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Park Y, Coccia MA, Prather AA, Epel ES. Maternal caregiving stress and metabolic health: Sexual activity as a potential buffer. Psychoneuroendocrinology 2024; 167:107068. [PMID: 38820717 DOI: 10.1016/j.psyneuen.2024.107068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/06/2024] [Accepted: 04/29/2024] [Indexed: 06/02/2024]
Abstract
Chronic stress lead to dysregulation of metabolic hormones, creating risk for obesity and type 2 diabetes. Based on previous work suggesting the potential for sexual activity to relieve psychological stress and reduce stress-related neuroendocrine activity, the present research explored sexual activity as a protective factor. We focused on chronic stress in the form of caregiving stress, comparing premenopausal mothers of a child with an autism spectrum disorder vs. a neurotypical child, in relation to metabolic hormones - insulin (and insulin resistance as assessed by HOMA), leptin, and ghrelin. Then, we explored the moderating role of sexual activity. Our results showed that high-stress mothers showed higher levels of insulin, insulin resistance, and lower levels of ghrelin compared to low-stress mothers. However, sexual activity modulated these associations such that among mothers who were sexually active (as coded from their daily diaries), no significant differences in these outcomes were observed between groups. This buffering effect of sexual activity was distinguishable from the buffering effect of physical activity and independent of global relationship satisfaction. Together, our findings provide novel evidence supporting the potential protective effects of sexual activity from chronic stress-related metabolic disease risk.
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Affiliation(s)
- Yoobin Park
- Department of Psychiatry and Behavioral Sciences, University of California, 675 18th Street, San Francisco, CA 94107, USA.
| | - Michael A Coccia
- Department of Psychiatry and Behavioral Sciences, University of California, 675 18th Street, San Francisco, CA 94107, USA
| | - Aric A Prather
- Department of Psychiatry and Behavioral Sciences, University of California, 675 18th Street, San Francisco, CA 94107, USA
| | - Elissa S Epel
- Department of Psychiatry and Behavioral Sciences, University of California, 675 18th Street, San Francisco, CA 94107, USA
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van der Lubbe A, Swaab H, Vermeiren RRJM, Ester WA. Stress, Eating Behavior and Adverse Health in Parents of Young Children with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:662-672. [PMID: 36434479 PMCID: PMC9702603 DOI: 10.1007/s10803-022-05825-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 11/26/2022]
Abstract
Mothers of children with Autism Spectrum Disorder (ASD) often experience chronic stress and are at risk for adverse health. However, little is known about fathers, especially when their child is in early childhood. Parenting stress, eating behavior and physical health was evaluated in mothers (n = 48) and fathers (n = 43) of young children (3-7 years) with ASD by questionnaires and physical measurements. Mother's prevalence rates of obesity (39.1%), abdominal obesity (59.6%) and metabolic syndrome (21.6%) were higher than the norm. In fathers, the prevalence rate of clinical parenting stress (33%) was higher than the norm. Parenting stress was positively related to disinhibited eating in mothers, not in fathers. It is crucial to monitor stress and health of parents of children with ASD.
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Affiliation(s)
- Anna van der Lubbe
- Sarr Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Dynamostraat 18, Rotterdam, The Netherlands.
- Clinical Neurodevelopmental Sciences, Leiden University, Wassenaarseweg 52, Leiden, The Netherlands.
| | - Hanna Swaab
- Sarr Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Dynamostraat 18, Rotterdam, The Netherlands
- Clinical Neurodevelopmental Sciences, Leiden University, Wassenaarseweg 52, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Robert R J M Vermeiren
- Curium-LUMC, Child- and Adolescent Psychiatry, Endegeesterstraatweg 27, Oegstgeest, The Netherlands
| | - Wietske A Ester
- Sarr Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Dynamostraat 18, Rotterdam, The Netherlands
- Parnassia Group, Parnassia Academy, Den Haag, The Netherlands
- Curium-LUMC, Child- and Adolescent Psychiatry, Endegeesterstraatweg 27, Oegstgeest, The Netherlands
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3
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De Zen L, Divisic A, Molinaro G, Solidoro S, Barbi E. Dexmedetomidine at Home for Intractable Dystonia and Insomnia in Children With Special Needs: A Case Series. J Pain Symptom Manage 2023; 66:e653-e657. [PMID: 37544550 DOI: 10.1016/j.jpainsymman.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND We know that syndromic conditions and severe chronic diseases can be associated with symptoms that may interfere with sleep, significantly impacting the life quality of children and caregivers. Drugs commonly used in treating insomnia, such as melatonin, benzodiazepines, niaprazine, and antihistamines, are often either ineffective or associated with adverse effects, requiring new therapeutic perspectives. Dexmedetomidine is a selective alpha-2 agonist with hypnotic and anxiolytic effects, which, by stimulating alpha-2 adrenergic receptors in the locus coeruleus, induces sleep comparable to stages 2-3 of the non-REM phase without substantially affecting the respiratory drive during sedation. Its use has already been extensively described in pediatric intensive care or procedural sedation literature. In 2018, the Italian Medicines Agency (Agenzia Italiana Del Farmaco AIFA) authorized the off-label use of dexmedetomidine outside of intensive care in Children undergoing palliative treatment to control distressing symptoms related to pathology and refractory sleep disorders, and the literature reported cases of children who received dexmedetomidine at home. OBJECTIVE Our study aims to describe the home use of dexmedetomidine in children with insomnia or intractable dystonic states. MEASURES We conducted a retrospective analysis through a questionnaire addressed to 12 Italian pediatric palliative care centers regarding the home use of dexmedetomidine in sleep disorders and intractable dystonic states. INTERVENTION We collected a case series of 9 children treated with dexmedetomidine at home, 8 via intranasal and 1 via intravenous route. All children received the first drug administration in the hospital or hospice during a dedicated admission, under close monitoring of vital signs parameters for 72 hours (3 days, range 2-7 days). After discharge, the potential side effects of the drug were explained to the patient's families, and, once informed consent was obtained, the home administration of dexmedetomidine continued, with follow-up by the palliative care team. At home, dexmedetomidine was administered for 3000 days (minimum 1 month, maximum 36 months). The first patient was treated for 1095 days, from 2019 to 2021 (discontinued due to underlying condition-related death). OUTCOMES All patients observed a persistent benefit from the treatment on symptoms, and none of them discontinued dexmedetomidine administration due to drug-related adverse effects or perceived lack of therapeutic efficacy. CONCLUSIONS Therefore, its use at home may represent a promising therapeutic approach for intractable sleep disorders or dystonic states in pediatric palliative care children. Further studies are needed to confirm our results.
