Exeley Inc.

Hadzik, Robert

Bombiński, Przemysław

Brzewski, Michał

Double aorta artifact in sonography – a diagnostic challenge

Brodzisz, Agnieszka

Mistakes in the ultrasound diagnostics of the abdominal cavity in pediatrics

Reiersen, Angela M.

 1 
 
Scandinavian Journal of Child and Adolescent Psychiatry and Psychology 
Vol. 5(1):1-2 (2017) DOI 10.21307/sjcapp-2017-005 
 
 
Editorial 
 
 
 
 
How should we classify complex neurodevelopmental disorders? 
 
Angela M. Reiersen 
 
 
 
 
 
 
The Diagnostic and Statistical Manual of Mental 
Disorders Fifth Edition (DSM-5) includes the 
category, “neurodevelopmental disorders”, which 
includes intellectual disabilities, communication 
disorders, autism spectrum disorder (ASD), 
attention-deficit/hyperactivity disorder (ADHD), 
specific learning disorder, and motor disorders (1). 
Grouping this set of disorders into the new 
neurodevelopmental disorders category is useful 
since is puts together a number of conditions related 
to atypical neurodevelopment, which are most often 
identified during childhood, and can frequently co-
occur. The DSM-5 gives clear descriptions of the 
individual neurodevelopmental syndromes, which 
are useful in classifying individuals for clinical and 
research purposes. However, the DSM-5 does not 
adequately address the issue of multiple co-occurring 
neurodevelopmental problems, especially in cases 
where multiple subthreshold neurodevelopmental 
symptoms occur in an individual. The DSM-5 does 
describe a number of “other specified” and 
“unspecified” neurodevelopmental diagnoses, which 
can be used for subthreshold or unclear cases with 
associated impairment, but some of these 
descriptions are problematic because they suggest 
that the diagnoses should not be used if the 
individual meets full criteria for any diagnosis in the 
entire neurodevelopmental disorders diagnostic 
class. This could discourage clinicians from 
providing a full diagnostic description in cases where 
multiple neurodevelopmental problems co-occur. 
The example of ADHD classification is particularly 
important to consider. As in the previous version of 
the manual, DSM-5 ADHD requires that an 
individual has either six of nine listed inattentive 
symptoms or six of nine hyperactive/impulsive 
symptoms in order to meet the full diagnostic 
criteria. Depending on whether they meet the 
symptom count threshold in just one or both of the 
above two symptom domains, individuals are 
classified as having the predominantly inattentive 
presentation, predominantly hyperactive/impulsive 
presentation, or the combined presentation (1). As 
noted in existing literature (2), this is problematic in 
the case of clinically impaired individuals who have 
six or more total symptoms but have less than six 
symptoms in each of the two domains. During the 
process of developing DSM-5 diagnostic criteria, it 
was suggested that an ADHD “not elsewhere 
classified” diagnosis could be used for such 
individuals (3). The need for this option is supported 
by research suggesting that individuals with 
subthreshold symptoms in both symptom domains 
may be more impaired than those with a similar 
number of total symptoms, but in just one of the two 
symptom domains (2). Although the final version of 
DSM-5 does not use the term “ADHD not elsewhere 
classified”, it does include “Other Specified 
Attention-Deficit/Hyperactivity Disorder” (for 
cases where the clinician specifies why full ADHD 
criteria are not met) and “Unspecified Attention-
Deficit/Hyperactivity Disorder” (to be used if the 
clinician chooses not to specify the reason full criteria 
are not met). The other specified ADHD category 
seems particularly appropriate for individuals with 
symptoms in both symptom domains who fail to 
meet the symptom count cutoff in either domain. 
Such individuals can be described as having a mild 
combined presentation of ADHD, a category which 
has been supported by latent class analysis of ADHD 
symptoms, and which (along with severe combined 
and severe inattentive latent class subtypes) is 
associated with significant impairment (4). The 
problem is that within the DSM-5 descriptions for 
other and unspecified ADHD diagnoses, the 
wording suggests these categories should not be used 
if the individual meets full criteria for any 
neurodevelopmental diagnosis (1). If strictly 
 2 
 
