The clinical picture of bipolar affective disorders in children and adolescents hospitalized at the psychiatric ward in Sosnowiec

OBJECTIVES

To determine the clinical picture of bipolar affective disorders (BD) in children and adolescents hospitalized at the Clinical Ward of Developmental Age Psychiatry and Psychotherapy (DAPP) in Sosnowiec, Poland.

METHODS

Documentation analysis of 288 BD patients below 18 years of age. Detailed clinical and demographic data were collected and symptoms present during hospitalization were assessed.

RESULTS

The mean age of illness onset was 13.6 ± 1.7 years. A total of 86.5% of the studied individuals received a first diagnosis different from BD/mania, and the average time until the proper diagnosis was 16.9 months. In 45.5% the first episode was depression with varied severity, in 29.2% a mixed episode and in 25.3% mania/hypomania. In 48.6% comorbid disorders were present. The most frequent reason for hospitalization was a mixed episode (47.6%). Among the symptoms, irritability was observed in over 80% of patients with mania or mixed episodes, but also in 60% of patients with depression. Suicidal thoughts were experienced by almost all the depression patients, 84.7% in the mixed episode and also 52.6% in mania/hypomania episode. Anxiety was mostly present in depression (40.7%) and mixed episode (22.6%), while moodcongruent delusions in depression and mania (around 20% of cases). Aggressive behaviours were manifested in around half of patients with mania and a mixed episode.

CONCLUSIONS

In the studied population of children and adolescents, BD usually started with a depression episode accompanied by a high rate of comorbid disorders and in most cases there was an original misdiagnosis. Study results also point to a significant frequency of some pathological symptoms in this population.

Evaluation of Peripheral Blood Concentrations of Phoenixin, Spexin, Nesfatin-1 and Kisspeptin as Potential Biomarkers of Bipolar Disorder in the Pediatric Population

There are some initial suggestions in the literature that phoenixin, spexin, nesfatin-1 and kisspeptin may play a role in the pathogenesis of affective disorders. Therefore, they may also be cautiously considered as potential diagnostic or predictive biomarkers of BD. This study aimed to evaluate the levels of the aforementioned neuropeptides in the peripheral blood of children and adolescents with bipolar. This study included 122 individuals: 67 persons with diagnosed bipolar disorder types I and II constituted the study group, and 55 healthy persons were included in the control group. Statistically significant differences in the concentrations of neuropeptides between the control and study groups were noted in relation to nesfatin-1 and spexin (although spexin lost statistical significance after introducing the Bonferroni correction). In a logistic regression analysis, an increased risk of bipolar disorder was noted for a decrease in nesfatin-1 concentration. Lower levels of nesfatin-1 seemed to be a significant risk factor for the development of bipolar disorder types I and II. Furthermore, the occurrence of bipolar disorder was associated with significantly elevated levels of spexin. None of the analyzed neuropeptides was significantly correlated with the number of symptoms of bipolar disorder.

Patterns of Food Selectivity among Children with Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a heterogeneous group of neurodevelopmental disorders characterized by food selectivity in a significant portion of the population. The nature of this selectivity remains unclear, with hypotheses suggesting associations with sensory disorders or stereotypical and repetitive patterns of activity and interests. This study aimed to determine the prevalence and nature of food selectivity traits in individuals with ASD compared with the neurotypical population. This study involved 219 participants, with 115 diagnosed with autism and 92 without. Twelve children undergoing diagnosis were excluded from the analyses. The findings revealed that food selectivity traits are more common in individuals with ASD, with differences in preferences mainly involving structure, color, taste, and serving method. Children with ASD had more food selectivity traits than those without, and the intake of certain food characteristics could be altered as they grow. Selectivity occurred for both sensory and stereotypical reasons, but stereotypical features significantly differentiated neurotypical individuals from those with ASD.

Polymorphisms in Oxytocin and Vasopressin Receptor Genes as a Factor Shaping the Clinical Picture and the Risk of ASD in Males

