Josefa Canals

The epidemiology of obsessive–compulsive disorder in Spanish school children

We aimed to assess the prevalence (at three levels of severity) and other epidemiological data of OCD in a sample of 1,514 Spanish non-referred children. The estimated prevalence was 1.8% for OCD, 5.5% for subclinical OCD and 4.7% for OC symptomatology. We did not find significant differences between genders or academic grade regarding OC symptoms and OCD, but more subclinical prevalence was found in males than in females. Socio-demographic variables were not related to any level of OCD, but academic performance was significantly lower in clinical OCD. The co-morbidity between OCD and any psychiatric disorder was high (85%) and higher for emotional disorders than for behavioral disorders. The impairment was associated with comorbidity and was worse for OCD with comorbid emotional problems. The results suggest that OCD is not rare in school children and adolescents and that it has an impact on their personal functioning. We suggest the possibility of an early diagnosis and treatment.

Effects of iron deficiency on neonatal behavior at different stages of pregnancy.

Animal and human studies have shown that prenatal and postnatal iron deficiency is a risk factor for behavioral, emotional and cognitive development. The aim of this study was to determine the associations between iron status of pregnant women and the behavior of their newborn, taking into account the timing in which the deficit occurs. This study was conducted in Spain (developed country) where: the general population is well-nourished; during pregnancy routine obstetrical checks are carried out; and pregnant women are systematically iron supplemented. A total of 216 healthy and well-nourished pregnant women and their term, normal weight newborn participated in this study. The neonatal behavior was assessed by the Neonatal Behavior Assessment Scale (NBAS). The results showed that in the first and second trimesters of pregnancy, iron deficiency was a weak and significant predictor of the NBAS autonomous nervous system cluster score, and in the third trimester, this condition predicted the NBAS motor and state organization clusters score and the NBAS robustness and endurance supplementary item. In conclusion, iron deficiency during pregnancy is related to the neonates general autonomous response, motor performance and self regulation capabilities.

Examination of a cutoff score for the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a non-clinical Spanish population

We aimed to find a valid cutoff score for the Screen for Child Anxiety Related Emotional Disorders, child (SCARED-C) and parent (SCARED-P) Spanish versions for detecting Anxiety Disorders (AD) in a non-clinical population. The predictive accuracy of the SCARED-C and SCARED-P was assessed using the Area Under the Curve (AUC) of ROC curves. In general, the predictive accuracy of the SCARED-C (full version, short version, and four factors) was good and better than that of the SCARED-P. To differentiate between children who meet the diagnostic criteria for any AD and children who do not, we propose cutoff scores of 25 and 17 for the SCARED-C and SCARED-P, respectively. The sensitivities are 75.9% and 62.8%, and the specificities are 68.5% and 69.5%. The SCARED-C factor that had the best predictive accuracy was Somatic panic followed by Separation Anxiety, Generalized Anxiety and Social Phobia. The SCARED-P factor with the best predictive accuracy was Separation Anxiety. The results support the use of SCARED-C as a screening test for Anxiety disorders while SCARED-P should only be used as complementary information.

Neonatal Behavioral Assessment Scale as a predictor of cognitive development and IQ in full‐term infants: a 6‐year longitudinal study

Aim:  To evaluate the predictive capacity of neonatal behaviour on infant mental and psychomotor development at 4 and 12 months, and infant intelligence at 6 years.

Do the emotional states of pregnant women affect neonatal behaviour

The emotional states of pregnant women affect the course of their pregnancies, their deliveries and the behaviour and development of their infants. The aim of this study is to analyse the influence of positive and negative maternal emotional states on neonatal behaviour at 2-3 days after birth. A sample of 163 healthy full-term newborns was evaluated using the Neonatal Behavioral Assessment Scale. Maternal anxiety, perceived stress, and emotional stability during pregnancy were evaluated in the immediate postpartum period with the State Trait Anxiety Inventory and the Perceived Stress Scale. Moderate levels of anxiety during pregnancy alter infant orientation and self-regulation. These aspects of infant behaviour could lead to later attachment, behavioural and developmental problems. Maternal emotional stability during pregnancy improves infant self-regulation and several aspects of infant behaviour that may predispose them to better interactions with their parents.

Relationships between early behavioural characteristics and temperament at 6 years

The aim of this study was to analyze the extent to which the relations and the stability of the neonatal behaviour and the infant behaviour at both 4 and 12 months could be used to predict the infant temperament at 6 years. Seventy-two full-term, normal-weight, healthy children were followed from 3 days postpartum to 6 years. Neonatal behaviour at 3 and 30 days was assessed using the Neonatal Behaviour Assessment Scale (NBAS), behaviour at 4 and 12 months was assessed using the Infant Behaviour Record (IBR) from the Bayley Scales for Infant Development (BSID) and temperament at 6 years was assessed using the Dimensions of Temperament Survey-Revised (DOTS-R). Negative and positive affectivity and attention were the factors extracted from the behaviours of the IBR. Our results showed a low/moderate correlation between neonatal behaviour on the one hand and behaviour at 4 and 12 months and temperament at 6 years on the other hand. The motor performance, orientation and ANS stability of the neonate at 3 and 30 days were predictors of positive and negative affectivity at 4 months. State regulation and ANS stability at 3 days were predictors of negative affectivity and attention respectively at 12 months. Negative affectivity at 12 months and endurance at 30 days were predictors of general activity and persistence/attention at 6 years. Also, an inverse relation was found between state regulation at 30 days and general activity at 6 years, and a positive relation was found between attention at 4 months and persistence/attention at 6 years. We conclude that neonatal behaviour and behaviour in the first year of life are good predictors of temperament at 6 years and that early negative affectivity has an important role on infant temperament development.

