Bone mineral density in adolescent girls with anorexia nervosa--a cross-sectional study.

UNLABELLED: The total body and lumbar spine bone mineral density (BMD) were measured in order to determine the prevalence and possible risk factors of decreased BMD in anorexia nervosa (AN). SUBJECTS: Sixty-one in-patient girls with DSM III-R AN: age 14.7+/-2.16 years; duration of AN 12.9+/-15.1 months; percentage of ideal body weight 70+/-8.7%; body mass index score -1.62+/-0.79. METHOD: Total body (in 61 patients) and lumbar spine BMD (in 43 patients), content of lean and fat tissue mass were measured by DXA during the first month of treatment. RESULTS: Low total body BMD was found in 23.7% and low lumbar spine BMD in 36.6% of patients. There was a negative correlation between BMD and age, age of menarche, degree of undernourishment, duration of AN and amenorrhea. A step-wise linear regression analysis revealed that age of menarche was the most important factor related to BMD in this group.

Bone mineral content and bone mineral density in adolescent girls with anorexia nervosa--a longitudinal study.

OBJECTIVE: Total body and lumbar spine bone mineral density (BMD-TB, BMD-L) and total body bone mineral content (BMC-TB) were measured to establish the course of bone demineralization in anorexia nervosa and the clinical factors influencing BMC-TB and BMD changes during treatment. METHOD: Forty-two girls with DSM III-R anorexia nervosa, age 14.7+/-2.4 years. BMC-TB, BMD-TB and BMD-L were measured in approximately 7-month intervals for 27.8+/-4.1 months using DXA. RESULTS: Despite nutritional improvement, there was an initial decrease of BMD-L, and no change in BMC-TB and BMD-TB. an increase in BMC-TB and BMD was observed after approx. 21 months from the beginning of the study. CONCLUSION: The improvement in BMC-TB and BMD was related to changes in nutritional status and was significantly marked in younger patients, with earlier anorexia onset and before menarche.

[Features of autism, autistic traits, autism: retrospective analysis of clinical symptoms in children treated in the Pediatric Psychiatric Clinic]. / Cechy autyzmu, rysy autystyczne, autyzm: analiza retrospektywna objawów klinicznych u dzieci leczonych w Klinice Psychiatrii Dzieciecej.

All currently accepted definitions of autism include three main criteria which have to be met for a diagnosis to be made. These are: disturbance of reciprocal social interaction, disturbance of communication and restriction of normal variation in behaviour and interests. The criteria used in the ICD-10 include all these domains. On the other hand, the number of mentally handicapping conditions and brain damage syndromes show the same triad of symptoms. Many of patients actually fulfill all currently accepted criteria for autism, but, for some reason do not receive the diagnosis. We analysed retrospectively the clinical picture of all children hospitalised in Department of Child Psychiatry in the last 10 years before the introduction of ICD-10 in Poland (1986-1996) and diagnosed as having autism, autistic traits or features. The group consist of 19 children (0.8% of all children hospitalised in that time). 4 of them had been diagnosed as having autism, 4 as having features of autism and 11 as having autistic traits. Additional diagnoses were: organic brain damage in 2 children, carnitine deficiency and cerebral palsy in 1 child and minimal brain dysfunction in 3 cases. Despite of the diagnosis all children met current ICD-10 criteria for autism or atypical autism, according to age of onset. There were no significant differences in constellation of symptoms included in ICD-10 between groups divided according to the past diagnosis.

[Follow-up study of adolescents with anorexia nervosa]. / Odlegle wyniki leczenia dorastajacych chorych na jadlowstret psychiczny.

Analysis of the results of treatment of 132 patients hospitalized because of anorexia nervosa is presented. Average time of observation after hospitalization was 7,9/12 years. Mean age when the disease started was 13,7/12 years, when the analysis was performed--22 years. Catamnestic data were received directly from patients--46, from family members--25, from health service--3.18 sent answers by post, 40 neither contacted us nor answered to questionnaire. Analysis was founded on Morgan, Russel criteria, modified by Ratnasuriya. It showed that good results of treatment were received in 76% of all analyzed patients, in 11% they were intermediate, and poor in 12%. Two persons (2%) died. The social functioning of patients was found to be the best. More than half of the examined group had depressive and/or anxiety disorders. These disorders are significant in all the patients who remain chronically ill.

