1.Increased behavioural problems associated with corticosteroid use in children with nephrotic syndrome: a Southeast Asian perspective.
Mohamad Nizam MAHMUD ; Azizah OTHMAN ; Mohamad Ikram ILIAS
Singapore medical journal 2023;64(9):557-562
INTRODUCTION:
The study was performed to determine the psychological problems in children with idiopathic nephrotic syndrome (INS) while they were on steroid therapy, as compared to healthy children.
METHODS:
This prospective cohort study was conducted in a paediatric clinic of a tertiary hospital. Parents of the participants in the INS group and control group (comprising children without chronic illness) completed questionnaires using the Child Behavioural Checklist (CBCL). The CBCL measures a range of age-specific emotional and psychological problems, including internalising and externalising domains. Analyses of the CBCL scores between groups were done using Mann-Whitney U test.
RESULTS:
A total of 140 children were recruited with an equal number in the INS and control groups. There was a significant difference in the mean total CBCL scores between the INS group and the control group, specifically in the withdrawal, somatic, anxious and aggressiveness subdomains. Similar findings were demonstrated in correlation between total psychological problems and corticosteroid dosage. In the INS group, steroid dose and cushingoid features were found to have a significant positive association with internalising psychological problems.
CONCLUSION
Children with INS on corticosteroid treatment showed an increase in internalising and externalising scores, as compared to healthy children.
Child
;
Humans
;
Child Behavior Disorders/psychology*
;
Nephrotic Syndrome/psychology*
;
Problem Behavior/psychology*
;
Prospective Studies
;
Southeast Asian People
;
Glucocorticoids/therapeutic use*
2.Analysis of genetic variants in a child with Intellectual developmental disorder with behavioral abnormalities and craniofacial dysmorphism without seizures.
Jiao TONG ; Tao WANG ; Leilei WANG ; Dongmei YAN
Chinese Journal of Medical Genetics 2023;40(12):1546-1550
OBJECTIVE:
To explore the clinical phenotype and genetic characteristics of a child with Intellectual developmental disorder with behavioral abnormalities and craniofacial malformations without epilepsy (IDDBCS).
METHODS:
A child who had visited the Lianyungang Maternal and Child Health Care Hospital in April 2021 was selected as the study subject. Clinical data of the child were collected. Genomic DNA was extracted from peripheral blood samples of the child and his parents and subjected to whole exome sequencing (WES). Candidate variants were verified by Sanger sequencing of his family members.
RESULTS:
The child, a 3-year-and-4-month-old male, had presented with global developmental delay and cranial malformation. Genetic testing revealed that he has harbored a heterozygous c.1703delA (p.K568Sfs9) variant of the PHF21A gene, for which both of his parents were of the wild type. This low-frequency variant may alter the structure and function of the protein product. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), it was classified as a pathogenic variant (PVS1+PS2+PM2_Supporting).
CONCLUSION
The heterozygous c.1703delA (p.K568Sfs9) variant of the PHF21A gene probably underlay the IDDBCS in this patient.
Child
;
Male
;
Humans
;
Infant
;
Developmental Disabilities/genetics*
;
Craniofacial Abnormalities/genetics*
;
Seizures/genetics*
;
Intellectual Disability/genetics*
;
Problem Behavior
;
Mutation
3.A review of research on psychological and behavioral problems in children with autism spectrum disorder during the coronavirus disease 2019 epidemic.
Hui-Fen LIU ; Wen-Yu SUN ; Qiang CHEN ; Bo-Yu CHEN ; Hong-Yan BI
Chinese Journal of Contemporary Pediatrics 2023;25(8):877-883
Since December 2019, coronavirus disease 2019 (COVID-19) has been rapidly spreading worldwide and affecting the physical and mental health of the general population. It may have even more serious potential harm to children with autism spectrum disorder (ASD). This paper provides a literature review on the psychological and behavioral problems experienced by children with ASD during the COVID-19 epidemic, as well as the factors influencing these issues. The findings of this review can serve as a basis for clinical research on ASD children.
Humans
;
Child
;
Problem Behavior
;
COVID-19
;
Autism Spectrum Disorder
;
Epidemics
4.The role of mother-child relationship in the association between maternal parenting stress and emotional and behavioral problems in preschool children.