followed, this means that a child with a diagnosis of 
intellectual disability, autism spectrum disorder, any 
communication disorder (even just a speech sound 
disorder), specific learning disorder, developmental 
coordination disorder, stereotypic movement 
disorder, or tic disorder cannot be given the 
diagnosis of other or unspecified ADHD simply 
because of their other neurodevelopmental disorder 
diagnosis. In other diagnostic classes, such as 
depressive disorders, it may make sense to reserve 
other and unspecified diagnosis labels for those who 
do not meet full criteria for any DSM-5 syndrome in 
the same class, but in the case of 
neurodevelopmental disorders, it is useful and 
important to be able to diagnose subthreshold but 
clinically impairing neurodevelopmental problems in 
multiple areas, so that each neurodevelopmental 
problem can be monitored over time and treated 
when appropriate.  
Given the high degree of phenotypic and genetic 
overlap among various neurodevelopmental 
symptoms and diagnoses (5, 6, 7, 8, 9), the presence 
of one neurodevelopmental disorder should make 
clinicians alert for co-occurring full syndrome or 
subthreshold neurodevelopmental problems in the 
same child, which may also need to be diagnosed and 
addressed. Hierarchical systems (such as ASD 
diagnosis disqualifying an individual from having an 
ADHD diagnosis in previous versions of the DSM) 
and symptom count cutoffs can be problematic when 
describing developmental deviations which can 
occur in various combinations and with differing 
severity. Research studies of neurodevelopmental 
disorders often focus on one disorder at a time, and 
may exclude individuals with another co-occurring 
neurodevelopmental disorder, but this leaves us with 
a relative lack of information regarding how to treat 
individuals with co-occurring neurodevelopmental 
disorders. Alternate methods of describing complex 
neurodevelopmental syndromes may be appropriate. 
For example, Gilger and Kaplan have suggested 
using the term “atypical brain development” and 
then specifying the child’s strengths and weaknesses 
(5). Gillberg has suggested the term “Early 
Symptomatic Syndromes Eliciting Neurodevelop-
mental Clinical Examinations” (ESSENCE) to 
describe neurodevelopmental syndromes which 
commonly co-occur and warrant comprehensive 
neurodevelopmental assessment (8). Although it may 
be more difficult to sort out mechanisms when 
studying complex cases with symptoms in multiple 
areas, it is important to include neurodevelop-
mentally complex cases in research, so that we will 
know how various neurodevelopmental symptoms 
interact and whether co-occurrence of multiple 
problems warrants different approaches to 
treatment. Some progress has been made in 
treatment studies of co-occurring ASD and ADHD 
(9), but further work is needed in this area, and in the 
study of other combinations of neurodevelopmental 
disorders. Future studies should bring improved 
methods of classifying and treating complex 
neurodevelopmental syndromes. 
 
Disclosure  
Dr. Reiersen has received grant or research support 
from the National Institutes of Health, the 
McDonnell Center for Systems Neuroscience, and 
the McDonnell Center for Cellular and Molecular 
Neurobiology. She has received speaker’s 
honorarium and travel support from the American 
Academy of Child & Adolescent Psychiatry, and 
speaker’s travel support from the Child and 
Adolescent Psychiatric Department, Region Zealand 
(a hospital in Denmark). Dr. Reiersen does not have 
any financial relationships with commercial industry. 
 
 
References 
 
1. American Psychiatric Association: Diagnostic and Statistical Manual 
of Mental Disorders, Fifth Edition. Arlington, VA, American 
Psychiatric Association, 2013. 
 
2. Reiersen AM, Todorov AA. Exploration of ADHD subtype 
definitions and co-occurring psychopathology in a Missouri 
population-based large sibship sample. Scand J Child Adolesc 
Psychiatr Psychol 2013;1(1):3-13. 
 
3. Tannock R. Rethinking ADHD and LD in DSM-5: proposed 
changes in diagnostic criteria. J Learn Disabil 2013;46(1):5-25. 
 
4. Volk HE, Henderson C, Neuman RJ, Todd RD. Validation of 
population-based ADHD subtypes and identification of three 
clinically impaired subtypes. Am J Med Genet B Neuropsychiatr 
Genet 2006; 141B(3):312-8. 
 
