Psychological disorders in perimenopausal women / 中华老年医学杂志

Perimenopausal period includes the whole process from the beginning of the decline of gonadal function to the complete loss, which lasts for 1 to 10 years.It is a fragile'window period'with the high incidence of mental illness for women.During this period, the mental health status of women is closely related to their mental health status at older age.Emotional disorders, sleep disorders, and cognitive impairment are common in perimenopausal and postmenopausal women, but currently receive insufficient attention.Therefore, the present review discusses the current state of research on the prevalence, pathogenesis, intervention, and management of the above-mentioned disorders, and thus to provide a basis for prevention and intervention programs among perimenopausal women.

Dysregulation in the secretion of the stress-related catecholamines in oral cancer patients: predictors and prognostic value / Desregulação da secreção das catecolaminas relacionadas ao estresse em pacientes com câncer de boca: valor preditivo e prognóstico

Introdução: Pacientes com câncer podem apresentar uma hiperativação do Sistema Nervoso Simpático (SNS). Como consequência, uma desregulação na secreção das catecolaminas relacionadas ao estresse norepinefrina (NE) e epinefrina (EPI) têm sido implicadas na progressão de alguns tipos de tumores malignos. No entanto, a associação entre os níveis sistêmicos das catecolaminas e o prognóstico do câncer, bem como seus fatores preditores são pobremente conhecidos. Pacientes e métodos: O presente estudo investigou os níveis plasmáticos de NE e EPI em 168 pacientes com carcinoma espinocelular (CEC) de boca, 70 pacientes com leucoplasia bucal e 54 voluntários saudáveis; bem como sua associação com variáveis demográficas, clínicopatológicas, biocomportamentais e psicológicas nos pacientes oncológicos. Os níveis plasmáticos de NE e EPI foram medidos por cromatografia líquida de alta eficiência com detecção eletroquímica (CLAE-ED) e o estado psicológico de humor foi avaliado pela Escala de Humor de Brunel (BRUMS). Análise de Kaplan-Meier e regressão de Cox foram usadas para investigar as associações entre os níveis de NE e EPI e a sobrevida global e específica após 5 anos de follow-up em 82 pacientes com câncer de boca. Os níveis sistêmicos das catecolaminas também foram avaliados em 32 pacientes após o tratamento da doença e comparados com os níveis pré-tratamento. Resultados: As concentrações plasmáticas de NE e EPI foram significativamente maiores em pacientes com CEC de boca em comparação aos pacientes com leucoplasia bucal (p< 0,0001 e p=0,024, respectivamente). Os pacientes com CEC de boca também apresentaram níveis plasmáticos de NE mais elevados do que os voluntários saudáveis (p= 0,0002). As concentrações plasmáticas de NE nos pacientes com leucoplasia bucal foram menores do que os voluntários saudáveis (p= 0,032). Análises de regressão múltipla mostraram que níveis aumentados de NE foram significativamente associados com uma sensação de "sentir-se sem energia", um descritor medido pelo BRUMS (OR= 2,9; p= 0,023). Baixa escolaridade e ocorrência de comorbidades com maior severidade foram independentemente associados a altos níveis de EPI (OR= 4,0; p= 0,004 e OR= 7,2; p= 0,005; respectivamente). Além disso, a presença de um estado de humor de raiva e "não estar em alerta" foram associados a altos níveis plasmáticos de EPI (OR= 2,6; p= 0,039 e OR= 3,2; p= 0,010, respectivamente). Os resultados mostraram que os pacientes com CEC de boca não casados e que tinham pior renda familiar foram preditivos para menor sobrevida global dos pacientes com CEC de boca (p< 0,05). Estágio clínico avançado foi associado à diminuição da sobrevida global (HR= 5,2; p= 0,000) e específica do câncer (HR= 4,2; p= 0,000). A análise de regressão de Cox também evidenciou que níveis sistêmicos aumentados tanto de NE como de EPI foram associados à menor sobrevida global (HR= 3,4; p= 0,002 e HR= 2,8; p=0,006, respectivamente). Os pacientes com CEC de boca apresentaram níveis plasmático de NE mais baixos após o tratamento do câncer em comparação com a fase pré-tratamento (p= 0,0008). Conclusão: Os resultados do presente estudo mostram que pacientes com câncer de boca podem apresentar níveis sistêmicos elevados das catecolaminas norepinefrina e epinefrina, e que esta desregulação hormonal associada com fatores clinicopatológicos e psicológicos é preditiva para pior sobrevida global(AU)

