitudes, and address structural barriers in adolescent mental health care.

本研究调查了影响有心理健康问题的青少年求助态度和行为的社会人口学和临床因素。作为 ProHEAD("利用电子技术促进青少年寻求帮助")联盟的一部分,该研究以学校为基础,对社会人口学信息、精神病理学、冒险和自残行为、寻求帮助的态度和行为以及寻求帮助的障碍进行了在线评估,评估对象是从德国五个地区随机抽取的学校中招募的年龄≥ 12 岁的青少年。使用 LMG 公式进行了线性回归分析,以探索求助态度和行为的预测因素,并评估其相对重要性。959 名参与者(95.5%)完成了在线评估(平均年龄:15.1 岁,58.6% 为女性)。共有 1606 名参与者(16.9%)存在相关的心理健康问题(如抑郁和饮食失调症状、酗酒问题以及有自残行为的想法)。其中,895 人(55.7%)表示曾寻求过帮助(终生),与专业人士(380 人,23.7%)相比,非正式渠道(842 人,52.4%)的比例更高。高求助倾向是导致寻求专业帮助的最重要因素,其次是精神病理学水平升高和感知障碍,而社会人口因素的影响较小。在预测消极求助态度方面,精神病理学的严重程度也超过了社会人口因素。这些研究结果表明,寻求专业帮助的态度、感知到的障碍和精神病理学的严重程度对青少年有限的求助行为有着至关重要的影响。这就强调了有必要采取一些措施来促进青少年寻求帮助,减少消极态度,并解决青少年心理健康护理中的结构性障碍。
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引用次数: 0
Negative impact of maternal depressive symptoms on infancy neurodevelopment: a moderated mediation effect of maternal inflammation. 母亲抑郁症状对婴儿神经发育的负面影响:母亲炎症的调节作用。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-27 DOI: 10.1007/s00787-024-02572-x
Shanshan Cui, Wenjuan Xiong, Ziyu Zhao, Yu Han, Tingkai Cui, Zhiyi Qu, Zhi Li, Xin Zhang

Maternal depression promotes maternal inflammation and the risk of neurodevelopmental disorder in offspring, but the role of inflammation on the association between depression and neurodevelopment in offspring has not been extensively studied in humans. This study aims to examine the mediating role of maternal inflammation on the relationship between maternal depression and neurodevelopment in infants. 146 mother-child pairs were identified from Tianjin Maternal and Child Health Education and Service Cohort (Tianjin MCHESC). Maternal depression was investigated by the Center for Epidemiologic Studies Depression Scale and the Edinburgh Postnatal Depression Scale, and depressive trajectories were identified by latent class growth analysis. Inflammatory biomarkers in the three trimesters were assessed with enzyme-linked immunoassay. The Children Neuropsychological and Behavior Scale-Revision 2016 was used to measure neurodevelopment in infants. Principal component analysis was performed to identify inflammatory condition. Stepwise multiple linear regression analysis and mediation analysis were used to identify association among maternal depression, maternal inflammation and neurodevelopment in infants. Offspring in the low and moderate maternal depression groups exhibited higher adaptive behavior development quotient than those in the high maternal depression group. Higher maternal c-reactive protein level and higher inflammatory level in acute-phase of inflammation in the first trimester, and moderate maternal depression were associated with lower adaptive behavior quotients of infants. Inflammatory level in acute-phase of inflammation in the first trimester significantly mediated the association between maternal depression and adaptive behavior development of infants, with explaining 11.85% of the association. Maternal depression could impair adaptive behavior development in infants by inflammation.

母体抑郁会促进母体炎症和后代神经发育障碍的风险,但炎症对抑郁与后代神经发育之间关系的作用尚未在人类中得到广泛研究。本研究旨在探讨母亲炎症对母亲抑郁与婴儿神经发育之间关系的中介作用。146对母婴来自天津市妇幼健康教育与服务队列(Tianjin MCHESC)。采用流行病学研究中心抑郁量表和爱丁堡产后抑郁量表对母亲抑郁进行调查,并通过潜类增长分析确定抑郁轨迹。用酶联免疫测定法评估了三个孕期的炎症生物标志物。2016年儿童神经心理和行为量表修订版用于测量婴儿的神经发育情况。进行主成分分析以确定炎症状况。采用逐步多元线性回归分析和中介分析来确定母亲抑郁、母亲炎症和婴儿神经发育之间的关系。低度和中度母亲抑郁组的后代比高度母亲抑郁组的后代表现出更高的适应行为发育商数。母体c反应蛋白水平较高和妊娠头三个月急性炎症期炎症水平较高以及中度母体抑郁与婴儿较低的适应行为商数有关。妊娠头三个月急性炎症期的炎症水平在很大程度上介导了母亲抑郁与婴儿适应行为发展之间的关联,解释了11.85%的关联。产妇抑郁会通过炎症损害婴儿的适应行为发展。
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引用次数: 0
Family therapy and cognitive behavior therapy for eating disorders in children and adolescents in routine clinical care: a systematic review and meta-analysis. 常规临床护理中针对儿童和青少年进食障碍的家庭疗法和认知行为疗法:系统回顾和荟萃分析。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-27 DOI: 10.1007/s00787-024-02544-1
Gro Janne Wergeland, Ata Ghaderi, Krister Fjermestad, Pia Enebrink, Lillan Halsaa, Urdur Njardvik, Eili N Riise, Gyri Vorren, Lars-Göran Öst

