The ESSENCE in child psychiatry: early symptomatic syndromes eliciting neurodevelopmental clinical examinations

Gillberg, C. (2010) The ESSENCE in child psychiatry: early symptomatic syndromes eliciting neurodevelopmental clinical examinations. Research in Developmental Disabilities, 31(6), pp. 1543-1551. (doi: 10.1016/j.ridd.2010.06.002)

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ESSENCE is the acronym explained in the title. While taxonomies, clinics and social benefits specialise in autism, attention deficit hyperactivity disorder (ADHD), and Tourette syndrome, kids display shared symptoms across many disorders, as Gillberg first pointed out in 1983. For example, autism spectrum disorder (ASD) and ADHD are familial, and they overlap in kids and prevail into adulthood. Girls are diagnosed much later than boys. Thus, kids need to be evaluated in the following aspects by specialists: language, interrelatedness, coordination, attention, activity level, mood, sleep, feeding and general development. The sum prevalence of clinical threshold problems identified by ESSENCE is 5-7% of children under age 6. They need to be monitored for years as their behaviour changes and adapts. What first fits with ASD may evolve into ADHD that in turn overlaps with oppositional defiant disorder, which is frequently accompanied by anxiety, depression and substance use, and sometimes by tics indicative of Tourette syndrome. Learning problems are common in these children. Pediatric bipolar disorder is a somewhat controversial concept, but extremes of mood swings may occur in children with a family history of bipolar disorder. ADHD may be present in at least 20% of adult psychiatric patients, and even more so in substance abusers and in prisoners. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM 5) is reviewing this conglomerate of issues to arrive at a dimensional holistic approach similar to the logic of ESSENCE. The author envisions clinical centres that can offer this broad expertise from cradle to school, and perhaps longer. For further reading, please see references {1-2}.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Gillberg, Professor Christopher
Authors: Gillberg, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Journal Name:Research in Developmental Disabilities
Journal Abbr.:Res. Dev. Disabil.
Published Online:14 July 2010

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