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Affiliation(s)
- Lucia De Zen
- Pediatric Palliative Care and Pain Service (L.D.Z., E.B.), Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Antuan Divisic
- Department of Women's and Children's Health (A.D.), Pediatric Pain and Palliative Care Service, University Hospital, Padova, Italy
| | - Grazia Molinaro
- Department of Pediatrics (G.M.), Hospital of Bolzano, Bolzano, Italy
| | - Sara Solidoro
- Department of Medical, Surgical and Health Sciences (S.S., E.B.), University of Trieste, Trieste, Italy.
| | - Egidio Barbi
- Pediatric Palliative Care and Pain Service (L.D.Z., E.B.), Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy; Department of Medical, Surgical and Health Sciences (S.S., E.B.), University of Trieste, Trieste, Italy
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Warreman EB, Lloyd SE, Nooteboom LA, Leenen PJ, Terry MB, Hoek HW, van Rossum EF, Vermeiren RR, Ester WA. Psychological, behavioural, and physical aspects of caregiver strain in autism-caregivers: a cohort study. EClinicalMedicine 2023; 64:102211. [PMID: 37767192 PMCID: PMC10520302 DOI: 10.1016/j.eclinm.2023.102211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/23/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Background People who give care to autistic individuals (autism-caregivers) experience higher levels of caregiver strain than people who provide care for individuals with other chronic conditions (non-autism-caregivers). This places them at higher risk for psychological, behavioural and physical health concerns. The aim of this study is to delineate psychological, behavioural, and physical aspects of caregiver strain in autism-caregivers compared to non-autism-caregivers. Methods We included 3354 adult caregivers from the general population in the Netherlands participating in the second assessment (January, 1, 2014-December, 31, 2017) of the Lifelines Cohort. In this cohort study, using multivariable regression adjusted for age, sex, and socioeconomic status, we analysed psychological (anxiety and depression based on a Mini International Neuropsychiatric Interview, and self-reported stress and perceived health), behavioural (questionnaire-assessed physical activity, alcohol use, and smoking), and physical aspects (body mass index, waist circumference, and leukocyte-counts) of caregiver strain in autism-caregivers (n = 722) compared with non-autism-caregivers (n = 2632). Findings Autism-caregivers reported more stress (OR 3.61, 95% CI 2.60-4.99). Both anxiety (OR 1.85, 95% CI 1.37-2.49) and depressive disorders (OR 1.83, 95% CI 1.17-2.86) were more common in autism-caregivers than in non-autism-caregivers. Perceived health, physical activity, alcohol use, and smoking were not different between autism- and non-autism-caregivers. In autism-caregivers, lymphocyte- and monocyte-counts were lower than in non-autism-caregivers. Interpretation In this large cohort, autism-caregivers had worse psychological health than non-autism-caregivers. Moreover, autism-caregiving might be associated with an altered immune balance. These findings underline the higher caregiver strain in autism-caregivers compared to other caregivers. This calls for increased support to autism-caregivers. Funding Lifelines has been funded by the Dutch government.
