Maternal Labor Force Participation During the Child's First Year and Later Separation Anxiety Symptoms.

Separation anxiety symptoms are frequent among preschool-aged children, but it is also a possible gateway for diagnosis of separation anxiety disorder. Early maternal employment after childbirth can increase the risk for the development of separation anxiety symptoms. From an economic perspective, however, securing employment is one effective strategy to ensure child well-being. This study investigated how mothers' participation in the labor force (vs. maternal leave) and the financial state of families when the child was 5 months old was prospectively associated with separation anxiety symptoms. This study is based on 1,295 Canadian families with children assessed longitudinally from 17 months to age 6 on their levels of separation anxiety. Separation anxiety was measured during face-to-face interviews with the mothers. Maternal labor force participation, financial status, and risk factors were measured at 5 months. Results adjusted for propensity scores and for sample weight revealed that children of working mothers, despite having sufficient income (n = 245, 18.9%), were at higher risk of separation anxiety during early childhood. In contrast, maternity leave was most beneficial for children's separation anxiety, whether they were in a family with sufficient income (n = 950, 73.4%) or temporary low income (n = 100, 7.7%). Children of mothers in maternity leave were at risk of heightened separation anxiety only if they experienced chronic economic hardship. Therefore, maternity leave uptake could help prevent the development of separation anxiety. Providing families with opportunity to care for the baby as their main occupation during this sensitive developmental period could help improve children's mental health.

The relationship of separation anxiety with the age of onset of panic disorder.

AIM: This study aimed to investigate whether separation anxiety (SA) constitutes a dimension related to age at onset of panic disorder (PD), in homogeneous subgroups of outpatients with PD, based on their age of onset and symptom severity. METHODS: A sample of 232 outpatients with PD was assessed with the Panic Disorder Severity Scale (PDSS) and the Sheehan Disability Scale (SDS) for functional impairments. Separation anxiety was evaluated using structured interviews and questionnaires. We applied a K-Means Cluster Analysis based on the standardized "PD age of onset" and "the PDSS total score" to identify distinct but homogeneous groups. RESULTS: We identified three groups of patients: group 1 ("PD early onset/severe", N = 97, 42%, onset 23.2 ± 6.7 years), group 2 ("PD early onset/not severe", N = 76, 33%, onset 23.4 ± 6.0 years) and group 3 ("PD adult onset/not severe", N = 59, 25%, onset 42.8 ± 7.0 years). Patients with early onset/severe PD had significantly higher scores on all SA measures than PD late-onset/not severe. Regression analyses showed that SA scores, but not PDSS scores, were predictive of impairment in SDS work/school, social life, and family functioning domains. CONCLUSIONS: Our data indicate a significant relationship between SA and PD with an earlier age of onset and an impact on individual functioning. This may have important implications for implementing preventive interventions targeting early risk factors for the subsequent onset of PD.

Is adult separation anxiety associated with offspring risk for internalizing psychiatric problems?

BACKGROUND: Awareness of adult separation anxiety (ASA) is growing, but there is a dearth of knowledge about how separation anxiety aggregates in families. We examined the intergenerational associations of separation anxiety and other forms of internalizing problems in an American community sample of 515 predominantly white children and their parents. METHODS: Children's separation anxiety (CSA), depression, and other anxiety disorders were modeled as latent factors using diagnoses from interviews and symptom scores from questionnaires completed by mothers, fathers, and children when children were 9 years old and again 3 years later. Parents' separation anxiety was assessed via a questionnaire and parents' other anxiety, depressive, and substance use disorders were assessed with a diagnostic interview when children were nine. Relationships between parents' and children's psychopathology were modeled using s.e.m. RESULTS: Mothers' and fathers' ASA were related to all three psychopathology factors in offspring, over and above other parental disorders, in concurrent and prospective analyses. CSA was also related to maternal depression concurrently and prospectively and to maternal anxiety prospectively. Of all paternal psychopathology variables, only ASA was significantly related to children's psychopathology in either model. CONCLUSIONS: Results indicate that parental separation anxiety is an important, but non-specific, risk factor for children's psychopathology. The pathway by which this risk is transmitted may be genetic or environmental, and the observed statistical associations likely also encompass child-to-parent effects.