Introduction: Cancer patients may have a hyperactivation of the Sympathetic Nervous System (SNS). Therefore, dysregulation in the secretion of the stress-related catecholamines norepinephrine (NE) and epinephrine (EPI) have been implicated in the progression of some types of cancer. However, the association between systemic levels of catecholamines and cancer prognosis, as well as its predictors, are poorly understood. Patients and methods: The present study investigated the plasma NE and EPI levels in 168 patients with oral squamous cell carcinoma (OSCC), 70 patients with oral leukoplakia and 54 healthy volunteers; as well as its association with demographic, clinicopathological, biobehavioral and psychological variables in cancer patients. Plasma NE and EPI levels were measured by high performance liquid chromatography with electrochemical detection (HPLC-ED) and psychological mood states was assessed by the Brunel Mood Scale (BRUMS). Kaplan-Meier analysis and Cox regression were used to investigate associations between the systemic levels of catecholamines and overall and specific survival after 5 years of follow-up in 82 patients with oral cancer. Systemic levels of catecholamines were also evaluated in 32 patients after oral cancer treatment and were compared with pre-treatment levels. Results: Plasma NE and EPI concentrations were significantly higher in patients with oral SCC compared to patients with oral leukoplakia (p<. 0001 and p=.024, respectively). Patients with oral SCC also displayed higher plasma NE levels than healthy volunteers (p=.0002). Patients with oral leukoplakia had lower plasma NE levels than healthy volunteers (p=.032). Multiple regression analyzes showed that increased NE levels were associated with a feeling of "no energy", a descriptor measured by BRUMS (OR= 2.9; p= .023). Low education and the occurrence of severe comorbidities were independently associated with high levels of EPI (OR= 4.0; p= .004 and OR= 7.2; p= .005; respectively). Furthermore, the presence of an angry mood state and denial of "being on alert" were associated with high EPI levels (OR= 2.6; p= .039 and OR= 3.2; p= .010, respectively). The results showed that nonmarried oral SCC patients and those who had a lower family income had lower overall survival in patients with oral SCC (p< 0.05). Advanced clinical stage was associated with decreased overall (HR=5.2; p=.000) and cancer-specific (HR=4.2; p=.000) survival. Cox regression analysis also showed that increased levels of both NE and EPI were associated with worse overall survival (HR=3.4; p=.002 and HR=2.8; p=.006, respectively). Patients with oral SCC had lower plasma NE levels after cancer treatment compared to the pre-treatment period (p=.0008). Conclusion: The results of the present study reveal that patients with oral cancer may have high systemic levels of the catecholamines norepinephrine and epinephrine, and that this hormonal dysregulation is associated with clinicopathological and psychological factors and predictive for worse overall survival(AU)

Suicide during COVID-19 infection - Case report and literature review

ABSTRACT The COVID-19 pandemic has a global effect on people's mental health. The SARS-CoV-2 infection is a new source of anxiety, depression, and psycho-emotional changes in people without morbid conditions, with even more important impact on patients with associated diseases. We present the case of a previously diagnosed patient with COVID-19, in which the psychological effects accumulated during hospitalization triggered an autolytic behaviour. The case presented by us and the review of the literature show that serious diseases are frequently associated with depression and emotional disorders, and SARS-CoV-2 infection is no exception

Comparing the effectiveness of the unified protocol in combination with an additional mindfulness treatment to the unified protocol alone as treatment for adolescents diagnosed with emotional disorders

Abstract Objective Many adolescents suffer from depressive and anxiety disorders simultaneously and current treatment methods do not put enough emphasis on comorbidity of these disorders. The unified protocol for treating emotional disorders in adolescents is a transdiagnostic therapy which targets mutual fundamental factors. Therefore, the current study aims to compare the effectiveness of the unified protocol alone with the unified protocol combined with mindfulness as an additional treatment in adolescents suffering from emotional disorders. Method A quasi-experimental study was conducted with adolescents. The participants had been diagnosed with emotional disorders and were divided into a control group (15 participants) and an experimental group (16 participants). Both groups were offered 14 sessions of therapy. They were assessed at pre-test, post-test, and two-month follow-up. Scales used in the study included the Child Behavior Checklist (CBCL), the Children's Depression Inventory (CDI), and the Youth Anxiety Measure for DSM-5 (YAM-5). Results The results showed that both of the treatment methods effectively reduced adolescents' emotional problems, but improvements were more significant in the group administered the additional mindfulness program. Among the variables assessed, non-phobic anxiety disorders and depression improved more than specific phobia and behavioral problems. Between-subjects (Group) partial etas for non-phobic anxiety, depression, specific phobia, and behavioral problems were 0.67, 0.50, 0.23, and 0.16, respectively. Conclusion According to the findings of this study, additional treatment methods such as mindfulness could increase the effectiveness of the unified transdiagnostic protocol for adolescents (UP-A). The therapeutic implications are discussed.

