Potential for oxytocin use in children and adolescents with mental illness

Neurodevelopmental impairments in children with septo-optic dysplasia spectrum conditions: a systematic review

BACKGROUND

Septo-optic dysplasia (SOD) is a rare condition diagnosed in children with two or more of the following: hypopituitarism, midline brain abnormalities, and optic nerve hypoplasia. Children with SOD experience varied visual impairment and endocrine dysfunction. Autistic-like behaviours have been reported; however, their nature and prevalence remain to be fully understood. The present systematic review aimed to explore the type and prevalence of neurodevelopmental impairments in children with SOD spectrum conditions.

METHODS

The search was conducted in PubMed, EMBASE, and PsycInfo. Hand-searching reference lists of included studies was conducted. All peer-reviewed, observational studies assessing behavioural and cognitive impairments or autism spectrum disorder (ASD) symptoms in children (< 18 years) with SOD, optic nerve hypoplasia, and SOD-plus were included. Studies were excluded if they did not report standardised measures of neurodevelopmental impairments or ASD outcomes.

RESULTS

From 2132 screened articles, 20 articles reporting data from a total of 479 children were included in prevalence estimates. Of 14 studies assessing cognitive-developmental outcomes, 175 of 336 (52%) children presented with intellectual disability or developmental delay. A diagnosis of ASD or clinical level of symptoms was observed in 65 of 187 (35%) children across five studies. Only five studies assessed for dysfunction across behavioural, emotional, or social domains and reported impairments in 88 of 184 (48%) of children assessed.

LIMITATIONS

Importantly, high heterogeneity among the samples in relation to their neuroanatomical, endocrine, and optic nerve involvement meant that it was not possible to statistically assess the relative contribution of these confounding factors to the specific neurodevelopmental phenotype. This was further limited by the variation in study designs and behavioural assessments used across the included studies, which may have increased the risk of information bias.

CONCLUSIONS

This systematic review suggests that the prevalence of neurodevelopmental impairments in children within the SOD spectrum may be high. Clinicians should therefore consider including formal assessments of ASD symptoms and neurodevelopmental impairments alongside routine care. There is, additionally, a need for further research to define and validate a standardised battery of tools that accurately identify neurodevelopmental impairments in SOD spectrum conditions, and for research to identify the likely causal mechanisms.

Interdisciplinary Approach to Biological and Health Implications in Selected Professional Competences

Everyday life’s hygiene and professional realities, especially in economically developed countries, indicate the need to modify the standards of pro-health programs as well as modern hygiene and work ergonomics programs. These observations are based on the problem of premature death caused by civilization diseases. The biological mechanisms associated with financial risk susceptibility are well described, but there is little data explaining the biological basis of neuroaccounting. Therefore, the aim of the study was to present relationships between personality traits, cognitive competences and biological factors shaping behavioral conditions in a multidisciplinary aspect. This critical review paper is an attempt to compile biological and psychological factors influencing the development of professional competences, especially decent in the area of accounting and finance. We analyzed existing literature from wide range of scientific disciplines (including economics, psychology, behavioral genetics) to create background to pursuit multidisciplinary research models in the field of neuroaccounting. This would help in pointing the best genetically based behavioral profile of future successful financial and accounting specialists.

Effects of Pet Therapy in Elderly Patients with Neurocognitive Disorders: A Brief Review

Introduction

Neurocognitive disorders (NCDs) are disturbances highly related to age. This means that, with the increasing trend in life expectancy, there is also an increase in this diagnosis, although NCDs are not exclusively found in the population over 65 years old. Likely, they will increase in the coming years together with improvements in diagnosis. In addition to the use of medicines and rehabilitative techniques, pet therapy is also used. Pet therapy makes use of animals with therapeutic, rehabilitative, educational, and recreational purposes for people affected by physical, neuromotor, and psychiatric disorders. Pet therapy seems to be functional for increasing social and communication competencies, facilitating verbal and body language, increasing self-esteem, improving quality of life, and reducing anxiety/stress.

Methods

This study was based on scientific papers and publications obtained from the PubMed and Google Scholar databases. Moreover, other articles from further cross-references were included. Specific database research criteria were (a) articles published in 2018 or later, (b) samples containing only adults over 65 years old, (c) written in English or Italian, and (d) on the topic of animal-assisted intervention.

Results

Uncertain results were obtained. Although a positive effect was found, the included articles were of insufficient methodological rigor.

Discussion/Conclusion

Although many studies reported positive results, these could not be generalized because of the numerous biases present (e.g., small sample size, lack of methodological rigor, lack of protocol, etc.). Future studies, therefore, should seek to address the limitations found in the analyzed studies.

