Abstract
Background
Lack of physicians’ knowledge regarding mental health, including Autism Spectrum Disorder (ASD) could have adverse effects on affected individuals’ health and quality of life. The ...purpose of this study was to provide construct validity for a modified questionnaire in order to determine the self-reported competency for underlying sub-constructs in ASD, make inferences on perceived competence in ASD based on a sample of Romanian physicians, and identify physicians’ characteristics associated with these sub-domains of competency.
Methods
For this survey, we modified a questionnaire that was used in Pakistan and Turkey, and administered it to a sample of 383 practicing physicians in Romania to assess their perceived competency regarding ASD. Exploratory factor analysis on 12 knowledge questions revealed five sub-domains: stigma, potential causes, children’s behavior, misconceptions, and educational needs associated with ASD knowledge. Using General Linear Models, we determined physicians’ characteristics that predict the total competency score and various competency sub-scores.
Results
Seventy-five percent of the responding physicians were female and 30% had over 30 years practicing medicine. The majority (73–94%) of physicians have correctly responded to some basic questions regarding knowledge about ASD. We also found that younger physicians were more knowledgeable about potential causes of ASD than older physicians (Adjusted Mean Score (AMS): 2.90 vs. 2.18,
P
< 0.01), while older physicians knew more about the behavior of children with ASD (AMS: 0.64 vs. 0.37,
P
= 0.02). We found a significant interaction (
P
< 0.01) between television as source of ASD knowledge and city where the clinic is located in relation to knowledge of the physicians regarding stigma related to ASD. However, the total score was not associated with the variables associated with sub-domains.
Conclusion
Using factor analysis, we demonstrated construct validity of five sub-domains related to Romanian physicians’ knowledge about ASD that include stigma, potential causes, behavior in ASD children, special education needs, and misconceptions related to ASD. The lack of significant association of the knowledge of physicians on ASD neither with the Psychiatry nor the Pediatric ward rotations at medical school may support the need for improving the curriculum on ASD in Romanian medical schools.
Objective: Retinal dehydrogenase 1 (RALDH1) is a cytosolic enzyme which acts both as a source of retinoic acid (RA) and as a detoxification enzyme. RALDH1 has key functions in the midbrain ...dopaminergic system, which influences motivation, cognition, and social behavior. Since dopamine has been increasingly linked to autism spectrum disorders (ASD), we asked whether RALDH1 could contribute to the autistic phenotype. Therefore, we investigated for the first time the levels of RALDH1 in autistic patients. To further assess the detoxification function of RALDH1, we also explored 4-hydroxynonenal protein adducts (4-HNE PAs) and reduced glutathione (GSH) levels. Moreover, considering the effect of testosterone on RALDH1 expression, we measured the second to fourth digit ratio (2D:4D ratio) for both hands, which reflects exposure to prenatal testosterone.
Methods: Male patients with ASD (n=18; age, 62.9±4.3 months) and healthy controls (n=13; age, 78.1±4.9 months) were examined. Erythrocyte RALDH1, serum 4-HNE PAs and erythrocyte GSH levels were measured using colorimetric assays, and digit lengths were measured using digital calipers.
Results: We found significantly lower (−42.9%) RALDH1 levels in autistic patients as compared to controls (p=0.032). However, there was no difference in 4-HNE PAs levels (p=0.368), GSH levels (p=0.586), or 2D:4D ratios (p=0.246 in the left hand, p=0.584 in the right hand) between healthy controls and autistic subjects.
Conclusion: We concluded that a subset of autistic patients had a low RALDH1 level. These results suggest that low RALDH1 levels could contribute to the autistic phenotype by reflecting a dopaminergic dysfunction. KCI Citation Count: 10
Studies on early onset schizophrenia are limited because of their low prevalence but the reported results stated that early onset is associated with a poorer outcome. The present research analyzed ...the stability rate of the psychotic-related disorders from childhood to adult life. The study was based on an observational, retrospective, descriptive analysis study. The subjects were selected from patients admitted to the pediatric psychiatry ward of “Alexandru Obregia” Psychiatry Hospital between 2009 and 2018 for a psychosis-related disorder, who were 18 years or older at the moment of data collection and who also had admissions into the adult’s psychiatry wards of the hospital. Of the 115 subjects, 93, representing 80.87% of the total, maintained a diagnosis of psychotic spectrum disorder into adulthood. The diagnosis was maintained in 82.4% of cases with onset before 13 years old and 80.6% of cases with onset after the age of 13 years of age. Of the 42 subjects who presented affective symptoms during childhood, 71.43% also presented affective symptoms into adulthood. These findings indicate an important stability rate of psychosis from childhood and adulthood and come in accordance with the theory of overlap between psychotic and affective disorders. The results underline the importance of an accurate diagnosis of early and very early onset schizophrenia (VEOS), the need for early and multimodal intervention, but also the need for long-term management of these patients and continuing research regarding psychotic-related disorders in children and adolescents.
