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Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation

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...

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Autores principales: Elbers, Jorina, Rovnaghi, Cynthia R., Golianu, Brenda, Anand, Kanwaljeet J. S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704132/
https://www.ncbi.nlm.nih.gov/pubmed/29140276
http://dx.doi.org/10.3390/children4110098
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author Elbers, Jorina
Rovnaghi, Cynthia R.
Golianu, Brenda
Anand, Kanwaljeet J. S.
author_facet Elbers, Jorina
Rovnaghi, Cynthia R.
Golianu, Brenda
Anand, Kanwaljeet J. S.
author_sort Elbers, Jorina
collection PubMed
description 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.
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spelling pubmed-57041322017-11-30 Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation Elbers, Jorina Rovnaghi, Cynthia R. Golianu, Brenda Anand, Kanwaljeet J. S. Children (Basel) Article 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. MDPI 2017-11-15 /pmc/articles/PMC5704132/ /pubmed/29140276 http://dx.doi.org/10.3390/children4110098 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Elbers, Jorina
Rovnaghi, Cynthia R.
Golianu, Brenda
Anand, Kanwaljeet J. S.
Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation
title Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation
title_full Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation
title_fullStr Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation
title_full_unstemmed Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation
title_short Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation
title_sort clinical profile associated with adverse childhood experiences: the advent of nervous system dysregulation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704132/
https://www.ncbi.nlm.nih.gov/pubmed/29140276
http://dx.doi.org/10.3390/children4110098
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