Lviv clinical bulletin 2023, 1(41): 15-21

https://doi.org/10.25040/lkv2023.01.015

The Relationships between the Problems with Somatic Health in Preschool Children and Disorders of Psychomotor Development

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А. Pushnyk, S. Niankovskyy

Danylo Halytsky Lviv National Medical University

Introduction. Multiple studies show the presence of interconnection between co-morbidity and psychomotor development disorders in children.

The aim of the study. To identify the relationships between the problems with somatic health in preschool children (3-7 years old) and disorders of their psychomotor development.

Materials and methods. Clinical and laboratory examination of 70 children was carried out in a randomized manner with preliminary stratification according to the presence of psychomotor development disorders regarding the somatic and infectious diseases and birth defects they had at the time of the examination and in the anamnesis. The examined group consisted of 70 children of preschool age (3-7 years) with psychomotor development disorders. Statistical processing included calculations using R. E. Fisher’s angular transformation and correlation analysis.

Results. The results of the multiple conducted researches prove that the frequency of comorbidities, primarily somatic, in children with psychomotor development disorders is higher than in the general population. The combined influence of adverse environmental conditions, perinatal factors, nutritional disorders, nutritional behavior, reduced motor activity, neuroinflammation, immune response disorders, abnormalities in the quantitative and qualitative species composition of the intestinal microbiota, the phenomenon of an abnormally high microbial load on the organism, violations of interaction in the brain-gut axis, autonomic and mitochondrial dysfunctions, oxidative stress, sensory hypersensitivity, behavioral problems, sleep disorders, increased anxiety and irritability inherent in this children, can be the main reason for this. It is also worth to mention the presence of atopy and dyspeptic manifestations in many examined children, which, presumably, can be components of the food allergy complex of symptoms. It is worth noting, that in most of the subgroups we selected, there were children with physical development disorders, in all subgroups cases of infectious diseases were found in the anamnesis of children, as well as burdened family and allergic anamnesis, which can be caused by both adverse environmental factors and peculiarities, inherent in children with psychomotor development disorders.

Among somatic diseases, respiratory ailments dominate in all studied subgroups. There is also a significant share of children with a burdened family and allergy history, atopic dermatitis, lesions of the ears and throat. We found full dependence, as well as medium strength and weak direct reliable correlation between somatic and infectious diseases, present in a significant part of the examined children with psychomotor development disorders, burdened allergic anamnesis and burdened family anamnesis (which conforms with a higher susceptibility to allergic diseases in children with psychomotor development disorders, in particular with mental retardation and ASD) in all subgroups, and also physical development disorders.
It is necessary to include a personalized approach into the complex of rehabilitation of children with psychomotor development disorders, with simultaneous correction of existing comorbid pathological symptoms and neurological disorders, inherent in this category of children.

Conclusions. Correlation between respiratory infections and a number of somatic and infectious diseases, disorders of physical development, burdened allergic and family history among the examined children in all the subgroups selected by us, which consists in the detection of complete dependence and a reliable correlation of varying strength, have been established.

