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  1 / 1389 MEDLINE  
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[PMID]:28697832
[Au] Autor:Guo JM; Shi XX; Yang SW; Qian QF; Huang Y; Xie YQ; Ou P
[Ad] Endereço:Fujian Provincial Maternity and Children's Hospital of Fujian Medical University, Fuzhou, Fujian 350001, China. eve1019@126.com.
[Ti] Título:[Efficacy of clonidine transdermal patch in treatment of moderate to severe tic disorders in children].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(7):786-789, 2017 Jul.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To investigate the difference in the efficacy between clonidine transdermal patch and haloperidol tablets in the treatment of moderate to severe tic disorders in children. METHODS: A total of 134 children with moderate to severe tic disorders were randomly divided into clonidine group (n=70) and haloperidol group (n=64). The clonidine and haloperidol groups were treated with clonidine transdermal patch and haloperidol tablets respectively, and the treatment lasted for 8 weeks in both groups. The Yale Global Tic Severity Scale (YGTSS) was used to evaluate the conditions of the children before and after treatment, and the adverse events during the treatment were recorded. RESULTS: The haloperidol group had a significantly better treatment outcome than the clonidine group after one week of treatment (P<0.05); the treatment outcome showed no significant difference between the two groups after 3, 5, and 8 weeks of treatment (P>0.05). The clonidine group had significantly less reductions in the motor tics, vocal tics, and function impairment scores and total score of YGTSS than the haloperidol group after one week of treatment (P<0.05); there were no significant differences in YGTSS score reductions between the two groups after 3, 5, and 8 weeks of treatment (P>0.05). The clonidine group had a significantly lower overall incidence of adverse events than the haloperidol group (8% vs 37%; P<0.01). CONCLUSIONS: Clonidine transdermal patch and haloperidol are both effective in the treatment of moderate to severe tic disorders in children. The clonidine transdermal patch, despite slow action, has comparable efficacy and fewer adverse effects compared with haloperidol.
[Mh] Termos MeSH primário: Clonidina/administração & dosagem
Transtornos de Tique/tratamento farmacológico
Adesivo Transdérmico
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Feminino
Haloperidol/uso terapêutico
Seres Humanos
Masculino
Índice de Gravidade de Doença
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
J6292F8L3D (Haloperidol); MN3L5RMN02 (Clonidine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE


  2 / 1389 MEDLINE  
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[PMID]:28594866
[Au] Autor:Uebel-von Sandersleben H; Albrecht B; Rothenberger A; Fillmer-Heise A; Roessner V; Sergeant J; Tannock R; Banaschewski T
[Ad] Endereço:Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany.
[Ti] Título:Revisiting the co-existence of Attention-Deficit/Hyperactivity Disorder and Chronic Tic Disorder in childhood-The case of colour discrimination, sustained attention and interference control.
[So] Source:PLoS One;12(6):e0178866, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Attention Deficit / Hyperactivity Disorder (ADHD) and Chronic Tic Disorder (CTD) are two common and frequently co-existing disorders, probably following an additive model. But this is not yet clear for the basic sensory function of colour processing sensitive to dopaminergic functioning in the retina and higher cognitive functions like attention and interference control. The latter two reflect important aspects for psychoeducation and behavioural treatment approaches. METHODS: Colour discrimination using the Farnsworth-Munsell 100-hue Test, sustained attention during the Frankfurt Attention Inventory (FAIR), and interference liability during Colour- and Counting-Stroop-Tests were assessed to further clarify the cognitive profile of the co-existence of ADHD and CTD. Altogether 69 children were classified into four groups: ADHD (N = 14), CTD (N = 20), ADHD+CTD (N = 20) and healthy Controls (N = 15) and compared in cognitive functioning in a 2×2-factorial statistical model. RESULTS: Difficulties with colour discrimination were associated with both ADHD and CTD factors following an additive model, but in ADHD these difficulties tended to be more pronounced on the blue-yellow axis. Attention problems were characteristic for ADHD but not CTD. Interference load was significant in both Colour- and Counting-Stroop-Tests and unrelated to colour discrimination. Compared to Controls, interference load in the Colour-Stroop was higher in pure ADHD and in pure CTD, but not in ADHD+CTD, following a sub-additive model. In contrast, interference load in the Counting-Stroop did not reveal ADHD or CTD effects. CONCLUSION: The co-existence of ADHD and CTD is characterized by additive as well as sub-additive performance impairments, suggesting that their co-existence may show simple additive characteristics of both disorders or a more complex interaction, depending on demand. The equivocal findings on interference control may indicate limited validity of the Stroop-Paradigm for clinical assessments.
