Cognitive-behavioural therapy for children and adolescents with tic disorders

The article provides an overview of tic disorders and empirically supported cognitive-behavioural techniques for treating tics and helping children and adolescents to learn effective coping skills to manage the adverse psychosocial consequences the ticks may produce. The article first defines and describes tics and tic disorders, it presents the epidemiological data, the course of the disorder, its comorbid conditions and the psychosocial consequences of tics, assessment methods and indications for treatment. The second part of the article focuses on the description of cognitive-behavioural treatment methods compliant with the clinical guidelines for the treatment of tic disorders. Psychoeducation and two of the most studied and empirically supported behavioural techniques – habit reversal training and exposure with response prevention – targeting tics directly, are described in more detail. The results of empirical research corroborating the effectiveness of the behavioural treatments of tics are provided. Other cognitive-behavioural techniques aimed at managing adverse psychosocial consequences and co-occurring problems are also presented. Finally, the requirements for effective cognitive-behavioural therapy for children and adolescents with tics are discussed together with ideas for the dissemination of knowledge of specific therapeutic methods among cognitive-behavioural therapists in Slovenia

Daily Eastern News: December 02, 1998

https://thekeep.eiu.edu/den_1998_dec/1001/thumbnail.jp

Prognostic Value of Various Diagnostic Methods for Long-Term Outcome of Newborns After Hypoxic-Ischemic Encephalopathy Treated With Hypothermia

IntroductionPrediction of outcome in newborns with hypoxic-ischemic encephalopathy (HIE) has been modulated by hypothermia treatment (HT). We assessed the predictive value of diagnostic methods commonly used in neonates with HIE for short-term neurodevelopmental outcome and long-term neurological outcome.Materials and MethodsThis longitudinal cohort study followed up 50 term newborns who underwent HT after HIE between July 2006 and August 2015, until preschool age. We estimated sensitivity and specificity for short-term neurodevelopmental outcome at 18 months and long-term neurological outcome at five years based on Amiel-Tison Neurological Assessment (ATNA), electroencephalography (EEG), and magnetic resonance imaging (MRI) performed in the neonatal period.ResultsThe accuracy of all neonatal methods tested was higher for long-term neurological outcome compared to the predictive accuracy for short-term neurodevelopmental outcome at 18–24 months. Sensitivity and specificity in predicting unfavorable long-term neurological outcome were: MRI (sensitivity 1.0 [95%CI 0.96–1.0]; specificity 0.91 [95%CI 0.86–1.0]), EEG (sensitivity 0.94 [95%CI 0.71–1.0]; specificity 1.0 [95% CI 0.89–1.0]), and ATNA (sensitivity 0.94 [95%CI 0.71–1.0]; specificity 0.91 [95%CI 0.76–0.98]).ConclusionMRI is a powerful predictor of long-term neurological outcome when performed in the first week after HIE in HT treated infants, as are EEG and ATNA performed in the second or third week postnatally

Prikaz primera prvega uspešnega genskega zdravljenja slovenskega bolnika z mukopolisaharidozo tipa I v tujini

Mukopolisaharidoze so skupina lizosomskih bolezni kopičenja. Njihova skupna značilnost je pomanjkanje delovanja encimov, ki razgrajujejo glikozaminoglikane, polisaharide, ki se povezujejo s proteoglikani in tvorijo zunajcelični matriks. Ker ni encimov, ki bi glikozaminoglikane razgrajevali, se ti kopičijo v lizosomih in povzročijo njihovo okvaro in zato se okvarijo drugi celični organeli, celice in končno organi. Klinična slika je široka, od nevro-kognitivnega upada, skeletno-mišičnih deformacij in tipičnih obraznih sprememb. Ključno je zgodnje prepoznavanje bolezni, čeprav s trenutno dostopnimi načini zdravljenja bolezni ne moremo ozdraviti, lahko pa le upočasnimo njen potek, kar je najbolj učinkovito v fazi bolezni še pred pojavom simptomov. Obetavni način zdravljenja je gensko zdravljenje, ki nakazuje možnost ozdravitve bolezni. Predstavljamo primer dečka, pri katerem je bil prepoznan zgodnji kognitivni upad in za bolezen tipične spremembe. Napoten je bil v terciarno ustanovo, kjer je bila diagnoza potrjena. Deček je bil julija 2018 zdravljen z eksperimentalnim genskim zdravljenjem v tujini (bolnišnica San Raffaele, Milano, Italija). V opisanem primeru gre po našem vedenju za prvo uspešno izpeljano gensko zdravljenje pri slovenskih bolnikih ter za enega prvih primerov genskega zdravljenja mukopolisaharidoze tipa I v svetovnem merilu. Gensko zdravljenje s tem postaja del nove klinične stvarnosti, kar predstavlja pomemben mejnik za naš prostor. Zaradi naprednih zdravljenj bi bilo v prihodnosti smiselno uvesti presejalno testiranje novorojenčkov za MPS tipa I, ki se pri nas ali v Evropi doslej še ne izvaja. Do tedaj pa ostaja najpomembnejši predpogoj za uspešno zdravljenje zgodnja klinična prepoznava bolezni in napotitev v terciarno zdravstveno ustanovo

