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OBJECTIVES: Model configuration is important for mental health data harmonization. We provide a method to investigate the performance of different bifactor model configurations to harmonize different instruments. METHODS: We used data from six samples from the Reproducible Brain Charts initiative (N = 8,606, ages 5-22 years, 41.0% females). We harmonized items from two psychopathology instruments, Child Behavior Checklist (CBCL) and GOASSESS, based on semantic content. We estimated bifactor models using confirmatory factor analysis, and calculated their model fit, factor reliability, between-instrument invariance, and authenticity (i.e., the correlation and factor score difference between the harmonized and original models). RESULTS: Five out of 12 model configurations presented acceptable fit and were instrument-invariant. Correlations between the harmonized factor scores and the original full-item models were high for the p-factor (>0.89) and small to moderate (0.12-0.81) for the specific factors. 6.3%-50.9% of participants presented factor score differences between harmonized and original models higher than 0.5 z-score. CONCLUSIONS: The CBCL-GOASSESS harmonization indicates that few models provide reliable specific factors and are instrument-invariant. Moreover, authenticity was high for the p-factor and moderate for specific factors. Future studies can use this framework to examine the impact of harmonizing instruments in psychiatric research.

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RESUMO O Transtorno do Espectro Autista (TEA) tem início precoce e é caracterizado predominantemente por prejuízos persistentes na comunicação social recíproca/interação social e por padrões restritos e repetitivos de comportamento, interesses ou atividades. Pesquisas apontam que indivíduos com TEA apresentam altas taxas de problemas emocionais e de comportamento. O objetivo do presente estudo é avaliar os aspectos emocionais e comportamentais através do Child Behavior Checklist (CBCL) em crianças que preencheram critérios para o diagnóstico de TEA. Trata-se de um estudo descritivo, quantitativo e retrospectivo. No CBCL/1½-5, contatou-se que a escala Problemas do Espectro Autista apresentou escore clínico. Quanto ao CBCL/6-18, as escalas Retraimento, Problemas de Pensamento, Problemas de Atenção e Problemas de Estresse (DSM) apresentaram sintomatologia clínica. Os achados desse estudo estão de acordo com outras pesquisas da área. Os resultados do presente estudo sugerem que o CBCL é útil para a identificação de sinais de alerta de TEA.

ABSTRACT Autism Spectrum Disorder (ASD) is a neurodevelopment disorder characterized by impairments in social interaction/communication and stereotyped behavior. The literature suggests that individuals with ASD often presents emotional and behavioral problems. The aim of this study was to examine emotional and behavioral aspects in patients who have been diagnosed with ASD after a psychological evaluation. The tool used for investigation was the Child Behavior Checklist (CBCL), in both versions (1½-5 and 6-18). This is a quantitative, descriptive and retrospective study. The CBCL/1½-5 profiles showed elevated scores in Withdrawn, Internalizing Problems and Autism Spectrum Problems scales. The CBCL/6-18 showed clinical scores for Withdrawn/Depressed, Thougt Problems, Attention Problems And Stress Problems. The pattern of elevations found in this study is consistent with prior studies. Although CBCL is not a diagnostic tool, it can be considered an useful instrument for detecting alarm signs of ASD.

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We aimed to verify the influence of intrinsic and extrinsic cell apoptotic pathways on the inhibition of cellular apoptosis in patients with tropical spastic paralysis/myelopathy related to human T cell lymphotropic virus type 1. The databases accessed were PubMed, Scopus, Science Direct, and Web of Science. Neither the time of publishing nor the language of the articles was limited. The descriptors used for this systematic literature review were: Tropical Paraparesis, Proto-Oncogenic Protein C, Bcl-2, Bcl-X Protein, Bax protein, Fas ligand (FasL) protein, Fas receptor, TNF-related apoptosis-inducing ligand and Fas-associated protein with death domain (FADD)-like apoptosis regulating. The search resulted in 546 articles from which 9 articles were selected for analysis; ranging from serum levels of Bcl-2, Fas and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) measured by enzyme-linked immunosorbent assay and the levels of cellular expression of Bcl-2 and Bcl-xL the TCD4+ lymphocytes accessed by western blot. Most studies accessed either gene expression or polymorphism of Fas, FasL, and TRAIL in patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), whereas one study used flow cytometry and fluorescence to determine Fas expression. Increased Bcl-xL expression inhibited T lymphocyte apoptosis, whereas Bcl-2, serum levels, and cellular expression did not influence T lymphocyte apoptosis and serum levels of Fas were significantly higher and associated with markers of leukocyte activation in patients with HAM/TSP. In addition, Fas polymorphism (FAS-670AA) was associated with higher proviral load. There is a need for additional research on this issue since the number of patients was small and the studies presented higher heterogeneity.

