Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation
| Autor: | Cynthia R. Rovnaghi, Kanwaljeet J. S. Anand, Brenda Golianu, Jorina Elbers |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Nervous system
medicine.medical_specialty Article 03 medical and health sciences stress 0302 clinical medicine 030225 pediatrics Internal medicine medicine Autonomic dysregulation Psychiatry Adverse Childhood Experiences child business.industry nervous system lcsh:RJ1-570 lcsh:Pediatrics Emotional dysregulation medicine.disease psychosomatic medicine.anatomical_structure Symptom profiles Pediatrics Perinatology and Child Health Pediatric neurology clinic adverse childhood experiences business Somatization 030217 neurology & neurosurgery Executive dysfunction |
| Zdroj: | Children; Volume 4; Issue 11; Pages: 98 Children, Vol 4, Iss 11, p 98 (2017) Children |
| ISSN: | 2227-9067 |
| DOI: | 10.3390/children4110098 |
| Popis: | Background: We report the prevalence of children with multiple medical symptoms in a pediatric neurology clinic, describe their symptom profiles, and explore their association with adverse childhood experiences (ACEs). Methods: We retrospectively reviewed 100 consecutive patients from an outpatient pediatric neurology clinic. Patients were included if they were ≥5 years old and reported ≥4 symptoms that were unexplained for ≥3-months. Symptom profiles across six functional domains were recorded: (1) executive dysfunction, (2) sleep disturbances, (3) autonomic dysregulation, (4) somatization, (5) digestive symptoms, and (6) emotional dysregulation. ACEs were scored for all patients. Results: Seventeen patients reported ≥4 medical symptoms. Somatization, sleep disturbances, and emotional dysregulation occurred in 100% patients, with executive dysfunction (94%), autonomic dysregulation (76%), and digestive problems (71%) in the majority. Forty-two children reported ≥1 ACE, but children with ≥4 symptoms were more likely to report ACEs compared to other children (88% vs. 33%; p < 0.0001) and had a higher median total ACE score (3 vs. 1; p < 0.001). Conclusions: Children with multiple medical symptoms should be screened for potential exposure to ACEs. A clinical profile of symptoms across multiple functional domains suggests putative neurobiological mechanisms involving stress and nervous system dysregulation that require further study. |
| Databáze: | OpenAIRE |
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