[Clinical variants and types of course of separation anxiety disorder in adults]. / Klinicheskie varianty i tipy techeniya trevozhnogo rasstroistva separatsii u vzroslykh.

OBJECTIVE: To study clinical manifestations of separation anxiety disorder (SAD) in adults with nonpsychotic mental disorders. MATERIAL AND METHODS: Fifty outpatients over 18 years of age with SAD and comorbid non-psychotic mental disorders were assessed for diagnosis by MINI and the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), the Adult Separation Anxiety Self-Report Checklist (ASA-27), HARS, the Experiences in Close Relationship Scale (ECR), the Personality Inventory for DSM-5 (PID-5), the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). RESULTS AND CONCLUSION: Two clinical variants of the disorder: affective and cognitive-behavioral as well as two variants of the course: with onset in childhood and in adults are identified. Clinical variants and types differ in the spectrum of comorbidity, objects and styles of attachment, personality characteristics as well as correlations and prognosis.

Separation Anxiety Disorder in Panic Disorder Patients with and without Comorbid Agoraphobia.

Objective: Previous studies have focused on the relationship between childhood separation anxiety disorder (SAD) and adult panic disorder (PD)-agoraphobia. It is not clear enough whether SAD, which continues into adulthood, is associated with PD with and without comorbid agoraphobia in adult patients. Our primary hypothesis was that PD patients with comorbid agoraphobia had a higher rate of SAD that continues into adulthood than those without agoraphobia. We also hypothesized that adulthood SAD symptoms were more likely to be associated with PD-agoraphobia than PD without agoraphobia.Method: 151 patients who were diagnosed with PD with (n = 106), and without comorbid agoraphobia (n = 45) were compared using Panic and Agoraphobia Scale, Structured Clinical Interview for Separation Anxiety Symptoms, Separation Anxiety Symptom Inventory, Adult Separation Anxiety Questionnaire, and State-Trait Anxiety Inventory. We performed Student's t-test, Pearson correlation test, and multiple linear regression analysis in this study.Results: PD patients with comorbid agoraphobia were more likely to have SAD both in childhood and adulthood (p = .028), than those without agoraphobia. There were mild to moderate significant correlations between PD severity and state anxiety (p = .002), trait anxiety (p = .006), and SAD in childhood (p = .049), and in adulthood (p = .001). SAD in adulthood (ß = 0.278, Exp(B) = 0.136, p = .003), and state anxiety (ß = 0.236, Exp(B) = 0.164, p = .012) significantly predicted the severity of PD in patients with comorbid agoraphobia.Conclusion: SAD that continues in adulthood may be related to the severity of PD in patients with agoraphobia. Our findings might provide some evidence of the role of SAD in adulthood in patients with adult-onset PD-agoraphobia.

[Separation anxiety disorder]. / Trennungsangststörung.

In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) separation anxiety disorder has been included in the chapter on anxiety disorders, thereby removing the age of onset restriction that previously required first onset during childhood or adolescence. Separation anxiety disorder has a lifetime prevalence of 4.8% and onset often occurs after the age of 18 years. Despite the high prevalence, separation anxiety disorder is often underdiagnosed and subsequently remains untreated. This narrative review summarizes the etiology, clinical features, diagnostic criteria as well as important differential diagnostic aspects, common comorbidity profiles and treatment implications of separation anxiety disorder. Furthermore, relevant implications for everyday practice and future perspectives for treatment and research are discussed.

Separation anxiety disorder among outpatients with major depressive disorder: Prevalence and clinical correlates.

Prior studies have reported that separation anxiety disorder (SEPAD) can continue into or may begin in adulthood. Association of SEPAD with other psychiatric disorders has been frequently examined, and high rates of comorbidities have been found. The aim of this study was to investigate the prevalence and clinical correlation of SEPAD in adult patients undergoing treatment for major depressive disorder (MDD). The study sample was comprised of 100 outpatients. Participants underwent a DSM-5-based comprehensive assessment. Purposefully-designed semi-structured sociodemographic information and illness history forms were filled out by the researchers, and diagnoses of SEPAD were made using the Structured Clinical Interview for Separation Anxiety Symptoms, Separation Anxiety Symptom Inventory and Adult Separation Anxiety Survey. The frequency of SEPAD was 41% in patients with MDD, three-quarters of whom were adult onset. The use of new-generation antidepressants, adjunctive medications and comorbidity of other anxiety disorders were higher in patients with SEPAD (p < 0.05). SEPAD was highly prevalent, with a majority of cases starting in adulthood among patients with MDD, while SEPAD comorbidity was associated with high levels of anxiety and an increased likelihood of suboptimal response to usual depression treatment. Further studies are required to define the relevance and pathological basis for the comorbidity of SEPAD in people with MDD.