"Background. In an attempt to find genetic explanations for the heterogeneous characteristics of autistic patients, research has shown that parents of autistic children are more likely than parents ...of neurotypical children to exhibit autistic-like characteristics, meeting the criteria for the so-called “broad autism phenotype” . Subclinical autistic traits have been identified in the families of children with ASD, in both fathers and mothers, but the way in which specific parental phenotypes influence the child’s pathology remains unclear.
Methods. This study aimed to analyse the progress that a group of children with Autism Spectrum Disorders (ASD) have made during a behavioural therapy programme and the way their evolution has been influenced by the parents’ systemizing level. 52 participants (aged 2 to 5 years old) diagnosed with an Autism Spectrum Disorder and both of their parents were included in the study. The severity of ASD symptomatology was assessed using the ADOS-G instrument, at the beginning of the study (T0) and after one year of behavioural therapy as well (T1), while the parents’ systemizing level was evaluated using the self-report Systemizing Quotient (SQ).
Results. The ADOS-G scores showed a significant improvement after one year of therapy in both Communication and Social Interaction domains. Only the fathers` systemizing level (SQF) had a significant effect on the ADOS-G scores after one year of therapy, with greater improvements reported for children having fathers with higher SQF scores.
Conclusion. The significance of these findings is discussed in relation to the empathizing-systemizing (E-S) theory. We consider that it’s particularly important to continue investigating the way that specific parents’ traits, including their systemizing level or their possible broad autism phenotype, can influence the severity of their children’s ASD or the outcome of the behavioural intervention."
Environmental exposure to lead (Pb), mercury (Hg), arsenic (As), cadmium (Cd), manganese (Mn), and aluminum (Al) has been associated with neurodevelopmental disorders including autism spectrum ...disorder (ASD). We conducted a pilot study during May 2015-May 2107 to estimate blood concentrations of six metals (Pb, Hg, As, Cd, Mn, and Al) and identify their associated factors for children with ASD or suspected of having ASD in Romania. Sixty children, age 2-8 years, were administered versions of ADOS or ADI-R translated from English to Romanian. After assessment, 2-3 mL of blood was obtained and analyzed for the concentrations of the six metals. The mean age of children was 51.9 months and about 90% were male. More than half (65%) of the children were born in Bucharest. Over 90% of concentrations of As and Cd were below limits of detection. Geometric mean concentrations of Pb, Mn, Al, and Hg were 1.14 μg/dL, 10.84 μg/L, 14.44 μg/L, and 0.35 μg/L, respectively. Multivariable linear regression analysis revealed that children who were female, had less educated parents, exhibited pica, and ate cold breakfast (e.g., cereal), watermelon, and lamb had significantly higher concentrations of Pb compared to their respective referent categories (all
< 0.05 except for eating lamb, which was marginally significant,
= 0.053). Although this is the first study that provides data on concentrations of the six metals for Romanian children with ASD, the findings from this study could be useful for designing future epidemiologic studies for investigating the role of these six metals in ASD in Romanian children.
