European Child & Adolescent Psychiatry

, Volume 2, Issue 3, pp 136–145 | Cite as

A follow-up study of child psychiatric clinic attenders with minor neurological dysfunction

  • Margot Völger
  • Hans-Christoph Steinhausen
  • Matthias Reitzle
Article

Abstract

Thirty-two child psychiatric patients with minor neurological dysfunction (MND) were followed-up after a mean interval of 5.3 years. Six clusters were analyzed that measured posture and muscle tonus, reflexes, coordination and balance, fine manipulative ability, choreiform dyskinesia, and associated movements. In the majority of cases, remission occurred for posture and muscle tonus, and choreiform dyskinesia and reflexes. Problems with fine manipulative ability and associated movements, however, persisted in most cases. Change in the total MND-abnormality score was also analyzed. Elevated scores and greater age at the initial assessment, and longer intervals between the initial assessment and follow-up were associated with greater improvement, indicating that biological maturation is an important factor in symptom remission. Slow background activity was the predominant EEG-pattern that tended to persist rather than to remit over time. A wide spectrum of psychiatric diagnoses was recorded on both occasions. In general, the tendency for remission of psychiatric disorders was stronger than that of persistence and new manifestation. In addition, with regard to behavioural abnormalities, the total score and subscore for emotional disorders diminished over time.

Keywords

Muscle Tonus Symptom Remission Slow Background Biological Maturation Clinic Attender 

Résumé

32 enfants consultants en psychiatrie avec des dysfonctionnements neurologiques mineurs (MND) furent suivis avec un délai moyen de 5,3 années. 6 paramètres furent analysés concernant la posture et le tonus musculaire, les réflexes, la coordination et l'équilibre, l'habilité aux manipulations fines, les dyskinésies choréiformes et les mouvements associés. Dans la majorité des cas une rémission survenait pour la posture et le tonus musculaire, les dyskinésies choréiformes et les réflexes. Des problèmes avec l'habilité aux manipulations fines et les mouvements associés persistaient cependant dans la plupart des cas. Des changements dans le score total d'MND furent aussi analysés. Des scores élevés et un âge plus avancé lors de l'évaluation initiale ainsi que l'intervalle plus long entre l'évaluation initiale et le suivi étaient associés avec une meilleure amélioration indiquant que la maturation biologique est un facteur important de rémission symptomatique. Une activité lente fut la modalité E.E.G. prédominante tendant à persister plutôt qu'à diminuer avec le temps. Un large spectre de diagnostics psychiatriques étaient retrouvés dans les deux cas. En général la tendance à une rémission des troubles psychiatriques fut plus importante que la tendance à une persistance ou à l'apparition de nouvelles manifestations. De plus par rapport aux anomalies comportementales, le score total et les sub-scores pour les troubles affectifs diminuent avec le temps.

Zusammenfassung

Zweiunddreissig kinderpsychiatrische Patienten mit einer ‘Minor Neurological Dysfunction’ (MND) wurden nach einem mittleren Intervall von 5,3 Jahren nachuntersucht. Es wurden sechs Cluster analysiert: Haltung und Muskeltonus, Reflexe, Koordination und Balance, Feinmotorische Fertigkeiten, Choreiforme Dyskinesie und Assoziierte Bewegungen. Bei der Mehrzahl der Fälle fanden Remissionen hinsichtlich Haltung und Muskeltonus, Choreiforme Dyskinesie und Reflexe statt, während bei den meisten Fällen Probleme in den Bereichen Koordination und Balance, Feinmotorische Fertigkeiten und Assoziierte Bewegungen persistierten. Die Veränderung wurde auch hinsichtlich eines MND-Gesamtauffälligkeitswerten analysiert. Kinder mit grösseren Problemen und höherem Alter bei Erstuntersuchung und längeren Intervallen zwischen den beiden Untersuchungen zeigten grössere Verbesserungen, was auf eine stattfindene biologische Reifung verweist. Ein nicht altersentsprechender Grundrhythmus war das dominante EEG-Muster, des eher persistierte als remittierte. In beiden Zeitpunkten wurde ein weiter Spektrum psychiatrischer Diagnosen festgestellt. Allgemein war die Remissionstendenz für psychiatrische Störungen stärker als die Tendenz zu Persistenz oder Neubildung. Hinsichtlich Verhaltensauffälligkeiten gingen ein Gesamtwert und eine Subskala für emotionale Störungen zurück.

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Copyright information

© Hogrefe & Huber Publishers 1993

Authors and Affiliations

  • Margot Völger
    • 1
  • Hans-Christoph Steinhausen
    • 2
  • Matthias Reitzle
    • 2
  1. 1.Department of Child and Adolescent Psychiatry and NeurologyFree UniversityBerlinGermany
  2. 2.Department of Child and Adolescent PsychiatryUniversity of ZürichZürichSwitzerland

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