Gender differences in the comorbidity of neurological and psychological disorders in a large clinical sample of children.
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ABSTRACT:
SUBMITTER: Brandt V
PROVIDER: S-EPMC8142543 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundFour times as many males are diagnosed with high functioning autism compared to females. A growing body of research that focused on females with autism spectrum disorder (ASD) questions the assumption of gender invariance in ASD. Clinical observations suggest that females with ASD superficially demonstrate better social and emotional skills than males with ASD, which may camouflage other diagnostic features. This may explain the under-diagnosis of females with ASD.MethodsWe hypothesised that females with ASD would display better social skills than males with ASD on a test of friendship and social function. One hundred and one 10- to 16-year-olds (ASD females, n?=?25; typically developing (TD) females, n?=?25; ASD males, n?=?25; TD males, n?=?26) were interviewed (using the friendship questionnaire (FQ)) with high scores indicating the child has close, empathetic and supportive relationships. One parent of each child completed the FQ to assess whether there are differences in perception of friendships between parents and children.ResultsIt was found that, independent of diagnosis, females demonstrated higher scores on the FQ than males. Further, regardless of gender, children with ASD demonstrated lower scores than TD children. Moreover, the effect of ASD was independent of gender. Interestingly, females with ASD and TD males displayed similar scores on the FQ.ConclusionsThis finding is supported by clinical reports that females with ASD have more developed social skills than males with ASD. Further research is now required to examine the underlying causes for this phenomenon in order to develop gender-appropriate diagnostic criteria and interventions for ASD.
| S-EPMC3945617 | biostudies-literature
Project description:OBJECTIVE:Analyze a large sample with detailed clinical data of misophonia subjects in order to determine the psychiatric, somatic and psychological nature of the condition. METHODS:This observational study of 779 subjects with suspected misophonia was conducted from January 2013 to May 2017 at the outpatient-clinic of the Amsterdam University Medical Centers, location AMC, the Netherlands. We examined DSM-IV diagnoses, results of somatic examination (general screening and hearing tests), and 17 psychological questionnaires (e.g., SCL-90-R, WHOQoL). RESULTS:The diagnosis of misophonia was confirmed in 575 of 779 referred subjects (74%). In the sample of misophonia subjects (mean age, 34.17 [SD = 12.22] years; 399 women [69%]), 148 (26%) subjects had comorbid traits of obsessive-compulsive personality disorder, 58 (10%) mood disorders, 31 (5%) attention-deficit (hyperactivity) disorder, and 14 (3%) autism spectrum conditions. Two percent reported tinnitus and 1% hyperacusis. In a random subgroup of 109 subjects we performed audiometry, and found unilateral hearing loss in 3 of them (3%). Clinical neurological examination and additional blood test showed no abnormalities. Psychological tests revealed perfectionism (97% CPQ>25) and neuroticism (stanine 7 NEO-PI-R). Quality of life was heavily impaired and associated with misophonia severity (rs (184) = -.34 p = < .001, p = < .001). LIMITATIONS:This was a single site study, leading to possible selection-and confirmation bias, since AMC-criteria were used. CONCLUSIONS:This study with 575 subjects is the largest misophonia sample ever described. Based on these results we propose a set of revised criteria useful to diagnose misophonia as a psychiatric disorder.
| S-EPMC7159231 | biostudies-literature
Project description:Background:Functional neurological disorders are generally more common in females than males, but the reason for this gender difference is not well understood. Objectives:In this study, we aim to compare the clinical and demographic features of functional movement disorders (FMDs) between males and females. Methods:We examined clinical data and video-recordings of patients with FMDs evaluated at the Baylor College of Medicine Movement Disorders Clinic. Results:Of the 196 patients with FMDs, males represented only 30% (n = 59) of the entire cohort. Men had an older age at onset: 40.5 versus 34.1?years (P =?0.026) and an older age at evaluation: 43.8 versus 38.1?years (P =?0.041) compared to women. Functional dystonia was more frequently observed in women: 47.5 versus 20.3% (P <?0.001), but there was a trend for higher frequency of functional gait disorder in men: 44 versus 30% (P =?0.056). Females were particularly over-represented (73.7%) in children and adolescents; but the genders were equally represented in patients aged ?50?years. Conclusions:Female patients are over-represented in FMDs, except in individuals aged ?50?years. Compared to female patients, males with FMDs present later in life and are less likely to have functional dystonia.
