Research progress and discipline development of mental disorders in children and adolescents / 四川精神卫生

A demand-capacity mismatch exists between the services for child and adolescent mental health and the needs of society， and the contradiction is becoming increasingly prominent. This study aims to present a thorough analysis of the current status of research in child and adolescent mental disorders and the direction of discipline development， which consists of the epidemiology， etiology and pathogenesis， diagnostic progress， treatment progress and disciplinary development in child and adolescent mental disorders. Mental disorders in children and adolescents are known to have a high prevalence rate， and the disease is most likely to continue into adulthood if it is not identified and treated in a timely manner， posing a serious burden on patients， families and society. Currently， the etiology and pathogenesis of mental disorders in children and adolescents still remain unclear due to its complexity and the numerous interrelated contributing factors such as genetics， environment， stress events and so on. And the diagnosis is limited to symptomatology and lacks objective indicators. Therapeutically， the various treatment options available have shown certain clinical effectiveness， while suboptimal treatment outcomes have been reported among some children， which require multidisciplinary comprehensive intervention. Furthermore， the research on imaging genetics， new drug-target search， wise information technology of med and brain sciences needs to be strengthened， thus providing a broader approach to better address the needs of mental health services for children and adolescents.

Prevalence of Autism Spectrum Disorder in China: A Nationwide Multi-center Population-based Study Among Children Aged 6 to 12 Years / 神经科学通报·英文版

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%-1.02% versus 0.30%; 95% CI: 0.26%-0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

Prevalence of Autism Spectrum Disorder in China: A Nationwide Multi-center Population-based Study Among Children Aged 6 to 12 Years / 神经科学通报·英文版

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%-1.02% versus 0.30%; 95% CI: 0.26%-0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

Multicenter clinical observation on the effect and safety of Xiaoerzhili syrup treatment for attention deficit/hyperactivity disorder in children / 中华实用儿科临床杂志

Objective To observe and evaluate the clinical efficacy and safety of Xiaoerzhili syrup in attention deficit/hyperactivity disorder(ADHD) in children.Methods This study was performed by a multicenter self-controlled clinical observation trial.A total of 1 833 children with ADHD selected from 18 clinical centers from June 2013 to December 2015 were treated by Xiaoerzhili syrup for 6 months,and the clinical efficacy and safety were evaluated.Chinese Version of ADHD Rating Scale-Ⅳ-Parent(ADHDRS-Ⅳ-P) and Clinical Global Impression (CGI) were used to evaluate the clinical efficacy,and the registration form of side reaction and the questionnaire of drug safety grade were used to assess the safety.Results Compared with the scores before treatment,the total scores of ADHDRS-Ⅳ-P,attention deficit subscale scores and hyperactivity impulsivity subscale scores decreased with statistically significant differences after treatment with Xiaoerzhili syrup in the total ADHD group,male ADHD group,female ADHD group,mild ADHD group,moderate ADHD group and severe ADHD group(all P ＜0.01).The statistically significant differences in the total scores of ADHDRS-Ⅳ-P,attention deficit subscale score and hyperactivity impulsivity subscale scores were not found in different gender before and after treatment (all P ＞ 0.05).According to the results of CGI-Ⅰ,the proportion of "improved obviously" and above were 80.98％ (1 379 cases),79.95％ (1 089 cases) and 85.05％ (290 cases),in the total poptlation group,male group and female group,respectively.The side effects of drugs were found in six male cases.After treatment,safety problems were not found in the analysis of the safety evaluation.Conclusion Xiaoerzhili syrup treatment is effective in children with ADHD treatment,and security problems are not found.

