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Biomedical subjects

Per Hove Thomsen

Publications and source records attributed to Per Hove Thomsen.

At least 19 recordsLinked to original sources
PubMed2007

Variation in incidence of neurodevelopmental disorders with season of birth.

BACKGROUND: The etiologies of autism spectrum disorder and many neurodevelopmental disorders are largely unknown. The detection of a seasonal variation of birth of children diagnosed with a certain disorder could suggest etiological factors that follow a seasonal pattern. We examined the seasonal variation of births of children diagnosed with any of 4 common childhood neuropsychiatric disorders: autism spectrum disorder, hyperkinetic disorder, Tourette syndrome, and obsessive-compulsive disorder. METHODS: The study cohort consisted of all children born in Denmark from 1990 through 1999 identified in the Danish Medical Birth Register (n = 669,995). Outcome data consisted of both inpatient and outpatient diagnoses reported to the Danish National Psychiatric Registry from 1995 through 2004 using the International Classification of Diseases, 10th edition, diagnostic coding system. Logistic regression combined with spline (a smoothing method) was used to estimate the variation with season of birth for each disorder. Estimates of risk of each disorder with season of birth were adjusted for differences in follow-up time and change in incidence over time. RESULTS: No convincing variations in season of birth were observed for any of the 4 disorders, or for the autism-spectrum-disorder subtypes. CONCLUSION: Although we cannot rule out the possibility of seasonal variation of birth for a range of childhood neurodevelopmental disorders, we find little evidence that seasonal environmental factors are related to these disorders.

Attention Deficit Disorder with Hyperactivity↗
PubMed2006

[Depression in children and adolescents].

This article reviews the recent literature on depression in children and adolescents. We describe the current knowledge about clinical presentation, epidemiology, prognosis and risk factors with a focus on the differences from depression in adults.

Adolescent↗
PubMed2006

Cigarette smoking during pregnancy and hyperactive-distractible preschooler's: a follow-up study.

AIM: To study the association between intrauterine exposure to tobacco smoke and behavioural disorders in preschool children, primarily symptoms of inattention, hyperactivity and impulsivity but also hostile-aggressive and anxious-fearful symptoms. METHODS: We conducted a follow-up study in 1355 singletons born to Danish-speaking mothers. Information on smoking habits during pregnancy and other lifestyle factors was obtained from self-administered questionnaires filled in during second and third trimester. Approximately 3.5 years later, the parents provided information on their child's behaviour using the self-administered Preschool Behaviour Questionnaire. The children were categorized into three not mutually exclusive behaviour groups: hyperactive - distractible (13.6%), hostile-aggressive (4.6%), and anxious-fearful (6.4%) children. RESULTS: Compared with children of non-smokers, children born to women who smoked 10 or more cigarettes per day had a 60% increased risk of hyperactivity and distractibility perceived by the parents (OR 1.6; 95% CI 1.0-2.3; P < 0.05). The results were adjusted for maternal lifestyle factors and socioeconomic characteristics. Additional adjustment for perinatal factors and parental psychiatric hospitalization did not change the results substantially (OR 1.7; 95% CI 1.1-2.6). We found no statistically significant association between maternal smoking in pregnancy and hostile-aggressive and anxious-fearful behaviour in the offspring. CONCLUSION: Exposure to tobacco smoke in utero was associated with hyperactive-distractible behaviour in preschool children.

Child Behavior Disorders↗
PubMed2006

Internalizing disorders in child psychiatric patients across time: diagnoses and causes for referral.

With regard to internalizing disorders we wanted to describe: 1) a possible change in diagnoses over time; 2) a possible corresponding change in causes for referral; 3) correspondence of hospital diagnosis with causes for referral. For 70 randomly selected records/year (n=560), referral papers were examined and compared with register-data on all 8-13-year-old children examined in the study period (1995-2002). The hospital-based frequency increased for depressive disorders and obsessive-compulsive disorder (OCD) and decreased for anxiety disorders. A corresponding increase occurred for depressive and OCD symptoms as cause for referral. Agreement between referral causes and subsequent clinical diagnoses was modest. In most cases (68%) referred for internalizing symptoms, a clinical diagnosis within the internalizing spectrum was given. The increase in the diagnoses of depressive disorder and OCD seems partly due to an increase in patients referred for these disorders. Referrers identify internalizing disorders reliably but child psychiatric examination leads to more precise diagnoses.