Educación terapéutica en pacientes con diabetes y trastornos emocionales / Terapeutic education in patients with diabetes and emotional disorders

La diabetes mellitus (DM) se considera como un conjunto de trastornos metabólicos relacionados con la hiperglucemia, que requiere cambios en estilos de vida, en virtud de que no solo se afecta el estado físico, sino que requiere cambios que pueden influir en el estado emocional y psicosocial. Las personas con diabetes requieren de cuidados continuos orientados al control metabólico centrados en el empoderamiento, autocuidado y en la educación terapéutica para alcanzar metas y resultados orientados a minimizar la aparición de las complicaciones crónicas. Objetivo: analizar la importancia de la educación terapéutica en los pacientes con trastornos afectivos como depresión y ansiedad, asociados a la diabetes. Conclusión: la educación terapéutica como parte integral del tratamiento de la DM ha demostrado mejorar los síntomas asociados a depresión y ansiedad, lo cual podría adquirir un valor importante en el manejo de este grupo de pacientes(AU)

Diabetes mellitus (DM) is considered as a set of metabolic disorders related to hyperglycemia, which requires changes in lifestyle, because not only physical condition is affected, but it also requires changes that can influence emotional state and psychosocial. People with diabetes require continuous care oriented to metabolic control focused on empowerment, self-care and therapeutic education to achieve goals and results aimed at minimizing the occurrence of chronic complications. Objective: to analyze the importance of therapeutic education in patients with affective disorders such as depression and anxiety, associated with diabetes. Conclusion: therapeutic education as an integral part of the treatment of DM has been shown to improve symptoms associated with depression and anxiety, which could acquire an important value in the management of this group of patients(AU)

El Protocolo Unificado para el Tratamiento Transdiagnóstico de los Trastornos Emocionales / The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

Los modelos dimensionales de la psicopatología indican que los trastornos emocionales (del estado de ánimo, de ansiedad, obsesivo-compulsivo, relacionados a traumas y otros) comparten factores de vulnerabilidad y mantenimiento: fuertes emociones perturbadoras, aversión a las mismas y utilización de estrategias para evitarlas que, paradójicamente, las intensifican y prolongan. David Barlow et al. (2011) diseñaron un protocolo transdiagnóstico, el Protocolo Unificado, que apunta a dichos factores. En este trabajo se presentan los fundamentos del tratamiento y los ocho módulos destinados a aumentar la motivación para el cambio; aprender sobre la funcionalidad de las emociones; practicar la conciencia plena; utilizar cogniciones más flexibles que disminuyan la catastrofización de las consecuencias temidas; cambiar las estrategias evitativas por acciones alternativas; tolerar las sensaciones físicas que acompañan a las emociones; exponerse a las emociones más temidas y prevenir recaídas. Una creciente investigación avala la eficacia del Protocolo Unificado

Dimensional models of psychopathology indicate that emotional disorders (mood, anxiety, obsessive-compulsive, related to trauma disorders, and others) share factors of vulnerability and maintenance: strong disturbing emotions, aversion to them and use of avoidant strategies that, paradoxically, intensify and prolong them. Barlow et al. (2011) developed a transdiagnostic protocol, the Unified Protocol, to address these factors. This paper presents the treatment rationale and the eight modules aimed at increasing motivation for change; learning about the functionality of emotions; practicing mindfulness; using more flexible cognitions to reduce the catastrophization of feared consequences; replacing avoidant strategies by alternative actions; tolerating the physical sensations that are part of emotions; exposing oneself to the most feared emotions and prevent relapses. Growing research supports the efficacy of the Unified Protocol

The clinical research progress of non-motor symptoms in myasthenia gravis / 中华神经科杂志

Myasthenia gravis (MG) is an acquired autoimmune disease involving neuromuscular junctions transmit dysfunction. The main clinical manifestations are partial or systemic skeletal muscle weakness and extreme fatigue, increased symptoms after activity, relieved after rest and treatment with cholinesterase inhibitors. However, recent studies have found that patients of MG are not only accompanied by motor symptoms such as muscle weakness and dysphagia, but also with non-motor symptoms. This article reviews the clinical research progress of non-motor symptoms in MG.

