The second main result was the significantly higher frequency of OIB observed in children and adolescents with autisticdisorder compared to typically developing control individuals during the blood drawing situation. Individuals with autism may perceive the blood drawing situation as more stressful than typically developing control individuals. This hypothesis is supported by our previous results showing enhanced biological stress responses to venipunc- ture in children with autism [26,35]. In addition, children and adolescents with autisticdisorder may be less capable than typically developing control individuals to regulate their emotional response to the blood drawing situation by expressing their noxious and/or psychic stress through verbal/non-verbal com- munication and social interaction, especially given their history of severe impairment in these two domains, and by developing other coping strategies. This result suggests that in a stressful situation, individuals with autism release their stress through OIB, whereas typically developing control individuals can regulate and express their stress using social interaction, verbal and non-verbal communication skills, as well as other cognitive skills such as symbolization skills with representation and anticipation of the stressful situation. This hypothesis is strengthened by our present results showing that the most frequent emotional circumstances in which OIB occur in autism are frustration, anger and opposition, and that the more frequent concurrent behaviors occurring just before OIB are anxiety-related behaviors and excitation. In addition, this hypothesis is in line with Dominick  who did not find any significant differences in OIB frequency between children with autistic spectrum disorder and children with history of language impairment. It is noteworthy that the usual decrease of aggression with age in typically developing children which begins at the age of two years old is explained, according to several authors, by the appearance of language [12,36,37]. Thus, the absence of significant age effect on OIB observed in individuals with autism from our study might be related to their verbal language impairment. Furthermore, the substantial and significant difference between individuals with autism and typically develop- ing control individuals for the occurrence of OIB in the blood drawing situation might not be specific to autism but more related to mental retardation, especially if we consider that our autistic group is severely mentally retarded. However, given the very Table 3. Circumstances in which OIB Occurred and their
nent occiput, malformed auricles, bilateral epicanthal folds, dow nslant ing palpebral fissures, st rabismus, high-arched palat e, m icrognat hia, kyphoscoliosis, pect us excavat um , and bilat eral fift h finger clinodact yly. Brain t omography, X-ray, and nuclear magnet ic resonance evaluat ions w ere all normal. At t hat t ime, t he diagnosis of aut ist ic disorder (DSM -IV) 3 w as est ablished.
The control group needed parental consent to participate in the study and a maximum of 18 years of age and children were excluded in presence of any psychiatric disorder at that moment. The exclusion criteria for mothers were as follows: being a step-mother, having chronic and severe physical illness during pregnancy or at present, infertility or having the pregnancy through in vitro fertilization.
The speech therapy, as the health science that studies human communication, plays a major role both on the diagnosis and on the treatment of people with autism. However, there are only few speech therapists who make regular publications on the theme – revealing that this is an area where more studies need to be made. The autisticdisorder is characterized by a developmental deicit on social interaction, communication and behavior. The diagnosis must be substantial and the three ields above are to be taken into account. Frequently, the speech therapist is the irst professional the parents look for; thus, such professional must be able to identify those cases. The objective of this research was to assess methods and protocols of assessment and diagnosis of the autisticdisorder, available in Brazilian literature, that could be applied to the clinical speech therapy. Based on several references, ten protocols were found: seven were translated and validated from a foreign language into Brazilian Portuguese and three were developed in Brazil. No Brazilian publications were found using four out of the ten instruments that aimed at screening or diagnosing suspected cases or under risk of autism. It is also clear the minor participation of the speech therapist in such process. Additionally, none of those instruments was considered accurate enough to diagnose such disorder. It is of major importance stressing the need of a critical point of view regarding the reality of things that still happen in the process of diagnosing autism.
