Attachment to Caregivers and Type 1 Diabetes in Children / Navezanost Na Starše in Sladkorna Bolezen Tipa 1 Pri Otrocih

Navezanost je vedenjski in fiziološki sistem, ki posamezniku omogoča dinamično prilagajanje na okolje. Navezanost se razvija pri sovplivu med dojenčkom in materjo, igra pomembno vlogo pri razvoju otrokovih možgan in vpliva na kvaliteto posameznikovih socialnih odnosov vse življenje

Support Group for Parents Coping with Children with Type 1 Diabetes / Skupina Za Starše Kot Podpora Družinam Pri Soočanju Z Otrokovo Sladkorno Boleznijo Tipa 1

Izhodišče. Sladkorna bolezen tipa 1 je ena izmed pogostejših kroničnih bolezni v otroštvu. Optimalno vodenje in presnovna urejenost otrokove sladkorne bolezni sta povezana z aktivno vključenostjo staršev/ skrbnikov, podporo otroku pri nadzoru nad boleznijo in funkcionalnostjo družine. Raziskava predstavlja oceno zadovoljstva staršev s programom skupine za starše in njihovo doživljanje vpliva omenjenega programa na življenje otroka in spoprijemanje z njegovo SBT1

Determination of psychosis-related clinical profiles in children with autism spectrum disorders using latent class analysis

In children with autism spectrum disorders (ASD), high rates of idiosyncratic fears and anxiety reactions and thought disorder are thought to increase the risk of psychosis. The critical next step is to identify whether combinations of these symptoms can be used to categorise individual patients into ASD subclasses, and to test their relevance to psychosis. All patients with ASD (n = 84) admitted to a specialist national inpatient unit from 2003 to 2012 were rated for the presence or absence of impairment in affective regulation and anxiety (peculiar phobias, panic episodes, explosive reactions to anxiety), social deficits (social disinterest, avoidance or withdrawal and abnormal attachment) and thought disorder (disorganised or illogical thinking, bizarre fantasies, overvalued or delusional ideas). Latent class analysis of individual symptoms was conducted to identify ASD classes. External validation of these classes was performed using as a criterion the presence of hallucinations. Latent class analysis identified two distinct classes. Bizarre fears and anxiety reactions and thought disorder symptoms differentiated ASD patients into those with psychotic features (ASD-P: 51 %) and those without (ASD-NonP: 49 %). Hallucinations were present in 26 % of the ASD-P class but only 2.4 % of the ASD-NonP. Both the ASD-P and the ASD-NonP class benefited from inpatient treatment although inpatient stay was prolonged in the ASD-P class. This study provides the first empirically derived classification of ASD in relation to psychosis based on three underlying symptom dimensions, anxiety, social deficits and thought disorder. These results can be further developed by testing the reproducibility and prognostic value of the identified classes

The Influence of Insecure Attachment to Parents on Adolescents’ Suicidality

Insecure attachment has been identified as a risk factor for adolescent psychopathology and, consequently, for suicidal behavior. We aimed to highlight the relationship between the attachment styles of adolescents and their suicidal behavior and to investigate the role of each parent in the suicidality pathway of adolescents. The sample consisted of 217 adolescent inpatients who were at the highest risk for suicidal behavior and who were hospitalized in the Unit for Intensive Child and Adolescent Psychiatry. Self-report questionnaires assessing their attachment to their parents, their acquired capability for attempting suicide, their suicidality, and a number of traumatic life events were administered. The results showed a higher level of attachment avoidance rather than attachment anxiety among the most at-risk adolescents. An acquired capability for suicide (ACS) mediated the positive correlation between adolescents’ attachment avoidance in relation to the mother or father and their suicidality. The suppressive mediating effect of an ACS on the association between attachment anxiety in relation to the father and suicidality was detected. The odds ratio for attempted suicide was more than two times higher for adolescents who were insecurely attached to their father compared to adolescents who were insecurely attached to their mother. Our results confirmed the importance of attachment, especially paternal attachment, in developing suicidality during adolescence. Preventive and clinical interventions should target these important domains with the aim of decreasing suicidality among adolescents

The use of quetiapine in treatment of acute psychotic symptoms in an adolescent patient with primary brain calcification:A case report

Abstract Background Primary brain calcification (PBC), a neurodegenerative disorder with characteristic calcium deposits in the basal ganglia and other brain areas, typically presents with various neurological and psychiatric symptoms in the fourth or fifth decade of life or later. We present the case of a patient with psychiatric manifestations much earlier than usual, in the second decade of life. Case presentation The case of an adolescent female with acute psychotic symptoms, emotional instability, disorganized and suicidal behavior, stereotypical movements, below average intelligence and a three-year history of headaches is reported. Among others, the presentation included tactile hallucinations with secondary hypochondriacal delusions, which are rarely described in this diagnosis. Massive calcinations in the area of the basal ganglia and thalamus were determined by computerized tomography. Other causes of brain calcification were excluded. No causative mutations were found in selected genes. All the symptoms apart from lower intellectual abilities improved with quetiapine and sertraline. The patient showed no side effects. Conclusions This case report highlights the successful use of quetiapine for symptomatic treatment of acute psychosis due to PBC in an adolescent without exacerbating extrapyramidal symptoms

Attachment in close relationships and glycemic outcomes in children with type 1 diabetes

Background: Our aim was to determine whether child attachment to parents, parent attachment style, and morning cortisol levels were related to diabetes outcomes measured by average glycated hemoglobin (HbA1c), HbA1c variability over 4 years and time in range (TIR) in children with type 1 diabetes (T1D). Research design and methods: 101 children with T1D and one of their parents were assessed at baseline for child attachment (Child Attachment InterviewCAI) and parent attachment (Relationship Structures QuestionnaireECR-RS). Serum samples were collected for cortisol measurements before the interviews. HbA1c levels were measured during a 4-year follow-up period at regular 3-monthly visits, and data for TIR were exported from blood glucose measuring devices. Multivariate linear regression models were constructed to identify independent predictors of glycemic outcomes. Results: More girls than boys exhibited secure attachment to their mothers. The results of the regression models showed that securely attached girls (CAI) had higher average HbA1c than did insecurely attached girls (B = -0.64, p = 0.03). In boys, the more insecure the parent\u27s attachment style, the worse the child\u27s glycemic outcome: the higher the average Hb1Ac (B = 0.51, p = 0.005), the higher the HbA1c variability (B = 0.017, p = 0.011), and the lower the TIR (B = -8.543, p = 0.002). Conclusions: Attachment in close relationships is associated with glycemic outcomes in children with T1D, and we observed significant differences between sexes. A sex- and attachment-specific approach is recommended when treating children with less favorable glycemic outcomes. Special attention and tailored support should be offered to securely attached girls in transferring responsibility for diabetes care and at least to male children of insecurely attached parents to prevent suboptimal glycemic control. Further studies in larger samples and more daily cortisol measurements may help us better understand the links between stress response, attachment and T1D