Hai-Yan HE ; Min YU ; Man NING ; Xiao-Chen CUI ; Li-Yuan JIA ; Ruo-Yu LI ; Yu-Hui WAN
Chinese Journal of Contemporary Pediatrics 2023;25(4):394-400
OBJECTIVES:
To study the moderating effect of mother-child relationship in the association between maternal parenting stress and emotional and behavioral problems in preschool children, and to provide reference for the prevention and control of emotional and behavioral problems in preschool children.
METHODS:
Using a stratified cluster sampling method, 2 049 preschool children were surveyed from November to December 2021, who sampled from 12 kindergartens in Wuhu City, Anhui Province. The emotional and behavioral problems of preschool children were assessed with the Strength and Difficulties Questionnaire. Pearson correlation analysis was used to evaluate the relationship of maternal parenting stress and mother-child relationship with children's emotional and behavioral problems. The PROCESS Macro was used to analyze the moderating effect of conflicted and dependent mother-child relationships in the association between maternal parenting stress and emotional and behavioral problems in these preschool children.
RESULTS:
Among these preschool children, maternal parenting stress was positively correlated with the scores of emotional symptoms, conduct problems, hyperactivity, and peer problems subscales and total difficulty scores (P<0.001); intimate mother-child relationships were negatively correlated with the scores of conduct problems, hyperactivity, and peer problems subscales and total difficulty scores (P<0.001); conflicted and dependent mother-child relationships were positively correlated with the scores of emotional symptoms, conduct problems, hyperactivity, and peer problems subscales and total difficulty scores (P<0.001). After controlling for relevant confounding factors, conflicted mother-child relationship (β=0.05, P=0.001) and dependent mother-child relationship (β=0.04, P=0.012) were found to have a moderating effect on the association between maternal parenting stress and total difficulty scores in these preschool children.
CONCLUSIONS
Negative mother-child relationships play a moderating role in the association between maternal parenting stress and emotional and behavioral problems in preschool children. Prevention of emotional and behavioral problems in preschool children should focus on reducing maternal parenting stress and improving negative mother-child relationships.
Humans
;
Child, Preschool
;
Female
;
Problem Behavior/psychology*
;
Parenting/psychology*
;
Emotions
;
Mother-Child Relations
;
Surveys and Questionnaires
;
Mothers/psychology*
5.Influence of sleep fragmentation in infancy and toddler period on emotional and behavioral problem at the age of 6 years: a birth cohort study.
Yu Jiao DENG ; Yi Ding GUI ; Jian Fei LIN ; Qing Min LIN ; Guang Hai WANG ; Yan Rui JIANG ; Qi ZHU ; Yu ZHANG ; Fan JIANG
Chinese Journal of Pediatrics 2023;61(5):418-424
Objective: To investigate the influence of sleep fragmentation in infancy and toddler period on emotional and behavioral problems at the age of 6 years. Methods: Using a prospective cohort design, 262 children were extracted from mother-child birth cohort recruited from May 2012 to July 2013 in Renji Hospital, School of Medicine, Shanghai Jiao Tong University. Children's sleep and physical activities were assessed using actigraphy at 6, 12, 18, 24, and 36 months of age, from which the sleep fragmentation index (FI) at each follow-up point was calculated. Children's emotional and behavioral problems at 6 years of age were assessed using the strengths and difficulties questionnaire. Group-based trajectory model was applied to determine sleep FI in infancy and toddler period trajectory groups with Bayesian information criteria being used to determine the best fitting model. Children's emotional and behavioral problems between groups were examined with independent t test and linear regression models, etc. Results: A total of 177 children, with 91 boys and 86 girls, were included in the final analysis and were divided into 2 groups: high FI group (n=30) and low FI group (n=147). Compared with children in the low FI group, those in the high FI group presents with higher total difficulties score and higher hyperactivity or inattention score ((11.0±4.9) vs. (8.9±4.1), (4.9±2.7) vs. (3.7±2.3) scores, t=2.17, 2.23, both P<0.05, respectively), with the differences remaining significant after adjusting for covariates (t=2.08, 2.09, both P<0.05 respectively). Conclusion: High sleep fragmentation in infancy and toddler period is associated with more emotional and behavioral problems, especially hyperactivity or inattention problems, at 6 years of age.