Early Signs of Emotional Recognition Deficits in Adolescent High-Binge Drinkers

Background: Emotional dysregulation, measured with face recognition tasks, is prevalent in alcohol use disorders (AUD), constituting a risk factor for alcohol use and relapse. It is not clear however whether emotional dysregulation is a by-product of alcohol consumption, or if it can act as a predisposing factor for AUD. Objective: Our aim was to examine early signs of emotional dysregulation in adolescent drinkers. Method: Twenty-four high-school students and 24 university students completed two tasks. On the first one, participants had to gradually increment the emotional content of different faces until they could perceive an emotional expression (emotion perception threshold task). We also examined the propensity to perceive fearful expressions in an emotion identification task. Participants were semantically primed with emotion words (i.e., "fear"), and they then had to indicate whether a neutral-fearful facial composite matched the prime. Results: Using repeated-measures ANOVAS, in the emotion perception threshold task, "happy" faces were the easiest to detect and "sad" ones the hardest. For high school students there was a differential response pattern depending on binge scores, such that High-binge drinkers found it easier to detect a sad face but harder to detect a happy one compared to Low-binge drinkers. In the facial emotion identification task, Low-binge drinkers observed more fearful expressions compared to High-binge drinkers. Conclusions: Differences in emotional processing in young adolescents depending on drinking habits point towards the relevance of emotional dysregulation as an early sign of AUD. These findings could help develop novel diagnostic and treatment tools for young populations.

Paradoxical Effects of Intranasal Oxytocin on Trust in Inpatient and Community Adolescents

Research suggests that oxytocin, a neuropeptide implicated in attachment, is a promising clinical tool because it increases affiliation and attachment behaviors, which are reduced in a range of psychiatric disorders. Oxytocin has been recommended as a psychiatric treatment for adolescents, but this remains largely unstudied. Skepticism is warranted, based on mixed findings in adults and absence of data across development. The objective of this study was to examine the effect of intranasal oxytocin on attachment-related and non-attachment-related trust in an interactive game, determining how this effect differs among inpatient adolescents and healthy controls and whether this effect is moderated by attachment security. There were 122 adolescents (ages 12-17; n = 75 inpatient, 70% female, 37% Black, 24% Hispanic, 20% White, and 20% multiracial; n = 46 control, 55% female, 75% Caucasian) randomized to receive self-administered intranasal oxytocin or a placebo and play a trust game with their mother and a stranger over the Internet. Oxytocin only affected the trust game behavior of adolescents when attachment security was moderate or low. At these levels, oxytocin increased the trust of patients, such that their behavior was equivalent to that of healthy controls. Paradoxically, oxytocin reduced the investments of healthy control subjects. This study takes a first step toward determining whether, and for whom, oxytocin may have a trust-enhancing effect and challenges simplistic notions of oxytocin as the attachment-chemical of the brain-pointing instead to differential oxytocin effects based upon clinical status (patient vs. control) and attachment security.

Adolescent oxytocin response to stress and its behavioral and endocrine correlates

Oxytocin (OXT) shows anxiolytic and stress-reducing effects, but salivary OXT response to laboratory-induced stress has only been assessed in one study in healthy adults. The present study aimed at extending these findings by assessing salivary OXT stress reactivity in healthy adolescents (aged 11-18) compared to a control condition. A higher salivary OXT response to stress compared to the control condition was expected. In addition, the association between OXT, cortisol (CORT) and psychological reactivity patterns was explored. Psychosocial stress was induced using the Trier Social Stress Test (TSST; 13 males, 15 females), while the Control-TSST (14 males, 15 females) served as a non-stress control condition. Salivary OXT increased in response to the TSST with a peak at +1 and decline at +10 min after stress. Baseline OXT correlated negatively with experienced anxiety and insecurity, while both correlated positively with OXT reactivity. OXT and CORT increase as well as OXT increase and CORT recovery were positively correlated. Results indicate that salivary OXT in response to the TSST is a valid method to assess biological effects of laboratory-induced stress also in adolescents. Due to a rapid increase and decline, salivary OXT needs to be assessed directly after stress exposure. Given the interplay of OXT with affective symptoms and CORT response, the combined measure of salivary OXT and CORT reactivity adds to studying stress reactivity in typically developing and clinical samples.

[Oxytocin and the mechanisms of alcohol dependence]

One of the crucial purposes of treating alcohol-dependent patients is to enhance their ability to stay abstinent after detoxification therapy. Anxiety and stress vulnerability are the main factors provoking alcohol craving and relapse. In the first months of abstinence, alcohol-dependent patients frequently show sleep disturbances, irritability and depression, indicating chronic activation of stress pathways. In addition, the loss of confidence in interpersonal interactions results in social withdrawal and reduced willingness to participate in therapeutic programs.Current research shows that the peptide hormone oxytocin exerts substantial anxiolytic effects and facilitates prosocial behavior. Oxytocin can be safely applied as intranasal preparation. Oxytocin acts by inhibiting the effects of the corticotropin-releasing factor on GABAergic interneurons in the amygdala and paraventricular nucleus of hypothalamus.Recent research strongly suggests that application of oxytocin may beneficially influence the mechanisms of relapse and craving by reduction of anxiety, stress vulnerability and social withdrawal in abstinent alcohol-dependent patients.This article reviews neurobiological mechanisms of oxytocin effects on stress-related pathways and discusses the potential use of oxytocin in the treatment of alcohol addiction.