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Affiliation(s)
- Eva B. Warreman
- Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Centre, Endegeesterstraatweg 27, Oegstgeest 2342 AK, the Netherlands
| | - Susan E. Lloyd
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, United States
| | - Laura A. Nooteboom
- Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Centre, Endegeesterstraatweg 27, Oegstgeest 2342 AK, the Netherlands
| | - Pieter J.M. Leenen
- Department of Immunology, Erasmus University Medical Centre, PO Box 2040, Rotterdam 3000 CA, the Netherlands
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, United States
| | - Hans W. Hoek
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, United States
- Department of Psychiatry, University Medical Centre Groningen, Hanzeplein 1, Groningen 9713 GZ, the Netherlands
- Parnassia Psychiatric Institute, Youz, Kiwistraat 43, The Hague 2552 DH, the Netherlands
| | - Elisabeth F.C. van Rossum
- Department of Internal Medicine, Erasmus University Medical Centre, PO Box 2040, Rotterdam 3000 CA, the Netherlands
| | - Robert R.J.M. Vermeiren
- Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Centre, Endegeesterstraatweg 27, Oegstgeest 2342 AK, the Netherlands
- Parnassia Psychiatric Institute, Youz, Kiwistraat 43, The Hague 2552 DH, the Netherlands
| | - Wietske A. Ester
- Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Centre, Endegeesterstraatweg 27, Oegstgeest 2342 AK, the Netherlands
- Parnassia Psychiatric Institute, Youz, Kiwistraat 43, The Hague 2552 DH, the Netherlands
- Sarr Autism Rotterdam, Youz Child and Adolescent Psychiatry, Dynamostraat 18, Rotterdam 3083 AK, the Netherlands
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Catalá-López F, Hutton B, Page MJ, Driver JA, Ridao M, Alonso-Arroyo A, Valencia A, Macías Saint-Gerons D, Tabarés-Seisdedos R. Mortality in Persons With Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:e216401. [PMID: 35157020 PMCID: PMC8845021 DOI: 10.1001/jamapediatrics.2021.6401] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
IMPORTANCE Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are childhood-onset disorders that may persist into adulthood. Several studies have suggested that they may be associated with an increased risk of mortality; however, the results are inconsistent. OBJECTIVE To assess the risk of mortality among persons with ASD or ADHD and their first-degree relatives. DATA SOURCES A search of MEDLINE, Embase, Scopus, Web of Science, and PsycINFO (published from inception to April 1, 2021) was supplemented by searching reference lists of the retrieved articles. STUDY SELECTION Cohort and case-control studies that reported mortality rate ratios (RRs) in persons with ASD or ADHD and/or their first-degree relatives compared with the general population or those without ASD/ADHD were included. DATA EXTRACTION AND SYNTHESIS Screening, data extraction, and quality assessment were performed by at least 2 researchers independently. A random-effects model was used to meta-analyze individual studies and assessed heterogeneity (I2). MAIN OUTCOMES AND MEASURES All-cause mortality in association with ASD or ADHD. Secondary outcome was cause-specific mortality. RESULTS Twenty-seven studies were included, with a total of 642 260 individuals. All-cause mortality was found to be higher for persons with ASD (154 238 participants; 12 studies; RR, 2.37; 95% CI, 1.97-2.85; I2, 89%; moderate confidence) and persons with ADHD (396 488 participants; 8 studies; RR, 2.13; 95% CI, 1.13-4.02; I2, 98%; low confidence) than for the general population. Among persons with ASD, deaths from natural causes (4 studies; RR, 3.80; 95% CI, 2.06-7.01; I2, 96%; low confidence) and deaths from unnatural causes were increased (6 studies; RR, 2.50; 95% CI, 1.49-4.18; I2, 95%; low confidence). Among persons with ADHD, deaths from natural causes were not significantly increased (4 studies; RR, 1.62; 95% CI, 0.89-2.96; I2, 88%; low confidence), but deaths from unnatural causes were higher than expected (10 studies; RR, 2.81; 95% CI, 1.73-4.55; I2, 92%; low confidence). CONCLUSIONS AND RELEVANCE This systematic review and meta-analysis found that ASD and ADHD are associated with a significantly increased risk of mortality. Understanding the mechanisms of these associations may lead to targeted strategies to prevent avoidable deaths in high-risk groups. The substantial heterogeneity between studies should be explored further.
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Affiliation(s)
- Ferrán Catalá-López
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada,Department of Medicine, University of Valencia/INCLIVA Health Research Institute and Centro de Investigación en Red de Salud Mental (CIBERSAM), Valencia, Spain,Department of Health Planning and Economics, National School of Public Health, Institute of Health Carlos III, Madrid, Spain
| | - Brian Hutton
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Matthew J. Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jane A. Driver
- Geriatric Research Education and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, Massachusetts,Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Manuel Ridao
- Instituto Aragonés de Ciencias de la Salud, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Zaragoza, Spain
| | - Adolfo Alonso-Arroyo
- Department of History of Science and Documentation, University of Valencia, Valencia, Spain,Unidad de Información e Investigación Social y Sanitaria, University of Valencia, Spanish National Research Council, Valencia, Spain
| | - Alfonso Valencia
- Life Sciences Department, Barcelona Supercomputing Center, Barcelona, Spain
| | - Diego Macías Saint-Gerons
- Department of Medicine, University of Valencia/INCLIVA Health Research Institute and Centro de Investigación en Red de Salud Mental (CIBERSAM), Valencia, Spain
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia/INCLIVA Health Research Institute and Centro de Investigación en Red de Salud Mental (CIBERSAM), Valencia, Spain
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Stress, anxiety and depression in parents of children with autism spectrum disorders in Kazakhstan: prevalence and associated factors. Glob Ment Health (Camb) 2022; 9:472-482. [PMID: 36618742 PMCID: PMC9806964 DOI: 10.1017/gmh.2022.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Studies worldwide reported increased levels of stress among parents of children with autism due to the unique caregiving challenges. While research has shown that parents' and autistic child's demographics and behavioral characteristics are associated with psychological distress among caregivers of children with autism, very few studies have investigated the impact of the caregiver's unmet needs on various aspects of the perceived family burden. METHODS This cross-sectional study examined the prevalence of stress, anxiety and depressive symptoms among a wide range of 146 parents with different sociodemographic characteristics, social support and unmet needs who care for children with autism spectrum disorder. These parents were recruited from autism non-governmental organizations and the National Children's Rehabilitation Center in Astana, Kazakhstan, a post-Soviet country in Central Asia. Multiple linear regression analyses were utilized to examine the relationship of parental psychological distress variables with social support, unmet needs and parental and child sociodemographic characteristics. RESULTS Significantly higher levels of stress and depression were reported among parents who perceived their needs as being unmet or extremely unmet as addressed by societal acceptance as compared to parents who reported adequate levels of needs met by social acceptance. Employed parents and parents with a higher level of perceived friends' support had less symptoms of stress, anxiety, and depression. CONCLUSIONS Increasing public awareness about autism and providing early detection and interventions for distressed caregivers of children with autism may be helpful in improving healthy functioning of parents and the entire family.
