Epidemiologic Studies in Child and Adolescent Psychiatry: A Review of Methodology

Childhood psychiatric disorders are estimated to influence about 9 to 21% of relevant age group and interest in this disorders are increasing all over the world. The growing need to child and adolescent mental health leads the task of establishing proposals and policies in this field to become a priority for governments. The first step of such proposals should be determination of prevalence of child and adolescent mental disorders in that country. However, several major methodological problems make it hard to provide accurate prevalence estimates from epidemiological studies. Most common problems are within the fields of sampling, case definition, case ascertainment and data analyses. Such issues increases the costs of studies and hinder to reach large sample sizes. To minimize these problems, investigators have to be careful on choosing the appropriate methodology and diagnostic tools in their studies. Although there are many interviews and questionnaires for screening and diagnosing in child and adolescent psychiatry, only a few of them are suitable for epidemiological research. In parallel with the improvement in all fields of child and adolescent mental health in our country, some of the major screening and diagnosing tools used in prevalence studies in literature have already been translated and validated in Turkish. Most important of this tools for screening purposes are Child Behavior Checklist and Strengths and Difficulties Questionnaire and for diagnosing purposes are Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version and Development and Well-Being Assessment. The aims of this article are to review the methodological problems of epidemiologic studies in child and adolescent psychiatry and to briefly discuss suitable diagnostic tools for extended sampled epidemiologic studies in our country

MITOCHONDRIAL DNA COPY NUMBER IS ASSOCIATED WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER

Background: Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder in children. Several hypotheses have been proposed to explain its etiology. Mitochondrial dysfunction (MD) is suggested to be one of the causes of Attention Deficit Hyperactivity Disorder. The objective of the study was to evaluate the relationship between MD and ADHD by investigating mitochondrial DNA (mtDNA) levels from peripheral blood leukocytes, one of the best biomarkers of mitochondrial dysfunction. Subjects and methods: This study included 56 children aged 6-16 years who were diagnosed with ADHD for the first time and 56 age- and sex matched children without ADHD. Real-time PCR was performed to determine the relative mtDNA copy number in each study participant. Results: The mean mtDNA copy number of the case group was 57.623±24.827 and that of the control group was 44.204±18.926 (p=0.002). The mtDNA copy number of the case group was higher than that of the control group. Results of ROC curve analysis provided a mtDNA cutoff value of 45. Conclusion: Significantly higher mtDNA copy number in ADHD group may suggest mitochondrial dysfunction in the etiopathogenesis of ADHD

The validation and adaptation of Turkish version of development and well being assesment

Çocuk ve ergen ruh sağlığı alanındaki ihtiyacın artması ile ülkelerin bu alanda sağlık politikaları oluşturmaları ve çocuk ergen ruh sağlığı açısından planlamalar yapmaları zorunlu hale gelmektedir. İngiltere'de çocuk ergen ruh sağlığı hizmetlerinin planlanması amacıyla yapılan ülke geneli sıklık çalışmasında tanılama, uygulamanın çok daha pratik, ekonomik ve etkin şekilde yapılmasına olanak veren ve epidemiyolojik çalışmalarda kullanılmak üzere geliştirilen Development and Well-being Assesment (DAWBA) isimli tanılama paketi ile yapılmıştır. Bu çalışmamızda, DAWBA tanı paketinin Türkçe'ye uyarlanması ve Türkçe uyarlamanın geçerliğinin sınanması amaçlanmıştır. DAWBA'nın Türkçe'ye uyarlanmasının, ülke geneli sıklık çalışmalarının çok daha kolay, ucuz ve etkin şekilde yapılabilmesinin yolunu açacağıæ böylece çocuk ergen ruh sağlığı politikalarının oluşturulması konusunda önemli bir adım atılacağı düşünülmüştür. Çalışma çeviri, uygulama, Değerlendirme ve istatistik olmak üzere 3 aşamada gerçekleştirilmiştir. DAWBA'nın Türkçe'ye çeviri aşaması çocuk ergen ruh sağlığı profesyonellerinden oluşan 7 kişilik bir ekip tarafından yaklaşık 2 yıllık bir sürede tamamlanmıştır. Türkçe uyarlamanın geçerliği, Dokuz Eylül Üniversitesi Tıp Fakültesi Çocuk Ergen Ruh Sağlığı ve Hastalıkları Polikliniğine başvuran ve çalışma ölçütlerine uyan 39 olgu ile yapılan çalışmada sınanmıştır. Olgular önce klasik klinik görüşmelerle değerlendirilmiş ve daha sonra da DAWBA görüşmeleri, uygulama konusunda eğitilen görüşmeciler tarafından bilgisayar ortamında online olarak yapılmıştır. Klinik görüşmelerde konulan tanılarla DAWBA ile konulan tanıların tutarlılığına bakılarak DAWBA Türkçe uyarlamasının geçerliliği değerlendirilmiştir. Sonuç olarak, DAWBA Türkçe uyarlaması ile konulan tanıların, klinik tanılarla orta-yüksek oranda tutarlığı olduğu görülmüştür. By the increasing need in child and adolescent mental health, to establish plans and policies in this field, became a necessity for governments. The first step of this plans is to provide prevelance of child and adolescent mental disorders in that country. The largest nation wide prevelance study in the literature was the one commited in 1999 to plan British Child and adolescent mental services. İn that study the diagnoses were made by ‘Development and Well-being Assesment' (DAWBA) a new diagnostic tool which allows to make epidemiologic studies more practical, effective and cheaper İn this study we aimed to translate and adapdate DAWBA in Turkish and to examine the validation of Turkish form. Having the Turkish form of DAWBA, it will be possible to make a nation wide prevelance study easier,cheaper and more effective and thus establish plans and policies for our country Our study is planned in 3 steps as translation, administration and data Analysis and statistical work. DAWBA was translated in Turkish by a team, which is consisted of 7 child and adolescent mental health Professionals, nearly in 2 years. The validation of Turkish form was examined in clinic sample, consisted of 39 children and adolescents.The sample was chosen from the Child And Adolescent Psychiatry Departmant of Dokuz Eylül University Hospital. DAWBA, was validated against routine clinical diagnoses The interviews in the clinic were administated by interviewers, trained on DAWBA administration. Eventually the results indicated that there were modarate to substantial agreement between the DAWBA and the independent clinic diagnosis

