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Biomedical subjects

M E Garralda

Publications and source records attributed to M E Garralda.

At least 37 records · Page 2Linked to original sources
PubMed1993

Psychosocial adjustment of adult survivors of a paediatric dialysis and transplant programme.

The social adjustment of 45 young adult renal patients who commenced treatment for end stage renal disease (ESRD) as children and of 48 age and sex matched controls were compared. Renal patients were less socially mature than controls. More lived with their parents, fewer had an intimate relationship outside the family, they had fewer school qualifications, and there was more unemployment among them. The majority, however, were in employment and the level of subjective stress and support derived from most of these areas was comparable in renal patients and in controls. Having a close relationship with a member of the opposite sex was the only domain in which renal patients reported more stress than controls. Early start of illness and current health problems were associated with poorer social outcome. A lifelong history of ESRD leads to suboptimal or delayed social functioning on conventional indicators. However this does not lead to increased overall distress in the patients about their social circumstances and quality of life does not appear to be substantially impaired.

Adaptation, Psychological↗
PubMed1993

Psychosocial adjustment in preschool children with atopic eczema.

Atopic eczema is a chronic skin disorder that is most common in early childhood, an important stage in the child's social and emotional development. The psychiatric adjustment and mother-child attachment in 30 preschool children with severe atopic eczema was compared with 20 matched controls. Patients with eczema had a significant increase in behaviour symptoms, 7/30 (23%) v 1/20 (5%); with significant excess of dependency/clinginess, 15/30 (50%) v 2/20 (10%); fearfulness, 12/30 (40%) v 2/20 (10%); and sleep difficulty, 19/30 (63%) v 9/20 (45%), but there was no significant difference between the two groups in the security of attachments, 25/29 (86%) v 14/20 (70%). Significantly fewer mothers of children with atopic eczema were in outside employment, 8/29 (27%) v 13/20 (65%), or felt supported socially, 10/29 (34%) v 13/20 (65%). Significantly more of them, 9/30 (30%) v 1/20 (5%), felt particularly stressed in relation to their parenting and less efficient in their disciplining of the affected child. In spite of this and at variance with earlier reports in the literature, they did not display negative attitudes towards their child. On the contrary mothers had a positive empathic attitude towards the child, 7/14 (50%) v 2/16 (12%). Child behaviour problems, 7/14 (50%) v 2/16 (12%), and maternal distress, 12/14 (85%) v 5/16 (31%), were significantly more common in the more severely affected children. Minor behaviour problems and parenting distress are important features of severe atopic eczema in early childhood but atopic eczema does not lead to insecurity of the mother-child attachment.

Adaptation, Psychological↗
PubMed1993

Psychiatric morbidity among children who are frequent attenders in general practice.

This two-part cross-sectional study set out to determine the frequency and nature of psychiatric disorder among children aged seven to 12 years who were frequent attenders at one of two general practices. The first part of the study was an interview survey with a sample of 109 children who attended frequently (four or more times in one year) and 23 children who had not attended in one year. Descriptive information from a structured parental interview was used to diagnose childhood psychiatric disorder. The second part of the study was a postal survey with a sample of 194 children selected independently of frequency of attendance. The children's score on a parental screening questionnaire was used to determine probable psychiatric disorder. The response rates were 78% and 75% for the interview and postal studies, respectively. Of the children aged seven to 12 years registered with the two practices 21% were found to be frequent attenders. Attendances by frequent attenders accounted for 51% of all attendances in this age group. Psychiatric disorder was more common among frequent attenders than non-attenders (29% versus 9%, P < 0.05). Most of the psychiatric disorders were of an emotional nature (63%). The postal survey revealed that 15% of the children in this age group had a probable psychiatric disorder. It can therefore be estimated that 40% of children in the population with psychiatric disorder were frequent attenders.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1992

Hyperkinetic syndrome and disruptive early experiences.

Five children aged 8-10 years presenting to child psychiatric clinics with hyperkinetic syndrome and severe disruptive early experiences are described. At referral all had been living in stable families for a minimum of four years. Biological risk factors were absent. It is proposed that the disruption of early attachments resulted in ill-regulated search and exploratory behaviour and that this had a continuing effect on the children's ability to focus and control attention skills and motor behaviour.

Adolescent↗
PubMed1992

A selective review of child psychiatric syndromes with a somatic presentation.

This review focuses on 'aches and pains' and conversion syndromes as a basis for the description of psychological factors and mechanisms of relevance for the somatisation of distress in childhood and which may contribute to medical help-seeking for children. The characteristic pattern of associated psychological factors includes child personality features; academic concerns; family health problems; and styles of family interaction. Further research is required to explore in more depth the nature of these factors, the mechanisms that mediate the development of severe handicapping problems, and effective interventions.