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Ten Hoopen LW, de Nijs PFA, Duvekot J, Greaves-Lord K, Hillegers MHJ, Brouwer WBF, Hakkaart-van Roijen L. Caring for Children with an Autism Spectrum Disorder: Factors Associating with Health- and Care-Related Quality of Life of the Caregivers. J Autism Dev Disord 2021; 52:4665-4678. [PMID: 34724164 PMCID: PMC9556348 DOI: 10.1007/s10803-021-05336-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 12/03/2022]
Abstract
This study investigated the association of child, caregiver, and caregiving measurements with the quality of life (QoL) in 81 caregivers (mostly parents) of clinically referred children with autism spectrum disorder (ASD). We used the EuroQol five-dimensional (EQ-5D) questionnaire and the care-related QoL questionnaire (CarerQol) to respectively assess health-related QoL and care-related QoL. Health-related QoL was associated with the caregiver’s internalizing problems and adaptive coping, explaining 38% of the variance. Parenting stress and adaptive coping were associated with the care-related QoL and explained 60% of the variance. Child variables were not associated with the caregiver’s health- and care-related QoL if caregiver and caregiving variables were taken into account. Findings indicate the importance of the caregiver’s mental health, coping, and parenting stress in caring for children with ASD.
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Affiliation(s)
- Leontine W Ten Hoopen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.
| | - Pieter F A de Nijs
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jorieke Duvekot
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.,Yulius Mental Health, P.O. Box 753, 3300 AT, Dordrecht, The Netherlands.,Jonx Autism Team Northern-Netherlands, Lentis Mental Health, Laan Corpus Den Hoorn 102-2, 9728 JR, Groningen, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.,Yulius Mental Health, P.O. Box 753, 3300 AT, Dordrecht, The Netherlands
| | - Werner B F Brouwer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Leona Hakkaart-van Roijen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
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Validity and Reliability of the Caregiving Difficulty Scale in Mothers of Children with Cerebral Palsy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115689. [PMID: 34073272 PMCID: PMC8198070 DOI: 10.3390/ijerph18115689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 11/16/2022]
Abstract
This study was conducted to determine the construct validity and reliability of the Caregiving Difficulty Scale, a tool developed to measure difficulties experienced by parents of children with cerebral palsy. To this end, a survey was conducted with 215 mothers of children with cerebral palsy, and the resultant data were analyzed. A confirmatory factor analysis was performed to verify the construct validity of this scale, and the intra-item fit value was calculated for reliability analysis. Validity analysis confirmed that a bi-factor model comprising four sub-factors, Concern for the Child, Impact on Self, Support for Caregiving, and Social and Economic Strain, was suitable for the Caregiving Difficulty Scale. In addition, the reliability analysis results showed that the reliability coefficients of three of these areas, excluding Social and Economic Strain, and the reliability of the entire scale were acceptable. Therefore, the Caregiving Difficulty Scale is an appropriate tool to measure the burden of caregiving for children with cerebral palsy, and the findings emphasize the need to improve its reliability by comparing sub-factors’ reliability.
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Sefotho MM. Basotho ontology of disability: An afrocentric onto-epistemology. Heliyon 2021; 7:e06540. [PMID: 33851043 PMCID: PMC8024603 DOI: 10.1016/j.heliyon.2021.e06540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/28/2020] [Accepted: 03/12/2021] [Indexed: 11/28/2022] Open
Abstract
This theoretical article offers a diachronic analysis that is a rebuttal of ontological hegemony of disability as negative. The article is premised on the Ubuntu paradigm from which African wisdom is mostly anchored in idioms and proverbs. This article emerges as a reflection on a Sesotho proverb: Sehole ho ‘Ma-sona ha se lahloe (A child with a disability is never abandoned by the mother). The aim of this article is to demonstrate that Basotho ontology of disability portrays an ubuntu cultural acceptance of people with disabilities as equally human as all human beings. A purposive focus group sample of ten parents of youth with intellectual disability discussed the proverb and shared their experiences of raising a child with disability; and, what the proverb: Sehole ho ‘Ma-sona ha se lahloe mean to them? The qualitative data from the focus group was used to support the theoretical adaptation of Basotho ontology in revising the current understanding of disability. The themes reported in this article are: experiences of raising a child with intellectual disability and a child's love begins with a parent.
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Affiliation(s)
- Maximus Monaheng Sefotho
- University of Johannesburg, Faculty of Education, Department of Educational Psychology, South Africa
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10
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Dijkstra-de Neijs L, Leenen PJM, Hays JP, van der Valk ES, Kraaij R, van Rossum EFC, Ester WA. Biological Consequences of Psychological Distress in Caregivers of Children with Autism Spectrum Disorder and its Potential Relevance to Other Chronic Diseases Including Cancer. CURR EPIDEMIOL REP 2020. [DOI: 10.1007/s40471-020-00237-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Abstract
Purpose of Review
Caregivers of children with a chronic illness are a neglected group in medical research and patient care, and are frequently confronted with chronic psychological distress. The biological consequences of this chronic distress are unclear but highly relevant, as these caregivers have a lifelong task in caring for their child. In this review, the authors specifically describe caregiver distress related to autism spectrum disorder (ASD), but the review may be relevant to other chronic diseases, including cancer.
