PubMed Health⌕ Search

Biomedical subjects

P H Thomsen

Publications and source records attributed to P H Thomsen.

At least 19 recordsLinked to original sources
PubMed2006

Gestational age, birth weight, and the risk of hyperkinetic disorder.

AIMS: To study the association between gestational age and birth weight and the risk of clinically verified hyperkinetic disorder. METHODS: Nested case-control study of 834 cases and 20 100 controls with incidence density sampling. RESULTS: Compared with children born at term, children born with gestational ages of 34-36 completed weeks had a 70% increased risk of hyperkinetic disorder (rate ratio (RR) 1.7, 95% confidence interval (CI) 1.2 to 2.5). Children with gestational ages below 34 completed weeks had an almost threefold increased risk (RR 2.7, 95% CI 1.8 to 4.1). Children born at term with birth weights of 1500-2499 g had a 90% increased risk of hyperkinetic disorder (RR 1.9, 95% CI 1.2 to 2.9), and children with birth weights of 2500-2999 g had a 50% increased risk (RR 1.5, 95% CI 1.2 to 1.8) compared with children born at term with birth weights above 2999 g. The results were adjusted for socioeconomic status of the parents, family history of psychiatric disorders, conduct disorders, comorbidity, and maternal smoking during pregnancy. Results related to birth weight were unchanged after adjusting for differences in gestational age. CONCLUSIONS: Children born preterm, also close to term, and children born at term with low birth weights (1500-2499 g) have an increased risk of clinically verified hyperkinetic disorder. These findings have important public health perspectives because the majority of preterm babies are born close to term.

Adolescent↗
PubMed2003

Psychopharmacological treatment with lithium and antiepileptic drugs: suggested guidelines from the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark.

A subcommittee under the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark have recently developed national guidelines for the psychopharmacological treatment with lithium and antiepileptic drugs, and the present translation aims at contributing to the international discussion on the development of proper guidelines for the treatment of bipolar disorder. Among the antiepileptic drugs, the report deals with valproate, carbamazepine and lamotrigine and to a lesser extent with oxcarbazepine, gabapentin and topiramate. The various drugs will be reviewed, outlining the scientific evidence for mood-stabilizing properties and discussing major side effects, the most important interactions with other drugs and practical use. Special considerations during pregnancy and lactation, during treatment of children and adolescents and during treatment of the elderly will also be presented. Antidepressants and antipsychotics are beyond the scope of the report, but due to the mood-stabilizing properties of at least some of the atypical antipsychotics, these agents will be brought into some focus in connection with the overall treatment guidelines for the different phases of bipolar disorder given at the end of this report.

Adolescent↗
PubMed2001

[Evidence-based treatment of ADHD/DAMP in children and adolescents with central stimulants].

The use of stimulants in the treatment of children and adolescents with Attention Deficit Hyperactivity Disorder, ADHD, and Deficit in Attention, Motor Control and Perception, DAMP, is often considered somewhat controversial. It was first used in 1937, and since the 1960s, 3000 published studies and 250 reviews have demonstrated the positive, short-term effect of stimulants on children and adolescents with ADHD/DAMP. More than 160 randomised, controlled trials (RCT) have studied the effect of attention, hyperactivity, and impulsivity. Furthermore, stimulants have proved effective on the social relation of such children, both in their families and in with their peers. Side effects are often mild, transient and dose-related. The short-term effectiveness of stimulants is thus well-documented and their prescription evidence-based, whereas further studies on the long-term effect are needed.

Adolescent↗
PubMed2001

Reassessment of ADHD in a historical cohort of children treated with stimulants in the period 1969-1989.

The operational diagnostic criteria for ADHD or HKD were not at hand in Denmark before 1994, when WHO's International Classification of Diseases -10 (ICD-10) was introduced. The criteria for ADHD/HKD were well known at our clinic, but when treating children with stimulants the criteria used clinically prior to 1994 were less specific than today. The aims of this paper are to examine the prevalence of ADHD in a historical cohort of children treated with stimulants during the period 1969-1989 and to reassess a wide range of comorbid disorders and sociodemographic characteristics in order to compare aspects of the given treatment with the modern recommendations. At our clinic 208 children (183 boys) were given stimulants during the period 1969-1989. Case records on these probands were reassessed retrospectively for DSM-IV criteria regarding ADHD and comorbid disorders as well as for characteristics of stimulant treatment. Sixty-five percent met full criteria for an ADHD diagnosis. Including Subthreshold ADHD as many as 81 % of the cohort were re-diagnosed with ADHD. Prevalence rates of conduct problems and anxiety disorder were similar to previous prospective ADHD studies. The use of stimulants during the period 1969-1989 were in accord with modern guidelines. This cohort is comparable to other clinically based ADHD cohorts as regards inattentive, hyperactive/impulsive symptoms, comorbidity, impairment, gender differences, intelligence and socio-economic status (SES).

