The epidemiology of mental disorders in early childhood is still under-researched. We aim to explore the incidence, comorbidities and risk factors of mental disorders in 0–3-year-olds referred to ...hospital settings. In a national cohort of 918,280 children born in 1997–2010, we calculated incidence rates per 1,000 person-years (IR) of first-time mental and developmental disorders diagnosed in hospitals before four years of age. Data were obtained from Danish population registries. We used logistic regression to analyse co-morbidity and Cox proportional hazard models to evaluate the influence of pre- and perinatal risk factors. A total of 16,164 children (1.76%) were diagnosed with a mental (0.90%) or developmental disorder (1.05%). Pervasive developmental disorders (PDD) and disorders of hyperactivity and inattention (ADHD) were increasingly diagnosed with age. Feeding and eating disorders and disorders of social functioning were most frequent among the youngest children. Comorbidity was found in 18%, e.g., between PDD and ADHD (OR 135.8; 95% CI 112.0–164.7) or between ADHD and disorders of social functioning (OR 148.0; 95% CI 106.4–205.7). Young maternal age, old paternal age, maternal smoking in pregnancy, boy sex, premature birth and being small for gestational age were associated with highly increased risk of mental and developmental disorders. Mental and developmental disorders diagnosed within the first four years of life show increasing incidence rates and a complex pattern of comorbidities. Study findings point to the need of clinical and research attention towards the manifestations of developmental psychopathology in very young children.
Objective
Binge‐eating disorder (BED) was established as a diagnosis in 2013 with the DSM‐5 and has been included in the ICD‐11 in 2018. In adulthood, BED is prevalent and correlated with somatic and ...mental health problems. Less is known about BED in adolescence, although this age period could represent a window of opportunity for early intervention. This study aimed to investigate the 1‐year prevalence, correlates, and impact of BED symptoms in a community sample of adolescents.
Method
We included 1,404 girls and 1,105 boys from the 16‐years‐follow‐up of the Copenhagen Child Cohort study, CCC2000. The adolescents self‐reported on BED symptoms, weight‐status, body perception, mental health problems, and self‐rated impact of food and weight‐related thoughts and behaviors. Information about socio‐economic factors and hospital diagnosed psychiatric disorders were obtained from national registries.
Results
A total of 8.5% reported weekly overeating with loss of control (10.9% of girls, 4.8% of boys), and 2.6% (3.6% of girls, 1.2% of boys) reported symptoms consistent with BED according to the DSM‐5. Regardless of sex, BED was correlated with concurrent overweight, body‐dissatisfaction, low self‐esteem, and mental health problems, especially emotional, but also with problems of behavior, inattention, and peer‐relations, and with high self‐rated impact on everyday life. Immigrant background and lower socio‐economy were potential risk factors for BED in boys in this sample.
Discussion
BED was prevalent and correlated with mental health problems and overall impact among adolescents in this community sample, indicating the need for clinical attention and intervention towards binge‐eating disorder in the adolescent period.
Clinical and population-based studies report increased prevalence of autism spectrum disorders (ASD) in individuals with anorexia nervosa and in their relatives. No nationwide study has yet been ...published on co-occurrence of these disorders.
To investigate comorbidity of ASD in individuals with anorexia nervosa, and aggregation of ASD and anorexia nervosa in their relatives.
In Danish registers we identified all individuals born in 1981-2008, their parents, and full and half siblings, and linked them to data on hospital admissions for psychiatric disorders.
Risk of comorbidity of ASD in probands with anorexia nervosa and aggregation of ASD in families of anorexia nervosa probands were increased. However, the risk of comorbid and familial ASD did not differ significantly from comorbid and familial major depression or any psychiatric disorder in anorexia nervosa probands.
We confirm aggregation of ASD in probands with anorexia nervosa and in their relatives; however, the relationship between anorexia nervosa and ASD appears to be non-specific.