Community-Based Prevalence of Externalizing and Internalizing Disorders among School-Aged Children and Adolescents in Four Geographically Dispersed School Districts in the United States.

The Project to Learn About Youth-Mental Health (PLAY-MH; 2014-2018) is a school-based, two-stage study designed to estimate the prevalence of selected mental disorders among K-12 students in four U.S.-based sites (Colorado, Florida, Ohio, and South Carolina). In Stage 1, teachers completed validated screeners to determine student risk status for externalizing or internalizing problems or tics; the percentage of students identified as being at high risk ranged from 17.8% to 34.4%. In Stage 2, parents completed a structured diagnostic interview to determine whether their child met criteria for fourteen externalizing or internalizing disorders; weighted prevalence estimates of meeting criteria for any disorder were similar in three sites (14.8%-17.8%) and higher in Ohio (33.3%). PLAY-MH produced point-in-time estimates of mental disorders in K-12 students, which may be used to supplement estimates from other modes of mental disorder surveillance and inform mental health screening and healthcare and educational services.

Bullying involvement and self-reported mental health in elementary school children across Europe.

BACKGROUND: Bullying behavior is recognized internationally as a serious issue associated with mental health and functioning problems among children. OBJECTIVE: The present study sought to determine the associations between bullying involvement and self-reported mental health among elementary school children across seven European countries. PARTICIPANTS AND SETTING: The School Children Mental Health in Europe study was conducted in Bulgaria, Germany, Italy, Lithuania, the Netherlands, Romania and Turkey in 2010 using similar methodology to collect cross-sectional data from children, parents, and teachers. METHODS: The study focused on children who had completed the Dominic Interactive and whose mother and/or teacher had completed the Strengths and Difficulties Questionnaire (n = 5,183). RESULTS: Overall 14.3 % of children were identified as bullies, 18.2 % as victims and, 19.0 % as both bullies and victims. Despite the low threshold for defining bullying status, children identified as being involved were highly likely to present with self-reported mental health problems: 31.6 % of bully-victims reported any disorder, while 25.4 % of bullies and 23.1 % of victims did. Adjusting for key factors, bullies and bully-victims were significantly more likely to present with any externalizing disorder, while victims were not. Additionally, bully-victim status was associated with significantly greater odds of presenting with each internalizing disorder: phobia (AOR = 1.48, 95 %CI = 1.01-2.19), GAD (AOR = 2.54, 95 %CI = 1.67-3.87), separation anxiety (AOR = 1.88, 95 %CI = 1.43-2.47) and depression (AOR = 2.52, 95 %CI = 1.61-3.93). However, victim status was only associated with GAD (AOR = 1.63, 95 %CI = 1.07-2.48) and bully status with separation anxiety (AOR = 1.44, 95 %CI = 1.07-1.93). CONCLUSIONS: The results highlight the association of bullying involvement and child mental health in elementary school children across Europe.

Prevalence, Comorbidity and Predictor of Separation Anxiety Disorder in Children and Adolescents.

Separation Anxiety Disorder(SAD) is one of the earliest anxiety disorders. The effect of this disorder on the performance of children and adolescents reveals the need for awareness of the prevalence and comorbidity of this disorder in each region. This study is a cross-sectional analytical study implemented in all provinces of Iran. The instrument used in this study is the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version(K-SADA-PL) questionnaire. The total number of participants was 29,699. The overall prevalence of SAD was 5.3%. The comorbidity rate of 65.3% was found between SAD and other psychiatric disorders. Specific phobia and oppositional defiant disorder had the highest comorbidity with this disorder in the studied population. The more prevalence of separation anxiety disorder in the age range of 6-9 years old highlights the need for early detection of this disorder and targeting screening programs in childhood and adolescence.