Hypnosis for induction of labour

BACKGROUND

Induction of labour using pharmacological and mechanical methods can increase complications. Complementary and alternative medicine methods including hypnosis may have the potential to provide a safe alternative option for the induction of labour. However, the effectiveness of hypnosis for inducing labour has not yet been fully evaluated.

OBJECTIVES

To assess the effect of hypnosis for induction of labour compared with no intervention or any other interventions.

SEARCH METHODS

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2014), handsearched relevant conference proceedings, contacted key personnel and organisations in the field for published and unpublished references.

SELECTION CRITERIA

All published and unpublished randomised controlled trials (RCTs) and cluster-RCTs of acceptable quality comparing hypnosis with no intervention or any other interventions, in which the primary outcome is to assess whether labour was induced.

DATA COLLECTION AND ANALYSIS

Two review authors assessed the one trial report that was identified (but was subsequently excluded).

MAIN RESULTS

No RCTs or cluster-RCTs were identified from the search strategy.

AUTHORS' CONCLUSIONS

There was no evidence available from RCTs to assess the effect of hypnosis for induction of labour. Evidence from RCTs is required to evaluate the effectiveness and safety of this intervention for labour induction. As hypnosis may delay standard care (in case standard care is withheld during hypnosis), its use in induction of labour should be considered on a case-by-case basis.Future RCTs are required to examine the effectiveness and safety of hypnotic relaxation for induction of labour among pregnant women who have anxiety above a certain level. The length and timing of the intervention, as well as the staff training required, should be taken into consideration. Moreover, the views and experiences of women and staff should also be included in future RCTs.

Oxytocin administered during labor and breast-feeding: a retrospective cohort study

OBJECTIVE

The relationship between labor physiology and the onset of lactation leads to assess the potential correlation between oxytocin administration during labor and duration of breast-feeding.

METHODS

This study was designed as a retrospective cohort study where patients given synthetic oxytocin during labor induction were considered as the exposed cohort, and patients not given oxytocin formed the non-exposed cohort. Four hundred of the 7465 children born at our maternity during 2006 were randomly selected. Information about breast-feeding was available for 316 of these children. Eventual confounding or adjustment factors were analyzed using stratified and multivariate analysis.

RESULTS

Oxytocin was used for delivery of 189 (59.8%) newborns, multiplying the risk of bottle-feeding by 1.451 (95% CI 1.28-1.63). The best-fit regression model of oxytocin use effect on bottle-feeding included sex and gestational age of the newborn. The use of oxytocin also multiplies the risk of breast-feeding withdrawal at 3 months by 2.29 (95% CI 1.41-3.74). This effect is confounded by maternal age, being higher for mothers under 27 years.

CONCLUSION

Oxytocin administration during labor had some impact on both onset and duration of breast-feeding, particularly in mothers under 27 years of age and newborns delivered at term. Clinical Study registered at U.S.

NIH, ID

NCT01951040.

Prevalence of neurobehavioral, social, and emotional dysfunction in patients treated for childhood craniopharyngioma: a systematic literature review

Background

Craniopharyngiomas (CP) are locally invasive and frequently recurring neoplasms often resulting in neurological and endocrinological dysfunction in children. In addition, social-behavioral impairment is commonly reported following treatment for childhood CP, yet remains to be fully understood. The authors aimed to further characterize the prevalence of neurobehavioral, social, and emotional dysfunction in survivors of childhood craniopharyngiomas.

Materials and Methods

A systematic literature review was conducted in PubMed to identify studies formally assessing neurobehavioral, social, and emotional outcomes in patients treated for CP prior to 18 years of age. Studies published between the years 1990-2012 that reported the primary outcome (prevalence of neurobehavioral, social, emotional/affective dysfunction, and/or impaired quality of life (QoL)) in ≥10 patients were included.

Results

Of the 471 studies screened, 11 met inclusion criteria. Overall neurobehavioral dysfunction was reported in 51 of 90 patients (57%) with available data. Social impairment (i.e. withdrawal, internalizing behavior) was reported in 91 of 222 cases (41%). School dysfunction was reported in 48 of 136 patients (35%). Emotional/affective dysfunction was reported in 58 of 146 patients (40%), primarily consisting of depressive symptoms. Health related quality of life was affected in 49 of 95 patients (52%). Common descriptors of behavior in affected children included irritability, impulsivity, aggressiveness, and emotional outbursts.

Conclusions

Neurobehavioral, social, and emotional impairment is highly prevalent in survivors of childhood craniopharyngioma, and often affects quality of life. Thorough neurobehavioral/emotional screening and appropriate counseling is recommended in this population. Additional research is warranted to identify risk factors and treatment strategies for these disorders.