High prevalence of psychiatric comorbidities in children and adolescents at a tertiary epilepsy center

ABSTRACT Background: Epilepsy is highly comorbid with psychiatric disorders and a significant amount of the morbidity related to epilepsy is in fact a result of psychiatric comorbidities. Objective: To investigate the frequency of different psychiatric comorbidities in children with refractory epilepsy. Methods: We present preliminary observational data from a series of patients (n=82) examined in the psychiatric branch of a tertiary epilepsy center in Rio de Janeiro, Brazil. Patients were classified as presenting autism spectrum disorders, mood disorders, anxiety disorders, disruptive disorders, attention deficit hyperactivity disorder (ADHD), intellectual development disorder, psychotic episode, dissociative/conversive disorders or others. We determined the frequency of each disorder, along with demographic data, medications prescribed, electroencephalogram findings and additional medical examinations and consultations. Results: The most common comorbidities in our sample were autism spectrum disorders and ADHD. Antipsychotics and selective serotonin uptake inhibitors were the most commonly prescribed psychiatric medications. Conclusions: Knowledge about the prevalence of such comorbidities may provide more targeted interventions in Psychiatry and Psychology services linked to epilepsy centers.

Prevalence of psychiatric disorders in Norwegian 10-14-year-olds: Results from a cross-sectional study

Youth mental health problems is the leading cause of disability worldwide and a major public health concern. Prevalence rates are needed for planning preventive interventions and health care services. We here report Norwegian prevalence estimates for youth mental disorders based on findings from the Bergen Child Study cohort. A web-based psychiatric interview; the Development and Well-Being Assessment, was completed by parents and teachers of 2,043 10-14-year-olds from the city of Bergen, Norway. Post-stratification weights were used to account for selective participation related to parental educational in the estimation of prevalence rates. Prevalence rates are presented for the whole sample and stratified by gender and age. The overall population weighted estimate suggests that 6.93% (95% CI 5.06–9.41) of the children met DSM-IV diagnostic criteria for one or more psychiatric disorders. There were no robust indications of age- or gender-related differences in the prevalence. 11.4% of the children fulfilled criteria for more than one diagnosis. The most common comorbid conditions were ADHD and disruptive disorders. The prevalence of psychiatric disorders was relatively low among Norwegian 10-14-year-olds, compared to published worldwide prevalence estimates. This is in line with estimates from prior studies from the Nordic countries. These findings raise important questions about the origins of different prevalence rates for psychiatric disorders between societies. The findings also illustrate the importance of locally driven epidemiological studies for planning preventative efforts and appropriately scaling mental health services to meet the need of the population.

Temperamental and behavioral characteristics during adolescence mediate associations between polygenic risk for internalizing and externalizing traits with cannabis use in young adulthood

Background: Cannabis use (CU) is an etiologically complex behavior with several social, temperamental, neurocognitive, and behavioral precursors. Biometrical and molecular studies suggest an interplay of environmental and pleiotropic genetic influences. However, it remains unclear whether identified genetic effects related to behavioral and temperamental characteristics have developmentally direct or indirect mechanisms on CU behavior. The Transmissible Liability Index (TLI) is a measure of continuous liability based on developmental precursors of substance use disorders (e.g., antisocial behavior, disruptive disorders, disinhibited personality traits, internalizing/externalizing characteristics) and may play a role in understanding genetic risk for CU.Methods: We interrogated the polygenic effects of several internalizing/externalizing behaviors on the TLI (derived from adolescent traits and behaviors) and CU (initiation and repeated use) in emerging adulthood using a homogeneous sample of 4077 individuals of European Ancestry. Summary statistics from discovery genome-wide association studies of cannabis use, risk tolerance, neuroticism, anxiety, and depression were used to construct polygenic scores (PGSs) that were used to predict CU. Mediation analyses assessed whether behavioral and temperamental traits exhibited during adolescence, as captured via the TLI, accounted for the association between PGSs and CU.Results: The marker-based heritability of TLI, CU initiation, and repeated CU were modest (14%, p=0.033; 15%, p=0.025; and 17%, p=0.008, respectively). TLI and repeated CU were genetically correlated (0.76, p=0.033). Among the PGSs, risk tolerance, neuroticism, and depression were associated with higher TLI. Mediation analyses indicated significant, but very modest, indirect effects of risk tolerance and depression on repeated CU. Conclusions: Adolescent behavioral and temperamental characteristics are early indicators of repeated cannabis use in adulthood. Polygenic risk for cannabis use does not appear to increase risk for later cannabis use. Polygenic risk for internalizing/externalizing traits may act through behaviors and traits exhibited during adolescence (i.e., the transmissible liability index) to increase risk for cannabis use.

Recent Developments in Metal-Based Drugs and Chelating Agents for Neurodegenerative Diseases Treatments

The brain has a unique biological complexity and is responsible for important functions in the human body, such as the command of cognitive and motor functions. Disruptive disorders that affect this organ, e.g. neurodegenerative diseases (NDDs), can lead to permanent damage, impairing the patients’ quality of life and even causing death. In spite of their clinical diversity, these NDDs share common characteristics, such as the accumulation of specific proteins in the cells, the compromise of the metal ion homeostasis in the brain, among others. Despite considerable advances in understanding the mechanisms of these diseases and advances in the development of treatments, these disorders remain uncured. Considering the diversity of mechanisms that act in NDDs, a wide range of compounds have been developed to act by different means. Thus, promising compounds with contrasting properties, such as chelating agents and metal-based drugs have been proposed to act on different molecular targets as well as to contribute to the same goal, which is the treatment of NDDs. This review seeks to discuss the different roles and recent developments of metal-based drugs, such as metal complexes and metal chelating agents as a proposal for the treatment of NDDs.

Analysis of Physiotherapy in Hip Osteoarthritis

Introduction: Osteoarthritis (OA) is one of the most prevalent and disruptive disorders worldwide, developing in 13% (Europe) to 15% (USA) of the overall population. The hip is the second most commonly affected joint. Aim: To assess the effects of physiotherapy on pain reduction, improvement in the range of motion in the hip, and improvement in the quality of life in patients with hip osteoarthritis. Material and Methods: The study group consisted of 25 patients (13 women and 12 men, mean age: 69.3 years) treated at the day ward of the Świętokrzyskie Rehabilitation Centre in Czarniecka Góra. The patients had Stage 2-3 disease according to the Gofton scale. Their treatment included cryotherapy, ultrasound therapy, laser therapy, low-frequency alternating magnetic fields, and kinesiotherapy. The following parameters were assessed before and after a series of procedures (a 3-week programme): range of motion in the hip, pain severity, and quality of life (QoL). Results: Physiotherapy used in the patients resulted in elimination or reduction of pain as well as significant improvements in the range of motion in the hip and in the patients’ QoL. The procedures contributed to an increase in muscle mass of the pelvic girdle and improved the quality of gait. Conclusions: Conservative treatment of osteoarthritis is based on physiotherapy and rehabilitation.

Evidence Update: Antipsychotics for Children with Hyperactivity or Disruptive Disorders

New evidence can help clinicians, caretakers, and others weigh the benefits and harms of antipsychotic treatment for children and adolescents.