Psychiatric comorbidity and familial factors in childhood epilepsy: Parental psychopathology, coping strategies, and family functioning

OBJECTIVE

This study aimed to examine the psychiatric diagnoses, parenting attitudes, family functioning among children and adolescents with epilepsy, coping styles of their mothers, and psychiatric symptoms of their mothers and fathers.

METHODS

Forty children and adolescents between the ages of 8 and 18 with epilepsy and 40 healthy controls were included in the study. The clinical interview and other measurements were used to assess psychiatric disorders and familial factors.

RESULTS

At least one psychiatric disorder was diagnosed in 65% of children and adolescents with epilepsy. It was determined that the mothers and fathers in the epilepsy group had higher anxiety and depression scores than the control group, and the fathers' hostility scores were also higher. The Family Assessment Device (FAD) (problem-solving and affective responsiveness), Coping Strategies Scale (COPE) (mental disengagement and substance use), and Parent Attitude Scale (PAS) (strictness/supervision) subtest scores of the epilepsy group were higher than the control group.

CONCLUSION

Psychiatric comorbidities, especially depression, anxiety disorders, and attention deficit hyperactivity disorder, are more common in children and adolescents with epilepsy. The mental health of parents, parent-child relationships, family functioning, and parental coping styles were adversely affected in families with children with epilepsy. It is essential to evaluate psychiatric comorbidity and family factors in children with epilepsy and to create a treatment plan for problem areas.

Validity and reliability study of coronavirus-related psychiatric symptom scale in children - parental form

Objective

The aim of this study is to develop a scale to assess the psychiatric symptoms that may emerge owing to the coronavirus disease 2019 (COVID-19) pandemic period in children and adolescents aged 4-18 years.

Material and Methods

To develop the scale, first, interviews with children, adolescents, and their parents were conducted, and the possible psychiatric symptom clusters were detected. The items were written with reference to the literature and reviewed by the experts. A 40-item scale form was shared as an online survey, and a factor analysis of the scale was carried out with data obtained from 441 participants. The test-retest reliability of the scale was carried out with data obtained from the 51 participants who filled the scale again after 14 days.

Results

According to the item-total correlations and factor analysis results with 40 items, 5 items with low correlation and factor load or loaded same under the two factors were removed from the scale. The final form had 35 items and had a two-factor structure. The internal consistency coefficient of the scale was calculated as 0.96, and the test-retest correlation coefficient was 0.98.

Conclusion

Coronavirus-related psychiatric symptom scale in children - parental form is a valid and reliable scale for measuring perceived psychiatric symptoms associated with COVID-19pandemic in children aged 4-18 years by their parents.

Finding underlying genetic mechanisms of two patients with autism spectrum disorder carrying familial apparently balanced chromosomal translocations

BACKGROUND

Genetic etiologies of autism spectrum disorders (ASD) are complex, and the genetic factors identified so far are very diverse. In complex genetic diseases such as ASD, de novo or inherited chromosomal abnormalities are valuable findings for researchers with respect to identifying the underlying genetic risk factors. With gene mapping studies on these chromosomal abnormalities, dozens of genes have been associated with ASD and other neurodevelopmental genetic diseases. In the present study, we aimed to idenitfy the causative genetic factors in patients with ASD who have an apparently balanced chromosomal translocation in their karyotypes.

METHODS

For mapping the broken genes as a result of chromosomal translocations, we performed whole genome DNA sequencing. Chromosomal breakpoints and large DNA copy number variations (CNV) were determined after genome alignment. Identified CNVs and single nucleotide variations (SNV) were evaluated with VCF-BED intersect and Gemini tools, respectively. A targeted resequencing approach was performed on the JMJD1C gene in all of the ASD cohorts (220 patients). For molecular modeling, we used a homology modeling approach via the SWISS-MODEL.

RESULTS

We found that there was no contribution of the broken genes or regulator DNA sequences to ASD, whereas the SNVs on the JMJD1C, CNKSR2 and DDX11 genes were the most convincing genetic risk factors for underlying ASD phenotypes.

CONCLUSIONS

Genetic etiologies of ASD should be analyzed comprehensively by taking into account of the all chromosomal structural abnormalities and de novo or inherited CNV/SNVs with all possible inheritance patterns.

Relationship between headache and Internet addiction in children

Background/aim

We aimed to investigate Internet addiction in pediatric patients with migraine- and tension-type headache in this study.

Materials and methods

Among our 200 subjects, 103 had migraine-type headache and 97 had tension-type headache.

Results

Headache triggered by computer use was more common in the migraine-type headache group. There was no difference between the Internet addiction scale score of the two groups. The Internet addiction scale scores of the patients were found to differ depending on the aim and duration of computer use. Internet addiction was found in six (6%) patients. Internet addiction prevalence was 3.7% and 8.5% in the two groups, respectively.

Conclusion

The prevalence of Internet addiction in children with recurrent headache was lower than that found in their peers in Turkey, possibly due to avoidance of computer use as a headache trigger. This finding raises the question of whether migraine- or tension-type headaches actually prevent Internet addiction.