Association between prolonged separation from parents and allostatic load among children in China.

OBJECTIVE: To capture the association of exposure to prolonged separation from both parents early in life and allostatic load (AL), a measure of biological multi-system dysregulation. METHODS: We used data from 557 7-12-year-old children enrolled in rural area of Chizhou city, Anhui Province, China. We computed an AL score based on eleven biomarkers representing four regulatory systems: immune/inflammatory system (high sensitivity C-reactive protein); metabolic system (body mass index; high density lipoprotein; low density lipoprotein, total cholesterol; triglycerides; fasting glucose; glycated hemoglobin; insulin) and cardiovascular system (systolic and diastolic blood pressure). Child's experiences of parent-child separation were collected a brief online questionnaire by parents of children. RESULTS: More than 1 in 3 of our participants separated with both parents at age 6 or younger and nearly 1 in 10 persistently separated from both parents after birth. The AL score was significantly higher among children separated from both parents during early childhood (3.25 ± 1.98) or persistently since birth (3.48 ± 1.92), compared with those who did not separated from both parents (2.34 ± 1.53, F = 12.992, P<0.001). After adjustment of demographic covariates, body mass index as well as parent frequency of communication and parental warmth, children who separated from both parents in early childhood (ß = 0.84, 95%CI:0.40, 1.28, P < 0.001) or persistently into adolescence (ß = 1.27, 95%CI:0.43, 2.12, P = 0.003) evinced the highest levels of AL. CONCLUSION: This study is the first to show an association between prolonged parent-child separation and physiological wear-and-tear as measured by AL, which provides potential insights into the biological mechanisms underpinning long-term health outcomes in contexts of parent-child separation.

Adult separation anxiety disorder: The human-animal bond.

BACKGROUND: The introduction of an adult onset Separation Anxiety Disorder in the DSM-V recognises that separation anxiety can occur at any stage across the lifespan. In this paper, we examine whether adult separation anxiety, which is known to occur when people are apart from other people close to them, can also develop when people are separated from animal companions. The social and individual psychological correlates of this reported phenomenon are examined. METHODS: Participants (N = 313, aged 18-76, M = 41.89 years), completed demographic information and questionnaires measuring separation anxiety from companion animals and humans, attachment towards companion animals and humans, and social support. RESULTS: Significant positive relationships were observed between separation anxiety from humans, people substitution and separation anxiety from animals. Participants with greater separation anxiety from animals also reported less social support and greater attachment anxiety involving humans. People substitution was also positively related to greater animal-related separation anxiety. Associations were generally weaker when cats were identified as the principal companion animal. Participants without children reported significantly less attachment-related avoidance (human); less perceived social support; greater people substitution; and, greater separation anxiety towards companion animals. Separation anxiety from humans, attachment avoidance, and attachment anxiety accounted for 41% of variance in separation anxiety from animals. LIMITATIONS: The correlational design does not allow the investigation of causal associations. CONCLUSIONS: A strong, positive relationship was observed between human-related separation anxiety and animal-related separation anxiety, which was significantly stronger for people with lower levels of social support.

Infant sleep and child mental health: a longitudinal investigation.

OBJECTIVE: To determine whether infants with severe persistent sleep problems are at increased risk of (1) meeting diagnostic criteria for a psychiatric disorder (age 10 years), and (2) having elevated symptoms of mental health difficulties (ages 4 and 10 years), in comparison with infants with settled sleep. DESIGN AND SETTING: Prospective longitudinal community cohort study-the Maternal Health Study. Mothers completed questionnaires/interviews at 15 weeks' gestation; 3, 6, 9 and 12 months post partum; and when their child turned 4 and 10 years old. Measures included parental report of infant night waking and sleep problems and child mental health (Strengths and Difficulties Questionnaire; Spence Children's Anxiety Scale; Development and Well-being Assessment). PARTICIPANTS: 1460 mother-infant dyads. RESULTS: 283 (19.4%) infants had persistent severe sleep problems, 817 (56.0%) had moderate/fluctuating sleep problems and 360 (24.7%) infants were settled. Infants with persistent severe sleep problems were more likely to report emotional symptoms at age 4 (adjusted odds ratio (AOR)=2.70, 95% CI 1.21 to 6.05, p=0.02), and meet diagnostic criteria for an emotional disorder at age 10 (AOR=2.37, 95% CI 1.05 to 5.36, p=0.04). Infants with persistent severe sleep problems also had elevated symptoms of separation anxiety (AOR=2.44, 95% CI 1.35 to 4.41, p<0.01), fear of physical injury (AOR=2.14, 95% CI 1.09 to 4.18, p=0.03) and overall elevated anxiety (AOR=2.20, 95% CI 1.13 to 4.29, p=0.02) at age 10. CONCLUSIONS: Infants with persistent severe sleep problems during the first postnatal year have an increased risk of anxiety problems and emotional disorders at age 10.

