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Biomedical subjects

M H Schmidt

Publications and source records attributed to M H Schmidt.

At least 145 records · Page 8Linked to original sources
PubMed1992

["Risk children": the importance of biological and psychosocial risks for child development in the first two years of life].

In a prospective longitudinal study the development of N = 362 children will be followed over four time points (T1-T4) from birth to school age utilizing a comprehensive battery of instruments. Aims of the study are the description of the developmental course of children born at differing degrees of biological and psychosocial risk, the identification of early predictors of developmental disorders and their compensation, as well as the analysis of the processes and mechanisms underlying differential developmental patterns. The results of waves 1 and 2 show that early development from 3 to 24 months is quite unstable. Depending on the examined domain of development up to 3/4 of the disturbances of infancy have remitted by the later age, whereas nearly a fifth of the hitherto well children developed new disturbances. Both risks have a marked negative effect on development. While biological risks go hand in hand with impaired motor functioning, psychosocial risks adversely affect cognitive and social-emotional competence. However, the relative weight of risk factors changes during the first two years with biological risks becoming less important and psychosocial risk factors gaining influence. Single risk factors identified as being prognostically very unfavourable are very low birth weight and neonatal seizures. Of the psychosocial risks a pattern of unfavourable family characteristics such as low educational level, history of broken home or mental health problems of parents and chronic difficulties is related most strongly to poor outcome.

Affective Symptoms↗
PubMed1992

Marital discord and early child development.

As part of a prospective study on the neuropsychiatric development of children born at varying degrees of organic and psychosocial risk, the effect of marital discord on the cognitive and social-emotional development of 315 first-born children into two parent households was investigated. Both the children and the quality of the parental relationship were evaluated when the children were 3 months and 2 years of age. The findings show that marital discord at 3 months does not affect child performance at 3 months, or at 24 months. Marital discord at 2 years does affect the emotional well-being of the 2 year olds, i.e. it is accompanied by a significant rise in psychopathological symptoms. When the effect of the stability of marital strife from the first assessment to the second was studied, a significant increase of behaviour problems and decrease in cognitive performance was found in the group of children whose parents' marital situation had deteriorated and failed in the meantime but surprisingly not in the group with chronic discordant relationships. Conversely, poor child performance and emotional adjustment improved with a positive change in the parental relationships. Analysis shows that negative marital change goes hand in hand with a decrease in parenting skills which affect children more adversely than their counterparts whose parents had a history of marriage and child-rearing problems. Further study of the course of marital relationships and child development at the next research waves (4.5 and 8 years) will show which results are of long-term versus short-term relevance.

Adolescent↗
PubMed1992

[Prevalence and follow-up of psychiatric disorders in childhood and adolescence. Results of a prospective epidemiologic longitudinal study from ages 8-18 years].

In a prospective longitudinal epidemiological study with assessments at age 8, 13 and 18 the prevalence rate for psychiatric disorders remained constant at about 16%. The sex ratio for severe disorders was male dominated even in adolescence, which was a consequence of the high rate of unsocialized disturbances of conduct in boys. Persistence of psychiatric disorders between age 13 and 18 was about 50%, as had previously been the case between age 8 and 13. One child in four suffered from a psychiatric disorder for at least 10 years. In childhood, conduct disorders had a very poor prognosis and emotional disorders a very good one. In adolescence, the course of disorders depended on an interaction between diagnosis and gender. Boys with unsocialized disturbances and girls with emotional problems had a poor prognosis.

Adaptation, Psychological↗
PubMed1992

[The effect of life change events on cognitive and socio-emotional development in early childhood].

The present study investigates the role of life events of differing durations in the cognitive and social-emotional development of infants. A total of 354 children were examined at the ages of 3 and 24 months and the children's parents were interviewed about the occurrence of live events in this interval. The total number of life events was a significant predictor of changes in the level of cognitive and social-emotional functioning. Changes in the caregiver and marital discord were the best predictors of a child's social-emotional development, and serious illness in the child and changes in the caregiver were the best predictors of a child's cognitive development.

Adaptation, Psychological↗
PubMed1992

[Behavioral disorders in infants and young children: a contribution to psychopathology of early childhood].

In a study on the psychological development of children born at biological and psychosocial risk adverse temperamental characteristics and psychopathological symptoms of 362 children were determined at the ages of 3 and 24 months. Adverse temperamental characteristics were measured with the help of behavioral observations in standardized situations. Symptoms were assessed in a highly structured parent interview. The results showed a higher-than-average rate of disturbed children, which increased from 15.5% at the age of 3 months to 19.5% at two years. Hyperkinesis was the most prevalent disturbance. Whereas no sex effect was found among infants, the 2-year-old boys manifested more symptoms and had more adverse temperamental characteristics than the 2-year-old girl. Sex differences in symptom patterns were similar to those seen in later childhood. The course of early disturbances was characterized by low persistence and stability. Four fifths of all infant disturbances had remitted by the age of two years. A small number of early problems (i.e. eating disorders) turned out to be predictive of later disorders.