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The prevalence of attention-deficit/hyperactivity disorder (ADHD) symptoms has been scarcely studied in indigenous cultures that preserve ancestral cultural characteristics. The objective of the study is to estimate the prevalence of suggestive diagnosis of ADHD among indigenous children and adolescents from villages in the Amazon. This is an analytical cross-sectional study using instruments to track ADHD symptoms (the Child Behaviour Checklist for ages 6-18: CBCL/6-18 and the teacher report form for ages 6-18: TRF/6-18) and to investigate their negative impact on the patients (using the Strengths and Difficulties Questionnaire-SDQ). The prevalence of a suggestive ADHD diagnosis according to the CBCL/TRF DSM-IV ADHD subscale without and with negative impact as assessed by the SDQ was 4.3% and 1.1%, respectively. Comorbid oppositional-defiant, conduct problems and anxious symptoms were present in all cases screening positive for ADHD. We also presented a case report as an illustration of the observed clinical presentation. ADHD is a recognizable disorder even in a culture that preserves millennial characteristics. Furthermore, the presence of ADHD symptoms was associated with significant impairment.

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OBJECTIVE: To evaluate the utility of assessing subsyndromal symptoms of major depressive disorder in childhood, indexed through the Child Behavior Checklist (CBCL) anxiety/depression scale, in predicting risk of developing major depressive disorder in adolescent and young adult years. STUDY DESIGN: The sample consisted of 537 children, 6-17 years of age, originally ascertained for a longitudinal family genetic study of youth with and without attention-deficit hyperactivity disorder and their first-degree relatives who were followed prospectively and blindly for 10 years from childhood into young adult years. Children with full diagnosis major depressive disorder at baseline were excluded. For analysis, the sample was stratified into 4 groups based on the presence or absence of parental mood disorders and by the presence or absence of subsyndromal scores on the CBCL anxiety/depression scale at baseline assessment in childhood. RESULTS: Children of parents with mood disorders plus subsyndromal scores on the CBCL anxiety/depression scale at baseline (n = 22) had the highest risk for developing major depressive disorder and anxiety disorders at the 10-year follow-up when compared with the other groups. Children with either subsyndromal scores on the CBCL anxiety/depression scale at baseline alone (n = 22) or parental mood disorders alone (n = 172) had intermediate outcomes. CONCLUSION: The CBCL anxiety/depression scale was useful in identifying children at high risk for the development of major depressive disorder and anxiety disorders at the 10-year prospective follow-up. Furthermore, our results emphasized the importance of familial psychiatric history in youth with subthreshold symptoms of depression. Parental mood disorder and subthreshold anxiety/depressive symptoms were predictive of developing depression.

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Resumen Introducción: La salud mental del cuidador influye en el desarrollo de los niños; sin embargo, desconocemos si existe una asociación entre síntomas depresivos del cuidador y problemas conductuales en preescolares chilenos. El objetivo fue analizar la asociación entre los síntomas depresivos del cuidador principal y la presencia de problemas conductuales en preescolares usuarios de la red pública de salud chilena. Método: Estudio transversal. Muestreo por conglomerados estratificados bietápico. Muestra de 1.377 preescolares de 2,5-4 años y sus cuidadores principales. Con consentimiento informado se aplicó encuesta sociodemográfica y Child Behavior Checklist 1½-5. Los síntomas depresivos del cuidador se evaluaron mediante Entrevista Diagnóstica Internacional Compuesta abreviada. Resultados: Edad promedio del preescolar 40,95 ± 4,6 meses, 51,3% varones. 97,5% fueron cuidadoras mujeres, edad promedio 31,6 ± 10,2 años y escolaridad 9,5 años. Se encontró problemas conductuales de rango clínico en las tres escalas: total de problemas conductuales 21,4%, conductas internalizantes 23,1% y externalizantes 16,4%. Se encontró sintomatologia depresiva en 9,1% de los cuidadores, la que aumenta a 14,5,% y 16,1% en cuidadores de preescolares con conductas internalizantes y externalizantes respectivamente. En el análisis de regresión logística multinomial ajustando por variables confundentes, la asociación bivariada con los problemas conductuales internalizantes desaparece, sin embargo, se mantiene para el total de problemas conductuales y conductas externalizantes. Conclusiones: La asociación entre síntomas depresivos del cuidador y problemas conductuales en preescolares chilenos es consistente y modulada por otras variables médicas y psicosociales, esto sugiere la importancia de la identificación, prevención e intervención temprana de la díada y su entorno.