The clinical research progress of non?motor symptoms in myasthenia gravis / 中华神经科杂志

Myasthenia gravis (MG) is an acquired autoimmune disease involving neuromuscular junctions transmit dysfunction. The main clinical manifestations are partial or systemic skeletal muscle weakness and extreme fatigue, increased symptoms after activity, relieved after rest and treatment with cholinesterase inhibitors. However, recent studies have found that patients of MG are not only accompanied by motor symptoms such as muscle weakness and dysphagia, but also with non?motor symptoms. This article reviews the clinical research progress of non?motor symptoms in MG.

Emotional and Social Disorders among Overweight and Obese Children in Enugu, Nigeria: An Evolving Menace.

Background: Obesity results mainly from changes in diet and physical activity and currently being regarded as a global epidemic. It comes at a cost, affecting physical, social and psychological health and having deleterious impact on psychological development, academic and social performance of an affected child. The aim is to determine the burden of psychosocial disorders among the overweight and obese children in our environment. Methods: A descriptive cross sectional study carried out among secondary school children aged 10-18 years in Enugu metropolis. Sampling involved stratified and multi-staged methods. The height and weight of selected subjects were measured and their BMI calculated. An adapted, semi-structured, self-administered questionnaire was used. Information sought included socio-demographics and psychometric measurements. Data was analyzed using SPSS version 19. Analytical test of significance was done using Chi square test at p value of ≤ 0.05. Results: Of 200 students studied, 136 (68%) were females and 64 (32%) were males. Most (157) were in the age range of 10-14 years old. Sixty seven were overweight while 133 were obese with most of the children’s parents belonging to the upper socioeconomic class. One hundred and nineteen of them had one emotional and/or social problem of depression, anxiety, low self-esteem, discrimination and stigma, giving a prevalence rate of 59.5%. Thirty five (54.7%) males and 81 (61.8%) females had at least one emotional and/or social problem (χ2 = 0.905, p = 0.342). Between the children aged 10-14 and 15-18 years, 56.1% and 72.1% respectively experienced at least one psychosocial disorder (χ2 = 3.605, p = 0.058). Emotional and social disorders was commoner among the upper class and difference was statistically significant (χ2 = 6.375, p = 0.041). Conclusion: The burden of emotional disorders among overweight and obese children in Enugu metropolis is high. Socioeconomic class is associated with emotional disorders.

Guías de buenas prácticas para la atención psicológica y social al paciente con epilepsia / Good practice guidelines for the social and psychological care to the patient with epilepsy

En la actualidad cobra vital importancia la preparación y divulgación de guías o protocolos de intervenciones esenciales para la atención del paciente epiléptico en el primer nivel de atención, ya que con frecuencia estos pacientes son victimas de imprecisiones terapéuticas. El propósito de este trabajo es presentar guías de buenas prácticas para la atención psicológica y social de este paciente. Se realizó análisis de contenido de los reportes de investigaciones que sobre atención psicosocial al paciente con epilepsia se prepararon en Cuba entre 2004 y 2013. A partir de la evidencia valorada se elaboraron las guías de buenas prácticas para la atención psicológica y social del paciente con epilepsia y en ellas se precisó la estructura asistencial y los recursos materiales necesarios, se describieron los procederes de actuación en orden cronológico: entrevistas clínico-psicológico y técnicas de evaluación psicológicas idóneas. Además se precisaron las especificidades para la atención clínico-psicológico al paciente con inadaptación psicosocial a la epilepsia y para la atención clínico-psicológica del paciente con epilepsia y trastornos emocionales asociados. Las guías aportan herramientas de trabajo para evitar la inadaptación psicosocial, los trastornos emocionales y la incapacidad para el autocuidado en pacientes con epilepsia(AU)

The preparation and dissemination of essential intervention guidelines or protocols for the care of patient with epilepsy at the first health care level is gaining importance, since these patients are frequent victims of therapeutic inaccuracies. The objective of this paper was to present good practice guidelines for the psychological and social care of this patient. A content analysis of the reports from research on this topic was made, which were made in Cuba from 2004 to 2013. On the basis of the assessed evidence, good practice guidelines were prepared for the social and psychological care of the patient with epilepsy. They detailed the assistance structure and the necessary material resources for adequate psychological and social care of this patient as well as the procedures of performance in a chronological order: clinical and psychological interview and ideal psychological evaluation techniques. Additionally, the specificities for the clinical and psychological care of the patient with faulty psychosocial adaptation to epilepsy and for the patient with epilepsy and associated emotional disorders were also specified. The guidelines provide working tools to avoid faulty psychosocial adaptation, emotional disorders and inability to self-care in epileptic patients(AU)

