ABSTRACT
Abstract Background: Individuals with sickle cell anemia may suffer symptomatic or silent cerebral infarcts leading to neurocognitive complications. This study investigated the cognitive and intellectual performance of children and adolescents with sickle cell anemia. Methods: The socioeconomic status, clinical aspects and behavioral profile of 15 young individuals with sickle cell anemia were evaluated. The Wechsler Intelligence Scale for Children, the Developmental Neuropsychological Assessment Test, and the Child Behavior Checklist were applied. Results: Participants with a history of stroke had lower intelligence quotient (IQ) scores. Alterations were found in attention and executive functioning, language, verbal and visual memory, visuospatial processing and sensorimotor skills. These alterations were found both in the children and adolescents who had had a cerebral infarction and in those who apparently had not. In the majority of cases, there were learning difficulties, a history of repeating school years and a need for specialist educational support. The most common additional diagnoses in accordance with the Diagnostic and Statistical Manual of Mental Disorders IV were depressive disorder, anxiety disorder and somatic disorder, as well as conditions associated with physical and psychosocial repercussions of sickle cell anemia. Conclusion: As sickle cell anemia is considered a progressive cerebral vasculopathy, it is a potential risk factor for neurocognitive and psychosocial development. Therefore, periodic neuropsychological and behavioral evaluations of children and adolescents with sickle cell anemia may represent a useful measure to reduce long-term biopsychosocial repercussions.
Subject(s)
Neurobehavioral Manifestations , Intelligence Tests , Anemia, Sickle Cell , Neuropsychological TestsABSTRACT
OBJECTIVE: This study investigates obsessive-compulsive disorder patients in terms of strategic planning and its association with specific obsessive-compulsive symptom dimensions. METHOD: We evaluated 32 obsessive-compulsive disorder patients. Strategic planning was assessed by the Rey-Osterrieth Complex Figure Test, and the obsessive-compulsive dimensions were assessed by the Dimensional Yale-Brown Obsessive-Compulsive Scale. In the statistical analyses, the level of significance was set at 5 percent. We employed linear regression, including age, intelligence quotient, number of comorbidities, the Yale-Brown Obsessive-Compulsive Scale score, and the Dimensional Yale-Brown Obsessive-Compulsive Scale. RESULTS: The Dimensional Yale-Brown Obsessive-Compulsive Scale "worst-ever" score correlated significantly with the planning score on the copy portion of the Rey-Osterrieth Complex Figure Test (r = 0.4, p = 0.04) and was the only variable to show a significant association after linear regression (β = 0.55, t = 2.1, p = 0.04). Compulsive hoarding correlated positively with strategic planning (r = 0.44, p = 0.03). None of the remaining symptom dimensions presented any significant correlations with strategic planning. CONCLUSION: We found the severity of obsessive-compulsive symptoms to be associated with strategic planning. In addition, there was a significant positive association between the planning score on the copy portion of the Rey-Osterrieth Complex Figure Test copy score and the hoarding dimension score on the Dimensional Yale-Brown Obsessive-Compulsive Scale. Our results underscore the idea that obsessive-compulsive disorder is a heterogeneous disorder and suggest that the hoarding dimension has a specific neuropsychological profile. Therefore, it is important to assess the peculiarities of each obsessive-compulsive symptom dimension.
OBJETIVO: Este estudo investiga o planejamento estratégico em pacientes com transtorno obsessivo-compulsivo e sua possível associação com dimensões de sintomas obsessivo-compulsivos. MÉTODO: Foram avaliados 32 pacientes com transtorno obsessivo-compulsivo. O planejamento estratégico foi avaliado pelo Teste da Figura Complexa de Rey. Presença e gravidade de sintomas obsessivo-compulsivos foram avaliadas pela Escala Dimensional para Sintomas Obsessivo-Compulsivos e a Yale-Brown Obsessive-Compulsive Scale. Análises estatísticas foram realizadas utilizando nível de significância de 5 por cento. RESULTADOS: Escores globais da Escala Dimensional para Sintomas Obsessivo-Compulsivos na pior fase apresentaram correlação significativa com os escores de cópia do Teste da Figura Complexa de Rey-Osterrieth (r = 0,4, p = 0,04), além de manter significância na análise de regressão, incluindo idade, quociente de inteligência, número de comorbidades e escores no Yale-Brown Obsessive-Compulsive Scale e Escala Dimensional para Sintomas Obsessivo-Compulsivos (β= 0,55, t = 2,1, p = 0,04). A dimensão colecionismo teve uma correlação significativa com o escore de planejamento estratégico (r = 0,44, p = 0,03). As outras dimensões de sintomas obsessivo-compulsivos não apresentaram correlações significativas com os escores de planejamento estratégico. CONCLUSÃO: A gravidade dos sintomas obsessivo-compulsivos e a dimensão colecionismo apresentaram associações significativas com escores de planejamento estratégico na cópia do Teste da Figura Complexa de Rey. Os achados reforçam a ideia de que o transtorno obsessivo-compulsivo é um transtorno heterogêneo, e de que é importante avaliar as especificidades de cada dimensão de sintomas obsessivo-compulsivos, além de sugerir que a dimensão colecionismo apresenta características neuropsicológicas distintas.