References

  1. Evidence-based clinical practice. Attention deficit hyperactivity disorder in children and youth. [Internet], 2019 [2022 Nov 19]; Available from: https://www.dec.gov.ua/wp-content/uploads/2019/11/2019_09_30_kn_rozladdu.pdf (Ukrainian)
  2. Evidence-based clinical practice “Pneumonia in children”. [Internet], 2022 [2022 Nov 19]; Available from: https://www.dec.gov.ua/wp-content/uploads/2022/08/2022_1380_kn_pnevmoniyi_u_ditej.pdf (Ukrainian)
  3. Mal’cev DV. Evaluation of the immune status in children with autism spectrum disorder associated with folate cycle genetic deficiency. Medical Affair. 2018;1-2:11-23 (Russian)
  4. Mamenko ME. Attention deficit hyperactivity disorder in children: modern views on etiology, pathogenesis, approaches to correction. Child’s Health. 2015;5(56):7-13 (Russian)
  5. Marcenkovs’kyj IA, Marcenkovs’ka II. Autism spectrum disorders: risk factors, peculiarities of diagnosis andt herapy. International Neurological Journal. 2018;4(98):75-83 (Ukrainian)
  6. Matusova MO, Marcenkovs’kyj IA. Peculiarities of functional digestive disorders in children with autism spectrum disorders. Archives of Psychiatry. 2018;24(2):102-104. (Ukrainian)
  7. Order of the Ministry of Health of Ukraine N 59, dated January 29, 2013 “On approval of unified clinical protocols for medical care for children with diseases of the digestive organs”. [Internet] 2013 [cited 2022 Nov 20]; Available from: https://zakononline.com.ua/documents/show/117384___531299 (Ukrainian)
  8. Order of the Ministry of Health of Ukraine № 181, dated 24.03.2009 “On the approval of protocols for the provision of medical care in the specialty “Otolaryngology”. [Internet] 2009 [cited 2022 Dec 20]; Available from: https://ips.ligazakon.net/document/MOZ9371 (Ukrainian)
  9. Niankovskyy SL, Pyshnyk AI, Kuksenko OV, Hrushka OI. The macro- and microelement provision of preschool children with psychomotor developmental disorders. Literature review and authors’ research. Child’s Health. 2021;16(7):40-47 (Ukrainian)
  10. Pakulova-Troc’ka JuV, Niankovskyy SL. Problems of somatic pathology in children with autism spectrum disorders. Child’s Health. 2016;1(69):63-67 (Ukrainian)
  11. Pidlisec’ka L, editor. Synopsis of DSM-V diagnostic criteria and NICE protocols for the diagnostics and treatment of major mental disorders in children and adolescents. Lviv: Ukrainian Catholic University Publishing House; 2014. 112 p. (Ukrainian)
  12. Pomeranceva TI, Skorobagatova OV. Characteristics of clinical and neuropsychological polymorphism in children with mental retardation. Ukrainian Bulletin of Psychoneurology. 2019;27(3):102 (Ukrainian)
  13. Unified clinical protocol of primary, secondary (specialized), tertiary (highly specialized) medical care and medical rehabilitation “Autism spectrum disorders (disorders of general development)”: Order of the Ministry of Health of Ukraine N 341 dated06.2015 [Internet] 2015 [updated 2022 Jun 20; cited 2022 Nov 20]; Available from: https://zakononline.com.ua/documents/show/62031___62031 (Ukrainian)
  14. Unified clinical protocol of primary, secondary, tertiary (highly specialized) medical care and medical rehabilitation “Cerebral palsy and other organic brain lesions in children accompanied by movement disorders”: Order of the Ministry of Health of Ukraine N 286 dated 04.09.2013. [Internet] 2013[cited 2022 Nov 19]; Available from: https://zakononline.com.ua/documents/show/74189___74189 (Ukrainian)
  15. Unified clinical protocol of primary medical care for adults and children “Acute respiratory infections”. Order of the Ministry of Health of Ukraine N 499, dated 16.07.2014 (as amended by Order of the Ministry of Health of Ukraine N 85 dated 11.02.2016). [Internet] 2016 [cited 2022 Nov 21]; Available from: https://www.dec.gov.ua/wp-content/uploads/2019/11/2014_499ykpmd_gri.pdf (Ukrainian)
  16. Unified clinical protocol of primary, secondary (specialized), tertiary (highly specialized) medical care “Atopic dermatitis”. Order of the Ministry of Health of Ukraine N 670, dated 4.07.2016. [Internet] 2016 [cited 2022 Nov 20]; Available from: https://www.dec.gov.ua/wp-content/uploads/2019/11/2016_670_ykpmd_ad.pdf (Ukrainian)
  17. Agnafors S, Kjellström NA, Torgerson J, Rusner M. Somatic comorbidity in children and adolescents with psychiatric disorders. Eur Child Adolesc Psychiatry. 2019;28(11):1517-1525.
