Dose-Dependent Enuresis in Methylphenidate Use.

OBJECTIVES: Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood. Although enuresis is a very common disorder in child diagnosed with ADHD, it may also develop because of methylphenidate. METHODS: Authors report here on a child case of ADHD that developed a probable enuresis related to methylphenidate. RESULTS AND CONCLUSIONS: Clinicians should be aware that methylphenidate used in ADHD causes dose-dependent enuresis.

Is Processing Speed (Gs) related to Hyperactivity (As a Narrow Cognitive Area of Gps): A Dimensional Approach to Heterogeneity of Clinical and WISC-IV Cognitive Profiles in ADHD From RDoC/HiTOP Perspective.

OBJECTIVE: The aim of this study was to investigate the relationship between symptomatology and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) cognitive profiles in Attention Deficit and Hyperactivity Disorder (ADHD), taking into account clinical heterogeneity. METHOD: The WISC-IV was administered to 60 children aged 6 to 13 years with ADHD who had not previously taken psychotropic medication. Conners Teacher-Rating Scale (CTRS-R/L) and Conners Parent-Rating Scale (CPRS-R/L) were completed by parents and teachers. RESULTS: We found a statistically significant positive correlation between the symptoms of hyperactivity/impulsivity and PSI (Processing Speed Index). A statistically significant negative correlation was found between the CTRS-R/L's DSM-IV Inattentive subscale and PRI (Perceptual Reasoning Index). No relationship was found between the inattention or hyperactivity/impulsivity symptomatology with Working Memory Index (WMI). WMI stood out as the most frequently reported weakness among the four index scores. CONCLUSION: Considering the relationship between the cognitive domains of RDoC (Research Domain Criteria) and dimensions of HiTOP with the ADHD symptom clusters, the assessment of cognitive and behavioral symptoms may be useful for phenotyping ADHD. According to the CHC (Cattell-Horn-Carroll) theory; the positive correlation level between PSI, which is accepted as Gs, and hyperactivity/impulsivity symptoms in people with ADHD may be due to the fact that hyperactivity is one of the narrow cognitive domains of Gps.

Anxiety, depression, and behavioural rating scales in children with non-cardiac chest pain.

INTRODUCTION: Chest pain is the second most common reason for referral to paediatric cardiologists after benign heart murmurs. Aetiology frequently depends on non-cardiac reasons. In addition, individuals may experience non-cardiac chest pain which is idiopathic or of unknown origin. The aim of this study is to examine psychological symptoms in children and adolescents with medically unexplained chest pain. METHODS: A total of 76 patients (ages 8-18 years) were included in the study, who were referred to the paediatric cardiology department with the complaint of chest pain but did not have any detected cardiac aetiology or any other organic causes of chest pain. The control group was composed of 51 healthy volunteers. Self-evaluation scales were given to both groups which included Beck Anxiety Inventory and Children's Depression Inventory. Also parents of both groups completed the Conner's Parent Rating Scale for assessment of Attention-deficit/hyperactivity disorder. RESULTS: Anxiety scores of the non-cardiac chest pain group were significantly higher compared to controls. No significant differences were found between patients and controls in terms of attention-deficit/hyperactivity disorder and depression scores. In patient group, patterns were similar for boys and girls and for children and adolescents; except girls scored significantly higher than boys in children's depression inventory. CONCLUSIONS: In children and adolescents, non-cardiac chest pain is associated with increased levels of anxiety. These results show the importance of psychiatric evaluation in non-cardiac chest pain patients. Larger controlled studies are needed to determine the prevalence and impact of attention-deficit/hyperactivity disorder and depression in children and adolescents with non-cardiac chest pain.

Parental attitudes in children with persistent developmental stuttering: a case-control study

Abstract Background Clinical experiences emphasize the possible role of parental attitudes and behaviours in shaping stuttering behaviors however, the number of studies in this area is still insufficient. Objective Our aims were to compare parental attitudes in children with and without stuttering and to determine the effect of parental attitudes on stuttering severity. Methods We used an age and gender matched case control design with 24 children with stuttering and 22 healthy school children. Demographic information form and Parental Attitude Research Instrument (PARI) were enrolled by the mothers. Results According to our results; there was a statistically significant difference in parental attitudes of children with and without stuttering. Our results showed that excessive maternal control of the child and the expectations of obedience from the child more frequently observed in parents of the children with stuttering. Also there was a significant positive correlation with the severity of stuttering and excessive maternal control of the child, the expectations of obedience from the child and marital conflict. Discussion In conclusion, there was an important difference in parental styles of study group and this difference was related to the severity of stuttering. Clinicans should address parental attitudes in this samples.

Does Correction of Strabismus Improve Quality of Life in Children with Autism Spectrum Disorder: Results of a Parent Survey by Ophthalmologists.

PURPOSE: Ophthalmic problems are reported to be common in children with autism spectrum disorder (ASD), and strabismus is of particular importance. We aimed to investigate the outcomes of strabismus management in cases with ASD and identify the impact of optical or surgical correction of the strabismus on the child using a questionnaire for parents. METHODS: A survey was designed to assess parents' perceptions of pre-management and post-management quality of life in 41 children aged 5-17 years with ASD and strabismus using a questionnaire with 10 questions, including three subscales. RESULTS: Significant improvements were noted after management in functional limitations (P < 0.01), psychosocial interactions (P < 0.01), and ocular alignment (P < 0.01) subscales. CONCLUSION: This is the first study of the literature that investigated the impact of ocular re-alignment on behavioral patterns and social interactions of children with ASD and strabismus.