Recent Findings
Epidemiological evidence illustrates the increased mortality risk in caregivers of children with ASD although some individual factors appear to diminish these risks. Biological studies demonstrate that caregiver distress can lead to dysregulation of the hypothalamic-pituitary-adrenal-axis, a pro-inflammatory state of the immune and central nervous system, and gut microbiome imbalance.
Summary
Caregivers of children with a chronic illness like ASD deserve more health-related attention with respect to their psychological and physical well-being. Such attention would benefit individual caregivers, as well as their children, as both are highly interconnected. Structural psychological and physical screening of caregivers can be considered.
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11
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Kalb L, Jacobson L, Zisman C, Mahone E, Landa R, Azad G, Menon D, Singh V, Zabel A, Pritchard A. Interest in Research Participation Among Caregivers of Children with Neurodevelopmental Disorders. J Autism Dev Disord 2019; 49:3786-3797. [PMID: 31172337 DOI: 10.1007/s10803-019-04088-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The goal of this study was to examine caregiver agreement to hear about local research opportunities by joining a clinical research registry. Data from this cross-sectional study were gathered, between 2014 and 2017, across two outpatient clinics: (1) a multidisciplinary Autism Spectrum Disorder (ASD) clinic (N = 5228) and (2) a general psychology clinic serving youth with, or at risk for, a neurodevelopmental disorder (NDD; N = 5040). Overall, more than 8 in 10 caregivers agreed to join the registry. Several child clinical characteristics, as well as racial and sociodemographic factors, were predictive of parental agreement. Findings suggest caregivers of youth with ASD and NDD are amenable to joining the local research enterprise, however further work is needed to understand why some caregivers decline.
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Affiliation(s)
- L Kalb
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA. .,Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA. .,Department of Mental Health, Johns Hopkins School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA.
| | - L Jacobson
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - C Zisman
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA
| | - E Mahone
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - R Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - G Azad
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA.,Department of Mental Health, Johns Hopkins School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - D Menon
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA
| | - V Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA
| | - A Zabel
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - A Pritchard
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
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12
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Naheed A, Islam MS, Hossain SW, Ahmed HU, Uddin MMJ, Tofail F, Hamadani JD, Hussain AHME, Munir K. Burden of major depressive disorder and quality of life among mothers of children with autism spectrum disorder in urban bangladesh. Autism Res 2019; 13:284-297. [PMID: 31647184 DOI: 10.1002/aur.2227] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 10/02/2019] [Indexed: 12/14/2022]
Abstract
This cross-sectional study examined the burden of depression and quality of life (QoL) among mothers of children with autism spectrum disorder (ASD) attending six schools offering special educational services for children with ASD in urban Dhaka, Bangladesh. All consenting mothers were 18 years of age and older and met criteria for major depressive disorder (MDD) on the Structured Interview for DSM-V-TR Research Version-non patient edition administered by trained raters. QoL was assessed by the EuroQol five-dimensional standardized questionnaire. MDD was diagnosed in 45% of mothers and was proportionally higher among those who did not work outside the home, had no childcare support at home, expressed low level of satisfaction with the quality of providers when they had sought care for their children with ASD, and reported being recipient of negative attitudes from neighbors toward their children with ASD. QoL was negatively associated with MDD, mothers' illness, and low satisfaction with the health care providers for children with ASD, as well as experiencing a negative attitude by neighbors toward their children. QoL was positively associated with the reported family monthly income and improvement of the children with ASD on school attendance. The prevalence of MDD among mothers of children with ASD was high and associated with poor QoL. Integrating mental health services and supports for mothers in the ASD care of children is likely to address the high burden of depression they face, and improve their overall quality of life. Autism Res 2020, 13: 284-297. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The levels of depression were assessed among mothers of children with autism spectrum disorder (ASD) attending six schools offering special educational services for children with ASD in urban Dhaka, Bangladesh. Almost one in two mothers was found to have major depression. The quality of life of these mothers was generally poor. Integrating mental health services for mothers with ASD care in children is likely to address the burden of depression among the mothers of children with ASD and improve overall quality of life.
