Clinical and sociodemographic features in offspring aged 0-3 years of mothers with schizophrenia spectrum disorders. A descriptive cross-sectional study.

OBJECTIVE: Offspring of parents with schizophrenia spectrum disorders (SSD) have an increased risk of neurodevelopmental disturbances. However, the ability to provide very early interventions to support these children and their families requires profound knowledge regarding characteristic features of both the parents and their offspring. Information on this subject is currently sparse. The aim of the present study is to investigate clinical and sociodemographic variables in offspring in the age range of 0-3 years of mothers diagnosed with SSD. METHODS: The study is descriptive with a cross-sectional design and includes parent-child dyads consisting of mothers diagnosed with SSD (ICD-10: F20-29) and their offspring aged 0-3 years, who were referred for examination and intervention at the infant and toddler psychiatric units, at the Mental Health Services, Capital Region, Copenhagen University Hospitals in two locations (Bispebjerg and Glostrup). Clinical and sociodemographic data were extracted from the Copenhagen "Infant Psychiatric Database" and processed by descriptive analysis. RESULTS: Out of 95 parent-child dyads considered for the study population, 85 were included. 27.8% of the mothers had psychiatric comorbidities, and 18.9% of the fathers had a psychiatric diagnosis at the time of investigation. Of the children, 89.7% were born full term (≥37th week) and most of them had a birth weight of ≥2500 g (81.8%). Of the mothers, 50% had experienced pregnancy complications of varying severity. Birth complications were seen in 62.9% of the dyads. Psychopathology was identified in 50% of the children at age 0-3 years, and 62.2% of the parent-child dyads appeared to have an affected relationship. CONCLUSION: Results show widespread psychopathology in offspring aged 0-3 years of mothers with SSD. Moreover, several psychosocial stressors, clinical parental features, and relational disturbances are identified. These results contribute to a better understanding and identification of early risk markers of long-term psychopathology in this infant patient group, and hence serve as potential targets for early interventions.

The longitudinal association of combined regulatory problems in infancy and mental health outcome in early childhood: a systematic review.

Co-occurring regulatory problems in infancy, RPs, including excessive crying, feeding-eating and sleeping, have been found associated with mental health problems in school ages. Still, an overview is needed on trajectories of co-occurring or combined RPs, and mental health problems in early childhood. The aim of this review is to systematically review the literature on longitudinal community-based studies of combined RPs measuring mental health outcomes in early childhood. Following the PRISMA guideline, we systematically reviewed the literature published 2000-2020, in which combined RPs are assessed in infancy, and mental health is examined using standardised measures at ages 1-7 years. The search was performed in four databases MEDLINE, EMBASE, PsycINFO and Scopus. A protocol is published on PROSPERO. Based on 1978 screened articles, 42 papers were screened for eligibility, of which six were included, comprising data on two or more RPs investigated among a total of 20,675 children. Assessment of risk of bias in the studies showed overall good quality in five of the six papers. The literature reviewed suggests that combined RPs in infancy are early markers of mental health problems during early childhood, and highlights that community studies exploring the longitudinal associations of combined RP and mental health problems in preschool and early school age are still scarce. Overall, the review points to the need of research into preventive intervention targeting early manifestations of childhood dysregulation, such as RPs.

Effects of manipulated levels of predation threat on parental provisioning and nestling begging.

Parental provisioning behavior is a major determinant of offspring growth and survival, but high provisioning rates might come at the cost of increased predation threat. Parents should thus adjust provisioning activity according to current predation threat levels. Moreover, life-history theory predicts that response to predation threat should be correlated with investment in current reproduction. We experimentally manipulated perceived predation threat in free-living great tits (Parus major) by presenting parents with a nest predator model while monitoring different aspects of provisioning behavior and nestling begging. Experiments were conducted in 2 years differing greatly in ecological conditions, including food availability. We further quantified male territorial aggressiveness and male and female exploratory tendency. Parents adjusted provisioning according to current levels of threat in an apparently adaptive way. They delayed nest visits during periods of elevated perceived predation threat and subsequently compensated for lost feeding opportunities by increasing provisioning once the immediate threat had diminished. Nestling begging increased after elevated levels of predation threat, but returned to baseline levels by the end of the experiment, suggesting that parents had fully compensated for lost feeding opportunities. There was no evidence for a link between male exploration behavior or aggressiveness and provisioning behavior. In contrast, fast-exploring females provisioned at higher rates, but only in the year with poor environmental conditions, which might indicate a greater willingness to invest in current reproduction in general. Future work should assess whether these personality-related differences in delivery rates under harsher conditions came at a cost of reduced residual reproductive value.

Problems of feeding, sleeping and excessive crying in infancy: a general population study.

