Risperidone versus haloperidol in children and adolescents with AD - A randomized, controlled, double-blind trial

The aim of the study was to compare safety, efficacy and tolerability of risperidone with haloperidol in the treatment of Autistic Disorder (AD). Method This study was designed as a double-blind, prospective, for a 12-week period. A total of 30 subjects, between the ages of 8 and 18 with AD based on DSM IV criteria, were included in the study. Behavioral Rating Scales were performed by the investigators and the parents. Safety assessment included vital signs, electrocardiogram, electroencephalogram, adverse events, laboratory tests, extrapyramidal symptoms and the side effects. Both treatments were applied in a once daily dosage regimen of 0.01-0.08 mg/kg/day. Results The reduction from baseline in Ritvo-Freeman Real Life Rating Scale (RF-RLRS), sensory motor (subscale I) and language (subscale V) scores were significant in risperidone group (P < 0.05). Compared to haloperidol, risperidone led to a significantly greater reduction in the Aberrant Behavior Checklist (ABC) and Turgay DSM-IV Pervasive Developmental Disorder (PDD) scale scores (P < 0.05 and P < 0.01). There was a greater increase of prolactin in the risperidone group, while alanine amino transferase (ALT) had further increased in the haloperidol group. Sensory motor behaviors (subscale I) and language at the end of the 12th week, RF-RLRS sensory motor and language subscale scores decreased in the risperidone group further than the other group (P < 0.05). Conclusions Risperidone was found to be more effective than haloperidol in the treatment of behavioral symptoms, impulsivity, language skills, and impaired social relations in children with AD. These results demonstrated that both drugs were safe and well tolerated in the treatment of AD

Comparison of long-term efficacy and safety of risperidone and haloperidol in children and adolescents with autistic disorder - An open label maintenance study

Background The aim of the study was to investigate safety, efficacy and tolerability of risperidone in comparison with haloperidol in the long-term treatment of autistic disorder. Methods This was an open-label continuation study of the randomized, double-blind, controlled trial of risperidone and haloperidol study for 12 week in autistic children and adolescents. A total of 28 subjects between 8 and 18 ages with autistic disorder were enrolled to the open label phase of the study. Behavioral rating scales (Clinical Global Impression Scale [CGI-I], Ritvo-Freeman Real Life Rating Scale [RF-RLRS]), Aberrant Behavior Checklist [ABC], Turgay DSM-IV Pervasive Developmental Disorder Rating Scale [TPDDRS]) and safety assessment scales (Extrapyramidal Symptoms Rating Scale [ESRS], UKU-Side Effect Rating Scale) were performed at 12, 16, 20 and 24 weeks, following the 12 week double-blind phase. Risperidone and haloperidol treatments were applied with a once daily dosage regimen as 0.01-0.08 mg/kg/day. Results Risperidone led to a significant greater reduction on CGI scale. There was significant improvement on RF-RLRS sensory motor and language subscale and ABC scores in risperidone group. Weight gain was observed more frequently in the haloperidol group at week 24. Conclusions These results demonstrate that risperidone is more efficacious and well tolerated than haloperidol in the long-term maintenance treatment of autistic disorder

Mood and disruptive behavior disorders and symptoms in the offspring of patients with bipolar I disorder

The study aimed to ascertain the prevalence of mood and disruptive behavior disorders and symptoms in 35 children of 29 adult outpatients with a DSM-IV diagnosis of bipolar I disorder, compared with 33 children of 29 healthy adults, matched with patients on age, socioeconomic status and education. The offspring of bipolar patients had a 9.48 fold higher risk of receiving a psychiatric diagnosis. While only two children of patients with bipolar disorder were diagnosed with a mood disorder, 30.9% displayed mild depressed mood, compared with 8.8% of the controls, a statistically significant difference. The bipolar offspring also scored significantly higher on the hyperactivity and conduct problems subscales as well as the ADHD index of the Conners’ Teacher Rating Scale. The disruptive behavior and mood symptoms observed in early life in the offspring of bipolar patients may indicate the need for early psychosocial intervention

Evaluation of interventions based on depression sign scores of adolescents

The aim in this study was to compare effects of problem-based group therapy and occupational therapy on depression scores six months after the Marmara earthquake in Golcuk. The study included 187 seventh grade students. Data were collected with the Children's Depression Inventory (CDI; Kovacs, 198 1, Turkish version by Oy, 199 1) and a sociodemographic form. The schools were randomly assigned into two groups, either to receive problem-based group therapy (Group A) or occupational therapy (Group B). CDI was administered before and after the therapies and depression sign scores were recorded. After the first and second sessions of the therapies, there was no significant difference in mean depression scores between both groups, but there was a significant decrease in CDI scores of the adolescents

Technetium-99m HMPAO brain SPECT in autistic children and their families

The purpose of the study was to investigate perfusion patterns in autistic children (AC) and their families. Ten AC (9 boys, I girl; mean age: 6.9 +/- 1.7 years) with autistic disorder defined by DSM-III-R criteria, five age-matched children (3 boys, 2 girls) as a control group, and the immediate family members of eight AC (8 mothers, 8 fathers, 7 siblings; mean ages: 39 +/- 4 years, 36 +/- 5 years and 13 +/- 5 years, respectively) were included in the study. Age- and sex-matched control groups for both the parents and the siblings were also included in the study. Brain perfusion images were obtained 1 h after the intravenous injection of an adjusted dose of Tc-99m HMPAO to children and the adults. Visual and semiquantitative evaluations were performed. Hypoperfusion was seen in the right posterior parietal cortex in three AC, in bilateral parietal cortex in one AC, bilateral frontal cortex in two AC, left parietal and temporal cortex in one AC, and right parietal and temporal cortex in one AC. Asymmetric perfusion was observed in the caudate nucleus in four AC. In semiquantitative analyses, statistically significant hypoperfusion was found in the right inferior and superior frontal, left superior frontal, right parietal, right mesial temporal and right caudate nucleus. In parents of AC, significant hypoperfusion was noted in the right parietal and bilateral inferior frontal cortex. In siblings of AC, perfusion in the right frontal cortex, right nucleus caudate and left parietal cortex was significantly decreased. This preliminary study suggests the existence of regional brain perfusion alterations in frontal, temporal, and parietal cortex and in caudate nucleus in AC and in their first-degree family members. (C) 2007 Elsevier Ireland Ltd. All rights reserved

The early Upper Paleolithic occupations at Ucagizli Cave (Hatay, Turkey)

This paper summarizes results from excavations at Ucagizli Cave (Hatay, Turkey) between 1999 and 2002 and 2005. This collapsed karstic chamber contains a sequence of early Upper Paleolithic deposits that span an interval between roughly 29,000 and 41,000 (uncalibrated) radiocarbon years BP. Lithic assemblages can be assigned to two major chronostratigraphic units. The earliest assemblages correspond with the Initial Upper Paleolithic, whereas the most recent ones fit within the definition of the Ahmarian. Substantial assemblages of stone tools, vertebrate faunal remains, ornaments, osseous artifacts, and other cultural materials provide an unusually varied picture of human behavior during the earliest phases of the Upper Paleolithic in the northern Levant. The sequence at Ucagizli Cave documents the technological transition between Initial Upper Paleolithic and Ahmarian, with a high degree of continuity in foraging and technological activities. The sequence also documents major shifts in occupational intensity and mobility. (C) 2008 Elsevier Ltd. All rights reserved