Introduction: The mental health of the caregiver influences the development of children; however we do not know if there is an association between depressive symptoms of the caregiver and behavioral problems in Chilean preschoolers. The objective was to analyze the association between primary caregiver depressive symptoms and behavioral problems in preschoolers users of the Chilean public health network. Method: Cross-sectional study. Two-stage stratified cluster sampling. Sample 1377 preschool children 2,5-4 years old and their primary caregivers. In order to assess child behavior, a sociodemographic survey and Child Behavior Checklist ½-5 we applied to each caregiver, under informed consent. Caregiver depressive symptoms were assessed using the International Diagnostic Composite Interview Short Form. Results: Preschool age was 40.95 ± 4.6 months, 51.3% were boys. 97.5% of caregivers were female, (ages 31.6 ± 10.2 yr, average schooling 9.5 years). Behavioral problems of clinical rank were found in the three scales: total behavioral problems 21.4%, internalizing 23.1%, and externalizing behaviors 16.4%. 9.1% of caregivers experienced depressive symptomatology. In preschool children with internalizing behavioral, caregivers showed depressive symptoms in 14,5% of cases, and 16,1% in those with an externalizing behavioral. In multinomial logistic regression analysis adjusted for confounding variables, bivariate association for internalizing behavioral problems was lost, but persisted for total behavioral problems and for externalizing behavioral. Conclusions: The association between caregiver's depressive symptoms and behavioral problems in Chilean preschool children is consistent and modulated by other medical and psychosocial variables, suggesting the importance of identification, prevention and early intervention of the dyad and their environment.

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Serotonin 2C receptors (5HT2C) are involved in serotonin-driven dynamic equilibrium adjustments responsible for homeostatic stability in brain structures that modulate behavior and emotions. Single nucleotide polymorphisms (SNPs) from the serotonin 2C receptor gene (HTR2C) have been associated with several neurological and mental disorders, including abnormalities in cognitive and emotional processes. The aim of this study was to evaluate the association between the rs6318 SNP of the HTR2C gene and behavioral characteristics exhibited by children and adolescents based on the Child Behavior Checklist (CBCL/6-18) inventory. Eighty-five psychiatric outpatients between 8 and 18 years of age underwent genotyping of the rs6318 SNP. The CBCL/6-18 scale was administered to their caregivers. The chi-squared test was used to assess differences in the frequency of C and G alleles of the rs6318 SNP relative to the grouped CBCL/6-18 scores; significance level was 5%. The presence of the G allele of rs6318 was found to be associated with characteristics of aggressive behavior and social problems, and aggressive behavior was found to be associated with heterozygosis in females. These findings contribute to the identification of mental and behavioral phenotypes associated with gene expression.

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RESUMO Objetivo Correlacionar o sono e o comportamento em indivíduos com transtorno específico da aprendizagem. Método Na análise do sono, foram utilizados o Questionário de Hábitos Gerais de Sono, o Diário de Sono e a Escala de Distúrbios do Sono em Crianças (EDSC) e, para análise do comportamento, foi utilizado o Child Behavior Checklist (CBCL). Resultados 65,5% dos indivíduos com transtorno específico de aprendizagem apresentaram indicativo de distúrbios de sono, sendo os mais frequentes os distúrbios de transição sono-vigília e escores totais para distúrbios de sono acima do aceitável. Além disso, os indivíduos com transtorno específico de aprendizagem apresentaram maior latência de sono que o respectivo grupo controle. Quanto ao comportamento, 72,4% dos indivíduos com transtorno específico de aprendizagem apresentaram quadro clínico de problemas comportamentais. No grupo controle, nenhum dos participantes apresentou indicativo de problemas de sono ou comportamento. No grupo transtorno específico de aprendizagem, os distúrbios de sono encontrados apresentaram correlação com os problemas comportamentais. Conclusão Indivíduos com transtorno específico da aprendizagem apresentaram altos índices de distúrbios de sono e alterações comportamentais. Quanto piores os distúrbios de sono, piores foram os aspectos comportamentais dos indivíduos com transtorno específico da aprendizagem.

ABSTRACT Purpose This study aimed to correlate sleep profile and behavior in individuals with Specific Learning Disorder (SLD). Methods The Sleep General Habits Questionnaire, Sleep Diary, and Sleep Disturbance Scale for Children (SDSC) were used in analysis of sleep, whereas the Child Behavior Checklist (CBCL) inventory was used in analysis of behavior. Results 65.5% of the individuals with SLD presented symptoms of sleep disorders, most frequently wakefulness-sleep transition and sleep disturbance total score, which showed values higher than acceptable. In addition, individuals with SLD presented higher sleep latency than those with typical development. Concerning behavior, 72.4% of the individuals with SLD presented clinical condition of behavior problems. In the control group, none of the participants showed symptoms of sleep or behavior problems. In the SLD group, correlation was observed between behavioral problems and sleep disturbance. Conclusion Individuals with SLD showed high rates of sleep disturbance and behavioral problems. The worse the sleep disturbance, the worse the behavioral aspects in these individuals.

