Panic disorder in prepubertal children.
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Age Factors↗
Biomedical subjects
D Behar
Publications and source records attributed to D Behar.
The borderline diagnosis for children.
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Age Factors↗
P.R.N. medications in child state hospital inpatients.
The authors reviewed the administration of p.r.n. medications over 12 months in 49 child psychiatry inpatients. There were 1263 p.r.n. administrations (mean +/- SD = 25.6 +/- 36.7 administrations/patient). Only 7 (14%) of the 49 patients had none; 9 (18%) had more than 50. The number of p.r.n. administrations correlated with the dose of regular neuroleptics and with the time spent in seclusion. Age, race, sex, diagnosis, neurological disorders, IQ, and self-injurious behavior were poor predictors of the number of p.r.n. administrations. Antihistaminics accounted for 54% (683) of the p.r.n. administrations, neuroleptics for 24% (303), and chloral hydrate for 17% (214). Seventy percent (891) of the p.r.n. drugs were given for disruptive behavior. Only 32% (403) of the 1263 administrations were clearly effective, 14% (170) were ineffective, and 54% (690) were dubious. A controlled trial is needed to assess the efficacy of this ubiquitous psychiatric practice.
Adolescent↗
A new temporary synthetic skin substitute.
Eighteen months of experience with a new synthetic temporary skin substitute (Omiderm, Omikron Scientific Ltd., Rehovot, Israel) is presented. The substitute is a thin, transparent, flexible membrane. It is used when a biological dressing would otherwise have been used. Our experience consists of laboratory studies and 75 clinical cases including donor sites application, chronic wounds, ulcers, partial thickness and full thickness burns. The membrane is very elastic, permitting free movement and physiotherapy during the healing process. The material protects the wound and prevents either the accumulation of fluid under it or wound desiccation. It does not interfere with the normal healing process. It reduces pain, prevents bacterial invasion and is very easy to handle. Complications, such as haematoma formation or infection, were quite few. We recommend its use in routine daily practice.
Adolescent↗
Aggressive conduct disorder: the influence of social class, sex and age on the clinical picture.
Past studies have shown that aggressive conduct disorder is more common in boys and in families of low socioeconomic status, and that affected children are usually seen in child psychiatry clinics before the age of 10. In this work we aimed to find how socioeconomic status, sex and age at admission influence the clinical picture of this disorder. We divided a series of 58 affected children into two groups on each of the three factors and compared the groups on 175 variables. We found little evidence that the children's difficulties varied with social class, sex or age. This apparent constancy of the clinical picture reinforces the idea that aggressive conduct disorder is a valid, though broadly defined, psychiatric syndrome.
Age Factors↗
Confirmation of concurrent illnesses in posttraumatic stress disorder.
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Adult↗
Computerized tomography and neuropsychological test measures in adolescents with obsessive-compulsive disorder.
The authors administered CAT scans and neuropsychological tests to 16 adolescents with obsessive-compulsive disorder (mean age +/- SD = 13.7 +/- 1.6 years) and 16 matched controls. The patients had a mean ventricular-brain ratio (VBR) significantly higher than the controls' and showed spatial-perceptual deficits similar to those found in patients with frontal lobe lesions. Memory, reaction time, and decision time did not differ significantly from controls'. Neurodevelopmental examination of seven patients yielded a high frequency of age-inappropriate synkinesias and left hemibody signs. These results suggest CNS dysfunctioning in children with obsessive-compulsive disorder, with possible right cerebral involvement. However, the patients' neuropsychological test deficits and VBRs were not correlated.
Adolescent↗
Depression in the abstinent alcoholic.
Of 72 alcoholics who had abstained for a mean of 64 months, 15% had serious, debilitating depressive symptoms, which had begun after a mean of 35 months of sobriety.
Adult↗
Depressed women with panic attacks.
Of a group of 288 depressed female inpatients, 43 (15%) had secondary panic attacks. Compared to other depressives, the subgroup with panic attacks had significantly higher frequencies of anorexia, weight loss, gastrointestinal disturbances, hypochondriasis, and psychomotor agitation, and significantly lower frequencies of melancholic symptoms, including loss of interest in usual activities, guilt feelings, delusional thinking, psychomotor retardation, and orientation or memory impairment. Patients with panic attacks were less likely to have a depressed parent and were more likely to be described as having been nervous, worrisome, sensitive, and sexually dysfunctional before the onset of depression. Phenomenologically, they resembled "anxious depressives" as described by other authors.
Adult↗
A naturalistic assessment of the motor activity of hyperactive boys. I. Comparison with normal controls.