[Mh] Termos MeSH primário: Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia
Percepção de Cores/fisiologia
Transtornos de Tique/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Feminino
Seres Humanos
Masculino
Testes Neuropsicológicos
Teste de Stroop
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0178866


  3 / 1389 MEDLINE  
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[PMID]:28538981
[Au] Autor:Orlovska S; Vestergaard CH; Bech BH; Nordentoft M; Vestergaard M; Benros ME
[Ad] Endereço:Mental Health Centre Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark2iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.
[Ti] Título:Association of Streptococcal Throat Infection With Mental Disorders: Testing Key Aspects of the PANDAS Hypothesis in a Nationwide Study.
[So] Source:JAMA Psychiatry;74(7):740-746, 2017 Jul 01.
[Is] ISSN:2168-6238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Streptococcal infection has been linked with the development of obsessive-compulsive disorder (OCD) and tic disorders, a concept termed pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). However, previous studies of this association have been small, and the results have been conflicting. Objective: To investigate the risk of mental disorders, specifically OCD and tic disorders, after a streptococcal throat infection. Design, Setting, and Participants: A population-based cohort study was conducted using data from the nationwide Danish registers from January 1, 1996, to December 31, 2013, with up to 17 years of follow-up. The Danish National Health Service Register provided information on individuals with the registration of a streptococcal test. Data analysis was conducted from January 1, 2016, to February 28, 2017. Main Outcomes and Measures: Individuals were followed up in the nationwide Psychiatric Central Register for a diagnosis of any mental disorder, OCD, or tic disorders. Incidence rate ratios (IRRs) were calculated by Poisson regression analysis. Results: Of the 1 067 743 children (<18 years of age) included in the study (519 821 girls and 547 922 boys), 638 265 received a streptococcal test, 349 982 of whom had positive test results at least once. Individuals with a positive streptococcal test result had an increased risk of any mental disorder (n = 15 408; IRR, 1.18; 95% CI, 1.15-1.21; P < .001), particularly of OCD (n = 556; IRR, 1.51; 95% CI, 1.28-1.77; P < .001) and tic disorders (n = 993; IRR, 1.35; 95% CI, 1.21-1.50; P < .001), compared with individuals without a streptococcal test. Furthermore, the risk of any mental disorder and OCD was more elevated after a streptococcal throat infection than after a nonstreptococcal infection. Nonetheless, individuals with a nonstreptococcal throat infection also had an increased risk of any mental disorder (n = 11 315; IRR, 1.08; 95% CI, 1.06-1.11; P < .001), OCD (n = 316; IRR, 1.28; 95% CI, 1.07-1.53; P = .006), and tic disorders (n = 662; IRR, 1.25; 95% CI, 1.12-1.41; P < .001). Conclusions and Relevance: This large-scale study investigating key aspects of the PANDAS hypothesis found that individuals with a streptococcal throat infection had elevated risks of mental disorders, particularly OCD and tic disorders. However, nonstreptococcal throat infection was also associated with increased risks, although less than streptococcal infections for OCD and any mental disorder, which could also support important elements of the diagnostic concept of pediatric acute-onset neuropsychiatric syndrome.
[Mh] Termos MeSH primário: Doenças Autoimunes/epidemiologia
Transtorno Obsessivo-Compulsivo/epidemiologia
Faringite/epidemiologia
Sistema de Registros/estatística & dados numéricos
Infecções Estreptocócicas/epidemiologia
Transtornos de Tique/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Fatores Etários
Criança
Pré-Escolar
Dinamarca/epidemiologia
Feminino
Seres Humanos
Masculino
Transtorno Obsessivo-Compulsivo/etiologia
Transtorno Obsessivo-Compulsivo/microbiologia
Faringite/complicações
Faringite/microbiologia
Risco
Fatores Sexuais
Transtornos de Tique/etiologia
Transtornos de Tique/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170525
[St] Status:MEDLINE
[do] DOI:10.1001/jamapsychiatry.2017.0995


  4 / 1389 MEDLINE  
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[PMID]:28339122
[Au] Autor:Meier SM; Dalsgaard S; Mortensen PB; Leckman JF; Plessen KJ
[Ad] Endereço:National Centre for Register-Based Research, NCRR, Aarhus University, Aarhus V, Denmark.
