Validating the Psychometric Characteristics of the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) in a Chinese Context

Background

Perinatal posttraumatic stress disorder (PPTSD) is a common stress-induced mental disorder worldwide. The Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) is an excellent questionnaire that measures the symptoms of PPTSD, but has not been translated into Chinese yet.

Consistency of the Moreau CLL score

Background

The Moreau score is essential for the diagnosis of B‐cell lymphoproliferative disorders (B‐LPD).

Methods

We assessed the consistency of the Moreau score in a series of 138 patients with at least two samples involved by a B‐LPD (316 samples) other than germinal center‐derived malignancies, hairy cell leukemia, and mantle cell lymphomas. Patients with evidence of two distinct B‐LPDs were also excluded.

Results

We found 53 inconsistencies in 44 of 138 (32%) patients. FMC7 was the most inconsistent (18 cases) and CD5 the least (5 cases). CD200 was inconsistent in 6 of 67 (9%) cases. The most important predictive factor for the finding of antigenic inconsistencies was sampling of a different anatomic site. Other factors, including number of samples, time between samples, or cytogenetic group, were not predictive. For the most part, these inconsistencies did not appear to be clinically relevant.

Conclusion

Inconsistencies in the Moreau score are common, supporting the importance of integrated laboratory diagnosis. However, the practical implications of these antigenic inconsistencies are probably limited.

     

Preliminary evidence of disparities in physical activity among adolescents with bipolar disorder

Physical activity can potentially mitigate the symptomatic burden and cardiovascular risk associated with bipolar disorder (BD). Studies have found that adults with BD are less physically active than controls. However, no previous study has examined this topic among adolescents with BD. This study compares physical activity among adolescents with BD vs. healthy controls without major psychiatric disorders, and examines characteristics associated with physical activity among adolescents with BD. Subjects were 86 adolescents with a diagnosis of BD via gold-standard psychiatric interviews, and 50 controls. The Quick Weight, Activity & Excess Screener (WAVE) was used to assess physical activity. Between-group analyses examined for differences in achieving recommended benchmarks for three types of physical activity: working out, “working in” (incidental physical activity), and screen time. Exploratory within-group analyses were based on a median split (high vs. low) of the total physical activity scores among BD adolescents. Adolescents with BD were significantly less likely to report working out regularly (6%) as compared to controls (22%; χ² = 7.98, p = 0.005). There were no significant between-group differences in working in or screen time. BD adolescents with low levels of physical activity were less likely to have a family history of substance use disorder (p = 0.03). Adolescents with BD are less likely than their peers to achieve the recommended benchmark for regular working out. Future studies are warranted to determine what factors explain this difference, and to identify strategies for optimizing physical activity among adolescents with BD.     

An investigation into the effects of different types of exercise on the maintenance of approach motivation levels

BackgroundThis study looked to investigate the interaction between exercise and approach motivation (AM) levels in a non-clinical sample as a first step towards investigating the impact of acute exercise upon hypomanic states within Bipolar Disorder. The Behavioural Activation System (BAS) dysregulation theory proposes that AM levels in individuals with Bipolar Disorder, are hyper-reactive to relevant cues and prone to fluctuation such that excessive levels underpin hypomania/mania. We hypothesise that exercise may interact with high AM levels to further increase AM levels in both the general population and individuals with BD, with this effect being exacerbated in the latter group. As an initial test of this theory we explore the impact of moderate and vigorous exercise and sedentary activity upon AM in an unselected student sample. We also tested the extent to which hypomania vulnerability predicts the impact of exercise.MethodParticipants were recruited from a University student population. After completing a measure of hypomanic personality traits, 61 participants completed a task designed to induce higher levels of AM before taking part in one of three 15 min activities (sedentary, moderate exercise or vigorous exercise). AM levels as well as variables relevant to hypomanic symptoms were measured prior to and post AM induction, at 5 min intervals during the activities and twice during a recovery period.ResultsVigorous exercise significantly increased individuals' AM levels in comparison to moderate or no exercise. No association was found between hypomania vulnerability and exercise impact.ConclusionsThese results provide a first step in investigating the possible risks associated with engaging in different intensities of exercise during a hypomanic episode. Any recommendations within this study should however be taken in light of the limitations identified. Further research replicating these results with a larger sample and among individuals with Bipolar Disorder is recommended.     