Autism spectrum disorders (ASD) are a heterogeneous group of disorders affecting virtually every population, regardless of their ethnic or socioeconomic background. Their pathogenesis is multifactorial, based on interactions between genetic and environmental factors. The key symptom of ASD are deficits in social communication, which are the basis of many difficulties in everyday functioning. The aim of the presented study was to analyze the clinical picture of social cognition deficits in boys with autism spectrum disorders and to relate its elements with the frequency of alleles of selected polymorphisms within the oxytocin receptor (OXTR) and vasopressin receptor 1A (AVPR1A) genes. The study included 58 boys with IQ > 90, who were divided into two groups based on a confirmed or excluded ASD diagnosis based on the DSM-5 and ICD-10 criteria and then using the ADOS-2 protocol. The results indicated that polymorphism rs10877969 (T) within the AVPR1a gene was the only one to show a statistically significant association with a higher risk of autism spectrum disorders and has an impact on clinical presentation in the ADOS-2 study, primarily in terms of the social affect subscale. Polymorphisms in the OXTR gene showed no significant association with ASD risk and severity of autistic traits in the ADOS-2 study. In the group of people with ASD and those who are neurotypical, the rs53572 (A) genotype in the OXTR gene significantly increased the severity of the clinical picture of social cognition disorders in reading mind in the eyes test (RMiE) and empathy quotient (EQ) studies.

Orthorexia - current approach. A review

The aim of the study was to define orthorexia nervosa (ON) based on the latest scientific findings regarding incidence, groups and risk factors as well as relationships between ON and other clinical entities. The paper is based on the review of the MEDLINE/PubMed databases. Publications published between 2009 and 2019 were analyzed in terms of epidemiology, risk factors and formulation of the ON concept. ON is a clinical entity of an unclear origin and various authors have continued their discussion on the relation between ON and other groups of disorders (AN, BN, OCD, ASD). Epidemiological data vary and depending on a population present extreme values from anywhere between 1% and 90%. Risk factors are alternatively identified in various groups and authors are not unanimous as for the effect of determinants such as anthropometric and sociodemographic variables on the presence of ON symptoms. Presented findings are affected by the fact that there is a relatively small number of studied groups, they are not fully representative and applied tools are different: BOT, ORTO-15, EHQ, DOS. Since the nosological status of ON remains unclear and there are no standard and operationalized diagnostic criteria and reliable assessment tools, ON requires further study. Similarly, because it is still not known how to best treat ON - which is caused by ambiguities in the concept of the phenomenon itself - prevention and therapy programs, which are non-existent, should be developed (in risk groups in particular).

Systematic Review of Literature on Eating Disorders During Pregnancy-Risk and Consequences for Mother and Child

Background: Eating disorders (ED) are a diagnostic category that includes several nosological units such as anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED). This category most often concerns women, while the peak incidence falls on the reproductive age. Therefore the issue of ED during pregnancy is an interesting topic. Due to the creation of unrealistic ideal of "desired," slim figure both by the mass media and social media even during and right after gestation, more and more pregnant women introduce behaviours aimed at maintaining the "perfect" appearance. However in some cases it may have serious consequences for the health of both mother and child leading to the creation of the term "pregorexia" by the media to describe this issue. Aim: The aim of this paper was to conduct a systematic review of the literature dealing with eating disorders in pregnant women, with particular emphasis on pregorexia. Method: A systematic review of literature published within the last 5 years (2016-2021) in English or Polish and available through MEDLINE / PubMed, Google Scholar and Cochrane Library databases was conducted based on the previously assumed inclusion and exclusion criteria. Results: Initially, 634 publications were obtained during the review, of which 55 papers were selected in the course of the title analysis. After further evaluation of abstracts, 28 papers were qualified for full text analysis. Ultimately, 10 papers were selected for the final analysis. Conclusions: The issue of ED in pregnant women is a broad topic covering a heterogeneous group of women-both those with a previous history and those with the onset during pregnancy. The occurrence of ED symptoms during this period is associated with a high likelihood of negative consequences for both the mother and the child. The course of pregnancies and deliveries in these patients is more complicated. Therefore, it seems reasonable to develop a multidisciplinary screening strategy and standards of management and supervision over this group of patients.

Longitudinal study on novel neuropeptides phoenixin, spexin and kisspeptin in adolescent inpatients with anorexia nervosa - association with psychiatric symptoms

OBJECTIVES

It is hypothesized that novel neuropeptides such as phoenixin (PNX), spexin (SPX), and kisspeptin (KISS) are involved in the pathogenesis of eating disorders. The study presented here analyzed neuropeptide concentrations during the course of anorexia nervosa (AN) and aimed to correlate those values with anthropometric and psychometric measurements.

METHODS

A longitudinal study was carried outin 30 AN adolescent patients and 15 age-matched healthy female controls. Selected neuroprotein serum levels were analyzed in malnourished patients (accAN) and following partial weight recovery (norAN), and these values were compared with the control group.

RESULTS

In accAN patients, decreased serum PNX levels were detected while SPX serum concentrations were lower in the accAN and norAN patients. No differences were observed in KISS concentrations in all studied groups.

