Resultados preliminares del impacto de la COVID-19 en niños/as y adolescentes expuestos a maltrato intrafamiliar / Preliminary results of the impact of COVID-19 on children and adolescents exposed to intrafamily abuse

Resumen: Los datos preliminares confirman el impacto psicológico que la crisis por COVID-19 está provocando en niños y adolescentes de población comunitaria. Se desconoce cómo afecta a la población infantil que sufre maltrato intrafamiliar. El objetivo del estudio fue examinar el impacto emocional adicional que supone la medida de confinamiento en menores de edad expuestos a violencia de pareja hacia la mujer que recibían atención psicológica en la Región de Murcia. Ciento ochenta y cinco madres informaron vía telefónica cómo el confinamiento afectó a 269 niños/as de entre 0 y 18 años. También los 108 menores que tenían 6 años o más, cumplimentaron el listado sobre su propio estado emocional. El incremento en la incidencia de alteraciones psicológicas en esta población ha sido baja (1.1-4.8%), si bien entre aquellos que aumentó la sintomatología predominaron la desorganización comportamental y la alteración emocional. Asimismo, se comprobó que algunas variables (sexo, edad, días de confinamiento, conflicto familiar) contribuyeron al incremento de desorganización comportamental y estrés traumático/depresión. Es preciso desarrollar más trabajos en esta línea por las implicaciones que se pueden derivar tanto a nivel de diagnóstico como de tratamiento.

Abstract: Preliminary data confirm the psychological impact that the COVID-19 crisis is causing in children and adolescents in the community population. It is unknown how it affects the child population who suffer intrafamilial abuse. The objective of the study was to examine the additional emotional impact of the measure of confinement in minors exposed to intimate partner violence towards women who received psychological attention in the Region of Murcia. One hundred and eighty-five mothers reported, by telephone comunication, how the confinement affected to 269 children between the ages of 0 and 18. Also the 108 minors who were 6 years old or older completed the list on their own emotional state. The incidence increasement of psychological disorders within this population has been low (1.1-4.8%), although among those with increased symptoms, behavioral disorganization and emotional disturbance was predominant. Likewise, it was found that some variables (sex, age, days of confinement, family conflict) contributed to increase the behavioral disorganization and traumatic stress/depression. It is necessary to develop more research in this line due to the derived implications both at diagnosis and treatment levels.

Is low docosahexaenoic acid associated with disturbed rhythms and neurodevelopment in offsprings of diabetic mothers?

BACKGROUND/OBJECTIVE: To evaluate the relation between docosahexaenoic acid (DHA) status and neurodevelopment in the offsprings of gestational diabetic mothers (ODMs). SUBJECTS/METHODS: A prospective cohort study was performed. The offspring of 63 pregnant women (23 controls, 21 diet-controlled gestational diabetes mellitus (GDM) and 19 insulin-treated GDM) were recruited. Maternal and venous cord plasma DHA percentages were analyzed. Skin temperature and activity in children were recorded for 72 h at 3 and 6 months of life. Neurodevelopment was assessed using the Bayley Scale of Infant Development II (BSID II) at 6 and 12 months of age. RESULTS: Cord plasma DHA percentage was significantly lower in the ODMs compared with that in the controls (Control 6.43 [5.04-7.82](a); GDM+diet 5.65 [4.44-6.86](ab); GDM+insulin 5.53 [4.45-6.61](b)). Both mental (Control 102.71 [97.61-107.81](a); GDM+diet 100.39 [91.43-109.35](a); GDM+insulin 93.94 [88.31-99.57](b)) and psychomotor (Control 91.52 [81.82-101.22](a); GDM+diet 81.67 [73.95-89.39](b); GDM+insulin 81.89 [71.96-91.85](b)) scores evaluated by the BSID II were significantly lower at 6 months in ODMs, even after adjusting for confounding factors such as breastfeeding, maternal educational level and gender. Cord plasma DHA percentage correlated with the psychomotor score from BSID II (r=0.27; P=0.049) and with the intra-daily variability in activity (r=-0.24; P=0.043) at 6 months. Maternal DHA was correlated with several sleep rhythm maturation parameters at 6 months. CONCLUSIONS: Lower DHA levels in cord plasma of ODMs could affect their neurodevelopment. Maternal DHA status was also associated with higher values in the sleep rhythm maturation parameters of children.

