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1 – 7 of 7Konstantinos Kontoangelos, Antonis Maillis, Maria Maltezou, Sofia Tsiori and Charalambos C. Papageorgiou
The 22q11.2 deletion syndrome (di George syndrome) is one of the most prevalent genetic disorders. The clinical features of the syndrome are distinct facial appearance…
Abstract
The 22q11.2 deletion syndrome (di George syndrome) is one of the most prevalent genetic disorders. The clinical features of the syndrome are distinct facial appearance, velopharyngeal insufficiency, conotruncal heart disease, parathyroid and immune dysfunction; however, little is known about possible neurodegenerative diseases. We describe the case of an 18-year old patient suffering from 22q11.2 deletion syndrome. Since adolescence, he presented with behavioral disorders, recommended treatment with 2 mg aloperidin and he presented cervical dystonia and emergence of torticollis and trunk dystonia. Antipsychotic medications either accelerate or reveal dys-tonic symptoms.
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Krister W. Fjermestad, Torun M. Vatne and Helene Gjone
22q11.2 deletion syndrome (22q11.2DS) is a rare genetic syndrome involving high risk of psychiatric disorders with average intellectual functioning in the lower borderline range…
Abstract
Purpose
22q11.2 deletion syndrome (22q11.2DS) is a rare genetic syndrome involving high risk of psychiatric disorders with average intellectual functioning in the lower borderline range. Due to the cognitive and social problems many adolescents with 22q11.2DS experience, adaptions may be needed to teach these adolescents cognitive behavioral therapy (CBT) skills. The purpose of this paper is to assess psychosocial functioning in adolescents with 22q11.2DS and to adapt CBT with this group.
Design/methodology/approach
Totally twelve adolescents (M age=14.5 years, SD=1.4, range 12-17 years; 25 percent boys) with 22q11.2DS were recruited from a competence center for rare disorders. Their parents completed the Child Behavior Checklist and the Kiddie SADS screening interview. The adolescents participated in 7×45-minute CBT group sessions, comprising emotional awareness, cognitive restructuring tasks, and problem-solving skills.
Findings
Adolescents had poor parent-reported social and school functioning at onset. The most frequent disorders indicated by screening interviews were attention deficit hyperactivity disorder (92 percent), anxiety (58 percent), depression (50 percent), autism spectrum disorders (50 percent), and potential post traumatic stress disorder (50 percent).
Practical implications
The main adaptions made to CBT groups were shorter sessions, frequent breaks, and repetition of main points, limited use of written materials and items that could distract participants (e.g. balloons, papers), extensive and explicit use of turn taking, and two adult group facilitators per group.
Originality/value
Offers practical advice on teaching CBT skills to adolescents with 22q11.2DS, which may also be applicable to other adolescents with lower borderline intellectual functioning or intellectual disabilities.
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Raja Mukherjee, Michael Layton, Evan Yacoub and Jeremy Turk
Associations between fetal alcohol syndrome (FAS) and other conditions have been reported, but the links between FAS and autistic spectrum disorders (ASD) remain unclear. This…
Abstract
Associations between fetal alcohol syndrome (FAS) and other conditions have been reported, but the links between FAS and autistic spectrum disorders (ASD) remain unclear. This study explored the relationship between FAS and ASD in individuals attending a specialist diagnostic clinic. Consecutive referrals over 24 months to a specialist neurodevelopmental clinic were evaluated using gold standard methods for FAS diagnosis and ASD. The first 18‐month cohort who met criteria for ASD were compared with controls attending the same clinic but who had not experienced prenatal alcohol exposure (nested data). Data for the whole group were also collected. Twenty‐one fetal alcohol spectrum disorder (FASD) individuals were assessed and 16 (72%) met ICD‐10 criteria for childhood autism. Further significant differences between the prenatally exposed and non‐exposed group with ASD were found in the nested study. The research shows an association between heavy prenatal alcohol exposure and ASD. As this is a small sample in a specialist clinic, the study suggests that a larger, more population‐based study of those exposed to heavy prenatal alcohol is warranted.
