Diphenhydramine use in the treatment of risperidone-induced sialorrhea

[No abstract available

Pulmonary aterial hypertension in an adolescent treated with methylphenidate

[No abstract available

Six months of treatment with risperidone may be associated with nonsignificant abnormalities of liver function tests in children and adolescents: A longitudinal, observational study from Turkey

Objective: Risperidone is a promising agent for the treatment of schizophrenia, Tourette's disorder, mood disorders, and disruptive behavior disorders in young populations. However, adverse effects of risperidone may take a long time to emerge. The objective of this study was to investigate the changes in the liver function tests (LFTs) associated with more than 6 months of risperidone treatment in children and adolescents. Method: A total of 102 youths treated with risperidone for more than 6 months were eligible for the study. For this study, patients' baseline and follow-up weight and hepatobiliary function tests, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and serum bilirubin levels, were measured at baseline and at 6 months. Results: Asymptomatic abnormalities of LFTs, mostly ALP elevation, were found in 38.2% of the cases, and marked elevation of liver enzymes was found in 0.8% of cases treated with risperidone. The mean levels of liver enzymes and bilirubin of the patients were significantly higher than the baseline after first and sixth months of treatment. However, there was no statistically significant change in the liver enzymes and bilirubin levels between the first and sixth months. There was no significant relationship between changes in weight and liver enzymes and biluribin levels after 6 months of risperidone treatment. Conclusion: These findings suggest that risperidone treatment in the long term commonly leads to liver function changes, although at therapeutic doses in children and adolescents it may rarely induce a serious hepatic toxicity. Concomitant use of antidepressants and methylphenidate and variations in age and pubertal status are limitations of present study. Further studies are needed to assess the importance and role of other variables over LFT abnormalities in youth population. © 2010, Mary Ann Liebert, Inc

Executive functions in frontal lob syndrome: A case report

Prefrontal cortex in the frontal lobe (FL) is the center of executive functions (EF). FL damage can lead to executive dysfunction by influencing frontal-subcortical circuits (dorsolateral, orbitofrontal, ventromedial). Damage to the dorsolateral prefrontal cortex (DLPFC) can lead to deterioration in EF, whereas damage to the orbitofrontal cortex (OFC) can lead to personality changes with characteristics of disinhibition and irritability. In addition, damage to the anterior cingulate cortex/medial prefrontal cortex (ACC/MPFC) can result in decreased spontaneity. Neuropsychological tests are important components in the assessment of EF including goal-directed behavior, decision-making, risk assessment, future plan management, prioritizing, and organization. Clinical conditions affecting frontal-subcortical connections outside of the FL can also lead to executive dysfunctions and frontal lobe syndrome (FLS). This case report is about an adolescent patient diagnosed with FLS. The clinical symptoms, assessment, and treatment processes of this case are discussed in this report. The case is a 15-year-old boy that was admitted to our clinic with behavioral problems that began after a car accident three years ago. A magnetic resonance imaging (MRI) study of the brain indicated hyper-intense signal increase in the periventricular deep white matter that was associated with traumatic brain damage. Neuropsychological test results (Stroop, Wisconsin Card Sorting Test, Serial Digit Learning Test, Judgement of Line Orientation Test, Verbal Memory Processes Scale) demonstrated impairment in the cognitive flexibility, verbal fluency, prioritizing, inappropriate response inhibition, sustained attention, planning, problem solving, organization, and subcortical memory functions. We thought that cognitive and behavioral symptoms of this case were associated with the dysfunctions of the frontal-subcortical circuits, independently from an obvious frontal lesion. FLS patients after head traumas, with sudden-onset behavioral and cognitive problems, should be kept in mind in differential diagnosis even in the absence of an obvious frontal lesion

Co-morbidity of panic disorder with or without agoraphobia

Objective: This study evaluated the clinical and sociodemographic features associated with concurrent Axis I psychiatric disorders among adult psychiatric outpatients with panic disorder (PD) with or without agoraphobia (AG). Method: This was a retrospective chart review study of 12.980 patients treated for any psychiatric disorders in psychiatric outpatient clinics. Diagnoses of comorbid disorders were determined in a sample of 478 patients with panic disorder as defined in DSM-IV. The subjects were divided into two groups: patients panic disorder with AG (n=221) and panic disorder without AG (n=254). Sociodemographic variables, illness characteristics such as symptoms, duration of illnes and family history of psychiatric disorders were evaluated. Results: Panic disorder was prevalent among 3.7 % of the sample. The most common Axis I psychiatric disorders among groups were major depressive disorder (21.7 %) and generalized anxiety disorder (8.9 %). The prevalence of other psychiatric disorders in present study was as follows: social phobia 7.3 %; obsessive-compulsive disorder 4.6 %; posttraumatic stress disorder 4.6 %; eating disorders 1.46 %; alcohol abuse/dependence 4.6 %; somatoform disorders 0.85 %; bipolar disorder 0.6 %; dysthymic disorder 2.3 % and impulse control disorder 0.4 %. Female subjects have higher comorbid conditions compared to males. Those with more concurrent Axis I conditions had longer histories of PD and younger age of onset. © Universitätsverlag Ulm GmbH 2007

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T)

PubMedID: 30964388Aim: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. Method: A nation-wide, randomly selected, representative population of 5830 children (6–13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. Results: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. Conclusion: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group. © 2019, © 2019 The Nordic Psychiatric Association

Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological study

Purpose: The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. Methods: This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014–2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years. Results: The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. Conclusion: Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany

Novel inflammatory targets for immunotherapies in pediatric patients with trichotillomania

Immune dysregulation may be important in the etiology of obsessive-compulsive and related disordersandbody-focusedrepetitivebehaviors, such as Trichotillomania (TTM). The role of inflammation and inflammatory markers in TTM has received relatively little attention. This study was aimed to determine the expression levels of inflammatory markers (i.e. IL-1β, IL-1α, IL-4, IL-6, IL-17, TNF-α and TGF-β) in peripheral blood mononuclear cells of children with TTM and healthy controls and to evaluate their association with clinical variables. Seventy-seven patients with TTM and 107 healthy controls were enrolled in the study. Peripheral blood was collected in standardized conditions. The mean age of patients and controls did not differ significantly (10.8 ± 4.4 and 12.0 ± 3.2 years; respectively). The majority of patients with TTM and controls were females (n = 55, 71.4 % and n = 55, 51.4 %; respectively); with a greater preponderance of females among TTM. Patients with TTM had significantly elevated expression levels of TNF-α, IL-6 and IL-17 compared to controls. However, the expression level of IL-4 was significantly reduced in TTM patients compared to controls. Accordingly, we found a pro-inflammatory state in TTM and those findings may suggest novel treatment options for TTM and further, cross-disciplinary studies focusing on neuro- inflammation in TTM conducted on larger samples are needed. © 2020 Elsevier Gmb

Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological study

Purpose: The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. Methods: This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014–2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years. Results: The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. Conclusion: Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment