RESUMO

Objective: Multiple sclerosis (MS) may include not only severe neurological signs and symptoms, but also cognitive and psychiatric disturbances. When psychiatric symptoms precede or are comorbid with MS, it poses a clinical challenge, because it may lead to a mistaken diagnosis of MS as a psychiatric disorder, delaying proper treatment. We describe the neuropsychological profile of a female patient with MS whose diagnosis was delayed due to neuropsychiatric symptoms. Method: A comprehensive analysis of the medical history and the results of a teleneuropsychological assessment of a 36-year-old Mexican woman with a diagnosis of relapsing--remitting MS (RRMS) was performed. Results: The patient indicates a long history of psychotic, anxious, and depressive features years before the first neurological symptom that led to MS going unnoticed for several years. Language, attentional, perceptual, motor, and learning skills were found to be preserved. Short-term memory and spatial orientation problems were identified, with decreased processing speed and executive dysfunction, including working memory and planning deficits. Conclusions: The patient has a non-typical presentation of neuropsychological alterations with cognitive and behavioral symptoms that resemble dorsolateral frontal lobe syndrome. This case study highlights the importance of considering MS in differential diagnosis of patients with psychiatric symptoms, even in the absence of obvious neurological signs.

RESUMO

OBJECTIVE: Assess the Health-Related Quality of Life in children and adolescents with non-syndromic craniosynostosis and compare it with participants without craniosynostosis. DESIGN: Non-experimental, cross-sectional design. SETTING: The assessment was done remotely and the instrument was sent via chat or email. PATIENTS/PARTICIPANTS: Participants (ages 8-17) with non-syndromic craniosynostosis (n = 27) and without craniosynostosis (n = 26). MAIN OUTCOME MEASURE(S): We used an adapted version for the Mexican population of the Health-Related Quality of Life Questionnaire for Children and Adolescents -KIDSCREEN-52. RESULTS: All scores were in the average clinical range and both groups scored similarly in all domains except those with craniosynostosis were significantly lower in the Social Support and Peers domain (rpb = 0.48). CONCLUSIONS: Children and adolescents with non-syndromic craniosynostosis reported similar Health-Related Quality of Life as the control group, except for the Social Support domain, which should be investigated in future studies.

RESUMO

Introduction: The study of food addiction (FA) has become relevant due to its high prevalence, the negative impact on quality of life, and its association with neuropsychological and psychiatric symptoms. Several studies have provided scientific support for these associations, however, the results are contradictory. Additionally, studies have unsuccessfully elucidated the true nature of the failures in executive functioning in people with FA symptomatology, particularly when it comes to executive deficits. Therefore, the purpose of this research was to establish whether the presence of executive dysfunction, depressive symptoms and binge eating problems, as well as high reward sensitivity entails a greater severity in FA traits and high body mass index (BMI) in a sample of Mexican adults. Methods: The sample consisted of Mexican men and women between 21-59 years (n = 36); who completed self-report questionnaires and performance tests to measure the study variables. Additionally, BMI was estimated with self-reported height and weight. Results: Our results showed that a high number of FA symptoms were associated with higher executive dysfunction scores, greater reward sensitivity, and more severe depressive and binge eating problems. Furthermore, factors that are more strongly associated with higher scores of FA include severe executive deficits, greater activation of the punishment avoidance system, and persistence in the search for reward when the depressive symptoms increased. The factors that best explained changes in the estimated BMI of women were a decreased crystallized intellectual capacity and the inability to control food intake as the number of FA symptoms increased. Discussion: In summary, the cognitive functioning profile characterized by general failure of the executive functioning, as well as a greater activation of the Punishment Avoidance System and persistence in the search for reward, were associated with greater severity of FA symptoms, especially when the depressive symptomatology was severe. In parallel, the psychopathology in participants associated with FA confirms the contribution of anxious and depressive symptomatology and borderline personality traits which could facilitate the expression of clinically relevant FA symptoms in women. Finally, we found that decreased crystallized intellectual capacity and inability to control food intake were linked to higher BMI when the number of FA symptoms increased.