CONCLUSIONS

In malnourished adolescent inpatients with AN, serum PNX and SPX level were decreased. The partial weight recovery normalized PNX concentrations but failed to normalize SPX levels. Therefore these two neuropeptides might be crucial for the etiology and course of the AN. The KISS levels did not change in the course of AN. The PNX levels were associated with some symptoms of eating disorders which may indicate its potential contribution in the regulation of emotions and behaviors in AN.

Differences in oxytocin and vasopressin levels in individuals suffering from the autism spectrum disorders vs general population - a systematic review

INTRODUCTION

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interactions, communication, and the presence of stereotyped, repetitive behaviors. Oxytocin (OXT) and arginine-vasopressin are neuropeptides produced in hypothalamus and they are related to processing emotions and social behavior. In the light of a growing number of scientific reports related to this issue, the two neurohormones started to be linked with the basis of neurodevelopmental disorders, including the ASD. The aim of this study was a systematic review of previous studies regarding the differences in OXT and vasopressin levels in ASD and neurotypical persons.

MATERIALS AND METHODS

Literature review focused on publications in the last 10 years located via the MEDLINE/PubMed database as well as the Google Scholar browser. Selection was made by assumptive criteria of inclusion and exclusion.

RESULTS

From the 487 studies qualified to the initial abstract analysis, 12 met the six inclusion criteria and were included in the full-text review.

CONCLUSION

Currently, available study reports still do not provide unequivocal answers as to the differences in concentrations of those neuropeptides between children with ASD and neurotypical control. Therefore, it is necessary to continue the research taking into account necessity of proper homogenization of study groups, utilization of objective and quantifiable tools for ASD diagnosis and broadening the range of biochemical and molecular factors analyzed.

Comorbidity of substance use and mental disorders

INTRODUCTION

Comorbidity is a term defined as the presence of two or more conditions occurring either at the same time or having a close relationship to the same individual. World Health Organization (WHO) define it as the "co-occurrence in the same individual of a psychoactive substance use disorder and another psychiatric disorder". Progressive deinstitutionalisation, despite indisputable benefits and improvement of life quality in psychiatric patients, resulted in appearance of new burdens, such as deterioration of family life. Furthermore, wide availability of alcoholic beverages and drugs in communities where the patients live, led comorbid substance abuse disorders to emerge as one of the biggest challenges in the modern psychiatry. There is a limited amount of data concerning the background of the patients with a dual diagnosis, available in the literature, and therefore our aim was to create a sociodemographic profile of such individuals.

MATERIALS AND METHODS

The study was conducted among the patients treated in a drug rehabilitation centre of the Upper Silesian Association "Familia" in Gliwice, Poland using authors' own questionnaire, consisting of 75 items. The study group consisted of 9 females and 91 males (n=100), average age of the patients equalled 29.7 years (95%CI: 28.5-31 years; min/max value: 20/48 years), all the patients had an established dual diagnosis.

OUTCOMES

66% of the study group was single, with permanent residency, living with family either in city (47%) or in village (19%). Remaining 34% was spread through the other options (1-4%), with the highest percentage in "single, with permanent residency, living alone in the city" (4%).

CONCLUSIONS

Obtained data, demonstrated high homogeneity among the patients with a dual diagnosis in terms of a socio-demographical profile.

Analysis of facial expressions in patients with schziophrenia, in comparison with a healthy control - case study

INTRODUCTION

Deficits in area of communication, crucial for maintaining proper social bonds, may have a prominent adverse impact on quality of life in patients with schizophrenia. Social exclusion, lack of employment and deterioration of family life, may be consequences of aggravated social competencies, caused by inability to properly exhibit and interpret facial expressions. Although this phenomenon is known since first clinical descriptions of schizophrenia, lack of proper methodology limited our knowledge in this area. Aim of our study was to compare facial expressivity of the patient with schizophrenia, and the healthy individual.

METHODS

47-years old patient suffering from schizophrenia, and 36-years old healthy individual were invited to participate in our study. They underwent the examination in Human Facial Modelling Lab in Polish-Japanese Institute of Information Technology in Bytom (Silesia, Katowice). Both participants were presented with two video materials, first one contained different facial expressions, which they had to imitate. Second one a part of comedy show, during which spontaneous reactions were recorded. Acquisition of facial expressions was conducted with marker-based technology of modelling. Obtained data was analyzed using Microsoft Excel.

RESULTS AND CONCLUSIONS

An overall facial expression intensity, expressed as an average value of distances traveled by markers during shifts from neutral position was higher in case of a healthy participant during both part of the study. The difference was especially visible in case of an upper half of the face. Utilization of marker-based methods in analysis of human facial expressions seem to be reliable and remarkably accurate.