Evaluation of a Neuropsychiatric Disorder: From PANDAS to PANS and CANS

WOS: 000379451400009PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) syndrome is a disorder seen before adolescence that possesses an abrupt onset of obsessive compulsive disorder symptoms and/or tics. Swedo and colleagues defined this disorder in 1998 as a syndrome related to Group A streptoccoccus (GAS) infection with neurological issues, such as motor hyperactivation and choreiform movements. The progress of the disorder may be described as wax-and-waning, apart from abrupt onset, and this relapse and remission course is associated with exacerbating infections, according to the creators of PANDAS syndrome Ruling out of Rheumatoid Fever and Sydenham's Chorea was a necessity for making a proper diagnosis. Since the recognition of this syndrome, clinicians encountered many children who could not fulfill all 5 criteria, which must be met for PANDAS diagnosis. In addition, due to literature showing failure and lack of strong evidence of a major role of GAS, the newly-defined categories PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and CANS (Childhood Acute Neuropsychiatric Syndrome) were created to encompass those of "almost met" non-PANDAS cases. PANS and CANS include concurrent significant psychiatric symptoms with abrupt onset of OCD symptoms and/or tics but do not require identification of any infection agent, immune dysfunction, or enviromental precipitants. In this paper, we aimed to discuss PANS/CANS, alterations of PANDAS, and diagnoses in which "almost met" PANDAS patients should be classified on the basis of a case who developed an abrupt onset of anxiety, obsessions, and vocal tics

Psychometric features of Turkish version of Autism-Spectrum Quotient

WOS: 000282841000010Objective: Autism is characterized by difficulties in three separate areas involving impairments in social abilities and communication, and repetitive or stereotyped behaviors and interests. Several studies have reported elevated rates of traits related to autism symptoms in first degree relatives called broad autism phenotype. The aim of the study was to evaluate the reliability and psychometric features of the Turkish version of the Autism-Spectrum Quotient (AQ-TR), that was developed by Baron-Cohen and his colleagues and which is a self-administered questionnaire designed to measure the degree to which an adult with normal intelligence has traits associated with autism. Methods: The AQ-TR was administered to 406 university students (58% female, 42% male). To show the reliability of the Turkish version of the AQ (ASQ-TR) Cronbach's alpha values and test-retest was evaluated on university students. Factor analysis was used to test the construct validity of the scale. Results: Cronbach's alpha value for the scale was 0.64. Test-retest reliability of the scale was satisfactory (0.72). Male students scored higher in total score (p=0.003) and social skills, communication and imagination subscales. Principal component analysis supported a three factorial structure. Discussion: These results suggest that the ASSQ-TR is a reliable instrument and also the construct validity was shown by factor analysis. The scale was successful on showing the male-female discrepancy which is notified about other cultures. It is necessary to support the validity of the scale by HFA/AS cases participation. (Anatolian Journal of Psychiatry 2010; 11:253-260

Risperidone, quetiapine and chlorpromazine may have induced priapism in an adolescent

WOS: 000369305300014PubMed ID: 26542690Priapism is the prolonged, painful erection of penile tissue not accompanied by sexual arousal. Priapism has been established as a rare adverse drug reaction to drugs such as antipsychotics, psychostimulants, antidepressants, and mood stabilizers. Immediate intervention is needed to prevent destructive and irreversible complications, such as erectile dysfunction, disfigurement, inability of the penis to stay erect, and related social/emotional problems. Antipsychotic-induced priapism may result from the alpha receptor occupancy property of those drugs. We report the case of a 13-year-old suffering from attention deficit-hyperactivity disorder plus conduct disorder with priapism related to antipsychotics. Episodes occurred with risperidone plus methylphenidate, quetiapine plus methylphenidate, and chlorpromazine alone

Theory of mind and verbal working memory deficits in parents of autistic children

WOS: 000264615300006PubMed ID: 19200606The objective of this study was to investigate the potential values of executive function and social cognition deficits as endophenotypes of autism. While theory of mind (ToM) is generally accepted as a unitary concept, some have suggested that ToM may be separated into two components (mental state reasoning and decoding). In this study, both aspects of ToM and verbal working memory abilities were investigated with relatively demanding tasks. The authors used a neurocognitive battery to compare the executive function and social cognition skills of 76 parents of autistic probands with 41 parents of healthy children. Both groups were matched for IQ, age and gender. Index parents had verbal working memory deficits. They had also low performance on a mental state reasoning task. Index parents had difficulties in reasoning about others' emotions. In contrast to findings in the control group, low performance of mental state reasoning ability was not associated with working memory deficit in index parents. Social cognition and working memory impairments may represent potential endophenotypes, related to an underlying vulnerability for autistic spectrum disorders. (c) 2007 Elsevier Ireland Ltd. All fights reserved

Asperger Disorder Follow-up Period: Discussion of Five Cases in the Context of Problems During Adolescence

WOS: 000406928300006Aim: We aimed to reassess the psychosocial difficulties, psychiatric diagnosis and follow-up period from childhood through adolescence of Asperger disorder cases. Materials and Methods: We reevaluated the files of five cases (four boys, one girl) between 13-17 years of age who had been up for theree to seven years. The psychiatric diagnosis and psychosocial adjustment levels during the last six months were re-evaluated by psychiatric interview. The severity of illness was evaluated with Clinical Global Impression Scale/Violence, and the improvement level with Clinical Global Impression Scale/Recovery. Results: We found that in adolescence, social adjustment problems, affective symptoms and impulse control problems were dominant in the cases. The psychiatric diagnosis were major depressive disorder (n=2), attention deficit hyperactivity disorder (n=1), obsessive compulsive disorder (n=1), bipolar disorder (n=1); psychotropic medications were antidepressants (n=3), antipsychotics (n=3), methyphenidate (n=1), and mood stabilizator (n=1). The cases benefited from psychopharmacological medication and psychological arrangements. Conclusion: Psychiatric comorbidity is among the factors that affect psychological adjustment in Asperger disorder. Social adjustment problems were found to have increased and additional psychiatric disorders occurred or the existing disorders became more severe in all 5 cases. Affective disorders, disruptive behavior disorders and anxiety disorder have often been seen in our cases as compatible with the literature