No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Influence of maternal psychological traits on sleep bruxism in children
Abstract
Background:
Sleep bruxism (SB) is a sleep disorder with high incidence in toddlers and may perpetuate to adulthood. The multifactorial etiology of bruxism includes pathophysiologic and psychological factors.
Aim:
To investigate the relationship between depression, stressful events, and the presence of symptoms of anxiety and depression with SB in children of adolescent mothers.
Design:
This cross-sectional study nested in a cohort evaluated a sample of 536 mothers and their children aged 24-36 months. Interviews were conducted with mothers. Maternal report of SB was collected. Mother's major depressive disorder was assessed using the Mini International Neuropsychiatric Interview (MINI Plus); Life Events Scale assessed the stressful events; Beck Depression Inventory and Beck Anxiety Inventory investigated the symptoms of depression and anxiety. Poisson regression analysis was applied to assess the association of maternal psychological disorders and stressful events with SB on children.
Results:
Prevalence of SB was 25.93% (95% CI 22.2-29.7). After adjustments, maternal major depression disorder [PR 1.43 (95% CI 1.06-1.92)] and the presence of stressful events mainly environmental changes [PR 1.47 (95% CI 1.08-2.00)] showed significant association with bruxism in children.
Conclusion:
This study showed a positive association between mother's psychological traits and SB development in their toddlers.
... La etiología del bruxismo es compleja y de naturaleza multifactorial, puede ser local, sistémica, psicológica, o hereditaria (Bulanda et al., 2021;Calvano Küchler et al., 2020;Goettems et al., 2017;Lamenha Lins et al., 2020;Serra-Negra et al., 2017). Estudios refieren que la regulación del bruxismo nocturno es principalmente centralizada que, aunque en sí el bruxismo no se considera como patología o trastorno, podría ser una posible alarma o síntoma de condiciones de salud o hábitos que perturban el sistema nervioso central (Restrepo, Santamaría, et al., 2021). ...
... Además, se han relacionado como causa del bruxismo a diversos factores como: psicosociales, obstrucción de la vía aérea, hábitos parafuncionales, la calidad del sueño, enfermedades sistémicas, uso de pantalla con fines recreativos, consumo de azúcar agregado y medicamentos (Calvano Küchler et al., 2020;Chisini et al., 2020;Goettems et al., 2017;Luconi et al., 2021;Restrepo, Santamaría, et al., 2021;Vieira et al., 2020). ...
... El bruxismo de vigilia se ha asociado con la incapacidad para expresar emociones, durante estados de ansiedad, rabia, odio, agresión, mientras que el bruxismo del sueño tiene una correlación positiva con el estrés, la angustia, trastornos del comportamiento, trastornos de personalidad, neuroticismo y agresividad debido a que ocasionan la liberación de serotonina y dopamina produciendo la fragmentación del ciclo normal del sueño que ocurre repetidas veces en la noche incrementando la actividad cerebral, frecuencia cardiaca y el tono muscular de la mandíbula, con la consecuente incapacidad de desarrollar una buena calidad del sueño (Berger et al., 2017;Calvano Küchler et al., 2020;Chisini et al., 2020;Goettems et al., 2017;Restrepo, Ortiz, et al., 2021;Vieira et al., 2020). ...
En el año 2017 en un consenso internacional con expertos en bruxismo a nivel mundial, se definió al mismo como una “actividad repetitiva de los músculos de la mandíbula caracterizada por apretar o rechinar los dientes y/ o apretar o empujar la mandíbula”. Al observarse características diferentes durante el bruxismo del sueño y el de vigilia respectivamente, se recomienda "retirar" la definición única de bruxismo en favor de dos definiciones separadas. De esta forma, el presente artículo tiene como objetivo reflejar la visión actual del bruxismo para establecer un adecuado diagnóstico y óptimo tratamiento en base a los resultados obtenidos. El presente es una investigación descriptiva que incluye un total de 25 artículos. No se han encontrado diferencias significativas respecto al género, se lo considera más un signo de una enfermedad que un trastorno y puede presentarse como un factor de riesgo o como factor protector; de etiología multifactorial. Se concluye que el tratamiento va enfocado dependiendo del factor etiológico desde un enfoque psicológico hasta un tratamiento quirúrgico descartando ideas preconcebidas que pueden tender a sobrestimar el verdadero alcance de las particularidades del bruxismo.
... Relatos na literatura indicam a presença de bruxismo em cerca de 56% das crianças durante o início da erupção dentária 8 e de 25% após a erupção dos segundos molares decíduos. 9 Acreditase, teoricamente, que conforme a musculatura se estabiliza, o comportamento regrida espontaneamente, sendo regulado pela maturação do sistema estomatognático durante esse período e pelos dentes que entram em posição e assumem as suas funções. 10 Além disso, é defendido pela literatura que o bruxismo está relacionado a fatores psicológicos, como o comportamento e altos níveis de ansiedade, 11-13 e fatores relacionados à higiene do sono, como o uso de telas, tempo de sono insuficiente, dormir com barulhos no quarto ou com luzes acesas. ...
... Em se tratando da primeira infância ou crianças mais novas, é possível que os principais sinais clínicos, como desgaste dentário e dores musculares e de cabeça, não estejam presentes, devido à ausência de dentes ou dentes recém-erupcionados. [8][9][10] Nesses casos, o relato torna-se a principal ferramenta de investigação da ocorrência do comportamento, sendo importante avaliar o estágio em que se encontra a dentição decídua e acompanhar os sinais e sintomas do paciente para investigar se o bruxismo detectado no bebê é fisiológico ou patológico. [8][9][10] Crianças e adolescentes Com a entrada no ambiente escolar, profissionais devem estar atentos a outros fatores associados à ocorrência do bruxismo, como o bullying. ...
... [8][9][10] Nesses casos, o relato torna-se a principal ferramenta de investigação da ocorrência do comportamento, sendo importante avaliar o estágio em que se encontra a dentição decídua e acompanhar os sinais e sintomas do paciente para investigar se o bruxismo detectado no bebê é fisiológico ou patológico. [8][9][10] Crianças e adolescentes Com a entrada no ambiente escolar, profissionais devem estar atentos a outros fatores associados à ocorrência do bruxismo, como o bullying. 29,42 Estudos mostram que crianças e adolescentes que são vítimas de bullying e vítimasintimidadores têm maior prevalência de bruxismo, 29,42 de modo que o odontopediatra pode auxiliar na detecção do bullying em seus pacientes. ...
Introdução: O bruxismo tem sido objeto de estudo no decorrer de décadas e
ainda é polêmica a abordagem em diferentes faixas etárias. Objetivo: O objetivo
deste manuscrito é apresentar uma proposta de protocolo clínico de bruxismo do
sono e vigília para crianças e adolescentes. Materiais e Métodos: Foi realizado
um protocolo clínico a partir de uma revisão crítica da literatura sobre o bruxismo
do sono e em vigília em crianças e adolescentes. Foram abordados o conceito
atual de bruxismo, os principais fatores associados, anamnese e principais sinais
clínicos, considerando as peculiaridades das diferentes etapas da vida
infantojuvenil: bebês, crianças e adolescentes. Resultados: O bruxismo precisa
ser abordado de forma diferenciada por faixa etária. Uma anamnese bem
detalhada, o conhecimento do desenvolvimento fisiológico do paciente
infantojuvenil, seus possíveis comportamentos, a presença de dores de cabeça e
dores nos músculos faciais merecem atenção especial pelo cirurgião dentista.
Conclusão: O bruxismo merece cuidados distintos por faixa etária.
... The diagnosis of SB can be made by a report/self-report, clinical examination, and/or instrumental approaches (electromyographic recordings, for example) [1]; however, most studies have used reporting/self-report positive as a diagnostic criterion [7,9,[13][14][15][16][17]. The positive clinical examination associated or not with a positive report/self-report characterizes probable SB and increases the validity and reliability of the diagnosis [1,2]. ...
... The expectation of the birth of a child, especially when she/he is an only child, generally triggers anxiety, stress, and a sense of responsibility in parents and family that can be transmitted to children [23]. These feelings have already been reported as factors associated with BS in children and adolescents [10,12,15,20,24]. BS is considered a mechanism for releasing accumulated stress during the day and a parameter for how the individual deals with daily conflicts [10,24]. ...
... In this study, a high prevalence of probable SB was observed when compared to other studies [7,9,15,18,22,29]. The discrepancy between the reported prevalences can be explained by the methodological differences in relation to the sample's representativeness and the fact that most studies used only the report of the parents/guardians as diagnostic criterion [7,9,15,22,29], although there is prevalence variability, probably due to the lack of standardization of diagnostic methods. ...
Purpose
To determine the prevalence of probable sleep bruxism (SB) in preschoolers and associated factors.
Methods
A cross-sectional, population-based study was carried out with 862 dyads of parents/preschoolers aged 5 from Teresina, Brazil. Data collection was performed through a questionnaire answered by parents/guardians about socioeconomic, demographic, and health condition data. Each child was examined for diagnosis of probable SB based on the presence of dental wear associated or not with the report of teeth grinding by parents/guardians. The analysis of independent variables was stratified into four levels of determinants: demographic characteristics of the child (distal), characteristics of the family, environmental factors (intermediate), and health conditions (proximal). Descriptive analysis and bivariate and multivariate Poisson’s regression were performed using a hierarchical approach (p < 0.05).
Results
The prevalence of probable SB was 36%. In the final adjusted multivariate hierarchical model, a preschooler who was the only child (PR = 1.25; 95%CI = 1.02–1.51), with breathing problems (PR = 1.43; 95%CI = 1.19–1.73), and having parents/guardians with possible sleep bruxism (PR = 1.65; 95%CI = 1.32–2.07) had a higher prevalence of probable SB.
Conclusion
The prevalence of probable SB in preschoolers was high and associated with the condition of being an only child, the presence of breathing problems, and having parents/guardians with possible sleep bruxism.
... Based on the idea that mental health can have an impact on oral health and that mothers are the main caregivers during childhood, studies have been assessing the relationship between maternal mental disorder and children's oral health 7,8 . Maternal mental problems may lead to a family dysfunction, inadequate care and a negative effect on mother-child interactions that could affect oral health of their offspring 9,10 . ...
... In relation to maternal mental health, there were studies that investigated more than one maternal mental problem, two studies considered Common Mental Disorders (CMD) 15 The distribution of age across studies was quite varied; children between 18 and 48 months were included in two studies that investigated the same sample for two different outcomes 15,16 .Children between 24 and 36 months were included in two studies 7,8 . Each one of the others studies had the following distribution: children between 0 and 4 years 18 , between 1 and 5 years 17 and 5 years old children 19 . ...