| S-EPMC7011817 | biostudies-literature
Project description:BackgroundThe co-occurrence of internalizing disorders is a common form of psychiatric comorbidity, raising questions about the boundaries between these diagnostic categories. We employ network psychometrics in order to: (a) determine whether internalizing symptoms cluster in a manner reflecting DSM diagnostic criteria, (b) gauge how distinct these diagnostic clusters are and (c) examine whether this network structure changes from childhood to early and then late adolescence.MethodSymptom-level data were obtained for service users in publicly funded mental health services in England between 2011 and 2015 (N = 37,162). A symptom network (i.e. Gaussian graphical model) was estimated, and a community detection algorithm was used to explore the clustering of symptoms.ResultsThe estimated network was densely connected and characterized by a multitude of weak associations between symptoms. Six communities of symptoms were identified; however, they were weakly demarcated. Two of these communities corresponded to social phobia and panic disorder, and four did not clearly correspond with DSM diagnostic categories. The network structure was largely consistent by sex and across three age groups (8-11, 12-14 and 15-18 years). Symptom connectivity in the two older age groups was significantly greater compared to the youngest group and there were differences in centrality across the age groups, highlighting the age-specific relevance of certain symptoms.ConclusionsThese findings clearly demonstrate the interconnected nature of internalizing symptoms, challenging the view that such pathology takes the form of distinct disorders.
| S-EPMC6767473 | biostudies-literature
Project description:In the adult population, psychiatric disorders are associated with somatic illness. Explanatory life style factors have been found, but also a failure to recognize somatic illness in this group. Another factor is side effects from long-term use of antipsychotic drugs. Given the psychiatric-somatic comorbidity in the adult population, it is of interest to investigate whether an association exists already during childhood. The aim of the present study was to investigate the frequency of somatic illness in children and adolescents with a psychiatric diagnose. Data were obtained from the regional health care database Vega, Sweden. Psychiatric and somatic diagnoses obtained during 2011-2013 for individuals aged 3-18 years were extracted. Descriptive statistics were used to examine difference in somatic morbidity between children with and without psychiatric diagnoses. Logistic regression was used in age-stratified models to test the association between psychiatric and somatic diagnoses. Anxiety and behavioral disorders were associated with all somatic conditions investigated at nearly all ages. The same applied to substance use, investigated at age 9-18 years. Affective disorders were associated with all somatic conditions at age 12-18 years. Psychotic conditions were associated with asthma, bowel disorders and myalgia in adolescents. Children with psychiatric disorders are at remarkably high risk for concurrent somatic illness. The associations span across many types of conditions and across all ages. The results support the need for awareness of somatic morbidity in child and adolescent psychiatric clinical settings, and the need for coordinated health care for children with comorbid states.
| S-EPMC6800882 | biostudies-literature
Project description:IntroductionWomen have been shown to be a vulnerable group in relation to mental health problems over time. Despite this, gender-focused studies are uncommon. The aim of this research is to study mental health in a sample of people with mental health problems and to analyze the differences and predictors focusing on gender.MethodsA cross-sectional study is conducted in a heterogeneous clinical sample in terms of mental health problems (N = 160). Interviews with hetero-reported standardized questionnaires to collect the data are conducted. Descriptive analyses, mean difference and a regression analysis on mental health are carried out taking into account different sociodemographic, clinical and psychosocial variables.ResultsWomen in the study present worse levels of mental health and subjective severity of the disorder. The main predictors of mental health are being female, followed by severity, shorter time with the diagnosis and internalized stigma.ConclusionBeing female is the most robust predictor of worse mental health and symptomatology. Recommendations according to the results found proposing a gender perspective are suggested.
