Meta-analysis of the effect of probiotics on core symptoms of children with autism spectrum disorder / 中国儿童保健杂志

【Objective】 To evaluate the therapeutic effect of probiotics on core symptoms in patients with autism spectrum disorder (ASD), in order to provide theoretical basis for the treatment and intervention of ASD. 【Method】 Articles published from January 2000 to May 2023 on the effect of probiotics on core symptoms in ASD children were retrieved from 7 databases, including Chinese Biomedical Literature Service System (SinoMed), Wanfang Data Knowledge Service Platform, VIP Citation Database, and China National Knowledge Infrastructure (CNKI), PubMed, Embase, and Web of Science.Meta-analysis was performed using RevMan 5.4.Effect size, combine heterogeneity test sensitivity analysis and subgroup analysis were calculated. 【Result】 Totally 10 studies with 343 patients were included in this Meta-analysis.Meta-analysis showed that there was statistically significant difference in ASD core symptom score between the intervention group and the control group (SMD=-0.34, 95%CI: -0.55 - -0.12, P0.05), while the efficacy of a composite microbial community was significant (SMD=-0.51, 95%CI: -0.81 - -0.21, P<0.05). 【Conclusions】 Probiotic therapy is effective in improving the core symptoms of ASD patients, but is influenced by factors such as race, age and probiotic strain. Composite microbiota has better efficacy in Caucasian and underage populations.

Preliminary intervention exploration of the new forest parenting programme in families of children with attention deficit hyperactivity disorder in China / 中华行为医学与脑科学杂志

Objective:To analyze the efficacy of the new forest parenting programme (NFPP) for children and families with attention deficit hyperactivity disorder (ADHD) in China, and to explore the feasibility and effectiveness of the programme in China.Methods:Twenty-two children with ADHD diagnosed at the Child Psychology Development and Behavior Outpatient Clinic of the First Affiliated Hospital of Jinan University and their primary caregivers were included in the study from January 2022 to May 2023. The children with ADHD were divided into an experimental group ( n=11) and a control group ( n=11) according to the personal preference of the primary caregivers. The experimental group was provided with the NFPP intervention once a week for a period of 8 weeks. The Chinese version of Swanson Nolan and Pelham, version Ⅳ scale-parent form(SNAP-Ⅳ)and Weiss functional impairment rating scales-parent report(WFIRS-P))were used to assess the improvement of core symptoms and social function impairment in the two groups before and after the intervention. In the experimental group, the Chinese parenting sense of competence scale (C-PSOC) and the parenting styles and dimensions questionnaire (PSDQ) were used to evaluate the parenting efficiency and improvement of parenting styles of primary caregivers in ADHD families before and after NFPP intervention. A Semi-open interview was conducted with 11 primary caregivers of ADHD children in the experimental group at the end of the intervention regarding knowledge of ADHD disease diagnosis and treatment, parenting attitudes, and parenting behaviors. The data was statistically analyzed by SPSS 26.0 software.Statistical analysis of data was used by independent sample t-test, paired sample t-test, Mann Whitney U-test, and rank sum test. Results:(1) Compared with the post-intervention control group, the total score((4.01±1.05), (2.79±0.94), t=2.875, P<0.05) in the SNAP-Ⅳ, the scores of the oppositional defiance dimension((1.27±0.34), (0.70±0.33), t=4.043, P<0.05) in the SNAP-Ⅳ, the scores of the family in WFIRS-P ((0.92±0.47), (0.56±0.26), t=2.246, P<0.05), and the scores of life skills in WFIRS-P (1.1(0.9, 1.3), (0.6(0.5, 0.8), Z=-2.013, P<0.05)were significantly lower in the post-intervention experimental group ( P<0.05). After intervention, the scores of the 3 dimensions of attention deficit, impulsivity/hyperactivity, and oppositional defiance and the total score of the SNAP-Ⅳ in the experimental group were significantly lower than those before intervention (all P<0.05). (2) After intervention, the score of the parenting efficacy dimension in the C-PSOC in experimental group was significantly higher than pre-intervention ( P<0.05). After intervention, the scores of the PSDQ for authoritative parenting style in the self-assessment and other-assessment in the experimental group were significantly higher than pre-intervention (all P<0.05), and the scores of the authoritarian parenting style and the permissive parenting style were significantly lower than pre-intervention (all P<0.05). (3) The results of the semi-open interview suggested that, the primary caregivers of children with ADHD in the experimental group had a positive attitude toward the NFPP intervention and were able to participate in the entire 8-week intervention, and apply the learned parenting skills to daily life to continuously improve parenting efficiency. After the NFPP intervention, the primary caregivers of children with ADHD had a deeper understanding of the knowledge of ADHD diseases, behavioral characteristics of children with ADHD, and so on. In the intervention content, the modules such as time management, communication skills and behavioral prediction were easy to grasp and effective. Conclusion:The NFPP can significantly improve the core symptoms of Chinese children with ADHD, increase the parenting efficacy of their primary caregivers, and improve their parenting styles.