... In relation to risk of bias assessment (Table 6), five studies were classified as high quality 7,8,[15][16][17] one study was classified as moderate quality 19 and one study was considered as low quality 18 . ...
Maternal mental problems may lead to a negative effect on children's oral health (COH). The aim of this study was to systematically review the literature to answer the question: Are maternal mental disorders (MMD) associated to COH from zero to 12 years old? Electronic searches were performed in 5 databases with no language restriction. Cohort, case‐control and cross‐sectional studies were included. A total of 1183 references were identified, 7 studies were included. In relation to MMD studies investigated: Common Mental Disorders (n=2), Major Depressive Disorder (MDD) (n=2), symptoms of depression (SD) (n=3), Alcohol‐related diagnosis (n=1) and symptoms of anxiety (n=2) . As outcome, the studies investigated dental caries (n=5), gingivitis and periodontal diseases (n=1), sleep bruxism (SB) (n=1) and malocclusion (n=1). Positive association was found between MDD and OH (SB and dental caries). There was no MMD associated with malocclusion. Alcohol‐related diagnosis showed a positive association with gingivitis and periodontal diseases and no association with dental caries, anxiety had a positive association with dental caries and no association with SB. The heterogeneity of the data precluded precise conclusions to be drawn, but MMD may have influence on COH.
... Furthermore, numerous studies have demonstrated that parents' anxiety, depression levels, and psychiatric symptom profiles affect the occurrence of sleep bruxism in their children (14,16,34). The majority of studies investigating the relationship between parental psychopathology and bruxism in children discovered a link between depression, anxiety symptoms, and stressful events in parents and bruxism in children (14,16,34). ...
... Furthermore, numerous studies have demonstrated that parents' anxiety, depression levels, and psychiatric symptom profiles affect the occurrence of sleep bruxism in their children (14,16,34). The majority of studies investigating the relationship between parental psychopathology and bruxism in children discovered a link between depression, anxiety symptoms, and stressful events in parents and bruxism in children (14,16,34). Our study yielded that 14.9% of mothers and 11.9% of fathers had a psychiatric disorder. ...
Background: Previous studies have revealed a close relationship between a variety of psychopathologies and psychosocial factors, and bruxism. However, psychosocial factors and psychiatric difficulties in children and adolescents with bruxism have not been extensively studied. In the current study, we sought to examine the sociodemographic characteristics, psychosocial factors, and comorbid psychopathologies of children and adolescents with sleep bruxism. Materials and Methods: The study included 67 children and adolescents between the ages of 4-17 who were diagnosed with sleep bruxism and followed up at two different Child and Adolescent Psychiatry outpatient clinics between 2018 and 2024. Data on behavioral and emotional characteristics and comorbid psychiatric disorders of these patients, clinical features of bruxism, and treatment approaches to bruxism were retrospectively investigated. Results: Our results indicated that 41.8 of the sample had at least one comorbid psychiatric disorder, and 10.4% had subthreshold psychiatric symptoms. The most common comorbid psychiatric disorders were anxiety disorders, attention deficit hyperactivity disorder, nocturnal enuresis, and conduct disorders. In 41.8% of cases, bruxism was linked to psychosocial factors. Comorbid psychiatric disorders were significantly more prevalent in the school and adolescent age groups than in preschoolers. Similarly, the connection between bruxism and psychosocial factors became more evident with age. The frequency of a positive family history of bruxism was 44.8%. As treatment options for bruxism, the behavioral approach and pharmacotherapy were preferred in 88.1% of cases, and only the behavioral approach was applied to 11.9%. The most common drugs used in pharmacotherapy were hydroxyzine, tricyclic antidepressants, antipsychotics, atypical antidepressants, and melatonin. In terms of response to treatment, 83.6% of the sample responded (completely or partially), while 16.4% did not respond or were resistant to treatment. Conclusions: This study yielded that psychiatric comorbidity is quite common in the pediatric population with sleep bruxism. The outcomes suggest that bruxism is not only a dental problem but is also associated with a variety of psychopathologies and psychosocial factors. Therefore, health professionals who may encounter bruxism should be aware of the relationship between bruxism and psychopathologies and psychosocial factors. It is recommended that children with bruxism be investigated carefully in a multidisciplinary and holistic approach from a bio-psycho-social perspective and screened for psychosocial and psychiatric difficulties.
... According to these researches, it was stated that a greater rate of SB among children whose mothers have a higher education level and those whose parents are divorced [5]. In another study, it was stated that children whose mothers with depressive and stressful have a greater likelihood of occurrence SB [24]. Much research has been done on children in relation to SB. ...
... Some of these studies are systematic reviews, and some have focused on the prevalence and incidence of SB or the aetiology and risk factors of SB. Additionally, there are a few studies that have examined the effects of the psychological and sociological statuses of families on children who have SB [4,5,20,21,24,25]. It is considered that the psychological status and behaviors of the family may contribute to the solution of the problem as it may be potentially related factors with sleep bruxism in children. ...
Objective:
The objective of this study was to evaluate the effects of parental anxiety, depression levels and psychiatric symptom profiles of parents on the occurrence of sleep bruxism in children.
Material & methods:
This cross-sectional study was carried out with a sample of 94 children aged 6 to 12 years, divided into two groups: with sleep bruxism (bruxism group-BG) and without sleep bruxism (control group-CG). Beck Depression Inventory (BDI), Symptom Checklist (SCL-90-R), Symptom Checklist and Screen for Child Anxiety Related Emotional Disorders-Parent (SCARED-P) scale were used to assess anxiety and depression levels of parents. All questionnaires were filled out by parents of children. Intraoral and extraoral examinations were carried out of children in the clinic and sleep bruxism was determined. All stress conditions were investigated by logistic regression analysis. In the comparison of the qualitative data, chi-square and Fisher exact tests were used.
Results:
The data revealed that participants whose mothers had high anxiety and interpersonal sensitivity scores, and participants whose fathers had a medium level of obsessive-compulsive disorder were more likely to have an SB problem (p < 0.05). According to the results of BDI, the fathers' results between the BG and the CG were not statistically significant (p > 0.05). However, the mothers' results between the BG and the CG were statistically significant (p < 0.05) When all subscales of SCARED-P were evaluated, the separation anxiety disorder subscore was statistically significant in the bruxism group.
Conclusion:
The psychological status of parents is a significant risk factor associated with SB development in school-age children.
... Such studies report a greater rate of SB among children whose mothers have a higher level of schooling [6] and those whose parents are divorced [8]. Another Brazilian study reports that children whose mothers have a depressive disorder and those stressful events have a greater likelihood of have SB [11]. Other studies show association between SB in children and a high level of stress related to psychological reactions [9] as well as association with the habit of biting objects [10,12], pacifier sucking, biting one's lips, and nail biting [13]. ...
... The investigation of these factors in children is important due to the possibility that SB can cause tooth wear [11], orofacial pain [16], temporomandibular pain, and headache [16,17] in both childhood and adulthood [16]. Moreover, poor sleep quality might be a consequence of SB [1,18]. ...
Objective
To investigate the association between probable sleep bruxism (PSB) and associated factors in schoolchildren.
Materials and methods
A case-control study was conducted with a representative sample of 320 schoolchildren aged 8 to 10 years. The case group (160 children with PSB) and the control group (160 children without PSB) were matched for sex and age at a proportion of 1:1. Information on audible characteristics of PSB, harmful oral habits, and socio-demographic characteristics as collected through questionnaires answered by the parents/caregivers. The family functioning of children was measured through The Family Adaptability and Cohesion Evaluation Scales (FACES III). Mothers self-administered the Lipp Stress Symptoms Inventory (LSSI) for adults to measure mothers’ stress and the children filled out the Child Stress Scale (CSS) to measure the children stress. Data analysis used descriptive and logistic regression analyses (p < 0.05).
Results
Among the children with stress, 67.3% had PSB. Children with stress (OR = 2.22, 95% CI 1.18–4.19), those with a history of nail biting (OR = 2.22, 95% CI 1.39–3.55), and biting objects (OR = 1.77, 95% CI 1.09–2.87) were more likely to have PSB.
Conclusion
Childhood stress and a history of nail biting or biting objects are important signs to be considered in schoolchildren with PBS.
Clinical relevance
These results alert that the PBS might be a sign of stress and other psychological problems such as tension and anxiety related to the presence of harmful oral habits. Furthermore, the results could help in the targeting of anamnesis, improved prevention and treatment strategies for sleep bruxism which should involve an interdisciplinary approach.
... Estudos relacionam que características psicológicas dos pais, em especial ansiedade, parecem estar associadas ao desenvolvimento do BS em seus filhos 16 . Além de que crianças, filhos de mães mais jovens, ti-nham mais chances de apresentar essa parafunção 10 . ...
... De acordo com Barros Atualmente, a polissonografia associada a eletrodos constituem o padrão de referência, identificando os episódios de ocorrência durante o sono 25,39 . Porém, de acordo com Goettems et al. 16 (2017), este exame pode ser considerado eficaz apenas quando ocorrem os episódios, podendo a criança não os apresentar durante a realização do mesmo. Também o elevado custo do exame e o uso de eletrodos podem causar desconforto, aumentando os níveis de ansiedade e, consequentemente, podem levar a um falso positivo, diminuindo a confiabilidade da polissonografia. ...
... Although signs and symptoms of bruxism are well known and can be often recognized, its etiology remains uncertain [5]. Several risk factors have been associated with bruxism, such as smoking, alcohol consumption, sleep disorders, gastro-esophageal reflux disease, and the presence of sleep bruxism in childhood [6][7][8][9]. Mental health status could influence oral health conditions [10]. In the last years, a possible association between mental health and bruxism has been investigated, since psychological factors as anxiety and stress have also been described within the onset of bruxism [11]. ...
... In this perspective, it may be hypothesized that there is a complex social environment in which all subjects are involved directly, and when a person presents more episodes of CMD through his/her life course is expected that this person lives a higher amount of time exposed to these mental health effects being more prone to present an important risk factor for bruxism in this trajectory. Also, psychological factors influencing bruxism during lifetime are reported since childhood [36] and has been observed that the presence of depression, anxiety symptoms and stressful events occurring in mothers could influence the presence of sleep bruxism in their offspring [7]. Thus, as a centrally regulated condition, it may be said that those common mental disorders Moreover, it has been hypothesized that bruxism and CMD conditions could be associated [11,37]. ...
Objectives:
This study aimed to assess the prevalence of bruxism and its relationship with common mental disorders (CMD) during the life course of individuals.