"Introduction. Child custody judicial course usually are intense conflictual raising a lot of pressure both on adult parents as on children. Always require a forensic psychiatry set-up at the court ...request and a professional team, legal doctors, psychiatrists, psychologists of adult and children from the legal medicine institution and from the hospital. Children are carefully looked upon separately by psychologists in a special setu-up diregarding intruding and manipulation. Objective of this presentation is to identify ethical aspects of the relationship physician-patient (the adult parent and separate the child) and psychologist-patient (i.e. similar) in custody litigation. Material and methods. We have casuistry with a high diversity of parental alienation in child custody cases. Discussions: Does physicians (psychiatrist or legal doctor) and psychologists uses different ethical models and concepts to approache the adult parent or the child? Forensic psichiatry examinations are completed with psychiatry examination and psychology examination as much as documents examinations which are presented in the dossier. Social inquiry is very important. Conclusions: similar to physician-patient relationship in pediatry, psychologist-minor patient relationship is based on the same moral values and ethical principles: beneficence, nonmaleficence, justice, loialty, trust, mostly in a paternalistic model to sustain always the best interest of the child/children. Lack of autonomy of the minor child creates correlativity obligations to protect his rights and to sustain the best interests of the child as a primary consideration. Beneficence in forensic psychiatry may take into consideration maintaining also beneficial emotional relationships with both parents after the separation. "
In this paper we present the case of a female teenager patient who was diagnosed with bipolar affective disorder and during psychotropic treatment with risperidone, the prolactin levels ranged ...between 55 ng/mL and 85 ng/mL at monthly repeated dosing. During this period, the patient presented somatic alterations in her state of health. The patient benefited from brain imaging, which revealed that in sella turcica is distinguished a well-defined and relatively homogeneous formation, measuring approximately 11/8 mm, suggestive of a pituitary adenoma. After changing the antipsychotic treatment, the pituitary formation resolved to a subsequent imaging re-evaluation.
Predictive factors in early onset schizophrenia Budisteanu, Magdalena; Andrei, Emanuela; Linca, Florentina ...
Experimental and therapeutic medicine,
12/2020, Letnik:
20, Številka:
6
Journal Article
Odprti dostop
Schizophrenia is a neurodevelopmental disorder, characterized by impairment in reasoning, affectivity and social relationships. Although the diagnosis of schizophrenia in children and adolescents has ...been challenged for many years, at present childhood-onset schizophrenia is considered and accepted as a clinical and biological continuum with the adult-onset disorder. The present study aimed to evaluate the influence of biological (psychiatric family history, perinatal factors), and socio-demographic factors (area of residence, gender) on the age at onset and severity of symptomatology in children and adolescent with schizophrenia. The data were collected from 2016 to 2019 and included 148 children and adolescents with schizophrenia. Data were analysed with statistical software (IBM SPSS 22, JASP and JAMOVI, Linear Regression Model, chi square tests, t-test, U-test). A positive familial history for psychiatric diseases was an important risk factor both for an early onset and for the severity of symptoms. Urbanicity was another studied risk factor, 61% of patients being from urban areas; no statistically significant correlations between urbanicity and age at onset and severity of symptoms were identified. There was no statistically significant gender difference in terms of age at onset and severity of symptoms. Moreover, no statistically significant correlations were found between perinatal factors and age at onset and severity of symptoms. Positive psychiatric family history showed a statistically significant influence on age at onset and symptoms severity in children and adolescent schizophrenia; no statistical significant impact on the aforementioned schizophrenia aspects was observed for urbanicity, gender or perinatal factors. Key words: schizophrenia, children, adolescents, biological factors, socio-demographic factors
Retinal dehydrogenase 1 (RALDH1) is a cytosolic enzyme which acts both as a source of retinoic acid (RA) and as a detoxification enzyme. RALDH1 has key functions in the midbrain dopaminergic system, ...which influences motivation, cognition, and social behavior. Since dopamine has been increasingly linked to autism spectrum disorder (ASD), we asked whether RALDH1 could contribute to the autistic phenotype. Therefore, we investigated for the first time the levels of RALDH1 in autistic patients. To further assess the detoxification function of RALDH1, we also explored 4-hydroxynonenal protein adducts (4-HNE PAs) and reduced glutathione (GSH) levels. Moreover, considering the effect of testosterone on RALDH1 expression, we measured the second to fourth digit ratio (2D:4D ratio) for both hands, which reflects exposure to prenatal testosterone.
Male patients with ASD (n=18; age, 62.9±4.3 months) and healthy controls (n=13; age, 78.1±4.9 months) were examined. Erythrocyte RALDH1, serum 4-HNE PAs and erythrocyte GSH levels were measured using colorimetric assays, and digit lengths were measured using digital calipers.
We found significantly lower (-42.9%) RALDH1 levels in autistic patients as compared to controls (
=0.032). However, there was no difference in 4-HNE PAs levels (
=0.368), GSH levels (
=0.586), or 2D:4D ratios (
=0.246 in the left hand,
=0.584 in the right hand) between healthy controls and autistic subjects.
We concluded that a subset of autistic patients had a low RALDH1 level. These results suggest that low RALDH1 levels could contribute to the autistic phenotype by reflecting a dopaminergic dysfunction.
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