Multicenter clinical observation on the effect and safety of Xiaoerzhili syrup treatment for attention deficit/hyperactivity disorder in children / 中华实用儿科临床杂志

Objective To observe and evaluate the clinical efficacy and safety of Xiaoerzhili syrup in attention deficit/hyperactivity disorder(ADHD) in children.Methods This study was performed by a multicenter self-controlled clinical observation trial.A total of 1 833 children with ADHD selected from 18 clinical centers from June 2013 to December 2015 were treated by Xiaoerzhili syrup for 6 months,and the clinical efficacy and safety were evaluated.Chinese Version of ADHD Rating Scale-Ⅳ-Parent(ADHDRS-Ⅳ-P) and Clinical Global Impression (CGI) were used to evaluate the clinical efficacy,and the registration form of side reaction and the questionnaire of drug safety grade were used to assess the safety.Results Compared with the scores before treatment,the total scores of ADHDRS-Ⅳ-P,attention deficit subscale scores and hyperactivity impulsivity subscale scores decreased with statistically significant differences after treatment with Xiaoerzhili syrup in the total ADHD group,male ADHD group,female ADHD group,mild ADHD group,moderate ADHD group and severe ADHD group(all P ＜0.01).The statistically significant differences in the total scores of ADHDRS-Ⅳ-P,attention deficit subscale score and hyperactivity impulsivity subscale scores were not found in different gender before and after treatment (all P ＞ 0.05).According to the results of CGI-Ⅰ,the proportion of "improved obviously" and above were 80.98％ (1 379 cases),79.95％ (1 089 cases) and 85.05％ (290 cases),in the total poptlation group,male group and female group,respectively.The side effects of drugs were found in six male cases.After treatment,safety problems were not found in the analysis of the safety evaluation.Conclusion Xiaoerzhili syrup treatment is effective in children with ADHD treatment,and security problems are not found.

Behavior problems in left-behind children living in rural areas of Changzhi City / 中华健康管理学杂志

Objective To understand the status quo and influencing factors of behavior problems in rural left-behind children. Methods Cross-sectional sampling approach was used for this comparative study.A total of 983 children of 7 to 9 grades from three counties of Changzhi City finished out questionnaires. Results The prevalence of behavior problems was significantly increased in the left-behind children in comparison with the non-left-behind children (59. 7% vs 50. 0% ; χ2 =5. 591 ,P＜0. 05). Long-time separation with mother and poorer education level were risk factors of behavior problems of left-behind children. Conclusion Behavior problems in rural left-behind children are even serious. Parents should avoid becoming a long-term migrant employee and have more concerns to children's mental and behavior health.

Correlation study on behavioral problems and self-concept of children with oppositional defiant disorder / 中南大学学报(医学版)

Objective To investigate the behavioral problems and self-concept of children with oppositional defiant disorder (ODD) and the correlation between them. Methods The subjects came from a sample survey of primary and middle school students' mental status in 6 regions in Hunan province. Achenbach child behavior checklist (CBCL) was filled out by parents. The Children's self-concept scale (CSCS) was completed by children themselves. Results There were significant differences between the scores of ODD group and the normal control among all CBCL subscales except the activities scale, and the scores for the CSCS scales were all lower in patients with ODD than the control group except for the physical appearance and attributes (P<0.01). In addition, according to correlation analysis, the CBCL scores yielded small but significant correlations with the CSCS scores for children with ODD(P<0.05). Conclusion Children with ODD have generally behavioral problems, poor social competence, and lower self-concept, whose behaviors were correlated with their self-concept.

Behavior Problems and Self-Consciousness in ADHD Children Comorbid with Anxiety Disorder / 中国心理卫生杂志