Materials and methods:
A representative sample (n = 537) of all 5914 births occurring in Pelotas in 1982 were prospectively investigated regarding their oral health. The CMD screening was assessed through Self-Reported Questionnaire-20 (SRQ-20) at ages 22 and 30. Bruxism information was collected in the oral health survey at the age 31. Exploratory variables included demographic and socio-economic, mental health and unhealthy behaviours. Multivariate Poisson Regression analysis was used to estimate the association between bruxism and CMD.
Results:
Bruxism prevalence was 41.1% at 31 years old. Presence of bruxism was positively associated with females (p = 0.003), lower school level (p = 0.001), and smoking habits (p = 0.021). CMD episodes were associated with bruxism (p < 0.001). Individuals presenting CMD at age of 30 years presented a 57% higher prevalence (PR 1.57; 95%CI 1.14-2.15) of bruxism, while in those individuals who presented CMD in both follow-ups (at 22 and 30 years old) the bruxism prevalence was 70% higher (PR 1.70; 95%CI 1.28-2.25).
Conclusion:
Subjects presenting signals and symptoms of common mental disorders during their life course presented higher prevalence of bruxism.
Clinical significance:
The presence of common mental disorders during life course impacts in the presence of bruxism in the adulthood. In addition, more episodes of common mental disorders were associated with higher prevalence of bruxism.
... O ambiente em que os indivíduos estão inseridos também foram primordiais no aparecimento de bruxismo infantil nos trabalhos da presente revisão. A influência do comportamento materno é um fator predisponente com grande relevância no aparecimento dos espasmos musculares, sendo que mães que apresentam estresse, ansiedade, depressão e/ou bruxismo, filhos com bruxismo (DRUMOND et al., 2017;GOETTEMS et al., 2017;SAMPAIO et al., 2018). Além disso, filhos de pais fumantes possuem maior predisposição ao bruxismo, já que o fumo passivo pode ser considerado fator de associação a condição estudada, com aumento de até 90% em diferentes períodos de avaliação (MONTALDO et al., 2012). ...
Introdução: O bruxismo do sono caracteriza-se como uma disfunção originada no sistema nervoso central que desencadeia a atividade muscular involuntária e repetitiva que pode promover o desgaste do dente. Objetivo: Realizar uma revisão de literatura a fim de descrever os fatores etiológicos associados ao bruxismo do sono em crianças. Método: Foram utilizadas as bases de dados PubMed, Scielo e Google Acadêmico, utilizando a combinação das palavras chaves: bruxismo ou bruxism, bruxismo do sono ou sleep bruxism, crianças ou children, etiologia ou etiology e fatores de risco ou risk factors. Resultados: Foram identificados trabalhos que apresentaram resultados relacionados aos fatores psicológicos, que podem ser enquadrados os transtornos de ansiedade, estresse, depressão e alterações comportamentais. Além disso, alterações sistêmicas como asma, obstrução de vias aéreas superiores, apnéia obstrutiva do sono, e refluxo gastroesofágico. Conclusão: O bruxismo possui origem multifatorial e pode ser desencadeado por fatores intrínsecos e extrínsecos ao paciente.
... Our results identified higher self-reported SB in women with depression, but with no significant association. Attention must be given to the fact that mother's impaired psychological aspects might be associated with bruxism activity in their toddler, and that the establishment of morbidities at this age may perpetuate to adulthood (Brancher et al., 2020;Goettems et al., 2017;Halal et al., 2021). Beginning assessments in early pregnancy have the added benefit of identifying women at the highest risk for later insomnia, allowing for earlier screening and intervention (Plancoulaine et al., 2017;Sedov et al., 2018). ...
Objective
To evaluate the self-reported SB prevalence and explore associated risk factors in puerperal women who had given birth in Rio Grande, Southern Brazil.MethodsA single, standardized questionnaire was given within the 48 h postpartum period. Self-reported SB was the main outcome investigated. Chi-square test was used to compare proportions, and Poisson regression with robust variance adjustment was used in the multivariate analysis.ResultsA total of 2225 women were included. Only 79 (3.6%) of these reported clenching or grinding their teeth during sleep. Adjusted analysis showed that the higher education level of the mothers (PR = 3.07; 95% CI 1.49–6.28; P = 0.006); living with three or more persons in the household (PR = 0.54; 95% CI 0.34–0.84; P = 0.007); medication intake during pregnancy (PR = 1.68; 95% CI 1.09–2.58; P = 0.017); smoking (PR = 1.93; 1.16–3.23; P = 0.024), or ever smoked (PR = 1.82; 95% CI 0.85–3.90; P = 0.024); severe anxiety (PR = 1.36; 95% CI 0.61–3.02; P = 0.005); and headache upon waking (PR = 4.19; 95% CI 1.95–9.00; P < 0.001) were significantly associated with self-reported SB.Conclusion for PracticeOur data pointed towards new factors in a specific group of women that may be relevant for preventing sleep-related behaviors in the pregnancy–puerperal cycle. The higher levels of education, medication intake, smoking or even smoked, severe anxiety, the higher the probability of puerperal woman to self-report SB. The nighttime tooth clenching strongly increased headache upon waking.
... Another factor that has also been identified as a risk for developing bruxism is separation anxiety [22] , which is defined as a reaction to stress in children aged 12 to 18 months who are separated from their parents and attachment is disrupted [23] . Likewise, certain psychological characteristics of the mothers, such as depression and environmental changes that cause stress, influence the children of adolescent mothers to present AB [24] . The psychological factors most frequently affected are stress and anxiety, which have increased due to confinement. ...
Introduction: Bruxism is a behavior that has negative consequences, its prevalence is in 33.65% of children. It can present as probable bruxism, awake bruxism, and sleep bruxism. This has been frequently present during the COVID-19 pandemic. Objective: Analyze the literature about bruxism and its relationship with signs and symptoms, psychological factors, sleep disorders, screen time, and treatment. Methodology: Articles on the subject published through the PubMed, SCOPUS and Google Academic databases were analyzed, with an emphasis on the last 5 years. It was carried out with the words "bruxism", "pediatric dentistry", "treatment", "symptoms" and "signs". Results: The signs and symptoms of bruxism are present more frequently in patients with attention deficit, hyperactivity disorder and with previous bruxism. Stress and anxiety are the psychological factors that influence more the increase of bruxism during the COVID-19 pandemic. Likewise, sleep disturbances have risen, so it is recommended to be more physically active and to reduce screen time to improve health status. Due to the limitations caused by the current pandemic, it is necessary to take advantage of electronic media to guide patients and provide care. Conclusion: Bruxism has increased during the COVID-19 pandemic. Patients present characteristic signs and symptoms, which are affected by different factors such as stress, anxiety, sleep disturbances and screen time. Due to current limitations, it is important to take advantage of teleodontology to guide and care for patients.
... 29 Bruksizmi artıran risk faktörleri arasında sigara, alkol, bazı ilaçlar, solunum problemleri, uyku bozuklukları, reflü ve çocukluk çağı uyku bruksizmi yer almaktadır. 25,[30][31][32][33] Çocuklarda bruksizm ile ilişkili risk faktörlerini tespit etmeyi amaçlayan çalışmalardan yapılan derlemede; cinsiyet, yaş, kalıtım, sigara dumanına maruz kalma, anksiyete, gergin kişilik, yüksek psikolojik reaksiyonlar, fazla sorumluluk duygusu, uyku boyunca fazla hareket etme, ağzı açık uyuma, yüksek sesle horlama, huzursuz uyku, sekiz saatten az uyku, ışıklı ortamda uyuma, gürültülü oda, baş ağrısı, obje ısırma, akranlarıyla problemler, duygusal semptomlar ve zihinsel sağlık problemleri bruksizm ile ilişkilendirilmiştir. 34 Dopaminerjik ve serotinerjik sistemler arasındaki dengesizlik bruksizm görülme sıklığını ve şiddetini etkiler. [35][36][37][38][39] Tipik ya da atipik antipsikotiklerin, merkezi sinir sistemindeki dopamine-2 reseptörleri üzerine inhibe edici etkileri vardır ve bu nedenle sıklıkla bruksizm, orofasiyal distoni ve oromandibular diskinezi de dahil olmak üzere ekstrapiramidal istemsiz hareketlere neden olabilir. ...
... göstermiştir. Çocuklardaki bruksizm ile annelerin ruhsal durumu arasındaki ilişkiyi araştıran bir çalışmada, annelerin majör depresyonda olmasının ve çevresinde ciddi stresör olayların olmasının çocuklarındaki bruksizm olasılığını artırdığını belirtilmiştir (14). Yani oldukça önemli bir etkisi olduğunu bildiğimiz stresin, bruksizm üzerindeki etkisi oldukça karmaşık bir yapıdadır. ...
Bruxism is a parafunctional activity characterized by daytime (diurnal) or nighttime (nocturnal) tooth grinding and squeezing and causing various pathologies in oropharyngeal tissues. Buspirone is used in the treatment of generalized anxiety disorder, to reduce the side effects of selective serotonin reuptake inhibitors, and to strengthen the treatment in depression and anxiety disorders. In addition to these uses, buspirone is also used in the treatment of bruxism in adults. In this study, it is aimed to summarize bruxism cases treated with buspirone in literature and to discuss treatment options. A systematic research was conducted on Pubmed, Google Academic and Web of Science databases to evaluate all peer-reviewed articles using buspirone in the treatment of bruxism. The whole study in which buspirone was used in the treatment of bruxism was included in the study. When evaluated on the basis of case reports, buspirone is seen as one of the psychotropes that can be used safely in the treatment of bruxism. In the treatment, it may be recommended to adjust the average daily dose to 10-20 mg and wait a minimum of 2 weeks, although the effectiveness may occur in a much shorter time. This study is important in terms of recommending buspirone, which has been shown to be effective in the treatment of bruxism in many cases, despite its various limitations and as a step for further studies on this subject.
... Gottems et al, in their research investigated 500 mothers on their mental well being, other stressful factors and its influence on their children. It was found that children were significantly more prone to bruxism when their mothers had major depressive disorders and lived in stressful environments [36]. ...
... O movimento rítmico anormal causado durante o sono e detectado durante a atividade do bruxismo é causado pelo sistema nervoso central e autônomo. Essas forças que podem ser geradas durante o BS e o BV podem ter efeitos prejudiciais sobre os componentes do sistema mastigatório, principalmente os dentes, seus tecidos de sustentação e a articulação temporomandibular 14,32 . ...