Adolescent↗
PubMed1991

Psychophysiological anomalies in children with emotional and conduct disorders.

We studied patterns of psychophysiological (skin conductance, heart rate) reactivity to sounds and to situations with varying emotional and alerting connotations in child psychiatric outpatients and in healthy controls. Children with emotional disorders were particularly reactive to situations with aversive components, while conduct disorder subjects showed increased reactivity to pleasant situations and decreased responses to neutral but high-intensity stimulation and to withdrawal of stimulation in silence periods. The results indicate patterns of biological reactivity which may underlie different psychiatric disturbances in children.

Adolescent↗
PubMed1991

Changes in psychosocial adjustment after renal transplantation.

The psychological aspects of transplantation were studied in 29 children and adolescents with functioning renal transplants. Most parents rated their child's physical health as considerably improved after transplantation. They also noted improvements in the child's behaviour and in the quality of family life. When compared with a sample of children being treated by hospital haemodialysis, children who had received transplants had more favourable parental views of behavioural and emotional adjustment, better parental psychiatric adjustment, and indications of superior child rated mood, self concept, and social functioning. Children who had received transplants did, however, show an increase in minor behavioural symptoms compared with healthy controls, and most parents required continuing psychological and social support as well as attention to physical aspects of the child's condition. Kidney transplantation is associated with improved psychosocial behaviour in children, but there is a continuing need for support for parents in dealing with minor psychological problems after the transplant.

Adaptation, Psychological↗
PubMed1990

Life events: children's reports.

Children 7 to 12 years of age were asked to indicate events they had experienced in the previous three months in a questionnaire devised for the study. Most children were able to complete the questionnaire and reported positive and negative events, the most common themes being personal achievement, illness-related events and problems in relationships. The agreement between parents and child reporting of individual events was uneven and children reported more events than parents. Psychiatrically disturbed children noted an excess of negative and loss events and children attending paediatric clinics reported fewer events, particularly fewer positive happenings, than non-attending primary school children. A child Life Events questionnaire may be of use to explore disturbed and ill children's perception of their lives.

Child↗
PubMed1990

Peripheral psychophysiological reactivity to mental tasks in children with psychiatric disorders.

Peripheral psychophysiological reactivity (skin conductance and heart rate changes) to mental activity tasks (imagery and listening to music) was examined in child psychiatric day or in-patients with conduct and emotional disorders. Children with predominant antisocial symptomatology showed higher electrodermal than cardiovascular reactivity to the experimental tasks, whilst children with predominant neurotic symptoms showed more marked cardiovascular reactivity. No statistical differences between the groups emerged in response to listening to music, but antisocials were more responsive (with higher skin conductance level increases) to imaging pleasant situations, whereas neurotics were more reactive (increased heart rate levels and decreases in skin conductance) to imaging unpleasant situations. The results are compatible with an enhanced biological responsiveness by antisocials to reward and with neurotics experiencing an unusually marked sense of threat and withdrawal to aversive stimuli.

Affective Symptoms↗
PubMed1990

Paediatrician identification of psychological factors associated with general paediatric consultations.

In a study of children 7-12 yr of age referred to general paediatric clinics, paediatricians reported psychological factors associated to somatic presentations in 47% of the children. These cases presented with a variety of somatic symptoms, but abdominal/chest/joint pains and soiling were particularly common. From research interviews with the parents we found increased rates of psychiatric disorder (abnormalities of emotions, behaviour or relationships) amongst them. The most common psychiatric symptoms were depressive mood changes and relationship problems. We also identified an excess of certain personality features in the children and of family health problems in this group. Paediatricians commonly identify psychosomatic issues in children attending general paediatric clinics and independent evidence supports the validity of their assessments.

Affective Symptoms↗
PubMed1989

Seasonal variations in the child and adolescent psychoses.

We examined seasonality effects in a controlled study of children and adolescents with psychotic states. There was a peak of psychotic births between February and March but this pattern did not differentiate psychotics from psychiatrically disturbed controls. Onset of illness was found to be significantly more common in the summer months (June to August) in psychotics than in controls. We discuss possible explanations for this phenomenon.

Adolescent↗
PubMed1989

Referral to child psychiatry: parent and doctor motives and expectations.

We studied general practitioner and parental attitudes towards the referral to child psychiatric clinics of 65 children aged 7-12 yrs. The doctors gave parental request and anxiety and the seriousness of the child's condition as the most common reasons for the referral. Their expectations of it were well in line with current psychiatric practice. There was a wide variety of parental motivations in attending the surgery, and the expectations of the referral were similarly diverse. Most prominent though were help for the child and a need to know underlying reasons. Although three-quarters of parents were satisfied with the general practitioner intervention, the majority said that they had not been given information about the psychiatric assessment process, nor knew what to expect from it, and three-quarters of the children were referred after only one consultation.

Child↗