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High-grade B-cell lymphomas with rearrangement of MYC, BCL-2 and/or BCL-6 were introduced by the update of the WHO classification of lymphoid neoplasms. They usually present unique morphological and molecular characteristics, with an aggressive clinical outcome and worse prognosis. We report a 48 year-old female patient presenting with B symptoms and enlarged lymph nodes. Blood count showed pancytopenia and peripheral blood smears showed large lymphoid cells, some with nuclei and vacuoles. LDH was 3524 g/L and serum calcium was 11.5 mg/dL. Flow cytometry immunophenotyping showed pathological mature B lymphocytes. Protein electrophoresis showed a slight monoclonal peak. The biopsy disclosed a triple expressor diffuse large B-cell lymphoma, arising from germinal center. FISH was positive for MYC, BCL-2 and BCL-6 (triple hit) with a clonal evolution. Conventional cytogenetics showed a complex karyotype. Chemotherapy was started with R-CHOP (Rituximab/cyclophosphamide/doxorubicin/vincristine/prednisone). She developed impaired consciousness; the brain CT scan showed a large brain mass. The patient died within 3 weeks.

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INTRODUCTION: Acquired brain injury (ABI) during childhood typically causes behavior problems in the child and high levels of stress in the family. The aims of this study are: (1) to investigate the effectiveness and feasibility of a parenting intervention in improving behavior and self-regulation in Mexican children with ABI compared to telephone support; (2) to investigate the effectiveness and feasibility of a parenting intervention in improving parenting skills, parent self-efficacy and decreasing parental stress in parents of children with ABI compared to telephone support. Our secondary aims are (1) to explore the impact that parent characteristics have on the intervention outcomes; (2) to investigate if changes are maintained 3 months after the intervention. METHODS: The research design is a blind randomized controlled trial (RCT). Eligible participants include children with a diagnosis of ABI, between 6 and 12 years of age, and their parents. Sixty-six children and their parents will be randomly allocated to either a parenting program group or telephone support group. The parenting program involves six face-to-face weekly group sessions of 2.5 h each. Participants in the control group receive an information sheet with behavioral strategies, and six weekly phone calls, in which strategies to improve academic skills are provided. Children and their parents are evaluated by blind assessors before the intervention, immediately after the intervention and 3-months post-intervention. DISCUSSION: This study will be the first to evaluate the efficacy and feasibility of a parenting program for Mexican parents of children with ABI. TRIAL IDENTIFIER: ACTRN12617000360314.

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Compreendendo a gravidade que os problemas de comportamento podem acarretar no desenvolvimento da criança ao longo da vida, o principal objetivo deste estudo foi comparar a percepção de mães em relação aos problemas de comportamentos listados no CBCL (Child Behavior Checklist) em duas amostras clínicas compostas de crianças brasileiras e espanholas com o diagnóstico de TDAH. O estudo é do tipo exploratório-descritivo, documental, retrospectivo, transversal, de caráter quantitativo dos prontuários de pacientes atendidos entre janeiro de 2010 a abril de 2015 no Hospital Universitário Virgen de la Arrixaca ­ Murcia/Espanha, e no Hospital Universitário Bettina Ferro de Souza ­ Belém/Brasil. Em comparação com as mães espanholas, as mães brasileiras relataram escores significativamente mais altos em quatro escalas, sendo elas: Internalização; Retraimento/Depressão; Queixas Somáticas e Problemas de Pensamento. Enquanto que, nas demais escalas, os escores foram relativamente similares em ambas as culturas. Estudos transculturais têm sido imprescindíveis para a melhor compreensão das semelhanças e diferenças das percepções de pessoas que vivem em culturas distintas.

Understanding the severity of the behavior problems can result in the development of the child throughout life, the aim of this study was to compare the perception of mothers in relation to behavior problems listed in the CBCL (Child Behavior Checklist) in two clinical samples composed of Brazilian and Spanish children diagnosed with ADHD. Method: The study is an exploratorydescriptive, documental, retrospective, cross-sectional, quantitative nature of the medical records treated between 2010 to April 2015 at the Hospital Universitario Virgen de la Arrixaca ­ Murcia/Spain, and the Hospital Universitário Bettina Ferro de Souza ­ Belém/Brasil. Results: The Brazilian mothers reported significantly higher scores on four scales compared to the Spanish mothers, and in the other, the scores were relatively similar in both cultures. Conclusion: cross-cultural studies have been essential to a better understanding of the similarities and differences in perceptions of people living in different cultures.