Adolescent↗
PubMed2006

A randomized, double-blind, placebo-controlled study of citalopram in adolescents with major depressive disorder.

In a European, multicenter, double-blind study, 244 adolescents, 13 to 18 years old, with major depression were randomized to treatment with citalopram (n = 124) or placebo (n = 120). One third of the patients in both groups withdrew from the study. No significant differences in improvement of scores from baseline to week 12 between citalopram and placebo were found. The response rate was 59% to 61% in both groups according to the Schedule for Affective Disorders and Schizophrenia for school-aged children-Present episode version (Kiddie-SADS-P) (depression and anhedonia scores < or =2) and Montgomery Asberg Depression Rating Scale (MADRS) (> or =50% reduction). Remission (MADRS score < or =12) was achieved by 51% of patients with citalopram and 53% with placebo. A post hoc analysis revealed that more than two thirds of all patients received psychotherapy during this study. For those patients not receiving psychotherapy, there was a higher percentage of Kiddie-SADS-P responders with citalopram (41%) versus placebo (25%) and a significantly higher percentage of MADRS responders and remitters with citalopram (52% and 45%, respectively) versus placebo (22% and 19%, respectively). Mild to moderate treatment-emergent adverse events were reported in 75% citalopram and 71% of placebo patients, most commonly headache, nausea, and insomnia. Serious adverse events occurred in 14% to 15% in both groups. Suicide attempts, including suicidal thoughts and tendencies, were reported by 5 patients in the placebo group and by 14 patients in the citalopram group (not significant) with no pattern with respect to duration of treatment, time of onset, or dosage. In contrast, the suicidal ideation (Kiddie-SADS-P) single item showed worsening more frequently in the placebo (18%) than in the citalopram group (8%).

Adolescent↗
PubMed2005

[How to treat ADHD/DAMP? Is there a conclusive answer? A critical survey of the MTA trial?].

Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder occurring in approximately 3-6% of the population. The high prevalence of the disease and the fact that it has an onset early in life emphasise the importance of adequate treatment. This article focuses on the largest long-term treatment study of ADHD, the Multimodal Treatment study of Attention Deficit Hyperactivity Disorder (MTA), taking into consideration especially the limitations of the design and their impact on the outcome of the study. Primary among these is the fact that outcome was measured 4-6 months after the most intensive phase of behavioural treatment but while medication was still active. This may have had an impact on the study results, especially since the MTA study did not indicate a significant difference between combined and strictly pharmacological treatment.

Attention Deficit Disorder with Hyperactivity↗
PubMed2005

[When thoughts become compulsions. Obsessive-compulsive disorder in children].

OCD (obsessive-compulsive disorder) is characterised by the presence of annoying, unwelcome and intrusive obsessions and compulsions. The obsessions appear over and over and the child recognize them as something strange and unwelcome, but at the same time they are clearly a product of his/her own mind and not a hallucination or a thought disorder as seen in psychotic disturbances. Compulsions are imposed actions that the child feels it has to perform, often in a certain pattern. Both children and adults can suffer from OCD. Almost 2/3 of adults with OCD report onset of their OCD symptoms in childhood or early adolescence. Previously, OCD among children and adolescents was considered to be rare, but newer epidemiologic surveys show that 1-1% of children and adolescents suffer from OCD in such a degree that they fulfil the diagnostic criteria. The prevalence varies surprisingly little in various countries regardless of cultural background.

Adolescent↗
PubMed2005

The Children's Depression Inventory and classification of major depressive disorder: validity and reliability of the Danish version.

The study examines the validity and reliability of the Danish version of the Children's Depression Inventory (CDI) in a child psychiatric population. Participants were 149 child psychiatric patients aged 8-13 and their parents. After diagnostic interview with the Kiddie-Schedule for Affective Disorders and Schizophrenia, the children completed the CDI. A subgroup of 44 children repeated the CDI after 2 weeks. The psychometric properties of the Danish CDI were similar to those reported for the English version. CDI is moderately correlated with other measures for depressive disorder, but the instrument is not sufficiently reliable or valid to be used as a single diagnostic or screening measure in a child psychiatric population.