Family therapy for eating disorders (ED) is well-established and represents the treatment choice for ED in children and adolescents according to guidelines, with cognitive behavior therapy (CBT) as a second line treatment. There is limited knowledge about how these treatments work in routine clinical care. The goal of the present meta-analysis is to investigate the effectiveness of family therapy and CBT for various EDs in children and adolescents when carried out in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were searched for articles published until December 2023. The outcome of family therapy and CBT, methodological quality, risk of bias, and moderators of treatment outcome were examined and benchmarked by meta-analytically comparing with ED efficacy studies. Forty-four effectiveness studies comprising 3251 family therapy or CBT patients were included. Large to very large within-group effect sizes (ES) were found for ED-psychopathology (0.80) and weight measures for AN (1.64) at post treatment. The attrition rate was 15%. Risk of bias was considerable. Moderate to large ES were found for family therapy and CBT, respectively. The benchmarking analysis showed that effectiveness studies had comparable ESs to efficacy studies (0.80 and 0.84 for the ED-psychopathology at post treatment). The findings support family therapy and CBT for ED in children and adolescents as effective treatments when delivered in routine clinical care, with effects comparable with those found in efficacy studies. The evidence needs to be interpreted with caution because of the risk of bias in a high proportion of studies.PROSPERO [CRD42023441794].

饮食失调症(ED)的家庭治疗已得到广泛认可,根据指南,家庭治疗是儿童和青少年饮食失调症的首选治疗方法,认知行为疗法(CBT)是二线治疗方法。对于这些治疗方法在常规临床护理中的效果,人们的了解还很有限。本荟萃分析旨在研究家庭治疗和 CBT 在常规临床治疗中对儿童和青少年各种 ED 的有效性。研究人员检索了 Ovid MEDLINE、Embase OVID 和 PsycINFO 在 2023 年 12 月之前发表的文章。通过与 ED 疗效研究进行元分析比较,对家庭治疗和 CBT 的疗效、方法学质量、偏倚风险和治疗结果的调节因素进行了研究和基准比较。共纳入了 44 项有效性研究,包括 3251 名家庭治疗或 CBT 患者。研究发现,在治疗后,ED-心理病理学(0.80)和AN体重测量(1.64)的组内效应大小(ES)较大或非常大。自然减员率为 15%。偏倚风险相当大。家庭治疗和 CBT 的 ES 值分别为中等到较大。基准分析表明,有效性研究的ES值与疗效研究的ES值相当(治疗后ED-心理病理学的ES值分别为0.80和0.84)。研究结果表明,在常规临床治疗中,家庭治疗和CBT对儿童和青少年的ED治疗是有效的,其效果与疗效研究中发现的效果相当。由于大部分研究存在偏倚风险,因此需要谨慎解释这些证据。PROSPERO [CRD42023441794].
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引用次数: 0
The association between maternal sleep and circadian rhythms during pregnancy and infant sleep and socioemotional outcomes. 母亲孕期睡眠和昼夜节律与婴儿睡眠和社会情感结果之间的关系。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-24 DOI: 10.1007/s00787-024-02571-y
Caroline P Hoyniak, Meghan R Donohue, Joan L Luby, Deanna M Barch, Peinan Zhao, Christopher D Smyser, Barbara Warner, Cynthia E Rogers, Erik D Herzog, Sarah K England

Studies have established that maternal sleep and circadian rhythm disturbances during pregnancy are associated with poor prenatal and perinatal outcomes for mothers and offspring. However, little work has explored its effects on infant sleep or socioemotional outcomes. The current study examined the relationship between maternal sleep and circadian rhythm disturbances during pregnancy and infant sleep and socioemotional outcomes in a diverse sample of N = 193 mothers and their infants (51% White; 52% Female; Mage = 11.95 months). Maternal sleep and circadian rhythms during pregnancy were assessed using self-reports and actigraphy. Mothers reported on infants' sleep and socioemotional outcomes when infants were one year old. When controlling for infant sex, age, gestational age at birth, family income-to-needs ratios, and maternal depression, mothers who reported more sleep problems during pregnancy had infants with more sleep disturbances when they were one year old. Moreover, mothers who had later sleep timing (i.e., went to bed and woke up later, measured via actigraphy) during pregnancy had infants with more dysregulation (e.g., increased feeding difficulties, sensory sensitivities) and externalizing problems, and mothers with increased intra-daily variability in rest-activity rhythms (as measured via actigraphy) had infants with more externalizing problems. Findings suggest that maternal sleep and circadian rhythm disturbances during pregnancy may be a risk factor for infant sleep problems and socioemotional difficulties.