Child Behavior Disorders↗
PubMed1992

[Marital disharmony of the parents and child development in infancy and early childhood].

As part of a prospective study currently being conducted in the Mannheim-Heidelberg region of Germany on the neuropsychiatric development of 362 children born at varying degrees of organic and psychosocial risk, the effect of marital discord on the cognitive and social-emotional development of 315 children born into two-parent households was investigated. Both the children and the quality of the parental relationship were evaluated when the children were 3 months and two-years of age. Assessment of the children included performance on the Bayley Scales of Infant Development, observed and reported temperament characteristics and measures of infant and child psychopathology. Evaluation of the relationship was based on pertinent information provided by the parents about their marriage within a standardized interviews as well as on the basis of a questionnaire. Results show that marital discord at 3 months does not effect child performance at 3 months, nor at 24 months. Marital discord at 2 years does affect the emotional well-being of the two-year-old i.e. is accompanied by a significant rise in psychopathological symptoms. When the effect of the stability of marital strife from the first assessment to the second was studied a significant increase in behavior problems and decrease in Bayley performance was found in the group of children whose parents' marital situation had deteriorated and failed in the meantime but surprisingly not in the group with chronic discordant relationships. Conversely, poor child performance and emotional adjustment improved with a positive change in the parental relationships. An increase, although not significant, was also found among the children whose parents' marriage had deteriorated but had not lead to separation.

Affective Symptoms↗
PubMed1991

Investigation of striatal dopamine D2 receptor acquisition following prenatal neuroleptic exposure.

To test the hypothesis that neuroleptic blockade impairs the development of striatal dopamine D2 receptors, pregnant rats were given haloperidol, thiothixene, or trifluoperazine for gestational days 15-18 (short-term exposure) or days 5-20 (long-term exposure). All of the drugs were demonstrated to cross the placenta and enter the fetal brains equally well. Striatal dopamine D2 receptors of the pups were assayed on postnatal day 14. Neither receptor density nor receptor affinity was altered significantly by the short- or long-term prenatal neuroleptic treatment.

Animals↗
PubMed1991

Familial adversities and child psychiatric disorders.

The well known association between child and adolescent psychiatric disorders and chronic adversities was proved in a field sample. Children (356) were investigated at the ages of 8 and 13 years. The association between child psychiatric disorders and chronic adverse conditions in the familial environment--measured by the FAI--was analysed with respect to the variables: age, sex, psychiatric diagnoses, and course (stability) of disorder. The FAI proved to be predictive of psychiatric disorder, in particular of early onset disorder, of disorders in boys, and of conduct disorders. According to the results, the common assumption that chronic adversities cause child psychiatric disorders must be viewed cautiously.

Adolescent↗
PubMed1991

[Follow-up of hyperkinetic syndrome in clinical and field samples].

Retrospective studies and short prospective studies in clinical samples are rarely helpful in elucidating the course of hyperkinetic syndromes. So far prospective longitudinal data have been published only on client populations. The results of such studies are summarized. They are compared with the data on a field sample (n = 399) followed from age 8 until 18. Initially 4.2% of the children had hyperkinetic syndrome. Over the 10-year period the symptoms of the syndrome decreased. In 40% of the cases the syndrome persisted, but with a general shift in the symptoms profiles toward antisocial behavior. Beyond this, the study showed that the symptoms temper tantrums, distractability and hyperkinesis are very important in connection with psychiatric morbidity in children and adolescents. There is a need for further analysis of such symptoms in the context of other symptoms of psychiatric disorder in youngsters not diagnosed as having hyperkinetic syndrome.

Adolescent↗
PubMed1991

[Development-dependent diagnosis in two children with a rare "combined disorder of school readiness" in accordance with ICD-10, F81.3].

The new category (ICD-10) of mixed disorder of scholastic skills (F81.3) includes the combination of specific reading and spelling disorders with specific disorder of arithmetical skills and the combination of specific spelling disorder with specific disorder of arithmetical skills. We could demonstrate such combinations of specific developmental disorders in two children. In addition to diagnostic approaches with standardized testing procedures we used a model that is based on the steps in the development of specific skills. This method can be helpful in determining what kinds of intervention would be most appropriate. Both children with mixed disorders of scholastic skills also had psychiatric disorders.

Achievement↗
PubMed1990

Psychiatric disorders in children and adolescents: results of the ICD-10 field trial.