Comprendiendo la gravedad que los problemas de conducta pueden causar en el desarrollo del niño durante toda la vida, el objetivo de este estudio fue comparar la percepción de las madres en relación con los problemas de conducta que figuran en el CBCL (Child Behavior Checklist) en dos muestras clínicas compuestas de niños brasileños y españoles diagnosticados con TDAH. Método: El estudio es un documental-exploratorio descriptivo, transversal, de naturaleza cuantitativa retrospectiva de los informes de pacientes asistidos entre 2010 y abril de 2015 en el Hospital Universitario Virgen de la Arrixaca ­ Murcia/España, y en el Hospital Universitario de Bettina Ferro de Souza ­ Belém/Brasil. Resultados: Las madres brasileñas tuvieron puntuaciones significativamente mayores en cuatro escalas en comparación con las madres españolas, y en las demás, las puntuaciones fueron relativamente similares en ambas culturas. Conclusión: los estudios transculturales han sido esenciales para una mejor comprensión de las similitudes y diferencias en las percepciones de las personas que viven en las diferentes culturas.

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OBJECTIVE: To test whether the reported association between pediatric epilepsy and behavioral problems may be distorted by the use of parental proxy report instruments. STUDY DESIGN: Children in the Connecticut Study of Epilepsy were assessed 8-9 years after their epilepsy diagnosis (time-1) with the parent-proxy Child Behavior Check List (CBCL) (ages 6-18 years) or the Young Adult Self-Report (≥18 years of age). For children <18 years of age, parents also completed the Child Health Questionnaire, which contains scales for impact of child's illness on the parents. The same study subjects completed the Adult Self-Report 6-8 years later (time-2). Sibling controls were also tested. Case-control differences were examined for evidence suggesting more behavioral problems in cases with epilepsy than in controls based on proxy- vs self-report measures. RESULTS: At time-1, parent-proxy CBCL scores were significantly higher (worse) for cases than controls (n = 140 matched pairs). After adjustment for Child Health Questionnaire scales reflecting parent emotional and time impact, only 1 case-control difference on the CBCL remained significant. Self-reported Young Adult Self-Report scores did not differ between cases and controls (n = 42 pairs). At time-2, there were no significant self-reported case-control differences on the Adult Self-Report (n = 105 pairs). CONCLUSIONS: Parent-proxy behavior measures appear to be influenced by the emotional impact of epilepsy on parents. This may contribute to apparent associations between behavioral problems and childhood epilepsy. Self-report measures in older adolescents (>18 years of age) and young adults do not confirm parental perceptions. Evidence suggesting more behavioral problems in children with epilepsy should be interpreted in light of the source of information.

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Os nevos melanocíticos (NMs) são proliferações benignas de células névicas, que podem serencontradas na pele e em mucosas de revestimento, incluindo a mucosa oral. Contudo, osNMs cutâneos são mais comuns, quando comparados os que acometem a mucosa oral. Osmecanismos moleculares envolvidos no desenvolvimento dos nevos e os fatores que podeminfluenciar no padrão de migração das células névicas são pouco explorados. O objetivo destapesquisa foi analisar a expressão imuno-histoquímica das proteínas E-caderina e Bcl-2 emNMs orais/cutâneos e relacioná-las com as características clínicas (sexo, idade, localização,exposição à radiação solar) e tipos histopatológicos. Foram analisados 36 casos de NMs orais34 de NMs cutâneos. Foi utilizada a técnina de imuno-histoquímica das proteínas E-caderinae bcl-2, na qual foram analisados a intensidade (fraca, intermediária e forte) e distribuição demarcação (focal e difusa). A imunoexpressão também foi analisada quanto aos tipos de célulasnévicas (A, B e C). A análise estatística foi realizada através dos testes de Qui-Quadradode Pearson e Correlação de Spearman com nível de significância estabelecido em 5%. Dos 70casos de NMs, 82,9% eram do sexo feminino, 48,6% com idade entre 26-50 anos, 60% eramda raça branca, 51,4% foram diagnosticados histopatologicamente como nevos intradérmicos/intramucosos e 80% eram NMs adquiridos. A expressão imuno-histoquímica da bcl2 e Ecaderinaforam variáveis na amostra e não exibiram associação com os parâmetros clínicos.

