Neuropsychological and Clinical Profiles of Children and Adolescents Diagnosed with Childhood Obsessive Compulsive Disorder

Attitude toward COVID-19 vaccines and its association with depressive symptoms in 386,924 Chinese primary school students during COVID-19 epidemic normalization

AIM

Before Chinese primary school students were generally vaccinated against the COVID-19 vaccine, this study evaluated the willingness of this population and its influencing factors before vaccination, and evaluate its association between attitudes toward the vaccine and depressive symptoms.

METHODS

A cross-sectional study involved 386,924 primary school students using a cluster sampling method during May 21-27, 2021. The Chinese version of the Children Depression Inventory (CDI) was used to assess depressive symptoms. Multiple logistic regression analysis models were used to estimate the relationship between attitudes toward COVID-19 vaccines and depressive symptoms.

RESULTS

Among the participants, the prevalence of depressive symptoms was higher in higher grades. The prevalence was higher in fifth and sixth grade students than third and fourth grade students and first and second grades (10.22% vs. 6.07% vs. 3.04%). In addition, 20.79% of students do not know whether the vaccine can protect him from the COVID-19 infection, and 40.60% of students do not know whether the vaccine is safe. Of note, in terms of attitudes toward COVID-19 vaccines, students with more positive attitudes have a lower risk of depressive symptoms (adjusted odds ratio (aOR) = 0.151; 95% confidence interval (CI): 0.140-0.164).

CONCLUSION

Based on these findings, it is necessary for the government and schools to promote vaccine safety and reliability information in a timely manner to increase vaccination uptake.

Prevalence and Associated Factors for Elevated Depressive Symptoms in 386,924 Primary Students during the COVID-19 Pandemic Normalization in China

We aimed to assess the prevalence of elevated depressive symptoms and its associated factors during the coronavirus disease 2019 (COVID-19) pandemic among primary students in China. We included 386,924 students aged 6–12 years from three cities in Henan province, China, over the period 21–27 May 2021. The overall prevalence of depressive symptoms was 5.8%. Participants with high depressive symptoms were more likely to be senior urban primary students, and exhibited an insignificant increase in hand washing frequency, non-mask wearing behavior, higher error rates of cognition tests, and greater levels of worry and fear. The associated factors for high depressive symptoms were found to include age, sex, grade, location, worry level, fear level, cognitive status, and change in lifestyle after gaining knowledge about COVID-19. Our results suggest that governments need to focus on factors affecting the mental health of school-age children while combating COVID-19, as it would facilitate better decision making on the international and national level.

Is sustained attention deficit related to subclinical obsessive thoughts in children and adolescents with ADHD?

Background: Thought content and its impact on sustained attention in individuals with attention deficit hyperactivity disorder (ADHD) are topics of growing interest in literature.Objective: We hypothesised that subclinical obsessive thoughts may be correlated with attention lapses in individuals with ADHD.Method: Thirty children diagnosed with ADHD participated in the study and their level of subclinical obsessive thoughts, attention, and executive function were measured using Children Yale-Brown Obsessive Scale and Conners' Continuous Performance Test II.Results: No significant correlation between sustained attention impairment and the level of obsessive thoughts in patients with ADHD was found. Nevertheless, patients with ADHD with subclinical obsessive thoughts showed more commission errors than those without (W = 51.5; p = 0.02).Conclusion: The nature of thought content in individuals with ADHD should be linked to executive dysfunction rather than attentional impairment. This could be of importance in the therapeutic strategy choice, addressing the importance of executive function remediation in the specific context of subclinical obsessive thoughts.Key points Patients with ADHD, without OCD or ASD comorbidity, still present subclinical obsessive thoughts (36% of our sample).  • Subclinical obsessive thoughts could be a part of thought content in patients with ADHD. • Subclinical obsessive thoughts as measured by the CPT-II are not correlated with attention function in patients with ADHD. • ADHD patients with subclinical obsessive symptoms present more impairment in response inhibition than the ones without. • Results on subclinical obsessive thoughts are similar to those on another type of thought content called 'mind wandering'. • A clinical improvement strategy for patients with ADHD could be using executive function remediation rather than classical attention function remediation, according to both to our and previous results.