[Ti] Título:Mortality risk in a nationwide cohort of individuals with tic disorders and with tourette syndrome.
[So] Source:Mov Disord;32(4):605-609, 2017 04.
[Is] ISSN:1531-8257
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Few studies have investigated mortality risk in individuals with tic disorders. METHODS: We thus measured the risk of premature death in individuals with tic disorders and with Tourette syndrome in a prospective cohort study with 80 million person-years of follow-up. We estimated mortality rate ratios and adjusted for calendar year, age, sex, urbanicity, maternal and paternal age, and psychiatric disorders to compare individuals with and without tic disorders. RESULTS: The risk of premature death was higher among individuals with tic disorders (mortality rate ratio, 2.02; 95% CI, 1.49-2.66) and with Tourette syndrome (mortality rate ratio, 1.63; 95% CI, 1.11-2.28) compared with controls. After the exclusion of individuals with comorbid attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, and substance abuse, tic disorder remained associated with increased mortality risk (mortality rate ratio, 2.30; 95% CI, 1.57-3.23), as did also Tourette Syndrome (mortality rate ratio, 1.81; 95% CI, 1.11-2.75). CONCLUSIONS: These results are of clinical significance for clinicians and advocacy organizations. Several factors may contribute to this increased risk of premature death, and more research mapping out these factors is needed. © 2017 International Parkinson and Movement Disorder Society.
[Mh] Termos MeSH primário: Transtornos de Tique/epidemiologia
Transtornos de Tique/mortalidade
Síndrome de Tourette/epidemiologia
Síndrome de Tourette/mortalidade
[Mh] Termos MeSH secundário: Adulto
Distribuição por Idade
Estudos de Coortes
Dinamarca/epidemiologia
Feminino
Seres Humanos
Masculino
Sistema de Registros
Distribuição por Sexo
Transtornos de Tique/complicações
Síndrome de Tourette/complicações
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.1002/mds.26939


  5 / 1389 MEDLINE  
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[PMID]:28121259
[Au] Autor:Cavanna AE; Black KJ; Hallett M; Voon V
[Ad] Endereço:This article represents the Report of the American Neuropsychiatric Association's Committee on Research (ANPA CoR).
[Ti] Título:Neurobiology of the Premonitory Urge in Tourette's Syndrome: Pathophysiology and Treatment Implications.
[So] Source:J Neuropsychiatry Clin Neurosci;29(2):95-104, 2017.
[Is] ISSN:1545-7222
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Motor and vocal tics are relatively common motor manifestations identified as the core features of Tourette's syndrome (TS). Although traditional descriptions have focused on objective phenomenological observations, such as anatomical location, number and frequency of tics, patients' first-person accounts have consistently reported characteristic subjective correlates. These sensory phenomena are often described as a feeling of mounting inner tension or urge to move ("premonitory urge"), which is transiently relieved by tic expression. This article reviews the existing literature on the clinical and neurobiological aspects of the premonitory urge in patients with TS, with focus on its pathophysiology and possible treatment implications.
[Mh] Termos MeSH primário: Neurologia/métodos
Síndrome de Tourette/fisiopatologia
Síndrome de Tourette/terapia
[Mh] Termos MeSH secundário: Bases de Dados Bibliográficas/estatística & dados numéricos
Seres Humanos
Transtornos de Tique/fisiopatologia
Tiques/fisiopatologia
Síndrome de Tourette/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE
[do] DOI:10.1176/appi.neuropsych.16070141


  6 / 1389 MEDLINE  
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[PMID]:27864156
[Au] Autor:Abramovitch A; Hallion LS; Reese HE; Woods DW; Peterson A; Walkup JT; Piacentini J; Scahill L; Deckersbach T; Wilhelm S
[Ad] Endereço:Department of Psychology, Texas State University, San Marcos, TX, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: abramovitch@txstate.edu.
[Ti] Título:Neurocognitive predictors of treatment response to randomized treatment in adults with tic disorders.
[So] Source:Prog Neuropsychopharmacol Biol Psychiatry;74:9-14, 2017 Mar 06.