Association between social ability deficiency and core symptoms, emotional and behavioral problems in children and adolescents with attention deficit hyperactivity disorder / 中华行为医学与脑科学杂志

Objective:To investigate the characteristic of social ability in children and adolescents with attention deficit hyperactivity disorder (ADHD) and its relationship with core symptoms, emotional and behavioral problems.Methods:Fifty-nine children with ADHD aged 6-13 for outpatient department from June 2019 to June 2021 were selected as the ADHD group, and 62 normal children matched in age and sex were recruited as the typical development group(TD group). The social responsiveness scale (SRS), SNAP-Ⅳ rating scale and strengths and difficulties questionnaire (SDQ) were used to evaluate the social ability, core symptoms and emotional and behavioral problems of the subjects.SPSS 26.0 was used for statistical analysis.Non parametric test was used to compare and analyze the differences in social ability, emotional and behavioral problems between the two groups.Spearman correlation analysis was used to analyze the relationship between social ability and core symptoms, emotional and behavioral problems of ADHD group.Generalized linear regression was used to analyze the impact of gender, age, IQ, core symptoms, emotional and behavioral problems of ADHD group on social ability.Results:In the ADHD group, the total score of SRS (65(42, 83)), social perception (10 (8, 13)), social cognition (13 (9, 19)), social communication (19 (11, 29)), and autism like behavior (9 (5, 14)) were significantly higher than those of TD group(38 (27.5, 59.5), 7 (4, 12.5), 8 (6, 15), 12 (6.5, 20), 4 (2, 11)) ( Z=-2.97, -2.75, -2.41, -3.01, -2.64, all P<0.05) .The total score of SDQ difficulty, influence factors, mood, hyperactivity, conduct and peer interaction were significantly higher than those of TD group ( Z=-5.80, -6.89, -2.82, -8.59, -2.52, -3.81, all P<0.05). The total score of SRS and the scores of each subscale in ADHD group were positively correlated with the total score of SNAP -Ⅳ and the scores of each subscale ( r=0.33-0.71, all P<0.05). The total score of SRS and the score of social communication scale were positively correlated with the total score of SDQ difficulty, influencing factors, emotion, hyperactivity, conduct and peer interaction subscale ( r=0.29-0.65, all P<0.05). Social perception was positively correlated with the total score of difficulty, hyperactivity and the scores of peer interaction subscale ( r=0.56, 0.32, 0.45, all P<0.05). The scores of social cognition and autism like behavior subscale were positively correlated with the total scores of difficulty, influencing factors, emotion and peer interaction subscale ( r=0.27-0.55, all P<0.05). The scores of social motivation subscale were positively correlated with the total scores of difficulty, emotion, hyperactivity, conduct and peer interaction subscale ( r=0.29-0.55, all P<0.05). The total score of SRS and the scores of each subscale were negatively correlated with the scores of prosocial behavior subscale ( r=-0.63--0.49, all P<0.05). The total score of SRS was positively affected by gender, age, opposites and disobedience, emotion, hyperactivity and peer interaction ( B=0.05-0.23, all P<0.05), and negatively affected by the prosocial behavior subscale ( B=-0.07, P<0.05). Conclusion:ADHD children often have obvious social ability defects, which are clearly related to core symptoms, emotional and behavioral problems.The risk factors are opposition and disobedience, emotions and peer relationships, and the protective factor is prosocial behaviors.