Aexpressão da bcl-2 e E-caderina foram variáveis de acordo com os tipos de células névicas (A,B e C) (p=0,001). A expressão da bcl-2 foi mais difusa em NMs congênitos (p=0,002). A Ecaderinafoi positiva em 83,3% dos NMs <1cm (p=0,001) e em exibiu uma fraca marcaçãoem 73,9% dos NMs que se encontravam em áreas expostas (p=0,010). Com base nestes resultados,sugere-se que a E-caderina tenha um controle na determinação dos tipos histopatológicosdos NMs, e que a bcl-2 seja um possível marcador de NMs com maior susceptibilidade aodesenvolvimento de lesões malignas. (AU)

Melanocytic nevi (MNs) are benign melanocytic proliferations of cells, which can be found in the skin and mucous coat, including the oral mucosa. However, skin NMs are more common when compared to those that affect the oral mucosa. The molecular mechanisms involved in the development of nevi and the factors that can influence the migration pattern of the nevus cells are little explored. The aim of this study was to analyze the immunohistochemical expression of E-cadherin protein and Bcl-2 in oral / skin NMs and relate them to the clinical characteristics (gender, age, location, exposure to solar radiation) and histopathological types. 36 cases of oral NMs and 34 Skin NMs were analyzed. The immunohistochemistry was used of the protein E-cadherin and bcl-2, which were analyzed the intensity (weak, moderate and strong) and distribution marking (diffuse and focal). The immunoreactivity also analyzed as to the types of nevus cells (epithelioid cells -A, -B lymphocyte and fibroblast-like -C). Statistical analysis was performed using the chi-square tests of Pearson and Spearman correlation with significance level set at 5%. Of the 70 cases of NMs, 82.9% were female, 48.6% aged 26-50 years, 51.4% were diagnosed histologically as intradermal / intramucosal nevi and 80% were NMs acquired. Immunohistochemical expression of BCL2 and E-cadherin were variables in the sample and showed no association with clinical parameters. The expression of bcl-2 and E-cadherin were variable according to the types of nevus cells (A, B and C) (P = 0.001). The expression of bcl-2 was more diffuse in congenital MNs (p = 0.002). E-cadherin was positive in 83.3% of MNs <1cm (p = 0.001) and exhibited weak staining in 73.9% of MNs that were in exposed areas (p = 0.010). Based on these results, it is suggested that the E-cadherin has a modulating effect on the migratory properties of NMs, and bcl-2 is a marker of MNs with increased proliferative capacity. (AU)

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A enurese é um problema que aflige muitas crianças. O objetivo deste estudo foi investigar a associação entre a falta de controle urinário noturno e problemas de comportamento. Participaram 774 pais de crianças e adolescentes de 5 a 18 anos, respondendo ao Child Behavior Checklist - CBCL. Foi selecionado o item “meu filho faz xixi na cama”, que foi comparado com os demais itens do instrumento e seus resultados. Verificou-se que 8,91% dos pais assinalaram positivamente este item. Houve associação entre falta de controle urinário noturno e idade, escolaridade - os mais novos, os que estudam nas séries iniciais do Ensino Fundamental e os com defasagem idade-série escolar -, e problemas de comportamento medidos pelo CBCL. Observou-se que ‘molhar a cama’ é um problema comum e pode levar a importantes distúrbios sociais e psicológicos. A implementação de uma triagem para problemas psicológicos pode contribuir para um melhor tratamento da enurese noturna.(AU)

Enuresis (bedwetting) is a problem that affects a large number of children. The aim of the present study was to investigate associations with bedwetting and behavioral problems. A total of 774 parents of children and adolescents aged five to 18 years responded to the Child Behavior Checklist. The item “my child wets the bed” was selected and compared to the other items on this checklist. A total of 8.91% of the parents checked the item in question. Nocturnal enuresis was associated with age (younger children), schooling (those in early years of elementary school and those behind in school for their age) and behavioral problems measured by the checklist. Bedwetting is a common problem that can lead to social and psychological disorders. The implementation of a screening protocol for psychological problems could contribute to better treatment in cases of nocturnal enuresis.(AU)

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A enurese é um problema que aflige muitas crianças. O objetivo deste estudo foi investigar a associação entre a falta de controle urinário noturno e problemas de comportamento. Participaram 774 pais de crianças e adolescentes de 5 a 18 anos, respondendo ao Child Behavior Checklist - CBCL. Foi selecionado o item “meu filho faz xixi na cama”, que foi comparado com os demais itens do instrumento e seus resultados. Verificou-se que 8,91% dos pais assinalaram positivamente este item. Houve associação entre falta de controle urinário noturno e idade, escolaridade - os mais novos, os que estudam nas séries iniciais do Ensino Fundamental e os com defasagem idade-série escolar -, e problemas de comportamento medidos pelo CBCL. Observou-se que ‘molhar a cama’ é um problema comum e pode levar a importantes distúrbios sociais e psicológicos. A implementação de uma triagem para problemas psicológicos pode contribuir para um melhor tratamento da enurese noturna.

