Six months methylphenidate treatment improves emotion dysregulation in adolescents with attention deficit/hyperactivity disorder: A prospective study

Purpose: Individuals with attention deficit/hyperactivity disorder (ADHD) may suffer from emotional dysregulation (ED), although this symptom is not listed among the diagnostic criteria. Methylphenidate (MPH) is useful in reducing emotional symptoms in ADHD. The aim of the present study was to determine both psychosocial risk factors and presence of ED in adolescents with ADHD before and after MPH treatment. Participants and methods: Eighty-two patients aged 12–18 years with ADHD were included as participants. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime, the Difficulties in Emotion Regulation Scale (DERS), sociodemographic form, and the Inventory of Statements About Self-Injury were administered. Results were compared before and after 6 months MPH treatment. Results: A significant improvement was detected on DERS for impulsivity (15.9±6.8 initial vs 14.2±6.5 final test, p<0.01) and total score (88.4±23.3 initial vs 82.4±2.7 final test, p<0.05) across all patients taking MPH regardless of subtype and sex. Despite treatment, a significant difference remained for impulsivity, strategies, and total score in patients with comorbid oppositional defiant disorder (ODD) compared with those without ODD, but no difference was detected for conduct disorder comorbidity. In patients who self-harm, scores for goals, impulsivity, strategies, clarity, and total score were higher before treatment: furthermore, impulsivity and total score remained high after treatment. In maltreated patients, goals, impulsivity, strategies, and total scores were significantly higher before treatment; however, their symptoms were ameliorated after treatment with MPH. Conclusion: Individuals with severe ED may “self-medicate” by smoking and/or self-harming. MPH led to significant improvements in ED possibly owing, in part, to a decrease in impulsivity, so that individuals felt more able to supervise their emotions and engage in goal-directed behaviors. ED should be considered particularly in patients with additional psychosocial factors and ODD comorbidity, and included in the treatment plan. © 2018 Suzer Gamli and Tahiroglu

Polypharmacy and EPS in a child; a case report.

PubMedID: 17514191Extrapyramidal symptoms (EPSs) (dystonic reaction, rigidity, and akathisia) occur as a result of D2 receptor blockade. Selective serotonin-reuptake inhibitors (SSRIs) have been reported to induce extrapyramidal signs and symptoms but tricyclic antidepressants have been rarely reported. Among the side effects attributed to valproic acid administration, the production of EPS is very rare, particularly in children. In this paper we present a case (10-year-old girl) under multiple pharmacologic treatment who developed EPSs (oculogyric crisis) shortly after the adjunct of imipramine to a combination of methylphenidate and valproic acid. Oculogyric crisis occurred on the third day of this combination treatment and these symptoms included ocular pain and sustained upward gaze. Benztropine 2 mg i.m. resulted in rapid relief of oculogyric crisis symptoms

Negative effects of excessive media exposure in children and adolescents; violence tendency and internet dependence [Medyanin çocuk ve gençler üzerine olumsuz etkileri; şiddet egilimi ve i·nternet bagimligi]

Although, marked contribution of media on modern life, excessive and inappropriate using may cause important behavioral and emotional problems, especially in children and adolescents. It was shown by many experimental and longitudinal studies that media violence result permanent and increased aggressive behaviors short and long periods. It includes viewing violence on television but it is more pronounced on computer and internet games because of active learning processes. Recently, internet addiction is an also important mental health problem which affects the most of the societies. Playing game and chatting on internet are more risky using forms for internet addiction. Other psychiatric disorders, especially attention deficit hyperactivity disorder, mood disorders and anxiety disorders are frequently seen together with internet addiction. Family training programs includes risks of media and appropriate media using forms; and legal measures are prime necessities at now

Aripiprazole improved obsessive compulsive symptoms in Asperger's disorder

There are many comorbid disorders associated with autism spectrum disorders in child and adolescent population. Although obsessive compulsive disorder and autism spectrum disorders (ASD) comorbidity has common in clinical practice, there are few reports about psychopharmacological treatment for obsessive compulsive symptoms in children with ASD in the literacy. We report a successful treatment case with aripiprazole in Asperger's Disorder with obsessive compulsive symptoms. The Yale Brown Obsessive Compulsive Scale was performed to assess symptom variety. This case report supports the effectiveness of aripiprazole in treatment of obsessive compulsive symptoms in Asperger's Disorder or ASDs. Aripiprazole may be beneficial to obsessive compulsive disorder comorbid autism spectrum disorders in child and adolescent age group. Copyright © 2011, Korean College of Neuropsychopharmacology

Parental psychological symptoms and familial risk factors of children and adolescents who exhibit school refusal

