Auditory training methods in children with psychiatric diagnosis: an integrative literature review / Métodos de treinamento auditivo em crianças com diagnóstico psiquiátrico: revisão integrativa da literatura

ABSTRACT Purpose: to identify auditory training approaches used in the pediatric population with psychiatric diagnoses and to characterize the contexts in which the intervention took place, as well as protocols and discernment of the results. Methods: a search was carried out in four databases, using the fixed terms "auditory training" OR "auditory rehabilitation". Regarding the sampling, there was a considerable range of diagnoses, signs and symptoms, including the most common ones. Articles published until August 2018 whose population did not present hearing loss were selected; articles whose subjects had made use of any personal sound amplification products, presented otitis or had any isolated diagnosis of auditory processing disorder, were excluded. Results: 16 articles out of the 103 references found, met the inclusion criteria. The samplings studied were children and adolescents with learning, language or reading disorders, dyslexia, attention deficit hyperactivity disorder, autism spectrum disorder and schizophrenia. The bottom-up intervention and the combined approach (bottom-up and top-down), in the formal context, were the most frequent approaches, whose results led to the improvement in linguistic, metalinguistic and auditory skills. The amount and frequency of sessions, as well as their duration varied. Conclusion: the heterogeneity of auditory training techniques diversified the results. However, it seems there is a potential for recommending auditory training in the reviewed population.

RESUMO Objetivo: identificar as abordagens de treinamento auditivo utilizadas na população infantil com diagnósticos psiquiátricos, caracterizar os contextos de intervenção, protocolos e discernimento dos desfechos. Métodos: busca realizada em quatro bases de dados, utilizando as expressões fixas "auditory training" OR "auditory rehabilitation" e, quanto à amostragem, variaram-se aos mais comuns diagnósticos, sinais e sintomas. Foram selecionados artigos publicados até agosto de 2018, com população sem perda auditiva e excluídos artigos com amostra com uso de dispositivos de amplificação sonora, otites ou diagnóstico isolado de Transtorno do Processamento Auditivo. Resultados: foram identificadas 103 referências, dentre as quais 16 preencheram os critérios de inclusão. As amostragens estudadas foram de crianças e adolescentes com distúrbios de aprendizagem, linguagem e leitura, dislexia, transtorno do déficit de atenção e hiperatividade, transtorno do espectro autista e esquizofrenia. As intervenções com a abordagem bottom-up e combinada (bottom-up e top-down), no contexto formal, foram as mais frequentes, cujos resultados direcionaram a melhora em habilidades auditivas, linguísticas e metalinguísticas. O número e frequência de sessões, assim como, a duração (tempo) foram diversificadas. Conclusão: a heterogeneidade das técnicas de treinamento auditivo diversificou os resultados, entretanto, parece existir um potencial para recomendação do treinamento auditivo na população abordada.

Changing disease pattern of patients attending a geriatric clinic in India

Background: Psychiatric morbidity is common in geriatric population along with other medical ailments. Increasing longevity contributes to higher prevalence of degenerative diseases in the elderly. In this perspective, the disease patterns may have changed in this age group and more so in the developing countries. Objectives: The current study explores the sociodemographic profile, disease patterns of various psychiatric ICD-10 diagnoses, and medical comorbidities in the elderly outpatients attending geriatric clinic. Materials and Method: The sample consists of 319 elderly outpatients attending geriatric clinic from September 1999 to December 2002 at National Institute of Mental Health and Neuro-Sciences, Bengaluru, India. This institute is one of the 10/66 centers. This sample is a heterogeneous population of both genders and age >60 years. The patients were assessed using a semi-structured interview as well as laboratory and other investigations as required. Results: The common psychiatric morbidity of this population is dementia (42.4%) and affective disorders (27.3%). However, the medical comorbidity of these patients is also high (41.9%). Previous study from the same center in 1996 reported that 4.2% of patients attending psychiatric services were 60 years and above. The most common problems in the previous study included psychoses (66%), of which about two-thirds (43% of the total) were non-organic psychoses. Conclusion: Dementia, a degenerative disease, forms the largest group of mental illness in elderly outpatients attending geriatric clinic. Other organic psychiatric diseases follow this. Medical comorbidity is concurrently seen in patients with the psychiatric morbidity. This extrapolates the requirement of the multidisciplinary approach in managing the patients in geriatric age group.

El neurodesarrollo en la infancia y la importancia de la comprensión nominal en el diagnóstico / Neurodevelopment in childhood. The importance of diagnostic names

The objective of this presentation is to review the denomination Neurodevelopmental Disorders contained in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by considering the latest paradigms on human development, which include the emerging neurobiological and intersubjective foundations required to understand and intervene in problems of the baby and the small child. The current denomination adopts a theoretical position that is exclusively biological (despite being defined as a-theoretical), and tends to make fundamental aspects of human development linked to inter-subjectivity invisible. The presentation also includes clinical experiences related to perinatal events in children with serious developmental problems and a revision of the underlying paradigms of the different concepts of Health and Mental Illness. Two relevant variables that intervene in human development are considered; firstly, epigenetics, underlining that its programming can be altered by diverse environmental conditions, thus revealing how certain acquired characters can be transmitted to offspring and that such modifications are potentially reversible; secondly, the recursive, visualized in the emergence of the mind from its biological bases, and the marks of inter-subjectivity in the body. New evidence is provided that mental phenomena begin as a mind shared with others and that early intersubjective experiences are mapped into the individual's brain performance. From the above, it follows that neurodevelopment requires intersubjectivity to enable the emergence of the mind as an eminently human phenomenon. Therefore, this should be reflected in the most commonly used diagnostic names.