Thinking of Emotional Counterbalance Therapy in Depression Clinical Experience / 浙江中医药大学学报

Objective] To study emotional counterbalance therapy which is used in depression treatment ,it plays an important role in the treatment of emotional disorders. [Method] With the research methods of taking depression for example ,through the sad,fear of these two emotional factors to explore the pathogenesis of depression,and analyze“happiness restrains sadness“ and“thought restrains fear”in the emotional counterbalance therapy, which are used in the depression clinical application.[Result]Emotional counterbalance uses one or more of the emotions to regulate ,control,overcome the other one or more negative emotions,which based on the restriction among the five elements theory is a kind of psychological therapy.Sadandfearare the most common chief complaints in depression which belong to the emotional depression in depression disease of Chinese medicine. On the basis of “sad doing harm to the lungs”and “dread doing harm to the kidneys”,lung,kidney and depression etiology,pathogenesis,symptoms are closely related. This reflects the lung,kidney play an indispensable role in the treatment of depression. It has significant curative effects to apply the theory of emotion counterbalance,such as happiness restrains sadness,thought restrains fear to cure diseases. At the same time,with a relaxed and pleasant mood,actively guiding to help thinking is also the treatment of depression,pessimistic disappointment medicine.[Conclusion] According to the restriction among five elements theory,to use the relation and restriction between emotion and five zang-organs to regulate emotional disorders can restore to the normal balance,which is an effective psychological treatment for emotional disorders.The therapy should be used alone or combined with traditional Chinese medicine treatment in different situations to relive the treatment effect.

Características epidemiológicas, consecuencias físicas y emocionales a corto y largo plazo en niños de 4 a 15 años con sospechas de abuso sexual. Hospital del Niño. Panamá 2009 al 2011

El abuso sexual se refiere a las conductas sexuales coercitivas , impuestas a una persona menor de edad, por otra persona, que puede ser físicamente superior, con más experiencia y recursos, que utiliza incorrectamente su poder o autoridad. Es un hecho significativo que cada día emerge con más fuerza e involucra la vulneración de los derechos humanos. Por esta razón ante el creciente interés en el tema a nivel mundial, ante las devastadoras consecuencias sobre el niño, su entorno, salud física, emocional y posterior desempeño escolar y social, hemos decidido abordarlo. Objetivo: Identificar las características sociodemográficas, consecuencias físicas en niños de 4 a 15 años con sospecha de abuso sexual, atendidos en el Hospital del Niño entre los años 2009 al 2011 y determinar si existe relación a corto y largo plazo entre la agresión y alteraciones psicoemocionales. Metodología: Se realizó un estudio en dos fases: La primera fase un estudio descriptivo retrospectivo simple y la segunda fase, analítica de seguimiento, en un periodo de 18 a 24 meses posterior a sufrir agresión sexual, de los casos referidos a los Juzgados de Niñez y Adolescencia del Distrito de Panamá, mediante la aplicación de La Escala Children's Depression Inventory y la Escala de Ansiedad de Spence. La muestra fue de 92 casos. Se analizaron los datos con Excel 2010. Resultados: El mayor número de casos de abuso sexual se encontró en la adolescencia temprana 36 %, con una media de edad de 9.6 años, encontrando un factor de asociación de ocurrencia en el ámbito extra familiar con 21 %; en donde el 79 % el agresor era conocido por las víctimas. Sólo un 45 % de los casos referidos se considero abuso según juzgados. Sólo un 26 % cumplió la ruta crítica de forma integral. Conclusiones: Encontramos la mayor afectación en el grupo de adolescencia intermedia. La agresión se realizó por un conocido de la víctima y el examen físico no fue concluyente para el dictamen de abuso. En los casos a quienes se aplicaron las herramientas de evaluación psicoemocionales se evidenció predominio de alteraciones de tipo emocionales.

