ABSTRACT
OBJECTIVE: Anxiety is highly prevalent in Pervasive Developmental Disorder (PDD) without mental retardation but is too often misdiagnosed. The authors suggest a critical review of current data of the PDD without mental retardation in children and adolescents, in order to summarize research published in this field. After describing specific features, this article tackles the issue of prevalence of anxiety among this population, then deals with present-time assessment and treatments of comorbid anxiety. METHODS: This review was based on a systematic search of the main online databases (Science Direct, PsychInfo, Medline and Pubmed) in order to compile surveys published on Asperger syndrome and high-functioning autism-related anxiety among children and adolescents. This study focuses on papers published between 1995 and 2010, using strict diagnostic criteria for anxiety and PDD, and a controlled group, with the exception of pharmacological studies because none are controlled. We found seven studies assessing the prevalence of anxiety among children and adolescents with PDD, four assessment tools and 12 treatments. RESULTS: Anxiety disorders were shown in 42% of children and adolescents with PDD without mental retardation. This disorder is related to age and level of cognitive functioning and is likely to affect PDD without mental retardation as children and adolescents with anxiety disorder without PDD. This review highlights a major problem: assessment of anxiety in PDD without mental retardation. Actually, only two PDD adapted instruments have been found: the Autism Co-Morbidity Interview Present and Lifetime Version (ACI-PI) and the Stress Survey Schedule (SSS) for persons with autism. Such tools being methodologically limited, the diagnosis of anxiety disorder is all the more difficult to establish. Consequently, considering suitable treatment is not always proposed. Recent surveys show how profitable pharmacological treatment and behavioral intervention like Cognitive-Behavior Therapy (CBT) or psychosocial treatments are. However, important methodological limitations are evoked: there is no control study assessing the efficiency of a pharmacological treatment in Asperger syndrome and high-functioning autism. Besides, the research on how profitable cognitive and behavioral treatment is, gives heterogeneous results. Finally, social skills' training does not treat anxiety disorder directly, but skills abilities that are the most important disabilities in PDD without mental retardation. Therefore, authors advocate adapting treatment in order to treat anxiety disorder. CONCLUSION: The research revealed an important need to create new assessment instruments suitable to PDD without mental retardation in order to facilitate the co-morbidity diagnosis. This survey also underlines the necessity to develop controlled research testing the efficiency of such treatments as pharmacological ones, cognitive and behavioral therapies as well as social skills training.
Subject(s)
Anxiety Disorders/diagnosis , Anxiety Disorders/epidemiology , Child Development Disorders, Pervasive/diagnosis , Child Development Disorders, Pervasive/epidemiology , Intellectual Disability/diagnosis , Intellectual Disability/epidemiology , Adolescent , Age Factors , Anti-Anxiety Agents/therapeutic use , Anxiety Disorders/therapy , Child , Child Development Disorders, Pervasive/therapy , Cognitive Behavioral Therapy , Comorbidity , Cross-Sectional Studies , Female , Humans , Intellectual Disability/therapy , Intelligence , Interview, Psychological , Male , Personality AssessmentABSTRACT
Informe de 2011 basado en una Revisión sistemática de la literatura sobre la eficacia y la seguridad de la IVE farmacológica con mifepristona hasta los cuarenta y nueve días de gestación. Se han revisado las principales bases de datos bibliográficas y se han incluido 33 ensayos clínicos aleatorizados y 7 revisiones sistemáticas de la literatura. Puede descargarse el texto completo gratuitamente en formato pdf.
Subject(s)
Abortion, Legal , Abortion, Induced , 50242 , LegislationABSTRACT
A series of cognitive enhancers (CEs) have been reported to increase spatial memory in rodents, information on behavioral effects, however, is limited. The aim of the study was therefore to examine the behavioral effects of three CEs in two well-documented inbred mouse strains. C57BL/6J and DBA/2 mice were administered intraperitonial. D-cycloserine (DCS; NMDA receptor agonist), 1-(4-Amino-5-chloro-2-methoxyphenyl)-3-[1-butyl-4-piperidinyl]-1-propanone hydrochloride (RS67333; 5HT4-receptor agonist), and (R)-4-{[2-(1-methyl-2-pyrrolidinyl)ethyl]thio}phenol hydrochloride (SIB-1553A; beta-4-nicotinic receptor agonist) and tested in the open field (OF), elevated plus maze (EPM), neurological observational battery and rota-rod. Cognitive performance was tested in the Morris water maze. All compounds modified behavioral performance in the OF, DCS showed an anxiolytic effect in the EPM, and differences in the observational battery were observed i.e. vestibular drop was decreased by SIB-1553A and RS67333 treatment in C57BL/6J and increased with DCS treatment in DBA/2 mice. In the rota rod SIB-1553A improved motor performance. DCS effects on learning and memory was comparable to controls whereas the other compounds impaired performance in the Morris water maze. In conclusion, behavioral testing of CEs in the mouse revealed significant changes that may have to be taken into account for evaluation of CEs, interpretation of cognitive studies and warrant further neurotoxicological studies. Moreover, strain-dependent differences were observed that in turn may confound results obtained from behavioral and cognitive testing.