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Abstract
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There needs to be an increased recognition of fetal alcohol spectrum disorder (FASD) in services that deal with young people with disruptive and offending behavior, not just those…
Abstract
Purpose
There needs to be an increased recognition of fetal alcohol spectrum disorder (FASD) in services that deal with young people with disruptive and offending behavior, not just those services that deal with adolescents with a recognized intellectual disability. The paper aims to discuss these issues.
Design/methodology/approach
This is a general review of the current available evidence on FASD and how it is likely to predispose affected young people to have contact with secure mental health services and the criminal justice system.
Findings
FASD is likely to have become a more common cause of intellectual disability and behavioral disturbance but the history of significant alcohol exposure in utero if often missed. There is evidence that the hyperactivity is less responsive to psychotropic medication and may represent a different condition to conventional ADHD. However the majority of those affected are in the low normal IQ range.
Research limitations/implications
There is so far very limited research in what is likely to be a relatively common disorder with significant costs to criminal justice, mental healthcare and social services. Epidemiological information from the UK is lacking and urgently needed.
Practical implications
Professionals who work with mentally disordered young people need to be more aware of FASD and its potential contribution to the problems and disabilities in their population.
Social implications
Social workers, foster carers and adoptive parents need to be more aware of FASD and how it can contribute to the breakdown of social care.
Originality/value
There is currently no other review of FASD and the implications for criminal justice, secure mental health and social care for young people.
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Anastasios Galanopoulos, Dene Robertson and Emma Woodhouse
The purpose of this paper is to explore and highlight the main elements of an autism spectrum disorder assessment in adults. It features significant challenges for the clinical…
Abstract
Purpose
The purpose of this paper is to explore and highlight the main elements of an autism spectrum disorder assessment in adults. It features significant challenges for the clinical teams responsible to undertake the assessment. This paper aims to explain the importance of the wider needs assessment in accordance to the Autism Act and Autism Strategy.
Design/methodology/approach
The paper describes the main symptom domains for an ASD diagnosis, according to the two basic diagnostic manuals. It provides compendious summary of the available diagnostic tools and the significant comorbidities people with ASD present with including other neurodevelopmental disorders, mental or physical health problems, challenging behaviour and risk issues.
Findings
The paper proposes that all National Health System professionals should be able to recognise possible signs of ASD and accordingly refer individuals for a comprehensive assessment to secondary services. It highlights the importance of a wider needs assessment as part of a broader approach to addressing the needs of those with suspected ASD.
Practical implications
The paper aims to improve the gaps which remain in the referral and diagnostic process of people affected by ASD.
Social implications
Through a comprehensive assessment the paper aims to improve the educational, social and personal functioning of people with ASD as well as the quality of life of their parents and carers.
Originality/value
The paper assembles a wide range of relevant considerations in regards to potential ASD in one place, and can be used to inform a comprehensive understanding of the assessment/diagnosis process.
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Considerable confusion surrounds the overlapping of autism and schizophrenia. This has significant implications for clinicians given that correct diagnosis is critical for…
Abstract
Purpose
Considerable confusion surrounds the overlapping of autism and schizophrenia. This has significant implications for clinicians given that correct diagnosis is critical for treatment.
Design/methodology/approach
This paper sets out to clarify the position by reviewing the history and current status of the relationship between autism and schizophrenia. A general review was conducted using a chronological approach that focused on phenomenology, aetiology, genetic mechanisms and treatment.
Findings
Persons with autism are far more rigid, have difficulties set shifting and get far more upset and aggressive when their routines have changed. They have far more severe theory of mind and empathy deficits than those with schizophrenia.
Research limitations/implications
Future diagnostic refinement by means of molecular genetic studies will alter the diagnostic categories. Further studies of the conditions of autism and schizophrenia are therefore necessary.
Practical implications
Both conditions need treatment both clinically and practically.
Originality/value
This paper elucidates the relationship between autism and schizophrenia from a historical and current perspective. It emerges that this confusion is likely to be resolved by molecular genetic studies that will alter the diagnostic categories.
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