RESUMO
Introduction Children with anxiety disorders have been suggested to possess deficits in verbal fluency, shifting and attention, with inconsistent results regarding working memory and its subcomponents. This study extends previous findings by analyzing the performance of children with anxiety disorders in a wide range of neuropsychological functions. Methods We evaluated 54 children with a primary diagnosis of an anxiety disorder according to diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) using subtests of a neuropsychological battery. The severity of anxiety disorders was assessed using the Pediatric Anxiety Rating Scale (PARS). We calculated the frequency of neuropsychological impairments (-1.5 standard deviation of the normative sample). Comparisons between groups were performed based on the severity of anxiety symptoms, as well as in the presence of one vs. more diagnoses of anxiety disorder. Results We found higher impairment in visuospatial working memory (23.1%), semantic memory (27.8%), oral language (35.4%) and word writing (44.4%) in anxious children. Moreover, children with higher anxiety severity presented lower performance in visuospatial working memory, inferential processing, word reading, writing comprehension, copied writing, and semantic verbal fluency (d = 0.49 to 0.96 [Cohen's d]). The higher the number of anxiety diagnoses, the lower the performance in episodic memory and oral and written language (d = 0.56 to 0.77). Conclusion Our data suggested the presence of memory (visuospatial working memory and semantic memory) and language deficits (oral and writing) in some children with an anxiety disorder. Severity and number of anxiety diagnoses were associated with lower performance in memory and language domains in childhood.
Assuntos
Transtornos de Ansiedade/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Transtornos da Linguagem/fisiopatologia , Transtornos da Memória/fisiopatologia , Transtornos de Ansiedade/complicações , Ansiedade de Separação/complicações , Ansiedade de Separação/fisiopatologia , Criança , Disfunção Cognitiva/etiologia , Feminino , Humanos , Transtornos da Linguagem/etiologia , Masculino , Transtornos da Memória/etiologia , Fobia Social/complicações , Fobia Social/fisiopatologia , Índice de Gravidade de DoençaRESUMO
Abstract Introduction Children with anxiety disorders have been suggested to possess deficits in verbal fluency, shifting and attention, with inconsistent results regarding working memory and its subcomponents. This study extends previous findings by analyzing the performance of children with anxiety disorders in a wide range of neuropsychological functions. Methods We evaluated 54 children with a primary diagnosis of an anxiety disorder according to diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) using subtests of a neuropsychological battery. The severity of anxiety disorders was assessed using the Pediatric Anxiety Rating Scale (PARS). We calculated the frequency of neuropsychological impairments (-1.5 standard deviation of the normative sample). Comparisons between groups were performed based on the severity of anxiety symptoms, as well as in the presence of one vs. more diagnoses of anxiety disorder. Results We found higher impairment in visuospatial working memory (23.1%), semantic memory (27.8%), oral language (35.4%) and word writing (44.4%) in anxious children. Moreover, children with higher anxiety severity presented lower performance in visuospatial working memory, inferential processing, word reading, writing comprehension, copied writing, and semantic verbal fluency (d = 0.49 to 0.96 [Cohen's d]). The higher the number of anxiety diagnoses, the lower the performance in episodic memory and oral and written language (d = 0.56 to 0.77). Conclusion Our data suggested the presence of memory (visuospatial working memory and semantic memory) and language deficits (oral and writing) in some children with an anxiety disorder. Severity and number of anxiety diagnoses were associated with lower performance in memory and language domains in childhood.
