DEHB ve otizm spektrum bozukluğu olan çocuklarda serum ürotensin-II düzeylerinin değerlendirilmesi

Objective: Urotensin-II (U-II) is one of the most vasoconstrictive substrates for the mammals. Lately, this substrate is thought to be responsible for developing of the neuropsychiatric disorders, by causing an abnormal brain bloodstream situation. Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are frequently seen disorders in childhood and their etiologies are remain unclear. This study evaluated the serum urotensin-II levels of children with ASD and ADHD and compared with healthy subjects' urotensin-II levels. Methods: Total of 179 children between age of 4-12, 60 of them diagnosed with ADHD and 60 of children with ASD, according to the DSM-5 criteria and both had no treatment for at least a month and 59 of healthy subjects whom they all admitted to the Ankara Pediatric Hematology-Oncology Training and Research Hospital were included. Schedule for Affective Disorders and Schizophrenia for School-Age Children, a semi-structured interview, was applied to all subjects. Venous samples of the participants were given after a-12 hours starvation. Serum U-II levels were analyzed by the use of ELISA kits. SPSS 16.0 was used for analysis and p<0.05 was accepted as significance level. Results: U-II levels of children with ASD were found higher than that of ADHD and healthy groups. There was also a positive correlation between U-II levels and autism behavior checklist scores. Discussion: Higher U-II levels and its levels' correlation with symptom severity of disorder are thought to be a responsible factor that could play a role in ASD etiology. Further studies with larger sample size could be useful to investigate the role of UII in the etiology and treatment research of AS

Serum oxytocin and vasopressin levels in children with social anxiety disorder and the effects of parent characteristics

OBJECTIVES: We aim to determine serum oxytocin, vasopressin levels and examine parent characteristics in children diagnosed with social anxiety disorder (SAD). METHODS: Thirty four children diagnosed with SAD and 34 mothers were compared with a healthy control group (21 control children and their mothers) in this case–control study. Assessment performed via State-Trait Anxiety Inventory (STAI), Symptom Checklist-90 (SCL-90), Parental Attitude Research Instrument (PARI), Beck Depression Inventory (BDI), Liebowitz Social Anxiety Scale (LSAS) and Social Anxiety Scale for Children-Revised (SASC-R). Serum samples collected for detection of oxytocin and vasopressin levels. RESULTS: The distribution range of vasopressin levels were found statistically higher in control group than SAD group (p = 0,002). Additionally results showed no statistically significant differences according to the mean levels of serum oxytocin and vasopressin between groups. The scores of STAI-C, SASC-R and democratic attitudes/egalitarianism subscales of PARI were found significantly higher in children with SAD. Similarly we reported that mean scores of SCL-90 scale, LSAS and SCL-90 subscales were higher in mothers of patients group. CONCLUSIONS: Although significantly lower distribution range of vasopressin levels was found in SAD patients, mean oxytocin and vasopressin levels were not associated with SAD etiology. Additionally psychopathologies particularly anxious behaviour in mothers may contribute SAD development in early period of childhood

Smoking and schizophrenia: Where is the biological connection? Turkish

Objective: Patients with psychiatric disorders have a higher incidence of smoking than the general population. In particular, the rate of smoking among patients with schizophrenia has been found to be between two and three times greater than the general population in western countries. This paper reviews the biological factors that might be contributing to the high rate of smoking among patients with schizophrenia and examines the interaction between nicotine and the neurobiological disturbances observed in schizophrenia. Method: Papers assessing the possible biological causes of smoking in patients with schizophrenia and the physiological effects of nicotine were reviewed following a search using the key words &quot;nicotine, schizophrenia, smoking, and cigarette&quot; in PubMed, Turk Medline, and the Turkish Psychiatric Index. Results: Studies conducted in humans and animals show that nicotine can directly increase dopaminergic transmission in the central nervous system, enhance cognitive performance, and improve sensory gating deficits observed in patients with schizophrenia. Moreover, smoking diminishes the efficacy of most antipsychotic drugs via increased hepatic metabolism. Conclusion: Studies in the literature suggest a link between the physiological effects of nicotine and the neurobiological disturbances in schizophrenia. Disturbances in cholinergic transmission may be responsible for some symptoms of schizophrenia. The harmful effects of smoking vastly outweigh any possible benefits, but, nevertheless, further investigation may lead to important insights regarding the etiology of schizophrenia, at the molecular level

