Child and Adolescent Psychiatric Center

Glostrup, Denmark

Child and Adolescent Psychiatric Center

Glostrup, Denmark
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Hvelplund C.,Copenhagen University | Hvelplund C.,University Hospital Herlev | Hansen B.M.,Copenhagen University | Koch S.V.,Child and Adolescent Psychiatric Center | And 3 more authors.
Pediatrics | Year: 2016

OBJECTIVE: To describe the incidence, age at diagnosis, and associations between perinatal risk factors of feeding and eating disorders (FED) diagnosed at hospital in children aged 0 to 3 years. METHODS: A nationwide cohort of 901 227 children was followed until 48 months of age in the national registers from 1997 to 2010. Multivariable Cox proportional hazards regression was used to estimate hazard ratios (HRs) for FED diagnosis according to the International Classification of Diseases and associations with perinatal risk factors. RESULTS: A total of 1365 children (53% girls) were diagnosed with FED at hospital, corresponding to a cumulative incidence of 1.6 per 1000 live births. High risk of FED was seen in children born before gestational week 28 (HR, 3.52; 95% confidence interval [CI], 2.15-5.78). HRs were 3.74 for children small for gestational age ≤3 SD (95% CI, 2.71-5.17) and 4.71 in those with congenital malformations (95% CI, 3.86-5.74). Increased risk of FED was associated with female gender (HR, 1.2; 95% CI, 1.08-1.34), maternal smoking in pregnancy (HR, 1.24; 95% CI, 1.08-1.42), immigrant status (HR, 2.24; 95% CI, 1.92-2.61), and being the firstborn (HR, 1.33; 95% CI, 1.19-1.50). CONCLUSIONS: FED in referred children aged 0 to 3 years are associated with perinatal adversities, female gender, maternal smoking in pregnancy, being firstborn, and having immigrant parents. The results suggest complex causal mechanisms of FED and underscore the need for a multidisciplinary approach in the clinical management of young children with persistent problems of feeding, eating, and weight faltering. Copyright © 2016 by the American Academy of Pediatrics.


Rasmussen H.B.,Copenhagen University | Bjerre D.,Copenhagen University | Linnet K.,Copenhagen University | Jurgens G.,Copenhagen University | And 15 more authors.
Pharmacogenomics | Year: 2015

CES1 is involved in the hydrolysis of ester group-containing xenobiotic and endobiotic compounds including several essential and commonly used drugs. The individual variation in the efficacy and tolerability of many drugs metabolized by CES1 is considerable. Hence, there is a large interest in individualizing the treatment with these drugs. The present review addresses the issue of individualized treatment with drugs metabolized by CES1. It describes the composition of the gene encoding CES1, reports variants of this gene with focus upon those with a potential effect on drug metabolism and provides an overview of the protein structure of this enzyme bringing notice to mechanisms involved in the regulation of enzyme activity. Subsequently, the review highlights drugs metabolized by CES1 and argues that individual differences in the pharmacokinetics of these drugs play an important role in determining drug response and tolerability suggesting prospects for individualized drug therapies. Our review also discusses endogenous substrates of CES1 and assesses the potential of using metabolomic profiling of blood to identify proxies for the hepatic activity of CES1 that predict the rate of drug metabolism. Finally, the combination of genetics and metabolomics to obtain an accurate prediction of the individual response to CES1-dependent drugs is discussed. © 2015 Future Medicine Ltd.


Elberling H.,Child and Adolescent Psychiatric Center | Elberling H.,Research Center for Prevention and Health | Linneberg A.,Research Center for Prevention and Health | Linneberg A.,Copenhagen University | And 6 more authors.
Journal of Child Psychology and Psychiatry and Allied Disciplines | Year: 2014