Age and gender differences of somatic symptoms in children and adolescents

Aims This study provides information about the prevalence of somatic symptoms (Ss) in a population of Spanish children and adolescents and their distribution by age and gender. It also sheds light on which Ss are more associated with depression and anxiety and which are associated with more disability. Method A sample of 2558 school children and adolescents aged 8–16 years old, 1297 girls, completed one questionnaire about Ss, and two about anxiety and depressive symptoms. Results About 37.6% reported at least one Ss, headache being the most prevalent. In terms of age distribution, 26.8% of children and 52.1% of adolescents reported Ss. Girls reported more Ss than did boys. These gender differences started at 13 years of age and decreased at 15. Headache, stomach-ache and muscle pain were the Ss that caused the most impairment. Conclusions In general, depressive symptoms were associated with all Ss, whereas anxiety symptoms were associated with fatigue and muscle pain.

Emotional psychopathology and increased adiposity: Follow- up study in adolescents

Based on data from a three-year longitudinal study, we assess the effect, according to gender, of emotional psychopathology in preadolescence on anthropometric and body composition parameters in adolescence (N = 229). Psychopathology was assessed using the Screen for Childhood Anxiety and Related Emotional Disorders, the Childrens Depression Inventory and the MINI-International Neuropsychiatric Interview for Kids. Body fat percentage (%BF), waist circumference (WC) and body mass index (BMI) were also determined. Following analysis with adjusted multiple regression models, the results indicated that symptoms of depression and separation anxiety were significantly associated with increased WC and BMI in boys, and that somatic symptoms were associated with increased WC and %BF in girls. Diagnosis of social phobia, panic disorder or dysthymia led to significantly increased WC and/or BMI in boys and dysthymia increased WC in girls. These findings suggest that emotional psychopathology in preadolescence is associated with increased weight gain and abdominal fat in adolescence.

Factors associated with body dissatisfaction in non-clinical adolescents at risk of eating disorders

AimTo examine factors (individual, familiar and socio-cultural) associated with body dissatisfaction (BD) by gender in non-clinical adolescents at risk of eating disorders (rED) and in a control group (CG).Subjects and methodsA total of 2,967 adolescent students was screened using the Eating Attitudes Test-40 and the Youth’s Inventory-4. Of these, 217 students (161 girls and 56 boys) identified as being at rED were chosen for the study, and 208 students (168 girls and 40 boys) were chosen as the CG. The subjects were given the Body Areas Satisfaction Test, the Youth’s Inventory-4, a questionnaire to evaluate social influences on the “model of thinness” (SI-MT), the Family Environment Scale, and their body mass index (BMI) was determined.ResultsBD frequency in at-risk girls (44.6%) was significantly higher than in boys (27.3%). Girls at rED were most dissatisfied with their weight. BMIs were significantly higher and energy intake was significantly lower in dissatisfied girls than in satisfied girls at rED. In girls at rED, multiple linear regression analyses showed that SI-MT factors and dysthymia were associated with BD. In the CG, higher BMI were associated with BD. These relationships were not found in adolescent boys.ConclusionWithin the at-risk group, adolescents with BD had higher BMIs, consumed fewer calories, were more influenced by socio-cultural factors and had more emotional issues than those who were satisfied. We suggest that although high BMIs are associated with BD, the interaction with other social and psychopathological characteristics increases the risk of the development of eating disorders.

ADHD Prevalence in Spanish Preschoolers Comorbidity, Socio-Demographic Factors, and Functional Consequences

Objective: The object was to examine the prevalence of ADHD among preschoolers, analyzing comorbidity, and the association with socio-demographic factors. Method: We conducted a two-phase epidemiological study of 1,104 preschoolers aged 3 to 6 years in Catalonia, Spain. The Early Childhood Inventory–4 (ECI-4) was administered to parents and teachers. Children at risk of ADHD were assessed using open-ended face-to-face interviews and were observed in a school setting. ADHD diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria. Results: The prevalence of ADHD diagnosis was 5.4%. Male sex and first-born status were risk factors for ADHD. Parents reported more symptoms (12.9%) than teachers (8.7%). Behavioral problems (odds ratio [OR] = 12, p = .001), autism spectrum disorder problems (OR = 9.5, p = .001), and obsessive-compulsive problems and tics (OR = 5.9, p = .001) were specifically related to ADHD diagnosis. Mother’s health status and school achievement were lower in ADHD children. Conclusion: Even at early stages of development, ADHD has high rates of comorbidity and a significant impact on school performance and family health.