Adolescent↗
PubMed2001

Gilles de la Tourette syndrome in a child with congenital deafness.

We present the case of a 10-year-old boy, Sam, with congenital deafness and Gilles de la Tourette Syndrome (GTS). GTS is characterised by multiple motor tics and one or more vocal tics that wax and wane. Due to his deafness Sam never developed vocal language but instead used sign language from the age of four. His tic disorder rapidly accelerated from the age of seven over a six-month period and soon sign language was incorporated into tics as complex "vocal" tics. Bursting out "words" in sign language would also occur in front of people unfamiliar with sign language and often with an obscene content although this was not evident to someone not trained in sign language. To our knowledge this is the first reported case of a congenital deaf child with GTS. The case presented here supports previously published work that the intentional share of the tics in GTS is very small. This case also questions former theories on which regions and circuits of the brain are involved in GTS.

Anti-Dyskinesia Agents↗
PubMed2001

Obstetric complications and risk for severe psychopathology in childhood.

The purpose of the study was to assess the association of obstetric complications with risk for mental disorders resulting in hospitalization before the age of 15. Records from all births in Denmark from 1973 through 1993 were linked to records of all psychiatric hospitalizations. Diagnoses were grouped into seven broad categories. A reference population of 10% of births in Denmark from 1973 to 1990 was used for comparison. Obstetric complications were associated with the range of mental disorders occurring in childhood. The strongest predictors were a variable indicating the interaction of birth weight with speed of growth and the 5-minute Apgar score. There was no diagnostic group that stood out as different with respect to obstetric complications. These results are consistent with the hypothesis of the continuum of reproductive casualty.

Adult↗
PubMed2001

Long-term experience with citalopram in the treatment of adolescent OCD.

OBJECTIVE: The primary purpose of the study was to describe tolerability and effectiveness of citalopram in the treatment of adolescent obsessive-compulsive disorder (OCD). METHOD: Thirty nondepressed patients (15 females, 15 males) with a mean age of 13.7 years (range 13-18 years) were treated for their OCD with citalopram in an open-label, flexible-dose study (range of dose 20-70 mg; mean dose 46.5 mg). All patients were referred to Aarhus University Hospital. The patients were monitored for 1 to 2 years. The mean total score on the Yale-Brown Obsessive Compulsive Scale (child or adult version) was 28.7 at base-line, 23.3 after 10 weeks of treatment, 20.0 after 6 months, 18.4 after 1 year, and 17.9 after 2 years (from baseline to 2 years of treatment: t = 11.65; p < .001). RESULTS: Seventy percent showed a decrease in total Yale-Brown Obsessive Compulsive Scale score in excess of 35% from baseline to 1 year of treatment. Twenty percent still had a score of greater than 20 after 1 year of treatment, indicating that clinically they still had OCD. Side effects were similar to those reported from the use of other selective serotonin reuptake inhibitors (SSRIs). No patient was excluded because of serious side effects during the 1 year of observation. CONCLUSIONS: The clinical effectiveness and tolerability of citalopram in the long-term treatment seem to be comparable with the observations of other SSRIs in childhood and adolescent OCD. A further, statistically significant reduction is provided by an extended treatment period of up to 1 year.

Adolescent↗
PubMed2000

[Refugee and immigrant children referred to a department of pediatric psychiatry during the years 1991-1994].

The purpose of this study was to describe a group of 42 refugee- and immigrant children up to 14 years old compared to Danish controls in order to identify groups at risk and describe course, examination, treatment and contact. The investigation was based on case records. The only statistically significant results were higher frequencies of referral than expected regarding children from Lebanon and Somalia. However, the data indicate differences between the foreign and Danish groups as to greater problems of speech and language and less behavioural and emotional problems among the foreigners. No foreign children were offered foster homes. The attitudes of the parents towards referral, examination and treatment are more negative in the foreign group. The need for more research is emphasized.

Adolescent↗
PubMed2000

Obsessive-complusive disorder: pharmacological treatment.

Obsessive-compulsive disorder (OCD) in children and adolescents is often a disabling condition, which demands treatment with medication. Research shows that serotonin is involved in the disorder and empirical treatment studies show that antidepressants with serotonin activity are effective. The first choice of treatment in the psychopharmacological approach to OCD in children and adolescents are the SSRI agents, which have been documented as being effective as well as well-tolerated in children and adolescents. The best-documented SSRI to this point is sertraline. However, fluoxetine and fluoxamine have also undergone systematic studies in children and adolescents. Clomipramine has been proven effective, however, side effects caused by this agent would suggest that an SSRI is a better choice. Treatment with an SSRI seems to have effect in approximately 75 % of patients with OCD. There are still no systematic studies analyzing augmenting medication for children and adolescents with OCD. Research indicates that the combination of medication and psychotherapy (cognitive behavioural therapy) is important in most cases. Based on a few long-term follow-up studies on OCD children and adolescents there is not evidence that all children and adolescents suffer a lifetime course of the disease. It is therefore recommended that discontinuation is attempted after 1-1.5 years of successful treatment.

