The safety and tolerability of atypical antipsychotics in bipolar disorder

Atypical antipsychotics (aAPs), have become a first-line treatment option, both in schizophrenia and bipolar disorders. Almost all aAPs now have proven efficacy in acute mania, some also in bipolar depression and in maintenance treatment. This provides reliable data on their safety and tolerability in this particular group of patients. This review focuses on the safety and tolerability of aAPs in the treatment of bipolar disorders. Both tolerability, for example, extrapyramidal symptoms, and safety issues, for example, occurrence of weight gain and hyperglycaemia, will be highlighted for olanzapine, quetiapine, risperidone, ziprasidone and aripiprazole.     

儿童抽动症的病因分析

目的分析儿童抽动症的病因,以指导其治疗。方法对儿童抽动症患儿进行眼科检查、耳鼻喉科检查、鼻窦区摄片、头颅MRI、脑电图、微量元素、肺功能检查及支气管激发试验、气质评价、脑生物反馈检查以发现其病因。结果儿童抽动症的主要病因是精神因素,是躯体疾病后致习惯性抽动,其反复发作与儿童抽动症反复发作易并存。结论积极控制躯体疾病,减少躯体不适因素刺激后出现习惯性抽动,在儿童抽动症的治疗中很重要,临床治疗过程中将儿童抽动症的心理、药物治疗与躯体疾病的治疗同时进行可取得更好的临床效果。     

A primary study on feeding behaviors of autism model rat pups in the weaning period

It is well known that children with autistic spectrum disorder possess various behavioral problems related to feeding, short attention span and maladaptation to surrounding environments. This study aimed to identify appropriate measures to address behavioral characteristics associated with eating and feeding in children with ASD by examining feeding behavior throughout the weaning period in rat pup models of autism.Male Sprague–Dawley (SD) rats and healthy SD rats were nursed with their mothers until 14 days after birth. Then, the pups were divided into the following three groups and related in separate cages without their mothers: group A, two model rats; group B, a model rat and a control rat; and group C, two control rats. The number of meals ingested together and the number of body contact made with other rats at mealtime in each cage were counted from the 15th day to the 21st day. During this period, the body weight of each rat and the amount of food intake in each cage were also measured.These were no remarkable differences in body weight gain between the model rats and control rats. In addition, the amount of food intake was not statistically different among the three groups. The number of body contacts made was not significantly different between group B and group C; however, the number of body contacts made was significantly lower in group A than in the other two groups.These findings indicate that the rat pup models of autism displayed a feeding behavior similar to that of children with autism. These behavioral problems were improved by the inclusion of healthy rat pups in the same cage at the time of feeding.     

Comparison of change detection performance and visual search patterns among children with/without ADHD: Evidence from eye movements

BackgroundADHD participants showed poorer change detection performance compared to participants without any diagnosis. The difficulty to detect changes in ADHD children might be due to their voluntary eye movement control and attentional deficits.AimsTo evaluate change detection performance and visual search patterns of children with ADHD and compare their performances with typically developing (TD) children.Methods and procedures48 children (n_ADHD = 24, n_TD = 24) participated (M_age = 8 years, 10 months). Flicker paradigm was used to evaluate change detection performance, while eye movements were recorded during the experiment.ResultsChange detection accuracies of TD children were higher compared to ADHD children. TD groups made longer fixations on the changed area and their first fixation duration was also longer than ADHD children which showed that TD children had longer fixation maintenance than ADHD children.ConclusionsThe change detection performance, which is associated with visual attention and memory, was found to be worse in ADHD children than TD children and these children made shorter fixations on the changed area than TD children. The findings were found to be in line with the difficulty to sustain attention in ADHD children that is necessary for encoding the scene properties and goal-oriented behavior.     

Clinical Characteristics and Long-Term Outcomes of Movement Disorders in Childhood Thalamic Tumors

BackgroundWe studied the outcomes of movement disorders that were associated with childhood thalamic tumors.MethodsWe retrospectively reviewed 83 children with thalamic tumors treated at our institution from 1996 to 2013 to document the incidence and outcome of movement disorders. Magnetic resonance imaging was used to analyze the involvement of thalamic nuclei, and three instruments were used to rate the severity of the disorders.ResultsNine (11%) patients had one or more of the following movement disorders: postural tremor, resting tremor, ballism, dystonia, myoclonus, and athetosis. Median age at tumor diagnosis was seven years (range, 0.25 to 11 years), and the average age at movement disorder onset was eight years (range, 1.5 to 11 years). Movement disorders developed at a median of 1.5 months (range, 0 to 4 months) after surgical resection. The severity of the disorders was either unchanged or slightly improved during follow-up. The red nuclei were the only thalamic structures that showed tumor involvement in all nine patients.ConclusionsNo specific injury of the thalamic nuclei was associated with movement disorders in children with thalamic tumors, and the severity of these disorders did not change over time.     

Characterizing associations and dissociations between anxiety,social, and cognitive phenotypes of Williams syndrome

Williams syndrome (WS) is a neurogenetic disorder known for its “hypersocial” phenotype and a complex profile of anxieties. The anxieties are poorly understood specifically in relation to the social-emotional and cognitive profiles. To address this gap, we employed a Wechsler intelligence test, the Brief Symptom Inventory, Beck Anxiety Inventory, and Salk Institute Sociability Questionnaire, to (1) examine how anxiety symptoms distinguish individuals with WS from typically developing (TD) individuals; and (2) assess the associations between three key phenotypic features of WS: intellectual impairment, social-emotional functioning, and anxiety. The results highlighted intensified neurophysiological symptoms and subjective experiences of anxiety in WS. Moreover, whereas higher cognitive ability was positively associated with anxiety in WS, the opposite pattern characterized the TD individuals. This study provides novel insight into how the three core phenotypic features associate/dissociate in WS, specifically in terms of the contribution of cognitive and emotional functioning to anxiety symptoms.     

Sentencing Offenders with Foetal Alcohol Spectrum Disorder (FASD): The Challenge of Effective Management

The criminal justice system in Australia is increasingly being required to deal with offenders exhibiting the symptomatology of Foetal Alcohol Spectrum Disorder (FASD). Disproportionately they are indigenous. Diagnosis of the disorder is challenging and too frequently still not being made accurately. More challenging still is responding to it in the forensic system so that options for provision of suitable support are availed of, and thereby the risk of ongoing offending which puts the community at risk is minimised. This paper reviews the creative and compassionate judgment of the Western Australian Court of Appeal in Churnside v The State of Western Australia [2016] WASCA 146. It argues that the decision constitutes a model for the efforts that can and should be made by sentencing judges and magistrates required to deal with recidivist offenders with FASD.