Initial Ophthalmic Findings in Turkish Children with Autism Spectrum Disorder.

Children with autism spectrum disorders (ASD) frequently have ophthalmologic disorders. Due to poor cooperation with ophthalmological examination, ocular abnormalities in such children may be overlooked. We retrospectively studied the records of 324 patients diagnosed as ASD that underwent ophthalmological examination between January 2011 and November 2014 at Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey. Ophthalmic pathology was noted in 26.9% of patients with ASD, of which 22% had significant refractive errors and 8.6% had strabismus. Comprehensive eye examination by a pediatric ophthalmologist is recommended for all children diagnosed as ASD.

Increased serum levels of epidermal growth factor in children with autism.

The etiology of autism is unclear, however autism is considered as a multifactorial disorder that is influenced by neurological, environmental, immunological and genetic factors. Growth factors, including epidermal growth factor (EGF), play an important role in the cellular proliferation and the differentiation of the central and peripheral nervous system. In this study we hypothesized that EGF may play a role in the pathophysiology of autism and examined serum EGF levels in children with autism. We measured serum levels of EGF in the 27 autistic children and 28 age- matched normal controls. The serum levels of EGF in the subjects with autism were significantly higher than those of normal control subjects. However, there were no correlations between serum EGF levels and clinical variables in the subjects with autism. This is the first report demonstrating the increased serum levels of EGF in children with autism. This study suggests that increased levels of EGF might have an importance in the pathophysiology of autism.

[Reliability and validity of Turkish translation of the pediatric sleep questionnaire]. / Çocuklarda Uyku Ölçegi'nin Geçerlik ve Güvenirligi.

OBJECTIVE: Aim of this study was to investigate the validity and reliability of the Turkish translation of Pediatric Sleep Questionnaire (PSQ)-the extended version. The Pediatric Sleep Questionnaire (PSQ) has two versions: a shorter one, which has been validated for sleep-related breathing disorders, and an extended version, which deals with a wider range of sleep disturbances. METHOD: After translation and back-translation of the PSQ, it was filled in by the parents of 99 patients with Attention Deficit Hyperactivity Disorder (ADHD), 34 patients with Upper Airway Resistance and Snoring (UARS), and 42 healthy controls. Cronbach alpha was computed as a measure of internal consistency along with test-retest reliability and item-total score correlations. We used principal components analysis and varimax rotation to investigate the factor structure. The Receiver Operator Characteristic (ROC) curves were used to determine cut-off points, sensitivity, specificity, and negative and positive predictive values. RESULTS: Cronbach alpha coefficient was 0.77 for the whole questionnaire. Similar to the original PSQ study, we found four factors, namely "Snoring," "Behavioral Problems," "Breathing Problems," and "Other Problems.". However, different items loaded to these factors. While the first three factors were reliable and valid, this was not the case for the last factor. ADHD patients had higher "Breathing Problems" score than the controls, while all sleep related problems were higher in the UARS group than the other two groups. Cut-off points obtained from the ROC curves indicated that when a PSQ total score of 6 points was used as a cut-off, UARS group and the controls could be discriminated easily. In order to discriminate the ADHD and UARS groups, using the "Total Sleep Problems Score", which did not include the "Behavioral Problems" factor, resulted in greater specificty and sensitivity. DISCUSSION: These results indicated that the Turkish version of the PSQ was a valid and reliable measure, that the PSQ total score could discriminate patients with primary sleep disorder from healthy controls, and that the "Total Sleep Problems Score", which was obtained by omitting the Behavioral Problems factor score, could be used to discriminate primary sleep problems from secondary sleep problems associated with ADHD.

Obstructive upper airway problems and primary enuresis nocturna relationship in pediatric patients: reciprocal study.

OBJECTIVE: To determine the relationship between primary enuresis nocturna (PEN) and obstructive upper airway problems (OUAPs). DESIGN: Prospective, descriptive study. SETTING: Tertiary care academic medical centre. METHODS: Two groups of patients were included in the study. Newly diagnosed pediatric PEN patients between August 2004 and June 2005 were evaluated for OUAPs in the Department of Otorhinolaryngology of our institution and constituted the first group of patients. During the same period, patients who were on the surgery list for upper airway problems were examined for PEN in the Department of Pediatric Psychiatry as the second group. Obtained data were analyzed with regard to patient demographics and the relationship between PEN and OUAPs, and follow-up results are reported. MAIN OUTCOME MEASURES: There were 32 patients in each group. In the first group, 5 patients (15.6%) had totally obstructing severe septal deviation, 8 patients (25.0%) had moderate septal deviation, 10 patients (31.3%) had allergic rhinitis and inferior turbinate hypertrophy, 3 patients had adenotonsillar hypertrophy (9.4%), and 1 patient (3.1%) had septal perforation. The frequency of OUAP in PEN patients was 65.6%. In the second group, 10 patients (31.3%) had a PEN diagnosis. After at least 3 months (mean 6.3 months) of follow-up, four patients (40%) were free of PEN and two patients (20%) experienced improvement in PEN. Another four patients did not have any change in the severity of PEN. CONCLUSIONS: According to our results, OUAPs are very common in PEN patients and PEN is a common symptom of OUAPs.