Separation anxiety in PTSD: A pilot study of mechanisms in patients undergoing IPT.

INTRODUCTION: Separation anxiety disorder (SAD) comprises one aspect of attachment dysregulation or insecurity. Although SAD aggravates posttraumatic stress disorder (PTSD) risk, no clinical research has tracked how many patients with PTSD have SAD, its clinical associations, or its response to PTSD treatment. Our open trial of interpersonal psychotherapy (IPT) for veterans with PTSD assessed these SAD domains. METHODS: Twenty-nine veterans diagnosed with chronic PTSD on the Clinician-Administered PTSD Scale were assessed for SAD using the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), and for Symptom-Specific Reflective Function (SSRF), another dysregulated-attachment marker capturing patients' emotional understanding of their symptoms. Patients received 14 IPT sessions for PTSD with assessments at baseline, Week 4 (SCI-SAS and SSRF), and termination for SAD, PTSD, and depression. RESULTS: At baseline, 69% of patients met SAD criteria. Separation anxiety did not correlate with baseline PTSD severity, depressive severity, or age when traumatized; patients with and without SAD had comparable PTSD and depression severity. Patients with baseline comorbid SAD who completed IPT (N = 17) reported significantly improved adult separation anxiety (p = .009). Adult SAD improvements predicted depressive improvement (p = .049). Patients with SAD showed a stronger relationship between early SSRF gains and subsequent adult SAD improvement (p = .021) compared with patients without SAD. DISCUSSION: This first exploration of dysregulated/insecure attachment features among patients with PTSD found high SAD comorbidity and adult SAD improvement among patients with SAD following IPT. Highly impaired attachment patients normalized attachment posttreatment: 14-session IPT improved attachment dysregulation. This small study requires replication but begins to broaden clinical understanding of separation anxiety, attachment dysregulation, and PTSD.

Childhood and adolescent mental health of NICU graduates: an observational study.

OBJECTIVE: To investigate the mental health of children and adolescents admitted to neonatal intensive/special care units (NICUs) in infancy. METHODS: This cross-sectional study used a provincially representative cohort from the 2014 Ontario Child Health Study. Parents provided data on psychiatric disorders using the MINI International Neuropsychiatric Interview for Children and Adolescents in 3141 children aged 4-11 years (NICU n=389; control n=2752) and in 2379 children aged 12-17 years (NICU n=298; control n=2081). Additionally, 2235 adolescents aged 12-17 years completed the interview themselves (NICU n=285; control n=1950). Odds of psychiatric disorder were compared in those admitted and controls. RESULTS: Based on parent reports, NICU graduates aged 4-11 years had increased adjusted ORs (95% CI) of 1.78 (1.39 to 2.28) for any psychiatric disorder, with a marginal prevalence of 32.4% in NICU participants and 27.6% in controls. At this age, NICU graduates also had increased ORs of 1.74 (1.25 to 2.40) for psychiatric comorbidity, 1.48 (1.04 to 2.11) for oppositional defiant disorder, 1.61 (1.19 to 2.19) for attention-deficit hyperactivity disorder, 4.11 (2.33 to 7.25) for separation anxiety disorder and 2.13 (1.37 to 3.31) for specific phobia. At 12-17 years, 40.5% and 30.5% of NICU graduates and 30.6% and 17.9% of controls had any psychiatric disorder as reported by parents and self-report, respectively. Parents and adolescents, respectively, reported increased adjusted ORs (95% CI) of 1.63 (1.18 to 2.26) and 1.55 (1.13 to 2.11) for any disorder, 1.64 (1.06 to 2.54) and 1.74 (1.11 to 2.73) for psychiatric comorbidity, and 1.89 (1.22 to 2.93) and 3.17 (2.03 to 4.95) for oppositional defiant disorder. CONCLUSIONS: NICU graduates are at increased risk for psychiatric disorders during childhood and adolescence.

