45 research outputs found
Depression and anxiety levels of the mothers of children and adolescents with left ventricular assist devices
No full textOzbaran B, Kose S, Yagdi T, Engin C, Erermis S, Yazici KU, Noyan A, Ozbaran M. Depression and anxiety levels of the mothers of children and adolescents with left ventricular assist devices. Abstract: VADs have been used to provide treatment for end-stage heart failure. Parents may feel overwhelmed with the VAD regimes responsibility and be affected from this process beside children. In this study, we aimed to evaluate the depressive and anxiety symptoms of mothers of the first eight children equipped with a VAD in Turkey. The mothers of eight pediatric patients living with VADs were filled BDI and STAI at first month of VAD implantation (E.I) and secondly six months after their first evaluation (E.II). In E.I, the BDI mean score of mothers was 20.87, in E.II 14.37. STAI-S mean score was 53.37 in E.I and 43.62 in E.II. The Wilcoxon nonparametric-paired t-test revealed significant difference between baseline and end-point STAI-S scores (Z: -2.035; p: 0.042), and for BDI scores (Z, -1.965; p, 0.049). Prolonged usage of VAD may increase distress in parents. Psychiatric evaluation and support of the primary caregiver is important for the well-being of the pediatric patients
The Psychometric Properties of Turkish Version of Autism Spectrum Screening Questionnaire in Children aged 6-18 years
No full textObjective: The objective of this study is to determine the psychometric properties of the Turkish version of the Autism Spectrum Screening Questionnaire (ASSQ-TR) and to find the best cutoff score for Pervasive Developmental Disorder (PDD) cases. Method: Children between 6 to 18 years old with diagnoses of PDD, Obsessive Compulsive Disorder (OCD), and Attention Deficit Hyperactivity Disorder (ADHD) were included. The healthy control (HC) group was recruited from children who did not have any psychiatric complaints or history. Furthermore, parents of 268 children filled the ASSQ-TR. Of the children, 51 were PDD, 67 were ADHD, 50 were OCD, and 100 were HC. In order to show the reliability of the ASSQ-TR, Cronbach's alpha values and test-retest were evaluated. ROC analyses was carried out to show concurrent validity and to determine the cutoff score. Results: The Cronbach's alpha of ASSQ-TR is 0,86, while the test retest reliability is r: 0,98. Total ASSQ-TR scores of children with PDD (27,96 +/- 9,5) were significantly higher than other groups (p<0,001). ROC analysis of ASSQ-TR showed the area under curve to be 0,97 with a cutoff of 16, having the maximum sensitivity (94,1%), specificity (89,0%), and 90,7% diagnostic accuracy of PDD versus HC scores. Conclusions: Our pilot data showed that ASSQ-TR is a reliable instrument that successfully differentiates clinically diagnosed PDD from HC. This instrument might therefore be useful for the screening of PDD in school-aged children in Turkish populations
Evaluation of a Neuropsychiatric Disorder: From PANDAS to PANS and CANS
No full textPANDAS (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
The process of assessing adolescent patient who need liver transplant because of suicide attempt
No full textSuicide ideations, attempts and completed suicides are frequent situations in clinical practice of child and adolescent psychiatry. Besides, these situations especially are more common in adolescence period and suicide is one of the major causes of death for this age group. Just because of its easy accessibility, paracetamol (acetominophen) is a drug that is commonly used in suicidal attempts. Paracetamol toxicity is a fatal situation which is one of the most frequent causes of acute liver failure. Liver transplantation is the only option for treatment of acute liver failure. Transplantation from a living donor is the first option because of limited organ sources. In transplantation process, both donor and recipient must be evaluated psychiatrically. Child and adult psychiatrists must work in cooperation with organ transplantation team, in this emergency of which a race against time endures. Furthermore, unlike from adult psychiatrists, child psychiatrists have to evaluate candidate pediatric cases according to their developmental characteristics. In this article, we aimed to evaluate pretransplantational process of child psychiatry consultation in an adolescent who has hepatic failure due to paracetamol intoxication. We discussed the common and urgent medical and psychiatric situations that may be experienced in emergent transplantation cases
Isoniazid-Induced Psychosis with Obsessive-Compulsive Symptoms (Schizo-Obsessive Disorder) in a Female Child
No full textRisperidone, quetiapine and chlorpromazine may have induced priapism in an adolescent