Male
;
Female
;
Humans
;
Infant
;
Child, Preschool
;
Child
;
Cohort Studies
;
Problem Behavior/psychology*
;
Sleep Deprivation
;
Prospective Studies
;
Bayes Theorem
;
China
;
Surveys and Questionnaires
6.Maternal mobile phone screen time during pregnancy and children's internalizing and externalizing behavioral problems.
Han LI ; Juan TONG ; Fang Biao TAO
Chinese Journal of Preventive Medicine 2023;57(12):2196-2200
The behavioral problems of children and adolescents are becoming more and more serious, and the prevalence rate is increasing year by year. The overall trend is increasing, which has become one of the important public health issues of global concern. There are many influencing factors for behavioral problems in children and adolescents, including genetic, psychosocial, family and early life environment. Among them, maternal screen exposure during pregnancy is a contributing factor that deserves attention and has practical intervention significance. This study systematically evaluated the association between maternal mobile phone screen time during pregnancy and children's internalizing and externalizing behavioral problems, its potential biological mechanisms and relevant intervention measures, in order to create a good intrauterine environment for fetal neurodevelopment and further reduce the occurrence of children's behavioral problems.
Adolescent
;
Child
;
Female
;
Pregnancy
;
Humans
;
Problem Behavior
;
Screen Time
;
Cell Phone
;
Family
;
Maternal Exposure
7.Maternal mobile phone screen time during pregnancy and children's internalizing and externalizing behavioral problems.
Han LI ; Juan TONG ; Fang Biao TAO
Chinese Journal of Preventive Medicine 2023;57(12):2196-2200
The behavioral problems of children and adolescents are becoming more and more serious, and the prevalence rate is increasing year by year. The overall trend is increasing, which has become one of the important public health issues of global concern. There are many influencing factors for behavioral problems in children and adolescents, including genetic, psychosocial, family and early life environment. Among them, maternal screen exposure during pregnancy is a contributing factor that deserves attention and has practical intervention significance. This study systematically evaluated the association between maternal mobile phone screen time during pregnancy and children's internalizing and externalizing behavioral problems, its potential biological mechanisms and relevant intervention measures, in order to create a good intrauterine environment for fetal neurodevelopment and further reduce the occurrence of children's behavioral problems.
Adolescent
;
Child
;
Female
;
Pregnancy
;
Humans
;
Problem Behavior
;
Screen Time
;
Cell Phone
;
Family
;
Maternal Exposure
8.Psychological and behavioral problems in children and adolescents during the coronavirus disease 2019 epidemic: a Scoping review.
Jin-Cao ZHI ; Fei PEI ; Shi-Wen ZHANG ; Mei-Ling HUANG ; Ming-Yue ZHAO ; Yan WANG
Chinese Journal of Contemporary Pediatrics 2022;24(7):728-735
OBJECTIVES:
To investigate the psychological and behavioral problems and related influencing factors in children and adolescents during the coronavirus disease 2019 (COVID-19) epidemic.
METHODS:
China National Knowledge Infrastructure, Wanfang Data, PubMed, and Web of Science were searched using the method of subject search for articles published up to March 31, 2022, and related data were extracted for Scoping review.
RESULTS:
A total of 3 951 articles were retrieved, and 35 articles from 12 countries were finally included. Most of the articles were from the journals related to pediatrics, psychiatry, psychology, and epidemiology, and cross-sectional survey was the most commonly used research method. Psychological and behavioral problems in children and adolescents mainly included depression/anxiety/stress, sleep disorder, internet behavior problems, traumatic stress disorder, and self-injury/suicide. Influencing factors were analyzed from the three aspects of socio-demographic characteristics, changes in living habits, and ways of coping with COVID-19.
CONCLUSIONS
During the COVID-19 epidemic, the psychological and behavioral problems of children and adolescents in China and overseas are severe. In the future, further investigation and research can be carried out based on relevant influencing factors to improve the psychological and behavioral problems.