High separation anxiety trajectory in early childhood is a risk factor for sleep bruxism at age 7.

STUDY OBJECTIVES: The evolution of sleep bruxism manifestations and their co-occurrence with separation anxiety in early childhood remain unclear. Our threefold aim was to: (1) describe developmental sleep bruxism trajectories in early childhood, (2) investigate co-occurrences between trajectories of sleep bruxism and separation anxiety, and (3) determine whether distinct trajectories of separation anxiety increase the risk of presenting sleep bruxism during the first year of elementary school. METHODS: This study is part of the Québec Longitudinal Study of Child Development. Sleep bruxism scores were assessed from age 1.5 to 7 years with the Self-Administered Questionnaire for Mother (n = 1946). Separation anxiety scores were measured from age 1.5 to 6 years with the Interviewer-Completed Computerized Questionnaire (n = 2045). RESULTS: We identified four sleep bruxism trajectories from age 1.5 to 6 years: High-Increasing sleep bruxism at age 1.5 (14.1%), High-Increasing sleep bruxism at age 4 (18.3%), Low-Persistent sleep bruxism (12.1%), and Never-Persistent sleep bruxism (55.5%); and four separation anxiety trajectories from age 1.5 to 6 years: Low-Persistent separation anxiety (60.2%), High-Increasing separation anxiety (6.9%), High-Decreasing separation anxiety (10.8%), and Low-Increasing separation anxiety (22.1%). Sleep bruxism and separation anxiety trajectories were weakly associated (X2 = 37.84, p < 0.001). Compared with preschoolers belonging to the Low-Persistent separation anxiety trajectory, preschoolers in the High-Increasing separation anxiety trajectory had almost double the risk of presenting sleep bruxism at age 7 (95% CI = 1.25-3.22, p = 0.04). CONCLUSION: When separation anxiety issues are detected in early childhood, it would be useful to target sleep bruxism during the first year of elementary school.

The relationship between separation anxiety and intolerance of uncertainty in pregnant women.

Background and aim: Pregnancy is a risky period to develop Adult Separation Anxiety Disorder (ASAD). The aim of this study was to investigate the frequency of separation anxiety in pregnant women, and the relationship of separation anxiety with sociodemographic variables and intolerance of uncertainty.Methods: This study included 310 pregnant women and used the Adult Separation Anxiety Questionnaire (ASAQ) and Intolerance of Uncertainty Scale-Short Form (IUS-12).Results: The average age in pregnant women with ASAD was lower. IUS-12 total score, prospective anxiety, and inhibitory anxiety subscale scores were significantly higher in the ASAD group. There were moderate and statistically significant positive correlations between the ASAD score and the IUS-12 total, prospective anxiety and inhibitory anxiety subscale scores.Conclusion: Intolerance of uncertainty may be an important factor in the mental processes of individuals with separation anxiety. Pregnancy period can be a risky period for developing ASAD. Cognitive behavioral treatments including intolerance of uncertainty may be effective in the treatment of ASAD. There is a need for follow-up studies on the effects of separation anxiety during pregnancy on maternal-fetal health.

Emotional and Behavioral Problems Among 3- to 5-Year-Olds Left-Behind Children in Poor Rural Areas of Hunan Province: A Cross-Sectional Study.