Assuntos
Criança , Feminino , Humanos , Masculino , Transtornos de Ansiedade/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Transtornos da Linguagem/fisiopatologia , Transtornos da Memória/fisiopatologia , Transtornos de Ansiedade/complicações , Ansiedade de Separação/complicações , Ansiedade de Separação/fisiopatologia , Índice de Gravidade de Doença , Disfunção Cognitiva/etiologia , Fobia Social/complicações , Fobia Social/fisiopatologia , Transtornos da Linguagem/etiologia , Transtornos da Memória/etiologiaRESUMO
Plenty of evidence suggests that childhood separation anxiety (CSA) predisposes the subject to adult-onset panic disorder (PD). As well, panic is frequently comorbid with both anxiety and depression. The brain mechanisms whereby CSA predisposes to PD are but completely unknown in spite of the increasing evidence that panic attacks are mediated at midbrain's dorsal periaqueductal gray matter (DPAG). Accordingly, here we examined whether the neonatal social isolation (NSI), a model of CSA, facilitates panic-like behaviors produced by electrical stimulations of DPAG of rats as adults. Eventual changes in anxiety and depression were also assessed in the elevated plus-maze (EPM) and forced-swimming test (FST) respectively. Male pups were subjected to 3-h daily isolations from post-natal day 2 (PN2) until weaning (PN21) allotting half of litters in individual boxes inside a sound-attenuated chamber (NSI, nâ=â26) whilst siblings (sham-isolated rats, SHAM, nâ=â27) and dam were moved to another box in a separate room. Non-handled controls (CTRL, nâ=â18) remained undisturbed with dams until weaning. As adults, rats were implanted with electrodes into the DPAG (PN60) and subjected to sessions of intracranial stimulation (PN65), EPM (PN66) and FST (PN67-PN68). Groups were compared by Fisher's exact test (stimulation sites), likelihood ratio chi-square tests (stimulus-response threshold curves) and Bonferroni's post hoc t-tests (EPM and FST), for P<0.05. Notably, DPAG-evoked panic-like responses of immobility, exophthalmus, trotting, galloping and jumping were markedly facilitated in NSI rats relative to both SHAM and CTRL groups. Conversely, anxiety and depression scores either did not change or were even reduced in neonatally-handled groups relative to CTRL, respectively. Data are the first behavioral evidence in animals that early-life separation stress produces the selective facilitation of panic-like behaviors in adulthood. Most importantly, results implicate the DPAG not only in panic attacks but also in separation-anxious children's predispositions to the late development of PD.
Assuntos
Ansiedade de Separação/complicações , Transtorno de Pânico/etiologia , Substância Cinzenta Periaquedutal/fisiopatologia , Isolamento Social/psicologia , Animais , Estimulação Encefálica Profunda , Funções Verossimilhança , Masculino , Aprendizagem em Labirinto , RatosRESUMO
O objetivo desta pesquisa foi verificar a ocorrência da síndrome de ansiedade de separação (SAS) na população de cães de Sinop, MT. Para identificar o problema, foi desenvolvido um questionário que foi aplicado a proprietários ou guardiões de cem cães, machos e fêmeas, de raças puras e sem raça definida (SRD), oriundos de clínicas do referido município e do Hospital Veterinário da UFMT campus Sinop. Os resultados obtidos demonstraram uma prevalência de 28% de cães positivos para a SAS. Os sinais mais frequentes foram vocalização excessiva (60,7%), micção inapropriada (50%), destruição de objetos (35,7%) e defecação inapropriada (17,8%). Todos os animais considerados positivos apresentavam hipervinculação aos seus donos e nove (32,1%) sofriam também de transtorno compulsivo. Tais resultados indicam que existe uma prevalência significativa de SAS na população de Sinop, devendo ser elaboradas novas pesquisas para mensurar o seu impacto sobre os animais e a sociedade.
The aim of this study was to verify the occurrence of anxiety separation syndrome (ASS) in dogs from Sinop/MT, Brazil. For this purpose, a questionnaire was developed and applied to owners of one hundred male and female dogs of both pure breed and mixed breeds from local veterinary clinics or from the Veterinary Hospital of UFMT, Campus Sinop. Results showed 28% prevalence of ASS among the studied population. Most frequent symptoms were excessive vocalization (60.7%), inappropriate urination (50%), destructive behavior (35.7%) and inappropriate defecation (17.8%). All positive dogs showed owner hyperattachment, and 32.1% (9 animals) had compulsive disorder. Results indicated a significant prevalence of ASS in dogs from Sinop; further research should be developed to measure its impact on animals and human society.
El objetivo de este trabajo fue verificar la incidencia del síndrome de ansiedad por separación (SAS) en la población de perros de la municipalidad de Sinop, Mato Groso - Brasil. Para identificar el problema se desarrolló un cuestionario al que fueron sometidos los propietarios o responsables de cien perros, tanto machos como hembras, de razas puras y mestizos, atendidos en consultorios del referido municipio y en el Hospital Veterinario de la UFMT del campus Sinop. Los resultados obtenidos mostraron una prevalencia de un 28% de perros positivos al SAS. Los signos más frecuentemente encontrados fueron vocalización excesiva (60,7%), micción inapropiada (50%), destrucción de objetos (35.7%) y defecación inadecuada (17.8%). Todos los animales considerados positivos, presentaban hipervinculación con sus dueños, y nueve de ellos (32,1%) sufrían también de trastornos compulsivos. Estos resultados indican que existe una prevalencia significativa del SAS en el municipio de Sinop, y que deberían ser realizadas nuevas investigaciones para medir su impacto sobre los animales y la sociedad.
Assuntos
Animais , Cães , Ansiedade de Separação/complicações , Hiperventilação/complicações , Transtorno da Personalidade Compulsiva/complicações , Cães/classificaçãoRESUMO
O objetivo desta pesquisa foi verificar a ocorrência da síndrome de ansiedade de separação (SAS) na população de cães de Sinop, MT. Para identificar o problema, foi desenvolvido um questionário que foi aplicado a proprietários ou guardiões de cem cães, machos e fêmeas, de raças puras e sem raça definida (SRD), oriundos de clínicas do referido município e do Hospital Veterinário da UFMT campus Sinop. Os resultados obtidos demonstraram uma prevalência de 28% de cães positivos para a SAS. Os sinais mais frequentes foram vocalização excessiva (60,7%), micção inapropriada (50%), destruição de objetos (35,7%) e defecação inapropriada (17,8%). Todos os animais considerados positivos apresentavam hipervinculação aos seus donos e nove (32,1%) sofriam também de transtorno compulsivo. Tais resultados indicam que existe uma prevalência significativa de SAS na população de Sinop, devendo ser elaboradas novas pesquisas para mensurar o seu impacto sobre os animais e a sociedade.(AU)
The aim of this study was to verify the occurrence of anxiety separation syndrome (ASS) in dogs from Sinop/MT, Brazil. For this purpose, a questionnaire was developed and applied to owners of one hundred male and female dogs of both pure breed and mixed breeds from local veterinary clinics or from the Veterinary Hospital of UFMT, Campus Sinop. Results showed 28% prevalence of ASS among the studied population. Most frequent symptoms were excessive vocalization (60.7%), inappropriate urination (50%), destructive behavior (35.7%) and inappropriate defecation (17.8%). All positive dogs showed owner hyperattachment, and 32.1% (9 animals) had compulsive disorder. Results indicated a significant prevalence of ASS in dogs from Sinop; further research should be developed to measure its impact on animals and human society.(AU)
El objetivo de este trabajo fue verificar la incidencia del síndrome de ansiedad por separación (SAS) en la población de perros de la municipalidad de Sinop, Mato Groso - Brasil. Para identificar el problema se desarrolló un cuestionario al que fueron sometidos los propietarios o responsables de cien perros, tanto machos como hembras, de razas puras y mestizos, atendidos en consultorios del referido municipio y en el Hospital Veterinario de la UFMT del campus Sinop. Los resultados obtenidos mostraron una prevalencia de un 28% de perros positivos al SAS. Los signos más frecuentemente encontrados fueron vocalización excesiva (60,7%), micción inapropiada (50%), destrucción de objetos (35.7%) y defecación inadecuada (17.8%). Todos los animales considerados positivos, presentaban hipervinculación con sus dueños, y nueve de ellos (32,1%) sufrían también de trastornos compulsivos. Estos resultados indican que existe una prevalencia significativa del SAS en el municipio de Sinop, y que deberían ser realizadas nuevas investigaciones para medir su impacto sobre los animales y la sociedad.(AU)
Assuntos
Animais , Cães , Ansiedade de Separação/complicações , Hiperventilação/complicações , Transtorno da Personalidade Compulsiva/complicações , Cães/classificaçãoRESUMO
The aim of this work was to determine the effect of chronic treatment with 5 mg/kg of tianeptine in male adult Wistar rats separated from the mother as neonates and submitted to variable chronic stress, plasma catecholamines, and anxiety. The plus maze test was performed in order to calculate the anxiety index and catecholamine levels were determined by high-pressure liquid chromatography. Both stress and maternal separation elevated catecholamine levels without affecting anxiety. In the maternally separated stress group, tianeptine decreased epinephrine. Anxiety was reduced in the maternally separated unstressed tianeptine group. Also, all groups showed a tendency to lower anxiety index.
