Serum Vitamin D, Folate and Fatty Acid Levels in Children with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis

Vitamin and fatty acid deficiency in children diagnosed with autism has been linked to the etiology and course of the disease but the results have been inconsistent. In our work, we present a narrative review, which includes 20 observational studies that provide data on the blood levels of vitamin D, folate, or fatty acids of children diagnosed with ASD (Autism Spectrum Disorder-AG group), and of a control group (children without this disorder-CG group). The main characteristics and results are presented in a summary table. Of the 20 above-mentioned studies, a meta-analysis of vitamin D and folate levels was carried out in 14 of them, with a total of 2269 children (AG = 1159, CG = 1110). Vitamin D levels were lower in AG compared to CG: SMD, 95% CI = - 0.83 [- 1.15, - 0.50]. In terms of folate levels, a total of 299 children (AG = 148, CG = 151) were analyzed, finding no significant differences with the control group: SMD, 95% CI = - 0.16 [- 0.63, 0.32]. Only one study that provided data on fatty acids in children with ASD was included in the review although it was not possible to include it in the meta-analysis. We conclude that the nutritional status (vitamin and fatty acid levels) of patients diagnosed with ASD should be taken into account, as correct adjustment of these levels-may produce an improvement in the course of the disease and could also reduce the risk of its development.

User violence in mental health services: Adaptation of an instrument. Healthcare-workers' Aggressive Behavior Scale-Users-Mental Health Version (HABS-U-MH)

Background/Objetive

According to the World Health Organization, one out of every four violent workplace acts takes place in the health setting. The aims of the study are to adapt the Healthcare-workers’ Aggressive Behavior Scale-Users (HABS-U) to mental health professionals, to establish the frequency of exposure to hostile indicators and to determine which professional group is most exposed.

Method

Study through qualitative and quantitative methodology in MH professionals of the Region of Murcia (Spain). In the qualitative phase, 12 in-depth interviews were conducted, and during the quantitative phase, the instrument was applied to 359 professionals of Mental Health Services (MHS).

Results

Non-medical and nursing staff were found to be the professional group most exposed, as well as Brief Psychiatric Inpatient and Medium-Stay Inpatient Services.

Conclusion

The resulting scale shows excellent psychometric properties. The distribution of user violence is not homogeneous among the different professional groups of MHS. The adaptation of the scale may be useful to detect user violence, as well as to evaluate the efficacy of intervention programs.

Psychotic depression induced by Obstructive Sleep Apnoea Syndrome (OSAS): a case reported

Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder that is frequently associated with a large variety of conditions, such as hypertension, cardiovascular, neuropsychological or metabolic diseases. The most common and prominent symptoms of apnea is excessive diurnal drowsiness, as well asin addition to alterations of the memory and concentration, irritability, headache, and depression, among others. To date, no known studies have related OSAS with another type of more serious psychiatric disorder, such as psychotic symptoms. The case of a 51-year-old man who was diagnosed of SAOS after presenting psychotic and affective symptoms that did not respond to any medication is presentedreported. The treatment resulted in complete remission of the psychiatric symptoms mentioned.