Emotional and Behavioral Disorders in Pediatric Cancer Patients

AbstractObjectives Childhood malignancies raise a range of medical, psychological and social concerns. Identifying psychiatric disorders along with providing mental health services to prevent the emergence and aggravation of mental health problems in children seems necessary in pediatric hospitals. We aimed to find out the frequency of probable emotional and behavioral disorders among children and adolescents with malignancy.Materials & MethodsThis was a cross sectional study conducted at Hematology-Oncology Ward of Mofid Hospital, Tehran, Iran in 2017-2018. Emotional and behavioral disorders was assessed in 399 pediatric patients with malignancy, aged 5 to 12 years, using the Parent Checklist of CSI-4. All data analyses performed using the Stata 14 at 95% sig-value.Results: In all, 89.2% of sample met diagnostic criteria for at least one disorder. The most prevalent psychiatric disorders were special phobia (57%) enuresis (41.9%) Obsessive-Compulsive disorder (45.6%) and Separation Anxiety disorder (30.3%). Our results did not show significant gender and disease type differences in prevalence of psychiatric disorders.Conclusion: Prevalence of emotional and behavioral disorders in pediatric patients with malignancy admitted in the children’s hospital is common. These disorders affect on the treatment and quality of life of pediatric patients. Therefore, these findings may guide parents, nurses and clinicians to become more careful about identification and management of them

The Effect of Long-Acting Methylphenidate and Modafinil on Attention and Impulsivity of Children with ADHD using a Continuous Performance Test: A Comparative Study

Objectives Given the importance of having a continuous performance for the academic and social life of children with attention-deficit/hyperactivity disorder (ADHD), in this study, a continuous performance test was used to compare the effect of long-acting methylphenidate and modafinil on attention and impulsivity of these children. Materials & Methods A randomized clinical trial was conducted on 50 children aged 6 to 12 years with ADHD in the child and adolescent psychiatric departments of Imam Hossein and Mofid hospitals, Tehran, Iran. The children were selected by availability sampling and randomly divided into two groups of 25. One group was treated with long-acting methylphenidate and the other with modafinil for 14 days. The continuous performance test was carried out before and after the treatment. The obtained data were analyzed by F and t tests Results Long-acting methylphenidate and modafinil were both effective in improving attention and impulsivity in children with ADHD. There was no significant difference between the two drugs in terms of effectiveness on attention and impulsivity. Conclusion The findings of this study showed that long-acting methylphenidate and modafinil are equally effective in improving attention and impulsivity in children aged 6 to 12 years with ADHD

Theory of mind in adolescents with Attention-Deficit Hyperactivity Disorder: A cross-sectional study

  Objective Attention-Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder which may be associated with impaired Theory of Mind (ToM) and social cognition. ToM is a domain in social cognition which refers to one's ability to attribute beliefs, intents, perspectives, and understandings to oneself or others and to understand other's mental state. Materials & Methods The present study enrolled 52 ADHD of adolescents and 41 healthyage-matched controls in this study. This study applied The Readingthe Mind in The Eyes Task (RMET) and Theory of Mind AssessmentScale (Th.o.m.a.s.) for all participants. The results of these tasks were compared between the two study groups. Results e no significant differences between these two study groups in terms of ToM abilities using mean scores in Th.o.m.a.s inventory and the Reading the Mind in the Eyes test. Also, we did not find any association between the mean score in ToM (in both study groups) and our study parameters of gender, mean age, birth rank, family structure, and income. Conclusion This study did not support the hypothesis that adolescents with ADHD perform worse on ToM tasks

The Effect of Rhythmic Movements on Mild Anxiety in Children of 7 to 12 Years Old with Cancer

 Background and Aim: Cancer is a chronic childhood disease with many unpleasant psychological consequences such as anxiety. The study conducted to assess the effect of rhythmic movement on mild anxiety of children with cancer.Material and Methods: This study was a Quasi-experimental study. The study population included all children aged 7 to 12 years old diagnosed with cancer who were hospitalized in oncology ward of a pediatrics hospital affiliated with Shahidbeheshti University of Medical Sciences in Tehran, Iran. Sampling was through convenient sampling and based on the inclusion criteria. 31 children with mild anxiety chosen according to ʺSpielberger Anxiety Inventoryʺ were recruited. Rhythmic movements with hip-hop style along with playing music performed in the playing room for 45 minutes during 6 sessions. Questionnaires were recompleted on the final day of intervention (sixth day) and 3 weeks later through reading the items for children and filling by researcher. Data analyzed using SPSS V.18 by repeated analysis of variance (ANOVA).Results: The results showed significant differences between the mean values of anxiety (P<0.05) score before intervention and at the end of day 6 and weeks 3.Conclusion: Rhythmic movements as a non pharmacologic intervention reduce mild anxiety in children with cancer. It is recommended that nurses use non pharmacological approaches such as rhythmic movements to reduce the psychological effects of cancer instead of using drugs

Investigating the prevalence of psychological disorders among children with diabetes aged 5-12 years old referring to Endocrinology clinic of Mofid Hospital in 2014-2015

