早期治疗苯丙酮尿症患者的心理健康和社会功能:PKU-COBESO 研究。

Mental health and social functioning in early treated Phenylketonuria: the PKU-COBESO study.

机构信息

Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

出版信息

Mol Genet Metab. 2013;110 Suppl:S57-61. doi: 10.1016/j.ymgme.2013.10.011. Epub 2013 Oct 22.

Abstract

This article presents a new Dutch multicenter study ("PKU-COBESO") into cognitive and behavioral sequelae of early and continuously treated Phenylketonuria (PKU) patients. Part of the study sample will consist of young adult PKU patients who have participated in a large neuropsychological study approximately 10 years ago, when they were 7-to-15-year-olds (Huijbregts et al., 2002 [1]). Their neurocognitive development will be mapped in association with their earlier and continued metabolic history, taking into account possible changes in, for instance, medication. A second part of the sample will consist of PKU patients between the ages of 7 and approximately 40 years (i.e., born in or after 1974, when neonatal screening was introduced in The Netherlands), who have not participated in the earlier neuropsychological study. Again, their cognitive functioning will be related to their metabolic history. With respect to aspects of cognition, there will be an emphasis on executive functioning. The concept of executive functioning will however be extended with further emphasis on the impact of cognitive deficits on the daily lives of PKU patients, aspects of social cognition, social functioning, and behavior/mental health (i.e., COgnition, BEhavior, SOcial functioning: COBESO). In addition to a description of the PKU-COBESO study, some preliminary results with respect to mental health and social functioning will be presented in this article. Thirty adult PKU patients (mean age 27.8, SD 6.4) and 23 PKU patients under the age of 18 years (mean age 11.0, SD 3.3) were compared to 14 (mean age 26.9 years, SD 5.9) and 7 matched controls (mean age 10.5, SD 2.6) respectively, with respect to their scores on the Adult Self-Report or Child Behavior Checklist (measuring mental health problems) and the Social Skills Checklist or Social Skills Rating System (measuring social skills). Whereas there were very few significant group differences (except for mental health problems in the internalizing spectrum for adult PKU patients), possibly due to the small control groups, several significant associations between mental health problems and Phe levels were observed for the PKU patients. Childhood Phe levels and internalizing problems for adult PKU patients were related; concurrent Phe was associated with both internalizing and externalizing behavioral problems for those under the age of 18. These preliminary results underline the importance of early dietary adherence.

摘要

本文介绍了一项新的荷兰多中心研究(“PKU-COBESO”),旨在探讨早期持续治疗苯丙酮尿症(PKU)患者的认知和行为后遗症。该研究的一部分样本将包括大约 10 年前参加过一项大型神经心理学研究的年轻成年 PKU 患者,当时他们的年龄在 7 至 15 岁之间(Huijbregts 等人,2002 [1])。将根据他们早期和持续的代谢史来绘制他们的神经认知发展情况,同时考虑到药物治疗等方面的可能变化。样本的另一部分将包括年龄在 7 岁至 40 岁之间的 PKU 患者(即出生于 1974 年或之后,当时荷兰开始进行新生儿筛查),他们没有参加早期的神经心理学研究。同样,他们的认知功能将与他们的代谢史相关联。在认知方面,将特别强调执行功能。然而,执行功能的概念将进一步扩展,以强调认知缺陷对 PKU 患者日常生活、社会认知、社会功能和行为/心理健康的影响(即认知、行为、社会功能:COBESO)。除了描述 PKU-COBESO 研究外,本文还将介绍一些关于心理健康和社会功能的初步结果。30 名成年 PKU 患者(平均年龄 27.8,标准差 6.4)和 23 名 18 岁以下的 PKU 患者(平均年龄 11.0,标准差 3.3)与 14 名(平均年龄 26.9 岁,标准差 5.9)和 7 名匹配的对照组(平均年龄 10.5 岁,标准差 2.6)进行了比较,比较的指标是成人自我报告或儿童行为检查表(测量心理健康问题)和社会技能检查表或社会技能评定系统(测量社会技能)。尽管成年 PKU 患者组之间的差异非常小(除了成年 PKU 患者的内化谱中的心理健康问题外),这可能是由于对照组较小,但是 PKU 患者的心理健康问题与 Phe 水平之间观察到了几个显著的关联。儿童时期的 Phe 水平与成年 PKU 患者的内化问题有关;对于 18 岁以下的患者,同时存在的 Phe 与内化和外化行为问题均有关联。这些初步结果强调了早期饮食依从性的重要性。

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