Fatigue and somatic symptoms.
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Abdominal Pain↗
Biomedical subjects
Deborah Christie
Publications and source records attributed to Deborah Christie.
Functional neuroimaging in early-onset anorexia nervosa.
Previous neuroimaging studies in early-onset anorexia nervosa provide evidence of limbic system dysfunction. The current study adds support to the possibility by revealing a significant association between unilateral reduction of blood flow in the temporal region and impaired visuospatial ability, impaired visual memory, and enhanced speed of information processing.
Adolescent↗
Nonsurgical factors in the success of hypospadias repair.
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Body Image↗
The ambitions of adolescents born with exstrophy: a structured survey.
OBJECTIVE: To determine the factors that control quality of life as perceived by adolescent patients with bladder exstrophy, and to compare their views using standard instruments. PATIENTS AND METHODS: Sixteen patients (mean age 19 years, range 16-21, 11 male and five female) were recruited from the departmental database; they represented 46% of those available for the study. After giving informed consent, each had a semi-structured interview, augmented by completing a self-reported scale, with the principal investigator. They then completed the Culture-Free Self-Esteem Inventory-2 (CFSEI-2) and the Brief Symptom Inventory (BSI). The interviews were recorded on audiocassette, transcribed verbatim and evaluated using interpretative phenomenological analysis. RESULTS: In the interviews there was a remarkable consistency in the domains identified as important to the patients. There was a wish to be normal and to be treated as such. This was defined (amongst other items) as being able to void with an appropriate noise, being treated as peers at school and at home, and having an umbilicus. All patients reported some bullying (all but one in the past), but only severely in three. Concerns about self-image centred on scars and genital appearance. Very similar and effective coping strategies had been created, including practical (e.g. suitable clothes) and emotional (e.g. joking, control of revealed information) aspects. Special arrangements made to help (care by a special assistant or use of a disabled lavatory at school) served only to emphasize their abnormality and were resented. No overt psychiatric or psychological morbidity was detected. There was no difference in scores with the CFSEI-2 or BSI from established age-related norms. CONCLUSION: This study confirms the anecdotally reported strong resilience and personality of adolescents with exstrophy. The domains that patients considered important were not those that their carers might have expected or that are used in standard quality-of-life instruments. No morbidity was identified by the two instruments used. In exstrophy, and perhaps in other uncommon conditions, the patients' views of relevant domains should be considered in assessing quality of life.
Adaptation, Psychological↗
Trials and triumphs, stories and solutions: using systemic therapy techniques to facilitate paediatric and community nurses' groups.
Staff groups for nurses are seen as useful for stress reduction and team building, with a widely-held belief that they should be made available and used by staff. However, while usually requested by service managers, staff have varying views regarding their need and varying levels of comfort with participation. This article considers the challenges that are faced in setting up staff support groups for two different groups of nurses. The first group, for paediatric nurses working on an adolescent medical in-patient unit, is now a settled and established entity. The second group, for a community paediatric nursing team, continues to evolve in response to changing needs. Ways to adapt the group model to increase attendance rates and ensure the groups are helpful are presented. This article is intended as a resource for professionals who are already running groups or are considering establishing one.
Adolescent↗
Early-onset anorexia nervosa: is there evidence of limbic system imbalance?
OBJECTIVE: This study, part of a continuing effort to understand the pathophysiology of the brain in early-onset anorexia nervosa, attempts to validate findings from an earlier study of regional cerebral blood flow and to correlate any abnormalities in blood flow with eating disorder psychopathology. METHOD: Fifteen newly referred children and adolescents with a diagnosis of anorexia nervosa (AN) underwent regional cerebral blood flow (rCBF) examination using single-photon computerized tomography (SPECT) and the Eating Disorders Examination (EDE) for children. RESULTS: Mean age was 14 years 11 months (SD = 1.35). Mean weight for height ratio was 82.79 % (SD = 10.66). SPECT findings showed that 11 (73%) had asymmetry (hypoperfusion) of blood flow in at least one area. Regions of the brain showing hypoperfusion included the temporal lobe (n = 9), parietal lobe (n = 5), frontal lobe (n = 3), thalamus (n = 3), and the caudate nuclei (n = 1). The median EDE subscale scores were high for all four subscales. Those patients with hypoperfusion had higher median EDE subscale scores than those without hypoperfusion, although the differences were not statistically significant. CONCLUSIONS: Most patients in our study had abnormal rCBF, predominantly affecting the temporal lobe, confirming our previous findings. There was no association with the EDE scores. The findings support earlier suggestions of an imbalance in neural pathways or circuits, possibly within the limbic system. This hypothesis is considered within the context of current knowledge and suggestions made with regard to how it might be tested.
Adolescent↗