The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (I): Clinical Presentation and Comorbidity

Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder that can affect individuals across their lifespan. It is characterized by the core symptoms of inattention, impulsivity and hyperactivity. ADHD develops as a result of the complex interplay between genetic and environmental factors. Children and adults with ADHD usually suffer concomitantly from other psychiatric comorbidities, including both externalizing and internalizing disorders. It is associated with functional impairment and poor long-term outcomes. This review aims to summarize the key findings from recent research into ADHD and its prevalence, core symptoms, cause and comorbidities from childhood to adulthood.

Effects of auditory integration training on brainstem auditory evoked potential and symptoms in children with autism spectrum disorders / 中华行为医学与脑科学杂志

Objective To investigate the curative effect of auditory integration training (AIT) on autism spectrum disorders (ASD) in children with abnormal brainstem auditory evoked potential (BAEP).Methods 56 cases of ASD patients with abnormal BAEP were treated with AIT (aged 2-6 years).BAEP will be reviewed after each course of treatments until the test results were back to normal or had no obvious changes.Children' s core symptoms were evaluated by using autism behavior checklist (ABC) and the childhood autism rating scale (CARS) before and after treatments.Results 56 children accepted (1.95±0.92) courses of AIT.Compared with the data before AIT,CARS scores ((36.32± 3.54),(34.11 ± 3.12)),scores of the sensory factor((5.65±4.61),(4.28±4.11)) and the stereotypes factor of ABC were decreased significantly(P＜0.05).After treatments,BAEP of 29 cases (51.79％) went back to normal levels.The bilateral wave incubation periods on left side (Ⅰ:(1.81 ± 0.17) ms,(1.71 ± 0.12) ms,Ⅲ:(4.14 ± 0.18) ms,(4.07 ±0.17)ms,V:(6.09±0.23)ms,(5.97±0.22) ms)and right side (Ⅰ:(1.79±0.17) ms,(1.74±0.13) ms,Ⅲ:(4.15±0.16) ms,(4.07±0.16) ms,V:(6.06±0.23) ms,(5.99±0.26) ms) were significantly shortened (P＜ 0.05).Conclusion AIT can improve the functional handicap of auditory pathway in brainstem of ASD children,and the core symptoms of ASD.

The Symptom Frequency Characteristics of the Hamilton Depression Rating Scale and Possible Symptom Clusters of Depressive Disorders in Korea: The CRESCEND Study

OBJECTIVE: This study analyzed the symptom frequencies of 17-item Hamilton Depression Rating Scale (HDRS-17) to understand the characteristics of each item and to propose the possible symptoms clusters. METHODS: From psychiatric clinics of 18 Hospitals in Korea, 1,183 patients, diagnosed with major depressive disorder (psychotic or non-psychotic), dysthymia or depressive disorder not otherwise specified. according to DSM-IV criteria, participated in this study from January 2006 to August 2008. The frequencies of each item of HDRS-17 were analyzed according to sex and severity. In addition, we compared this study with a previous study performed in England by Hamilton and with two studies performed in Korea by Kim et al. RESULTS: The frequencies of HDRS-17 items varied widely in this study, ranging from 95.8% in work and activities to 37.4% in loss of weight. But, depressed mood, psychic anxiety and work and activities items exhibited constant and higher frequency or rank regardless of study, the severity of depression or sex. Insomnia early, somatic gastrointestinal, genital symptoms and insight showed relatively constant but lower frequency or rank in disregard of studies or the clinical variables. Other symptoms had variable frequencies or ranks according to the variable clinical situations (culture, time, sex, severity of depression). CONCLUSION: We propose three clusters of symptoms in depressive disorders: core symptoms cluster, an associated symptoms, and a situation-specific symptoms. We can use these possible symptom clusters of depression in simplifying diagnosis of depression, increasing diagnostic specificity in special situation and indexing disease severity.