The sexual abuse refers to coercive sexual behaviors imposed to a minor by another person who can be physically superior, with more experience, resources, using in a wrong way his authority. It is significant fact that every day more strongly emerges and involves the violation of human rights. For this reason at the global increase of the topic with devastating consequences for the child, their environment, physical and emotional health and subsequent school and social performance, we decide to address this issue. Objective: Identify the sociodemographic characteristics and physical consequences in children from 4 to15 years with suspected sexual abuse, attended in Hospital del Niño between years 2009-2011 and determine if there exists association in a short or long term between the aggression and psycho-emotional disorders. Methods: The study was conducted in two phases: the first one was a single retrospective study and the second phase was a follow-up analysis in a period from 18 to 24 months after the sexual attack, in those cases referred to the courts for Childhood and Adolescence Panama District, through the application of Children's Depression Inventory Scale and the Spence Anxiety Scale. The sample was 92 cases. Data were analyzed with excel 2010. Results: The most cases of child sexual abuse were in the middle adolescence (36%), with a mean age of 9.6 years. We found association of occurrence in the extra-familiar environment with 21%, where the 79% of the aggressors were known people from the victim. 45% of the cases were considered sexual abuse by the Tribunals. Just 26% complete the entire process (Critical Route). The psycho-emotional disturbances were seen in a short term with 16% in adolescents. Conclusions: the most affected group was the middle adolescence. The attack was done by a known person of the victim and the physical examination was not conclusive to determine sexual abuse. In the cases evaluated with the anxiety and depression scales the most resulted in emotional disturbances.

Cognitive Functions among Children with Attention Deficit Hyperactive Disorder (ADHD) & Emotional Disorders.

Objectives: Attention Deficit Hyperactivity Disorder (ADHD) and Emotional Disorders (ED) afflict young children and adolescents significantly and children with these psychiatric disorders clearly have impairment in cognitive functions. The present study aims to study the impairment in cognitive functions (Focused Attention & Executive Function) among children with ADHD and ED compared to normal control. The study further aims to study the variation in the cognitive functions with severity of the illness. Method: Twenty diagnosed ADHD children meeting the ICD-10 criteria for ADHD and twenty children having Emotional Disorders (ED) meeting the ICD-10 criteria under F-93 were assessed on the measures of Focused Attention and Executive Function and compared with twenty age and education matched normal control group. Results: Children with ADHD and ED performed poorly on the measures of Focused Attention and Executive Function compared to normal control, however, the severity of illness was not identified as a factor contributing to the impairment in cognitive functioning. Conclusion: Inattention and impairment in executive functions are not restricted to children with ADHD alone, but are also manifested in children with ED. Both the groups (Children with ADHD and ED) can be placed in juxtaposition with regard to their pattern of cognitive impairment. However, the difference lies in relation to the degree of impairment, as children with ADHD demonstrate greater deficit in their cognitive functioning as compared to those with EDs. Thus, inattention does not always indicate that the child stands in the crowd of ADHD rather the clinicians and researchers need to look for the other possible childhood disorders that are likely to contribute to the impairment in executive functions and attentional abilities of the child

Síndrome Williams: una enfermedad rara con sintomatología contradictoria / Williams syndrome: A rare disease with contradictory symptomatology

El síndrome Williams (SW) es una de las enfermedades raras o infrecuentes. Tiene una incidencia de un caso cada 20.000 nacimientos vivos. Se trata de una alteración genética, localizada en el cromosoma 7 (banda 7q11.23), en el 99% de los casos. La alteración genética afecta el desarrollo y el funcionamiento del sistema nervioso central. Esta enfermedad no tiene cura pero se pueden suavizar los síntomas cognitivos, emocionales y sociales. El SW ocurre casi en exclusividad en niñas y de forma excepcional en niños. Los estudios epidemiológicos indican que está presente en todas las etnias, lenguas y culturas. El rango más llamativo de las personas con SW es la discrepancia entre el funcionamiento intelectual general (retraso leve o moderado) acompañado de unas habilidades lingüísticas sobresalientes, muy superiores a lo esperado para su edad cronológica y mental. En un porcentaje alto de casos se observan problemas cardiacos, endocrinos, alteraciones del sueño, hiperacusia selectiva y alteraciones en la cognición espacial.

Williams syndrome (WS) is considered one of the rare or uncommon diseases. It has an incidence of a case each 20.000 live births. It is a genetic disorder, located on chromosome 7 (band 7q11.23), in 99% of cases. This genetic alteration affects the development and operation of the central nervous system. Does not exist cure for the disease but the social, emotional and cognitive symptoms can smooth. WS occurs almost exclusively in girls and exceptionally in children. The most striking feature of the WS is the discrepancy between the general intellectual functioning (mild or moderate delay) accompanied by outstanding linguistic skills, much higher than expected for their chronology and mental age. High number of cases shows cardiac and endocrine problems, sleep disturbances, selective hyperacusis and spatial cognition disorders.