PubMedID: 22215791Objectives: To assess the levels of psychological symptoms in the parents of children with school refusal and determine the familial risk factors in its development. Methods: This study was performed on 55 pairs of parents who had children exhibiting school refusal and were compared with a control group. A socio-demographic data form, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Symptom Checklist-90 revised were applied to these parents. Results: Parents of the school refusal group had higher anxiety and depression scores than the controls. Among the risk factors for school refusal, physical punishment by the parents, a history of organic disease in the parents or children, and a history of psychiatric disorders in the parents or other relatives were found to be significant. Conclusions: Depending on genetic and environmental factors, parents with psychiatric disorders appeared to be associated with development of psychiatric disorders in their children. Moreover, psychiatric disorders in parents negatively affected the treatment of their children and adolescents who exhibited school refusal. It is therefore vital to treat psychiatric disorders of parents with the children having psychiatric disorders, and thus increase parent participation in their children's therapeutic process. © 2011 Hong Kong College of Psychiatrists

Child sexual abuse: Seven years in practice

PubMedID: 20345776The purpose of this study was to determine the socio-demographic characteristics of sexually abused children. The records of 101 cases of child sexual abuse (CSA) were retrospectively evaluated. Socio-demographic characteristics of the victims, type of sexual abuse, and psychiatric diagnosis were studied. Of the victims, 56.4% (n = 57) were female and 43.6% (n = 44) were male. The mean age was 9.57 ± 3.5, with a range of 4-17 years. Ninety-three (92.1%) of the victims had been admitted as part of the legal process. The majority (66.3%) of the victims had been abused by an acquaintance, while 33.7% had been abused by a stranger. Anal or vaginal penetration was reported in 48.5% of the cases. Post-traumatic stress disorder was the most common (54.5%) psychiatric diagnosis established after sexual abuse. Descriptive data related to the abused children and an understanding of the consequences of CSA will help authorities in planning prevention. © 2010 American Academy of Forensic Sciences

Fluoxetine in posttraumatic eating disorder in 2-year-old twins

PubMedID: 17489718Feeding disorders of infancy or early childhood are relatively uncommon in the pediatric population. In posttraumatic eating disorder, the infant demonstrates food refusal after a traumatic event or repeated traumatic events to the oropharynx or esophagus. We present case reports of 24-month-old twin girls, A and B, who presented to our clinic with food refusal and fear of feeding. Several invasive gastrointestinal procedures were performed when they were 3 months old, and they started to refuse all solid food and some liquids soon after hospitalization. Fluoxetine 0.3 mg/kg per day (5 mg/day) was started to target their anxiety and fear about feeding. In the second month of weekly follow up, the children began to be fed without a nasogastric catheter. A significant decrease in anxiety and fear was observed during feeding. Although the use of serotonin-selective reuptake inhibitors (SSRIs) in preschool children is controversial due to the lack of empirical data in this age group, we observed clinical improvements in anxiety in these two cases. Furthermore, fluoxetine was well tolerated and no side effects were observed. © Mary Ann Liebert, Inc

Eating disorders in male children a case of anorexia nervosa [Erkek çocuklarda yeme bozukluklari; bir anoreksiya nervosa vakasi]

Eating disorders consist of conditions which are prevalent, chronic, and specifically, diagnosed in females. In this article, a 13-year-old boy with anorexia nervosa and major depression is presented and pharmacotherapy and psychotherapy of this case are reported. General characteristics and treatment of eating disorders in males are discussed, emphasizing different features between genders

Internet use among Turkish adolescents

PubMedID: 18785800The aim of this study was to investigate Internet use habits and problematic Internet use (PIU) in Turkish adolescents. Participants were 3,975 undergraduate students, 7.6% of whom used the Internet for more than 12 hours weekly. The Online Cognition Scale (OCS) was used. The most common purpose for using the Internet was playing games, followed by general information search. Female users mostly preferred searching for general information; male users preferred playing games (p < 0.001, ? = 995.205). The most preferred type of game was violent games. While preference for strategy and fantasy role-play (FRP) games increased with age, preference for other games decreased (p < 0.0001, ? = 283.767). Participants who used the Internet mostly for general information searches and school-related searches had lower OCS scores (p < 0.0001). The highest OCS scores were related to violent games, followed by FRP, strategy, and sports and motor racing games. Computers and the Internet are useful, important inventions, but like other inventions, if used improperly, they may be harmful. Risk of harm raises concerns about who should use the Internet and computers, and where, when, and why the Internet and computers should be used. © 2008 Mary Ann Liebert, Inc

Short-term effects of playing computer games on attention

PubMedID: 19773602Objective: The main aim of the present study is to investigate the short-term cognitive effects of computer games in children with different psychiatric disorders and normal controls. Method: One hundred one children are recruited for the study (aged between 9 and 12 years). All participants played a motor-racing game on the computer for 1 hour. The TBAG form of the Stroop task was administered to all participants twice, before playing and immediately after playing the game. Results: Participants with improved posttest scores, compared to their pretest scores, used the computer on average 0.67 ± 1.1 hr/day, while the average administered was measured at 1.6 ± 1.4 hr/day and 1.3 ± 0.9 hr/day computer use for participants with worse or unaltered scores, respectively. According to the regression model, male gender, younger ages, duration of daily computer use, and ADHD inattention type were found to be independent risk factors for worsened posttest scores. Conclusion: Time spent playing computer games can exert a short-term effect on attention as measured by the Stroop test. © 2010 SAGE Publications