4. Rezaei V, Mohammadi MR, Ghanizadeh A, Sahraian A, Tabrizi M, Rezazadeh SA, et al. Double-blind, placebo-controlled trial of risperidone plus topiramate in children with autisticdisorder. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34:1269-72. 5. Asadabadi M, Mohammadi MR, Ghanizadeh A, Modabbernia A,
Na SciVerse Scopus (Scopus) (https://www.elsevier.com/) e ScienceDirect (https://www.sciencedirect.com/) foi utilizada a seguinte estratégia de busca ((“Autism Spectrum Disorder” OR "Transtorno do Espectro Autista” OR “AutisticDisorder”) and ("apraxias" OR "speech apraxia") and (“Children” OR “Criança”) and (randomized controlled trial[pt] OR controlled clinical trial[pt] OR randomized controlled trials[mh] OR random allocation[mh] OR double-blind method[mh] OR singleblind method[mh] OR clinical trial[pt] OR clinical trials[mh] OR ("clinical trial"[tw]) OR ((singl*[tw] OR doubl*[tw] OR trebl*[tw] OR tripl*[tw]) AND (mask*[tw] OR blind*[tw])) OR ("latin square"[tw]) OR placebos[mh] OR placebo*[tw] OR random*[tw] OR research design[mh:noexp] OR follow-up studies[mh] OR prospective studies[mh] OR cross-over studies[mh] OR control*[tw] OR prospectiv*[tw] OR volunteer*[tw]) NOT (animal[mh] NOT human[mh])).
ABSTRACT | Autism is one of the most common neurological disorders that afects the neurological development of children. Therapeutic interventions may intervene in communication disorders and stereotyped behaviors such as dancing, which as therapy can activate sensory pathways that enable gesture improvement. This study aimed to observe the efects of dance therapy in motor performance and gesture, body balance and gait, as well as in the quality of life of an adolescent with autisticdisorder. It is a case study of a ifteen-year-old male who participated in 120 sessions of dance therapy, lasting 30 minutes, twice a week, on alternate days, over a period of one year. The assessment instruments used were the Motor Function Measure (MFM), Tinetti test and Childhood Autism Rating Scale (CARS). According to the MFM, the total score increased 27.08%; the Tinetti test regarding balance increased from 68 to 75%, and gait, from 16% to 66%. CARS changed from 41.5 to 34 points, changing the severe disorder to moderate within the proposed parameters. The dance therapy can optimize the psychomotor behavior of young people with autistic disorders.
60 Beyer JL, Taylor WD, MacFall JR, Kuchibhatla M, Payne ME, Provenzale JM, et al. Cortical white matter microstructural abnormal- ities in bipolar disorder. Neuropsychopharmacology. 2005;30:2225-9. 61 Versace A, Andreazza AC, Young LT, Fournier JC, Almeida JR, Stiffler RS, et al. Elevated serum measures of lipid peroxidation and abnormal prefrontal white matter in euthymic bipolar adults: toward peripheral biomarkers of bipolar disorder. Mol Psychiatry. 2014;19: 200-8.
Objective: To know the experience of the family in the care of the child with Autism Spectrum Disorder (ASD) and to discuss possibilities of health care. Method: Descriptive research with qualitative approach, carried out with 15 families of children with ASD, living in two municipalities in the interior of the state of São Paulo, from October 2016 to March 2017. The Symbolic Interactionism was used as theoretical reference, and Narrative Analysis, as method. Results: Families perceive signs of autism, however, believe that there are not suspicious behaviors, but the child's personalities. When diagnosis is defined, family acceptance is painful and sad. The mother shows to be the main caretaker, while the father remains in the background. A significant change of direction of the family towards the care/attention/stimulation of the autistic child is observed. Conclusion: Unveiling family experience in the care of children with ASD amplifies strategies for reinforcement and adaptation.