Adolescent
;
Anxiety/etiology*
;
COVID-19
;
Child
;
China/epidemiology*
;
Cross-Sectional Studies
;
Depression/epidemiology*
;
Humans
;
Mental Health
;
Problem Behavior
9.Association of MTHFR gene C677T polymorphism with problem behavior and inheritance pattern among children with autism.
Shihao XU ; Shuang MEN ; Xulong WANG ; Fangfang ZHAN ; Xiangdong YUAN
Chinese Journal of Medical Genetics 2022;39(8):898-902
OBJECTIVE:
To assess the association of C677T polymorphism of methylenetetrahydrofolate reductase (MTHFR) gene with autistic behavior and inheritance pattern of children patients.
METHODS:
Ninety three autism patients were selected as the study group, whilst 93 healthy children were selected as the control group. The C677T genotype of the MTHFR gene was determined, and the correlation between the genotype and the autistic behavior and inheritance pattern were investigated.
RESULTS:
MTHFR gene C677T locus revealed three genotypes CC, CT and TT. Compared with the control group, the study group had fewer CC genotype but more TT genotype (P<0.05). Individuals with the three genotypes showed a statistically significant difference in the frequencies of four problem behaviors (P<0.05). Regression analysis showed that at least one T allele encoding the degree of 1 and 2 for the 4 problem behaviors that were statistically different. MTHFR gene C677T genotype was associated with autism under the recessive inheritance model and allelic inheritance model (P<0.05).
CONCLUSION
The C677T polymorphism of the MTHFR gene is associated with autistic behaviors. Children with the TT genotype or T allele are at higher risk of developing autism, particularly direct gaze, complex limb movements, self-injurious behavior and hyperactivity 1 and 2 related with the degree of coding.
Autistic Disorder/genetics*
;
Child
;
Genetic Predisposition to Disease
;
Genotype
;
Humans
;
Inheritance Patterns
;
Methylenetetrahydrofolate Reductase (NADPH2)/genetics*
;
Problem Behavior
10.Early childhood screen time as a predictor of emotional and behavioral problems in children at 4 years: a birth cohort study in China.
Wenwen LIU ; Xiaoyan WU ; Kun HUANG ; Shuangqin YAN ; Liya MA ; Hui CAO ; Hong GAN ; Fangbiao TAO
Environmental Health and Preventive Medicine 2021;26(1):3-3
BACKGROUND:
Previous studies have suggested that screen time (ST) has a negative effect on children's emotional and behavioral health, but there are few longitudinal studies that have been conducted with infants and toddlers. This study sought to examine the effect of ST in early childhood on emotional and behavioral problems in children aged 4 years, based on a birth cohort study in China.
METHODS:
A total of 2492 children aged 4 years were enrolled in this study. The parents and guardians of each child completed a questionnaire that included items eliciting information on children's birth information, socio-demographic information at baseline, and ST at each follow-up. Emotional and behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) at 4 years of age. Multivariate logistic analysis was used to explore the effects of ST on emotional and behavioral problems.
RESULTS:
The percentages of children with ST > 0 h/day at age 0.5 years, ST > 2 h/day at age 2.5 years, and ST > 2 h/day at age 4 years were 45.7, 55.5, and 34.5% respectively. The prevalence of emotional and behavioral problems was 10.8%. ST at 6 months was a risk factor for emotional symptoms and hyperactivity at the age of 4 years. ST at age 2.5 years was a risk factor for hyperactivity at the age of 4 years. However, ST at age 4 years was a risk factor for total difficulties, conduct problems, peer problems, hyperactivity, and prosocial behavior.
CONCLUSIONS
Higher ST exposure at early childhood is associated with later emotional and behavioral problems. In particular, sustained high ST exposure is a risk factor for behavioral problems. These findings suggested the importance of controlling ST to prevent the occurrence of emotional and behavioral problems in the early years.
Altruism
;
Child, Preschool
;
China/epidemiology*
;
Cohort Studies
;
Emotions
;
Female
;
Humans
;
Male
;
Prevalence
;
Problem Behavior/psychology*
;
Psychomotor Agitation/psychology*
;
Screen Time

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