The motor activity of hyperactive and normal boys was studied in 12 age- and classroom-matched pairs. Activity was measured continuously for a one-week period with a portable solid-state monitor. Hyperactives exhibited generally higher levels of motor activity than normal controls regardless of the time of day, including during sleep and on weekends. In a situation-by-situation analysis, hyperactives were most consistently and significantly more active than the controls during structured school activities. Little evidence was found, however, to support the hypothesis that hyperactivity is simply an artifact of the structure and attentional demands of a given setting. Pervasive increases in simple motor behavior are a clear attribute of hyperactive behavior and distinguished hyperactives from controls as well as did a standardized measure of attention.
Attention↗
A naturalistic assessment of the motor activity of hyperactive boys. II. Stimulant drug effects.
Twenty-four-hour motor activity was assessed in a naturalistic setting in 12 hyperactive boys for four weeks (672 consecutive hours). Dextroamphetamine, 15 mg/day, or placebo was administered on alternate weeks, using a double-blind ABAB design. When the boys received dextroamphetamine, motor activity was significantly decreased for about eight hours after drug administration. This decrease was followed by a period of slight but significant increases in activity ("rebound"). Dextroamphetamine decreased activity most strikingly during structured classroom activity; during physical education, however, there was a significant drug-induced increase in motor activity.
Attention Deficit Disorder with Hyperactivity↗
Behavioral and physiological effects of ethanol in high-risk and control children: a pilot study.
Blood and breath acetaldehyde levels were measured following ethanol ingestion (0.5 ml/kg) in 11 boys familially at risk for alcoholism and 11 age-matched controls. No significant differences were found between groups for acetaldehyde, objective, or subjective measures of intoxication. Previous reports of acetaldehyde as a marker of risk for alcoholism were not confirmed. Baseline behavioral state predicted response to alcohol. Children tended to have a subjective response in a direction opposite from the baseline mood state.
Acetaldehyde↗
Subtypes of aggressive conduct disorder.
The subjects were 46 boys with aggressive conduct disorder who were admitted to a psychiatric ward. We divided them according to level of activity and number of antisocial "symptoms"; then compared the resulting groups on clinical and social variables. Seventy-four per cent of the boys were observed to be hyperactive. Compared to those with a normal level of activity, this group developed their problems earlier, had more frequent speech and language deficits and came from more disrupted homes. Thirty boys were classed as antisocial and 16 as not. The former differed from the latter chiefly in their failure to respond to treatment. At follow-up significantly more non-antisocial boys were improved than antisocial. The results suggest that antisocial behavior affects outcome, while the variations in activity level are related to different origins of the disorder.
Age Factors↗
Aggressive conduct disorder of children.
We studied 58 children with aggressive conduct disorder who had been admitted to a psychiatric ward and 33 with other disorders, excluding autism and organic syndromes, who were also inpatients. Nurses's observations of the children's behavior on the ward sharply separated the two groups and confirmed the parents' and teachers' descriptions of the conduct disorder children's behavior at home and in school. Items in the clinical history also separated the two groups; for example, conduct disorder began at a much earlier age than the other disorders. Our evidence gives further support to the validity of aggressive conduct disorder as a psychiatric syndrome.
Aggression↗
Clinical overlap among familial subtypes of unipolar depression.
Unipolar depressives (n = 288) were subclassified according to family history. Depression spectrum patients (DSD; n = 104) were defined as those with first-degree relatives suffering from alcoholism. Familial pure depression patients (FPDD; n = 86) were those with only depression in the immediate family, and sporadic depressive patients (SDD; n= 98) had negative family histories. An analysis was performed using index symptoms, precipitating events, and premorbid personality features. A positive family history was associated with greater premorbid personality difficulties. This pattern was highlighted when each was compared to SDD. DSD and FPDD could not be differentiated from each other. The differences between them and SDD could not be explained by the differing age distribution. Overall, the premorbid and index symptom differences were not striking enough to be clinically useful.
Age Factors↗
Abnormal sexual behaviour in pre-pubescent children.
Abnormal sexual behaviour in pre-pubescent children is uncommon even in a psychiatrically referred population. Among 516 referrals there were 6 boys and 10 girls, the girls starting younger. The boys differed little in history or background from other conduct-disordered boys, but the girls were more commonly victims of sexual abuse and lacking a father in the home. The personalities of the girls suggested continued risk of sexual experimentation and possible development of personality disorder.
Adolescent↗
Familial subtypes of depression: a clinical view.
The clinical workup of 238 unipolar depressives were subdivided according to immediate family history. Pure depressives (with only depression in the family) typically have an illness involving more endogenous features and chronicity. Depression spectrum patients (with only alcoholism or sociopathy in first-degree relatives) have the mildest illness. Sporadic depression (with a negative family history) is associated with an intermediate severity. Premorbid unstable personality characteristics are more common to the spectrum patients. Sporadic patients have the least personality difficulties. While these differences are definite, they are not large enough to justify separation of unipolar depression into subsyndromes dependent on symptom differences. Rather, family history seems to exert its effect most strongly on the distinctive premorbid personality characteristics of the 3 groups.
Adult↗