O bruxismo é descrito como uma parafunção orofacial que afeta crianças e adultos caracterizado pelo hábito de ranger ou apertar os dentes, com etiologia complexa, multifatorial, assim como seu diagnóstico e controle. Pode ser considerado cêntrico, quando o hábito de apertar os dentes ocorre de ação semi-inconsciente, denominado diurno ou vigília (BV) e, excêntrico, quando ocorre ranger dos dentes de ação inconsciente, denominado noturno ou do sono (BS). A homeopatia (H) visa restabelecer o equilíbrio da energia vital do paciente permitindo o movimento de cura do organismo. O objetivo desta pesquisa foi avaliar a eficácia dos medicamentos homeopáticos (Matricaria chamomilla e Cimex lectularius), concomitante com a terapêutica convencional para que se tenha uma alternativa no controle do bruxismo. A amostra abordou 60 pacientes com diferentes antecedentes sociais, de ambos os gêneros, com idade de 18 a 60 anos, os quais responderam a questionários específicos e passaram por exames clínicos orais com resposta positiva para o bruxismo. Foram divididos aleatoriamente em Grupo Teste (GT) com 30 indivíduos tratados com placas interoclusais de acrílico associadas com medicamentos homeopáticos e Grupo Controle (GC) com 30 indivíduos utilizando placas interoclusais mais placebo (medicamentos homeopáticos sem o princípio ativo) por um período total de 6 meses, avaliados mensalmente para a verificação da diminuição dos sinais e sintomas do bruxismo. O resultado final concluiu a eficácia da terapêutica homeopática como coadjuvante ao tratamento convencional com as placas interoclusais, amenizando os transtornos de dor e desgastes dentários provocados pelo bruxismo.
... Age 7 years coincides with the first year of elementary school, a major, daily event involving separation that may strengthen the association between sleep bruxism and separation anxiety. This result also highlights the need to consider separation anxiety as a risk factor, along with other psychological aspects associated with sleep bruxism in children [57][58][59]. ...
Study Objectives
The evolution of sleep bruxism manifestations and their co-occurrence with separation anxiety in early childhood remain unclear. Our threefold aim was to: (1) describe developmental sleep bruxism trajectories in early childhood, (2) investigate co-occurrences between trajectories of sleep bruxism and separation anxiety, and (3) determine whether distinct trajectories of separation anxiety increase the risk of presenting sleep bruxism during the first year of elementary school.
Methods
This study is part of the Québec Longitudinal Study of Child Development. Sleep bruxism scores were assessed from age 1.5 to 7 years with the Self-Administered Questionnaire for Mother (n=1,946). Separation anxiety scores were measured from age 1.5 to 6 years with the Interviewer-Completed Computerized Questionnaire (n=2,045).
Results
We identified four sleep bruxism trajectories from age 1.5 to 6 years: High-Increasing sleep bruxism at age 1.5 (14.1%), High-Increasing sleep bruxism at age 4 (18.3%), Low-Persistent sleep bruxism (12.1%), and Never-Persistent sleep bruxism (55.5%); and four separation anxiety trajectories from age 1.5 to 6 years: Low-Persistent separation anxiety (60.2%), High-Increasing separation anxiety (6.9%), High-Decreasing separation anxiety (10.8%), and Low-Increasing separation anxiety (22.1%). Sleep bruxism and separation anxiety trajectories were weakly associated (X2=37.84, P<0.001). Compared with preschoolers belonging to the Low-Persistent separation anxiety trajectory, preschoolers in the High-Increasing separation anxiety trajectory had almost double the risk of presenting sleep bruxism at age 7 (95% CI=1.25–3.22, P=.04).
Conclusion
When separation anxiety issues are detected in early childhood, it would be useful to target sleep bruxism during the first year of elementary school.
... [16] Another study said that children who drooled and sleep talked were 1.7 and 1.6 times more likely to be bruxers than other children who did not have these habits. [42] Goettems et al. 2017 [43] investigated over 500 mothers and the effect of their mental well-being as well as any stressful environmental factors on its impact on their children, it was reported that the presence of major depressive disorder and existence of stressful events more importantly environmental changes had a significant association with bruxism in children. In this study, the mothers work status could present as a stressful environmental factor for children, and thus, the many habits seen in WM children which are associated with Bruxism. ...
Aims and Objectives
The aims and objectives of this study were to determine if an association exists between mothers work status and her children's incidence of bruxism and habits related to bruxism.
Materials and Methods
A cross-sectional study was conducted through data collection of a questionnaire answered by 561 mothers’ about their working status and their child's habits and behaviors. The survey consisted of 5 parts with a total of 34 questions: mother's information, child's behavior, child's sleeping pattern, mother's knowledge about bruxism, and child's medical history. Odds ratios, Chi-square, and their corresponding 95% confidence intervals are reported. Statistical significance was set at P ≤ 0.05.
Results
The work status of the mother was not statistically significant in increasing the incidence of a child to have bruxism. However, this study clearly elucidates that 7 of the 15 habits correlate significantly with a status of bruxism. According to this sample, a child, that is, reported to be aggressive is more than twice as likely to have nocturnal bruxism. Likewise, any child that bites their nails, complains of headaches, drools in their sleep, snores, complains of muscle cramps, and colic is more than twice as likely to be a nocturnal bruxer than a child that does not have these habits.
Conclusion
The prevalence of children's bruxism in this convenient sample was 34.5% (n = 141). The concerning habits related to bruxism can serve the pediatric dentist, general dentist, general practitioner, and primary care provider of children having these red flags as indicators of bruxism. It is imperative that parents of these children be made aware these habits that may occur together, alone or even simultaneously with bruxism.
Objective:
To explore the relationship between parenting styles and children's personality traits and parental-reported sleep bruxism (SB).
Methods:
A total of 301 parents/caregivers of Brazilian children participated in this cross-sectional study and answered an online questionnaire addressing sociodemographic characteristics, sleep-related behaviors and parent-reported SB. The Brazilian versions of the Parenting Styles and Dimensions Questionnaire and the Eysenck Personality Questionnaire-Junior assessed children's parenting styles and personality traits. Descriptive analysis and multinomial logistic regression were used.
Results:
Boys (OR=2.07; 95% CI=1.09-3.91) whose snoring (OR=2.98; 95% CI=1.55-5.73) were associated with mild parent-reported SB. Boys (OR=2.61; 95% CI=1.20-5.70) and high levels of neuroticism (OR=2.27; 95% CI=1.06-4.860) were associated with moderate/severe parent-reported SB. Authoritarian parenting attitudes decreased the likelihood of moderate/severe parent-reported SB (OR=0.37; 95% CI=0.16-0.86).
Conclusions:
Parents/caregivers who exhibited more authoritarian attitudes reported a lower prevalence of moderate/severe children SB. Neuroticism trait and snoring influenced the severity of parent-reported SB.
This study aimed to test for an association between hair cortisol, as an indicator of chronic stress, and possible sleep bruxism among children participating in the 2015 Pelotas Birth Cohort Study. Data from 3229 children were analysed. Possible sleep bruxism was identified based on caregivers' reports when the child was 4 years old. Trained fieldworkers collected hair samples from children, and a standardized protocol was used for hormone extraction and cortisol quantification from the hair. Information on socioeconomic, demographic, psychological and behavioural characteristics was gathered through questionnaires. Poisson regression with robust variance was used to evaluate the impact of hair cortisol concentration on the occurrence of possible sleep bruxism, guided by a directed acyclic graph. The prevalence of possible sleep bruxism was 21.46% (n = 693); median hair cortisol concentration was 7.8 pg mg-1. Hair cortisol concentration was not found to be associated with the occurrence of sleep bruxism. However, the presence of sleep bruxism was linked to higher maternal education (p = 0.027), maternal stress level (p = 0.032), excessive use of electronic devices (p = 0.007), and child emotional and behavioural problems (p = 0.003). Furthermore, female sex was associated with a lower frequency of possible sleep bruxism (p = 0.003). There was no association between chronic stress, as measured by hair cortisol concentration, and the occurrence of possible sleep bruxism. This study underscores the role of sociodemographic factors and children's mental health in the occurrence of sleep bruxism among children in this population.
Background/Objectives: The purpose of this systematic review was to assess the global prevalence of sleep bruxism and awake bruxism in pediatric and adult populations. Methods: This systematic review was conducted by analyzing studies published from 2003 to 2023. The following keyword combination was utilized: prevalence, epidemiology, population, and bruxism. The PubMed database was analyzed, supplemented by manual searches using the Google search. Additionally, the snowballing procedure method was applied. A double assessment of the quality of publications was carried out to preserve the highest possible quality of evidence (e.g., Joanna Briggs Institute critical appraisal checklist). Analyses were conducted using the R statistical language. Results: The global bruxism (sleep and awake) prevalence is 22.22%. The global sleep bruxism prevalence is 21% and awake prevalence is 23%. The occurrence of sleep bruxism, based on polysomnography, was estimated at 43%. The highest prevalence of sleep bruxism was observed in North America at 31%, followed by South America at 23%, Europe at 21%, and Asia at 19%. The prevalence of awake bruxism was highest in South America at 30%, followed by Asia at 25% and Europe at 18%. Conclusions: One in four individuals may experience awake bruxism. Bruxism is a significant factor among women. It was observed that age is a significant factor for the occurrence of sleep bruxism in women. Among the limitations of the study is the lack of analysis of the prevalence of bruxism in Africa and Australia due to not collecting an adequate sample for analysis. The study was registered in the Open Science Framework (10.17605/OSF.IO/ZE786).
Sleep-related movement disorders, for example, restless legs syndrome and sleep related bruxism, interfere with acquisition of good quality sleep. These disorders can interfere with onset or maintenance of sleep, and underlying motor events lead to micro-arousals during sleep. Hence, patients suffering from sleep-related movement disorders can show signs of sleep deprivation which possible result in daytime consequences including among others increased sensitivity to pain, distressed and anxious mood, headaches, generalized fatigue, loss of appetite, and cognitive impairment. These symptoms may be mistaken for psychiatric disorders or may pave way for psychiatric disorders. This chapter reviews though scant but available literature in this area.KeywordsRestless legs syndromeBruxismDepressionAnxietyHeadache
Objetivo: analisar a literatura pertinente sobre diagnóstico do bruxismo infantil, a fim de auxiliar o cirurgião-dentista em como detectar esta condição. Materiais e métodos: através das bases de dados PubMed, SciELO e Lilacs, com termos específicos, foi revisada a literatura e realizada a seleção de artigos mais relevantes, por dois examinadores independentes. Os critérios incluíram crianças com bruxismo, de 0 a 12 anos, independentemente de sexo, ano ou contexto geográfico. Resultados: inicialmente, 1.409 artigos foram identificados. Após a exclusão de duplicatas, avaliação dos títulos, resumos e textos completos, foram selecionados 42 artigos. Uma tabela foi delineada para extrair dados e através desta foram mapeados os estudos. Questionários/ relatos dos responsáveis foram os métodos mais utilizados para diagnóstico de bruxismo infantil, relatados na literatura, 21 artigos, e associados com exame clínico, 16 artigos. A polissonografia foi utilizada em 5 artigos, sendo 2 exclusivamente, 1 em revisão sistemática e 2 associados com questionário aos responsáveis. Os indicadores da Associação Americana de Medicina do Sono (AASM) foram utilizados em 9 artigos. Conclusão: a associação entre exame clínico/relato dos responsáveis, com critérios específicos, sugere uma boa conduta para o cirurgião-dentista, embora a polissonografia seja considerada o método padrão-ouro, pois independe de condições financeiras e manejo, principalmente por se tratar de crianças.