Objective：To explore the characteristics of behavioral problems and self-concept level in children with attention deficit hyperactivity disorder(ADHD)accompanying anxiety disorder.Methods：With stratified random sampling method,a sampling survey was made in 9495 children(aged 5～17 years)from 6 regions of Hunan province together.Using the two stage epidemiologic research method,three groups,including control group(214 cases),pure ADHD(219 cases)and ADHD accompanying anxiety disorder(111 cases)were determined as the subjects.All the subjects completed the Children's Self-Concept Scale(CSCS),and the Achenbach Child Behavior Checklist(CBCL)was completed by their parents.Results：(1)Compared to the control group,the pure ADHD group scored higher in CBCL [e.g.,the total score:(30.35±24.32)vs.(16.97±14.86)],and scored lower in CSCS [e.g.,total score:(50.85±9.98)vs.(57.46±10.80),P<0.05].(2)Compared to the control group,children with ADHD accompanying anxiety disorder scored higher in CBCL [e.g.,total score:(41.66±28.07),P<0.01],and in CSCS except physical activities(Ps<0.05).(3)Compared to the pure ADHD group,ADHD accompanying anxiety disorder group scored higher in CBCL and lower in CSCS[behavior:(10.44±3.17)vs.(11.55±2.80);anxiety:(8.06±2.61)vs.(9.21±2.61),gregariousness:(7.42±2.22)vs.(8.16±1.89);total score:(47.25±9.93)vs.(50.85±9.98);Ps<0.05].Conclusion：ADHD children have more behavioral problems and lower level of self-concept than normal children,and children with ADHD accompanying anxiety disorder have more prominent presence of behavioral problems and lower self-concept rating than children with pure ADHD.

Correlation of plasma 5 hydroxytryptamine levels with season of birth and maternal mood during pregnancy in children with autism / 中国组织工程研究

ACKGROUND:Autism is a kind of neurobiological disease.The increase of plasma concentration of 5 hydroxytryptamine(5 HT) is considered to be one of study results,which is the most definite and has the best repetition,for the biological investigation of autism. Whether the season of birth and maternal mood during pregnancy are correlated with the occurrence of autism? OBJECTIVE:To compare the differences of the plasma concentration of 5 HT,season of birth and the maternal mood during pregnancy between autistic and normal children,and probe into the cause of increased 5 HT in autism. DESIGN:An observational comparative study taking autistic and normal children as the subjects. SETTINGS:A clinical psychological department of a university hospital;Mental Health Institute of the Xiangya Second Hospital;A rehabilitation center for dumb children of city grade. PARTICIPANTS:Children in the autistic group(n=54),who were in accordance with the diagnostic criteria of autism in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM IV) and had the total score of social adaptive ability scale(SAAS) over 40, were selected from the Outpatient Clinic for Children of the Mental Health Institute,Xiangya Second Hospital of Central South University and the training class of autism of Shenzhen Special Education School;Children in the normal control group,who had no obvious somatic and neurological diseases,and developing delay detected by physical,neurological and mental status examinations, rough detection of developing level,were selected from the primary school and kindergarten in Changsha and Shenzhen cities. INTERVENTIONS:The plasma level of 5 HT was examined, season of birth and maternal mood during pregnancy were investigated in autistic and normal children.The children with autism were accessed with SAAS. MAIN OUTCOME MEASURES:The plasma level of 5 HT,the season of birth and the maternal mood during pregnancy in both groups. RESULTS:The score of SAAS in children with autism was 67.65± 1.67.The plasma level of 5 HT was(0.78± 0.32) μ mol/L in the autistic group,which was significantly higher than that in the normal control group [(0.62± 0.16) μ mol/L](t=3.17,P=0.002). There were 17 children with autism had increased 5 HT.Compare with normal children,most children with autism were born in winter and spring,and their mother had obvious mood problems during pregnancy. CONCLUSION:The 5 HT level is higher in children with autism than in normal children.Most children with autism were born in winter and spring,and their mother had obvious emotional problems during pregnancy.There are phase of high functioning of 5 HT in mother in key period of fetus cerebra development that may be one of the causes of hyperserotonemia in autism,and that is possibly one of the etiologies of autism.

Preliminary Test of the Werry-Weiss-Peters Activity Rating Scale / 中国临床心理学杂志

Objective: To evaluate the utility of the Werry-Weiss-Peters Activity Rating Scale (WWPARS) for children with a Chinese background. Methods:In the city of Changsha, 465 normal children aged 8～12 in two primary schools and 27 ADHD children in an outpatient department were tested with WWPARS. Psychometric properties of the scale were analyzed for reliability and validity. Results: While levels of activity increased with age for all children, there was no significant difference between the two groups assessed. The scale attained good reliability and validity. Conclusion: This scale can be applied for evaluation of activity levels for Chinese children.