[Is] ISSN:1878-4216
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Tourette's disorder (TS) and chronic tic disorder (CTD) are neurodevelopmental disorders characterized by involuntary vocal and motor tics. Consequently, TS/CTD have been conceptualized as disorders of cognitive and motor inhibitory control. However, most neurocognitive studies have found comparable or superior inhibitory capacity among individuals with TS/CTD relative to healthy controls. These findings have led to the hypothesis that individuals with TS/CTD develop increased inhibitory control due to the constant need to inhibit tics. However, the role of cognitive control in TS/CTD is not yet understood, particularly in adults. To examine the role of inhibitory control in TS/CTD, the present study investigated this association by assessing the relationship between inhibitory control and treatment response in a large sample of adults with TS/CTD. As part of a large randomized trial comparing behavior therapy versus supportive psychotherapy for TS/CTD, a battery of tests, including tests of inhibitory control was administered to 122 adults with TS/CTD at baseline. We assessed the association between neuropsychological test performance and change in symptom severity, as well as compared the performance of treatment responders and non-responders as defined by the Clinical Global Impression Scale. Results indicated that change in symptoms, and treatment response were not associated with neuropsychological performance on tests of inhibitory control, intellectual ability, or motor function, regardless of type of treatment. The finding that significant change in symptom severity of TS/CTD patients is not associated with impairment or change in inhibitory control regardless of treatment type suggests that inhibitory control may not be a clinically relevant facet of these disorders in adults.
[Mh] Termos MeSH primário: Terapia Comportamental
Inibição (Psicologia)
Transtornos de Tique/reabilitação
Síndrome de Tourette/reabilitação
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Testes Neuropsicológicos
Escalas de Graduação Psiquiátrica
Índice de Gravidade de Doença
Transtornos de Tique/psicologia
Síndrome de Tourette/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170830
[Lr] Data última revisão:
170830
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161120
[St] Status:MEDLINE


  7 / 1389 MEDLINE  
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[PMID]:27734468
[Au] Autor:Capriotti MR; Turkel JE; Johnson RA; Espil FM; Woods DW
[Ad] Endereço:San José State University, University of California San Francisco, University of Wisconsin-Milwaukee.
[Ti] Título:Comparing fixed-amount and progressive-amount DRO Schedules for tic suppression in youth with chronic tic disorders.
[So] Source:J Appl Behav Anal;50(1):106-120, 2017 Jan.
[Is] ISSN:1938-3703
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Chronic tic disorders (CTDs) involve motor and/or vocal tics that often cause substantial distress and impairment. Differential reinforcement of other behavior (DRO) schedules of reinforcement produce robust, but incomplete, reductions in tic frequency in youth with CTDs; however, a more robust reduction may be needed to affect durable clinical change. Standard, fixed-amount DRO schedules have not commonly yielded such reductions, so we evaluated a novel, progressive-amount DRO schedule, based on its ability to facilitate sustained abstinence from functionally similar behaviors. Five youth with CTDs were exposed to periods of baseline, fixed-amount DRO (DRO-F), and progressive-amount DRO (DRO-P). Both DRO schedules produced decreases in tic rate and increases in intertic interval duration, but no systematic differences were seen between the two schedules on any dimension of tic occurrence. The DRO-F schedule was generally preferred to the DRO-P schedule. Possible procedural improvements and other future directions are discussed.
[Mh] Termos MeSH primário: Terapia Comportamental/métodos
Reforço (Psicologia)
Esquema de Reforço
Transtornos de Tique/reabilitação
[Mh] Termos MeSH secundário: Adolescente
Criança
Doença Crônica
Feminino
Seres Humanos
Testes de Inteligência
Masculino
Escalas de Graduação Psiquiátrica
Índice de Gravidade de Doença
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170714
[Lr] Data última revisão:
170714
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161014
[St] Status:MEDLINE
[do] DOI:10.1002/jaba.360


  8 / 1389 MEDLINE  
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[PMID]:27320768
[Au] Autor:Singal A; Daulatabad D
[Ad] Endereço:Department of Dermatology and STD, University College of Medical Sciences (University of Delhi) and GTB Hospital, New Delhi, India.
[Ti] Título:Nail tic disorders: Manifestations, pathogenesis and management.
[So] Source:Indian J Dermatol Venereol Leprol;83(1):19-26, 2017 Jan-Feb.
