Psychiatric disorders in incident patients with juvenile idiopathic arthritis-a case-control cohort study

Background Chronic illness, such as juvenile idiopathic arthritis (JIA), appears to have an impact on the mental health of children and adolescents. The aim of this study was to explore the incidence of mental and behavioural disorders according to age at JIA onset and gender in JIA patients compared to a control population. Methods Information on all incident patients with JIA in 2000-2014 was collected from the nationwide register, maintained by the Social Insurance Institution of Finland. The National Population Registry identified three controls (similar regarding age, sex and residence) for each case. They were followed up together until 31st Dec. 2016. ICD-10 codes of their psychiatric diagnoses (F10-F98) were obtained from the Care Register of the National Institute for Health and Welfare. The data were analysed using generalized linear models. Results The cumulative incidence of psychiatric morbidity was higher among the JIA patients than the controls, hazard ratio 1.70 (95% Cl 1.57 to 1.74), p < 0.001. Phobic, anxiety, obsessive-compulsive, stress-related and somatoform disorders (F40-48) and mood (affective) disorders (F30-39) were the most common psychiatric diagnoses in both the JIA patients (10.4 and 8.2%) and the control group (5.4 and 5.1%), respectively. Female patients were more prone to mental and behavioural disorders than males were, and the risk seemed to be higher in patients who developed JIA in early childhood or adolescence. Conclusion Patients with JIA are diagnosed with mental and behavioural disorders more often than controls, and the age at onset of JIA could have implications for future mental health.Peer reviewe

Processing of pragmatic communication in ASD: a video-based brain imaging study

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Psychometric evaluation of social phobia and anxiety inventory for children (SPAI-C) and social anxiety scale for children-revised (SASC-R)

The study evaluated the psychometric properties of Finnish versions of the Social Phobia and Anxiety Inventory for Children (SPAI-C) and the Social Anxiety Scale for Children-Revised (SASC-R). 352 students (M = 12.2 years) participated in the study and completed the SPAI-C and SASC-R. In addition, 68 participants (M = 12.2 years) and their parents were interviewed with the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS-PL). The SPAI-C was more sensitive for identifying youth meeting criteria for social phobia (SP), whereas the SASC-R demonstrated greater specificity. The youth in this sample had lower mean total scores on the self-report questionnaires than did those in the original validitation studies of the SPAI-C and SASC-R conducted in America. These findings question whether cross-cultural differences in the expression of SP influence the clinical cut-off scores used in translated versions of social anxiety questionnaires

Hyötyykö käytöshäiriöinen nuori nuorisopsykiatrisesta osastohoidosta?

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Lasten ja nuorten mielenterveyskuntoutus : Terveydenhuollon ja Kelan yhteistyötä

Suositus on tehty Kelan ja julkisen terveydenhuollon asiantuntijoiden valtakunnallisessa yhteistyössä. Suositus on suunnattu kuntoutusta suunnitteleville ja toteuttaville tahoille. Lapsi tai nuori voi saada Kelan vaativaa lääkinnällistä kuntoutusta, kun • hän ei ole julkisessa laitoshoidossa • hänellä on sairaus tai vamma sekä siihen liittyvä suoritus- ja osallistumisrajoite • suoritus- ja osallistumisrajoite on niin suuri, että hänellä on sen vuoksi huomattavia vaikeuksia arjen toiminnoista suoriutumisessa ja osallistumisessa kotona, opiskelussa, työelämässä tai muissa elämäntilanteissa • rajoite aiheuttaa vähintään vuoden kestävän kuntoutustarpeen • kuntoutus ei liity välittömään sairaanhoitoon • kuntoutuksen tavoitteet eivät ole ainoastaan hoidollisia • kuntoutus on perustellusti tarpeen mahdollistamaan aktiivista ja harkittua arjen toiminnoista suoriutumista ja osallistumista. Suosituksessa ei esitetä yksityiskohtaisesti kuntoutusmenetelmiä eikä vaikuttavuusnäyttöä. Näiltä osin suosituksessa viitataan Käypä hoito -suosituksiin, ajankohtaisiin oppikirjoihin ja tutkimuksiin. Muihin kuin mielenterveyshäiriöiden diagnooseihin, kuten esimerkiksi aistivammaisuuteen tai kehitysvammaisuuteen liittyviä erityistarpeita ei käsitellä tässä suosituksessa. Suosituksessa kuvataan julkisen terveydenhuollon järjestämisvastuu sekä ikäryhmäkohtainen toimintakyvyn arvioinnin ja kuntoutuksen valinnan, käynnistämisen ja seuraamisen prosessi. Suosituksessa kuvataan Kelan järjestämien kuntoutustoimenpiteiden asiakkuuskriteerit vaativan lääkinnällisen kuntoutuksen (luvut 9 ja 10), harkinnanvaraisen kuntoutuksen (luvut 10, 11 ja 12), kuntoutuspsykoterapian (luku 13) sekä ammatillisen kuntoutuksen (luku 14) osalta. Lisäksi suosituksessa esitetään keskeiset lapsen ja nuoren kuntoutusta tukevat etuudet (luvut 15 ja 16) ja se, milloin lapsella tai nuorella voi olla mahdollisuus Kelan maksamaan opiskelun apuvälineeseen (luku 17).nonPeerReviewedVertaisarvioimato

When does the Autism Spectrum Screening Questionnaire (ASSQ) predict autism spectrum disorders in primary school-aged children?