| S-EPMC9260627 | biostudies-literature
Project description:BackgroundUrban emergency department (ED) patients have elevated smoking and substance use compared with the general population. We analyzed gender differences in smoking among an urban ED sample and assessed the contribution of substance use, demographic, and couple factors.MethodsWe conducted a secondary analysis of data obtained from a cross-sectional, observational survey (N = 1037 participants) on drinking, drug use, and intimate partner violence (IPV). Gender-specific logistic regression models for current (past 30-day) smoking and multinomial regression models for smoking intensity (light: ⩽5 cigarettes per day [CPD]; moderate: 6 to 10 CPD; heavier: >10 CPD) were estimated.ResultsSmoking prevalence was higher among men than women (35.5% vs 18.9%; P < .001). Substance use (frequency of intoxication, marijuana, amphetamine, and cocaine use), demographic (food insufficiency, unemployment), and couple-related factors (having a spouse/partner who smoked, IPV involvement, being in a same-gender couple) were differentially associated with current smoking and level of intensity among men and women.ConclusionsEmergency department staff should consider the impact of polysubstance use, food insufficiency, unemployment, and whether both partners in the couple smoke when screening patients for smoking and formulating cessation treatment plans. Women in same-gender relationships and those who have experienced IPV involvement may require additional referral.
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Project description:This study examined gender differences in how internalizing and externalizing symptoms affect adolescents' decisions about smoking in Chile, where girls smoke at some of the highest rates in the world. In multivariate logistic regression analyses with 607 adolescents, internalizing symptoms, such as depressed mood and anxiety, predicted smoking among girls more than boys, with girls who were low in internalizing symptoms being more likely to smoke than those who were high in internalizing symptoms. In Chile's high-risk context, internalizing symptoms may be indirectly protective for girls by decreasing their exposure to peer pressure and related influences that encourage cigarette use.
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Project description:There are important sex differences in the brain that seem to arise from biology as well as psychosocial influences. Sex differences in several aspects of human behavior and cognition have been reported. Gonadal sex steroids or genes found on sex chromosomes influence sex differences in neuroanatomy, neurochemistry and neuronal structure, and connectivity. There has been some resistance to accept that sex differences in the human brain exist and have biological relevance; however, a few years ago, it has been recommended by the USA National Institute of Mental Health to incorporate sex as a variable in experimental and clinical neurological and psychiatric studies. We here review the clinical literature on sex differences in pain and neurological and psychiatric diseases, with the aim to further stimulate interest in sexual dimorphisms in the brain and brain diseases, possibly encouraging more research in the field of the implications of sex differences for treating these conditions.
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Project description:We examined reading, spelling, and mathematical skills in an unselected group of 129 Italian fifth graders by testing various cognitive predictors for each behaviour. As dependent variables, we measured performance in behaviours with a clear functional value in everyday life, such as reading a text, spelling under dictation and doing mental and written computations. As predictors, we selected cognitive dimensions having an explicit relation with the target behaviour (called proximal predictors), and prepared various tests in order to select which task had the best predictive power on each behaviour. The aim was to develop a model of proximal predictors of reading (speed and accuracy), spelling (accuracy) and maths (speed and accuracy) characterized by efficacy also in comparison to the prediction based on general cognitive factors (i.e., short-term memory, phonemic verbal fluency, visual perceptual speed, and non-verbal intelligence) and parsimony, pinpointing the role of both common and unique predictors as envisaged in the general perspective of co-morbidity. With one exception (reading accuracy), the proximal predictors models (based on communality analyses) explained a sizeable amount of variance, ranging from 27.5% in the case of calculation (accuracy) to 48.7% of reading (fluency). Models based on general cognitive factors also accounted for some variance (ranging from 6.5% in the case of spelling to 19.5% in the case of reading fluency) but this was appreciably less than that explained by models based on the hypothesized proximal predictors. In general, results confirmed the efficacy of proximal models in predicting reading, spelling and maths although they offered only limited support for common predictors across different learning skills; namely, performance in the Orthographic Decision test entered as a predictor of both reading and spelling indicating that a single orthographic lexicon may account for performance in reading and spelling. Possible lines of research to expand on this approach are illustrated.
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