[Is] ISSN:0973-3922
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:Nail tic disorders are classic examples of overlap between the domains of dermatology and psychiatry. They are examples of body-focused repetitive behaviors in which there is an irresistible urge or impulse to perform a certain behavior. The behavior is reinforced as it results in some degree of relief and pleasure. Nail tic disorders are common, yet poorly studied and understood. The literature on nail tic disorders is relatively scarce. Common nail tics include nail biting or onychophagia, onychotillomania and the habit tic deformity. Some uncommon and rare nail tic disorders are onychoteiromania, onychotemnomania, onychodaknomania and bidet nails. Onychophagia is chronic nail biting behavior which usually starts during childhood. It is often regarded as a tension reducing measure. Onychotillomania is recurrent picking and manicuring of the fingernails and/or toenails. In severe cases, it may lead to onychoatrophy due to irreversible scarring of the nail matrix. Very often, they occur in psychologically normal children but may sometimes be associated with anxiety. In severe cases, onychotillomania may be an expression of obsessive-compulsive disorders. Management of nail tic disorders is challenging. Frequent applications of distasteful topical preparations on the nail and periungual skin can discourage patients from biting and chewing their fingernails. Habit-tic deformity can be helped by bandaging the digit daily with permeable adhesive tape. Fluoxetine in high doses can be helpful in interrupting these compulsive disorders in adults. For a complete diagnosis and accurate management, it is imperative to assess the patient's mental health and simultaneously treat the underlying psychiatric comorbidity, if any.
[Mh] Termos MeSH primário: Gerenciamento Clínico
Hábito de Roer Unhas/psicologia
Hábito de Roer Unhas/terapia
Transtornos de Tique/psicologia
Transtornos de Tique/terapia
[Mh] Termos MeSH secundário: Seres Humanos
Transtornos Mentais/diagnóstico
Transtornos Mentais/psicologia
Transtornos Mentais/terapia
Doenças da Unha/diagnóstico
Doenças da Unha/psicologia
Doenças da Unha/terapia
Transtornos de Tique/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170523
[Lr] Data última revisão:
170523
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160621
[St] Status:MEDLINE
[do] DOI:10.4103/0378-6323.184202


  9 / 1389 MEDLINE  
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[PMID]:27277754
[Au] Autor:Storch EA; Johnco C; McGuire JF; Wu MS; McBride NM; Lewin AB; Murphy TK
[Ad] Endereço:Department of Pediatrics, University of South Florida, Box 7523, 880 6th Street South, St. Petersburg, FL, 33701, USA. estorch@health.usf.edu.
[Ti] Título:An initial study of family accommodation in children and adolescents with chronic tic disorders.
[So] Source:Eur Child Adolesc Psychiatry;26(1):99-109, 2017 Jan.
[Is] ISSN:1435-165X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:This initial study examined the nature, incidence, and clinical correlates of family accommodation in youth with tic disorders, and validated a brief self-report measure of tic-related family accommodation, the Tic Family Accommodation Scale (TFAS). Seventy-five youth aged 6-18 who were diagnosed with a tic disorder and their parent completed a diagnostic clinical interview, and clinician and parent-report measures of tic severity, depressive symptoms, anxiety symptoms, behavioral problems, family accommodation and impairment. An exploratory factor analysis of the TFAS showed a two-factor structure, with good internal consistency for the Total score, Modification of Child Environment and Modification of Parent Environment subscales (α = 0.88, 0.86, and 0.81, respectively). Family accommodation was not associated with tic severity. Family accommodation was associated with increased anxiety and depressive symptoms, higher externalizing, rule breaking, aggressive behaviors and social problems, and with greater tic-related functional impairment. Anxiety and externalizing problems (but not depressive symptoms) predicted family accommodation when controlling for tic severity. Family accommodation predicted high levels of functional impairment over and above the effect of tic severity, anxiety, depression and externalizing problems. Family accommodation is a common phenomenon for youth with tic disorders, with modifications typically encompassing changes to the child and/or parent environments. Accommodation was not associated with tic severity, but was related to higher levels of anxiety, depressive symptoms, externalizing symptoms, aggression, and rule breaking behaviors. Results suggest that other emotional symptoms are more likely to drive accommodation practices than the tic symptoms per se.