研究证实,孕期母体睡眠和昼夜节律紊乱与母亲和后代的不良产前和围产期结局有关。然而,很少有研究探讨其对婴儿睡眠或社会情感结果的影响。本研究以 N = 193 名母亲及其婴儿(51% 白人;52% 女性;年龄 = 11.95 个月)为样本,研究了孕期母亲睡眠和昼夜节律紊乱与婴儿睡眠和社会情感结果之间的关系。采用自我报告和昼夜节律仪对孕期母亲的睡眠和昼夜节律进行了评估。婴儿一岁时,母亲报告婴儿的睡眠和社会情感结果。在控制了婴儿性别、年龄、出生胎龄、家庭收入与需求比率和母亲抑郁等因素后,孕期睡眠问题较多的母亲,其婴儿一岁时的睡眠障碍也较多。此外,孕期睡眠时间较晚的母亲(即上床睡觉和起床时间较晚,通过行为记录仪测量),其婴儿有更多的调节障碍(如喂养困难、感官敏感性增加)和外部化问题;休息-活动节律日内变异性增加的母亲(通过行为记录仪测量),其婴儿有更多的外部化问题。研究结果表明,孕期母亲睡眠和昼夜节律紊乱可能是导致婴儿睡眠问题和社会情感障碍的风险因素。
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引用次数: 0
Post-traumatic stress and joint hypermobility in children and adolescents of Nepal after exposure to an earthquake. 尼泊尔儿童和青少年遭受地震后的创伤后应激反应和关节过度活动。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-23 DOI: 10.1007/s00787-024-02559-8
Cristian-Daniel Llach, Guillem Pailhez, Carla Conejo-Gonzalez, Pradip Man Singh, Antoni Bulbena

A substantial body of literature has traditionally addressed the connection between the exposure to catastrophic events and the development of Post-Traumatic Stress disorder (PTSD), especially in the vulnerable stratum of children and adolescents. However, little is known about their biological predisposing factors, and further research is needed, especially in the context of the recent earthquakes in Turkey and Syria. The data of this study was collected 4 months after the 2015 earthquakes in Nepal, with the objective of providing new evidence to the field and documenting the role of a new potential predisposing factor: the Joint Hypermobility Syndrome (JHS). 941 subjects from three different regions of the country, aged 8-18 years, were assessed in a school-based cross-sectional investigation. PTSD, as the main response variable, was assessed using the Child PTSD Symptom Scale (CPSS) questionnaire and analysed considering three sub-dimensions: the severity of symptoms, the severity of impairment, and both taken together. JHS was assessed using the Screening Questionnaire to detect Hypermobility (SQ-CH) questionnaire. The severity of symptoms was strongly predicted by the distance to the epicentre. Females showed more severe symptomatology, but a lower perturbation in the daily functioning. Younger children reported a greater functional impairment. JHS group showed more severe PTSD than non-JHS group. We observed variability in the severity of PTSD according to previously known risk factors such as the distance to the epicentre, sex, and age. We also found an association between PTSD and JHS, which is discussed in reference to the neuroconnective endophenotype. It might be useful to consider the role of each variable when planning a mass intervention after a disaster.

传统上,有大量文献探讨了灾难性事件与创伤后应激障碍(PTSD)之间的联系,尤其是在儿童和青少年这一脆弱群体中。然而,人们对他们的生物学易感因素知之甚少,需要进一步研究,尤其是在土耳其和叙利亚最近发生地震的背景下。本研究的数据是在2015年尼泊尔地震发生4个月后收集的,目的是为该领域提供新的证据,并记录新的潜在易感因素:关节活动过多综合征(JHS)的作用。在一项以学校为基础的横断面调查中,对来自该国三个不同地区、年龄在 8-18 岁之间的 941 名受试者进行了评估。创伤后应激障碍作为主要反应变量,使用儿童创伤后应激障碍症状量表(CPSS)问卷进行评估,并从三个子维度进行分析:症状的严重程度、损伤的严重程度以及两者的综合程度。JHS是通过 "活动过多筛查问卷"(SQ-CH)进行评估的。症状严重程度与震中距离密切相关。女性的症状更为严重,但对日常功能的影响较小。年龄较小的儿童报告的功能障碍程度更高。创伤后应激障碍的严重程度与非创伤后应激障碍组相比更高。我们观察到,创伤后应激障碍的严重程度因之前已知的风险因素(如与震中的距离、性别和年龄)而有所不同。我们还发现创伤后应激障碍与 JHS 之间存在关联,这一点将在神经连接内表型中加以讨论。在计划灾难后的大规模干预时,考虑每个变量的作用可能会有所帮助。
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European Child & Adolescent Psychiatry
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