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Affiliation(s)
- Aliya Naheed
- Initiative for Non-Communicable Diseases, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Saimul Islam
- Initiative for Non-Communicable Diseases, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Helal Uddin Ahmed
- National Institute of Mental Health, Bangladesh (NIMH,B), Sher-E-Bangla Nagar, Dhaka, Bangladesh
| | - M M Jalal Uddin
- National Institute of Neurosciences & Hospital, Bangladesh (NINS,B), Sher-E-Bangla Nagar, Dhaka, Bangladesh
| | - Fahmida Tofail
- NCSD Administration, Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jena Derakhshani Hamadani
- Maternal and Neonatal Health, Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - A H M Enayet Hussain
- Planning and Development, Director General of Health Services (DGHS), Dhaka, Bangladesh
| | - Kerim Munir
- Division of Developmental Medicine, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Division of Developmental Medicine, Boston Children's Hospital and Department and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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13
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Weston CSE. Four Social Brain Regions, Their Dysfunctions, and Sequelae, Extensively Explain Autism Spectrum Disorder Symptomatology. Brain Sci 2019; 9:E130. [PMID: 31167459 PMCID: PMC6627615 DOI: 10.3390/brainsci9060130] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 12/13/2022] Open
Abstract
Autism spectrum disorder (ASD) is a challenging neurodevelopmental disorder with symptoms in social, language, sensory, motor, cognitive, emotional, repetitive behavior, and self-sufficient living domains. The important research question examined is the elucidation of the pathogenic neurocircuitry that underlies ASD symptomatology in all its richness and heterogeneity. The presented model builds on earlier social brain research, and hypothesizes that four social brain regions largely drive ASD symptomatology: amygdala, orbitofrontal cortex (OFC), temporoparietal cortex (TPC), and insula. The amygdala's contributions to ASD largely derive from its major involvement in fine-grained intangible knowledge representations and high-level guidance of gaze. In addition, disrupted brain regions can drive disturbance of strongly interconnected brain regions to produce further symptoms. These and related effects are proposed to underlie abnormalities of the visual cortex, inferior frontal gyrus (IFG), caudate nucleus, and hippocampus as well as associated symptoms. The model is supported by neuroimaging, neuropsychological, neuroanatomical, cellular, physiological, and behavioral evidence. Collectively, the model proposes a novel, parsimonious, and empirically testable account of the pathogenic neurocircuitry of ASD, an extensive account of its symptomatology, a novel physiological biomarker with potential for earlier diagnosis, and novel experiments to further elucidate the mechanisms of brain abnormalities and symptomatology in ASD.
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14
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Forés-Martos J, Catalá-López F, Sánchez-Valle J, Ibáñez K, Tejero H, Palma-Gudiel H, Climent J, Pancaldi V, Fañanás L, Arango C, Parellada M, Baudot A, Vogt D, Rubenstein JL, Valencia A, Tabarés-Seisdedos R. Transcriptomic metaanalyses of autistic brains reveals shared gene expression and biological pathway abnormalities with cancer. Mol Autism 2019; 10:17. [PMID: 31007884 PMCID: PMC6454734 DOI: 10.1186/s13229-019-0262-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/19/2019] [Indexed: 12/27/2022] Open
Abstract
Background Epidemiological and clinical evidence points to cancer as a comorbidity in people with autism spectrum disorders (ASD). A significant overlap of genes and biological processes between both diseases has also been reported. Methods Here, for the first time, we compared the gene expression profiles of ASD frontal cortex tissues and 22 cancer types obtained by differential expression meta-analysis and report gene, pathway, and drug set-based overlaps between them. Results Four cancer types (brain, thyroid, kidney, and pancreatic cancers) presented a significant overlap in gene expression deregulations in the same direction as ASD whereas two cancer types (lung and prostate cancers) showed differential expression profiles significantly deregulated in the opposite direction from ASD. Functional enrichment and LINCS L1000 based drug set enrichment analyses revealed the implication of several biological processes and pathways that were affected jointly in both diseases, including impairments of the immune system, and impairments in oxidative phosphorylation and ATP synthesis among others. Our data also suggest that brain and kidney cancer have patterns of transcriptomic dysregulation in the PI3K/AKT/MTOR axis that are similar to those found in ASD. Conclusions Comparisons of ASD and cancer differential gene expression meta-analysis results suggest that brain, kidney, thyroid, and pancreatic cancers are candidates for direct comorbid associations with ASD. On the other hand, lung and prostate cancers are candidates for inverse comorbid associations with ASD. Joint perturbations in a set of specific biological processes underlie these associations which include several pathways previously implicated in both cancer and ASD encompassing immune system alterations, impairments of energy metabolism, cell cycle, and signaling through PI3K and G protein-coupled receptors among others. These findings could help to explain epidemiological observations pointing towards direct and inverse comorbid associations between ASD and specific cancer types and depict a complex scenario regarding the molecular patterns of association between ASD and cancer. Electronic supplementary material The online version of this article (10.1186/s13229-019-0262-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jaume Forés-Martos
- 1Biomedical Research Networking Center of Mental Health (CIBERSAM), Madrid, Spain
| | - Ferrán Catalá-López
- 1Biomedical Research Networking Center of Mental Health (CIBERSAM), Madrid, Spain.,2Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Blasco-Ibañez 15, 46010 Valencia, Spain.,3INCLIVA Health Research Institute, Valencia, Spain.,4Department of Health Planning and Economics, National School of Public Health/IMIENS, Institute of Health Carlos III, Madrid, Spain
| | | | | | - Héctor Tejero
- 7Structural Biology Program, Spanish National Cancer Research Program (CNIO), Madrid, Spain
| | - Helena Palma-Gudiel
- 1Biomedical Research Networking Center of Mental Health (CIBERSAM), Madrid, Spain.,8Anthropology Section, Department of Evolutionary Biology, Ecology and Environmental Sciences, Biomedicine Institute (IBUB), University of Barcelona (UB), Barcelona, Spain
| | - Joan Climent
- 3INCLIVA Health Research Institute, Valencia, Spain.,9Departamento de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Ramon y Cajal s/n 46115 Alfara del Patriarca, Valencia, Spain
| | - Vera Pancaldi
- 5Barcelona Supercomputing Center (BSC), Barcelona, Spain
| | - Lourdes Fañanás
- 1Biomedical Research Networking Center of Mental Health (CIBERSAM), Madrid, Spain.,8Anthropology Section, Department of Evolutionary Biology, Ecology and Environmental Sciences, Biomedicine Institute (IBUB), University of Barcelona (UB), Barcelona, Spain
| | - Celso Arango
- 1Biomedical Research Networking Center of Mental Health (CIBERSAM), Madrid, Spain.,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- 1Biomedical Research Networking Center of Mental Health (CIBERSAM), Madrid, Spain.,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Anaïs Baudot
- 11Aix-Marseille Univ, Inserm, MMG, Marseille Medical Genetics, Marseille, France
| | - Daniel Vogt
- 12Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI 48824 USA