[Transient cognitive disorder from sub clinical paroxysmal EEG activity]. / Afectación cognitiva transitoria por actividad electroencefalográca paroxística subclínica.

INTRODUCTION: Transient cognitive disorder (TCD) defines the existence of a decrease in reaction time that coincides with an epileptiform EEG discharge, without any simultaneous manifestation of a classical epileptic seizure. Aims. To analyse the relation between episodes of TCD and the neurolopsychological manifestations in infancy that condition a high percentage of neuropaediatric visits to the surgery. At the same time we analyse the relation between the interictal paroxysmal disorders of patients with childhood benign partial idiopathic epilepsy with centrotemporal spikes (BIE CS) and the neurolopsychological manifestations that are frequently detected in such patients. PATIENTS AND METHODS: Two groups of patients were studied. Group A: 23 children who sought medical attention because of different neurolopsychological disorders (language retardation, hyperactivity, lack of attention, retarded academic achievement, behavioural disorders, bad social interaction); gender: 16 males and 7 females; age interval: from 2 years and 10 months to 11 years and 1 month (average age: 6 years and 8 months). Group B: 10 patients who were BIE CS carriers, two of which evolved toward atypical BIE; gender: 5 males and 5 females; age interval: from 3 years and 3 months to 9 years and 9 months (average age: 7 years and 4 months). Both groups were submitted to a clinical examination protocol involving neurological, EEG, child psychiatric and psychological aspects. RESULTS: In group A, sub clinical paroxysmal EEG discharges were seen in three cases, two of which corresponded to a lack of attention disorder with hyperactivity, and the third had a generalised growth disorder. In group B we detected a high percentage of perceptive and psychomotor disorders, without the existence of differences between those who displayed an irritative focus in the right or in the left hemisphere, although the alteration in the level of language was greater in the latter. Likewise, in a large percentage of cases (80%) the evaluation of the level of personality revealed obvious anxiety traits, which were related with suffering from seizures. CONCLUSIONS: Sufficient evidence has been found to demonstrate the existence of the possible relation between different neuropsychological disorders and epileptic EEG discharges, although revealing it in daily clinical practice requires a thorough diagnostic protocol and an accurate neuropsychological examination under video EEG monitoring, the positive results of which are considered to be decisive in evaluating the possibility of pharmacological treatment.

Afectación cognitiva transitoria por actividad electroencefalográfica paroxística subclínica / Transient cognitive disorder from sub-clinical paroxysmal eeg activity

Introducción. La afectación o alteración cognitiva transitoria (ACT) define la existencia de un descenso del tiempo de reacción coincidente con una descarga epileptiforme en el registro electroencefalográfico, sin manifestación simultánea de una crisis epiléptica clásica. Objetivo. Analizar la relación fisiopatogénica entre los episodios de ACT y las manifestaciones neuropsicológicas infantiles que condicionan un elevado porcentaje de consultas neuropediátricas. Simultáneamente se analiza la relación existente entre las alteraciones paroxísticas interictales de pacientes con epilepsia parcial idiopática benigna de la infancia con puntas centrotemporales (EPBICT) y las manifestaciones neuropsicológicas que frecuentemente se detectan en dichos pacientes. Pacientes y métodos. Se estudian dos grupos de pacientes. Grupo A: 23 niños que consultan por alteraciones neuropsicológicas diversas (retraso del lenguaje, hiperactividad, déficit de atención, retraso del rendimiento escolar, alteración de conducta, mala interacción social); sexo: 16 de sexo masculino y siete de sexo femenino; intervalo de edad: de 2 años y 10 meses a 1 años y 1 mes (edad media: 6 años y 8 meses). Grupo B: 10 pacientes portadores de EPBICT, dos de los cuales evolucionan hacia EPBI atípica; sexo: cinco de sexo masculino y cinco de sexo femenino; intervalo de edad: de 3 años y 3 meses a 9 años y 9 meses (edad media: 7 años y 4 meses). En ambos grupos se aplicó un protocolo de examen clínico neurológico, electroencefalográfico, paidopsiquiátrico y psicólogico. Resultados. En el grupo A se constatan descargas paroxísticas subclínicas EEG en tres, dos de ellos correspondientes a un trastorno de déficit de atención con hiperactividad, y el tercero, a un trastorno generalizado del desarrollo. En el grupo B se detecta un alto porcentaje de alteraciones en el nivel perceptivo y psicomotor, sin existir diferencias entre los que muestran el foco irritativo en el hemisferio derecho o en el izquierdo, aunque en éstos últimos es mayor la alteración del nivel del lenguaje. Asimismo se comprueba en la valoración del nivel de personalidad un elevado porcentaje de casos (80 por ciento) con rasgos evidentes de ansiedad, que se relacionan con la vivencia de las crisis. Conclusiones. La posible relación entre diferentes alteraciones neuropsicológicas y descargas epilépticas en el registro EEG se ha demostrado suficientemente, aunque su hallazgo en la práctica clínica diaria requiere un protocolo diagnóstico riguroso y precisa exploración neuropsicológica bajo monitorización vídeo-EEG, cuyos resultados positivos se consideran determinantes para valorar la posibilidad de tratamiento farmacológico. (AU)

