| 421. |
- Landgren, Valdemar, 1988, et al.
(författare)
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Attention-deficit/hyperactivity disorder with developmental coordination disorder: 24-year follow-up of a population-based sample
- 2021
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAlthough the body of research concerning neurodevelopmental disorders is vast, there is a scarcity of longitudinal studies beyond late adolescence, and of studies taking co-existing disorders into account. The present study aimed to investigate outcome in adulthood for children with attention-deficit/hyperactivity disorder (ADHD) combined with developmental coordination disorder (DCD) diagnosed at 6.6years of age.MethodsOut of a screening-based population cohort of 589 individuals, 62 (10 female) diagnosed with ADHD+DCD at mean age 6.6years naive to stimulant treatment were followed into adulthood through national registries. Results were compared to a screen- and assessment negative population matched group from the same cohort (PM group, n=51) and a registry-matched (RM group, n=410) group of the same county and age.ResultsAt 30 to 31years of age, five deaths had occurred; one in the ADHD+DCD group and two each in the comparison groups. In time to event analyses of the composite outcome of any psychiatric disorder, psychotropic prescription, sick pension or criminal sentence, events occurred at a significantly higher rate in the ADHD+DCD group (p=0.0032, vs PM group p=0.0115, vs RM group p=0.0054). The ADHD+DCD group had significantly higher rates of psychiatric diagnoses, prescriptions of psychoactive medications and occurrence of sick pension than both comparison groups. Further, the ADHD+DCD group had significantly lower educational attainment compared to both comparison groups, more years with unemployment, and overall higher welfare recipiency. Rates of pain diagnoses and analgesic prescriptions did not separate the groups.ConclusionADHD+DCD entailed a less favorable outcome in adulthood compared to a non-clinical comparison group and a registry-matched population. Neurodevelopmental disorder diagnosed upon school entry is of prognostic utility with respect to function in adulthood, and warrants early identification and management.
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| 422. |
- Landgren, Valdemar, 1988, et al.
(författare)
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Deficits in attention, motor control and perception childhood to age 30 years: prospective case-control study of outcome predictors
- 2022
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 12:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective Investigate predictors of adverse outcome in children with and without attention-deficit/hyperactivity disorder (ADHD) combined with developmental coordination disorder (DCD) at 6 years of age. Design Prospective population-based cohort study. Setting Western Sweden. Participants From a screening-based population cohort of 589 individuals, 62 (11 female) diagnosed with ADHD+DCD at mean age 6.6 years, and a comparison group of 51 population-matched (10 female) children were followed prospectively. Outcome measures Drawn from a clinical reassessment at age 9 years of 110 of the 113 individuals, neuropsychiatric symptoms, continuous performance test results and measures of motor function were used as predictors of outcome in linear regression models. Participants were followed in national registers up to 30-31 years of age for outcomes in adulthood. Predictors were regressed onto an adverse outcome score (range 0-7) comprising seven binary endpoints, and when applicable onto each continuous outcome separately (low educational attainment, low occupation level, psychiatric disorder, psychotropic medication prescription, sick pension, high dependence on social benefits and criminal conviction). Results Of the 110 individuals, 3 had died. In univariable regression onto the adverse outcome score, the strongest predictors at age 9 years were symptoms of conduct disorder, oppositional defiant disorder, ADHD and motor dysfunction, with an R-2 around 25%, followed by autistic traits (R-2=15%) and depressive symptoms (R-2=8%). Combining these six strongest predictors in a multivariable model yielded an adjusted R-2=38%. Subgroup analyses were similar, except for a strong association of autistic traits with the adverse outcome score in females (n=20, R-2=50%). Conclusion Several neurodevelopmental symptoms, including ADHD severity at age 9 years, accounted for a considerable amount of the variance in terms of adulthood adverse outcome. Broad neurodevelopmental profiling irrespective of diagnostic thresholds should inform research and clinical practice. The study highlights the importance of considering associated comorbidities and problems in ADHD.
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| 423. |
- Landgren, Valdemar, 1988, et al.