Assuntos

RESUMO

This study aimed to determine the cognitive profile of preschool children undergoing surgery to correct non-syndromic craniosynostosis, compare them with typically developing children, and analyze possible cognitive deficits in the most prevalent subtypes: sagittal and unicoronal. Thirty-one children aged 3 years to 5 years and 11 months with non-syndromic craniosynostosis (11 sagittal, 9 unicoronal, 4 metopic, 3 lambdoid, 4 multisutural) who underwent surgery were compared with thirty-one typically developing children. The Wechsler Preschool and Primary Scale of Intelligence-Third Edition (WPPSI-III) was used to assess cognitive function. Children with non-syndromic craniosynostosis scored below the typically developing children in the Verbal Intelligence Quotient (VIQ) and Full-Scale Intelligence Quotient (FISQ). When specific subtypes were compared, children with sagittal synostosis scored similarly to the typically developing children; in contrast, children with unicoronal synostosis had lower performance in the Processing Speed Quotient and FISQ. The proportion of participants scoring below one standard deviation on the VIQ, General Language Composite, and FISQ was greater in the non-syndromic craniosynostosis group. This study supports the finding that children with non-syndromic craniosynostosis, particularly those with unicoronal synostosis, have more cognitive difficulties than those with normal development. Assessing cognition at preschool age in children with non-syndromic craniosynostosis is important in order to detect difficulties before they become more apparent at school age.

RESUMO

Children with acquired brain injury (ABI) are at risk of impairments in self-regulation and disruptive behavior. We aimed to investigate the effectiveness of the Signposts program to reduce disruptive behavior and improve self-regulation in Hispanic children with ABI, and reduce parental stress and improve parenting practices. Using a randomized controlled trial design, we assigned children (n = 71) and their parents to Signposts or generic telephone support. Blinded assessors conducted assessments at pre-intervention, immediately post-intervention, and at 3 months post-intervention. Signposts was effective in reducing dysfunctional parenting practices. Further, when analyzing participants at risk of behavioral disturbance (n = 46), Signposts was effective in reducing child disruptive behavior in the home environment and emotional self-regulation. No differences were found for parental stress, parent sense of competence, child disruptive behaviors at school, and child cognitive and behavioral self-regulation. The reduction in disruptive behavior was associated with the implementation of authoritative parenting practices (external regulation), and not associated with child self-regulation.

Assuntos

RESUMO

BACKGROUND: Acquired brain injury (ABI) during childhood typically causes behaviour problems in the child and high levels of stress in the family. OBJECTIVES: (1) To investigate the feasibility and effectiveness of a parenting programme to: improve behaviour and self-regulation (SR) in Mexican children with ABI, enhance parenting skills, and decrease parental stress in parents of children with ABI; (2) to explore the impact of parent SR on child. METHODS: Case study design with four participants post-ABI, aged 7-12 years, recruited in Mexico City. A parenting programme (Signposts for Building Better Behaviour) was delivered and provided parents with strategies to manage child behaviour. Child behaviour, child self-regulation, parental stress and parenting practices were measured before, immediately post-intervention, and three months post-intervention. RESULTS: At immediate and three months post-intervention improvements in parenting skills, reduction in parental stress, and improvement in child behaviour were identified. CONCLUSIONS: The programme is feasible in a Mexican population and was effective in improving parenting skills and reducing stress in parents of children with ABI, as well as improving child behaviour and behavioural SR. These domains continue improving three months after the intervention. The improvements in challenging behaviour at home did not transfer to the school environment.