Case Report

ABS TRACT Asperger&apos;s disorder (AD) is a pervasive developmental disorder characterized by social impairment, restricted interests and repetitive behaviors. It is seldom that individuals with AD are referred to a psychiatry clinic only for their social and communication deficits. Quite often, the main reason for referral is the presence of other disabling symptoms, such as physical aggression and depression. Although diagnosed mainly in children, AD is increasingly being diagnosed for the first time in adulthood. Here, we present a 24-year-old patient with recurrent depression who was diagnosed as having AD for the first time in adulthood. This case is important to show the difficulty of diagnosing AD for the first time in adulthood and to show how a proper and effective treatment may be delayed if the underlying diagnosis of AD is missed for years. We wanted to emphasize the importance of developmental history and the usefulness of liaison with child and adolescent psychiatry in similar cases when the diagnosis is not clear. (Arc hi ves of Neu ropsy chi atry 2013; 50: 78-81) Key words: Asperger&apos;s disorder, adulthood, diagnosis, depression. Conflict of interest: The authors reported no conflict of interest related to this article. ÖZET Asperger Bozukluğu (AB), sosyal etkileşim bozukluğu, kısıtlı ilgi alanı ve davranışlarla karakterize yaygın gelişimsel bir bozukluktur. AB olan bireyler nadiren sadece sosyal ve iletişim zorlukları nedeniyle kliniğe başvururlar. Asıl başvuru sebebi sıklıkla, fiziksel agresyon ve depresyon gibi işlevselliği etkileyen diğer belirtilerin varlığıdır. AB tanısı genellikle çocukluk çağında konsa da, erişkin dönemde tanı konma sıklığının son yıllarda arttığı bildirilmektedir. Bu makalede tekrarlayıcı depresif atakları olan ve ilk olarak erişkin çağda AB tanısı konan bir olgu sunulmuştur. Olgumuz daha önce tanı almamış erişkin dönemi AB olgularında tanı koyma zorlukların dikkat çekmesi, altta yatan AB tanısının yıllarca atlandığında tam ve etkili bir tedavinin nasıl gecikebileceğini göstermesi açısından önemlidir. Bu olgu sunumu ile psikiyatri kliniklerine çeşitli belirtilerle başvuran bireylerden gelişim öyküsü alınmasının önemi ve tanı karmaşası yaşanan benzer olgularda çocuk ve ergen psikiyatri bölümüyle liyezonun yararlı olacağının vurgulaması amaçlanmıştır. (Nö rop si ki yat ri Ar fli vi 2013; 50: 78-81) Anah tar ke li me ler: Asperger Bozukluğu, erişkin çağ, tanı, depresyon Çıkar çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir

Serebral Palsili Çocukların Bakıcılarının Ev Egzersiz Programına Uyumları

Amaç: Bu çalışmanın amacı, Serebral Palsili (SP) çocukların bakıcılarının ev egzersiz programına uyumunu etkileyen faktörleri belirlemektir. Gereç ve Yöntemler: Yüz kırk yedi SP'li çocuğun bakıcısı çalışmaya dahil edildi. Bakıcıların egzersiz programına uyumları bir anket ile belirlendi. Çocukların ve bakıcılarının sosyo-demografik verileri, aile özellikleri, çocukların SP tipi ve Kaba Motor Fonksiyon Sınıflandırma Sistemi (KMFSS) seviyeleri, bakıcıların ruh sağlığı ve tükenmişlik ölçeklerine ait verilerin tümünün bakıcıların uyum durumu ile ilişkili olup olmadığı araştırıldı. Bulgular: Univariate testlerde istatistiksel olarak anlamlı verilerin [çocukların yaşı, ağırlığı, KMFSS seviyesi, bakıcıların yaşı ve Maslach emosyonel tükenme (EE) skoru] egzersiz programına uyumu tahmin gücünü belirlemek için lojistik regresyon modeli ile analiz edildi.Sonuç: Serebral palsili çocukların fonksiyonel limitasyonlarının ciddiyeti bakıcıların ev egzersiz programına uyumlarını arttırırken, bakıcıların tükenmişlikleri uyumu olumsuz etkilemektedir. Bu nedenle bakıcıların sosyal ve medikal olarak desteklenmeleri başarılı ev egzersiz programları için gereklidir.Objective: The objective of this study is to determine the factors that affect the adherence to home exercise programs among caregivers of children with cerebral palsy (CP).Methods: The caregivers of 147 children with CP were recruited for the study. The adherence status of the caregivers to an exercise program was assessed by a survey. The sociodemographic data of both children and caregivers; family characteristics, CP type, and Gross Motor Function Classification System (GMFCS) level of the disabled child; and inventories related to mental health and burnout of the caregivers were evaluated to determine whether these data were related with the adherence status or not. Results: Using statistically significant parameters in univariate tests [age, weight, and GMFCS level of the children and age and Maslach emotional exhaustion (EE) score of the caregiver], a logistic regression model was constructed to predict the adherence to exercise programs. GMFCS level and Maslach EE score were statistically significant independent factors that predicted the adherence to home exercise programs.Conclusion: The severity of the functional limitation of children with CP seems to enhance the adherence of caregivers to home exercise programs, while the burnout of caregivers has a negative impact. Caregivers should be supported socially and medically for a successful home exercise program

Agresif ve yıkıcı davranışsal belirtileri olan okul öncesi çocuklarda risperidon kullanımı

Amaç: Temel olarak agresif ve yıkıcı davranışsal belirtiler ile başvuran okul öncesi çağdaki çocuklarda risperidon kullanım yaygınlığı ve özelliklerini araştırmayı amaçladık. Yöntem: Bu geriye dönük dosya tarama çalışmasında, hastaların tıbbi kayıtları yaş, cinsiyet, birincil ve eş tanılar, risperidon dozu ve tedavi süresi açısından gözden geçirildi. Risperidon dozu ve tedavi süresi birincil tanılar arasında karşılaştırıldı. Bulgular: Risperidonun 2790 çocukta kullanım yaygınlığı %18.5ti (s516). Ortalama yaş 4.861.12 yıl idi. Bu hastaların %74.4ünde bir yıkıcı davranış bozukluğu (YDB) birincil tanısı vardı. Risperidon ortalama başlangıç dozu 0.35 mg/gün ve ortalama idame dozu 0.52 mg/gün idi. Tedavinin ortalama süresi 4.9 ay idi. Zeka geriliği (ZG) olan hastalarda, YDB olan hastalara göre, başlangıç ve sürdürme dozları anlamlı olarak daha yüksek ve tedavi süresi anlamlı olarak daha uzundu. Tartışma: Okul öncesi çocuklarda, risperidon MR olan hastalarda daha yüksek dozlarla ve daha uzun süreli tedavi ile azaltılabilen agresif ve yıkıcı davranışsal belirtilerini kontrol etmek için sıklıkla kullanılır Agresif ve yıkıcı davranışları olan çocuklar için kanıta dayalı tedavi yöntemlerinin geliştirilmesi kontrollü çalışmalara ve onların klinik pratiğe uygunluğunun onayını gerektirir.Objective: We aimed to investigate the prevalence and mode of risperidone use in preschool aged children admitted with a chief complaint of aggressive and destructive behavioral symptoms. Methods: In this retrospective chart review study, medical records of the patients were reviewed for age, gender, primary and comorbid diagnoses, dosage and duration of risperidone treatment. Dosage and duration of risperidone treatment were compared among primary diagnoses. Results: In 2790 children prevalence of risperidone use was 18.5% (n516). Mean age was 4.86±1.12 years. Of these patients, %74.4 had primary diagnosis of a disruptive behavior disorder (DBD). Mean starting dosage of risperidone was 0.35 mg/day and mean maintenance dosage was 0.52 mg/day. The mean length of treatment was 4.9 months. Starting and maintenance doses were significantly higher and treatment duration was longer in patients with mental retardation (MR) than in those with DBDs. Conclusion: In preschoolers, risperidone is frequently used to control aggressive and destructive behavioral symptoms which may improve with higher doses and longer treatment in those with MR. The development of evidence-based treatment modalities for children with aggressive and destructive behaviors necessitates controlled studies and confirmation of their pertinence to clinical practice