Emil Kraepelin (1856-1926) is considered one of the founders of modern psychiatric nosology. However, his conceptualization of obsessive-compulsive phenomena is relatively understudied. In this article, we compare and contrast excerpts from the eighth edition (1909-1915) of Kraepelin’s Textbook of Clinical Psychiatry focusing on what Kraepelin called ‘‘obsessive neurosis’’ and related ‘‘original pathological conditions’’ with the current DSM-5 criteria for obsessive-compulsive disorder (OCD). Consistently with DSM-5 OCD, Kraepelin described obsessive neurosis as characterized by obsessive ideas, compulsive acts, or both together. His detailed descriptions of these symptoms are broadly coherent with their characterization in DSM-5, which is also true for the differential diagnoses he provided. He also mentioned cases illustrating decreased insight into symptoms and association with tic disorders. In conclusion, Kraepelin’s experience, which reflects decades of consistent clinical work, may help validate current ideas and explain how the current conceptualization has emerged and developed. Even though one can hardly say that the classification laid out in DSM-5 goes back to Kraepelin’s views directly, it still is true that Kraepelin played an outstanding role in systematizing psychiatric diagnostic criteria in general, and provided a major contribution to the conceptual history of OCD. Keywords: History of psychiatry; obsessive-compulsive disorder; diagnosis and classification; neurosis; Tourette’s disorder
In the same article, the authors described a pilot case-control study for a retrospective evaluation of childhood ADHD symptoms on individuals with comorbid BN and cluster B personality disorder versus a control group with no psychiatric diagnosis, using the Conners Scale. Interviews were conducted on six BN patients and on seven control subjects (medical students). BN patients presented significantly higher Conners Scale scores than the control group (25.3 ± 4 vs. 16.8 ± 2.4, p = 0.02). Authors suggested that BN women with comorbid cluster B personality disorder presented higher prevalence of ADHD than the comparison group. 12
The inal version of the instrument is shown in Table 1. The constructs and symptoms assessed by Malay SCAS, based on the DSM-IV, referred to separation anxiety disorder, social phobia, obsessive-compulsive disorder, panic disorder and agoraphobia, generalized anxiety disorder, and speciic phobias, and were the same as those found in the original SCAS. 33,34 This
The field research, descriptive and qualitative approach, aimed to evaluate the influence of psychomotricity on the development of children with Autistic Spectrum Disorder (ASD). It was questioned whether the psychomotricity emphasized during recreational activities in adapted physical education would positively influence the global development of children with ASD. Data collection was done through an observational record form of psychomotor aspects and a battery of psychomotor assessment proposed by Mattos and Kabarite (2005), with adaptations by LÚRIA (1987). The data analysis was in accordance with observations of the psychomotor aspects collected during the proposed activities. As final considerations, it was observed that the research carried out indicates that the use of psychomotricity in adapted physical education classes can be an excellent strategy for achieving better results in global development and for children with ASD. It is believed that the contribution of this study to science is to show that it is possible to favor the psychomotor development of students with ASD during physical education classes. Thus, it is emphasized that if the teacher incorporates psychomotricity in his classes, he will certainly be using an excellent pedagogical resource.
The symptoms that should make a pediatrician consider the diagnosis of a depressive disorder are sudden behavioral changes, aggressiveness, anger, agitation, changes in sleep pattern (either insomnia or hypersomnia) or in appetite, low self-esteem, alienation from friends or family, dressing in scruffy clothes or having a disheveled appearance. Some symptoms not apparently related to depression are often associated with it, such as headache. 66 In these cases, headache
and April 2015 in a non-proit reference health center, which offers treatment for autistic children. The authors chose to analyze the perception of 15 parents because their children had communication and cognitive disorders. Inclusion criteria were de- termined as follows: being parents of children who had a conirmed medical diagnosis of autism; pa- rents of autistic children aged between 4 and 12 years.
and she was medicated with a low dose of an antipsychotic drug. Ater about 15 asymptomatic days, the patient presented again to the Child Psychiatry Service with allopsychic disorientation, psychomotor agitation, disorganized speech broken by irrational laughter that was inconsistent with the mood, disorganized think- ing, abnormalities of thought control and content, and bizarre egosyntonic visual hallucinations. A drug test on urine that was requested proved benign. Ater emergency administration of an antipsychotic drug, followed by short hospitalization for reassess- ment, a new evaluation of the patient’s mental state was made. She was found to be cognizant, cooperative and focused. Contact was reserved and she showed hypomimia. Her emotions were consistent with mild depression and blunted afect. She did not continue to show abnormalities of thought and sensory percep- tion. Her condition was relatively similar to her previous state and she had no memory of the episode. At this stage, a diagnosis of psychotic disorder with symptoms of schizophrenia was made, in accordance with ICD-10. It was concluded from the assess- ment that she should be monitored long-term. Her antipsychotic medication was then adjusted, accordingly.
Half of the these adult patients with social phobia reported a history of trauma aging 16 years including divorce (n=3), pa- rental death (n=3), physical abuse (n=5) and sexual abuse (N=3). There was a trend for patients with a history of child- hood trauma to have a lifetime history of major depression (75% vs. 33.3%, p=0.1, chi-square test with Yates correction), but not of comorbid anxiety disorder. The presence of trauma did not influence the presentation of the disorder and it was not associated to childhood history of anxiety disorder or family history of psychiatric disorders.