screening tool for attention deficit hyperactivity disorder in children in Saudi Arabia

A clinically validated attention deficit hyperactivity disorder [ADHD] scale in Arabic for evaluating children in Saudi Arabia who might be suspected of having ADHD is lacking. Thus, we studied the validity of an Arabic version of the ADHD Rating Scale in discriminating children with an ADHD diagnosis from normal children or from those with non-ADHD psychiatric diagnoses, including mental retardation. The guardians of 119 children provided demographic data and completed the standardized Arabic version of the ADHD Rating Scale on their children, who were either normal, had a diagnosis of ADHD, or had a non-ADHD psychiatric diagnosis. The mean rating scores of the groups were compared, and the cutoff points were calculated for both sexes. The scores discriminated children with ADHD diagnosis [mean and [SD], 28 [6.288]] from normal children [10.93 [8.009]], and those with a non-ADHD psychiatric diagnosis [16.63 [8.865]]. ADHD cutoff points were obtained for male [23.5] and female [22.5] children. Psychosocial characteristics associated with children having ADHD were not associated with the diagnosis of ADHD. The ADHD Rating Scale [Arabic version], in terms of either the grand total score or the total score of each of its two subscales, demonstrated concurrent and discriminant validity by discriminating children with ADHD from other clinical and non-clinical children groups. The study obtained cutoff points for both sexes based only on the grand total score of the scale because of the relatively small sample size. Replication of the study, utilizing a larger sample and eliciting ratings from both parents and teachers, is recommended

Psychosocial aspects of short stature: critical review

Short stature is a common finding in general population. Most available studies have confirmed association between short stature and emotional, behavioral, educational and social negative consequences. Few studies have rejected such association and tired to correlate such consequences to the original organic problems that lead to short stature. Phychosocial intervention is not indicated for all short individuals but psychosocial screening is valid especially for those who attend clinics for growth problems

[Pattern of child and adolescent admission into psychiatric wards]

To describe the pattern of admission into psychiatric wards for patients aged 18 years and younger, identifying their psychiatric disorders, associated medical problems and mental sub-normality, the length of stay in the hospital, referrals and pattern of discharge. First admission of people 18 years of age or younger to the psychiatric wards of King Khalid University Hospital in Riyadh, Kingdom of Saudi Arabia, from May 1st, 1995 to April 30th, 2005 were reviewed regarding admission data. A total of 140 patients [4.5% of all admission] were 18 years of age or younger. Adolescents constitute 95%, females form 75%. Sixty-five percent were admitted via emergency department. Most of them stayed less than 2 months. Bipolar affective disorder was diagnosed in 30% and schizophrenia was diagnosed in 27%. Physical diseases were not significantly associated. Only 9.3% had associated mental retardation. Most of referrals were directed to the psychologists. Seven patients [5%] received electro-convulsive therapy [ECT]. About 10.7% reported history of suicide attempt. About 19.3% were secluded at least once during admission. Most discharges, 72.9%, were decided by the treating psychiatrists. Most of admitted patients were adolescents with aggressive behavior and diagnosed as bipolar affective disorder or schizophrenia, with low utilization of the service by children

Psychosocial aspects of diabetes mellitus in children and adolescents

To review the links between psychosocial factors and diabetes mellitus in children and adolescents, trying to look for these factors whether they play a role in the etiology of diabetes or not, and whether there are psychosocial consequences of diabetes or not. Reviewing the available and relevant published articles, from 1990 to 2005. Psychosocial factors could precipitate the onset of diabetes and may influence the timing of symptoms presentation. Stress and family problems may affect children and adolescents compliance with diabetic regimen leading to more medical, psychological and social complications. Presence of psychiatric co morbidity can result in difficult clinical course of diabetes. Diabetes can affect children negatively at different phases of development from infancy to adolescence. Diabetic children have high rates of depression, anxiety, adjustment disorders and disruptive behavioral disorders. Their siblings and families are affected negatively as well. Management should include psychosocial assessment of diabetic children and adolescents and their families, diabetic education, individual psychotherapy, family counseling, management of psychiatric co morbidity and issues related to school attendance and achievement. Links between psychosocial factors and diabetes do exist. The psychosocial components should be considered early in the process of assessment, management and subsequent rehabilitation

Use of psychotropic medications for children and adolescents

Use of psychotropic medications for children and adolescents has increased despite the availability of only limited studies on safety and efficacy. The aim of the study is to shed light on some issues regarding prescribing Psycho-tropics for children and adolescents. A retrospective study of the case records of all patients younger than 18 years of age who had attended a child psychiatric clinic at King Khalid University Hospital over a period of 10 years. About two thirds of patients received one or more psychotropic medications. Anti-psychotics were the most prescribed group of medications, followed by Tri-cyclic antidepressant, stimulants and the selective serotonin reuptake inhibitors. However methylphenidate was the most prescribed drug followed by imipramine and then haloperidol. Mood stabilizers and anxiolytics were used less frequently. In this study psychotropic prescription for children and adolescents tends to be much more than expected compared to other studies

Mental retardation and associated psychiatric disorders

There is a high rate of psychiatric disorders in mentally retarded children and adolescents. The aim of this study is to highlight the issues related to mental retardation like socio- demographic data, degree of mental retardation and associated psychiatric disorders. Retrospective review of the case records of all patients younger than age of 18. attending the psychiatric clinic in regards to socio-demographic data, degree of mental retardation and psychiatric disorders. The most reported psychiatric diagnosis in [borderline-mildly mentally retarded] were attention deficit hyperactivity disorder 16.8%, dual diagnosis of attention deficit hyperactivity disorder and expressive language disorder 11.7% and non-specific behavioral disturbance 10.9%. The most reported psychiatric diagnosis in moderate-severely mentally retarded were autistic disorder 15.8%. attention deficit hyperactivity disorder 10.5% and non-specific behavioral disturbance 10.5%. Mentally retarded children and adolescents have high rate of psychiatric disorders, the kinds of disorders generally do not differ from those found in non-retarded individuals. The degree of mental retardation correlates with the behavioural disturbance and the severity of psychiatric disorders

Obsessive compulsive disorder leading to unusual dental damage

Obsessive compulsive disorder [OCD] is a psychiatric disorder characterized by obsessive thought and/or compulsive action that cause[s] distress and Impairment in social interaction and performance. OCD is not a rare condition in children. Its prevalence range is from 2 to 3% in the general population, with 66% being boys. Approximately 30% of these patients experience an onset between the ages of five and fifteen years. Two common types of compulsive activity are obsessive 'cleaning' and 'checking.' Children with OCD typically display bizarre behavior patterns that involve orofacial structures such as practicing excessive or ritualized tooth brushing that results in abrasion of the oral mucous membrane and teeth. Others may be mentally terrified by body secretions including saliva as manifested by continual spitting, in recent years this obsession has come to Include repeated spitting to remove the AIDS germs from the mouth. The literature has rarely reported cases of removal of body parts such as teeth as a ritual of alien and absurd behavior. This paper presents a case of a 10 year-old boy, who extracted by himself seven of his own teeth, five of them being permanent. He was under psychiatric treatment for OCD. The purpose of this paper is to shed light on recognizing dental findings in and dental management of children with obsessive disorder, Including other oral destructions due to obsessive compulsive behavior

Frontal meningioma presenting with organic mood disorder in a patient with delusional disorder a case report

This is a report on a diagnosed case of persecutory delusional disorder of eleven years duration. The patient presented with organic mood disorder [depressive type] due to frontal lobe meningioma. Issues relating to misdiagnosis of such cases are discussed, such as overlooking of new complains of chronic psychiatric patients by psychiatrists, explaining new developments in such psychiatric patients as part of the condition and absence of neurological signs and symptoms, such as headaches and vomiting