Verificou-se a relação entre Bruxismo Infantil e ansiedade associada ao uso de dispositivos tecnológicos, através de um estudo clínico pautado em uma revisão integrativa. O escopo revisional foi realizado nas bases bibliográficas BVS, MEDLINE, BBO e LILACS, empregaram-se as palavras-chave "bruxismo", "crianças", "ansiedade" e "alfa-amilases", critérios de elegibilidade foram estabelecidos e seguidos para a seleção dos artigos. Na etapa clínica, os participantes entretiveram-se com um jogo digital, coletou-se uma amostra de saliva, antes e após o uso do dispositivo. Posteriormente procedeu-se o exame intraoral, mensuração da alfa-amilase-salivar (AAS) e aplicação de questionários. A média de idade dos participantes foi 8,4 anos (n=10). Dentre os pacientes com bruxismo, observou-se que (57,2%) acordam durante a noite, falam (60%), roncam (80%), relatam pesadelos (80%) e apertamento dentário (75%). O dispositivo mais utilizado foi celular/tablet (90%), com tempo médio semanal de (27h) (DP ± 6,05), não se observou diferença estatisticamente significativa entre as médias dos níveis de AAS antes e após a exposição ao jogo digital (teste T-Student, p-valor 0,653). Concluiu-se que a ansiedade é um fator que pode estar relacionado ao acometimento do Bruxismo Infantil. A maioria dos bruxômanos usuários de dispositivos tecnológicos possuíam hábito de apertar os dentes e qualidade do sono inferior aos que não tinham bruxismo. Os níveis de AAS mostram-se elevados antes e após a exposição ao jogo digital.
Purpose of Review
This study aimed to review the current knowledge on sleep-related bruxism, highlight the most recent findings, and discuss future research perspectives.
Recent Findings
Sleep-related bruxism etiology appeared to follow a genetic-environmental model, whereas comorbidity with other sleep disorders, obstructive sleep apnea, and gastroesophageal reflux has been recently described and deserves further investigations.
Summary
Sleep-related bruxism is an involuntary motor activity characterized by episodic and rhythmic masticatory muscle contractions of tooth grinding or jaw clenching during sleep. It predominantly occurs during light sleep stages and in association with sleep arousal. Although the gold standard diagnostic tool is a polysomnography recording, most of the time diagnosis is based on the medical and dental history and the clinical examination. A conservative therapeutic approach is generally recommended, using dental guards, and it aims to manage and prevent the eventual consequences on the masticatory system, including tooth wear, prosthetic biomechanical complications, implant failure, muscle pain, and headaches.
Background:
The early environment is important for child development and wellbeing. Gene-by-environment studies investigating the impact of the serotonin transporter gene-linked polymorphic region (5-HTTLPR) and the Brain Derived Neurotrophic Factor (BDNF) Val66Met polymorphisms by life events on mental health and behaviour problems have been inconclusive. Methodological differences regarding sample sizes, study population, definitions of adversities and measures of mental health problems obstacle their comparability. Furthermore, very few studies included children. The aim of this study was to examine the associations between a broad range of risk factors covering pregnancy and birth, genetic polymorphism, experience of multiple life events and psychosocial environment, and child behaviour at age 3, using a comparably large, representative, population-based sample.
Methods:
A total of 1,106 children, and their mothers, were followed from pregnancy to age 3. Information on pregnancy and birth-related factors was retrieved from the Medical Birth Register. Questionnaires on depressive symptoms, child behaviour and child experiences of life events were filled in by the mothers. Child saliva samples were used for genotyping the 5-HTTLPR and BDNF Val66Met polymorphisms. Multiple logistic regression was used to investigate the association between psychological scales and genetic polymorphisms.
Results:
Symptoms of postpartum depression increased the risk of both internalizing and externalizing problems. Experience of multiple life events was also a predictor of behavioural problems across the scales. No gene-by-environment or gene-by-gene-by-environment interactions were found. Children of immigrants had an increased risk of internalizing problems and parental unemployment was significantly associated with both internalizing and externalizing type of problems.
Conclusion:
This study shows the importance of the psychosocial environment for psychosocial health in preschool children, and adds to the literature of null-findings of gene-by-environment effects of 5-HTTLPR and BDNF in children.
Early identification of problems with psychosocial stress regulation is important for supporting mental and physical health. However, we currently lack knowledge about when reliable individual differences in stress-responsive physiology emerge and which aspects of maternal behavior determine the unfolding of infants' stress responses. Knowledge of these processes is further limited by analytic approaches that do not account for multiple levels of within- and between-family effects. In a low-risk sample (
n
= 100 dyads), we observed infant cortisol and mother/infant behavior during regular play and stress sessions longitudinally from age 1 to 3, and used a three-level model to separately examine variability in infant cortisol trajectories within sessions, across years, and across infants. Stable individual differences in hypothalamus–pituitary–adrenal axis regulation were observed in the first 3 years of life. Infants of less sensitive and more intrusive mothers manifested stress sensitization, that is, elevated cortisol levels during and following stress exposure, a profile related to behavioral distress. These findings have important practical implications, suggesting that children at risk for long-term stress dysregulation may be identified in the earliest years of life.
Background:
Episodes of depression and anxiety (D&A) during the transition from late adolescence to adulthood, particularly when persistent, are predictive of long-term disorders and associated public health burden. Understanding risk factors at this time is important to guide intervention. The current objective was to investigate the associations between maternal symptoms of D&A with offspring symptoms during their transition to adulthood.
Method:
Data from a large population-based birth cohort study, in South Brazil, were used. Prospective associations between maternal D&A and offspring risk of these symptoms during the transition to adulthood (18/19, 24 and 30 years) were estimated.
Results:
Maternal D&A in adolescence was associated with offspring symptoms across the transition to adulthood, associations were consistently stronger for females than for males. Daughters whose mothers reported D&A were 4.6 times (95% confidence interval 2.71-7.84) as likely to report D&A at all three time-points, than daughters of symptom-free mothers.
Conclusions:
Maternal D&A is associated with persistent D&A during the daughter's transition to adulthood. Intervention strategies should consider the mother's mental health.
Parenting interventions have been implemented to improve the compromised developmental potential among 39% of children younger than 5 years living in low-income and middle-income countries. Maternal wellbeing is important for child development, especially in children younger than 3 years who are vulnerable and dependent on their mothers for nutrition and stimulation. We assessed an integrated, community-based parenting intervention that targeted both child development and maternal wellbeing in rural Uganda.
In this community-based, cluster randomised trial, we assessed the effectiveness of a manualised, parenting intervention in Lira, Uganda. We selected and randomly assigned 12 parishes (1:1) to either parenting intervention or control (inclusion on a waitlist with a brief message on nutrition) groups using a computer-generated list of random numbers. Within each parish, we selected two to three eligible communities that had a parish office or a primary school in which a preschool could be established, more than 75 households with children younger than 6 years, and at least 15 socially disadvantaged families (ie, maternal education of primary school level or lower) with at least one child younger than 36 months. Participants within communities were mother-child dyads, where the child was 12-36 months of age at enrolment, and the mother had low maternal education. In the parenting intervention group, participants attended 12 fortnightly peer-led group sessions focusing on child care and maternal wellbeing. The primary outcomes were cognitive and receptive language development, as measured with the Bayley Scales of Infant Development, 3rd edn, and self-reported maternal depressive symptoms, using the Center for Epidemiologic Studies Depression Scale. Theoretically-relevant parenting practices, including the Home Observation for Measurement of the Environment inventory, and mother-care variables, such as perceived spousal support, were also assessed as potential mediators. Baseline assessments were done in January, 2013, and endline assessments were done in November, 2013, 3 months after completion of the programme. Ethics approval was received from Mbarara and McGill universities. This trial is registered with ClinicalTrials.gov, NCT01906606.
Between December, 2012, and January, 2013, 13 communities (194 dyads) were randomly assigned to receive intervention, and 12 communities (154 dyads) were assigned to a waitlist control. 319 dyads completed baseline measures (171 in the intervention group and 148 in the control group), and 291 dyads completed endline measures (160 in the intervention group and 131 in the control group). At endline, children in the intervention group had significantly higher cognitive scores (58·90 vs 55·65, effect size 0·36, 95% CI 0·12-0·59) and receptive language scores (23·86 vs 22·40, 0·27, 0·03-0·50) than did children in the control group, and their mothers reported significantly fewer depressive symptoms (15·36 vs 18·61, -0·391, 95% CI -0·62 to -0·16) than did mothers in the control group.
The 12 session integrated parenting intervention delivered by non-professional community members improved child development and maternal wellbeing in rural Uganda. Because this intervention was largely managed and implemented by a local organisation, using local community members and minimal resources, such a programme has the potential to be replicated and scaled up in other low-resource, village-based settings.
Plan Uganda via Plan Finland (Ministry of Foreign Affairs) and Plan Australia (Australian Aid).
Copyright © 2015 Singla et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by Elsevier Ltd.. All rights reserved.
Purpose:
Maternal psychological distress is one of the most common perinatal complications, affecting up to 25% of pregnant and postpartum women. Research exploring the association between prenatal and postnatal distress and toddler cognitive development has not been systematically compiled. The objective of this systematic review was to determine the association between prenatal and postnatal psychological distress and toddler cognitive development.
Methods:
Articles were included if: a) they were observational studies published in English; b) the exposure was prenatal or postnatal psychological distress; c) cognitive development was assessed from 13 to 36 months; d) the sample was recruited in developed countries; and e) exposed and unexposed women were included. A university-based librarian conducted a search of electronic databases (Embase, CINAHL, Eric, PsycInfo, Medline) (January, 1990-March, 2014). We searched gray literature, reference lists, and relevant journals. Two reviewers independently evaluated titles/abstracts for inclusion, and quality using the Scottish Intercollegiate Guideline Network appraisal tool for observational studies. One reviewer extracted data using a standardized form.