El objetivo de esta presentación es la revisión de la denominación Trastornos del Neurodesarrollo del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5). Los paradigmas actuales sobre el desarrollo humano incluyen las bases neurobiológicas e intersubjetivas emergentes, requeridas para comprender e intervenir en problemáticas del recién nacido y del niño pequeño. Se advierte que la denominación vigente adopta una postura teórica exclusivamente biológica, no obstante definirse como ateórico, tendiendo a invisibilizar aspectos fundamentales del desarrollo humano vinculados con la intersubjetividad. Se incorporan, además, experiencias clínicas vinculadas con acontecimientos perinatales en niños con graves problemáticas del desarrollo. Se efectúa una revisión de distintos paradigmas que subyacen en los conceptos de salud y enfermedad mental. Se consideran dos relevantes variables que intervienen en el desarrollo humano; primero, la epigenética, subrayando que su programación puede ser alterada por diversas condiciones ambientales, evidenciando cómo ciertos caracteres adquiridos pueden trasmitirse a la descendencia y que tales modificaciones son potencialmente reversibles. Segundo, lo recursivo, visualizado en la emergencia de la mente desde sus bases biológicas y las marcas que imprime la intersubjetividad en el cuerpo. Se incorporan evidencias de que los fenómenos mentales comienzan como una mente compartida con otros y de que las experiencias intersubjetivas tempranas se mapean en el funcionamiento cerebral del individuo. Se deriva que el neurodesarrollo requiere la intersubjetividad para posibilitar la emergencia de la mente como fenómeno eminentemente humano y, por lo tanto, sería de gran utilidad que ello sea reflejado en las denominaciones diagnósticas más utilizadas.

The 12-Item General Health Questionnaire as an Effective Mental Health Screening Tool for General Korean Adult Population

OBJECTIVE: The 12-item General Health Questionnaire (GHQ-12) has been used extensively in various settings across different cultures. This study was conducted to determine the thresholds associated with optimum sensitivity and specificity for the GHQ-12 in Korean adults. METHODS: Data was acquired from a sample of 6,510 Korean adults, ages 18 to 64 years old, who were selected from the 2005 Census (2,581 men and 3,929 women). Participants completed the GHQ-12 and the Korean Composite International Diagnostic Interview (K-CIDI). Receiver Operating Characteristic (ROC) curve analysis was conducted. RESULTS: The mean GHQ-12 score for the total sample was 1.63 (SD 1.98). The internal consistency of the GHQ-12 was good (Cronbach's alpha=0.72). Results from the ROC curve indicated that the GHQ-12 yielded greater accuracy when identifying mood and anxiety disorders than when identifying all mental disorders as a whole. The optimal threshold of the GHQ-12 was either 1/2 or 2/3 point depending on the disorder, but was mainly 2/3. CONCLUSION: The Korean version of the GHQ-12 could be used to screen for individuals at high risk of mental disorders, namely mood and anxiety disorders.

The Effects of Sociodemographic Factors on Psychiatric Diagnosis

OBJECTIVE: Several studies have reported that ethnic differences influence psychiatric diagnoses. Some previous studies reported that African Americans and Hispanics are diagnosed with schizophrenia spectrum disorders more frequently than Caucasians, and that Caucasians are more likely to be diagnosed with affective disorders than other ethnic groups. We sought to identify associations between sociodemographic factors and psychiatric diagnosis. METHODS: We retrospectively examined the medical records of all psychiatric inpatients (ages over 18 years) treated at Kern county mental hospital (n=2,051) between July 2003 and March 2007 for demographic, clinical information, and discharge diagnoses. RESULTS: African American and Hispanic males were more frequently diagnosed with schizophrenia spectrum disorders than Caucasians, whereas Caucasian females were more frequently diagnosed with affective disorders than females in the other ethnic groups, suggesting that patient ethnicity and gender may influence clinical diagnoses. Demographic variables, that is, a lower education, failure of marriage, homelessness, and low quality insurance, were found to be significantly associated with a diagnosis of schizophrenia spectrum disorders after adjusting for clinical variables. And, the presence of a family psychiatric history, failure of marriage, not-homelessness, and quality insurance were found to be associated with a diagnosis of affective disorders. CONCLUSION: Our results show that these demographic factors, including ethnicity, have effects on diagnoses in psychiatric inpatients. Furthermore, these variables may help prediction of psychiatric diagnoses.

Psychological Characteristics and Changes after the Tattoo Removal

Tattooing has been practised since pre-Christian times, as an object of both fascination and revulsion. In the Present day, body tattoo has been a flourishing and contemporary teen issue. Adolescents have discovered tattoos as a means of self-expression. Due to the external characteristics of the tattoo however, a lot of researchers have shown their interest and done various researches. The examination of the psychological characteristics of the tattooed people revealed that a lot of people have psychological problems, the tattoos revealing the person's deviated image. As a result, several attempts have been made to try and correlate tattoos with the psychiatric diagnoses such as schizophrenia or personality disorder, or with adverse social circumstances such as poverty. The subject of tattoo removal is as old as the history of tattooing itself. Plastic surgeons have witnessed numerous tragic instances where a tattoo has caused hardship, including diminished employment prospects, even loss of love and affection from family and friends and, very commonly, loss of self-esteem. For this reason, the bearers of tattoo often consider the inevitable scarring left by tattoo removal as a preferable alternative. Past techniques of removing tattoos, using corrosive agents or skin graft, have been universally unsuccessful, or certainly less than satisfactory. But, currently laser therapy has been introduced into the market to remove tattoos. As a result, a lot of people have visited hospitals to get tattoos removed. In addition, many of those who had tried to hide the fact that they had tattoos, have been given the opportunity to express their feelings, and rate their psychological statements. This research enables to find the best approach to the person's psychiatric point of view, by objectively observing the person's psychological characteristics and psychological changes after the tattoo removal.