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Continuity of health anxiety from childhood to adolescence and associated healthcare costs: a prospective population-based cohort study / Martin K. RIMVALL in Journal of Child Psychology and Psychiatry, 62-4 (April 2021)
[article]
Titre : Continuity of health anxiety from childhood to adolescence and associated healthcare costs: a prospective population-based cohort study Type de document : Texte imprimé et/ou numérique Auteurs : Martin K. RIMVALL, Auteur ; Pia JEPPESEN, Auteur ; Anne Mette SKOVGAARD, Auteur ; Frank VERHULST, Auteur ; Else Marie OLSEN, Auteur ; Charlotte Ulrikka RASK, Auteur Article en page(s) : p.441-448 Langues : Anglais (eng) Mots-clés : Health anxiety childhood and adolescence healthcare costs longitudinal cohort Index. décimale : PER Périodiques Résumé : BACKGROUND: Severe health anxiety (HA) is characterized by excessive and impairing worry and preoccupation with health issues and can cause increased and unnecessary medical examinations. HA in childhood and adolescence is scarcely explored, hindering the potential for prevention and early intervention. METHODS: HA was assessed in 1,278 children/youths at two time points at ages 11 and 16 years in a general population-based birth cohort. Register-based data on costs related to nonhospital-based primary and secondary somatic health services were obtained over the follow-up period. The presence of functional somatic symptoms, emotional disorders and chronic somatic illness at baseline were included as covariates. RESULTS: High HA (top 10% score) at age 11 predicted high HA at age 16 (relative risk [RR] 2.03, 95% CI: 1.26-3.31). The group with persistent HA was small (n = 17, 1.3%), resulting in broad confidence intervals. The statistical effect of HA at age 11 on HA at age 16 was heavily reduced after adjustment for sex and all covariates (RR: 1.49, 95% CI: 0.85-2.60). In the adjusted model, somatic illness at age 11 (RR: 1.91, 95% CI: 1.22-2.98) and female sex (RR: 3.33, 95% CI: 2.01-5.50) were independently associated with HA at age 16. Persistent HA was associated with approximately doubled healthcare costs compared to the group with consistently low HA. Incident HA at age 16 was associated with increased costs over follow-up. The increased costs were not explained by chronic somatic illness. CONCLUSIONS: A small subgroup of children had persistent high levels of HA from late childhood to adolescence and displayed increased healthcare costs. Female sex and chronic somatic disorders at age 11 were independent risk factors of HA at age 16. These findings provide potential means of early identification and of therapeutic levers. Further intervention development and evaluation are needed. En ligne : http://dx.doi.org/10.1111/jcpp.13286 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=445
in Journal of Child Psychology and Psychiatry > 62-4 (April 2021) . - p.441-448[article] Continuity of health anxiety from childhood to adolescence and associated healthcare costs: a prospective population-based cohort study [Texte imprimé et/ou numérique] / Martin K. RIMVALL, Auteur ; Pia JEPPESEN, Auteur ; Anne Mette SKOVGAARD, Auteur ; Frank VERHULST, Auteur ; Else Marie OLSEN, Auteur ; Charlotte Ulrikka RASK, Auteur . - p.441-448.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 62-4 (April 2021) . - p.441-448
Mots-clés : Health anxiety childhood and adolescence healthcare costs longitudinal cohort Index. décimale : PER Périodiques Résumé : BACKGROUND: Severe health anxiety (HA) is characterized by excessive and impairing worry and preoccupation with health issues and can cause increased and unnecessary medical examinations. HA in childhood and adolescence is scarcely explored, hindering the potential for prevention and early intervention. METHODS: HA was assessed in 1,278 children/youths at two time points at ages 11 and 16 years in a general population-based birth cohort. Register-based data on costs related to nonhospital-based primary and secondary somatic health services were obtained over the follow-up period. The presence of functional somatic symptoms, emotional disorders and chronic somatic illness at baseline were included as covariates. RESULTS: High HA (top 10% score) at age 11 predicted high HA at age 16 (relative risk [RR] 2.03, 95% CI: 1.26-3.31). The group with persistent HA was small (n = 17, 1.3%), resulting in broad confidence intervals. The statistical effect of HA at age 11 on HA at age 16 was heavily reduced after adjustment for sex and all covariates (RR: 1.49, 95% CI: 0.85-2.60). In the adjusted model, somatic illness at age 11 (RR: 1.91, 95% CI: 1.22-2.98) and female sex (RR: 3.33, 95% CI: 2.01-5.50) were independently associated with HA at age 16. Persistent HA was associated