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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2017
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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. |
format | Online Article Text |
id | pubmed-5704132 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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