As there were a few studies about the mental disorders resulting from diabetes in children, this study aimed at investigating the prevalence of psychological disorders among children.the studied samples included 323 children with diabetes type 1 aged 5-12 years old referring to Endocrinology clinic of Mofid Hospital in 2014-2015. Also, 317 healthy children were considered as control group. The materials used for data analysis were information form and questionnaire CSI-4 filled out by their parents. The filled questionnaires were rated in that day and then analyzed and diagnosed by the Pediatric Psychiatry in order to determine the type and intensity of psychological disorder. Results were analyzed using SPSS 20. T tests, Scheffe post hoc test and Pearson’s correlation test were used for analysis of data. The amounts were significantly different at P<0.05.In terms of Neuro-Evolutionary disorders, Attention-deficit (ADD), hyperactivity (HD) and Attention-deficit hyperactivity disorders (ADHD) in children with diabetes were significantly higher than those in healthy children (P=0.001). Intense/ fundamental Depressive disorders were higher in diabetic children (P=0.001). In terms of anxiety disorder, a specific phobia and panic was significantly higher in diabetic children (P=0.005). In terms of aggressive behaviors, diabetic children were more disobedient and stubborn than the others.this study showed that prevalence of psychological disorders among diabetic children was higher than the others. As psychological disorders will effect on the life quality of children, improvement of life quality of diabetic children and adolescents, on-time diagnosis and treatment of psychological disorders in these patients seems essentia

Early screening of Autism among 18 to 24 months old toddlers using Quantitative-Checklist for Autism in Toddlers (Q-CHAT)

Objective The aim of the present study was to screen the toddlers who are suspected to be autistic in their well-child visits at age 18 to 24 months via the Quantitative-Checklist for Autism in Toddlers (Q-CHAT). Materials & Methods After the screening, the screen-positive cases were clinically assessedby a child psychiatrist and a child developmental psychologist. The total sample included 2467 toddlers; the mean total score of Q-CHAT was 30.64 (SD: 9.133). Result According to the clinical examinations, 6 cases met the criteria for autism (equal to 5.8% of screen-positive cases and 0.25% of the total sample), and 18 cases had a high probability of autism or otherneurodevelopmental disorders. Conclusion This study showed that the toddlers who were at risk of autism could be screened in PHC. Also, Q-CHAT could be used as a screening tool in Iran

Clinical and MRI Characteristics of Multiple Sclerosis in Iranian Children and Adolescents: Multiple sclerosis in the Iranian Children and Adolescents

Objective To determine the clinical and MRI characteristics of multiple sclerosis (MS) in the children and adolescents. Material & Methods In this cross-sectional study, information of 95 MS patients was obtained from the Iranian MS registry. Disease characteristics and imaging data were collected using medical records. Results  Ninety-five patients including 64 female and 31 male subjects with mean age of 13.97±2.4 (range, 8-18) years were enrolled. The most frequent signs and symptoms were ophthalmic symptoms (n=61, 64.2%), brainstem signs (n=44, 46.3%), cerebellar signs (n=32, 33.6%) and pyramidal signs (n=26, 27.3%). Blurred vision (n=21, 34.4%) was the most common ophthalmic symptom and ataxia (n=24, 75%) the most prevalent cerebellar sign. The most common brainstem signs/symptoms were motor symptoms and vertigo (each n=14, 31.8%) and the most common pyramidal sign/symptom was right upper monoparesis (n=14, 23.3%). Active demyelinating lesions were reported in brain MRI of all patients, mostly appeared as periventricular (n=91, 95.8%) and pericallosal (n=55, 57.9%) lesions. Acute demyelinating spinal lesions were presented in 38 patients (51.3%) with a prominent involvement of the cervical spine (n=33, 86.8%). Conclusion In our study, the most frequent signs and symptoms were eye symptoms, brainstem signs, cerebellar signs and pyramidal signs, respectively. Moreover, our results showed that MRI plays a critical role in the diagnostic evaluation of MS in children with presence of brain lesions in all patients and spinal lesion in a considerable portion of patients

The Efficacy of Addition of Atomoxetine to Speech Therapy on the Stuttering Severity of Children Aged 4-12 Years; a Double-Blind Controlled Randomized Clinical Trial

  Objectives Stuttering is a common problem at all ages and it is thus required to treat this problem since childhood. Atomoxetine is currently used for the treatment of attention deficit hyperactivity disorder (ADHD) and can also be effective for the treatment of stuttering due to its selective inhibition of norepinephrine reuptake and dopaminergic properties. Therefore, this randomized clinical trial (RCT) aimed to evaluate the effect of Atomoxetine on children’s stuttering. Materials & Methods Children aged 4–12 years, diagnosed with stuttering, who referred to pediatric neurology clinic, were randomly divided into experimental (N=50) and control (N=50) groups. One group received atomoxetine plus speech therapy and the other group only speech therapy. Both groups completed the Stuttering Severity Questionnaire (SSI4) at baseline (on the first visit) and three months after the intervention. Results Most (67%) were boy; 24% aged <60mo,46% 60–95mo,and 30% >95mo. About half (52%) had a positive family history of stuttering. Stuttering severity was highest at ages of 60–95mo, in left–handed children,those who used formula,and those who felt insecure in the family; but was not different based on child’s sex, concomitant ADHD, multilingualism, facial or movement tics, based on sleeping hours, and using teats. Mean stuttering severity reduced in both groups (P<.001) with a greater decrease in the experimental group, compared to the control group (P=.011). Conclusion Atomoxetine,plus speech therapy,is effective for the treatment of children’s stuttering and can be used as a complementary treatment strategy in these patients