Behavioral disorders in children and adolescents with atopic dermatitis.

OBJECTIVES: To assess the prevalence and pattern of behavioral problems in children and adolescents with atopic dermatitis (AD) and to study their associations with clinical data and severity. METHODS: This was a single-center, cross-sectional study of patients (6-17 years) with AD. Assessment of competencies and syndrome scale scores of behavioral problems was performed by applying the Child Behavior Checklist 6-18 (CBCL 6-18) and AD severity using the Eczema Area Severity Index (EASI) score. RESULTS: Of the 100 patients with AD, 56% were male, with a mean age of 11±3 years, and 43% had moderate/severe AD. Borderline or abnormal values were found in 75% of the patients for total social competence, 57% for internalization, 27% for externalization, and 18% for aggressive behavior. A higher prevalence of aggressive behavior (27.9% vs. 10.5%; p = 0.02) and sleep disorders (32.6% vs. 15.8%; p = 0.04) was observed in patients with moderate/severe AD than in those with mild AD. Children with current or previous use of immunosuppressants/immunobiological tests had a lower frequency of normal social competence (53% vs. 83%, p = 0.012). Regarding the critical questions, 8% responded affirmatively to suicidal ideation. CONCLUSION: A high prevalence of behavioral problems was observed among children and adolescents with AD, with a predominance of internalizing profiles, mainly anxiety and depression. Children with moderate/severe AD have a higher prevalence of aggressive behaviors and sleep disorders. These findings highlight the importance of multidisciplinary teams, including mental health professionals, in caring for patients with AD.

Behavioral disorders in children and adolescents with atopic dermatitis

Abstract Objectives To assess the prevalence and pattern of behavioral problems in children and adolescents with atopic dermatitis (AD) and to study their associations with clinical data and severity. Methods This was a single-center, cross-sectional study of patients (6-17 years) with AD. Assessment of competencies and syndrome scale scores of behavioral problems was performed by applying the Child Behavior Checklist 6-18 (CBCL 6-18) and AD severity using the Eczema Area Severity Index (EASI) score. Results Of the 100 patients with AD, 56% were male, with a mean age of 11±3 years, and 43% had moderate/severe AD. Borderline or abnormal values were found in 75% of the patients for total social competence, 57% for internalization, 27% for externalization, and 18% for aggressive behavior. A higher prevalence of aggressive behavior (27.9% vs. 10.5%; p= 0.02) and sleep disorders (32.6% vs. 15.8%; p= 0.04) was observed in patients with moderate/severe AD than in those with mild AD. Children with current or previous use of immunosuppressants/immunobiological tests had a lower frequency of normal social competence (53% vs. 83%, p= 0.012). Regarding the critical questions, 8% responded affirmatively to suicidal ideation. Conclusion A high prevalence of behavioral problems was observed among children and adolescents with AD, with a predominance of internalizing profiles, mainly anxiety and depression. Children with moderate/severe AD have a higher prevalence of aggressive behaviors and sleep disorders. These findings highlight the importance of multidisciplinary teams, including mental health professionals, in caring for patients with AD.

The effectiveness of Sandplay Therapy in children who are victims of maltreatment with internalizing and externalizing behavior problems / A efetividade da Terapia do Sandplay em crianças vítimas de maus tratos com problemas de comportamento internalizantes e externalizantes

This study aims to investigate the effect of Sandplay Therapy on the treatment of children who are victims of mistreatment with internalizing and/or externalizing behavioral problems. Method: The Child Behavior Check List instrument was applied to all children between 6 years 6 months and 10 years 11 months from 24 institutions. All of them presented clinical and/or borderline levels of behavior concern. The institutions where the children would compose a control group, those where they would receive Sandplay Therapy treatment (experimental group), and those where they would receive Placebo treatment were determined by drawing lot. The same instrument was applied after the treatments, or 20 weeks; in the experimental group, a test was applied after six months. The results show that the children in the experimental group showed significant improvements. These changes remained six months after the end of therapy and were verified by analyzing Sandplay scenarios.

O presente estudo tem como objetivo investigar o efeito da Terapia do Sandplay no tratamento de crianças vítimas de maus tratos e com problemas de comportamento internalizantes e/ou externalizantes. Participantes: 60 crianças vítimas de maus tratos e institucionalizadas. O instrumento Child Behavior Checklist foi aplicado nas crianças avaliadas, todas com idades entre 6 anos e 6 meses e 10 anos e 11 meses, de 24 instituições. Todas apresentaram níveis clínicos e/ou limítrofes. Por sorteio, foi determinado em qual instituição as crianças seriam grupo controle e em quais receberiam tratamento com terapia de Sandplay (grupo experimental) ou tratamento placebo. O mesmo instrumento foi aplicado após tratamentos ou 20 semanas; no grupo experimental houve testagem após seis meses. Os resultados demonstram que as crianças do grupo experimental apresentaram melhoras significativas. Essas mudanças ainda eram perceptíveis seis meses após o término da terapia e foram verificadas pela análise dos cenários de Sandplay