The aims of this study were, firstly, to study the association between parents’ and teachers’ ratings for the Finnish version of the Autism Spectrum Screening Questionnaire (ASSQ), secondly, to find out whether the original cut-off scores of the ASSQ identify primary school-aged children with Asperger syndrome (AS) or autism by using the Finnish ASSQ, and thirdly, to evaluate the validity of the ASSQ. Parents and/or teachers of higher-functioning (full-scale intelligence quotient ≥ 50) 8-year-old total population school children (n = 4,408) and 7–12-year-old outpatients with AS/autism (n = 47) completed the Finnish version of the ASSQ. Agreement between informants was slight. In the whole total population, low positive correlation was found between parents’ and teachers’ ratings, while in the sample of high-scoring children the correlation turned out to be negative. A cut-off of 30 for parents’ and teacher's summed score and 22 for teachers’ single score is recommended. A valid cut-off for parents’ single score could not been estimated. The clinicians are reminded that the ASSQ is a screening instrument, not a diagnosing instrument. The importance of using both parents’ and teachers’ ratings for screening in clinical settings is underlined

Nuorten käytöshäiriöt: arviointi ja hoito

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Familiality of Quantitative Autism Traits

Autistic traits exist along a continuum that extends into social functioning in the general population, and they aggregate in the family members of children with autism spectrum disorder (ASD). Quantitative measures are therefore essential when investigating the patterns of familiality of these traits. Prior studies have suggested differential inheritance patterns of autistic traits that depend on the cognitive level of the child with ASD as well as the family type.Our goal was to examine the family patterns of quantitative autism traits (QAT) in a group of simplex autism families of high-functioning children with ASD.We used the Social Responsiveness Scale (SRS) to evaluate QAT in 47 ASD families and 46 control families. SRS assessments (parental/spousal evaluations) were collected for the children with ASD, their siblings, and their parents as well as for the control children and their parents.The SRS was able to distinguish individuals with ASD from the control children and from their unaffected siblings. Significant group differences were also found when comparing the fathers of ASD families to control fathers and when comparing the brothers of individuals with ASD to control boys, with male members of ASD families having higher SRS scores. Gender differences were observed in the group of siblings of children with ASD and the group of parents of children with ASD, with males having higher scores than females. In ASD families, a positive trend between child and father QAT was found, whereas mothers' scores were not associated with child outcomes. By contrast, in control families, mothers' QAT correlated more strongly with child QAT.Autistic traits aggregate in the fathers and brothers of children with ASD in simplex autism families. The QAT levels of the family members should be taken into consideration when planning the rehabilitation of the child or adolescent with ASD and when designing family interventions

Autismikirjon häiriön varhainen tunnistaminen ja diagnosointi Suomessa - perheiden näkemys

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Brain structural deficits and working memory fMRI dysfunction in young adults who were diagnosed with ADHD in adolescence.

When adolescents with ADHD enter adulthood, some no longer meet disorder diagnostic criteria but it is unknown if biological and cognitive abnorma lities persist. We tested the hypothesis that people diagnosed with ADHD during adolescence present residual brain abnormalities both in brain structure and in working memory brain function. 83 young adults (aged 20-24 years) from the Northern Finland 1986 Birth Cohort were classified as diagnosed with ADHD in adolescence (adolescence ADHD, n = 49) or a control group (n = 34). Only one patient had received medication for ADHD. T1-weighted brain scans were acquired and processed in a voxel-based analysis using permutation-based statistics. A sub-sample of both groups (ADHD, n = 21; controls n = 23) also performed a Sternberg working memory task whilst acquiring fMRI data. Areas of structural difference were used as a region of interest to evaluate the implications that structural abnormalities found in the ADHD group might have on working memory function. There was lower grey matter volume bilaterally in adolescence ADHD participants in the caudate (p < 0.05 FWE corrected across the whole brain) at age 20-24. Working memory was poorer in adolescence ADHD participants, with associated failure to show normal load-dependent caudate activation. Young adults diagnosed with ADHD in adolescence have structural and functional deficits in the caudate associated with abnormal working memory function. These findings are not secondary to stimulant treatment, and emphasise the importance of taking a wider perspective on ADHD outcomes than simply whether or not a particular patient meets diagnostic criteria at any given point in time.This work was supported by an Academy of Finland Award to Dr Veijola; a Sigrid Juselius Foundation grant to Dr Moilanen; a Medical Research Council fellowship to Dr Murray (G0701911); a NARSAD, the Brain and Behavior Research Fund independent investigator award to Dr Miettunen; an Oon Khye Beng Ch'Hia Tsio Studentships in Preventative Medicine awarded by Downing College, Cambridge to Dr Roman-Urrestarazu together with a Becas Chile Doctoral Grant awarded by CONICYT, an Academy of Finland grant and Finnish Medical Foundation grant to Dr Kiviniemi, and an award from the Signe and Ane Gyllenberg Foundation, Finland, to Dr Mäki.. The work was partially conducted with the University of Cambridge Behavioural and Clinical Neuroscience Centre, supported by a joint award from the Medical Research Council (G1000183) and Wellcome Trust (093875/Z/10Z).This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s00787-015-0755-