Assuntos

RESUMO

RESUMEN Antecedentes: Se ha reportado que los pacientes con esquizofrenia presentan alteraciones en el procesamiento emocional, específicamente en la percepción de emociones. Sin embargo, poco se sabe sobre otros aspectos de este proceso, como la regulación emocional. Objetivo: Evaluar y comparar la regulación emocional y neurocognición en pacientes con esquizofrenia y sujetos control, así como identificar correlaciones entre regulación emocional, neurocognición y datos demográficos. Método: Se evaluaron nueve pacientes (GE) y nueve controles (GC). Se obtuvieron datos demográficos, para evaluar regulación emocional se utilizó la Prueba de Inteligencia Emocional Mayer-Salovey Caruso, sección Manejo de Emociones y se realizó una breve evaluación neurocognitiva. Resultados: El GE tuvo un desempeño significativamente inferior que el GC en la prueba de regulación emocional y en neurocognición (p<.05). No se encontraron correlaciones entre regulación emocional, neurocognición, datos demográficos y clínicos. Discusión y conclusión: Los pacientes con esquizofrenia presentan menor capacidad de regulación emocional y alteraciones en la neurocognición. Estos resultados son consistentes con lo descrito en la literatura.

ABSTRACT Background: It has been reported that schizophrenia patients display emotional processing impairments, specifically in the emotion perception domain. However, less is known about other domains of emotional processing, like emotion regulation. Objective: The aim of this study was to assess and compare emotion regulation abilities and neurocognition in schizophrenia patients and healthy controls, as well as to identify correlations between emotion regulation, neurocognition and demographic data. Methods: 9 patients (GE) and 9 controls (GC) were recruited. Demographic data was obtained. To assess emotion regulation, the Mayer-Salovey-Caruso Emotional Intelligence Test -Managing Emotions section- was administered. Finally, a brief neurocognitive assessment was conducted. Results: The GE showed significant poorer performance than the GC in the emotion regulation test as well as in the neurocognitive assessment (p < .05). No correlations were identified between emotion regulation, neurocognition, demographic and clinical data. Discussion and conclusion: Schizophrenia patients show emotion regulation impairment, as well as neurocognitive deficits. Our results are consistent with other studies.

RESUMO

INTRODUCTION: Acquired brain injury (ABI) during childhood typically causes behavior problems in the child and high levels of stress in the family. The aims of this study are: (1) to investigate the effectiveness and feasibility of a parenting intervention in improving behavior and self-regulation in Mexican children with ABI compared to telephone support; (2) to investigate the effectiveness and feasibility of a parenting intervention in improving parenting skills, parent self-efficacy and decreasing parental stress in parents of children with ABI compared to telephone support. Our secondary aims are (1) to explore the impact that parent characteristics have on the intervention outcomes; (2) to investigate if changes are maintained 3 months after the intervention. METHODS: The research design is a blind randomized controlled trial (RCT). Eligible participants include children with a diagnosis of ABI, between 6 and 12 years of age, and their parents. Sixty-six children and their parents will be randomly allocated to either a parenting program group or telephone support group. The parenting program involves six face-to-face weekly group sessions of 2.5 h each. Participants in the control group receive an information sheet with behavioral strategies, and six weekly phone calls, in which strategies to improve academic skills are provided. Children and their parents are evaluated by blind assessors before the intervention, immediately after the intervention and 3-months post-intervention. DISCUSSION: This study will be the first to evaluate the efficacy and feasibility of a parenting program for Mexican parents of children with ABI. TRIAL IDENTIFIER: ACTRN12617000360314.

RESUMO

The aim of this work is to offer an updated review of the major cognitive difficulties that appear in Type 2 Diabetes Mellitus (T2DM), and its association with the patient compliance related factors proposed by the Panamerican Health Organization (PAHO), such as characteristics of patient, of the disease and of treatment. The review included electronic databases search (PubMed, Psy-cINFO and SpringerLink) from January 2000 to December 2011, predominating research from the United States, Canada, Holland, UK, Japan, Mexico and Germany. Most of the reviewed articles identified that factors which have shown to be associated with cognitive functioning in T2DM include: glycemic fluctuations, disease duration and pharmacological treatment. As for the changes that occur in the Central Nervous System (CNS), to date there is no consensus as to whether these are purely degenerative, vascular or a combination of both. Most affected cognitive abilities are: verbal memory, working memory, verbal fluency, attention, mental planning and psychomotor speed. The latter have been related with frontal, temporal and hyppo-campal structure functioning, which are also compromised on T2DM. In the cognitive aspect, it is reported that T2DM is a risk factor for developing mild cognitive impairment. Also, chronicity of this condition associated with hypertension, inadequate glycemic control, and macrovascular complications increases the odds for vascular dementia to occur. It is concluded that even though some risk factors of the cognitive deficiencies have been identified on T2DM, it is important to determine how they interact, and to what degree they affect overall cognitive performance, and specific functions in this population.