5. Gilger JW, Kaplan BJ. Atypical brain development: A conceptual 
framework for understanding learning disabilities. Dev 
Neuropsychol 2001;20(2):465-81. 
 
6. Reiersen AM, Constantino JN, Todd RD.  Co-occurrence of motor 
problems and autistic symptoms in attention-deficit/hyperactivity 
disorder. J Am Acad Child Adolesc Psychiatry 2008;47(6):662-72. 
 
7. Lichtenstein P, Carlström E, Råstam M, Gillberg C, Anckarsäter H. 
The genetics of autism spectrum disorders and related 
neuropsychiatric disorders in childhood. Am J Psychiatry 
2010;167(11):1357-63. 
 
8. Gillberg C. The ESSENCE in child psychiatry: Early Symptomatic 
Syndromes Eliciting Neurodevelopmental Clinical Examinations. 
Res Dev Disabil 2010;31(6):1543-51. 
 
9. Reiersen AM, Todd RD. Co-occurrence of ADHD and autism 
spectrum disorders: phenomenology and treatment. Expert Rev 
Neurother 2008;8(4):657-69. 
 
 


How should we classify complex neurodevelopmental disorders?

Kim, Jiyeon

Kim, Taeho

Park, Joong-Ki

Description of Pseudacrobeles (Pseudacrobeles) curvatus sp. n. (Cephalobidae: Rhabditida) in South Korea

Kakko, Kirsi

Pihlakoski, Leena

Salmelin, Raili

Keskinen, Päivi

Puura, Kaija

Tamminen, Tuula

Clinical use of second-generation antipsychotics in children

Storebø, Ole Jakob

Rasmussen, Pernille Darling

Bilenberg, Niels

50 
 
Scandinavian Journal of Child and Adolescent Psychiatry and Psychology 
Vol. 5(2):50-51 (2017) DOI 10.21307/sjcapp-2017-010 
 
 
Editorial 
 
 
 
 
Fake open access journals –“predatory journals”  
- an increasing problem 
 
Ole Jakob Storebø, Pernille Darling Rasmussen, Niels Bilenberg 
 
 
 
 
Every day we receive emails from different types of 
open access journals advertising for publishing 
manuscripts in their Journal. We are surprised by this 
development. At first sight, it may seem worthwhile, 
but upon closer inspection, you discover that most 
of these journals are illegitimate in that they only 
want to make money. Usually they take huge 
publication fees. One of our students submitted a 
manuscript to one of these journals. The journal had 
acknowledged people on the editorial board, and had 
a good description of their journal policy, peer review 
process, aims and scope on their website. We 
contacted one of the researchers on the Editorial 
Board, who was surprised about being listed in this 
Editorial Board as he had never been approached 
about it. After a few days, the student received an 
acceptance of her article without any comments from 
editors or peer reviewers. Realizing this was odd, she 
tried to retract the paper, but the journal declined to 
do so. We were left no choice but to contact the legal 
department to receive help in handling the situation. 
The journal in question is a predatory journal. The 
term "predatory journal" was introduced in 2010 by 
Jeffrey Beall to describe unscrupulous open access 
journals (or publishers) who were publishing articles 
with no real peer review process. Many of the 
predatory journals charge high publication fees. 
Jeffrey Beall has made a list of predatory journals and 
publishers: http://beallslist.weebly.com/standalone-
journals.html. This year marks the seventh annual 
release or announcement of this list, which is 
continuously updated. There are now over one 
thousand predatory open-access publishers and 
journals on the list. 
The business model for the predatory journals is 
based on the “gold open access model”, as the 
publishing costs are covered by fees charged to the 
authors after their manuscripts have been accepted 
(1). The advantage of this publishing model is that 
the published articles have open access for everyone 
free of charge.  
There are many advantages to open access journals 
for both authors and readers. Funding organizations 
are increasingly demanding that the published article, 
based on money from the grant, is published in open 
access journals. The European Research Council has 
been supporting the principle of open access to the 
published research articles as an important part of its 
mission (2). Department of Homeland Security 
performed a plan to support increased public access 
to the results of research funded by the federal 
government (3). Denmark has developed a national 
strategy for open access and the vision of this 
strategy is described as “To create free access for all 
citizens, researchers and companies to research 
articles from Danish research institutions financed by 
public authorities and/or private foundations” (4). 
Being editors of a small new journal, we know that 
new journals always have to start from the bottom, 
only being indexed in few databases, and without 
having any impact factor calculated. The reason for 
starting another journal should not primarily be 
economic profit and in our opinion, one should 
basically only consider starting a new journal if there 
is either a lack of good journals in the specific subject 
area or wanting to start a platinum open access 
journal, i.e. an open access journal with no 
publication fees (1). We are not against publication 
fees, and we realize that when our journal grows 
beyond a certain limit, we will not be able to run it 
without considering a small publication fee from the 
authors. However, the publication fee should be kept 
low and other ways of getting income should be 
considered, e.g., advertisements. Most importantly, 
the focus must be on quality and not quantity. We 
have been lucky to receive grant money from The 
Nordic Board for Periodicals in the Humanities and 
Social Sciences (NOP-HS), the Psychiatric Research 
Unit, Region Zealand, and the Center of 
51 
 