No full textPriapism 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
Social cognition in pervasive developmental disorders
No full textOtizmin de içinde bulunduğu yaygın gelişimsel bozukluklar (YGB) iletişim, sosyal biliş ve duygusal işaretlerin işlenmesi gibi kişiler arası ilişkileri oluşturan birçok alanda ciddi ve süregen bozukluklarla karakterize, genetik temelleri olan ve anormal beyin gelişiminin görüldüğü nörogelişimsel hastalıklardır. Otistik bozukluk (OB) ve diğer YGB’si olan çocuklardaki bilişsel yetersizlikler; zihin kuramı bozukluğu, yürütücü işlev bozukluğu ve zayıf merkezi bütünleşme gibi nöropsikiyatrik modellerle açıklanmaya çalışılmaktadır. Bu makalede YGB’de sosyal bilişi açıklamaya çalışan zihin kuramı ve sosyal bilişin nörobiyolojik temellerinin gözden geçirilmesi amaçlanmıştır. OB ve diğer YGB’deki sosyal biliş ve zihin kuramını inceleyen çalışmalara PubMed arama motoru kullanılarak ulaşılmış ve elde edilen veriler bu derleme kapsamında ele alınmıştır. Sosyal biliş, diğerlerinin düşüncelerini ve niyetlerini anlayabilme aracılığıyla onların davranışlarının anlamını çıkarabilme, öngörebilme ve karmaşık sosyal çevreler ile etkileşime girebilme yeteneği olarak tanımlanabilir. Zihin kuramı yetersizliği OB’deki temel sorunlardan biridir ve otizmi olan bireylerde zihinsel süreçlerin kavranmasında, kendi zihinsel temsillerinin ve diğer insanların zihinsel temsillerinin kavranmasında yetersizlik bulunmaktadır. OB olan bireylerde, normalde olması gereken, yüz tanıma, göz göze ilişki kurma, yüzdeki emosyonu okuma gibi, kişilerarası ilişkilerin ve sosyal gruptaki işlevselliğin önemli bir parçası olan sosyal işlevlerin bozukluğu söz konusudur. Sosyal biliş ile ilişkili beyin alanları; frontal lob, temporal lob, ön singulat korteks, fusiform girus, amigdala, ve arka assosiasyon korteksi ile bunların iç bağlantılarıdır. Fusiform girus ve amigdala yüz tanıma ve algılamasında görev alır ve yapılan çalışmalarda özellikle erken gelişim dönemlerinde amigdaladaki bir bozukluğun, ileride yüz kimliği ve yüz ifadelerinin dışavurumunu algılamada sosyal algısal bozukluklara yol açtığından bahsedilmektedir. YGB’si olan bireylerin yüzleri algılarken fusiform girus aktivasyonunda düşüklük saptanmıştır. Amigdalanın fusiform girus üzerine düzenleyici bir etkisi bulunduğundan, amigdala lezyonlarında, emosyon yüklü yüzlere karşı fusiform girusdaki azalmış aktivasyon, amigdaladaki işlevsizliğin derecesiyle bağlantılıdır. Birçok çalışmanın ortak bulgusu, OB’deki fusiform girus hipoaktivasyonunun amigdalaya bağlı bazı süreçlerden kaynaklandığı yönündedir. OB olan bireylerde, gözlerin bakış yönü, hareketleri ve karşıdaki kişinin beden hareketlerinden sosyal uyaranın anlaşılmasında rolü bulunan üst temporal sulkusun hipoaktivasyonu ve anormal hacim ölçümleri saptanmıştır. Temelde bir sosyal biliş bozukluğu olduğunu söyleyebileceğimiz OB, beynin bu sistemlerinin mikroskopik ve/veya makroskopik düzeydeki aksaklıklarına bağlı olarak açığa çıkmaktadır. Sonuç olarak, OB ve diğer YGB’de sosyal biliş nörobiyolojisine bakıldığında, erken bebeklikte amigdalada ve amigdalanın fusiform girus, üst temporal sulkusu içeren diğer temporal alanlarla bağlantısında varolan bir bozukluğun, çocuğun yüzlere ve diğer sosyal olarak anlamlı olan uyaranlara karşı ilgisinin azalmasına ya da yok olmasına neden olduğu görülmektedir. Bu da normal uyarana bağlı aktivasyon gerektiren fusiform girus gibi beyin bölgelerinin normal gelişimlerinden sapmasına neden olduğu anlaşılmaktadır. Otizmdeki sosyal kognisyon sorunlarının anlaşılması üzerine çalışırken, temelde bilinmesi gereken şey, otizmin bir tek nöroanatomik yapı ya da döngünün hastalığı değil, daha yaygın, birçok nöronal sistemin etkilendiği nörogelişimsel bir bozukluk olduğudur.Pervasive developmental disorders (PDDs) and autistic disorder (AD) are neurodevelopmental disorders with genetic basis and abnormal brain development, and characterized by severe and permanent deficits in many interpersonal relation areas like communication, social cognition and processing of emotional signs. Cognitive impairments in AD and other PDDs are tried to be explained by neuropsychiatric models like theory of mind deficits, executive dysfunction and weak central coherence. This article aimed to review neurobiological bases of social cognition and theory of mind which try to explain social cognition. PubMed medical search engine was queried to find out the studies and review articles on social cognition and theory of mind in AD and PDDs. Social cognition may be defined as the ability to interact in complex social areas with understanding the others’ intentions and thoughts. The mind deficit is theorized to be one of the basic difficulties in autism. Individuals with autism have deficits in recognizing mental processes and mental representations of self and others’. Patients with AD have deficits