The role of factors associated with the course of pregnancy and childbirth in attention deficit hyperactivity disorder (ADHD). / Rola czynników zwiazanych z przebiegiem ciazy i porodu w zespole nadpobudliwosci psychoruchowej z deficytem uwagi.

OBJECTIVES: Assessment of the prevalence of risk factors associated with the course of pregnancy and childbirth and the condition of the child after birth in agroup of children and adolescents with ADHD and a control group. METHODS: 205 unrelated children and adolescents diagnosed with ADHD and 106 primary and secondary school students aged 7-17. Method. Mothers of children and adolescents diagnosed with ADHD, and those from the control group, were asked to provide a medical history in order to obtain data to supplement the Pregnancy and perinatal history questionnaire. RESULTS: Statistically significant differences (p < 0.05) were demonstrated for the incidence rates of factors related to the course of pregnancy and childbirth such as: the occurrence of maternal diseases during pregnancy, especially in the I/II trimester, and other problems during pregnancy; exposure to stress and taking medication during pregnancy; smoking during pregnancy; mother's age at childbirth, i.e., < 25 years or > 35 years; use of pain reducing substances during labor and problems with the child during the delivery;an APGAR score in the range of 5-7 points; the occurrence of neonatal jaundice necessitating treatment, especially replacement transfusion; physical anomalies or other congenital problems in the newborn, as well as adaptive problems necessitating neonatal oxygen administration or placement in an incubator. CONCLUSIONS: Significantly more frequent occurrence of risk factors related to the course of pregnancy, childbirth and the child's condition after birth in the ADHD group may indicate their potential role in the etiology of ADHD.

[Obsessive-compulsive symptoms, tics, stereotypic movements or need for absolute consistency? The occurrence of repetitive activities in patients with pervasive developmental disorders--case studies]. / Objawy obsesyjno-kompulsyjne, tiki, stereotypie ruchowe czy daznosc do zachowania stalosci otoczenia? Wystepowanie powtarzalnych aktywnosci u pacjentów z calosciowymi zaburzeniami rozwoju--opis przypadków.

Repetitive and stereotyped behaviours in the form of stereotyped interests or specific routine activities are one ofthe diagnostic criteria in pervasive developmental disorders. The occurrence of repetitive behaviours in patients with pervasive developmental disorders is a starting point for questions about the type and classification criteria of such behaviours. The aim of the article is to present case studies of patients with pervasive developmental disorders and co-morbid symptoms in the form of routine activities, tics, obsessive-compulsive symptoms or stereotyped behaviours. The first case study describes a patient with Asperger's syndrome and obsessive compulsive symptoms. The diagnostic problems regarding complex motor tics are discussed in the second case study which describes a patient with Asperger's syndrome and Gilles de la Tourette syndrome. The third and fourth case study describes mono-zygotic twins with so called High Functioning Autism whose repetitive activities point to either obsessive compulsive symptoms, stereotypic movements, need for absolute consistency or echopraxia. The possible comorbidity of pervasive developmental disorders and symptoms in the form of repetitive behaviours, possible interactions as well as diagnostic challenges is discussed in the article.