Evaluation of the corpus callosum using magnetic resonance imaging histogram analysis in autism spectrum disorder.

BACKGROUND: Histogram analysis is a texture analysis method that can be used in medical images. Quantitative values of the intensity of images can be obtained with histogram analysis. It aimed to evaluate corpus callosum in magnetic resonance images (MRIs) using histogram analysis of pediatric patients with autism spectrum disorder (ASD) to compare them with healthy controls. METHODS: This study included 29 children with ASD and 29 healthy children with normal brain MRI. High-resolution three-dimensional turbo field echo images were obtained with a 1.5 T scanner device for brain magnetic resonance imaging. On the corpus callosum in the sagittal T1-weighted images obtained, mean gray level density (mean), the standard deviation, median, minimum, maximum, entropy, variance, skewness, kurtosis, uniformity, size % L, size % M, size % U, and percentile parameters were measured. RESULTS: In ASD patients, mean, standard deviation, maximum, median, variance, entropy, 25%, 75%, 90%, 97%, and 99% values were found to be lower than the control group, and size % U value was higher. In addition, the corpus callosum area was significantly lower in the ASD compared to the controls. CONCLUSION: According to our study, corpus callosum of patients with ASD showed differences compared to healthy controls by histogram analysis, even though they were seen as normal in brain MRI. We think that histogram analysis can be used to evaluate possibly affected areas of brain in ASD patients.

Effect of Impairment on the Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder in a National Survey: Nation-Wide Prevalence and Comorbidities of ADHD.

OBJECTIVE: This study aimed to determine the prevalence and comorbidities of attention-deficit hyperactivity disorder (ADHD) by evaluating a large-scale nation-wide sample of children. METHOD: The inclusion criterion was being enrolled as a 2nd, 3rd, or 4th-grade student. A semi-structured diagnostic interview (K-SADS-PL), DSM-IV-Based Screening Scale for Disruptive Behavior Disorders, and assessment of impairment (by both parents and teachers) were applied to 5,842 participants. RESULTS: The prevalence of ADHD was 19.5% without impairment and 12.4% with impairment. Both ADHD with and without impairment groups had similar psychiatric comorbidity rates except for oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses. Impairment in the ADHD group resulted in significantly higher ODD and CD diagnoses. CONCLUSION: Even when impairment is not described, other psychiatric disorders accompany the diagnosis of ADHD and may cause impairment in the future. Impairment in the diagnosis of ADHD significantly increases the likelihood of ODD and CD.

Index depressive episode and antidepressant exposure were associated with illness characteristics of pediatric bipolar disorder.

OBJECTIVE: Pediatric bipolar disorder (PBD) is a serious, recurrent disorder leading to severe functional impairment. As a first mood episode, index episode could affect the long-term course of the illness. This study aimed to investigate the clinical characteristics of youth with PBD from our multicenter, nationwide, naturalistic follow-up samples and to identify (i) the effects of index mood episode and (ii) the effect of previous antidepressant treatments on the age at mania onset of PBD. METHOD: The study sample consisted of 271 youth with BD-I followed by the child and adolescent psychiatry clinics of seven different university hospitals and three research state hospitals, representing six geographic regions across Turkey. All diagnoses were made according to structured interviews, and all data were retrospectively obtained from clinical records by the clinicians. RESULTS: When patients with index depressive/mixed episodes (IDE, n=129) and patients with index (hypo)manic episodes (IME, n=142) were compared, the total number of mood episodes and rapid cycling feature were significantly higher in the IDE group than in the IME group. The Cox regression analysis adjusted for sociodemographic and illness characteristics revealed female adolescents in the IDE group treated with antidepressants were more likely to have an earlier onset of mania (hazard ratio=2.03, 95% confidence interval=1.31-3.12, p=0.001). CONCLUSION: This is the first large-scale nationwide follow-up study in Turkey that indicated prior antidepressant treatments were associated with an earlier onset of mania in youth, particularly in adolescent females. Larger prospective studies are needed to identify neurodevelopmental processes underlying PBD and initiate prevention approaches.

Can Temperament and Character Traits Be Used in the Diagnostic Differentiation of Children With ADHD?

ABSTRACT: In this study, it was aimed to determine the contributions of temperament and character traits to the diagnosis of attention deficit hyperactivity disorder (ADHD) in children. Thirty-six patients between the ages of 9 and 14 with a diagnosis of combined type ADHD and 39 healthy children were included in the study. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Version and the Turgay DSM-IV Disruptive Behavior Disorders Rating Scale parent form were used to assess hyperactivity/impulsivity and inattentiveness, and comorbid disorders. The Junior Temperament and Character Inventory-Revised form was used to evaluate temperament-character traits. The classification-based association rules (CBARs) method was used for finding rules predicting ADHD accurately. Low persistence and self-directedness scores, and higher disorderliness and fatigability subgroup scores were found in the ADHD group. In CBARs, the separation of children with ADHD from healthy controls could be made with 0.83 accuracy, 0.80 sensitivity, and 0.86 specificity. The results of our study support the view that temperament-character traits can help clinical diagnosis of ADHD.

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T).

AIM: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. METHOD: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. RESULTS: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. CONCLUSION: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.

Vitamin D levels in children and adolescents with obsessive compulsive disorder.

BACKGROUND: Recent studies showed that vitamin D deficiency may lead to dysfunctional changes in the brain and may be associated with neuropsychiatric diseases. AIMS: The present study aims to investigate vitamin D, calcium, phosphorus and alkaline phosphatase levels in children and adolescents diagnosed with obsessive-compulsive disorder (OCD) and compared them to healthy controls. Additionally, the correlation of OCD symptom severity with serum vitamin D level will be analyzed. METHODS: A semi-structured interview form (K-SADS-PL) was used to diagnose OCD and other comorbidities in accordance with DSM-IV criteria. In addition, all participants were assessed with clinical interviews based on DSM-5 OCD diagnostic criteria. Children's Yale Brown Obsession Compulsion Scale (CY-BOCS) and Children's Depression Inventory were used in the clinical evaluation. RESULTS: Vitamin D levels were lower in patients diagnosed with OCD (15.88 ± 6.96 ng/mL) when compared to healthy controls (18.21 ± 13.24 ng/mL), but the difference was not statistically significant (p = .234). Serum calcium, serum phosphate and serum alkaline phosphatase levels were not different between the groups. A negative correlation was found between serum 25OH-D3 levels and obsession scale scores in CY-BOCS. CONCLUSIONS: To our knowledge this is the first study that evaluated vitamin D levels in OCD patients without comorbidity. The vitamin D levels of newly diagnosed OCD cases were lower but not statistically different than healthy controls. Furthermore, the study does also not support the presence of a significant association between serum vitamin D levels and OCD.