[Life threatening metabolic and pathophysiological complication in anorexia nervosa patients]. / Zagrazajace zyciu zaburzenia metaboliczne i patofizjologiczne u chorych na jadlowstret psychiczny.

Medical records of 210 adolescents hospitalised because of anorexia nervosa (1978-1995) were analysed. 8 patients have demonstrated life threatening metabolic and pathophysiologic complications. These complications were seen in cachectic patients or when their body mass index decreased in a very short time. They were parenterally fed. When physical state permitted, family and individual psychotherapy was introduced.

[Mental disorders in children with epilepsy]. / Zaburzenia psychiczne u dzieci chorych na padaczke.

In a group of 80 epileptic children aged 10-11-12 years in 75% of cases psychic changes were found, including disturbances of intellectual abilities of the oligophrenic-dementive type, and personality disorders. The cause of these disturbances was organic brain damage due mainly to pathological events in pregnancy and labour, and to mechanical craniocerebral trauma in early childhood. Other causes included: duration, type and frequency of seizures and longstanding pharmacological polytherapy not considering the interaction of drugs. The coexistent neurotic symptoms in 60% out of 80 studied children were caused by abnormal family situation and situation in school which had undoubtedly an effect on the prognosis and course of epilepsy in children.

[Catamnestic studies of children with epilepsy]. / Badanie katamnestyczne dzieci chorych na padaczke.

Late results of epilepsy treatment in 150 children hospitalized in the Department of Psychiatry, Institute of Paediatrics, Medical Academy in Warsaw and followed-up in the outpatient clinic of this Department are described. The criteria of selection of the cases for analysis were age of 10 years, at least, and disease duration at least 4 years. It was found that in 72% of cases the seizures had been completely controlled (absent for at least 2 years). In 28% the seizures continued despite systematic treatment. The analysis showed that persistence of seizures was caused, among other factors, by the degree and extent of the organic damage to the central nervous system confirmed in neurological and psychological examination and electroencephalographic investigations, the type of seizures, mainly seizures of salaam type and partial seizures with complex signs, recurring status epilepticus, and coexistence of various types of seizures in a child. Interseizure psychic disturbances were more frequently observed in children in whom the seizures could not have been controlled completely.

[Difficulties in the diagnosis of epilepsy in children]. / Trudnosci diagnostyczne w rozpoznawaniu padaczki u dzieci.

On the basis of an analysis of 3 cases it was shown that the occurrence of seizure-like symptoms with abnormal EEG and history data suggesting possible damage to the central nervous system are not always sufficient for an unequivocal diagnosis of epilepsy and for beginning of long-term antiepileptic treatment which is not without adverse effects on the developing organism of a child. For establishing of correct diagnosis and avoiding of too hasty introduction of anticonvulsant treatment not only careful history and family data and pathological EEG tracings should be considered, but the seizure-like symptoms and results of laboratory investigations should be carefully analysed. On many cases, especially in younger children, the diagnosis should be established in hospital.

[Evaluation of the mental state of children with early-childhood onset of epilepsy treated between 1977 and 1981 (preliminary report)]. / Ocena stanu psychicznego dzieci z padaczka wczesnodziecieca leczonych w latach 1977-1981 (doniesienie wstepne).

From a group of 248 cases of epilepsy observed in the last five years 69 (28%) children, 32 boys and 37 girls, were isolated (aged from several months to 14 years) in whom the first epileptic seizures appeared at the age of 3 years or less. The subgroups were subjected to detailed psychiatric-psychological analysis for establishing whether epilepsy beginning in the life period of the most intense developmental processes may have any decisive influence on the psychic development and social adaptation of the child. It was found that children with epilepsy beginning at the age below 3 years require not only a careful differential diagnosis but even more a comprehensive therapeutic management, which should include, besides systematic administration of drugs and periodic EEG control also a continuous psychological and psychiatric supervision and care which would ensure a possibly optimal development of mental skills and social adaptation in the family and outside it.