Assuntos
Antidepressivos Tricíclicos/uso terapêutico , Ansiedade de Separação/sangue , Ansiedade de Separação/complicações , Ansiedade/sangue , Ansiedade/tratamento farmacológico , Catecolaminas/sangue , Privação Materna , Estresse Psicológico/sangue , Estresse Psicológico/complicações , Tiazepinas/uso terapêutico , Corticosteroides/sangue , Medula Suprarrenal/fisiologia , Animais , Animais Recém-Nascidos , Ansiedade/psicologia , Ansiedade de Separação/psicologia , Comportamento Animal/fisiologia , Doença Crônica , Feminino , Masculino , Ratos , Ratos Wistar , Estresse Psicológico/psicologiaRESUMO
Anxiety disorders constitute the most common psychiatric diseases in children. These disorders predict an increase in the risk of later anxiety disorders, mayor depression and hospitalization for psychiatric pathology. The primary feature of Separation Anxiety Disorder is developmentally inappropriate anxiety sufficient to cause clinically significant distress or impairment when faced with separation from home or major attachment figures. Drugs that selectively inhibit serotonin reuptake, psychotherapy and parent education constitute effective treatments for children and adolescents with anxiety disorders. Pediatricians and other health care professionals are in a unique position to assist families in understanding the etiology, prevention and treatment of separation anxiety disorder. Early identification in pediatric primary care and effective management may help improve outcome. The objective of our review is to analyze clinical and therapeutic aspects of the Separation Anxiety Disorder and its differences with Separation Anxiety as an expression of the evolutionary emotional development in children.
Los trastornos por ansiedad son cuadros clínicos psiquiátricos frecuentes y predicen un riesgo aumentado de presentar posteriormente trastornos ansiosos y depresivos, además de hospitalizaciones por causa psiquiátrica. El trastorno por ansiedad de separación tiene como característica principal ansiedad excesiva e inapropiada para el desarrollo del niño, concerniente a su separación respecto de las personas con quienes está vinculado. El uso de fármacos, psicoterapia y apoyo parental son medidas terapéuticas eficaces. Los pediatras pueden ser los primeros profesionales que tomen contacto clínico con los niños y realicen la primera aproximación diagnóstica y terapéutica. El propósito de nuestra revisión es analizar aspectos clínicos y terapéuticos del trastorno de ansiedad por separación y sus diferencias con la ansiedad de separación propia del desarrollo emocional del niño.
Assuntos
Humanos , Criança , Ansiedade de Separação/diagnóstico , Ansiedade de Separação/terapia , Ansiedade de Separação/complicações , Ansiedade de Separação/epidemiologia , Diagnóstico DiferencialRESUMO
En este trabajo se revisan los factores de riesgo psicológico en los trastornos límite de personalidad. Se concluye que el desarrollo de la psicopatología de estos trastornos no puede ser explicada por un único factor psicológico de riesgo o por un grupo de factores psicológicos de riesgo. Probablemente hay muchas vías que conducen el trastorno límite de personalidad. Las historias de tráuma tienen un papel relevante en un subgrupo de pacientes, mientras que otros factores de riesgo psicológico pueden ser más importantes en otros casos