| | - John L Rubenstein
- 13Nina Ireland Laboratory of Developmental Neurobiology, University of California, San Francisco, CA 94158 USA.,14Department of Psychiatry, University of California, San Francisco, CA 94158 USA
| | - Alfonso Valencia
- 5Barcelona Supercomputing Center (BSC), Barcelona, Spain.,15Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Rafael Tabarés-Seisdedos
- 1Biomedical Research Networking Center of Mental Health (CIBERSAM), Madrid, Spain.,2Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Blasco-Ibañez 15, 46010 Valencia, Spain.,3INCLIVA Health Research Institute, Valencia, Spain
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15
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Landon J, Shepherd D, Goedeke S. Predictors of Satisfaction with Life in Parents of Children with Autism Spectrum Disorder. J Autism Dev Disord 2017; 48:1640-1650. [DOI: 10.1007/s10803-017-3423-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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16
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Catalá-López F, Hutton B, Page MJ, Ridao M, Driver JA, Alonso-Arroyo A, Forés-Martos J, Macías Saint-Gerons D, Vieta E, Valencia A, Tabarés-Seisdedos R. Risk of mortality among children, adolescents, and adults with autism spectrum disorder or attention deficit hyperactivity disorder and their first-degree relatives: a protocol for a systematic review and meta-analysis of observational studies. Syst Rev 2017; 6:189. [PMID: 28915839 PMCID: PMC5603059 DOI: 10.1186/s13643-017-0581-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 09/05/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are childhood onset neurodevelopmental disorders that may persist into adulthood. ASD and ADHD tend to run in families and may have a significant negative impact on the health and longevity of those with the disorder and their relatives. The aim of this study will be to analyze the risk of mortality among children, adolescents, and adults with ASD or ADHD and their first-degree relatives. METHODS/DESIGN We will conduct a systematic review and meta-analysis of observational studies. Searches of PubMed/MEDLINE, EMBASE, PsycINFO, SCOPUS, and ISI Web of Science will be used to identify epidemiological studies. Eligible studies will be observational studies reporting study-specific data for all-cause mortality or cause-specific mortality in children, adolescents, or adults with ASD or ADHD and/or their first-degree relatives. Cohort studies and case-control studies will be included. The primary outcome will be all-cause mortality. The secondary outcome will be cause-specific mortality. Two reviewers will independently screen references identified by the literature search, as well as potentially relevant full-text articles. Data will be abstracted, and study risk of bias/methodological quality will be appraised by two reviewers independently. The methodological quality of epidemiological studies will be appraised using the Newcastle-Ottawa Scale (NOS). Conflicts at all levels of screening and abstraction will be resolved through discussion. Random-effects meta-analyses of primary studies will be conducted where appropriate. Subgroup analyses for exploring statistical heterogeneity, if feasible, will include gender, age group, ethnicity, comorbidities, classification of cause of death, and relevant study characteristics. DISCUSSION Our study will establish the extent of the epidemiological evidence underlying the risk of mortality among children, adolescents, and adults with ASD or ADHD and their first-degree relatives. We anticipate that our findings will be of interest to patients, their families, caregivers, healthcare professionals, scientists, and policy makers. Implications for future epidemiological research will be discussed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017059955 .
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Affiliation(s)
- Ferrán Catalá-López
- Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain. .,Fundación Instituto de Investigación en Servicios de Salud, Valencia, Spain. .,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
| | - Brian Hutton
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Matthew J Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Manuel Ridao
- Instituto Aragonés de Ciencias de la Salud, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Zaragoza, Spain.,Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Salud Pública), Valencia, Spain
| | - Jane A Driver
- Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA.,Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Adolfo Alonso-Arroyo
- Department of History of Science and Documentation, University of Valencia, Valencia, Spain.,Unidad de Información e Investigación Social y Sanitaria-UISYS, University of Valencia-Spanish National Research Council (CSIC), Valencia, Spain
| | - Jaume Forés-Martos
- Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
| | - Diego Macías Saint-Gerons
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency, Madrid, Spain.,Department of Health Systems and Services, Pan American Health Organization, Unit of Medicines and Health Technologies, Washington, DC, USA
| | - Eduard Vieta
- Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and CIBERSAM, Barcelona, Spain
| | - Alfonso Valencia
- Life Sciences Department, Barcelona Supercomputing Center, Barcelona, Spain.,Structural Biology and Biocomputing Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
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17
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Pivovarciova A, Durdiakova J, Babinska K, Kubranska A, Vokalova L, Minarik G, Celec P, Murin M, Ostatnikova D. Testosterone and Androgen Receptor Sensitivity in Relation to Hyperactivity Symptoms in Boys with Autism Spectrum Disorders. PLoS One 2016; 11:e0149657. [PMID: 26910733 PMCID: PMC4765851 DOI: 10.1371/journal.pone.0149657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 02/03/2016] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Autism spectrum disorders (ASD) and hyperactivity symptoms exhibit an incidence that is male-biased. Thus androgen activity can be considered a plausible biological risk factor for these disorders. However, there is insufficient information about the association between increased androgen activity and hyperactivity symptoms in children with ASD. METHODS In the present study, the relationship between parameters of androgenicity (plasmatic testosterone levels and androgen receptor sensitivity) and hyperactivity in 60 boys (age 3-15) with ASD is investigated. Given well documented differences in parent and trained examiners ratings of symptom severity, we employed a standardized parent`s questionnaire (Nisonger Child Behavior Rating Form) as well as a direct examiner`s rating (Autism diagnostic observation schedule) for assessment of hyperactivity symptoms. RESULTS Although it was found there was no significant association between actual plasmatic testosterone levels and hyperactivity symptoms, the number of CAG triplets was significantly negatively correlated with hyperactivity symptoms (R2 = 0.118, p = 0.007) in the sample, indicating increased androgen receptor sensitivity in association with hyperactivity symptoms. Direct trained examiner´s assessment appeared to be a relevant method for evaluating of behavioral problems in the investigation of biological underpinnings of these problems in our study. CONCLUSIONS A potential ASD subtype characterized by increased rates of hyperactivity symptoms might have distinct etiopathogenesis and require a specific behavioral and pharmacological approach. We propose an increase of androgen receptor sensitivity as a biomarker for a specific ASD subtype accompanied with hyperactivity symptoms. Findings are discussed in terms of their implications for practice and future research.
