The authors present a review of literature on the initial rationale and efficacy in clinical trials of carbamazepine (CBZ) in the treatment of alcohol withdrawal, and the pharmacokinetics of carbamazepine in alcoholics as well. Neurophysiological and clinical studies support the kindling hypothesis in the pathophysiology of alcohol withdrawal. The exact physiological action mechanism of CBZ has not been entirely examined. However, the "antikindling effects" are of particular importance in epilepsy and other neurological and psychiatric conditions. Numerous controlled studies were able to demonstrate the effectiveness of carbamazepine in the treatment of alcohol withdrawal symptoms and have compared its properties to other drugs such as clomethiazole and benzodiazepines. Carbamazepine could be a useful alternative to conventional therapeutic approaches, especially in the treatment of mild and moderate alcohol withdrawal symptoms, and alcohol withdrawal with generalized tonic-clonic seizures.
The aims of the study were to evaluate the prevalence of psychiatric, behavioral and emotional disorders in children and adolescents with perinatal HIV infection and to establish their possible relationships with clinical and sociodemographic variables.56 children with perinatal HIV infection (PHIV+ group), 24 healthy children perinatally HIV-exposed but uninfected (PHEU) and 43 healthy children of uninfected parents (HIV-nA), aged 6-18 years, were assessed. The Child Behavior Checklist (CBCL/4-18), completed by parents, and the Youth Self-Report (YSR) were used to assess behavioral and emotional disorders, while the semi-structured diagnostic interview K-SADS-PL was used to assess the symptoms of psychiatric disorders.Higher prevalence of psychiatric disorders was found in the PHIV+ group and the PHEU group compared to the HIV-nAgroup. Anxiety disorders and affective disorders were diagnosed most often. Prevalence of symptoms of emotional and behavioral disorders in the PHIV+ group and in the PHEU group was associated with similar sociodemographic variables (male, not living with the biological caregiver, the experience of stressful life events). Psychiatric disorders were noted more often among PHIV+ subjects whose ARV treatment was started after 12 months of age. Positive correlations were observed between the results of some YSR and CBCL/4-18 problem scales and CD4 counts at the time of the study, higher logarithm of viral load at the start of ARV treatment and at the time of HIV diagnosis.The prevalence of psychiatric disorders in PHIV+ group and the PHEU group is higher in comparison with HIV-nAgroup. Amore serious course of HIV infection and its severity before treatment are associated with the severity of internalizing problems.
To assess attachment styles among adolescents (13-16 years) with ADHD or ADHD and oppositional defiant disorders (ODD).The Parents and Peers Attachment (IPPA) and the Parent Bonding Questionnaire (PBI) were used in three groups of teenagers raised in biological families: (1) ADHD/ODD group (n = 40), (2) ADHD group (n = 40) and (3) K (control) group of teenagers (n = 40) who have not benefited from psychological or psychiatric care in the past or at present.Parental attachment styles in the area of "Trust", "Communication" and "Alienation" (IPPA), and "Care" and "Control" (PBI) in the ADHD/ODD group differ significantly compared to the control group. Teens from the ADHD/ODD group report to have experienced significantly less "Trust" and "Communication" (IPPA), and "Care" (PBI) in relationships with parents and more "Alienation" (IPPA) and "Control" (PBI) than adolescents in the ADHD group. Attachment patterns with peers in both clinical and control groups differ significantly. The ADHD/ODD group is dominated by the anxious-avoidant style of attachment to the mother and father, in the ADHD group, a secure style in relation to the mother and anxious-avoidant in relation to the father. In relations with peers in the ADHD/ODD group and the ADHD group, the anxious-avoidant style dominates.The attachment style is significantly different in adolescents diagnosed with ADHD and ODD than in adolescents with only ADHD. In the ADHD/ODD group and the ADHD group, unlike in the group of adolescents without a psychiatric diagnosis, insecure attachment styles for parents and peers dominate (mainly anxious-avoidant style).
There is a growing need for multicultural collaboration in child mental health services, training, and research. To facilitate such collaboration, this study tested the 8-syndrome structure of the Child Behavior Checklist (CBCL) in 30 societies. Parents' CBCL ratings of 58,051 6- to 18-year-olds were subjected to confirmatory factor analyses, which were conducted separately for each society. Societies represented Asia; Africa; Australia; the Caribbean; Eastern, Western, Southern, and Northern Europe; the Middle East; and North America. Fit indices strongly supported the correlated 8-syndrome structure in each of 30 societies. The results support use of the syndromes in diverse societies.