Oxytocin in the regulation of social behaviours in medial amygdala‐lesioned mice via the inhibition of the extracellular signal‐regulated kinase signalling pathway

The neuropeptide oxytocin (OXT) has been implicated in the pathophysiology of behavioural deficits among patients with autism spectrum disorder (ASD). However, the molecular mechanisms underlying its role in ASD remain unclear. In the present study, a murine model with ASD‐like phenotypes was induced by intra‐medial amygdala injection of N‐methyl‐d ‐aspartate, and it was used to investigate the role of OXT in behaviour regulation. Behavioural tests were performed to verify the ASD‐like phenotypes of N‐methyl‐d ‐aspartate‐treated mice, and the results showed that mice with bilateral medial amygdala lesions presented significant behavioural deficits, including impaired learning and memory and increased anxiety and depression. We also observed a notably decreased level of OXT in both the plasma and the hypothalamus of medial amygdala‐lesioned mice, and the extracellular signal‐regulated kinase (ERK) was activated. Further studies demonstrated that the administration of OXT alleviated ASD‐like symptoms and significantly inhibited phosphorylation of ERK; the inhibitory effect was similar to that of U0126, an ERK signalling inhibitor. In addition, OXT administration modulated the expression of downstream proteins of the ERK signalling pathway, such as cyclic adenosine monophosphate response element binding and c‐fos. Taken together, our data indicate that OXT plays an important role in ameliorating behavioural deficits in an ASD‐like mouse model, which was mediated by inhibiting the ERK signalling pathway and its downstream proteins.     

The diffusion of autism spectrum disorder in Costa Rica: Evidence of information spread or environmental effects?

In the U.S., children with autism spectrum disorder (ASD) have been found to live in spatial clusters. Studies have suggested that the clustering is caused by social or environmental factors, but determining the cause of the clustering is difficult in the U.S. setting because of unmeasured variation in healthcare access and diagnostic practices. The present study explores the diffusion of ASD in a small setting in which the diagnosis is not widely publicised and there is no variation in healthcare access or diagnostic practices. Costa Rica provides universal healthcare and only has one diagnosing clinic for young children, and the diagnosis is relatively new and little known among clinicians and parents. In addition, the potential for mercury exposure from the source that has been associated with ASD is absent, and areas with high levels of air pollution are spatially concentrated. Focusing on all young children who underwent an ASD assessment from 2010 to 2013, we identify spatial clusters that suggest a mechanism that does not depend on information about ASD, healthcare access, diagnostic practices, or environmental toxicants. These findings provide details of the “contextual drivers” of the increasing worldwide prevalence of ASD.     

儿童孤独症谱系障碍早期筛查管理模式研究

目的通过三级网络进行早期筛查早期诊断儿童孤独症谱系障碍(ASD)的管理模式研究,探讨ASD早期发现的网络筛查程序及管理流程,为ASD儿童获得早期干预提供有利的条件。方法成立市级ASD早期诊断管理中心,建立基层社区筛查一级网络及管理流程,进行社区筛查管理技术的指导及培训,再结合二、三级的筛查与诊断给予确诊。结果 1)社区一级网络ASD初筛率由2013年的20.19%上升到2014年的33.68%,呈逐年提高趋势,阳性率维持在4‰~6.0‰;确诊率由0.41‰上升到0.95‰。2)ASD早期诊断中心2年干预疑似患儿38例。结论三级网络ASD早期筛查的管理模式提高了社区儿保医生对ASD的初筛率,有利于ASD儿童的早期发现,为ASD儿童早期干预提供了最佳时期,是切实可行的ASD早期筛查管理模式。     

注意缺陷多动障碍共患数学学习困难儿童韦氏儿童智力结构特征

目的探讨合并数学困难(mathematical difficulties,MD)的注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童在韦氏儿童智力量表第四版(Wechsler Intelligence Scale for Children-The Fourth Vision,WISC-Ⅳ)中的智力结构特征。方法选取根据美国《精神障碍诊断和统计手册第四版》(Diagnostic and Statistical Manual,DSM-Ⅳ)诊断标准确诊为ADHD且数学成绩低于同年级P10、语文成绩不低于同年级P50的儿童30名,并按性别、年龄匹配抽取确诊为ADHD且语文、数学成绩不低于同年级P25的30名作为对照组。使用WISC-Ⅳ对两组儿童的智力结构特点进行比较。结果研究组儿童总智商及四指数均低于对照组儿童(P0.05),两组儿童在字母-数字排序、背数、译码、矩阵推理、积木、理解等分测验的差异有统计学意义(P0.05)。结论 WISC-Ⅳ可以全面评估儿童的一般认知功能,MD-ADHD儿童有独特认知特点,应根据与数学能力相关的认知缺陷进行个体化的科学干预。