Background Epidemiological studies infancy predictors of mental disorders are scarce.Methods The study is part of a longitudinal birth-cohort study, The Copenhagen Child Cohort CCC2000. Infant mental health and development and mother-infant relations were assessed by community health nurses from birth to age 10 months. Data on the perinatal period were obtained from Danish National Registers. Mental health outcome at age 5-7 years was investigated in 1,585 children who were assessed by the Developmental and Well-Being Assessment (DAWBA) and diagnosed according to the ICD-10.Results Predictors of autism spectrum disorders were problems of oral-motor development OR 5.02 (95% CI: 1.63-15.42) and overall development OR 4.24 (95% CI: 1.35-13.33). A deviant pattern of activity and interests were predictive of autism spectrum disorder, OR 5.34 (95% CI 1.45-19.70) and hyperkinetic disorder, OR 4.71 (95% CI: 1.28-17.39). Hyperkinetic disorder was furthermore predicted by mother-infant relationship problems, OR 8.07 (95% CI: 2.90-22.47). The significant associations between infant developmental problems and autism spectrum disorders persisted in multiple logistic regression analyses controlled for maternal psychological problems and mother-infant relationship problems, OR 3.21 (95% CI: 1.09-9.45). Mother-infant relationship problems remained strongly associated to hyperkinetic disorders in the multivariate analyses controlled for child development problems and maternal psychological problems, OR 5.20 (95% CI: 1.55-17.47). No significant infancy predictors were found regarding emotional and behavioural disorders at age 5-7 years.Conclusion Predictors of autism spectrum/pervasive developmental disorders and hyperkinetic disorders at child age 5-7 years were identified between birth and child age 10 months in community health settings. The study results suggest potential areas of early preventive intervention, which have to be further explored regarding the psychometric qualities of the identification of infants at risk, and concerning methods to handle and intervene towards these children in the general child health surveillance. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.


Li X.Q.,Glostrup Hospital | Li X.Q.,Copenhagen University | Jeppesen P.,Copenhagen University | Jeppesen P.,Child and Adolescent Psychiatric Center | And 4 more authors.
Investigative Ophthalmology and Visual Science | Year: 2014

Purpose. To investigate subfoveal choroidal thickness and ocular- and systemic-associated factors in a population-based cohort of children. Methods. Cross-sectional, observational study where 1323 healthy 11- and 12-year-old children were examined with enhanced-depth imaging spectral-domain optical coherence tomography (EDI-SD-OCT), ocular interferometric biometry blood pressure manometry, and measurement of height, weight, nonmydriatic refraction, and best-corrected visual acuity. Self-reported stage of pubertal development was classified as Tanner stages 1 through 4.Results. Mean subfoveal choroidal thickness was 369 ±81 μm in girls and 348 ± 72 μm in boys. Longer axial length was associated with a thinner subfoveal choroid (-27.2 [95% confidence interval (CI) -32.7 to -21.7] μm/mm; P < 0.0001), adjusting for age and sex. There was no difference in choroidal thickness between sexes (P - 0.14) after adjusting for age and axial length. In girls, the choroid was thickest in participants in the more advanced stage of pubertal development (54.2 [95% CI 20.7-87.7] μm for Tanner 4 versus Tanner 1,P - 0.0015) and increased with body height (19.2 [95% CI 10.8-27.5] μm/10 cm, P < 0.0001). There was no effect of height or puberty in boys, who were less sexually mature than girls. Conclusions. Choroidal thickness in girls increased with body height and sexual maturation. The results suggest that puberty promotes choroidal thickening in girls, an effect that may be mediated by the pubertal growth spurt. The lack of pubertal effect in boys may be related to a smaller proportion of boys in this study having entered puberty. © 2014 The Association for Research in Vision and Ophthalmology, Inc.


Li X.Q.,Glostrup Hospital | Li X.Q.,Copenhagen University | Munkholm A.,Copenhagen University | Munkholm A.,Child and Adolescent Psychiatric Center | And 9 more authors.
Investigative Ophthalmology and Visual Science | Year: 2015