Enuresis (bedwetting) is a problem that affects a large number of children. The aim of the present study was to investigate associations with bedwetting and behavioral problems. A total of 774 parents of children and adolescents aged five to 18 years responded to the Child Behavior Checklist. The item “my child wets the bed” was selected and compared to the other items on this checklist. A total of 8.91% of the parents checked the item in question. Nocturnal enuresis was associated with age (younger children), schooling (those in early years of elementary school and those behind in school for their age) and behavioral problems measured by the checklist. Bedwetting is a common problem that can lead to social and psychological disorders. The implementation of a screening protocol for psychological problems could contribute to better treatment in cases of nocturnal enuresis.

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Attention-deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder that implies several-step process, and there is no single test to diagnose both ADHD and associated comorbidities, such as oppositional-defiant disorder (ODD), anxiety disorder, depression, and certain types of learning disabilities. The purpose of the present study was to examine correlations between behavioral and clinical symptoms by administering an extensive neuropsychological battery to a sample of children and adolescents from a developing country. The sample was divided into three groups: non-ADHD, ADHD-non-comorbid, and ADHD + comorbidity. A full neuropsychological battery and clinical assessment found that 105 children met DSM-5 criteria, of whom 46.6% had the predominantly inattentive presentation, 37.3% had combined presentation, and 16% were predominantly hyperactive/impulsive presentation. The internal correlation between neuropsychological tests did not reach statistical significance in the comparison between ADHD and non-ADHD cases (p < 0.17). Clinical ADHD cases, including both + comorbidity and non-comorbid groups, performed substantially worse on continuous performance test (CPT), working memory. Comparing ADHD-non-comorbid and ADHD + comorbidity groups, the latter did significantly worse on inhibitory control, time processing, and the level of perseveration response on CPT indexes, as well as on working memory performance and child behavior checklist (CBCL) tests particularly the CBCL-deficient emotional self-regulation test in the ADHD + comorbidity group. Children diagnosed as ODD or with conduct disorder showed close correlations between clinical CBCL profiles and externalized symptoms. Our findings suggest that ADHD + comorbidity and ADHD non-comorbid cases may be differentiated by a number of neuropsychological measures, such as processing speed, inhibitory control, and working memory, that may reflect different levels of involvement of the hot and cool executive domains, which are more impaired in cases of severe symptomatic-externalized behavior and emotional regulation problems. Therefore, profiles based on clinical and behavioral findings can help clinicians select better strategies for detecting neuropsychological impairment in Brazilian children with ADHD.

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Maternal exposure to stress or adversity during pregnancy has been associated with negative health effects for the offspring including psychiatric symptoms. Programming of the hypothalamic-pituitary-adrenal (HPA) axis has been suggested as one mediating process. In order to investigate possible long term effects of stressors during pregnancy, we followed 70 children and their mothers from pregnancy up to nine years aiming to investigate if maternal cortisol levels and distress/exposure to partner violence were associated with child psychiatric symptoms and child cortisol levels at follow-up. Maternal distress was evaluated using The Self Reporting Questionnaire, exposure to partner violence by an instrument from WHO and child psychiatric symptoms with Child Behavior Checklist (CBCL). We adjusted the analyses for gestational week, gender, SES, perinatal data and maternal distress/exposure to partner violence at child age of nine years. Elevated maternal cortisol levels during pregnancy, as a possible marker of maternal stress load, were correlated with higher CBCL-ratings, especially concerning externalizing symptoms. Maternal cortisol levels during pregnancy were not associated with child cortisol levels at child age of nine years. Maternal distress and exposure to partner violence during pregnancy were neither associated with child psychiatric symptoms nor child cortisol levels. To conclude, intrauterine exposure to elevated cortisol levels was associated with higher ratings on offspring psychopathology at nine years of age. The lack of association between maternal cortisol levels during pregnancy and child cortisol levels does not support the hypothesis of fetal programming of the HPA-axis, but reliability problems may have contributed to this negative finding.

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As neoplasias mieloproliferativas crônicas cromossomo Filadélfia negativas são doenças hematológicas clonais que se caracterizam pela independência ou pela hipersensibilidade dos progenitores hematopoiéticos às citocinas. Os mecanismos celulares e moleculares envolvidos na fisiopatologia das neoplasias mieloproliferativas crônicas ainda não estão totalmente esclarecidos. Achados fisiopatológicos relevantes para as neoplasias mieloproliferativas crônicas estão associados às alterações genéticas como, por exemplo, a mutação somática no gene que codifica o JAK2 (JAK2V617F). A desregulação do processo de morte celular programada, denominada apoptose, parece participar da patogênese dessas desordens. Sabe-se que a desregulação da expressão dos genes pró- e antiapoptóticos promove a resistência das células à apoptose, culminando com o acúmulo das células mieloides e estabelecendo a neoplasia. Esta revisão enfocou as alterações na regulação da apoptose em neoplasias mieloproliferativas crônicas e a importância da melhor compreensão desse mecanismo para o desenvolvimento de novas terapias para essas doenças.

