The benefits of digitisation of psychiatric care facilities

The potential benefits of providing digital mental healthcare to isolated rural populations are emphasised in two articles from Pakistan. Novel programmes of support have been instituted by both private and publicly funded services

Toward specifying Pervasive Developmental Disorder - Not Otherwise Specified

Pervasive developmental disorder-not otherwise specified (PDD-NOS) is the most common and least satisfactory of the PDD diagnoses. It is not formally operationalized, which limits its reliability and has hampered attempts to assess its validity. We aimed, first, to improve the reliability and replicability of PDD-NOS by operationalizing its DSM-IV-TR description and, second, to test its validity through comparison with autistic disorder (AD) and Asperger's disorder (AsD). In a sample of 256 young people (mean age = 9.1 years) we used Developmental, Diagnostic and Dimensional (3Di) algorithmic analysis to classify DSM-IV-TR AD (n = 97), AsD (n = 93) and PDD-NOS (n = 66). Groups were compared on independent measures of core PDD symptomatology, associated autistic features, and intelligence. Contrary to the assumption that PDD-NOS is heterogeneous, almost all (97%) of those with PDD-NOS had one distinct symptom pattern, namely impairments in social reciprocity and communication, without significant repetitive and stereotyped behaviors (RSB). Compared to AD and AsD, they had comparably severe but more circumscribed social communication difficulties, with fewer non-social features of autism, such as sensory, feeding and visuo-spatial problems. These individuals appear to have a distinct variant of autism that does not merely sit at the less severe end of the same continuum of symptoms. The current draft guidelines for DSM-V, which mandate the presence of RSBs for any PDD diagnosis, would exclude such people from the autistic spectrum. Autism Res 2011, 4: 121-131. (C) 2011 International Society for Autism Research, Wiley Periodicals, Inc

Mental health and neurodevelopment in children and adolescents with Turner syndrome

OBJECTIVES: Turner syndrome (TS) is a rare sex chromosome aneuploidy, with an incidence of four in 10,000 new-born girls. TS is often associated with impaired social communication skills, but the extent to which these are attributable to Autism Spectrum Disorders (ASD) is uncertain. We made standardized assessments of the mental health and associated neurodevelopmental disorders in children and adolescents with TS and report on the prevalence of concurrent conditions. METHODS: Our sample comprised 127 girls with TS, 5-19 years of age. We obtained reports of their mental health from a combination of diagnostic interview (the Development and Wellbeing Assessment (DAWBA)), from the Strengths and Difficulties Questionnaire (SDQ) and from the Social Responsiveness Scale (SRS-2). Sources of information included parents, teachers and self-reports. The prevalence of mental health disorders in this sample was compared with age/sex matched national English data from typical controls. RESULTS: Most individuals with TS (83%) had experienced significant social communication difficulties and nearly one in four (23%) met diagnostic criteria for ASD on the DAWBA. One-third (34%) had at least one mental health or neurodevelopmental condition, and those girls with an ASD were at a greater risk of a co-occurring emotional disorder and/or attention deficit hyperactivity disorder (ADHD). CONCLUSION: Children and adolescents with TS are substantially more likely to meet criteria for ASD than their typically developing peers. Our finding has clinical implications for appropriate behavioural management from preschool through to adolescence

Can Children See Emotions in Faces?

One way in which we figure out how people are feeling is by looking at their faces. Being able to do this allows us to react in the right way in social situations. But, are young children good at recognizing facial expressions showing emotion? And how does this ability develop throughout childhood and the teenage years? Children are able to recognize certain emotions very well when they are just 6 years old, but become better at recognizing other emotions as they grow older. At all ages, girls seem to have less difficulty than boys in recognizing emotions. Hormones that our bodies produce at puberty do not only influence how our bodies develop but also influence how our brains develop and how we change emotionally. Understanding more about the typical development of emotion recognition can guide us in helping children who have difficulties with these skills

The benefits of digitisation of psychiatric care facilities

The potential benefits of providing digital mental healthcare to isolated rural populations are emphasised in two articles from Pakistan. Novel programmes of support have been instituted by both private and publicly funded services

Practising psychiatry in Sri Lanka: challenges and opportunities

This month's issue of BJPsych International focuses on psychiatry in Sri Lanka, with articles on suggested improvements in education and training, the country's outdated legislation regarding involuntary psychiatric treatment, and the misuse of prescription medications

Factor associated with the occurrence of epilepsy in autism: A systematic review

This systematic review aimed to identify factors significantly associated with the occurrence of epilepsy in autistic individuals and to consider the impact of study quality on findings. Electronic databases were systematically searched on October 2nd, 2020 and records retrieved were limited to those published from 2000 onwards. Study quality was categorised as 'good', 'moderate' or 'weak'. Fifty-three studies were included and in studies where the prevalence of epilepsy was reported (n = 257,892), 18,254 (7%) had co-occurring epilepsy. Intellectual disability/cognitive impairment was the most commonly reported risk factor associated with occurrence of epilepsy in autistic individuals. The evidence supporting other, potentially relevant factors was weak and inconsistent and requires further evaluation. Only 9/53 studies were considered 'good' quality

We have been in lockdown since he was born':A mixed methods exploration of the experiences of families caring for children with intellectual disability during the COVID-19 pandemic in the UK

OBJECTIVES: This study aimed to explore the experiences of parents caring for children with intellectual and developmental disabilities (IDD) during the UK national lockdown in spring 2020, resulting from the COVID-19 pandemic. DESIGN: Participants were identified using opportunity sampling from the IMAGINE-ID national (UK) cohort and completed an online survey followed by a semistructured interview. Interviews were analysed using thematic analysis. SETTING: Interviews were conducted over the telephone in July 2020 as the first UK lockdown was ending. PARTICIPANTS: 23 mothers of children with intellectual and developmental disabilities aged 5–15 years were recruited. RESULTS: Themes reported by parents included: managing pre-existing challenges during a time of extreme change, having mixed emotions about the benefits and difficulties that arose during the lockdown and the need for appropriate, individualised support. CONCLUSIONS: Our findings confirm observations previously found in UK parents of children with IDD and provide new insights on the use of technology during the pandemic for schooling and healthcare, as well as the need for regular check-ins

Protocol: New approaches to managing the social deficits of Turner Syndrome using the PEERS program [version 2; peer review: 2 approved]

Turner Syndrome (TS) is a sex chromosome aneuploidy (45,X) associated with social skill difficulties. Recent clinical care guidelines recommend that the Program for the Education and Enrichment of Relational Skills (PEERS) social skills intervention programme be trialled in this population. PEERS has been successfully used in adolescents with autism spectrum conditions without intellectual disabilities. The PEERS program will be piloted with adolescents and young women with TS aged 16-20 using an uncontrolled study trial with a multiple-case series design. The program will be delivered face to face and online. The assessment battery is designed to measure social skills comprehensively from diverse informants (parent, teacher young person). It includes measures of social performance, social knowledge and social cognition. Parents and young people taking part in the intervention will also feedback on the acceptability and feasibility of the pilot. The outcomes of this small scale pilot (n=6-10) will be used to adapt the programme based on feedback and estimate the sample for a future randomised controlled trial