Results:
Thirteen of 2448 studies were included. There is evidence of an association between prenatal and postnatal distress and cognitive development. While variable effect sizes were reported for postnatal associations, most studies reported medium effect sizes for the association between prenatal psychological distress and cognitive development. Too few studies were available to determine the influence of the timing of prenatal exposure on cognitive outcomes.
Conclusion:
Findings support the need for early identification and treatment of perinatal mental health problems as a potential strategy for optimizing toddler cognitive development.
To examine familial aggregation of irritable bowel syndrome (IBS) via parental reinforcement/modeling of symptoms, coping, psychological distress, and exposure to stress.
Mothers of children between the ages of 8 and 15 years with and without IBS were identified through the Group Health Cooperative of Puget Sound. Mothers completed questionnaires, including the Child Behavior Checklist (child psychological distress), the Family Inventory of Life Events (family exposure to stress), SCL-90R (mother psychological distress), and the Pain Response Inventory (beliefs about pain). Children were interviewed separately from their parents and completed the Pain Beliefs Questionnaire (beliefs about pain), Pain Response Inventory (coping) and Child Symptom Checklist [gastrointestinal (GI) symptoms]. In addition, health care utilization data was obtained from the automated database of Group Health Cooperative. Mothers with IBS (n = 207) and their 296 children were compared to 240 control mothers and their 335 children, while controlling for age and education.
Hypothesis 1: reinforcement of expression of GI problems is only related to GI symptoms, but not others (cold symptoms) in children. There was no significant correlation between parental reinforcement of symptoms and child expression of GI or other symptoms. Hypothesis 2: modeling of GI symptoms is related to GI but not non-GI symptom reporting in children. Children of parents with IBS reported more non-GI (8.97 vs 6.70, P < 0.01) as well as more GI (3.24 vs 2.27, P < 0.01) symptoms. Total health care visits made by the mother correlated with visits made by the child (rho = 0.35, P < 0.001 for cases, rho = 0.26, P < 0.001 for controls). Hypothesis 3: children learn to share the methods of coping with illness that their mothers exhibit. Methods used by children to cope with stomachaches differed from methods used by their mothers. Only 2/16 scales showed weak but significant correlations (stoicism rho = 0.13, P < 0.05; acceptance rho = 0.13, P < 0.05). Hypothesis 4: mothers and children share psychological traits such as anxiety, depression, and somatization. Child psychological distress correlated with mother's psychological distress (rho = 0.41, P < 0.001 for cases, rho= 0.38, P < 0.001 for controls). Hypothesis 5: stress that affects the whole family might explain the similarities between mothers and their children. Family exposure to stress was not a significant predictor of children's symptom reports. Hypothesis 6: the intergenerational transmission of GI illness behavior may be due to multiple mechanisms. Regression analysis identified multiple independent predictors of the child's GI complaints, which were similar to the predictors of the child's non-GI symptoms (mother's IBS status, child psychological symptoms, child catastrophizing, and child age).
Multiple factors influence the reporting of children's gastrointestinal and non-gastrointestinal symptoms. The clustering of illness within families is best understood using a model that incorporates all these factors.
This study evaluated the association of level of anxiety in children with and without sleep bruxism (SB). The study was performed with 84 six- to eigth-years-old children, divided into two groups: with bruxism (BG) and without bruxism (CG). Following the criteria purposed by American Academy of Sleep Medicine (AASM) to determine SB, the presence of tooth wear has been verified through clinical examinations, and the parents have answered a questionnaire about their children's behavior and habits. Additionally, the State-Trait Anxiety Inventory for Children (STAIC) was applied to parents of the selected patients. Data analysis revealed a statistical significant difference between the groups (Student's t-test, p = 0.0136). Based on the results, anxiety assessment revealed that children with bruxism have reached higher levels in the STAIC scale than the non-bruxism group. Therefore, it indicates a direct relationship between the presence of anxiety disorder and the onset of bruxism in children.
Objetivos: O MINI é uma entrevista diagnóstica padronizada breve (15-30 minutos), compatível com os critérios do DSM-III-R/IV e da CID-10, que é destinada à utilização na prática clínica e na pesquisa em atenção primária e em psiquiatria, e pode ser utilizada por clínicos após um treinamento rápido (de 1 a 3 horas). A versão Plus do MINI, mais detalhada, gera diagnósticos positivos dos principais transtornos psicóticos e do humor do DSM-IV. Este artigo apresenta os resultados de quatro estudos de validação do instrumento, realizados na Europa e nos EUA. Métodos: Os estudos 1 (França) e 2 (EUA) testaram a confiabilidade - entre avaliadores e teste-reteste - da versão DSM-III-R do MINI (n=84, sendo 42 pacientes psiquiátricos de cada centro) e sua validade com relação ao CIDI (n=346, sendo 296 pacientes psiquiátricos e 50 controles) e ao SCID-P (n=370, sendo 308 pacientes psiquiátricos e 62 controles), respectivamente. O estudo 3 testou a validade de diagnósticos gerados por clínicos gerais usando o MINI (DSM-IV) com relação aos diagnósticos clínicos habituais de psiquiatras, em 409 pacientes de centros de atenção primária de quatro países (França, Espanha, Itália e Reino Unido). O estudo 4 testou a confiabilidade entre avaliadores (n=20 pacientes psiquiátricos) e a validade dos módulos Transtornos Psicóticos, Depressão e Mania do MINI Plus - DSM IV (n=104 pacientes psiquiátricos) com relação a dois critérios de referência: diagnósticos do CIDI e diagnósticos clínicos de psiquiatras. Análises quantitativas (índices de concordância e de validade) e qualitativas (razões de discordância) foram realizadas. Resultados: Os índices de confiabilidade do MINI (estudos 1 e 2) e do MINI Plus (estudo 4) foram globalmente satisfatórios. Comparados a vários critérios de referência (CIDI, SCID-P, opinião de peritos), em diferentes contextos (unidades psiquiátricas e centros de atenção primária), o MINI e o MINI Plus mostraram qualidades psicométricas similares às de outras entrevistas diagnósticas padronizadas mais complexas, permitindo uma redução de 50% ou mais no tempo da avaliação. Análises qualitativas identificaram dificuldades e erros diagnósticos ligados aos casos, métodos de avaliação e critérios de diagnósticos estudados. Modificações foram introduzidas para corrigir os problemas identificados e otimizar as propriedades psicométricas do MINI e do MINI Plus. Conclusões: O MINI e sua versão Plus são adaptados ao contexto clínico e à avaliação de pacientes mais graves, e representam uma alternativa econômica para a seleção de pacientes, segundo critérios internacionais, em estudos clínicos e epidemiológicos. O MINI já está disponível em aproximadamente 30 idiomas, incluindo a versão brasileira. As perspectivas atuais de adaptação e aplicação transcultural do instrumento são discutidas.
To assess the associations of the perceived quality of parental bonding with suicidality in a sample of pregnant adolescents.
A cross-sectional study with a sample size of 828 pregnant teenagers receiving prenatal medical assistance in the national public health system in the urban area of Pelotas, southern Brazil. Suicidality and psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview (MINI), and the Parental Bonding Instrument (PBI) was employed to measure the perceived quality of parental bonding. A self-report questionnaire was used to collect sociodemographic, obstetric and other psychosocial data.
Forty-three (4.94 %) teenagers from a consecutive sample of 871 refused to participate, resulting in 828 participants. Prevalence of suicidality was 13.3 %, lifetime suicide attempts were 7.4 % with 1.3 % reporting attempting suicide within the last month. Significant associations of suicidality with the 18-19-year-old subgroup, low education, prior abortion, physical abuse within the last 12 months were present, and most psychiatric disorders were associated with a higher suicidality prevalence. Additionally, after adjustment in the multivariate analysis, the style of parental bonding was independently associated with suicidality in the pregnant adolescent, with a PR of 2.53 (95 % CI 1.14-5.59) for the maternal 'affectionless control' and a PR of 2.91 (95 % CI 1.10-7.70) for the paternal 'neglectful parenting.' CONCLUSIONS: We found that maternal 'affectionless control' and paternal 'neglectful parenting' were independent predictors of suicidality in this sample of pregnant teenagers.
Objective: The aim of the present work was to systematically review the literature and identify all peer-reviewed papers dealing with etiological and risk factors associated with bruxism. Data sources: Data extraction was carried out according to the standard Cochrane systematic review methodology. The following databases were searched for randomized clinical trials (RCT), controlled clinical trials (CCT) or cohort studies: Cochrane Library, Medline, and Embase from 1980 to 2011. Unpublished literature was searched electronically using ClinicalTrials.gov. Data selection: The primary outcome was bruxism etiology. Studies should have a standardized method to assess bruxism. Data extraction: Screening of eligible studies, assessment of the methodological quality and data extraction were conducted independently and in duplicate. Two reviewers inspected the references using the same search strategy and then applied the same inclusion criteria to the selected studies. They used criteria for methodological quality that was previously described in the Cochrane Handbook. Among the 1247 related articles that were critically assessed, one randomized clinical trial, one controlled clinical trial and seven longitudinal studies were included in the critical appraisal. Of these studies, five were selected, but reported different outcomes. Data synthesis: There is convincing evidence that (sleep-related) bruxism can be induced by esophageal acidification and also that it has an important relationship with smoking in a dose-dependent manner. Disturbances in the central dopaminergic system are also implicated in the etiology of bruxism.
To describe the prevalence of Major Depressive Disorder (MDD) during pregnancy in teenage mothers and to assess its association with socio-demographic characteristics, obstetric history and psychosocial variables.
A cross-sectional study was conducted with a sample of pregnant teenagers enrolled in the national public health system in the urban area of Pelotas, southern Brazil. MDD was assessed with the Mini International Neuropsychiatric Interview, the Abuse Assessment Screen was used to identify physical abuse within the last 12 months and during pregnancy, and social support was assessed with the Medical Outcomes Survey Social Support Scale.
Forty-three (4.94%) potential subjects refused to participate, resulting in 828 total participants. The prevalence of MDD was 17.8%, 9.2% reported they had been subjected to violence within the last 12 months, while 5.8% had suffered violence during pregnancy, and the mean (SD) overall social support score was 87.40 (11.75). After adjustment, we found the highest incidence of MDD in adolescents with less than 8 years of education, followed by those with previous episodes of MDD and those with lower overall social support.