Adolescent↗
PubMed2005

DSM-IV or ICD-10-DCR diagnoses in child and adolescent psychiatry: does it matter?

OBJECTIVE: DSM-IV is the most widely used diagnostic classification system in research, whereas ICD-10 is more widely used clinically. Knowledge of differences is essential when research findings are implemented in daily clinical practice. We examined differences between the two diagnostic systems regarding three major child psychiatric diagnostic categories. METHODS: A total of 199 consecutively referred, child psychiatric patients were interviewed with a semistructured diagnostic interview (K-SADS-PL) including questions covering specific ICD-10-DCR criteria, and diagnosed according to both diagnostic systems. RESULTS: Differences were found regarding the diagnoses major depressive disorder/depressive episode and attention deficit hyperactivity disorder/disturbance of activity and attention. In both cases, more children met DSM-IV-TR criteria than ICD-10-DCR criteria. The diagnosis, oppositional defiant disorder, proved interchangeable between the two diagnostic systems. CONCLUSION: Differences between diagnostic systems must be taken into account when research findings using one diagnostic system are implemented with children diagnosed by another diagnostic system.

Adolescent↗
PubMed2005

Age and gender differences in depressive symptomatology and comorbidity: an incident sample of psychiatrically admitted children.

BACKGROUND: Studies indicate that major depressive disorder (MDD) is frequent in children but that it may be missed. This study determines the incidence of hospital-treated MDD based on the frequency of MDD in child psychiatric patients, and analyses effects of age and gender on depressive symptoms and psychiatric comorbidity. METHODS: One hundred ninety-nine consecutive child psychiatric patients were interviewed using a semi-structured diagnostic interview (K-SADS-PL). Comorbidity and symptoms were compared across age and gender. RESULTS: Current or partly remitted MDD was found in 42 children (21%). Thirty-eight (90%) had comorbid psychiatric disorder(s). Onset of the comorbid disorder was prior to onset of depression in 74% of cases. No significant gender-differences were found, but anhedonia, hypersomnia and decreased ability to concentrate were more frequent in the older age group. In contrast, feelings of worthlessness were more frequent in the younger age group. The number of melancholic symptoms was significantly associated with older age. CONCLUSION: MDD is frequent in child psychiatric patients aged 8-13 years. Age-but not gender-had significant effects on melancholy score and the prevalence of specific symptoms. Results suggest that MDD may be underdiagnosed in clinical samples unless careful examined with diagnostic interview.

Adolescent↗
PubMed2005

Smoking during pregnancy and the risk for hyperkinetic disorder in offspring.

OBJECTIVE: Maternal smoking during pregnancy may increase the risk for behavioral disorders. The aim of this study was to investigate the association between smoking during pregnancy and hyperkinetic and attention-deficit/hyperactivity disorder in the offspring in a large population-based study. METHODS: This study was designed as a nested case-control study. Data were obtained from Danish longitudinal registers and included 170 children with hyperkinetic disorder and 3765 population-based control subjects, who were matched by age, gender, and date of birth. Potential confounders, including newborn characteristics, socioeconomic status, and family history of psychiatric illnesses, were evaluated by conditional logistic regression analyses. RESULTS: Women who smoked during pregnancy had a 3-fold increased risk for having offspring with hyperkinetic disorder compared with nonsmokers. Socioeconomic factors and history of mental disorder in the parents or siblings seemed to confound the result to some extent (adjusted relative risk: 1.9; 95% confidence interval: 1.3-2.8). Adjustment for parental age or exclusion of children with low birth weight (<2500 g), preterm delivery (<37 weeks completed gestation), and Apgar scores <7 at 5 minutes revealed no changes in the results. Also, excluding children with conduct disorders or comorbid disorders revealed no change in the results. CONCLUSIONS: Our results showed an increased risk for hyperkinetic disorder in children of mothers who smoked during pregnancy. This could not be explained by newborn characteristics, parental socioeconomic status, family history of psychiatric hospitalizations or contact as outpatients, conduct disorders, or comorbidity.

Attention Deficit Disorder with Hyperactivity↗
PubMed2004

Developmental profiles on the basis of the FTF (Five to Fifteen) questionnaire-clinical validity and utility of the FTF in a child psychiatric sample.

The Five to Fifteen parent questionnaire (FTF) was developed to offer a neuropsychological dimension to the assessment of children with Attention Deficit/Hyperactivity Disorder and other child psychiatric disorders. The domains included in the FTF were motor skills, executive functions, perception, memory, language, social skills and learning, in addition to a domain for emotional and behavioural problems. The aim of the present study was to test the clinical validity and utility of the FTF with a main focus on discriminant and criterion validity. The clinical sample consisted of 155 clinically diagnosed children (ICD-10 criteria), 102 were tested with WISC-III. The parents rated their children independent of the diagnostic evaluation. The results were presented as profiles. These clinical profiles were compared to those of a Swedish norm sample consisting of 854 children from the age of five to fifteen. Results demonstrated that the profiles for the clinical groups were similar in forms and levels to those of the upper 10 percent of the norm sample (those with most difficulties). Five out of eight FTF domains discriminated significantly between diagnostic groups in the clinical sample. Influence of IQ, gender and age on the results were low. Three out of four relevant FTF domains correlated significantly with corresponding WISC-III indexes/measures. The clinical utility of individual children's profiles were demonstrated. On the whole, the findings supported the clinical validity and utility of the FTF.

Attention Deficit Disorder with Hyperactivity↗
PubMed2004

Social risk factors as predictors for parental report of deviant behaviour in 3-year-old children.

The objective of this study was to examine whether social risk factors adjusted for gender and some well-known perinatal risk factors were related to parental descriptions of deviant behaviour in 3(1/2)-year-old children. The study was a prospective cohort study of 1345 mothers enrolled during early pregnancy. Parents answered a questionnaire and children's behavioural difficulties were categorized into the following groups; "hyperactive-distractible", "hostile-aggressive" and "anxious-fearful" following a modified Behar scale. The male gender was found to be related to a description of all kinds of deviant behaviour. Having a family member experiencing employment difficulties was the factor most closely related to "hyperactive-distractible" behaviour. Familial stress due to lack of time, experience of divorce and mothers in excess of 35 years at childbirth were found to be related to "hostile-aggressive" behaviour, but male gender was the most closely related. Social disadvantage was not found to be related to "anxious-fearful" behaviour.

Anxiety↗
PubMed2004

Parental engagement in psychotherapy with adolescents: a preliminary study.

Treating adolescents referred for psychiatric services usually involves engaging their parents in the treatment process. However, this is a complicated task, which calls for sensitivity to the developmental needs of the adolescents, as well as addressing parental needs and their role in therapeutic endeavour. The aim of this study was to describe the extent to which parents were engaged in outpatient psychotherapy with adolescents. Eight therapists registered their consultations with the parents, adolescents and other professionals over a 3-month period. Results showed that therapists had the same amount of contact with parents, primarily with the mother, as they had with the adolescents. However, parents initiated relatively few consultations with the therapists. Furthermore, there was no association between the age and gender of the adolescent and amount of parental engagement. We believe that consultations with parents came in addition to and not instead of individual consultations with the adolescents. Future directions for research and implications for clinical practice are discussed.

Adolescent↗
PubMed2004

Quality of life with OCD. A self-reported survey among members of the Danish OCD Association.

Obsessive-compulsive disorder (OCD) is today the fourth most frequent diagnosis issued within psychiatry. OCD can be quite incapacitating for the affected person and often becomes chronic. The purpose of the present study has been to help illuminate the character of the quality of life among the members of the Danish OCD Association. The data was compiled from 406 questionnaires sent out to all those members of the Danish OCD Association who had reported to suffer from OCD. The level of response was 54.4%. Persons with OCD signalled striking influences on their academic, occupational and social functions and thereby a corresponding influence on their quality of life in general. Emerging were significant levels of comorbidity and suicidal tendency. The time interval between symptom onset and the establishment of a correct diagnosis was found to be 13 years in average in this study. There appeared to be a marked tardiness in treatment as a consequence of the latency period between onset of symptoms and the establishment of a diagnosis. This has proven to be of importance in relation to the provision of proper treatment, the developmental course of the OCD condition, and not least in the quality of life for the person with OCD as well as his/her family members.

Activities of Daily Living↗