(författare)
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Neurodevelopmental problems, general health and academic achievements in a school-based cohort of 11-year-old Swedish children
- 2023
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Ingår i: Acta Paediatrica. - 0803-5253.
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Assessing rates of neurodevelopmental problems (NDPs) in 11-year-old children and possible association with other health complaints and school performance.Methods: In-school study of 11-year-old children as an add-on assessment to the 4th grade regular health check-up, comprising a structured physical neurodevelopmental examination, neuropsychological assessment, behavioural ratings, maternal interview, review of medical records and academic achievements.Results: Out of 348 children recruited from eight schools, 223 (64%) participated. Any physical condition was found in 102/222 (46%), most commonly atopy (18%). One in five had a BMI z-score >2 standard deviations over the reference mean. One or more NDP was found in 86/221 (40%) children. The number of failed national tests correlated positively with NDP severity rated with the clinical global impression severity instrument (Spearman's r = 0.41, p < 0.001). The majority of participants with failed national tests, also had co-occurring health complaints (>= 2 of: stomach or extremity ache, headache, difficulties sleeping, internalising symptoms or obesity) and NDPs.Conclusion: Health complaints, physical conditions and NDPs are very common in 11-year-old children and warrant adequately staffed, thoroughly equipped school healthcare services.
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| 424. |
- Landgren, Valdemar, 1988, et al.
(författare)
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The ESSENCE-Questionnaire for Neurodevelopmental Problems – A Swedish School-Based Validation Study in 11-Year-Old Children
- 2022
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Ingår i: Neuropsychiatric Disease and Treatment. - 1178-2021. ; 18, s. 2055-2067
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To determine the prevalence of parent-rated developmental concern using the ESSENCE-Q (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations-Questionnaire, 12-items, score range 0–24) and to ascertain the predictive validity and optimal cutoff level of the instrument in a school-based sample of 11-year-old children. Methods: In a cross-sectional, school-based study, participants underwent a clinical assessment by a physician and a psychologist, teachers and parents completed the SDQ (Strength and Difficulties Questionnaire), medical health records and national tests were reviewed, and parents independently completed the ESSENCE-Q. In a case-conference outcomes were defined as a) the need for further clinical work-up due to suspected neurodevelopmental problems (NDPs) and b) degree of investigator-rated symptoms/ impairment from NDPs on the CGI-S (Clinical Global Impression-Severity instrument, range 1–7, 4–7 defined as clinically sympto-matic). Classification and optimal cutoffs of the ESSENCE-Q were determined using ROC (Receiver Operating Characteristic) analysis. Results: Out of 343 eligible children, 223 enrolled, of whom 173 (50% of all eligible) had a parent-rated ESSENCE-Q. At least one of the 12 possible concerns was reported by parents of 36% of participants. Overall, in 101 (57%) participants a work-up was warranted, and 64 (37%) were clinically symptomatic from NDPs. The AUC of the ESSENCE-Q in detecting need for work-up was 0.70 (95% confidence interval [CI] 0.63–0.77), and the AUC in detecting clinically symptomatic participants was 0.82 (95% CI 0.76–0.88). ESSENCE-Q ratings correlated positively with CGI-S scores (r=0.48, p<0.05). A cutoff of ≥3 had the highest accuracy (78%) with a negative predictive value of 82%. Ratings >6 conferred few false positives cases with positive likelihood ratios >10 and positive predictive values of 86% or more. Significance: This study of the ESSENCE-Q in 11-year-old children suggests it might be an acceptable instrument for screening of NDPs in children in middle school, optimally in conjunction with other methods.
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| 425. |
- Lang, J., et al.
(författare)
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Adverse childhood experiences, epigenetics and telomere length variation in childhood and beyond: a systematic review of the literature
- 2020
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Ingår i: European Child and Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- A systematic review following PRISMA guidelines was conducted to answer the question: What epigenetic, telomeric and associated biological changes are associated with exposure to adverse childhood experiences (ACEs) in the under 12s? Using PRISMA guidelines, appropriate databases were searched. 190 papers were returned with 38 articles fully reviewed. Articles were each independently quality rated by two authors using the Crowe Critical Appraisal Tool and data were extracted. Of the 38 articles, 23 were rated as very high quality. Most study participants were adults (n = 7769) with n = 727 child participants. Only seven of the very/high-quality studies were prospective and involved children. Methylation was the most studied method of epigenetic modification. There is some evidence supporting epigenetic modification of certain markers in participants exposed to ACEs measured in adulthood. Research is lacking on non-coding aspects of the epigenome and on coding aspects other than DNA methylation. There is some evidence of a more powerful effect on telomere length if physical neglect was involved. Much further work is required to model biological and psychological effects of epigenetic changes during childhood using prospective study designs. The effect of ACEs on the cellular ageing process during childhood is inadequately investigated and relies solely on measure of telomere length. Future research suggestions are proposed. © 2019, The Author(s).
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| 426. |
- Lantz, Elin L., et al.
(författare)
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Premorbid BMI predicts binge-purge symptomatology among individuals with anorexia nervosa
- 2017
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Ingår i: International Journal of Eating Disorders. - : Wiley. - 0276-3478 .- 1098-108X. ; 50:7, s. 852-855
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Tidskriftsartikel (refereegranskat)abstract
- Objective: A finding consistent with the transdiagnostic approach to eating disorders is that about half of those with restricting anorexia nervosa (AN) eventually undergo a transition to the binge/purge (BP) subtype or to bulimia nervosa. Given evidence that individuals with bulimic symptoms exhibit elevated weights premorbidly, we tested the hypothesis that among those with AN, highest premorbid BMI would predict which individuals with AN would develop AN-BP. Method: The current study used longitudinal data from a community sample of adolescents with AN in Sweden. Premorbid weights were obtained from growth charts, and participants were re-assessed at 6, 10, and 18 years after first presentation with AN. Results: A greater highest premorbid BMI z score predicted a greater likelihood of developing binge/purge symptoms over 18 years. Discussion: Among individuals who develop an eating disorder, premorbid BMI may be implicated in the type and course of the eating disorder that emerges.
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| 427. |
- Lassalle, A., et al.
(författare)
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Effect of visual stimuli of pain on empathy brain network in people with and without Autism Spectrum Disorder
- 2018
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Ingår i: European Journal of Neuroscience. - : Wiley. - 0953-816X .- 1460-9568. ; 48:6, s. 2333-2342
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Tidskriftsartikel (refereegranskat)abstract
- The extent to which affective empathy is impaired in Autism Spectrum Disorder (ASD) remains unclear, as some-but not all-previous neuroimaging studies investigating empathy for pain in ASD have shown similar activation levels to those of neurotypicals individuals. These inconsistent results could be due to the use of different empathy-eliciting stimuli. While some studies used pictures of faces exhibiting a painful expression, others used pictures of limbs in painful situations. In this study, we used fMRI to compare activation in areas associated with empathy processing (empathy network) for these two types of stimuli in 31 participants (16 with ASD, 15 controls). We found a group difference in the inferior frontal gyrus (IFG) and the thalamus when participants viewed stimuli of limbs in painful situations, but not when they viewed face stimuli with a painful expression. Both groups of participants activated their empathy network more when viewing pictures of limbs in painful situations than when viewing pictures of faces with a painful expression; this increased activation for limbs versus faces was significantly enhanced in controls relative to ASD participants, especially in the secondary somatosensory cortex (SII). Our findings suggest that empathy defect of people with ASD is contingent upon the type of stimuli used, and may be related to the level of Mirror Neuron System involvement, as brain regions showing group differences (IFG, SII) underlie embodiment. We discuss the potential clinical implications of our findings in terms of developing interventions boosting the empathetic abilities of people with ASD.
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| 428. |
- Lassalle, Amandine, et al.
(författare)
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Hypersensitivity to low intensity fearful faces in autism when fixation is constrained to the eyes.
- 2017
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Ingår i: Human brain mapping. - : Wiley. - 1097-0193 .- 1065-9471. ; 38:2, s. 5943-57
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies that showed decreased brain activation in people with autism spectrum disorder (ASD) viewing expressive faces did not control that participants looked in the eyes. This is problematic because ASD is characterized by abnormal attention to the eyes. Here, we collected fMRI data from 48 participants (27 ASD) viewing pictures of neutral faces and faces expressing anger, happiness, and fear at low and high intensity, with a fixation cross between the eyes. Group differences in whole brain activity were examined for expressive faces at high and low intensity versus neutral faces. Group differences in neural activity were also investigated in regions of interest within the social brain, including the amygdala and the ventromedial prefrontal cortex (vmPFC). In response to low intensity fearful faces, ASD participants showed increased activation in the social brain regions, and decreased functional coupling between the amygdala and the vmPFC. This oversensitivity to low intensity fear coupled with a lack of emotional regulation capacity could indicate an excitatory/inhibitory imbalance in their socio-affective processing system. This may result in social disengagement and avoidance of eye-contact to handle feelings of strong emotional reaction. Our results also demonstrate the importance of careful control of gaze when investigating emotional processing in ASD. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.
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| 429. |
- Leblond, Claire S, et al.
(författare)
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Both rare and common genetic variants contribute to autism in the Faroe Islands.
- 2019
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Ingår i: NPJ genomic medicine. - : Springer Science and Business Media LLC. - 2056-7944. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- The number of genes associated with autism is increasing, but few studies have been performed on epidemiological cohorts and in isolated populations. Here, we investigated 357 individuals from the Faroe Islands including 36 individuals with autism, 136 of their relatives and 185 non-autism controls. Data from SNP array and whole exome sequencing revealed that individuals with autism had a higher burden of rare exonic copy-number variants altering autism associated genes (deletions (p = 0.0352) or duplications (p = 0.0352)), higher inbreeding status (p = 0.023) and a higher load of rare homozygous deleterious variants (p = 0.011) compared to controls. Our analysis supports the role of several genes/loci associated with autism (e.g., NRXN1, ADNP, 22q11 deletion) and identified new truncating (e.g., GRIK2, ROBO1, NINL, and IMMP2L) or recessive deleterious variants (e.g., KIRREL3 and CNTNAP2) affecting autism-associated genes. It also revealed three genes involved in synaptic plasticity, RIMS4, KALRN, and PLA2G4A, carrying de novo deleterious variants in individuals with autism without intellectual disability. In summary, our analysis provides a better understanding of the genetic architecture of autism in isolated populations by highlighting the role of both common and rare gene variants and pointing at new autism-risk genes. It also indicates that more knowledge about how multiple genetic hits affect neuronal function will be necessary to fully understand the genetic architecture of autism.
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| 430. |
- Lee, D A, et al.
(författare)
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Psychological profile of children with Noonan syndrome.
- 2005
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Ingår i: Developmental Medicine and Child Neurology. - 0012-1622. ; 47:1, s. 35-38
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Tidskriftsartikel (refereegranskat)abstract
- A cohort of 48 children with Noonan syndrome, with a mean age of 9 years 10 months (SD 3y 7mo; 28 males, 20 females), was recruited from a national study. Children were assessed using the Wechsler Intelligence Scales and Test of Motor Impairment-Revised (TOMI-R). The Piers-Harris Self-evaluation Questionnaire was also completed in a subgroup of age-appropriate children. Children's parents and teachers completed the Rutter A and B scales to assess of the degree of behavioural and emotional problems respectively. Mean Full-scale IQ score was 84, and one-quarter of the participants had learning disabilities. Verbal IQ tended to be slightly lower than Performance IQ. About half of the group showed evidence of mild to moderate impairment, confirming the impression of 'clumsiness/developmental coordination disorder' on the TOMI-R. Level of self-esteem, as determined by the Piers-Harris Questionnaire, was comparable to that of a standardized population. This research has identified some characteristic psychological features in Noonan syndrome. However, a specific behavioural phenotype could not be identified.
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