with approximately doubled healthcare costs compared to the group with consistently low HA. Incident HA at age 16 was associated with increased costs over follow-up. The increased costs were not explained by chronic somatic illness. CONCLUSIONS: A small subgroup of children had persistent high levels of HA from late childhood to adolescence and displayed increased healthcare costs. Female sex and chronic somatic disorders at age 11 were independent risk factors of HA at age 16. These findings provide potential means of early identification and of therapeutic levers. Further intervention development and evaluation are needed. En ligne : http://dx.doi.org/10.1111/jcpp.13286 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=445 Glutamatergic agents in Autism Spectrum Disorders: Current trends / Roberto CANITANO in Research in Autism Spectrum Disorders, 8-3 (March 2014)
[article]
Titre : Glutamatergic agents in Autism Spectrum Disorders: Current trends Type de document : Texte imprimé et/ou numérique Auteurs : Roberto CANITANO, Auteur ; Valeria SCANDURRA, Auteur Article en page(s) : p.255-265 Langues : Anglais (eng) Mots-clés : Glutamate Autism Spectrum Disorders Novel treatments Childhood and adolescence Index. décimale : PER Périodiques Résumé : Abstract Glutamate transmission dysfunction has been found in various preclinical models of Autism Spectrum Disorders (ASD), thus the glutamate system is a target for therapeutics. This report reviews current treatments for glutamate dysfunction in ASD models and clinical trials. Antagonists of metabotropic glutamate receptor subtype 5 (mGluR5) have been tested in preclinical models of autism. Black and Tan Bachyuric (BTBR) mice model behavioral phenotypes of the three core diagnostic domains of autism, e.g. social deficits, impaired language and communication, and repetitive behaviors. A significant reduction in repetitive self-grooming was observed after mGluR5 antagonist administration in BTBR mice. SHANK 3 deficient mice which have altered synaptic transmission and plasticity, were administered IGF-1 treatment to reverse these deficits based on the hypothesis that reduced AMPA receptor levels reflect less mature synapses. Clinical trials have been carried out in ASD with glutamate NMDA receptors, but current findings are not sufficient for conclusions on safety and efficacy. Memantine is an NMDA antagonist under investigation in controlled trials that hopefully will provide new insight on its use in autism. Studies using novel treatments with other glutamatergic agents are also underway and encouraging results have been observed with N-acetylcysteine in treating irritability in ASD. En ligne : http://dx.doi.org/10.1016/j.rasd.2013.12.009 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=224
in Research in Autism Spectrum Disorders > 8-3 (March 2014) . - p.255-265[article] Glutamatergic agents in Autism Spectrum Disorders: Current trends [Texte imprimé et/ou numérique] / Roberto CANITANO, Auteur ; Valeria SCANDURRA, Auteur . - p.255-265.
Langues : Anglais (eng)
in Research in Autism Spectrum Disorders > 8-3 (March 2014) . - p.255-265
Mots-clés : Glutamate Autism Spectrum Disorders Novel treatments Childhood and adolescence Index. décimale : PER Périodiques Résumé : Abstract Glutamate transmission dysfunction has been found in various preclinical models of Autism Spectrum Disorders (ASD), thus the glutamate system is a target for therapeutics. This report reviews current treatments for glutamate dysfunction in ASD models and clinical trials. Antagonists of metabotropic glutamate receptor subtype 5 (mGluR5) have been tested in preclinical models of autism. Black and Tan Bachyuric (BTBR) mice model behavioral phenotypes of the three core diagnostic domains of autism, e.g. social deficits, impaired language and communication, and repetitive behaviors. A significant reduction in repetitive self-grooming was observed after mGluR5 antagonist administration in BTBR mice. SHANK 3 deficient mice which have altered synaptic transmission and plasticity, were administered IGF-1 treatment to reverse these deficits based on the hypothesis that reduced AMPA receptor levels reflect less mature synapses. Clinical trials have been carried out in ASD with glutamate NMDA receptors, but current findings are not sufficient for conclusions on safety and efficacy. Memantine is an NMDA antagonist under investigation in controlled trials that hopefully will provide new insight on its use in autism. Studies using novel treatments with other glutamatergic agents are also underway and encouraging results have been observed with N-acetylcysteine in treating irritability in ASD. En ligne : http://dx.doi.org/10.1016/j.rasd.2013.12.009 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=224