Otizm Spektrum Bozukluğunun Nedenlerine Ait Ebeveyn Algısının Tedavi Tercihine Etkisi

Aim:Due to the complex etiology and the lack of effective treatment for core symptoms, there are different views on the causes of ASD in many cultures. In this study, it was aimed to investigate the opinions, treatment choices, and expectations of families about the causes of ASD.Materials and Methods:Children diagnosed with ASD who applied to the Ondokuz Mayıs University Child Psychiatry Clinic between 2015 and 2019 were retrospectively included in the study. Patients who filled the information in the "preliminary interview forms" filled by the families before the interview for each patient who applied to our clinic were included in the study. The preliminary interview form contains questions about the child's age, gender, previous treatment, why the disease or disorder originated, and the prospect of treatment.Results:The data of 241 children and caregivers were examined in the study group. Comparing the clinical features and family views of the families of male and female patients, it was observed that the caregivers of the female patients had higher clinical global follow-up scores (p=0.022) and marked the "child's self" option (p=0.014). After a two-step clustering analysis, two clusters formed, and the most determining feature for the clusters was "Child-related causes". It was observed that "psychiatric examination", "drug treatment “and "age" were determinative between the two clusters.Conclusion:Opinions of caregivers about the causes of autism, duration of the disease, and previous psychiatric examinations affect the choice of treatment. These findings are essential for understanding the family's treatment choices and helping families and clinicians interested in ASD to guide and make decisions

Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes.

Background: The discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series. Aim: To describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015. Method: Data of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Turkiye. Clinical and paraclinical features were compared between patients with dis-ease onset before 12 years (earlier onset) and >= 12 years (later onset) as well as between our current (2015-2021) and previous (< 2015) cohorts. Results: A total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset < 12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort. Conclusion: Pediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought