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The association of psychiatric disorders (PDs) with other PDs and medical disorders (MDs) has been insufficiently explored in children and adolescents.
To estimate medical and psychiatric comorbidity present in children with PDs and to determine the medical service usage of children with PDs.
We use administrative health care data to describe the h...
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Background
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Background
Hydrops fetalis, a pathological fluid accumulation in two or more body compartments, is aetiologically heterogeneous. We investigated a consanguineous family with recurrent pregnancy loss due to severe early-onset non-immune hydrops fetalis.
Methods and results
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Citations
... ISSN 2221-2582 ния, послужившим поводом для госпитализации [1]. В опубликованной в 2018 г. статье Л.Б. ...
Приведена выписка из истории болезни 17-летнего подростка с коморбидностью — патологией 4 систем, включая пищеварительную, выделительную, иммунную и нервную системы. Сделана попытка найти общее звено патогенеза — несостоятельность мезенхимальной ткани. Предложен план дополнительного обследования для подтверждения этой гипотезы. Обоснована необходимость совместного обследования детей с коморбидной патологией группой специалистов соответствующих профилей.
An extract from the medical history of a 17-year-old teenager with comorbidity is given — pathology of 4 systems, including the digestive, excretory, immune and nervous systems. An attempt was made to find a common link in pathogenesis — the failure of mesenchymal tissue. An additional survey plan has been proposed to confi rm this hypothesis. The need for a joint examination of children with comorbid pathology by a group of specialists of the relevant profiles is justified.
... However, ASD was not included in that study while several demographic variables, such as socioeconomic factors were not accounted for. Thus far, data of somatic comorbidities in children and adolescents with broader psychiatric diagnoses are relatively sparse and allow no firm conclusions due to limited numbers of participants and/ or a lack of robust methodological design [4,19,20]. As such, a clear picture about the impact of somatic comorbidities in child psychiatric services is missing. ...
Many children with psychiatric disorders display somatic symptoms, although these are frequently overlooked. As somatic morbidity early in life negatively influences long-term outcomes, it is relevant to assess comorbidity. However, studies of simultaneous psychiatric and somatic assessment in children are lacking. The aim of this study was to assess the prevalence of somatic comorbidities in a clinical sample of children and adolescents with psychiatric disorders in a naturalistic design. Data were assessed from 276 children with various psychiatric disorders (neurodevelopmental disorders, affective disorders, eating disorders and psychosis) aged 6–18 years. These data were collected as part of routine clinical assessment, including physical examination and retrospectively analyzed. For a subsample (n = 97), blood testing on vitamin D3, lipid spectrum, glucose and prolactin was available. Results of this cross-sectional study revealed that food intake problems (43%) and insomnia (66%) were common. On physical examination, 20% of the children were overweight, 12% displayed obesity and 38% had minor physical anomalies. Blood testing (n = 97) highlighted vitamin D3 deficiency (< 50 nmol/L) in 73% of the children. None of the predefined variables (gender, age, medication and socioeconomic factors) contributed significantly to the prevalence of somatic comorbidities. The main somatic comorbidities in this broad child- and adolescent psychiatric population consisted of (1) problems associated with food intake, including obesity and vitamin D3 deficiency and (2) sleeping problems, mainly insomnia. Child and adolescent psychiatrists need to be aware of potential somatic comorbidities and may promote a healthy lifestyle.
... However, ASD was not included in that study while several demographic variables, such as socioeconomic factors were not accounted for. Thus far, data of somatic comorbidities in children and adolescents with broader psychiatric diagnoses are relatively sparse and allow no rm conclusions due to limited numbers of participants and/ or a lack of robust methodological design [4,19,20]. As such, a clear picture about the impact of somatic comorbidities in child psychiatric services is missing. ...
Many children with psychiatric disorders display somatic symptoms, although these are frequently overlooked. As somatic morbidity early in life negatively influences long-term outcomes, it is relevant to assess comorbidity. However, studies of simultaneous psychiatric and somatic assessment in children are lacking. The aim of this study was to assess the prevalence of somatic comorbidities in a clinical sample of children and adolescents with psychiatric disorders in a naturalistic design. Data were assessed from 276 children with various psychiatric disorders (neurodevelopmental disorders, affective disorders, eating disorders and psychosis) aged 6–18 years. These data were collected as part of routine clinical assessment, including physical examination and retrospectively analyzed. For a subsample (n = 97), blood testing on vitamin D3, lipid spectrum, glucose and prolactin was available. Results of this cross-sectional study revealed that food intake problems (43%) and insomnia (66%) were common. On physical examination, 20% of the children were overweight, 12% displayed obesity and 38% had minor physical anomalies. Blood testing (n = 97) highlighted vitamin D3 deficiency (< 50 nmol/L) in 73% of the children. None of the predefined variables (gender, age, medication and socioeconomic factors) contributed significantly to the prevalence of somatic comorbidities. The main somatic comorbidities in this broad child- and adolescent psychiatric population consisted of (1) problems associated with food intake, including obesity and vitamin D3 deficiency and (2) sleeping problems, mainly insomnia. Child and adolescent psychiatrists need to be aware of potential somatic comorbidities and may promote a healthy lifestyle.
... In the general pediatric population, there is growing evidence of associations between mental health problems and different genitourinary symptoms. Using administrative health care data, a study conducted among more than 400,000 children living in Alberta, Canada, revealed that girls (aged 6 through 17 years) who had menstrual problems or diseases of the genitourinary system were up to three times more at risk of also receiving a diagnosis for either behavioral, emotional or psychotic psychiatric disorders (Spady, Schopflocher, Svenson, & Thompson, 2005). ...
Objective:
The present study aimed to determine whether psychiatric comorbidity (i.e., diagnostic comorbidity in eight categories of mental and behavioral disorders) mediates the relationship between childhood sexual abuse (CSA) and diseases of the genitourinary system (International Statistical Classification of Diseases and Related Health Problems, 10th revision) among girls.
Method:
Using a prospective matched-cohort design, we documented diagnoses given by a physician after a medical consultation or hospitalization for diseases of the genitourinary system, for 661 sexually abused girls and 661 matched controls via administrative databases covering the period between January 1996 and March 2013. Path analyses using negative binomial regressions with CSA as independent variable, psychiatric comorbidity as mediator and genitourinary diseases diagnoses as dependent variables were performed.
Results:
After controlling for socioeconomic level, prior genitourinary diseases and number of years of medical data, the mediation effect for the path from CSA to genitourinary diseases through psychiatric comorbidity was significant for the urinary system (b = .125, 95% confidence interval [0.057, 0.192]) as well as for the genital system (b = .213, 95% confidence interval [0.141, 0.285]). Psychiatric comorbidity carried 62% of the sexual abuse total effect on the number of diagnoses received for genital diseases, whereas it carried 23% of the sexual abuse total effect on the number of diagnoses received for urinary diseases.
Conclusions:
Findings suggest that CSA may have an indirect effect on girls' diagnosed genitourinary diseases during a medical consultation or hospitalization through the increased risk for psychiatric comorbidity. Early interventions aimed at addressing psychological distress among sexually abused girls might prevent the emergence of genitourinary diseases years after the abuse. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
... В ранних работах коморбидность определялась как одновременное сосуществование или последовательное развитие у пациента двух и более независимых друг от друга патологий, ни одна из которых не является осложнением другой [2]. В более поздних определениях допускалось, что сочетающиеся заболевания являются патогенетически взаимосвязанными, могут являться осложнениями, возникшими вследствие основного заболевания или его лечения [2,3]. H.C. Kraemer и M. van den Akker определили коморбидность как наличие у одного пациента одновременно двух или более хронических заболеваний, патогенетически связанных между собой или совпадающих по времени независимо от активности каждого из них [1,[3][4][5]. ...
... В более поздних определениях допускалось, что сочетающиеся заболевания являются патогенетически взаимосвязанными, могут являться осложнениями, возникшими вследствие основного заболевания или его лечения [2,3]. H.C. Kraemer и M. van den Akker определили коморбидность как наличие у одного пациента одновременно двух или более хронических заболеваний, патогенетически связанных между собой или совпадающих по времени независимо от активности каждого из них [1,[3][4][5]. Внимание к таким нарушениям у пациентов с эпилепсией нашло отражение и в определении Эп, где заболевание представляется не только как судорожные приступы, но и как расстройство с широким спектром нейробиологических, когнитивных, психологических и социальных аспектов [6,7]. Таким образом, общепринятой терминологии коморбидности из-за разного понимания патогенетических механизмов множественных заболеваний у одного человека пока не выработано, поэтому, несмотря на продолжающиеся дискуссии исследователей, в настоящее время термин «коморбидность» используется для обозначения любой сочетанной патологии. ...
... However, a few populationbased as well as clinical studies have shown increased somatic illness in children and adolescents with psychiatric disorders. [12][13][14][15]. Goodwin et al. found an association between mental illness during childhood and chronic somatic illnesses such as asthma, overweight and epilepsy in young adulthood [16]. ...
... Psychiatric diagnoses included were chosen to cover common childhood psychiatric conditions. Somatic diagnoses were selected in part based on previous studies [12,13] and in part exploratory. Somatic illness diagnosed in 2011-2013 was compared between individuals with and without psychiatric diagnose in 2011-2013. ...
