Salivary Alpha-Amylase Reactivity under Psycho-Physiological Stress. A Nonverbal Communication Measurement Tool?

Previous studies have shown that changes in salivary alpha-amylase (sAA) levels are dependent on psychosocial stress stimulation and reflect the activity of the sympathetic nervous system. sAA measurement can be performed easily and quickly;therefore, it may be useful for evaluating psychosocial or physical stress. The aim of this preliminary study was to examine the use of sAA measurements as objective indicators of psychological and physiological stress levels by examining sAA changes in volunteers subjected to conditions similar to those suffered by children with severe motor and intellectual disabilities and cerebral paralysis. Twelve healthy volunteers were required to not move or speak, as is found in patients suffering from total paralysis, for 30 min. Saliva samples were taken at three points, and sAA activity was measured using a hand-held monitor before the test, immediately after the test, and 10 min after the test. In the present study, a marked increase in sAA activity due to physiological stress and a rapid return to the baseline level were observed. Many subjects felt bodily pain and psychotic discomfort. This measurement method is useful for evaluating stress in children with severe motor and intellectual disabilities, who can not fully express their emotions or communicate with their caregivers.

Increase in Salivary Alpha-Amylase Levels among Non-Attending Junior High School Students Diagnosed with Social Anxiety Disorder

Purpose: Several studies have demonstrated that the measurement of salivary alpha-amylase (sAA) levels is a useful tool for evaluating the autonomic nervous system. Psychosocial stress increases the release of sAA as a useful marker for autonomic nervous system (ANS). To our knowledge, although some studies have evaluated sAA levels under psychosocial stress, no studies have investigated the changes in sAA activity that occur in junior high school students who are not attending school due to social anxiety disorder (SAD). We aimed to investigate the relationship between the sAA levels and psychiatric states of such patients. Methods: The study subjects consisted of SAD patients (n = 39) and healthy controls (n = 57). We used a portable hand-held monitor to measure the level of sAA and State-Trait Anxiety Index (STAI) to evaluate the psychiatric state. Results: The patients’ sAA activity was significantly higher than that of the controls (n = 57) (p < 0.001). Significant differences in heart rate (HR) (76.10 ± 11.96 vs. 68.69 ± 10.61, respectively, p < 0.01) and STAI scores (both the STAI-State and STAI-Trait scores) (49.35 ± 10.57 vs. 41.24 ± 8.59, respectively, p < 0.01;55.69 ± 10.44 vs. 45.61 ± 9.36, respectively, p < 0.001) were detected between the patients and healthy controls. Conclusions: These results indicated that junior high school students with SAD exhibit a higher state of anxiety and high autonomic activity, probably due to changes in the sympathetic nervous system. As a result, junior high school students with SAD are expected to exhibit high levels of sAA accompanied by anxiety symptoms.

Importance of Early Intervention and Special Educational Support for High School Students with Attention-Deficit/Hyperactivity Disorder

Aim: The present study aimed to investigate problems relating to education, past situations and treatments in high school students with attention-deficit/ hyperactivity disorder (ADHD) and to discuss appropriate considerations. Methods: Participants were 6 students who were diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental Disorders IV, Text Revision (DSM-IV-TR) criteria. Results: In total, 6 cases of high-school students with ADHD showed dominantly inattention features. They had notably not been diagnosed with ADHD or received appropriate special support education until they were of high-school age, although they had clearly shown characteristic features of the disorder from childhood. As a result, they had decreased motivation to study and showed indolence, and suffered from low self-esteem. Conclusion: This case report suggests that early diagnosis of ADHD and early intervention with special support education are of great importance. To support these students, better educational and medical support systems are warranted.

Liaison conference for adolescent psychosomatic disease in pediatric ward

We held the liaison case conferences for two adolescent cases with psychosomatic disease in the pediatric ward to understand the patient's emotional problems and family situations, and to discuss how approach their psychological problems. We considered that the liaison conference played a useful role in both the clinical diagnosis and treatment. Furthermore, the liaison conference was useful for reducing the staff’s anxieties and for contributing to have a proper understanding for the disease. We suggest that a liaison conference should be implemented in pediatric units, for pediatric patients with emotional and behavioral problems.