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Affiliation(s)
- Anna Pivovarciova
- Academic Research Center for Autism, Institute of Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
- * E-mail:
| | - Jaroslava Durdiakova
- Academic Research Center for Autism, Institute of Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Katarina Babinska
- Academic Research Center for Autism, Institute of Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Aneta Kubranska
- Academic Research Center for Autism, Institute of Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Lenka Vokalova
- Academic Research Center for Autism, Institute of Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Gabriel Minarik
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - Peter Celec
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Marianna Murin
- Department of Child and Adolescent Mental Health, Social Communication Disorders Clinic, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Daniela Ostatnikova
- Academic Research Center for Autism, Institute of Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
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18
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Al-Farsi OA, Al-Farsi YM, Al-Sharbati MM, Al-Adawi S. Stress, anxiety, and depression among parents of children with autism spectrum disorder in Oman: a case-control study. Neuropsychiatr Dis Treat 2016; 12:1943-51. [PMID: 27536117 PMCID: PMC4977076 DOI: 10.2147/ndt.s107103] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Previous studies carried out in Euro-American populations have unequivocally indicated that psychological disorders of the CASD (caregivers of children with autism spectrum disorder) are marked with high levels of stress, anxiety, and depression. This finding has been attributed to the reaction of having to care for a child with neurodevelopmental disorders. While there have been reports on autism spectrum disorder in Arab/Islamic countries such as Oman, there is no study from this region, to our knowledge, reporting the performance of indices of stress, anxiety, and depression among CASD. This study aimed to examine whether there is variation in the performance of indices of stress, depression, and anxiety explored via Depression, Anxiety and Stress Scale 21 among CASD, caregivers of children with intellectual disabilities, and caregivers of typically developing children. All indices of stress, depression, and anxiety were higher in CASD compared to other caregivers in the control group. This study corroborates with other studies carried out in other populations that caring for children impacts the mental health status of caregivers. Therefore, there are strong grounds to contemplate the mechanism to help such a vulnerable group of family caregivers.
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Affiliation(s)
- Omar A Al-Farsi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Yahya M Al-Farsi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman; Department of Epidemiology, School of Public Health, Boston, MA, USA
| | - Marwan M Al-Sharbati
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
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19
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Fox-Edmiston E, de Water JV. Maternal Anti-Fetal Brain IgG Autoantibodies and Autism Spectrum Disorder: Current Knowledge and its Implications for Potential Therapeutics. CNS Drugs 2015; 29:715-24. [PMID: 26369920 PMCID: PMC4605883 DOI: 10.1007/s40263-015-0279-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Several studies have found a correlation between the presence of circulating maternal autoantibodies and neuronal dysfunction in the neonate. Specifically, maternal anti-brain autoantibodies, which may access the fetal compartment during gestation, have been identified as one risk factor for developing autism spectrum disorder (ASD). Studies by our laboratory elucidated seven neurodevelopmental proteins recognized by maternal autoantibodies whose presence is associated with a diagnosis of maternal autoantibody-related (MAR) autism in the child. While the specific process of anti-brain autoantibody generation is unclear and the detailed pathogenic mechanisms are currently unknown, identification of the maternal autoantibody targets increases the therapeutic possibilities. The potential therapies discussed in this review provide a framework for possible future medical interventions.
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Affiliation(s)
- Elizabeth Fox-Edmiston
- Division of Rheumatology/Allergy and Clinical Immunology, University of California, Davis, 451 E. Health Sciences Drive, Suite 6510 GBSF, Davis, CA 95616 USA,The M.I.N.D. Institute, University of California, Davis, Davis, CA 95616, USA
| | - Judy Van de Water
- Division of Rheumatology/Allergy and Clinical Immunology, University of California, Davis, 451 E. Health Sciences Drive, Suite 6510 GBSF, Davis, CA 95616 USA,The M.I.N.D. Institute, University of California, Davis, Davis, CA 95616, USA,NIEHS Center for Children’s Environmental Health, University of California, Davis, Davis, CA 95616, USA
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20
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Fairthorne J, Klerk ND, Leonard H. The relationship between maternal psychiatric disorder, autism spectrum disorder and intellectual disability in the child: a composite picture. ACTA ACUST UNITED AC 2015. [DOI: 10.7243/2054-992x-2-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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