Adolescent↗
PubMed2000

Obsessions: the impact and treatment of obsessive-compulsive disorder in children and adolescents.

In the development of the majority of children, ritualistic behaviour may be seen as a normal phenomenon. In some children and adolescents, however, these rituals become time-consuming, interfering, irritating and annoying. The most common obsessions in both children and adults with obsessive-compulsive disorder (OCD) are related to a fear of dirt and contamination, fear of some terrible happening, and the fear of harming a loved one. The most common compulsions are washing fixations, checking behaviour and rituals (including mental rituals). Prevalence studies show that OCD in children and adolescents is far more common than previously thought. It is estimated that up to 2% of this population have symptoms fulfilling OCD criteria. The impact of early OCD onset can be profound, with long-term studies indicating that approximately 50% of these patients will also suffer from OCD in early adulthood. These patients tend to remain socially isolated, to have fewer relationships than their non-OCD peers, and have a tendency to remain within the family home during early adulthood. In addition, childhood OCD is associated with comorbid psychiatric disorders, in particular depression, anxiety and panic disorders, Tourette's syndrome and eating disorders. Treatment strategies for childhood OCD reflect those used in adult psychiatry. The most effective psychotherapeutic approach is based on cognitive-behavioural therapy with exposure and prevention. In contrast to pharmacotherapeutic agents without serotonin activity, the serotonin-specific antidepressants appear to be effective and well-tolerated in the treatment of OCD in children.

Adolescent↗
PubMed1998

[Long-term course among child psychiatric patients. A registry-based study of psychiatric morbidity and mortality among 546 Danish children].

A total of 546 children and adolescents, aged 5 to 15 years, who were admitted as in-patients to psychiatric hospitals throughout Denmark between 1970 and 1973, were followed up regarding to later readmissions and mortality. Approximately one-third of the sample had at least one readmission after the age of 18 years: there was no significant difference between male and female subjects. Probands with three selected diagnoses, namely childhood neurosis, conduct disorder and maladjustment reactions, had a significantly greater general risk of readmission to psychiatric hospital in adulthood than the background population. In total, 24 probands (22 male, and 2 female subjects) died during the study period. Eight subjects had committed suicide. The standard mortality rate was significantly increased.

Adolescent↗
PubMed1997

Child and adolescent obsessive-compulsive disorder treated with citalopram: findings from an open trial of 23 cases.

The adverse effects and potential clinical value of citalopram, a highly selective serotonin reuptake inhibitor, were examined in 23 children and adolescent (9-18 years old, 11 boys) with obsessive-compulsive disorder (OCD) in an open-label trial of citalopram 10-40 mg (modal 40 mg) daily. After 10 weeks of citalopram treatment, statistically significant improvements were reflected in OCD symptom ratings (mean Total Y-BOCS/CY-BOCS scores, 30 +/- 4 vs. 21 +/- 4, p < 0.001) and global assessment scores (mean CGAS, 59 +/- 11 vs. 71 +/- 11, p < 0.001). Over 75% of these youth showed a marked improvement (4 patients had more than 50% reduction in CY-BOCS scores) or moderate improvement (14 patients had 20%-50% reduction) in OCD symptoms. No patient was found to have worsened during citalopram treatment. Adverse effects appeared minor and transient. None of the 23 patients dropped out of the study or had the medication discontinued because of side effects. These open trials of citalopram do not allow for any firm conclusions regarding its effectiveness in the treatment of childhood and adolescent OCD, but these preliminary findings suggest that citalopram might be particularly well-tolerated in children and adolescents with OCD at doses up to 40 mg daily.

Adolescent↗
PubMed1997

Three cases of severe early-onset eating disorder: are they cases of anorexia nervosa?

3 cases of early onset, severe eating disorder are described. These young children did not present a distorted body image even though they had suffered a great weight loss, were somatically distressed and in all other aspects fulfilled the criteria for anorexia nervosa. The criteria for anorexia nervosa are discussed for this group of young patients.

Age Factors↗
PubMed1996

[Obsessive-compulsive disorder in children and adolescents. Epidemiological and clinical aspects].

Obsessive-compulsive disorder (OCD) in children and adolescents is apparently a much more common disorder than previously believed. The literature on OCD in children and adolescents is reviewed, and OCD is described as a severe disorder with a poor prognosis for about half of the patients. The clinical picture seems to be the same across different cultures. The most common symptoms are obsessions about dirt and contamination and washing rituals.

Adolescent↗