ObjectivesEmploying national registers for research purposes depends on a high diagnostic validity. The aim of the present study was to examine the diagnostic validity of recorded diagnoses of ...early-onset obsessive-compulsive disorder (OCD) in the Danish Psychiatric Central Register (DPCR).DesignReview of patient journals selected randomly through the DPCR.MethodOne hundred cases of OCD were randomly selected from DPCR. Using a predefined coding scheme based on the Children’s Yale Brown Obsessive Compulsive Scale (CYBOCS), experienced research nurse or child and adolescent psychiatrists assessed each journal to determine the presence/absence of OCD diagnostic criteria. The detailed assessments were reviewed by two senior child and adolescent psychiatrists to determine if diagnostic criteria were met.Primary outcome measurementsPositive predictive value (PPV) was used as the primary outcome measurement.ResultsA total of 3462 children/adolescents received an OCD diagnosis as the main diagnosis between 1 January 1995 and 31 December 2015. The average age at diagnosis was 13.21±2.89 years. The most frequent registered OCD subcode was the combined diagnosis DF42.2. Of the 100 cases we examined, 35 had at least one registered comorbidity. For OCD, the PPV was good (PPV 0.85). Excluding journals with insufficient information, the PPV was 0.96. For the subcode F42.2 the PPV was 0.77. The inter-rater reliability was 0.94. The presence of the CYBOCS in the journal significantly increased the PPV for the OCD diagnosis altogether and for the subcode DF42.2.ConclusionThe validity and reliability of International Classification of Disease 10th revision codes for OCD in the DPCR is generally high. The subcodes for predominant obsessions/predominant compulsions are less certain and should be used with caution. The results apply for both children and adolescents and for both older and more recent cases. Altogether, the study suggests that there is a high validity of the OCD diagnosis in the Danish National Registers.
Implementation of the EU Water Framework Directive (WFD) is a huge environmental management challenge for Europe, demanding an integrated sustainable approach to water management and a common ...objective of obtaining 'good status' for all water bodies before 2015. The main task is the preparation of a river basin management plan for each of the 96 European river basin districts before the end of 2009. In Odense River Basin (island of Fyn, Denmark), one of 14 appointed European Pilot River Basins, the implementation of the WFD has been developed and tested in practice. Reference conditions and ecological status classification for Odense Fjord, based on eelgrass (Zostera marina) depth limit and nutrient concentrations, have been drawn up through a combination of historical data and modelling tools. A subsequent quantitative linking of pressures and impact, in casu between land-based nitrogen (N) loading of the fjord and resulting nutrient concentrations and eelgrass appearance, provided an estimate of the needed nitrogen load reduction of the fjord. This amounted to approx. 1,200 tonnes N per year (an annual load reduction of ca. 11 kg N ha⁻¹ of catchment area or ca. 19.5 g N m⁻² of fjord surface)--a load reduction of ca. 60% from the present level--to obtain at least 'good' ecological status sensu WFD. It is presently not possible to quantify a target load for phosphorus (P) in relation to marine environmental objectives. An economically feasible programme of measures to obtain 'good' status in all surface water and groundwater bodies in Odense River Basin, using an integrated cost-effectiveness analysis, showed that re-establishment of wetlands, catchcrops, and reduced fertilisation norms are the most effective measures if large reductions in N loads to the aquatic environment are to be achieved. The total socio-economic cost of implementing the WFD in the river basin amounts to about 13 million Euro Sign/year, which will increase the expense for water services by only 0.5-0.6% of the total income and production value in the basin (15,650 million Euro Sign/year). Investments to obtain the needed nitrogen load reductions from agriculture are thus economically feasible. Further, it is not an impossible task, either economically or technically, to reach the objectives of the WFD while still retaining the possibility of keeping a high agricultural production in the catchment (maintaining livestock production but decreasing crop production in the case of Odense River Basin). The future conditions in Odense Fjord will not only depend on the success in reducing the load from the river basin area, but will also be affected by the trend in the nutrient loss from the whole Baltic catchment area. The high growth rates in the new EU Member States thus pose an important challenge to water managers, and decoupling of economic growth from pressure on water bodies will be necessary. Finally, a number of challenges facing water managers around the Baltic and within the EU, namely preconditions required to successfully implement the WFD, are presented.
HPV detection in children prior to sexual debut Koch, Anders; Hansen, Susanne V.; Nielsen, Nete M. ...
International journal of cancer,
27 November 1997, Letnik:
73, Številka:
5
Journal Article
Retinitis pigmentosa (RP) is a group of genetically heterogeneous, severe retinal diseases commonly leading to legal blindness. Mutations in the CNGB1a subunit of the rod cyclic nucleotide-gated ...(CNG) channel have been found to cause RP in patients. Here, we demonstrate the efficacy of gene therapy as a potential treatment for RP by means of recombinant adeno-associated viral (AAV) vectors in the CNGB1 knockout (CNGB1(-/-)) mouse model. To enable efficient packaging and rod-specific expression of the relatively large CNGB1a cDNA (~4 kb), we used an AAV expression cassette with a short rod-specific promoter and short regulatory elements. After injection of therapeutic AAVs into the subretinal space of 2-week-old CNGB1(-/-) mice, we assessed the restoration of the visual system by analyzing (i) CNG channel expression and localization, (ii) retinal function and morphology and (iii) vision-guided behavior. We found that the treatment not only led to expression of full-length CNGB1a, but also restored normal levels of the previously degraded CNGA1 subunit of the rod CNG channel. Both proteins co-localized in rod outer segments and formed regular CNG channel complexes within the treated area of the CNGB1(-/-) retina, leading to significant morphological preservation and a delay of retinal degeneration. In the electroretinographic analysis, we also observed restoration of rod-driven light responses. Finally, treated CNGB1(-/-) mice performed significantly better than untreated mice in a rod-dependent vision-guided behavior test. In summary, this work provides a proof-of-concept for the treatment of rod channelopathy-associated RP by AAV-mediated gene replacement.