Of the numerous changes made in the classification of psychiatric disorders in children and adolescents in ICD-10 the most important are described. In an evaluation of the revised scheme, 7 raters from 2 facilities classified 40 case histories with both ICD-10 and ICD-9 codes. For ICD-10 and 4 character codes the level of agreement was 56% (ICD-9: 60%). As expected, 3-character codes yielded better agreement (ICD-10: 71%; ICD-9: 72%). Within-facility agreement was roughly the same for each. The lowest levels of agreement for a given category were for mixed disorders of conduct and emotions (F92) and depressive disorders (F31, F43). The reasons for this are discussed.

Adolescent↗
PubMed1990

Phenomenal and operationalized classification of psychiatric disorders in children and adolescents with ICD-9 and ICD-10, on the basis of a field study.

In connection with the implementation of ICD-10, a further multicenter field study was conducted with 33 raters from 9 facilities for child and adolescent psychiatry. Each rater evaluated the same 29 case studies, resulting in a total of 957 ratings. When coding was done with 4-character ICD-10 codes interrater agreement on a given diagnosis averaged 50.3% (ICD-9: 47.3%); with 3-character ICD-10 codes the figure was 61.0% (ICD-9: 66.5%). When alternative diagnoses were also considered, agreement improved by about 7% (4-character codes) and 7.4% (3-digit codes), respectively. The highest levels of agreement were found for monosymptomatic disorders (F94, F95 and F98), the lowest for mixed disorders of conduct and emotions (F92) and depressive disorders (F31, F43). These results indicate that, on the whole, psychiatric disorders in children and adolescents can be classified reliably with the ICD-10, even when the raters have had no experience with the scheme.

Adolescent↗
PubMed1990

Epidemiology and course of psychiatric disorders in school-age children--results of a longitudinal study.

In an epidemiological longitudinal study, 356 out of 399 8-yr old children were re-examined at age 13. Prevalence rates for psychiatric disorders of about 16% remained constant during adolescence. The course of emotional disorders proved very promising, while that of conduct disorders was extremely unfavorable. Remission of psychiatric disorders was also influenced by an improved psychosocial environment within the family. Development of disorders in initially healthy children was related to prior learning disabilities and stressful life events. More effective approaches in the treatment of conduct disorders as well as early detection of detrimental familial conditions and learning disabilities are called for.

Affective Symptoms↗
PubMed1990

[Differential results of treatment in pedagogic-therapeutic long-term intervention in residential treatment centers for children].

In a longitudinal evaluation study the developmental progress of 223 children, who have been treated between 1968 and 1987 in a residential facility for psychiatric care, was explored from referral until time of discharge. Initial state and state at discharge were defined multidimensionally according to MAS. Comparisons between children with different initial clinical diagnosis met expectations, that introversive disturbances recover more frequently than autistic as well as conduct disorders or hyperactivity. Associations between recovery and initial cognitive-intellectual state did not reach statistical significance, when type of disorder was controlled for. But rate of recovery appeared to be throughout higher for children with learning disabilities than for children without such deficits. Age at onset and age at referral were apparently rather irrelevant for the state at discharge. But rate of recovery was in general clearly reduced, when length of time between onset and referral had been above average. The relation between duration of treatment and state at discharge depended on the type of disorder. For children with conduct or autistic disorders the rate of recovery increased with longer duration of treatment, whereas for children with introversive disturbances the contrast was true. This could suggest confounding effects of severity of disorder. When the treatment in the facility had been precociously terminated, rate of recovery in general was remarkably lower than in case of a planned termination. Analysis on effects of alternative methods of treatment was only with restrictions possible and did not suggest a general or differential superiority of a special type of treatment.

Adolescent↗
PubMed1990

Indication of different forms of therapy in long-term in-patient treatment.

The contribution presented attempts to demonstrate disturbance characteristics in children who are used in practice as differential indication criteria in the choice between medical-pedagogical and psychotherapeutic methods of treatment. 171 of a total of 238 children in a medical-pedagogical/psychotherapeutic children's home were examined; these children were discharged between the foundation of the institution in 1968 and July 1987. Apparently, the presence of a partial performance weakness, a hyperkinetical/development-dependent or dissocial disturbance as well as a disturbance of the central nervous system can be regarded as indicators for medical-pedagogical measures, the diagnosis of a neurotic/emotional disturbance as well as at least average intelligence level as indication criteria for an analytical child therapy. The disturbance conditions found correspond with the indicators for a medical-pedagogical and/or psychotherapeutical treatment described in specialist literature. Moreover, the success quota was compared with the remission rate known in child psychiatric practice.

Adolescent↗