Philadelphia-chromosome negative chronic myeloproliferative neoplasms are clonal hematologic diseases characterized by hematopoietic progenitor independence from or hypersensitivity to cytokines. The cellular and molecular mechanisms involved in the pathophysiology of myeloproliferative neoplasms have not yet been fully clarified. Pathophysiologic findings relevant for myeloproliferative neoplasms are associated with genetic alterations, such as, somatic mutation in the gene that codifies JAK-2 (JAK V617F). Deregulation of the process of programmed cellular death, called apoptosis, seems to participate in the pathogenesis of these disorders. It is known that expression deregulation of pro- and anti-apoptotic genes promotes cell resistance to apoptosis, culminating with the accumulation of myeloid cells and establishing neoplasms. This review will focus on the alterations in apoptosis regulation in myeloproliferative neoplasms, and the importance of a better understanding of this mechanism for the development of new therapies for these diseases.

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OBJECTIVE: To investigate the relationship between preterm birth, adolescent, and adult psychosocial outcomes, and alterations in gray matter volume. STUDY DESIGN: Individuals (n = 73) born at <33 weeks of gestation (very preterm) and 49 controls completed the Child Behavior Checklist (CBCL) at age 15 years to identify 'social immaturity' (SI) cases. Voxel-based morphometry was used to investigate gray matter volumes according to CBCL-SI 'caseness.' The Clinical Interview Schedule-Revised (CIS-R) was administered at age 19 years. RESULTS: Very preterm adolescents were almost 4 times more likely to reach CBCL-SI 'caseness' compared with controls. Ex-preterm SI 'cases' had increased gray matter volume in the fusiform gyrus bilaterally (Talairach coordinates: x = 60, y = -27, z = -30; Z = 3.78; x = -61, y = -35, z = -27; Z = 3.56, after correction for multiple comparisons) compared with ex-preterm SI 'noncases.' Left fusiform volume displayed a stronger correlation with ipsilateral orbitofrontal cortex in SI 'cases' (x = -15, y = 22, z = -26; Z = 3.64). CIS-R total scores were slightly higher in ex-preterm individuals compared with controls. In the whole sample, SI 'cases' in midadolescence also had higher CIS-R scores in adulthood compared with 'noncases' (SI 'cases': mean = 5.7, 95% CI = 4.0-7.4; SI 'noncases': mean = 2.7, 95% CI = 1.1-4.3; F = 6.4, df = 74; P = .013). CONCLUSIONS: Ex-preterm adolescents had increased socialization problems in adolescence, which were associated with volumetric alterations in an emotion-processing brain network. Atypical social development is linked to an increased vulnerability to psychiatric disorder.

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OBJECTIVE: To examine soda consumption and aggressive behaviors, attention problems, and withdrawal behavior among 5-year-old children. STUDY DESIGN: The Fragile Families and Child Wellbeing Study is a prospective birth cohort study that follows a sample of mother-child pairs from 20 large US cities. Mothers reported children's behaviors using the Child Behavior Checklist at age 5 years and were asked to report how many servings of soda the child drinks on a typical day. RESULTS: In the sample of 2929 children, 52% were boys, 51% were African-American, 43% consumed at least one serving of soda per day, and 4% consumed 4 or more servings per day. In analyses adjusted for sociodemographic factors, consuming one (beta, 0.7; 95% CI, 0.1-1.4), 2 (beta, 1.8; 95% CI, 0.8-2.7), 3 (beta, 2.0; 95% CI, 0.6-3.4), or 4 or more (beta, 4.7; 95% CI, 3.2-6.2) servings was associated with a higher aggressive behavior score compared with consuming no soda. Furthermore, those who consumed 4 or more (beta, 1.7; 95% CI, 1.0-2.4) soda servings had higher scores on the attention problems subscale. Higher withdrawn behavior scores were noted among those consuming 2 (beta, 1.0; 95% CI, 0.3-1.8) or 4 or more (beta, 2.0; 95% CI, 0.8-3.1) soda servings compared with those who consumed no soda. CONCLUSION: We note an association between soda consumption and negative behavior among very young children; future studies should explore potential mechanisms that could explain this association.

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