Risperidone use in preschool children with aggressive and destructive behavioral symptoms

WOS: 000348148800009Objective: We aimed to investigate the prevalence and mode of risperidone use in preschool aged children admitted with a chief complaint of aggressive and destructive behavioral symptoms. Methods: In this retrospective chart review study, medical records of the patients were reviewed for age, gender, primary and comorbid diagnoses, dosage and duration of risperidone treatment. Dosage and duration of risperidone treatment were compared among primary diagnoses. Results: In 2790 children prevalence of risperidone use was 18.5% (n=516). Mean age was 4.86 +/- 1.12 years. Of these patients, %74.4 had primary diagnosis of a disruptive behavior disorder (DBD). Mean starting dosage of risperidone was 0.35 mg/day and mean maintenance dosage was 0.52 mg/day. The mean length of treatment was 4.9 months. Starting and maintenance doses were significantly higher and treatment duration was longer in patients with mental retardation (MR) than in those with DBDs. Conclusion: In preschoolers, risperidone is frequently used to control aggressive and destructive behavioral symptoms which may improve with higher doses and longer treatment in those with MR. The development of evidence-based treatment modalities for children with aggressive and destructive behaviors necessitates controlled studies and confirmation of their pertinence to clinical practice

A Retrospective Investigation of Clozapine Treatment in Autistic and Nonautistic Children and Adolescents in an Inpatient Clinic in Turkey

WOS: 000388118400007PubMed: 26771824Objective: The aim of this retrospective study is to examine the clinical outcomes and safety of clozapine in children and adolescents with schizophrenia or other psychotic disorders/autism spectrum disorder (ASD) or affective disorders. Methods: The inpatient and outpatient files of all children and adolescents treated with clozapine over a period of 34 months (from October 2011 to July 2014) were reviewed. Demographic and clinical data were examined to describe clinical and metabolic findings, dosing, and tolerability of clozapine treatment in youth with schizophrenia, other psychotic disorders, ASD, or bipolar disorder. Results: The 37 pediatric patients included 26 patients with schizophrenia or other psychotic disorders, 7 patients with ASD complicated by schizophrenia or other psychotic disorders or affective disorders, and 4 patients with ASD only. In all groups (n = 37) there was a significant reduction (p 30% symptom reduction on BPRS). In patients with ASD complicated by schizophrenia or other psychotic disorders or bipolar disorders (n = 7), there was a significant reduction (p = 0.017) in BPRS scores after clozapine treatment. The discontinuation rate for clozapine was 10.8%, and the most frequently observed side effect was hypersalivation (54.1%). Neutropenia associated with clozapine was observed in only one patient (2.7%). Conclusions: Clozapine seems to be effective and safe in children and adolescents with schizophrenia or other psychotic disorders co-occuring with ASD or not. There is a need for further studies for determining the efficacy of clozapine in children and adolescents with bipolar affective disorder or ASD