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The objective of this study was to measure the frequency and severity of the behavioral effects of high-dose oral steroid therapy in children with nephrotic syndrome. We conducted a prospective assessment of the behavior of 12 children using a standardized psychological questionnaire at the time of diagnosis and again after 4 weeks of steroid therapy. A group of control children was also assessed. There was a significant increase in the total behavior score (P=0.03) and specifically in aggressive and poor attention behavior items in the group of nephrotic children compared with the control group. Four of the children with nephrotic syndrome developed abnormal behavior in the clinical range compared with none of the controls. In conclusion, children with nephrotic syndrome treated with high-dose oral steroids are at risk of developing clinically relevant behavioral changes. [ABSTRACT FROM AUTHOR]

Symptom rating sheets completed by psychiatrists over a 9-year period on 2602 intellectually normal child and adolescent clinic attenders were subjected to factor analysis (principal components). Two types of factor sets were derived, one for younger subjects (3-11 years) and another for older subjects (12-18). Both had three factors in common: conduct disturbance, relationship problems and emotionality, but differed on the fourth-developmental immaturity for the younger group, depression for the older. A factor solution was also derived for the whole clinic sample with three scales: conduct, emotionality and immaturity. Both types of factor solutions were subjected to MANOVA for age and sex effects, both of which proved to be of significant influence. Good correspondence was found between the symptom factors identified and conceptually similar clinical diagnoses. [ABSTRACT FROM AUTHOR]

Sixty boys, aged from 6 to 10 years, were studied after their referral to psychiatric clinics for antisocial or disruptive behaviour. Their scores on reliable measures of hyperactivity, defiant behaviour, emotional disorder and attention deficit were taken for the home, school and clinic settings; and subjected to two techniques of cluster analysis. Both gave a similar set of clusters, one of which had high scores on all measures of hyperactivity and attention deficit. Membership of this cluster was associated with a lower IQ, a younger age of problem onset and referral, an abnormal neurological examination, a history of developmental delay, smaller family size, poor peer relationships and a high rate of accidental injuries; and it predicted a good response to stimulant medication in a controlled trial. Other research on the classification of hyperactivity is discussed, and proposals are made for the criteria of a rather narrow definition of 'hyperkinetic conduct disorder'. [ABSTRACT FROM AUTHOR]

The distinction between hyperactivity and conduct disorder was explored in a mixed group of 64 children referred to psychiatric clinics because of antisocial or disruptive behaviour. A semi-structured interview measure (the Parental Account of Children's Symptoms, PACS) proved to have adequate inter-rater reliability, internal consistency and factorial validity. The PACS scales of defiance and hyperactivity, and similar subscales from Conners' Teacher Rating Scale, were tested against laboratory and clinical measures of activity, attention, cognitive performance, psychosocial background and family relationships. The hyperactivity (but not the defiance) scales were associated with greater activity, younger age, poorer cognitive performance and abnormalities on a developmental neurological examination. The defiance (but not the hyperactivity) scales were associated with impairment of family relationships and adverse social factors. It was concluded that a dimension of inattentive, restless activity should be separated from one of antisocial, defiant conduct in children with psychiatric disorder. [ABSTRACT FROM AUTHOR]

The diagnosis of hyperkinetic syndrome is rarely used in the UK, in marked contrast to its counterpart in the USA. Most of the work on hyperkinesis is concerned with the North American concept and relatively little attention has been paid to the British approach. The present paper reviews the development of the UK concept and diagnosis, describes the characteristics of 73 hyperkinetic syndrome children seen at the Bethlem and Maudsley Hospitals over 13 years and compares them to matched psychiatric controls diagnosed as conduct disordered. Results indicate that the two groups are differentiated by a number of symptomatic and clinical features, with the conduct disorder group showing a greater frequency of aggressive, antisocial, emotional and psychosocial disturbance which contrasts with higher frequencies of motor disturbance, inattentive and articulatory disturbance in the hyperkinetic group. No differences were found between the groups in brain pathology or sensory handicap. The findings provide support, at least in terms of symptoms and clinical features, for the concept and diagnosis of hyperkinetic syndrome (ICD 9). [ABSTRACT FROM AUTHOR]