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Free AccessOriginalarbeiten/Original articles

Severe Affective and Behavioral Dysregulation in Youths Is Associated with a Proinflammatory State

1MH and LP contributed equally to the paper

Published Online:November 14, 2013https://doi.org/10.1024/1422-4917/a000255

Abstract

Objective: A heritable behavioral phenotype, the so-called Dysregulation Profile (DP), characterized by extreme scores on the syndrome scales Anxious/Depressed (A/D), Attention Problems (AP), and Aggressive Behavior (AGG), has been identified on the Child Behavior Checklist (CBCL). It characterizes children with severe affective and behavioral dysregulation. The present study examined possible alterations of the inflammatory system in CBCL-DP using a clinical sample of n = 133 children and adolescents. Method: Participants with the CBCL-DP scoring ≥ 2.5 SDs above average constituted the CBCL-DP subgroup (n = 51). Those with CBCL-DP scores of 1 SD or less above average were regarded as controls (n = 82). Groups were compared in terms of serum levels of C-reactive protein (CRP) and albumin. Results: Participants showing the CBCL-DP exhibited increased CRP and decreased albumin levels compared to controls. CRP was correlated with AGG, AP, and the CBCL-DP total score. A negative correlation was observed between albumin and AGG, AP, the CBCL-DP score, and A/D. These associations could not be attributed to differences in age, sex, weight, socioeconomic status, global functioning, or duration of illness. Conclusions: This is the first study to demonstrate associations between the CBCL-DP and a proinflammatory state. Limitations include the lack of a healthy control group, the use of a single measurement of inflammatory markers, and the lack of follow-up data. Future research should address whether inflammatory diathesis in these children confers increased susceptibility to later development of cardiovascular disease and other medical morbidities.


Die schwere Dysregulation von Affekt und Verhalten bei Kindern und Jugendlichen ist verbunden mit einem proinflammatorischen Zustand

Fragestellung: Ein erblicher Verhaltensphänotyp, das sog. Dysregulations-Profil (DP), gekennzeichnet durch extreme Werte auf den Syndromskalen Ängstlich/Depressiv (A/D), Aufmerksamkeitsprobleme (AP) und aggressives Verhalten (AGG) wurde mittels der Child Behavior Checklist (CBCL) identifiziert. Er erfasst Kinder mit schwerer affektiver und verhaltensbezogener Dysregulation. Die vorliegende Studie untersucht Veränderungen des Entzündungssystems bei Patienten mit CBCL-DP an einer klinischen Stichprobe von n = 133 Kindern und Jugendlichen. Methodik: Patienten mit einem CBCL-DP-Wert = 2.5 SD über der Norm bildeten die CBCL-DP-Untergruppe (n = 51). Patienten mit CBCL-DP-Werten mit höchstens 1 SD über dem Durchschnitt galten als Kontrollgruppe (n = 82). Beide Gruppen wurden im Hinblick auf die Serumspiegel von C-reaktivem Protein (CRP) und Albumin verglichen. Ergebnisse: Die CBCL-DP-Gruppe zeigte ein erhöhtes CRP und verringertes Albumin. CRP war positiv mit AGG, AP und dem CBCL-DP-Gesamtwert korreliert. Eine negative Korrelation wurde zwischen Albumin und AGG, AP, dem CBCL-DP-Wert und A/D beobachtet. Die Zusammenhänge konnten nicht durch Alter, Geschlecht, Gewicht, sozio-ökonomischen Status, globales Funktionsniveau oder die Dauer der Erkrankung erklärt werden. Schlussfolgerungen: Dies ist die erste Studie, die Zusammenhänge zwischen dem CBCL-Dysregulations-Profil und einem proinflammatorischen Zustand beschreibt. Einschränkungen betreffen das Fehlen einer gesunden Kontrollgruppe, eine einzige Messung der Entzündungsmarker und das Fehlen von Follow-up-Daten. Künftige Studien sollten untersuchen, ob Veränderungen im Entzündungssystem bei diesen Kindern mit einer erhöhten Anfälligkeit für die Entwicklung von Herz-Kreislauf-Erkrankungen und anderen medizinische Auffälligkeiten einhergehen.

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