Monogenic diabetes caused by mutation in the glucokinase gene (GCK-MD) is a rare disorder manifesting in childhood as mild, prevalent hyperglycemia. By consensus, it is managed by dietary supervision and infrequent consultations. However, its impact on the mental health of the affected children is largely unknown.To estimate the prevalence of psychiatric comorbidities in children with monogenic glucokinase-related diabetes (GCK-MD) and evaluate their association with quality of life (QoL).The study invited children with GCK-MD aged 5-18 years identified in the Central National Registry and treated in 3 pediatric diabetes centers in Poland. The control group comprised children with type 1 diabetes (T1D, the most common diabetes type in youth) matched for age and family history of diabetes. Participants underwent a semistructured clinical interview diagnostic for psychiatric comorbidities, questionnaires assessing behavioral problems, depressive symptoms, parental stress, and measuring general and diabetes-related QoL (PedsQl).We included 35 patients with GCK-MDMD and 199 with T1D. Eight (22.9%) GCK-MD patients were diagnosed with psychiatric disorder in their lifetime, compared with 16 (8.1%) in the T1D group (odds ratio 3.4 [95% confidence interval: 1.3-8.7]). Patients with GCK-MD showed better parent-reported general QoL (87.1 ± 11.9 vs 82.0 ± 14.0, P = 0.0060) and higher diabetes-related QoL in both parental (84.5 ± 13.8 vs 74.1 ± 15.2, P < 0.0001) and child's perspective (87.6 ± 10.9 vs 77.3 ± 13.9, P < 0.0001). Psychiatric disorders (+P) were associated with worse child-reported diabetes QoL (T1D+P 66.6 ± 16.7, T1D-P 78.2 ± 13.3, GCK-MD+P 79.6 ± 16.3, GCK-MD-P 90.1 ± 7.5, P = 0.0002).High prevalence of psychiatric disorders in children with GCK-MD and lower QoL emphasizes the need for psychologic surveillance in those otherwise mildly-treated patients.
Assessment of the prevalence of risk factors associated with the course of pregnancy and childbirth and the condition of the child after birth in agroup of children and adolescents with ADHD and a control group.205 unrelated children and adolescents diagnosed with ADHD and 106 primary and secondary school students aged 7-17. Method. Mothers of children and adolescents diagnosed with ADHD, and those from the control group, were asked to provide a medical history in order to obtain data to supplement the Pregnancy and perinatal history questionnaire.Statistically significant differences (p < 0.05) were demonstrated for the incidence rates of factors related to the course of pregnancy and childbirth such as: the occurrence of maternal diseases during pregnancy, especially in the I/II trimester, and other problems during pregnancy; exposure to stress and taking medication during pregnancy; smoking during pregnancy; mother's age at childbirth, i.e., < 25 years or > 35 years; use of pain reducing substances during labor and problems with the child during the delivery;an APGAR score in the range of 5-7 points; the occurrence of neonatal jaundice necessitating treatment, especially replacement transfusion; physical anomalies or other congenital problems in the newborn, as well as adaptive problems necessitating neonatal oxygen administration or placement in an incubator.Significantly more frequent occurrence of risk factors related to the course of pregnancy, childbirth and the child's condition after birth in the ADHD group may indicate their potential role in the etiology of ADHD.
We used population sample data from 25 societies to answer the following questions: (a) How consistently across societies do adolescents report more problems than their parents report about them? (b) Do levels of parent-adolescent agreement vary among societies for different kinds of problems? (c) How well do parents and adolescents in different societies agree on problem item ratings? (d) How much do parent-adolescent dyads within each society vary in agreement on item ratings? (e) How well do parent-adolescent dyads within each society agree on the adolescent's deviance status? We used five methods to test cross-informant agreement for ratings obtained from 27,861 adolescents ages 11 to 18 and their parents. Youth Self-Report (YSR) mean scores were significantly higher than Child Behavior Checklist (CBCL) mean scores for all problem scales in almost all societies, but the magnitude of the YSR-CBCL discrepancy varied across societies. Cross-informant correlations for problem scale scores varied more across societies than across types of problems. Across societies, parents and adolescents tended to rate the same items as low, medium, or high, but within-dyad parent-adolescent item agreement varied widely in every society. In all societies, both parental noncorroboration of self-reported deviance and adolescent noncorroboration of parent-reported deviance were common. Results indicated many multicultural consistencies but also some important differences in parent-adolescent cross-informant agreement. Our findings provide valuable normative baselines against which to compare multicultural findings for clinical samples.
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