Significance of Healthy Family Structure in Preventing Child Sexual Abuse: A Prospective Controlled Study

The aim of this study was to determine the socio-demographic characteristics of victims, parents, and accused or suspected child abusers, and to evaluate the conditions that constitute the risk factors for children falling victim to sexual abuse in Eastern Anatolian Region of Turkey. Personal data files of 63 victims of child sexual abuse were analyzed and compared with 201 individuals in a control group. The children’s age, gender, educational level, number of siblings, and the nature of the event they experienced, were all examined. In addition, parents’ educational and economic levels; and parents’ relationship, were also evaluated. Of the victims 66.7% were female (n=42), while the average age of the victims was 14.2 years. A total of 52.4% (n=33) of the victims were exposed to major crime, and 47.6% (n=30) were exposed to simple sexual activity. Risk factors for children who were exposed to sexual abuse were parental conflict, low educational level of the father, non-working father, low economic level of the family, and crowded family. Domestic violence negatively affects family members, especially children, and is a main risk factor for children becoming victims of abuse. [Med-Science 2014; 3(1.000): 1046-53

Psychopathology and Related Psychosocial Factors in Children with Office Discipline Referrals at School: Evidence from a Developing Country

Many childhood psychiatric disorders present their first symptoms as challenging behaviors at school. Evidence from cross-national studies enhance the understanding of the biological and cultural variables underlying these behaviours. In this study, we aim to identify the psychopathology among children with office disciplinary referrals and assess psychosocial risk factors related to this situation. Forty-seven students who had received an office discipline referral and eighty-three controls who had never been given an office disciplinary referral participated in this study. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime, socio-demographic data form were administered to children to assess their respective psychopathologies and psychosocial risk factors. Attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, and obsessive compulsive disorder were significantly higher in children with Office discipline referrals. Psychiatric assessment should be one of the first steps in the evaluation processes of assessing challenging behaviors at school

Myasthenia Gravis Attack after Oral Risperidone Treatment: A Case Report

Myasthenia gravis (MG) is an autoimmune disease, which can be triggered by anticholinergic agents. The 6-year-old female patient was admitted to the outpatient clinic. She was had been previously diagnosed with comorbid attention deficit hyperactivity disorder and conduct disorder and was receiving short-acting methylphenidate and risperidone, as recommended by a child psychiatrist. However, after using the drugs, she stated that she was overly tired during the day and that her eyelids drooped. Hence, the current treatment was stopped. She was hospitalized with a prediagnosis of ocular type MG and pyridostigmine (90 mg/day) treatment was started. The patient recovered and subsequently the treatment was stopped. Since psychiatric symptoms of the patient resurfaced, long-acting methylphenidate treatment was initiated. During this treatment, the symptoms of MG did not return. The Naranjo's scale of adverse drug reaction probability was completed. Consequently, there may be an association between risperidone and MG

Psychiatric aspects of 47, XYY (Jacobs) syndrome: A case report

In this case, psychiatric aspects of 47, XYY syndrome is discussed in a male adolescent patient diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), conduct disorder (CD), mild intellectual disability, and Tourette syndrome. A 13-year-old boy was diagnosed with ADHD, CD, mild intellectual disability, Tourette syndrome, and 47, XYY syndrome. As in our case, the presence of the XYY syndrome with Tourette syndrome, ADHD, CD and mild intellectual disability is the first demonstrative case. As it is known that XYY syndrome can often lead to neurodevelopmental disorders, genetic counseling can be provided when more than one neurodevelopmental disorders are detected as comorbid. [Med-Science 2018; 7(2.000): 446-7

Serum NGF levels may be associated with intrauterine antiepileptic exposure-related developmental problems

Objective: It has been shown that maternal epilepsy and antiepileptic drug use during pregnancy have adverse developmental outcomes in children. The aim of this study was to investigate the developmental outcomes of maternal epilepsy and prenatal antiepileptic exposure. We also looked for the associations between serum levels of glial cell-derived neurotrophic factor (GDNF) and nerve growth factor (NGF) and developmental outcomes