Quality of life and psychiatric comorbidity in children and adolescents with functional constipation: a case-control study

Background: The behavioral and psychological problems associated with chronic constipation include a wide range of disorders, which lead to impaired quality of life. The purpose of the current study was to evaluate psychiatric disorders and quality of life in children and adolescents suffering from chronic functional constipation

Materials and Methods: In a case-control clinical trial, 55 children and adolescents with functional constipation and 55 individuals without constipation were included into case and control groups, respectively. After taking medical history and physical examination, three questionnaires including demographic information, pediatric quality of life [PedsQL] questionnaire, and strengths and difficulties questionnaire [SDQ] were provided to parents, children, and adolescents. Collected data were coded and analyzed using SPSS software

Results: The mean child self-reported and parent-reported scores of PedsQL were 54.67+/-3.9 and 49.86+/-3.2 in the case group, while it was 63.26+/-4 and 66.09+/-3.4 in the controls. Only parent-reported quality of life score was statistically different among case and control participants [p =0.014]

The emotional performance of quality of life was statistically different based on both self and parents' reports [p=Q.Ol6 and 0.024, respectively]

Total SDQ score was in abnormal levels in 93% and 83% of the case and control participants, which was insignificant [p =0.631]

There was no statistically difference in SDQ subgroups between the two groups

Conclusion: Quality of life and emotional performance are impaired in children with functional constipation and they should be screened for consequent disorders. Treatment and management of these patients can be improved through evaluating constipation related indices, quality of life, and referring at risk patients to related specialists

Ginkgo biloba as an adjunct to methylphenidate in the treatment of attention deficit hyperactivity disorder in children: review of articles

Attention-deficit/hyperactivity disorder is one of the most common psychiatric disorders in childhood. The medications which inhibit the reuptake of noradrenline and dopamine including psychostimulants such as methylphenidate and dextroamphetamine and non-stimulating pre-frontal cortex noradrenaline reuptake inhibitor such as atomoxetine, are the standard treatment of ADHD. Adverse effects of stimulants have been reported in thirty percent of patients with attention-deficit/hyperactivity disorder. More than fifty percent of the parents of these children have tried one or more complementary or alternative medicines including vitamins in their children. Ginkgo biloba has been described to be effective for various neuropsychiatric symptoms. It was assumed that ginkgo biloba might improve some symptoms of attention deficit disorder as well. Nevertheless, no systematic study reported a possible efficacy of ginkgo biloba in attention deficit disorder. This review article evaluates the available evidence on the efficacy of ginkgo biloba medication in Attention-deficit/hyperactivity disorder children to present an appropriate guidance for this common child disorder

Quality of life in cystic fibrosis children

Cystic fibrosis [CF] is a chronic, multisystem genetic disease with a wide variability in clinical severity. The measurement of quality of life in CF provides additional information about the impact of this disease. This article tries to assess quality of life [QoL] in children and adolescents with CF and to compare it with control group. Patients 2-18 years old with admission diagnosis of cystic fibrosis entered the study. QoL was observed in CF patients and compared with control group. Based on children's reports, significant differences between the CF patients and control group were noted for emotional, physical, social, school performance, and total scores [P<0.05]. Based on parents' reports, quality of life score in CF patients from the physical point of view as well as social and total scores were decreased [P<0.05]. QoL in CF patients seems to be low, and therapy programs should take into account the suggestive perceived quality of life

Effect of topiramate augmentation in chronic schizophrenia a placebo-controlled trial

The limitations of antipsychotics for treatment of schizophrenia have led to investigation of the usefulness of pharmacological augmentation strategies. Clinical studies have provided evidence for glutamate abnormalities in schizophrenia. Topiramate is an anticon-vulsant drug with alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptor antagonist properties; therefore, the objective of the present study was to explore the therapeutic efficacy of topiramate as an adjunctive medication in schizophrenia. A17 week, double-blind, placebo-controlled clinical trial was performed on 80 patients [25 - 65 years] from 2005 - 2007. All were hospitalized in Mashhad psychiatric hospitals with chronic DSM-IV-TR-diagnosed schizophrenia. All participants received up to 300 mg/day of clozapine. In addition, participants randomly received either topiramate [200 - 300 mg/day] or placebo gradually added to their ongoing treatment. Efficacy of medication was measured by administering. Positive and Negative Syndrome Scale at baseline and weeks 4, 8, 12, and 17. During the study, 5 patients from the placebo group and 12 participants from topiramate group were excluded. Clozapine and topiramate group showed significant decreases in all three subscales of PANSS values from baseline, with the maximum efficacy in week 12. However, after tapering topiramate, the general psychopathology sign was the only subscale that showed a significant difference. The clozapine and placebo group showed a significant decrease in all three subscales of PANSS values compared to baseline. The significant efficacy for all subscales was obtained at the end point. No significant differences in PANSS scores from baseline to end point were noted between case and control groups. Augmentation of clozapine and topiramate did not significantly decline patterns in any of the three subscales of PANSS compared to the clozapine and placebo group. Irct ID: IRCT138904014236N1

[On the relationship between maternal fatigue and postpartum depression]

Postpartum depression may be related to pregnancy and postpartum fatigue. This research was accomplished to investigate the relationship between maternal fatigue in pregnancy and postpartum period with postpartum depression. In this research, 60 women with 36 weeks of gestational age and Edinburgh scale score equal or less than 9, were selected through a multi-stages sampling method among the clients of health care centers in 2009 in Mashhad, north-eastern part of Iran. Fatigue was assessed by Modified Fatigue Symptom Checklist in 36-7 weeks of pregnancy, and 5 and 14 days of postpartum. Postpartum depression was evaluated by Edinburgh scale and interview at the postpartum days 5, 14 and 28. Data were analyzed by chi-square, fisher, variance analysis with repeated scores, correlation and regression tests using SPSS software. There were significant correlation between fatigue in the 37[th] week of pregnancy with postpartum depression in the 5[th] [r=0.651, P=0.045], 14[th] [r=0.651, P=0.045] and 28[th] day [r=1.000, P=0.000]. Also there was a significant correlation between the fatigue in 36[th] week of pregnancy, and postpartum depression in 5[th] day [r=1.000, P=0.000] and also between the fatigue in 14[th] day of postpartum and postpartum depression in 28[th] day [r=1.000, P=0.000]. Expression of fatigue at the end of pregnancy and postpartum period is related to postpartum depression. Fatigue in pregnant women must be considered as a predicting factor of postpartum depression

[Level of expressed emotion, depression and caregiver burden in wives of veterans admitted in psychiatric ward and their relationship with readmissions]

The present study was planned to evaluate the level of expressed emotion [EE], depression and caregiver burden in wives of veterans admitted in Ibn-e-Sina psychiatric hospital and determine the relationship with number of readmissions in 6-month follow up. This cross-sectional study was performed on 50 veterans hospitalized in Ibn-e-Sina psychiatric hospital and their wives in 2008. Psychiatric disorders had been diagnosed based on semi structural clinical interview and DSM-IV-TR diagnostic criteria and the severity of illnesses was assessed with clinical global impression scale [CGI-S]. Beck depression inventory [BDI], family burden interview scale [FBIS] and the level of expressed emotion [LEE] tests were performed for wives. The number of readmission of veterans was assessed 6 months later. Data were analyzed by Pearson correlation, Mann-Whitney and ANOVA tests. It was shown that 42% of wives had mild depression, 26% had moderate depression and 8% had severe depression. Also 52% of them were suffering from severe caregiver burden and 14% had high EE. Veterans' average number of readmission in 6 months follow up was 1.6 +/- 1.28. The average of FBIS scores in wives was 31 +/- 10.49. There was no significant relationship between average of LEE [P=0.67], BDI [P=0.19] and FBIS [P=0.92] scores and LEE subsets in wives with the number of veterans' readmissions. The level of expressed emotion, depression and caregiver burden in wives are not related with the number of readmission in veterans admitted in psychiatric hospital in Iran

Double-blind, randomized, clinical trial of topiramate versus sodium valproate for the treatment of bipolar disorder in adolescents

To study the efficacy and safety of Topiramate versus Sodium Valproate for the Treatment of Bipolar Disorder in Adolescents. One hundred twenty adolescents [aged 12-18] with an admission diagnosis of bipolar I disorder, manic or mixed episode were enrolled from the Adolescent Ward at Ebn-e-Sina Psychiatric Center of Mashhad University. They were assigned to receive 8 weeks of double-blinded, flexibly dosed treatment with topiramate or sodium valproate. The primary efficacy measure was the mean change from baseline to endpoint in the Young Mania Rating Scale [YMRS]. Sodium Valproate was superior to topiramate. The YMRS scores decreased significantly in both groups. However, when efficacy of topiramte was analyzed, only 18.64% of the patients showed YMRS scores decrease more than 50% from baseline. This study does not support the efficacy of topiramate as monotherapy in acute mania or mixed episodes in adolescents with bipolar I disorder and sodium valproate was found superior to topiramate