[Cognitive profile of children with neurological disorders: II. Myelomeningocele]. / Perfil cognitivo de niños con trastornos neurológicos: II. Mielomeningocele.

The Myelomeningocele is a neurological dysfunction, as a consequence of some injury in the SNC. Since, this brain disease has an inevitable influence maturity and psychological development in children who suffer it, it is considered as essential as know the place and extension of the injury, finding out the knowledge competence of child who suffers Myelomeningocele. This would be the main objective of this research, specifically we study that the knowledge development of 25 children with Myelomeningocele (14 boys, 11 girls) aged 5-14 years. 18 suffers Myelomeningocele with Hydrocephalus and 7 are affected with Myelomeningocele without Hydrocephalus. This research wants to improve the knowledge of the cognitive development of these children, to achieve, from a psychological evaluation with psychometric instrument specialized (Wechsler Intelligence Scale for Children-Wisc) a tailed inventory about the development levels reached for these children. Therefore, intending to define the areas of potency and dysfunction in children that we know are affected with a SN pathology.

[Personality traits and hyperactive behavior]. / Rasgos de personalidad y conducta hiperactiva.

The hyperactive child has traditionally been considered impulsive rather out of self-control, anxious, problematic as regards his/her interpersonal relationships, and highlystrung. In this paper, we aim to prove the existence of these traits by analyzing them from a psychometric perspective, and starting from Cattell's theory of traits. We have worked with a sample of 130 hyperactive children and 79 control individuals, aged six to ten, who were diagnosed according to DSM III criteria. We have used the CPQ and ESPQ tests. The data were submitted to a contrast of differences. The results agree with the hypothesis proposed.

[Illness behavior. Attempt to identify clinical types]. / Conducta de enfermedad. Un intento de identificacíon de tipos clínicos.

The present study brings for the first time the description and assess of several types of "abnormal illness behavior" by using the I.B.Q. in 571 general practice psychiatric ambulatory and hospital surgery and medical patients. Using multivariate analysis techniques (Cluster and Discriminant) we found five patterns of response with the I.B.Q. Two of them (50.5%) showed adaptative response, the other three patterns (49.5%) are classified as "abnormal illness behavior". Its importance and repercussion in medical care is discussed.

[Neonatal meningitis. Study of 26 cases and a review of its sequelae after 5 years]. / Meningitis neonatal. Estudio de 26 casos y revisión de sus secuelas a los cinco años.

Twenty-six cases of neonatal meningitis in term newborns are studied. Incidence, etiological features, treatment, clinical and biochemical evolution and mortality are analysed. Lief motif of this paper is the search for deficits in psychomotor growth in propositi of four and six years old, finding an important relation between neonatal bacterial meningitis and neuropsychological deficits (hyperkinesia, perceptive area impairment, reading-writing disorders, etc.) in contrast to the good evolution of lymphocytic meningitis.