in social functions which an important part of interpersonal interactions and functioning within a social group; like face recognition, eye contact and emotional expression recognition. Frontal lobe, temporal lobe, anterior cingulate cortex, fusiform gyrus, amygdala, posterior association cortex and their internal associations are brain areas associated with social cognition. Fusiform gyrus and amygdala are effective in face perception and recognition. Studies suggest that a deficit in amygdala may lead to social perceptional deficits like face identity and emotional expression recognition. It is determined that individuals with PDDs have hypoactivation in fusiform gyrus during perception of faces. Amygdala has a regulatory effect on fusiform gyrus and in lesions of amygdala, the hypoactivation of fusiform gyrus for emotional salient faces are parallel to the level of amygdala lesion. The common result of many studies is that the hypoactivation of fusiform gyrus is based on some processes related to amygdala. Superior temporal sulcus hypoactivations and abnormal volume measures were found in patients with autistic disorder. Superior tempral sulcus has a role in perception of social stimulus from gaze directions, and eye and body movements of others’. Autism can be defined as a social cognition disorder and is caused by deficits at microscopic and/or macroscopic levels in these brain systems. The review of the neurobiology of social cognition in AD and other PPDs defisits in amygdala and in connections of amygdala with other temporal areas including fusiform gyrus, superior temporal sulcus in early infancy and that leads to a deficit or absence of infant’s interest for faces and other stimuli which are socially significant. This causes abnormal development of brain areas like fusiform gyrus which needs a stimulus dependent activation. When studying social cognition deficits, it is important to note that autism is not a disorder of a unique neuroanatomical system or cyclus; but it is a neurodevelopmental disorder in whichmany pervasive neural systems are affected
Psychosocial implications of Thalassemia Major
No full textBackground: Many causes including the chronicity of disease, burden of treatment modalities, morbidities, and the expectation of early death resulting from the disease complications, may lead to psychosocial burden in Thalassemia Major (TM) patients. Methods: A total of 38 patients with TM and their mothers were recruited to evaluate the psychosocial burden as well as to disclose whether the psychological status of the patients contribute to the compliance with the therapy or to the contrary. Demographic and disease variables were obtained. Child Behavior Check-list (CBCL) was completed by the mothers of the patients. A detailed psychiatric interview based on the 4th edition of the Diagnostic and Statistical Manual diagnostic criteria was performed for each patient. Symptom Distress Checklist 90 (SCL-90) scale was given to all mothers for evaluating their psychopathology. Results: Although CBCL scores remained between the normal ranges, desferrioxamine mesylate (DFO)-compliant patients and the patients with lower ferritin values had significantly higher scores. A total of 24% of the patients had a psychiatric diagnosis including major depression, anxiety disorder, tic disorder, and enuresis nocturnal. The psychiatric diagnosis was significantly higher in the patients who were compliant with desferrioxamine compared with the non-compliant group (P = 0.007). The SCL-90 scores indicated that the mothers who had a child with good adherence to DFO had higher scale scores than the mothers with a poor adherent child. Conclusions: The increase risk of psychosocial and behavioral problems in thalassemics and their parents indicated the importance of a lifelong psychosocial support for the prevention of mental health issues. The patients and their parents, who were more conscious of the illness, were more worried but more compliant with the therapy and need stronger psychiatric support
Theory of mind and verbal working memory deficits in parents of autistic children
No full textThe 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
The Quality of Life and Mental Health in Children with Primary Immunodeficiency
No full textPrimary immunodeficiency disorders (PIDs) are characterized by recurrent and numerous infections, autoimmune disorders, and malignancies. These diseases are a heterogeneous group that contains many disorders caused by the disruption of the immune system. Despite being seen rarely, PIDs lead to serious morbidity and mortality. Children and adolescents with PIDs are expected to have a higher prevalence of psychopathologies and a lower level of the health quality of life In this text, we aim to review and summarize the current literature