An Investigation Into Response Inhibition in Distinct Clinical Groups Within Obsessive-Compulsive Disorder

OBJECTIVE

Response inhibition has been frequently studied in obsessive-compulsive disorder (OCD) with mixed results. The inconsistent findings may stem in part from failure to consider the heterogeneity of the disorder.

METHODS

The authors examined behavioral and event-related potential (ERP) components (N2 and P3) during a simple response inhibition go/nogo task in a sample of patients with OCD (N=48) and control subjects (N=53). Comparisons in behavioral and electrophysiological measures were made between groups (OCD compared with control) and within the OCD group in terms of symptom clusters (symmetry, forbidden thoughts, and cleaning) and comorbidity status (OCD only and OCD with depression).

RESULTS

In the OCD group, the N2 component appeared more frontally localized compared with the control group. Participants with OCD demonstrated longer N2 latency and a larger difference in N2 between the nogo and go conditions, suggesting slower but greater conflict monitoring. P3 had a larger amplitude in the OCD group compared with the control group, indicative of greater response inhibition, but was also reduced in the nogo compared with go condition, suggesting suppressed response inhibition. No significant differences were found between symptom clusters, but patients with OCD only made more omission errors compared with patients with OCD and comorbid depression. The latter cohort also had faster P3 latencies, which, combined with the behavioral data, indicates slightly improved response inhibition when comorbid depression is found.

CONCLUSIONS

On the basis of these results, it would seem unlikely that symptom clusters have contributed to previous inconsistencies in the literature. Comorbid depression, which may have affected previous results, should be considered in future research.

Are candidate neurocognitive endophenotypes of OCD present in paediatric patients? A systematic review

To-date it has been difficult to ascertain the exact cognitive profile of childhood OCD as studies report variable results. Adult OCD research lately utilises the endophenotype approach; studying cognitive traits that are present in both patients and their unaffected first-degree relatives, and are thought to lie closer to the genotype than the full-blown disorder. By observing whether candidate endopenotypes of adult OCD are present in child patients, we can determine whether the two subtypes show cognitive overlap. We conducted a systematic review of the paediatric OCD literature focussing on proposed neurocognitive endophenotypes of OCD: cognitive flexibility, response inhibition, memory, planning, decision-making, action monitoring, and reversal learning. We found that paediatric patients present robust increases in brain error related negativity associated with abnormal action monitoring, impaired decision-making under uncertainty, planning, and visual working memory, but there is less evidence for deficits in other cognitive domains. This implies that children with OCD show some cognitive similarities with adult patients, but other dysfunctions may only manifest later in the disorder trajectory.

Shared and disorder-specific task-positive and default mode network dysfunctions during sustained attention in paediatric Attention-Deficit/Hyperactivity Disorder and obsessive/compulsive disorder

Patients with Attention-Deficit/Hyperactivity Disorder (ADHD) and obsessive/compulsive disorder (OCD) share problems with sustained attention, and are proposed to share deficits in switching between default mode and task positive networks. The aim of this study was to investigate shared and disorder-specific brain activation abnormalities during sustained attention in the two disorders. Twenty boys with ADHD, 20 boys with OCD and 20 age-matched healthy controls aged between 12 and 18 years completed a functional magnetic resonance imaging (fMRI) version of a parametrically modulated sustained attention task with a progressively increasing sustained attention load. Performance and brain activation were compared between groups. Only ADHD patients were impaired in performance. Group by sustained attention load interaction effects showed that OCD patients had disorder-specific middle anterior cingulate underactivation relative to controls and ADHD patients, while ADHD patients showed disorder-specific underactivation in left dorsolateral prefrontal cortex/dorsal inferior frontal gyrus (IFG). ADHD and OCD patients shared left insula/ventral IFG underactivation and increased activation in posterior default mode network relative to controls, but had disorder-specific overactivation in anterior default mode regions, in dorsal anterior cingulate for ADHD and in anterior ventromedial prefrontal cortex for OCD. In sum, ADHD and OCD patients showed mostly disorder-specific patterns of brain abnormalities in both task positive salience/ventral attention networks with lateral frontal deficits in ADHD and middle ACC deficits in OCD, as well as in their deactivation patterns in medial frontal DMN regions. The findings suggest that attention performance in the two disorders is underpinned by disorder-specific activation patterns.