[Mh] Termos MeSH primário: Relações Familiares/psicologia
Transtornos de Tique/epidemiologia
Transtornos de Tique/psicologia
[Mh] Termos MeSH secundário: Adolescente
Ansiedade/epidemiologia
Ansiedade/psicologia
Ansiedade/terapia
Criança
Depressão/epidemiologia
Depressão/psicologia
Depressão/terapia
Feminino
Seres Humanos
Masculino
Pais/psicologia
Transtornos de Tique/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160610
[St] Status:MEDLINE
[do] DOI:10.1007/s00787-016-0879-5


  10 / 1389 MEDLINE  
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[PMID]:27780333
[Au] Autor:Pozzi M; Pisano S; Bertella S; Capuano A; Rizzo R; Antoniazzi S; Auricchio F; Carnovale C; Cattaneo D; Ferrajolo C; Gentili M; Guastella G; Mani E; Rafaniello C; Riccio MP; Scuderi MG; Sperandeo S; Sportiello L; Villa L; Radice S; Clementi E; Rossi F; Pascotto A; Bernardini R; Molteni M; Bravaccio C
[Ad] Endereço:Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy.
[Ti] Título:Persistence in Therapy With Risperidone and Aripiprazole in Pediatric Outpatients: A 2-Year Naturalistic Comparison.
[So] Source:J Clin Psychiatry;77(12):e1601-e1609, 2016 Dec.
[Is] ISSN:1555-2101
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The practical effectiveness of second-generation antipsychotics in children and adolescents is an understudied issue. It is a crucial area of study, though, because such patients are often treated for long-lasting disorders. METHODS: We carried out a 24-month (March 2012-March 2014) observational study on an unselected population of pediatric outpatients treated with risperidone, aripiprazole, olanzapine, or quetiapine aiming to (1) describe drug use, (2) compare post hoc the discontinuation rates due to specific causes and dose adjustments by Kaplan-Meier analyses between drugs, and (3) analyze predictors influencing these outcomes by Cox multivariate models. RESULTS: Among 184 pediatric patients, 77% patients were prescribed risperidone, and 18% were prescribed aripiprazole. Olanzapine or quetiapine were scantly used; therefore, they were excluded from analyses. Risperidone was prevalent in younger, male patients with disruptive behavioral disorders; aripiprazole, in patients with tic disorders. Overall, discontinuations occurred mostly in the first 6 months, and, at 24 months, the discontinuation numbers were similar between users of risperidone and aripiprazole (41.5% vs 39.4%). In univariate analyses, dose reduction was higher for aripiprazole (P = .033). Multivariate analyses yielded the following predictors: for all-cause discontinuation, baseline severity (hazard ratio [HR] = 1.48, P = .001) and dose increase (HR = 3.55, P = .001); for patient-decided discontinuation, dose change (increase: HR = 6.43, P = .004; reduction: HR = 7.89, P = .049) and the presence of concomitant drugs (HR = 4.03, P = .034), while autistic patients discontinued less (HR = 0.23, P = .050); for clinician-decided discontinuation due to adverse drug reactions, baseline severity (HR = 1.96, P = .005) and dose increase (HR = 5.09, P = .016); for clinician-decided discontinuation due to inefficacy, baseline severity (HR = 2.88, P = .014) and the use of aripiprazole (HR = 5.55, P = .013); for dose increase, none; for dose reduction, the occurrence of adverse drug reactions (HR = 4.74, P = .046), while dose reduction was less probable in autistic patients (HR = 0.22, P = .042). CONCLUSIONS: The findings of this study show a similarity between the overall effectiveness of risperidone and aripiprazole in a real-life pediatric outpatient setting.
[Mh] Termos MeSH primário: Antipsicóticos/farmacologia
Aripiprazol/farmacologia
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/tratamento farmacológico
Adesão à Medicação/estatística & dados numéricos
Transtornos Mentais/tratamento farmacológico
Avaliação de Resultados (Cuidados de Saúde)
Risperidona/farmacologia
Transtornos de Tique/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Antipsicóticos/administração & dosagem
Antipsicóticos/efeitos adversos
Aripiprazol/administração & dosagem
Aripiprazol/efeitos adversos
Criança
Feminino
Seguimentos
Seres Humanos
Masculino
Pacientes Ambulatoriais
Risperidona/administração & dosagem
Risperidona/efeitos adversos
Fatores Sexuais
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Antipsychotic Agents); 82VFR53I78 (Aripiprazole); L6UH7ZF8HC (Risperidone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.4088/JCP.15m10247



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