MDD is a relatively common condition in pregnant teenagers and appears to be more prevalent in young mothers who are both socioeconomically and psychosocially underprivileged.
To date, there is no consensus about the definition and diagnostic grading of bruxism. A written consensus discussion was held among an international group of bruxism experts as to formulate a definition of bruxism and to suggest a grading system for its operationalisation. The expert group defined bruxism as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism has two distinct circadian manifestations: it can occur during sleep (indicated as sleep bruxism) or during wakefulness (indicated as awake bruxism). For the operationalisation of this definition, the expert group proposes a diagnostic grading system of 'possible', 'probable' and 'definite' sleep or awake bruxism. The proposed definition and grading system are suggested for clinical and research purposes in all relevant dental and medical domains.
The theory that adolescence is universally a time of emotional turmoil has been disproved, yet research indicates higher rates of negative affect among adolescents than preadolescents. This study evaluates the relationship of distressed affect in early adolescence to the experience of stressful life events. 483 5th–9th graders provided experience sampling reports on their daily emotional states; data on recent major events in the child's life were obtained from the child and a parent. Findings indicate that older students in this age range encountered more negative events than younger ones, including more peer, school, and family events, and that experience of multiple negative events had a stronger association with daily negative affect among the older students. These findings suggest that the higher rates of daily distress experienced in adolescence may be partly attributable to the greater number of negative life events encountered by some youths. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The purpose of this study was to determine the association among stress levels, personality traits, and sleep bruxism in children.
A population-based case control study (proportion=1:2) was conducted involving 120 7- to 11-year-olds with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from schools in Belo Horizonte, Minas Gerais, Brazil. The following instruments were used for data collection: questionnaire administered to parents; child stress scale; and neuroticism and responsibility scales of the big five questionnaire for children. Psychological tests were administered and evaluated by psychologists. Sleep bruxism was diagnosed from parents' reports. The chi-square test, as well as binary and multivariate logistic regression, was applied for statistical analysis.
In the adjusted logistic model, children with a high level of stress, due to psychological reactions (odds ratio=1.8; confidence interval=1.1-2.9) and a high sense of responsibility (OR=1.6; CI=1.0-2.5) vs those with low levels of these psychological traits, presented a nearly 2-fold greater chance of exhibiting the habit of sleep bruxism.
High levels of stress and responsibility are key factors in the development of sleep bruxism among children.
The development of a 21-item self-report inventory for measuring the severity of anxiety in psychiatric populations is described. The initial item pool of 86 items was drawn from three preexisting scales: the Anxiety Checklist, the Physician’s Desk Reference Checklist, and the Situational Anxiety Checklist. A series of analyses was used to reduce the item pool. The resulting Beck Anxiety Inventory (BAI) is a 21-item scale that showed high internal consistency (α = .92) and test—retest reliability over 1 week, r (81) = .75. The BAI discriminated anxious diagnostic groups (panic disorder, generalized anxiety disorder, etc.) from nonanxious diagnostic groups (major depression, dysthymic disorder, etc). In addition, the BAI was moderately correlated with the revised Hamilton Anxiety Rating Scale, r (150) = .51, and was only mildly correlated with the revised Hamilton Depression Rating Scale, r (153) = .25.
Although the association between maternal depression and adverse child outcomes is well established, the strength of the association, the breadth or specificity of the outcomes, and the role of moderators are not known. This information is essential to inform not only models of risk but also the design of preventive interventions by helping to identify subgroups at greater risk than others and to elucidate potential mechanisms as targets of interventions. A meta-analysis of 193 studies was conducted to examine the strength of the association between mothers' depression and children's behavioral problems or emotional functioning. Maternal depression was significantly related to higher levels of internalizing, externalizing, and general psychopathology and negative affect/behavior and to lower levels of positive affect/behavior, with all associations small in magnitude. These associations were significantly moderated by theoretically and methodologically relevant variables, with patterns of moderation found to vary somewhat with each child outcome. Results are interpreted in terms of implications for theoretical models that move beyond main effects models in order to more accurately identify which children of depressed mothers are more or less at risk for specific outcomes.
Stress is discussed as a potential factor in the development of sleep bruxism (SB). The aim of this study was to investigate whether specific stress-factors correlate with SB-activity.
Sixty-nine subjects, of which 48 were SB-patients, completed three German questionnaires assessing different stress-parameters and stress-coping-strategies: Short questionnaire for recognition of stress-factors (Kurzer Fragebogen zur Erfassung von Belastungen, KFB), Questionnaire for recuperation and strain (Erholungs-Belastungs-Fragebogen, EBF-24 A/3) and the stress-coping questionnaire (Stressverarbeitungsfragebogen-78, SVF-78). The diagnosis of SB was based on the clinical criteria of the American Academy of Sleep Medicine (AASM). The degree of SB-activity was measured by the Bruxcore-Bruxism-Monitoring-Device (BBMD, Bruxcore, Boston, USA), worn for five consecutive nights and analyzed using a computer-based method. Non-parametric Spearman correlation coefficients, rho, were calculated between the psychometric data and the amount of SB-activity measured by a pixel score of the BBMD.
Significant correlations were found for 'daily problems' (r = 0.461, p < 0.01), 'trouble at work' (r = 0.293), 'fatigue' (r = 0.288), 'physical problems' (r = 0.288) and the coping-strategy 'escape' (r = 0.295) (all p < 0.05).
Within the limitations of this study it could be shown that subjects with high SB-activity tend to feel more stressed at work and in their daily life, which in turn might influence their physical state. These subjects also seem to deal with stress in a negative way. However, due to the rather low to almost moderate correlation coefficients and the descriptive character of the study, further investigations are necessary to examine a possible causal relationship.
OBJETIVO: Determinar a prevalência de depressão, ansiedade e ideação suicida em adolescentes grávidas e verificar associações entre ideação suicida e variáveis psicossociais. MÉTODOS: A amostra foi composta por 120 adolescentes grávidas (40 de cada trimestre gestacional), de 14-18 anos, atendidas em um serviço público de pré-natal. Utilizaram-se a Entrevista Clínica Estruturada-edição revisada (CIS-R), a Escala Hospitalar de Ansiedade e Depressão (HAD) e a Escala de Ideação Suicida de Beck. A análise estatística utilizou os testes do Qui-quadrado, de Fisher e o teste U de Mann-Whitney. RESULTADOS: Foram encontrados 28 (23,3%) casos de ansiedade, 25 (20,8%) de depressão e 19 (16,7%) de ideação suicida. Não houve diferenças nesses quadros nos trimestres gestacionais. Tentativa de suicídio anterior à gravidez foi relatada por 16 (13,3%) adolescentes. A ideação suicida associou-se com depressão (p = 0,001), ser solteira sem namorado (p = 0,01) e contar com pouco apoio social (p = 0,001). Os casos de ideação suicida apresentaram alta freqüência de falta de concentração, ansiedade, depressão, preocupações, obsessões, idéias depressivas, fadiga, preocupações com o funcionamento do corpo e compulsões. As idéias depressivas foram o sintoma comum para os casos de depressão, de ansiedade, de ideação suicida e de tentativa de suicídio anterior. CONCLUSÕES: O grupo apresentou-se heterogêneo quanto à saúde mental. No entanto, diante da freqüência com que se observam quadros de depressão, ansiedade e ideação suicida em adolescentes, recomenda-se aos profissionais de saúde atenção para detectar a presença de idéias depressivas em adolescentes grávidas.
The purpose of this study was to determine the prevalence of depression, anxiety and suicide ideation among pregnant adolescents and verify the relationship between suicide ideation and other variables.
120 pregnant adolescents (40 in each gestational trimester) attended at a public health center in Brazil were assessed. The following research instruments were used: the Clinical Interview Schedule (CIS-R), the Hospital Anxiety and Depression scale (HADS) and the Beck's Suicide Ideation Scale (BSI). The Chi-square test, the Fishers and the Mann-Whitney U tests were performed. Results: There were 28 cases of anxiety (23.3%), 25 (20.8%) of depression and 20 cases of suicide ideation (16.7%). There was no difference in these prevalences in the gestational trimesters. There was a significant relationship between suicide ideation suicide and depression (p = 0.001), single individuals without boyfriends (p = 0.01) and little social support ( p = 0.001). Cases of suicidal ideation presented a high frequency of lack of concentration, anxiety, depression, preoccupations, obsessions, depressive ideas, tiredness, worries concerning body functions and compulsions.
The group of pregnant adolescents showed heterogeneous results regarding mental health. The most common symptom of depression, anxiety, ideation suicide and previous suicide attempts were depressive ideas. The health professionals working with pregnant adolescents should observe them carefully, in order to detect the presence of depressive ideas.
The incidence of postpartum depression (PPD) in Western societies is approximately 10-15% and its cause multi-faceted. Because mothers largely constitute infants' social environment and mediate their experience of the external world, it is imperative to investigate the effects of PPD on child growth and development. PsycInfo, Medline, Embase, CINAHL, ProQuest, and Health Star databases were searched with key terms for English language abstracts from 1990 onwards, and key contents were searched. There are small effects of PPD on cognitive development such as language and IQ, seen particularly among boys. Behavioral effects are variably supported, but may persist up to 5 years postpartum and beyond. However, chronic or recurrent maternal depression, rather than postpartum depression per se is likely related to later effects on the child. These adverse effects of PPD based on sex of infant are discussed.
To examine how maternal depressive symptoms are related to infant development among low-income infants in rural Bangladesh and to examine how the relationship is affected by maternal perceptions of infant irritability and observations of caregiving practices.
Development was measured among 221 infants at 6 and 12 months with the Bayley Scales II. Mothers reported on their depressive symptoms and on perceptions of their infant's temperament, and a home visit was made to complete the HOME Inventory.
Half (52%) the mothers reported depressive symptoms. In bivariate analyses, maternal depressive symptoms were related to low scores on the Bayley Scales. Infants whose mothers reported depressive symptoms and perceived their infants to be irritable acquired fewer cognitive, motor, and Orientation/Engagement skills between 6-12 months than infants whose mothers reported neither or only one condition. The relationship linking maternal depressive symptoms and perceived infant irritability with infant cognitive skills was partially mediated by parental responsiveness and opportunities for play in the home.
The intergenerational risks of maternal depressive symptoms on infant development extend to rural Bangladesh and are accentuated when mothers perceive their infants as irritable. Mothers who report depressive symptoms and infant irritability may lack the capacity to provide responsive, developmentally-oriented caregiving environments.
