Association of Tourette syndrome and obsessive-compulsive disorder with allergic diseases in children and adolescents: a preliminary study.

OBJECTIVES: To investigate the rate of allergic diseases including asthma, allergic rhinitis and eczema in children and adolescents diagnosed with obsessive-compulsive disorder (OCD) (n:26) and/or Tourette syndrome (TS) (n:32) [OCD plus TS, n:13] compared to control subjects (n:35) [total, n:80]. PATIENTS AND METHODS: The symptoms of any allergic disease were assessed using the ISAAC questionnaire form. Allergy diagnoses were made by a pediatric allergy specialist. Skin prick tests were applied, and IgE levels and eosinophil counts were measured. RESULTS: While only one-fifth of the control subjects had allergic diseases, more than half of the children with TS and/or OCD had comorbid allergic diseases. Positive skin prick tests were greater in OCD patients compared to control subjects. There were no significant differences between the groups in terms of eosinophil counts or IgE levels. Among the allergic diseases, while allergic rhinitis was diagnosed at significantly higher rates in TS patients, eczema was significantly higher in OCD patients compared to control subjects. CONCLUSIONS: This preliminary study shows an association between allergic diseases and TS and/or OCD. The results revealing differences in associations between types of allergic disease (rhinitis or eczema) and neuropsychiatric disorder (tic disorder or OCD) need to be investigated in further studies with higher numbers of participants, and immune markers should be examined.

Association between emotional and behavioral problems and metabolic control in children and adolescents with Type 1 diabetes.

OBJECTIVE: We aimed to investigate the differences in emotional and behavioral problems and to explore the association between the level of psychiatric problems and the metabolic control in Type 1 diabetes. METHODS: The children with Type 1 diabetes (no.=42) and the "healthy" control group (no.=42), their parents and endocrinology specialist completed the forms prepared for the study. The parents completed the Child Behavioral Checklist (CBCL/4- 18). RESULTS: The groups had significant differences in CBCL activities (p<0.001), social competence (p<0.001), total competences (p<0.001), withdrawal (p=0.036), anxiety/depression (p=0.033), social problems (p=0.009), and aggressive behavior (p=0.04) scores. We did not find significant differences in CBCL scores between the groups with good, moderate and bad metabolic control (p>0.05). DISCUSSION: The parents of children with Type 1 diabetes reported emotional and behavioral problems significantly more. We did not find any significant association between the level of metabolic control and the emotional and behavioral problems.

Symptoms of inattention and hyperactivity in children with habitual snoring: evidence from a community-based study in Istanbul.

BACKGROUND: Neurobehavioural symptoms of inattention and hyperactivity are common in children with sleep-disordered breathing (SDB). Prevalence rates of habitual snoring and attention deficit hyperactivity disorder (ADHD) are very similar and both have a substantial negative effect on children's behavioural health. OBJECTIVE: We examined the differences for subjective attentional and hyperactivity measures reported by parents and teachers among primary school children with habitual snoring and age- and sex-matched controls in a community-based case-control study in Istanbul. Methods In 2002, a survey was carried out to determine the prevalence of snoring in 2147 primary school children. After one year, in 2003, 151 children with habitual snoring and 302 controls from this survey were studied with parental SDB questionnaire, Conners' Parent (Conners-P) and Teacher Scales, and an inattention hyperactivity scale (IHS). Exclusion criteria included history of ADHD diagnosis, controls who started to snore and habitual snorers (HS) who no longer snored in this follow-up study. RESULTS: Ninety-six HS and 190 control subjects (mean age: 9.4 +/- 1.3) were evaluated. HS had significantly more symptoms of hyperactivity (Conners-ADHD index) (P: 0.033), attentional (P: 0.019), and conduct and oppositional defiant in subscales (P: 0.001) of Conners-P and IHS-Parents. A pooled score of Conners-P ADHD Index > 60 and IHS-Parent score > 1.25 showed considerable difference in HS when compared with controls (5.1% vs. 1.4%) (P < 0.0001). Daytime hyperactivity and excessive daytime sleepiness reported by parents correlated with scores of Conners-P and IHS-P (P < 0.01). Teachers' observations showed significant correlations with learning disability and the level of academic performance in HS (P < 0.01). Other behavioural parameters related to SDB were not significantly correlated with teachers' ADHD ratings in HS. CONCLUSION: Increased rates of moderate hyperactivity as well as conduct and oppositional defiant symptoms in HS reported by the parents might reflect a negative impact on overall neurobehavioural health. The teachers' scores yielded no significant results among HS and controls. This may be caused by the limitation due to shared method variance. The negative effect of crowded classes on teachers' evaluations must be also taken into consideration. After exclusion of a diagnosis of ADHD in children presenting with hyperactivity and inattention, children with habitual snoring with prominent scores of behavioural measures should be considered as candidates for further assessment by a sleep specialist.