Pretreatment cognitive impairment in cancer patients is well established but unexplained. Similar cognitive compromise has been observed in post-traumatic stress disorder (PTSD) patients, and PTSD ...symptoms are a frequent concomitant of cancer diagnosis. We tested the hypothesis that pretreatment cognitive impairment is attributable to cancer-related post-traumatic stress.
Women aged 65 years or younger who were diagnosed with breast cancer (case patients) or had undergone negative routine breast imaging (control patients) at one of six participating breast centers underwent traditional and computerized neuropsychological testing, clinician-administered diagnostic assessment of stress disorders, and self-report assessments of cognitive function and depression. To minimize confounding, case patients were evaluated prior to any local or systemic treatment. Cognitive indices of case patients, control patients, and normative samples were compared. The patients' risk of overall cognitive impairment was determined. Linear regression and a mediation model were used to test the study hypothesis. All statistical tests were two-sided.
The 166 case patients and 60 well-matched control patients showed near-identical deviations from population norms. Case patients scored worse than control patients on two of 20 cognitive indices (Go/Nogo commission errors, Go/Nogo omission errors). Self-reported cognitive problems were associated with Go/Nogo omission errors and more pronounced in case patients. Only PTSD symptoms (Beta = 0.27, P = .004) and age (Beta = 0.22, P = .04) statistically significantly predicted Go/Nogo errors. The effect of having cancer on Go/Nogo errors was mediated by PTSD symptoms. Case patients did not have an increased risk of overall cognitive impairment.
Prior to any treatment, breast cancer patients may show limited cognitive impairment that is apparently largely caused by cancer-related post-traumatic stress.
A full description of the ModelE version of the Goddard Institute for Space Studies (GISS) atmospheric general circulation model (GCM) and results are presented for present-day climate simulations ...(ca. 1979). This version is a complete rewrite of previous models incorporating numerous improvements in basic physics, the stratospheric circulation, and forcing fields. Notable changes include the following: the model top is now above the stratopause, the number of vertical layers has increased, a new cloud microphysical scheme is used, vegetation biophysics now incorporates a sensitivity to humidity, atmospheric turbulence is calculated over the whole column, and new land snow and lake schemes are introduced. The performance of the model using three configurations with different horizontal and vertical resolutions is compared to quality-controlled in situ data, remotely sensed and reanalysis products. Overall, significant improvements over previous models are seen, particularly in upper-atmosphere temperatures and winds, cloud heights, precipitation, and sea level pressure. Data–model comparisons continue, however, to highlight persistent problems in the marine stratocumulus regions.
Identifying factors associated with risk for eating disorders is important for clarifying etiology and for enhancing early detection of eating disorders in primary care. We hypothesized that ...autoimmune and autoinflammatory diseases would be associated with eating disorders in children and adolescents and that family history of these illnesses would be associated with eating disorders in probands.
In this large, nationwide, population-based cohort study of all children and adolescents born in Denmark between 1989 and 2006 and managed until 2012, Danish medical registers captured all inpatient and outpatient diagnoses of eating disorders and autoimmune and autoinflammatory diseases. The study population included 930 977 individuals (48.7% girls). Cox proportional hazards regression models and logistic regression were applied to evaluate associations.
We found significantly higher hazards of eating disorders for children and adolescents with autoimmune or autoinflammatory diseases: 36% higher hazard for anorexia nervosa, 73% for bulimia nervosa, and 72% for an eating disorder not otherwise specified. The association was particularly strong in boys. Parental autoimmune or autoinflammatory disease history was associated with significantly increased odds for anorexia nervosa (odds ratio OR = 1.13, confidence interval CI = 1.01-1.25), bulimia nervosa (OR = 1.29; CI = 1.08-1.55) and for an eating disorder not otherwise specified (OR = 1.27; CI = 1.13-1.44).
Autoimmune and autoinflammatory diseases are associated with increased risk for eating disorders. Ultimately, understanding the role of immune system disturbance for the etiology and pathogenesis of eating disorders could point toward novel treatment targets.
PDF