Awake bruxism is defined as the awareness of jaw clenching. Its prevalence is reported to be 20% among the adult population. Awake bruxism is mainly associated with nervous tic and reactions to stress. The physiology and pathology of awake bruxism is unknown, although stress and anxiety are considered to be risk factors. During sleep, awareness of tooth grinding (as noted by sleep partner or family members) is reported by 8% of the population. Sleep bruxism is a behaviour that was recently classified as a 'sleep-related movement disorder'. There is limited evidence to support the role of occlusal factors in the aetiology of sleep bruxism. Recent publications suggest that sleep bruxism is secondary to sleep-related micro-arousals (defined by a rise in autonomic cardiac and respiratory activity that tends to be repeated 8-14 times per hour of sleep). The putative roles of hereditary (genetic) factors and of upper airway resistance in the genesis of rhythmic masticatory muscle activity and of sleep bruxism are under investigation. Moreover, rhythmic masticatory muscle activity in sleep bruxism peaks in the minutes before rapid eye movement sleep, which suggests that some mechanism related to sleep stage transitions exerts an influence on the motor neurons that facilitate the onset of sleep bruxism. Finally, it remains to be clarified when bruxism, as a behaviour found in an otherwise healthy population, becomes a disorder, i.e. associated with consequences (e.g. tooth damage, pain and social/marital conflict) requires intervention by a clinician.
Studies examining mechanisms underlying associations between maternal depression and adverse child outcomes (including behaviour, socioemotional adjustment, and emotion regulation) indicate that during pregnancy, maternal depression could affect child outcomes through altered placental function, epigenetic changes in the child, and stress reactivity. Infection and dietary deficiencies in the mother and the child, together with the child's genetic vulnerability, might also affect outcome. Postnatally, associations between maternal depression and child outcome are influenced by altered mother–child interactions, sociodemographic or environmental influences, and social support. Knowledge is scarce on mechanisms in low-income and middle-income countries where maternal depression is highly prevalent, and stressful factors that influence the development of perinatal maternal depression and adverse child outcome (eg, food insecurity, perinatal infections, crowded or rural living conditions, and interpersonal violence) are both more intense and more common than in high-income countries. We reviewed evidence and use the biopsychosocial model to illustrate risk factors, mediators and moderators underlying associations between maternal depression and child outcomes in low-income and middle-income countries.
The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12 in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations."Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15 These have been well summarized in a review article by Lorr11 on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific
This study examines state-trait anxiety, anxiety sensitivity (AS), depressive symptom levels, and psychiatric disorders in children and adolescents with sleep bruxism (SB).
Thirty-five patients (aged 8-17 years) with a diagnosis of SB and 35 healthy controls were included in the study. All participants were evaluated for psychiatric disorders using a structured clinical interview and completed self-report questionnaires.
At least one psychiatric disorder was present in 42.9 % of the patient group and 17.1 % of the control group (p < 0.05). Trait and state anxiety, anxiety sensitivity, and the severity of depression symptoms were also higher in the SB group (p < 0.05). After the multivariate analysis, the associations between state and trait anxiety, depression, and SB became statistically insignificant, while the association with anxiety sensitivity persisted.
This study suggests that SB is related to AS, regardless of the severity of anxiety or depressive symptoms.
The aim of the present investigation was to perform a systematic review of the literature dealing with the issue of sleep bruxism prevalence in children at the general population level. Quality assessment of the reviewed papers was performed to identify flaws in the external and internal validity. Cut-off criteria for an acceptable external validity were established to select studies for the discussion of prevalence data. A total of 22 publications were included in the review, most of which had methodological problems limiting their external validity. Prevalence data extraction was performed only on eight papers that were consistent as for the sampling strategy and showed only minor external validity problems, but they had some common internal validity flaws related with the definition of sleep bruxism measures. All the selected papers based sleep bruxism diagnosis on proxy reports by the parents, and no epidemiological data were available from studies adopting other diagnostic strategies (e.g. polysomnography or electromyography). The reported prevalence was highly variable between the studies (3·5-40·6%), with a commonly described decrease with age and no gender differences. A very high variability in sleep bruxism prevalence in children was found, due to the different age groups under investigation and the different frequencies of self-reported sleep bruxism. This prevented from supporting any reliable estimates of the prevalence of sleep bruxism in children.
Objectives:
The aims for this study were to determine the prevalence of sleep-bruxism among young children, explore child behavior problems that may be associated with sleep-bruxism, and identify relations among sleep-bruxism, health problems, and neurocognitive performance.
Methods:
The current study was a retrospective analysis of parent report surveys, and behavioral and neurocognitive assessments. Parents of 1953 preschool and 2888 first grade children indicated their child's frequency of bruxism during sleep. A subsample of preschool children (n=249) had additional behavioral, as well as neurocognitive assessments. Among the subsample, parents also reported on their child's health, and completed the Child Behavioral Checklist; children were administered the Differential Ability Scales, and Pre-Reading Abilities subtests of the Developmental Neuropsychological Assessment.
Results:
36.8% of preschoolers and 49.6% of first graders were reported to brux ⩾1time per week. Among the preschool subsample, bruxing was independently associated with increased internalizing behaviors (β=.17). Bruxism was also associated with increased health problems (β=.19), and increased health problems were associated with decreased neurocognitive performance (β=.22).
Conclusions:
The prevalence of sleep-bruxism was high. A dynamic and potentially clinically relevant relation exists among sleep-bruxism, internalizing behaviors, health, and neurocognition. Pediatric sleep-bruxism may serve as a sentinel marker for possible adverse health conditions, and signal a need for early intervention. These results support the need for an interdisciplinary approach to pediatric sleep medicine, dentistry, and psychology.
Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries, and risk factors are generally incomplete, fragmented, and of uncertain reliability and comparability. The Global Burden of Disease (GBD) Study has provided a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY). This article describes key features of the Global Burden of Disease analytic approach, the evolution of the GBD starting from the first study for the year 1990, and summarizes the methodological improvements incorporated into GBD revisions carried out by the World Health Organization. It also reviews controversies and criticisms, and examines priorities and issues for future GBD updates. © 2008
Bruxism is described as an orofacial parafunction that affects both children and adults. The maintenance of the childhood habit into adulthood may compromise health. As there are few studies on this issue, there is a need for further research on sleep bruxism among children.
The aim of this study was to assess the prevalence of sleep bruxism in children and the influence of psychosocial factors.
A cross-sectional study was carried out on 652 randomly selected children aged 7-10 years at public and private schools in Belo Horizonte, Brazil. The instruments used were: questionnaire for parents, Child Stress Scale, and the scales on neuroticism and responsibility from the prevalidated Big Five Questionnaire for Children. Psychological tests were administered and evaluated by psychologists. Sleep bruxism among children was reported by parents. The Social Vulnerability Index from the city hall database was used to determine the social classification of the families. The chi-squared test, binary and multivariate logistic regressions were used, with the significance level set at 5%.
A 35.3% prevalence of bruxism was found. No association was found between bruxism and stress, gender, age, or social vulnerability. The adjusted logistic model determined that children with high levels of neuroticism (OR = 1.9, CI 1.3-2.6) and responsibility (OR = 2.2, CI 1.0-5.0) are twice as likely to have the habit of sleep bruxism when compared to those who have low levels of these personality traits.
A high degree of responsibility and neuroticism, which are individual personality traits, are determinant factors for the development of sleep bruxism among children.
IN PREVIOUS studies [l] it has been established that a cluster of social events requiring change in ongoing life adjustment is significantly associated with the time of illness onset. Similarly, the relationship of what has been called ‘life stress,’ ‘emotional stress,’ ‘object loss,’ etc. and illness onset has been demonstrated by other investigations [2-131. It has been adduced from these studies that this clustering of social or life events achieves etiologic significance as a necessary but not sufficient cause of illness and accounts in part for the time of onset of disease. Methodologically, the interview or questionnaire technique used in these studies has yielded only the number and types of events making up the cluster. Some estimate of the magnitude of these events is now required to bring greater precision to this area of research and to provide a quantitative basis for new epidemiological studies of diseases. This report defines a method which achieves this requisite. METHOD
The primary purposes of the present study were to survey the prevalence of sleep problems in school-aged children and to examine these associations with parental perception of sleep problems, medical history, and childhood psychopathology.
Sleep and medical history questionnaires and the Child Behavior Checklist were administered to the parents of 472 children between ages 4 and 12 years receiving routine pediatric care from urban, rural, and suburban pediatric practices.
Although sleep problems were reported for 10.8% of the sample during the past 6 months, less than one half of the parents who identified sleep problems reported that they had discussed sleep with their child's pediatrician. The best predictor of current sleep problems was a history of sleep problems before age 2 years. Sleep problems such as snoring, tiredness during the day, and taking excessive time to fall asleep were very common, occurring at least 1 night per week in over 20% of the total sample. Factor analysis of the sleep problems questionnaire resulted in 5 sleep problem factors that accounted for 58.7% of the variance. Specific sleep problem factors include: parasomnias, enuresis/gags, tiredness, noisy sleep, and insomnia. Sleep problem factor scores were differentially associated with medical history variables and measures of childhood psychopathology. Children rated highly on parasomnias were more likely to have frequent falls and to display pica. Parasomnias and noisy sleep were inversely associated with socioeconomic status (SES). Children from lower SES families were rated higher on these factors than children from higher SES families. Enuresis/gags was the only sleep problem factor associated with age. Younger children scored higher on this factor. Duration of naps was highly correlated with age and with bed times during the week and weekends. As expected, younger children were more likely to nap for longer periods and to have earlier bed times. In addition, higher tiredness factor scores were associated with napping and with later bed times during the week and weekend. Boys were much more likely than were girls to have higher scores on enuresis/gags, and higher enuresis/gags scores were associated with an increased prevalence of trauma and falls. Bed times were not associated with any other sleep problem factor score. Children rated highly on tiredness were more likely to have a history of hospitalizations. Tiredness factor scores were strongly associated with the sleep practice of sharing a bed but not with sharing a room. Sharing a room was not associated with any sleep problem factor score. High scores on noisy sleep were associated with allergies, falls frequently, and with sharing a bed. Children with high scores on the insomnias were also more likely to display an increased prevalence of allergies.
Parental perception of global sleep problems was surprisingly common in school-aged children receiving routine pediatric care. Parental reports of their children's sleep problems may be a red flag for specific sleep problems and psychiatric, social, or medical problems. Sleep problems should be queried about during pediatric visits for school-aged children.
The Global Burden of Disease
- C Mathers
- D Fat
- J T Boerma
Mathers C, Fat D, Boerma JT. The Global Burden of
Disease: 2004 Update. Geneva, Switzerland: World
Health Organization, 2008.