PURPOSE. To examine choroidal thickness in a population-based child cohort in relation to birth parameters. METHODS. The Copenhagen Child Cohort 2000 Eye Study examined 1406 children aged 11 to 12 years using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT), ocular biometry and measurement of height, weight, refraction, and self-reported pubertal development status. Birth parameters were obtained from the Danish Medical Birth Registry. RESULTS. The subfoveal choroid in low birth weight children (<2500 g, n ¼ 51, mean 324 6 76 lm) was thinner than in normal birth weight children (2500-4500 g, n ¼ 1194, mean 361 6 78 lm), the difference being 37 (CI95 60 to 15) lm, P ¼ 0.001 after adjusting for age, sex, height, Tanner stage by sex, axial length, anterior chamber depth, and spherical equivalent refractive error. The subfoveal choroid in high birth weight children (>4500 g, n ¼ 48, mean 351663 lm) was comparable with normal birth weight children, P ¼ 0.44. The subfoveal choroid was thinner in preterm children, however the difference was not significant (18 [37 to 2] lm, P ¼ 0.08). Small for gestation children had thinner subfoveal choroid (19 [37 to 1] lm, P ¼ 0.04) compared with appropriate for gestation children. Longer birth length was associated with a thicker subfoveal choroid (2 [1-4] lm/cm, P ¼ 0.005). Macular choroidal thickness at 16 extrafoveal locations was measured in a subset of children and found to have the same associations with birth weight as the subfoveal choroidal thickness. CONCLUSIONS. In 11-to 12-year-old children, thinner choroids were associated with lower birth weight, lower birth length, and being small for the gestational age. © 2015 The Association for Research in Vision and Ophthalmology, Inc.


Storebo O.J.,Child and Adolescent Psychiatric Center | Storebo O.J.,Psychiatric Research Unit | Storebo O.J.,Copenhagen University | Pedersen J.,Child and Adolescent Psychiatric Center | And 8 more authors.
Trials | Year: 2011

Background: Children with attention deficit hyperactivity disorder (ADHD) are hyperactive and impulsive, cannot maintain attention, and have difficulties with social interactions. Medical treatment may alleviate symptoms of ADHD, but seldom solves difficulties with social interactions. Social-skills training may benefit ADHD children in their social interactions. We want to examine the effects of social-skills training on difficulties related to the children's ADHD symptoms and social interactions.Methods/Design: The design is randomised two-armed, parallel group, assessor-blinded trial. Children aged 8-12 years with a diagnosis of ADHD are randomised to social-skills training and parental training plus standard treatment versus standard treatment alone. A sample size calculation estimated that at least 52 children must be included to show a 4-point difference in the primary outcome on the Conners 3rdEdition subscale for 'hyperactivity-impulsivity' between the intervention group and the control group. The outcomes will be assessed 3 and 6 months after randomisation. The primary outcome measure is ADHD symptoms. The secondary outcome is social skills. Tertiary outcomes include the relationship between social skills and symptoms of ADHD, the ability to form attachment, and parents' ADHD symptoms.Discussion: We hope that the results from this trial will show that the social-skills training together with medication may have a greater general effect on ADHD symptoms and social and emotional competencies than medication alone.Trial registration: ClinicalTrials (NCT): NCT00937469. © 2011 Storebø et al; licensee BioMed Central Ltd.


Children with attention deficit hyperactivity disorder (ADHD) are hyperactive and impulsive, cannot maintain attention, and have difficulties with social interactions. Medical treatment may alleviate symptoms of ADHD, but seldom solves difficulties with social interactions. Social-skills training may benefit ADHD children in their social interactions. We want to examine the effects of social-skills training on difficulties related to the childrens ADHD symptoms and social interactions.The design is randomised two-armed, parallel group, assessor-blinded trial. Children aged 8-12 years with a diagnosis of ADHD are randomised to social-skills training and parental training plus standard treatment versus standard treatment alone. A sample size calculation estimated that at least 52 children must be included to show a 4-point difference in the primary outcome on the Conners 3rd Edition subscale for hyperactivity-impulsivity between the intervention group and the control group. The outcomes will be assessed 3 and 6 months after randomisation. The primary outcome measure is ADHD symptoms. The secondary outcome is social skills. Tertiary outcomes include the relationship between social skills and symptoms of ADHD, the ability to form attachment, and parents ADHD symptoms.We hope that the results from this trial will show that the social-skills training together with medication may have a greater general effect on ADHD symptoms and social and emotional competencies than medication alone.ClinicalTrials (NCT): NCT00937469.

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