OBJECTIVE: To study regulatory problems (RPs) of feeding, sleeping and excessive crying in infancy, and explore the influence of maternal mental health problems and parent-child relationship problems. DESIGN AND SETTING: Data were collected in the general child health surveillance delivered to infant families by community health nurses (CHNs). Information on CHNs' assessments and conclusions were obtained on 2598 infants and merged with data from national registers. Descriptive statistics and logistic regression models were used to study RPs in early and late infancy, and the influences due to child, family and parent-child relationship problems. RESULTS: Combined RPs (C-RPs), defined as two or more simultaneous problems of feeding, sleeping or excessive crying, was identified in 2.9% and 8.6% of the population between age 2-6 and 8-11 months, respectively. Low maternal schooling and immigrant parents were associated with an increased risk of late C-RPs, but RPs in early infancy stand out as the main predictor of late C-RPs OR 3.4 (95% CI 1.8 to 6.6), and the effect of early maternal mental health problems and parent-child relationship problems seem to be mediated by early C-RPs. CONCLUSIONS: Combined problems of feeding, sleeping or excessive crying may exist throughout infancy independently of exposures to maternal mental health problems and parent-child relationship problems. The results indicate that infants with RPs exceeding age 2 months need special attention, in clinical as well as community settings. Suggested intervention includes specific guidance to the parents to help them understand and regulate their infant's sensitivity and reactions.

[Eating disorder in a nineteen months-old girl and associated mother child relationship disturbance]. / Spiseforstyrrelse hos en 19 måneder gammel pige med komorbid mor-barn-relationsforstyrrelse.

Feeding and eating problems and weight faltering are common causes for parents contact to health services in infancy and early childhood, and 0.15% of the child population aged 0-3 years are diagnosed at hospital with an ICD-10 childhood eating disorder. We describe the clinical presentation of an early feeding and eating disorder in a child of basically normal health and development. The case illustrates the significance of the mother child relationship both in the putative risk mechanisms and as a key factor in the treatment. The importance of a close cooperation between paediatric and child psychiatric services in these patients is underscored.

Long-term prognosis for children with breath-holding spells.

INTRODUCTION: The aim of this study was to investigate the long-term prognosis for children with severe breath-holding spells (BHS). MATERIAL AND METHODS: The study was a retrospective cohort study. Data from the medical records of all patients with severe BHS admitted during a ten-year period were recorded and a questionnaire was sent to the families. A matched group of adolescents with febrile convulsions served as controls (n = 289). RESULTS: A total of 85 out of 115 families (73.9%) responded. The mean age of the included patients was 20.5 years. Among first-degree relatives 21.5% had BHS and 14.6% had epilepsy. The peak age for severe BHS was 16 months. The children had a total of 1-25 attacks. All electrocardiogram (ECG) recordings were normal. One patient died of asystolia at the age of 20 years, ECG two weeks previously showed a WPW-block. Twenty-six (30.6%, p < 0.001) had fainting spells. Twenty-five (29.4%) had concentration problems. The grades achieved by BHD children at the final school exam did not differ from the mean values achieved by all children in the area. CONCLUSION: In this study on the long-term prognosis of children with BHS, we found a predisposition to fainting spells as expected. We also found that 29.4% of children with BHS had concentration problems. Further follow-up studies are needed to confirm this trend.

Pleiotropía en familias con leucemia linfocítica crónica / Pleiotropy in families with chronic lymphocytic leukemia

La pleiotropía de la leucemia linfocítica crónica (LLC) indica la aparición de otros tipos de enfermedades linfoproliferativas en ancestros del probando. En 35 pares de padres-descendientes con LLC en los padres, 27 pares (77%) tenían también LLC. en los descendientes, igual en herencia materna y paterna. En 8 descendientes (23%) sin LLC, hubo 6 casos con otra enfermedad linfoproliferativa y dos casos con plicitemia vera. Por ende, la pleitropía de la LLC comprende tanto trastornos linfoproliferativos como mieloproliferativos. En relación con la anticipación, no se observó ninguna diferencia en la edad al inicio de la enfermedad entre padres e hijos. Se debate que estos hallazgos puedan estar de acuerdo con un modo no mendeliano de transmisión de la LLC con muchos alelos de bajo riesgo que confieren un pequeño riesgo fenotípico de LLC. Además, la transmisión de los genes no alélicos refleja la impronta (silenciamiento) materna de los genes paternos como consecuencia del microquimerismo relacionado con el embarazo.

Pleiotropía en familias con leucemia linfocítica crónica / Pleiotropy in families with chronic lymphocytic leukemia

La pleiotropía de la leucemia linfocítica crónica (LLC) indica la aparición de otros tipos de enfermedades linfoproliferativas en ancestros del probando. En 35 pares de padres-descendientes con LLC en los padres, 27 pares (77%) tenían también LLC. en los descendientes, igual en herencia materna y paterna. En 8 descendientes (23%) sin LLC, hubo 6 casos con otra enfermedad linfoproliferativa y dos casos con plicitemia vera. Por ende, la pleitropía de la LLC comprende tanto trastornos linfoproliferativos como mieloproliferativos. En relación con la anticipación, no se observó ninguna diferencia en la edad al inicio de la enfermedad entre padres e hijos. Se debate que estos hallazgos puedan estar de acuerdo con un modo no mendeliano de transmisión de la LLC con muchos alelos de bajo riesgo que confieren un pequeño riesgo fenotípico de LLC. Además, la transmisión de los genes no alélicos refleja la impronta (silenciamiento) materna de los genes paternos como consecuencia del microquimerismo relacionado con el embarazo.(AU)