Neurodevelopmental Disorder at Karolinska 
Institutet (KIND) via Stiftelsen Barnforskning. 
Because of this money, we can continue without any 
publication fees and with free English language 
editing services for a few more years.  
In all types of businesses, there are people cheating. 
An increasing number of open access journals are 
now simply trying to make money without any 
scholarships involved. This makes it difficult for 
journals like the Scandinavian Journal of Child and 
Adolescent Psychiatry and Psychology to develop 
into a new quality journal in the area.  
Chrissy Prater has described some ways to identify 
a questionable journal. Some of the most important 
ones are; 1) The journal asks for a submission fee 
instead of a publication fee, or tries to keep the 
copyright to the authors’ work; 2) The Editorial 
Board is either very small or “coming soon”; 3) The 
website is not professional when it comes to quality; 
4) The journal title notes a national or international 
affiliation that does not match its editorial board or 
location; 5) The content of the journal varies from 
the title and stated scope.  
We really hope that more people will find it easier 
to recognize these journals and that the list of 
predatory journals will be smaller in the future. It is 
crucially important that scientific journals are of high 
quality so that one can trust the research being 
published and preferably with open access to 
everyone.    
 
 
References 
 
1. Crow R. Income models for open access: an overview of current 
practice. Version 1.0, September 2009. Available at 
http://www.arl.org/sparc   Accessed November 5, 2017 
 
2. European Research Council. Open Access. 
https://erc.europa.eu/funding-and-grants/managing-
project/open-access)  Accessed November 5, 2017 
 
3. Plan to support increased public access to the results of research 
funded by the Federal Government. Department of Homeland 
Security. January 5, 2017 https://www.dhs.gov/publication/plan-
support-increased-public-access-results-research-funded-federal-
government    
 
4. Denmark’s National Strategy for Open Access. Danish Agency for 
Science, Technology and Innovation. July 2014, Copenhagen, 
Denmark 
 
5. Prater C. 8 ways to identify a questionable open access journal. 
http://www.aje.com/en/arc/8-ways-identify-questionable-open-
access-journal/ Accessed November 5, 2017 
 


Fake open access journals –“predatory journals” - an increasing problem

Raaijmakers, Daphne

Polak, Marike G.

Arends, Lidia R.

van Eldik, Willemijn M.

Prinzie, Peter

The Dimensional Assessment of Personality Pathology – Short Form for Adolescents (DAPP-SF-A): normative data for Flemish adolescents aged 16 to 21 years

Nichols, Linda

Cecula, Dawid

Editorial and Guest Editorial

Badowska-Szalewska, Ewa

Ludkiewicz, Beata

Krawczyk, Rafał

Melka, Natalia

Moryś, Janusz

Comparison of the influence of two models of mild stress on hippocampal brain-derived neurotrophin factor (BDNF) immunoreactivity in old age rats

Gravius, Andreas

Dekundy, Andrzej

Vanaga, Anita

Franke, Lutz

Danysz, Wojciech

Further pharmacological characterization of eltoprazine: focus on its anxiolytic, anorexic, and adverse-effect potential

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