El objetivo de este trabajo es ofrecer una revisión actualizada de las principales dificultades cognoscitivas que se presentan en la Diabetes mellitus tipo 2 (DM2) y su asociación con factores relacionados con la adherencia terapéutica propuestos por la Organización Panamericana de la Salud para las enfermedades crónicas como: las características del paciente, de la enfermedad y del tratamiento. La revisión se basó en una búsqueda en las bases de datos PubMed, PsycINFO y SpringerLink. Se abarcó el periodo de enero de 2000 hasta diciembre de 2011, y predominaron las investigaciones procedentes de los Estados Unidos de América, Canadá, Holanda, Inglaterra, el Japón, México y Alemania. En la mayoría de los estudios consultados se identificó que las fluctuaciones glicémicas, la duración de la enfermedad y el tipo de tratamiento farmacológico son los factores que más se han asociado con el funcionamiento cognoscitivo en la DM2. En cuanto a los cambios que se producen en el Sistema Nervioso Central (SNC), hasta la fecha no hay consenso en cuanto a si estos son exclusivamente degenerativos, vasculares o si son una combinación entre ambos. En el aspecto cognoscitivo, se ha reportado que la DM2 es un factor de riesgo para desarrollar deterioro cognoscitivo leve y que la cronicidad de esta condición, asociada a hipertensión, a un control glicémico inadecuado y a complicaciones macrovasculares aumenta la posibilidad de desarrollar demencia vascular. Las habilidades cognoscitivas más referidas como afectadas son memoria verbal y de trabajo, fluidez verbal, atención, planificación mental y velocidad psicomotora, las cuales se han relacionado con el funcionamiento de estructuras frontales, temporales e hipocámpicas, que en la DM2 también se encuentran comprometidas. Se concluye que a pesar de que se han identificado algunos factores de riesgo de las deficiencias cognoscitivas en la DM2, es importante que se determine cómo interactúan y en qué grado influyen estos factores en el rendimiento cognoscitivo global y en funciones específicas en esta población.

RESUMO

Event related potentials (ERP) associated with early sensory information processing have been proposed as possible vulnerability markers for psychosis. Compared to other ERPs reported in schizophrenia research, like Mismatch Negativity (MMN), little is known about P3a, an ERP related to novelty detection. The aim of this study was to analyze the MMN-P3a complex in 20 antipsychotic naïve first-episode psychosis patients (FEP), 23 antipsychotic naïve individuals at clinical high-risk for psychosis (CHR) and 24 healthy controls. The MMN-P3a amplitudes and latencies were obtained during a passive auditory mismatch frequency deviant ERP paradigm and analyzed in frontal and central scalp regions. There were no significant differences in MMN amplitude between groups. There was a significant group difference in P3a due to reduced amplitude (F[2,64] = 3.7, p = 0.03) in both CHR and FEP groups (Mean difference (MD) = 0.39, p = 0.04 and MD = 0.49, p = 0.02, respectively) compared to the control group and this effect was most prominent on the right side (Group × laterality effect: MD = 0.57, p < 0.01 and MD = 0.58, p < 0.01, respectively). No significant differences were observed for MMN or P3a latencies between groups. Although a P3a decrement in chronic schizophrenia and FEP has been previously reported, our results suggest that this novelty detection impairment is present even in pre-psychosis stages in antipsychotic naïve subjects. This study supports the evidence that P3a could represent a neurophysiological vulnerability marker for the development of psychosis.

Assuntos