  18. Chen Q, Hartman CA, Kuja-Halkola R, Faraone SV, Almqvist C, Larsson H. Attention-deficit/hyperactivity disorder and clinically diagnosed obesity in adolescence and young adulthood: a register-based study in Sweden.Psychological Medicine. 2019; 49(11):1841-1849.
  19. Chua RX, Tay MJ, Ooi DS, Siah KT, Tham EH, Shek LPC et al. Understanding the link between allergy and neurodevelopmental disorders: a current review of factors and mechanisms. Front Neurol. 2015;11:603571.
  20. De Rubeis S, Buxbaum JD. Genetics and genomics of autism spectrum disorder: embracing complexity. Hum Mol Genet. 2015; 24(R1):R24-31.
  21. Doshi-Velez F, Avillach P, Palmer N, Bousvaros A, Ge Y, Fox K et al. Prevalence of inflammatory bowel disease among patients with autism spectrum disorders. Inflamm Bowel Dis. 2015;21(10):2281-2288.
  22. Fulceri F, Morelli M, Santocchi E, Cena H, Del Bianco T, Narzisi A et al. Gastrointestinal symptoms and behavioral problems in preschoolers with autism spectrum disorder. Dig Liver. 2016;48(3):248-254.
  23. Jensberg Leirbakk M, Clench-Aas J, Raanaas RK. ADHD with co-occurring depression/anxiety іn children: the relationship with somatic complaints and parental socio-economic position. J Psychol Abnorm Child. 2015;4(1):1-6.
  24. Kalkman HO, Feuerbach D. Microglia M2A polarization as potential link between food allergy and autism spectrum disorders. Pharmaceuticals (Basel). 2017;10(4):95.
  25. Kedem S, Yust-Katz S, Carter D, Levi Z, Kedem R, Dickstein A et al. Attention deficit hyperactivity disorder and gastrointestinal morbidity in a large cohort of young adults. World J Gastroenterol. 2020;26(42):6626-6637.
  26. Lambregts-Rommelse N, Hebebrand J. The role of nutrition in child and adolescent onset mental disorders. Eur Child Adolesc Psychiatry. 2017;26:1007-1010.
  27. Markovic-Jovanovic SR, Milovanovic JD, Jovanovic AN, Zivkovic JB, Balovic AD, Nickovic V et al. Comorbidities in children with intellectual disabilities. Birth Defects Res. 2020;112(1):54-61.
  28. Masi L, Gignac M. ADHD and comorbid disorders in childhood psychiatric problems, medical problems, learning disorders and developmental coordination disorder. Clinical Psychiatry. 2015;1(1:5):1-9.
  29. Minen MT, De Dhaem OB, Kroon A, Powers S, Schwedt TJ, Lipton R et al. Migraine and its psychiatric comorbidities. J Neurol Neurosurg Psychiatry. 2016;87(7):741-749.
  30. Pan P-Y, Tammimies K, Bölte S.The association between somatic health, autism spectrum disorder, and autistic traits. Behavior Genetics. 2020;50:233-246.
  31. Perrel F. Integrative review about somatic care improvement tools for people with autistic syndrome disorder. Perspect Psychiatr Care. 2022;58(3):1177-1189.
  32. Salem H, Vivas D, Cao F, Kazimi IF, Teixeira AL, Zeni CP. ADHD is associated with migraine: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry. 2018;27(3):267-277.
  33. Sharma SR, Gonda X, Tarazi F. Autism spectrum disorder: classification, diagnosis and therapy. Pharmacol Ther. 2018;190:91-104.
  34. Shubayeva GS, Tayzhan AA, Baydosova DK. Comorbidities of children with intellectual disabilities. Asian Social Science. 2015;11(16):168-174.
  35. Sztein DM, Lane WG. Examination of the comorbidity of mental illness and somatic conditions in hospitalized children in the United States using the kids inpatient database. Hosp Pediatr. 2016;6(3):126-134.
  36. Tanner K, Case-Smith J, Nahikian-Nelms M, Ratliff-Schaub K, Spees C, Darragh AR. Behavioral and physiological factors associated with selective eating in children with autism spectrum disorder. Am J OccupTher. 2015;69(6):6906180030p1-8.
  37. Telnes Instanes J, Klungsøyr K, Halmøy A, Fasmer OB, Haavik J. Adult ADHD and comorbid somatic disease: a systematic literature review. J Atten Disord. 2018;22(3):203-228.
  38. Vissoker RE, Latzer Y, Gal E. Eating and feeding problems and gastrointestinal dysfunction in autism spectrum disorders. Research in Autism Spectrum Disorders. 2015;12:10-21.
  39. Weissenberger S, Ptacek R, Klicperova-Baker M, Erman A, Schonova K, Raboch J et al. ADHD, lifestyles and comorbidities: a call for an holistic perspective – from medical to societal intervening factors. Front Psychol. 2017;8:454.
  40. Williams ZJ, Gotham KO. Current and lifetime somatic symptom burden among transition-aged autistic young adults. Autism Res. 2022;15(4):761-770.
  41. Xu G, Snetselaar LG, Jing J, Liu B, Strathearn L, Bao W. Association of food allergy and other allergic conditions with autism spectrum disorder in children. JAMA Netw Open. 2018;1(2):e180279.