Characteristics of Behavior and Self-concept in Psychological Abused/Neglected Juveniles with Generalized Anxiety Disorder / 中国临床心理学杂志

Objective: To invesgate the situation of psychological abuse and neglect among juveniles with generalized anxiety disorder(GAD) and explore the characteristics of behavior and self-concept in psychological abused/neglected juveniles with GAD.Methods: A sampling survey was made in 9495 juveniles(5~17) from six regions of Hunan Province.After using the two-stage epidemiologic research method,409 children including 206 normal controls,99 GAD without abuse/neglect and 104 GAD with abuse/neglect,completed CPANS,CSCS and their parents completed CBCL.Results: There were significantly higher rates of psychological abuse or neglect in the GAD group than the normal controls;the factor scores of juveniles with GAD were significantly higher than those with no mental disorders in all six aspects in CPANS(P=0.000),higher scores of internalizing and externalizing behaviors characterized the subgroup of juveniles with both GAD and abuse history compared with the subgroup with GAD without such history,and the scores including total score,behavior,anxiety,gregariousness and happiness factors(P=0.000),of the subgroup of juveniles with GAD and abuse histories were significantly lower than the GAD subgroup without abuse or neglect.Conclusion: Psychological abuse and neglect are more prevalent and severe in juveniles with GAD than in normal ones;when psychological abuse/neglect co-occurs with GAD,juveniles’ behavior problems are even greater and their level of self-concept are much lower.

Norms of the Piers-Harris Children's Self-concept Scale of Chinese Urban Children / 中国心理卫生杂志

Objective: To develop the norm of Piers-Harris Children's Self-concept Scale (PHCSS) in Chinese urban children and test the reliability and validity. Method: A total of 1698 children with the mean age 12?3 year-old (846 boys and 852 girls) from 20 cities in China completed the scale. Results: The test-retest reliability, split-half and Crobach were in 0.695～0.858, the correlation between each item score and total score were in 0.078～0.467, showed better item differentiation except for 3 items. The validity was perfect, represented by significant correlation (r=0.051～0.353) between the score and Conners Parent Symptom Questionnaire and Teacher Rating Scale. Conclusion: The results demonstrate the scale are suitable for demands of psychometrics and applicable in Chinese children.

Primary Clinical Investigation of Broader Autism Phenotype / 中国心理卫生杂志

Objective:To investigate the main manifestation of broader autism phenotype (BAP) in autism family, find the rate of BAP.Method:Exploring the BAP in 75 autism family with Family Investigation Schedule and Bolton's BAP operating definition.Result:There were 42 cases that met the criteria of BAP in the 75 families. They mainly presented as reciprocal social interaction deficits and language developing disorder.Conclusion:BAP do exit in Chinese autism families.

Clinical Features of Subtypes of ADHD in DSM-Ⅳ / 中国心理卫生杂志

Objective:To explore the clinical features of subtyp es of ADHD in DSM-Ⅳ.Method:126 children fulfilled ADHD criteria of D S M-Ⅳ were further divided into 3 subtypes:predominantly inattentive(PI,61 cases) , predominantly hyperactive-impulsive(HI,9 cases)and combined type(CT,56 cases).C om orbid mental disorders were compared among the three groups.Parents and teacher s of children in each group completed CBCL(child behavior checklist)and TRF(teach er's report form).CWISC(Wechsler intelligence scale for children,Chinese versio n )and attention tests were also applied in each group.Results:Childr e n in CT group had more conduct disorder,more externalizing,delinquent and aggres sive behaviors rating by parents and teachers,and more inattentive than children in PI group.School performance of children in PI group was better than that of the other two groups evaluated by teachers.Conclusion:ADHD CT subty pe had highest rate of comorbid conduct disorder.They have more externalizing b ehavior,more academic problems and more inattentive.This subtype may be the mos t impaired subtype.