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Updated: Jun 20, 2025

Psychophysiological Assessment of the Effectiveness of Emotion Regulation Strategies in Childhood
Published on: February 11, 2017
Emotional and behavioural functioning in children with tyrosinaemia type 1
Monika Pohorecka1, Marcin Biernacki2, Anna Jakubowska-Winecka3
1Clinical Department of Pediatrics and Allergology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland.
Insights
Fluctuations in phenylalanine levels in tyrosinaemia type I patients correlate with emotional and behavioral issues. Managing these levels may improve quality of life and development.
Area of Science:
- Metabolic disorders
- Neurodevelopmental disorders
- Pediatric psychology
Background:
- Tyrosinaemia type I is a rare hereditary metabolic disease.
- Nitisinone treatment has improved survival but revealed socio-emotional challenges.
- Understanding the impact of metabolic control on behavior is crucial.
Purpose of the Study:
- To assess the relationship between serum tyrosine and phenylalanine levels and socio-emotional functioning.
- To determine the intelligence quotient (IQ) of patients with tyrosinaemia type I.
- To identify factors influencing behavioral outcomes in treated patients.
Main Methods:
- Study included 12 children with tyrosinaemia type I treated with nitisinone and diet.
- Psychological evaluation used the Child Behaviour Checklist (CBCL)/4-18.
- Intelligence was measured using the Stanford-Binet 5 (SB5) Intelligence Scale.
Main Results:
- Phenylalanine variability correlated with emotional and behavioral functioning, particularly externalizing behaviors.
- Externalizing behaviors were associated with maladjustment and aggression.
- All patients demonstrated intellectual and cognitive function within the normal range.
Conclusions:
- Avoiding significant phenylalanine level fluctuations may enhance quality of life.
- Regular psychological evaluations are recommended for early detection and intervention.
- Optimizing development and potential requires managing metabolic control and behavior.
Introduction:
Tyrosinaemia type I is a rare hereditary metabolic disease caused by deficiency of the enzyme involved in the breakdown of tyrosine. Since the use of nitisinone in addition to diet in 1992, survival rates have increased significantly, but more and more socio-emotional problems have become apparent. The aim of the study was the assessment the relationship between variations in serum tyrosine and phenylalanine levels and measurements of socio-emotional functioning and determination of patients' IQs.
The Aim Of The Study:
was the assessment the relationship between variations in serum tyrosine and phenylalanine levels and measurements of socio-emotional functioning and determination of patients' IQs.
Material And Methods:
Twelve children were studied, from a single centre, born between 1994 and 2012, treated with nitisinone and a low-phenylalanine and -tyrosine diet. The psychological evaluation was conducted using the parent form of the Child Behaviour Checklist (CBCL)/4-18. Additionally, the patients' IQs were measured using the Stanford-Binet 5 (SB5) Intelligence Scale. Statistical analyses were performed using PAWS software suite version 26. We found that phenylalanine variability over time correlated with measures of emotional and behavioural functioning. This relationship holds true for externalising behaviour, associated with the experience of maladjustment and aggression. Total score intellectual and cognitive function was within the norm for all patients.
Conclusions:
To maintain better quality of life for patients and their families in terms of emotional and behavioural functioning, it may be important to avoid spikes (significant fluctuations) in phenylalanine levels. Regular, detailed psychological evaluations are recommended to detect potential problems and implement interventions aimed at achieving the best possible individual development and realise the intellectual and behavioural potential, thereby improving the patient's and her family's quality of life.
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