Risperidone in the treatment of conduct disorder in preschool children without intellectual disability

<p>Abstract</p> <p>Background</p> <p>The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4^thedition Textrevision) highlights the especially poor outcomes of early-onset conduct disorder (CD). The strong link between the patient's age at treatment and its efficacy points the importance of early intervention. Risperidone is one of the most commonly studied medications used to treat CD in children and adolescents. The aim of this study is to obtain preliminary data about the efficacy and tolerability of risperidone treatment in otherwise typically developing preschool children with conduct disorder and severe behavioral problems.</p> <p>Method</p> <p>We recruited 12 otherwise normally developing preschoolers (ten boys and two girls) with CD for this study. We could not follow up with 4 children at control visits properly; thus, 8 children (six girls, two boys; mean age: 42.4 months) completed the study. We treated the patients with risperidone in an open-label fashion for 8 weeks, starting with a daily dosage of 0.125 mg/day or 0.25 mg/day depending on the patient's weight (<20 kg children: 0.125 mg/day; >20 kg children: 0.25 mg/day). Dosage titration and increments were performed at 2-week interval clinical assessments. The Turgay DSM-IV Based Disruptive Behavior Disorders Child and Adolescent Rating & Screening Scale (T-DSM-IV-S) as well as the Clinical Global Impression Scale (CGI) assessed treatment efficacy; the Extrapyramidal Symptom Rating Scale (ESRS) and laboratory evaluations assessed treatment safety.</p> <p>Results</p> <p>The mean daily dosage of risperidone at the end of 8 weeks was 0.78 mg/day (SD: 0.39) with a maximum dosage of 1.50 mg/day. Based on the CGI global improvement item, we classified all patients as "responders" (very much or much improved). Risperidone was associated with a 78% reduction in the CGI Severity score. We also detected significant improvements on all of the subscales of the T-DSM-IV-S. Tolerability was good, and serious adverse effects were not observed. We detected statistically significant prolactin level increments (p < 0.05), but no clinical symptoms associated with prolactinemia.</p> <p>Conclusion</p> <p>The results of this study suggest that risperidone may be an effective and well-tolerated atypical antipsychotic for the treatment of CD in otherwise normally developing preschool children. The findings of the study should be interpreted as preliminary data considering its small sample size and open-label methodology.</p

Social Cognition in Child and Adolescents with Anorexia Nervosa

Social cognition represents the mental processes of social interaction between oneself and others. In recent years, the interest in social cognition skills has increased in cases with eating disorders. Anorexia nervosa is an eating disorder that is associated with the multiple factors in etiology. Treatment of anorexia nervosa is still controversial. The youths diagnosed with anorexia nervosa are known to be as the most difficult group in eating disorders for building therapeutic relations. Studies, mostly suggests that there are difficulties in social cognitive functions in patients with anorexia nervosa. However, there are studies that reported different results. It seems that, the majority of studies which evaluate the social cognitive functions in patients with anorexia nervosa, are carried out with the adult age group. There are limited number of studies in child and adolescent age group. The purpose of this paper was to examinate the studies of social cognitive skills in children and adolescents diagnosed with anorexia nervosa and present the general characteristics. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(2): 178-189

Theory of mind and emotion regulation difficulties in children with ADHD

WOS: 000454972600015PubMed ID: 30245374Social cognition deficits and emotion dysregulation (ED) are frequently separately studied in relation to ADHD. This study aimed to examine the link between theory of mind (ToM) abilities and ED in children with ADHD. Participants were 200 children aged 11-17 years (study group, n = 100; healthy controls, n = 100). Emotion regulation skills were quantified by using the Difficulties in Emotion Regulation Scale (DERS). ToM was quantified by three different tasks. Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) Disruptive Behavior Disorders Rating Scale parents form was used for determination of ADHD symptom severity (ADHD-SS). Children in the study group had more overall difficulties regulating their emotions than healthy controls. Within the study group, a significant correlation was found between the scores of DERS-total and ADHD-SS; and between the scores of DERS-total and gender. The linear regression showed that the predictor variables accounted for 56% of the variation in DERS-total. Unexpected Outcomes Test (UOT) scores significantly improved the accountability of the total variance when added to the linear regression. Our findings show that theory of mind deficits may partly explain ED in children with ADHD

Relationship Between Oxytocin and Attention Deficit Hyperactivity Disorder

WOS: 000418537000004Attention deficit hyperactivity disorder (ADHD), while characterized by attention problems, hyperactivity and impulsivity, essentially is a phenotypically heterogenous disorder. Social cognition disorders are important in ADHD, particularly in children due to their role in difficulties in social relations. Social cognition is crucial for the individual to build relations with others and through such relations inform social behavior. It has been suggested that sub-units of social cognition such as facial recognition and empathy are related to oxytocin. It is thought that individuals diagnosed with ADHD, for whom such skills are less readily available, have difficulties communicating on a social scale. PubMed medical search engine was used to identify the studies and review articles on oxytocin and ADHD. While the oxytocin gene and the oxytocin receptor gene are extensively studied in autism spectrum disorders, data on ADHD is scarce. Oxytocin, known as a mediator of social behavior, also affects the phenotype of ADHD, a disease subject to genetic and environmental influences determining its phenotype and individual case differences

Motor tics due to atomoxetine use: a case report

WOS: 000297959300012Motor tics due to atomoxetine use: a case report The comorbidity ratio of attention deficit and hyperactivity disorder (ADHD) and tic disorders (TD) or Tourette's syndrome (TS) is very high. It is also known that, psychostimulant use in the treatment of ADHD can increase existing tics or cause new tics. Therefore, a selective noradrenaline reuptake inhibitor, atomoxetine, which is effective in the treatment of tics and ADHD symptoms, was introduced into clinical practice as a treatment choice in patients with ADHD and TD/TS comorbidity. However, recently there have been reports about reverse effects of atomoxetine on tics. In this report, we discuss a clinical case that had an increase in existing tic severity and developed new tics during atomoxetine treatment