Medical education in the field of communication as a value and a means of health quality improvement

The article discusses the issues of communication between a doctor and a patient as one of the main approaches within the patients\u27 medical treatment. This approach, which includes the field of communication in medicine as a value, more and more appears as obligatory not only in the field of profession itself, but also in the field of the patients\u27 needs. Communication covers a huge part of our social as well as intimate lives . Our social functioning is based on communication. The transfer and preserving of values is based on communication. Especially in the field of medicine, the function of communication appears to be one of the key elements to allow a better and complete treatment of the patient. The article discusses studies which have shown that communication skills have to be developed, it is advisable to introduce them into the educational programmes for med students and medical staff. Researches have shown that students, who were taught the field of communication skills, later as doctors or medical staff obtained a lot more information about patients than those who were not given such education

Adaptive skills

Adaptive skills are defined as a collection of conceptual, social and practical skills that are learned by people in order to function in their everyday lives. They include an individual's ability to adapt to and manage her or his surroundings to effectively function and meet social or community expectations. Good adaptive skills promote individual's independence in different environments, whereas poorly developed adaptive skills are connected to individual's dependency and with greater need for control and help with everyday tasks. Assessment of adaptive skills is often connected to assessment of intellectual disability, due to the reason that the diagnosis of intellectual disability includes lower levels of achievements on standardized tests of intellectual abilities as well as important deficits in adaptive skills. Assessment of adaptive behavior is a part of standard assessment battery with children and adults with different problems, disorders or disabilities that affect their everyday functioning. This contribution also presents psychometric tools most regularly used for assessment of adaptive skills and characteristics of adaptive skills with individual clinical groups

Association Between Neurological Signs and Developmental Outcome: Pilot Results in Preterm Group

Aim To study the correlations between neurological signs and developmental performance, and to analyze the value of neurological signs in identification of developmental disabilities. Methods A group of 26 preterm infants (gestational age from 23 weeks to 36 weeks) was studied. The neurological assessment described by Amiel-Tison and Gosselin was performed at term age and repeated every 3 months up to the age of 2, when the sum of all adverse findings was categorized. According to the nature and associations of neurological and cranial signs, patients were divided into 5 categories: 1) cerebral palsy; 2) minimal cerebral palsy; 3) Amiel-Tison triad; 4) intermediate; and 5) normal. Developmental assessment using the Bayley Scales of Infant Development, second edition, was performed between the age of 2 and 3, and the Mental and Psychomotor Developmental Index was determined. Results The developmental performance was highest in the group of children without neurological signs and lowest in the group with cerebral palsy. There was a strong correlation between neurological signs and mental developmental performance (Spearman ρ = 0.71), while the correlation between neurological signs and psychomotor developmental performance was weaker (Spearman ρ = 0.54). Conclusion Categorization of neurological assessment and identification of 3 minor neurological signs may be a valuable tool for early detection of children with developmental disabilities

Effectiveness of psychoeducation for children, adolescents and caregivers in the treatment of eating disorders

Background: Eating disorders in childhood and adolescence negatively affect many areas of development and functioning of children, adolescents, and their families. Psychoeducation has an important role in management and treatment of eating disorders. Methods: A systematic literature review was performed using multiple databases (PsycInfo, PubMed, and Web of Science). The inclusion criteria comprised empirical studies of psychoeducation for patients with eating disorders or their caregivers. The study reporting quality was assessed with the revised Cochrane Collaboration\u27s risk of bias tool and the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields for non‐randomized studies. Results: Ten studies met the inclusion criteria, in three of which the interventions were patient‐centred and in seven of which the interventions were caregiver‐centred. The studies differed in terms of methodology, outcome measures, and quality. The results suggest that psychoeducation is an effective intervention for children, adolescents and caregivers in the treatment of eating disorders. It may lead to weight gain, a decrease in eating disorder symptoms, and a reduction in caregiver burden. Conclusions: There is a need for more randomized controlled trials to determine the effectiveness of psychoeducation for children, adolescents and caregivers in treatment of eating disorders