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K I Bjørnholm

Publications and source records attributed to K I Bjørnholm.

4 recordsLinked to original sources

[Infant psychiatry].

Infant psychiatry is a discipline concerned with diagnostic assessment, treatment, and prevention of mental health problems in infancy and early childhood. A new diagnostic framework: Zero to three (DC 0-3) has been designed to complement the ICD 10/DSM IV, including new diagnostic categories, and a multiaxial construct addressing developmental and relational aspects. Prevalence and outcome for mental retardation and pervasive developmental disorders are well known. Our knowledge of variations in attachment patterns, disorders of neurophysiological regulation, eating disorders, failure to thrive, emotional, affective, and behavioural problems, disorders of relating and communication, and eventually parent-child relationship disorders is still incomplete. It is recommended to use video and combine clinical evaluation with structured tests in assessment. Intervention may include guidance, psychoeducation, psychotherapy, as well as social and educational support. Parent-child relationship treatment seems effective. Evaluating intervention and treatment raises immense methodological problems. Future research should address how risk and resilience interacts in the psychopathological process and enhance our knowledge of effective intervention strategies.

Child↗

[Infant and child psychiatry in Denmark].

INTRODUCTION: A descriptive epidemiological study of children aged 0-36 months. METHODS: Diagnoses reported from the child psychiatric departments to The National Psychiatric Register were collected from a three-year period 1996, 1997, and 1998. The child psychiatric departments in Denmark filled in a questionnaire concerning referral, assessment, treatment, and consultant/liason functions. All the child psychiatric departments took part in the study. RESULTS: 529 children aged 0-3 years were reported to the National Psychiatric Register. In the period studied, there was a 30% increase in the number of children reported. Adjustment reactions were the commonest diagnosis in the youngest children, aged 0-12 months. Pervasive developmental disorders, particularly infantile autism, were commonest used in the age group 2-3 years. Twenty-four per cent of the children reported, especially the youngest children, had no specific psychiatric diagnosis. The increase in the number of children aged 0-1 year with adjustment reactions and non-specific diagnoses is discussed. Children aged 0-3 years are mainly treated as outpatients or by a consultant/liason child psychiatric service. The children referred to the child psychiatric departments in 1997 varied from fewer than 10 to about 100 children. Infant psychiatric units were established in two places in Denmark, in 1992 and 1997. DISCUSSION: The increasing number of children aged 0-3 years reported to the National Psychiatric Register in the period 1996-1998 reflects an increase in the children aged 2-3 years diagnosed with pervasive developmental disorders, and in the case of the youngest children, aged 0-1 year, a more extensive child psychiatric intervention in relation to populations at risk, such as infants with mentally ill mothers.

Child↗

Factitious illness by proxy presenting as anorexia and polydipsia by proxy.

Factitious illness by proxy is a highly pathological form of parent-child relationship. To our knowledge no former case of polydipsia by proxy has been published. The case of a 2-y-old boy suffering from malnutrition due to displacement of maternal anorexia and polydipsia is presented. Child psychiatric evaluation found cognitive delay and psycho-social impairment in the child, as well as a severe mother-child relationship disturbance. Psychological assessment showed a personality disorder with depressive and paranoid features in the mother. The father was described as a schizoid personality. The possible mechanisms of displacement are hypothesized.

Anorexia↗

[Cardiovascular manifestations of hypothyroidism].

On the basis of a case history, the clinical and paraclinical manifestations of hypothyroidism are reviewed. Exertion dyspnoea without signs of cardiac insufficiency occurs frequently. The minute and stroke volume and heart rate are reduced. The blood pressure may rise (reversible) and hypertension may occur. The function of the left ventricle is reversibly reduced. A tendency to formation of exudates has been observed. X-ray of the thorax may revial massive relatively asymptomatic pleural exudates and cardiomegaly. Pericardial exudate occurs frequently and is demonstrated best by echocardiography. Inter- and intracellular deposits, infiltrations and fibroses have been demonstrated in the myocardium and these probably contribute to some of the non-specific, reversible ECG changes (low voltage, flattening/inversion of T waves, sinus bradycardia). The plasma concentrations of several different enzymes (including creatine kinase (CK), CK-MB and LDH) may be raised in myxoedema. The reason for this is perhaps compromized membrane function in the skeletal muscle cells. The diagnosis of myocardial infarction in myoedema requires that CK-MB constitutes at least 6% of the total CK and that the increase is transient. In patients with coronary sclerosis, substitution treatment should be initiated carefully because the risk of ischaemic symptoms is otherwise considerably increased. It is not elucidated whether the hypothyroidism per se can increase atheroma formation.

Aged↗