The term left-behind children (LBC) refers to underage children who have been separated from their father/mother or parents for a long period of time. At present, there are few studies on the emotional and behavioral problems of three- to five-year-old LBC in poor rural areas of China. In this study, random cluster sampling was used to recruit caregivers of left-behind children (CLBC) aged three to five years in two poor rural areas in Hunan Province. General demographic data of LBC and their caregivers were collected via face-to-face questionnaires. Children's emotional and behavioral problems were assessed by the Strength and Difficulties Questionnaire (SDQ). Among 557 LBC, the prevalence of a total difficulties score in an abnormal/borderline range was 27.6-50.6%. The most common problem of LBC was hyperactivity, with a rate of 33.6%. Compared with boys, girls had more emotional problems (p < 0.05) and fewer hyperactivity disorders (p < 0.01). Factors related to the emotional and behavioral problems of LBC were the LBC's age, the number of sick people at home, and the CLBC's willingness to take care of the LBC. The detection rate of emotional and behavioral problems of three- to five-year-old LBC in poor rural areas is higher than that of children of the same age in urban areas and Western developed countries. There were gender differences in hyperactivity and emotional symptoms. Poor care will increase the risk of children's emotional and behavioral abnormalities.

La hiperlaxitud articular como marcador de ansiedad en niños / Joint hypermobility is a marker for anxiety in children

Antecedentes: Se ha encontrado que el síndrome de hiperlaxitud articular (SHLA) está asociado a trastornos de ansiedad en poblaciones clínicas y no clínicas, aunque hasta la fecha ningún estudio ha evaluado esta asociación en niños. El objetivo principal de este estudio es evaluar el SHLA junto con la ansiedad, las medidas somáticas y conductuales en niños, para clarificar si el SHLA está asociado a cualquiera de estas variables en este rango de edad. Métodos: Se reclutó una muestra de 160 niños (74 chicas y 86 chicos) con edades comprendidas entre los 5 y los 17 años, procedentes de una clínica de salud mental de niños/adolescentes, para participar en el estudio. A todos los niños se les realizó una entrevista diagnóstica utilizando Mini International Neuropsychiatric Interview for Children and Adolescents. Los instrumentos utilizados incluyeron Child Behavior Checklist (CBCL), Screening Questionnaire to detect Hypermobility (SQ-CH) y Children Manifested Anxiety Scale (CMAS-R). Resultados: La prevalencia de SHLA en esta muestra fue del 22%, siendo significativamente alta en chicas (31%) en comparación con los chicos (14%) (χ2=6,83; p=0,001). El grupo SHLA obtuvo una puntuación considerablemente superior en la escala de ansiedad total CMAS-R (F=4,51; p=0,035), ansiedad fisiológica CMAS-R (F=7,19; p=0,008) y quejas somáticas CBCL (F=8,46; 0,004), y los análisis de regresión reflejaron que estas 3 variables eran factores predictivos de SHLA (χ2=36,77; p <0,001; r2=0,22). El grupo SHLA obtuvo también puntuaciones superiores en determinadas medidas conductuales. Conclusión: Los niños con SHLA tienen mayor frecuencia de trastornos de ansiedad y mayor intensidad de ansiedad fisiológica, quejas somáticas y, por tanto, podría utilizarse el SHLA como marcador para este fenotipo de ansiedad en los jóvenes

Background: Joint hypermobility syndrome (JHS) has been found to be associated with anxiety disorders in clinical and nonclinical populations, but to date no studies have evaluated this association in children. The main goal of this study is to evaluate JHS along with anxiety, somatic and behavioral measures in children to clarify if JHS is associated with any of these variables in this age range. Methods: A sample of 160 children (74 girls and 86 boys) ranging from 5 to 17 o were recruited from a Child-Adolescent Mental Health clinic to participate in the study. All children underwent a diagnostic interview using the Mini International Neuropsychiatric Interview for Children and Adolescents. Instruments used include the Child Behavior Checklist (CBCL), the Screening Questionnaire to detect Hypermobility (SQ-CH) and the Children Manifested Anxiety Scale (CMAS-R). Results: The prevalence of JHS in this sample was 22%, and this was significantly higher in girls (31%) than in boys (14%) (χ2=6.83; P=.001). The JHS group scored significantly higher in the CMAS-R total anxiety (F=4.51; P=.035), CMAS-R Physiological anxiety (F=7.19; P=.008) and the CBCL somatic complaints (F=8.46; 0.004) and regression analyses showed that these 3 variables were predictors of JHS (χ2=36.77; P<.001; r2=0.22). The JHS group also scored higher in some behavioral measures. Conclusion: Children with JHS have higher frequency of anxiety disorders and higher intensity of physiological anxiety, somatic complaints, and therefore, JHS might be used as marker for this anxiety phenotype in youngsters