In the adult population, psychiatric disorders are associated with somatic illness. Explanatory life style factors have been found, but also a failure to recognize somatic illness in this group. Another factor is side effects from long-term use of antipsychotic drugs. Given the psychiatric-somatic comorbidity in the adult population, it is of interest to investigate whether an association exists already during childhood. The aim of the present study was to investigate the frequency of somatic illness in children and adolescents with a psychiatric diagnose. Data were obtained from the regional health care database Vega, Sweden. Psychiatric and somatic diagnoses obtained during 2011–2013 for individuals aged 3–18 years were extracted. Descriptive statistics were used to examine difference in somatic morbidity between children with and without psychiatric diagnoses. Logistic regression was used in age-stratified models to test the association between psychiatric and somatic diagnoses. Anxiety and behavioral disorders were associated with all somatic conditions investigated at nearly all ages. The same applied to substance use, investigated at age 9–18 years. Affective disorders were associated with all somatic conditions at age 12–18 years. Psychotic conditions were associated with asthma, bowel disorders and myalgia in adolescents. Children with psychiatric disorders are at remarkably high risk for concurrent somatic illness. The associations span across many types of conditions and across all ages. The results support the need for awareness of somatic morbidity in child and adolescent psychiatric clinical settings, and the need for coordinated health care for children with comorbid states.
... Анализ результатов современных отечественных и зарубежных исследований показывает высокую коморбидность соматической и психической патологии во всех возрастных группах. По мнению ряда авторов, до половины всех жалоб, предъявляемых врачу общего профиля (терапевту и педиатру), относятся к психосоматическому спектру, затрудняют диагностику и лечение основного расстройства [1,2,3,4]. ...
... In particular, they reported a 9.6% prevalence of mental disorders in children affected with sinusitis; interestingly, a similar prevalence was reported for asthma and bronchitis and, actually, only 6 medical categories (pregnancy, abortion, menstrual problems, contraception, poisoning, developmental delay) out of 30 showed a prevalence of neuropsychiatric disorders > 20% and an odds ratio > 2, suggesting a significant association. [7] In conclusion, I think that there is still a long way before we can state a real and significant association between sinusitis itself and neuropsychiatric symptoms. Of course, a rigorous selection of patients is important to control the clinical variables leading to potential bias in the analysis, but the presence of pre-existing behavioral problems in most children (as occurred in the present study by Mahoni T et al.) must be appropriately considered, too. ...
... Many children and adolescents have both physical and mental disorders, and it has been found that the majority of children and adolescents with medical problems have higher levels of mental disorders (20), suggesting that having a chronic health condition, such as overweight, may increase the likelihood of mental health issues and concerns. In fact, one recent study found serious adverse consequences of overweight on health-related quality of life (HRQOL) in a clinical sample of severely overweight (BMI: 34.7) children and adolescents 5 to 15 years of age (21). ...
... Specifically, there was a trend for adolescents with positive SCARED-C screens being more likely to have asthma, which is in accordance with a previously reported relationship between asthma and anxiety disorders. [34][35][36][37][38] In one prior investigation, as many as one in four patients attending a pediatric asthma clinic met criteria for a probable anxiety disorder. 39 In addition, we examined three common somatic complaints in anxious youthabdominal pain, headache or migraine, and chest pain. ...
Adolescence is a time of increasing risk for some anxiety disorders. Scant data exist on adolescent anxiety in emergency department (ED) settings. We sought to characterize select clinical characteristics and health care use associated with anxiety disorders in a pediatric ED.
We screened a convenience sample of 100 adolescent-parent dyads presenting to the ED for the presence of child anxiety disorders using the 5-item Screen for Child Anxiety Related Emotional Disorders, parent (SCARED-P) and child (SCARED-C) versions. Additional demographic and clinical data were also collected.
The SCARED-P and SCARED-C screens identified probable anxiety disorder(s) in 26% to 33% of adolescent participants, respectively. Correlates of positive SCARED-C screens were female sex, asthma, presenting complaint involving headache or migraine, and school absenteeism due to physical problems. Correlates of positive SCARED-P screens were lower parental educational level, presenting complaint involving headache or migraine, and more medical specialty and total medical visits. Few anxious adolescents had received mental health services in the past 6 months. In multivariate models, female sex was independently associated with SCARED-C total score, and presenting complaint involving headache or migraine was independently associated with SCARED-P total score.
The current pilot data suggest that anxiety disorders are more prevalent among adolescent ED patients than among the general population but largely untreated. Several demographic and clinical variables may help to identify occult anxiety disorders. Greater awareness of anxiety disorders in this population may assist in redirecting a pattern of low use of mental health services but higher overall health care use.