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.

[Comparing Two Editions of Wechsler Intelligence Scales and Assessing Reading Skills in Children with Attention Deficit and Hyperactivity Disorder]

OBJECTIVE

This study aimed to examine the cognitive profiles of children with Attention Deficit and Hyperactivity Disorder (ADHD) with the Wechsler Intelligence Scales for Children-Revised (WISC-R) and the Wechsler Intelligence Scales for Children-Fourth Edition (WISC-IV), the latter of which was recently standardized in Turkey. In addition, the reading abilities and intelligence scores of these children were also investigated.

METHODS

A total of 48 children with ADHD between the ages of 6 and 16 years who were outpatients in Muş State Hospital were included in this study. The children were administered the WISC-R, the WISC-IV, and the Oral Reading Skills and Reading Comprehension Test (ORCT).

RESULTS

There were no significant differences between the WISC-R IQ scores and WISC-IV index scores. Moreover, reading comprehension skills (derived from ORCT scores) were predicted with significant accuracy by both the WISC-R Verbal IQ and the WISC-IV WMI (Working Memory Index).

CONCLUSION

Results of this study suggest that the WISC-R and the WISC-IV scale are not sufficient for obtaining a specific cognitive profile for ADHD - there is no significant difference between them. However, the four-factor structure of the WISC-IV is believed to provide more specific information. In addition, results of this study related to reading skills indicate that the importance of reading skills should not be overlooked when assessing children with ADHD.

[Analyzing the Wechsler Intelligence Scale for Children-Revised (WISC-R) in Children With Attention Deficit and Hyperactivity Disorder: Predictive Value of Subtests, Kaufman, and Bannatyne Categories]

OBJECTIVE

The aim of this study is to evaluate the predictive value of intelligence quotients scores (IQs), subtests of Wechsler Intelligence Scale for Children-Revised (WISC-R) and Kaufman's and Bannatyne's categories scores which are the sums of subtests of WISC-R in attention deficit hyperactivity disorder (ADHD). Another aim is to examine the difference of some neurocognitive skills between the children with ADHD and their unaffected peers by WISC-R subtests.

METHOD

WISC-R's subtest and IQ scores, and scores of Kaufman's and Bannatyne's categories of the children who were diagnosed with only ADHD were compared with the same scores of the children who were in healthy control group (N= 111) and were in ADHD with co morbidity group (N= 82).

RESULTS

It was found that the subtest scores (vocabulary, comprehension, digit span, picture completion and block design) of the children with only ADHD and ADHD with comorbidity were significantly lower than healthy group. It was observed that subtests of comprehension (Wald= 5.47, df= 1, p=0.05), digit span (Wald= 16.79, df= 1, p=0.001) and picture completion (Wald= 5.25, df= 1, p=0.05) predicted significantly ADHD. In addition, the categories of freedom from distractibility (Wald= 8.22, df= 1, p=0.01) and spatial abilities (Wald= 12.22, df= 1, p<0.0001) were predictive for ADHD in this study.

CONCLUSION

Problem solving abilities in social processes, auditory short-term memories, visual-spatial abilities and visual configuration abilities of the children with ADHD was observed to be lower than their healthy peers. It was thought that in WISC-R's profile analysis, the categories of freedom from distractibility and spatial abilities can be distinctive in ADHD diagnose.

Quality of life and self-esteem in children with chronic tic disorder

AIM

In this study, it was aimed to evaluate the quality of life and self-esteem in children and adolescents with Tourette syndrome (TS) and other chronic motor or vocal tic disorders in comparison with the control group. This is the first study examining the effects of quality of life and self-esteem on each other in chronic tic disorders.

MATERIAL AND METHODS

Among 62 patients aged between 6 and 16 years who were diagnosed with chronic tic disorder according to the Diagnostic and Statistical Manual of Mental Disorders-IV, 57 patients who met the study inclusion criteria constituted the study group and 57 age- and gender-matched individuals constituted the control group (Ethics committee file number: 2009/69; ethics committee meeting number: 2009/14 (11.06.2009); ethics committee decision number: 16). The Rosenberg self-esteem scale, Pediatric Quality of Life Inventory, Children's Depression Inventory, Screen for Child Anxiety Related Disorders, Maudsley Obsessional Compulsive Inventory and the Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version were applied to the children and adolescents.

RESULTS

In the study group, all quality of life subtests were found to be lower compared to the control group both in children and adolescents except for self-reported emotional functionality and social functionality. Being below the age of 12 years and female gender were found to be predictors of low self-esteem in tic disorder. In the reports obtained from the children and adolescents, low self-esteem was related with decreased quality of life in all areas except for academic functionality.

CONCLUSIONS

Children and adolescents with tic disorder experience functional disruption with a higher rate compared to the group without a psychiatric disorder or severe medical condition. Applying holistic approaches considering other clinical psychiatric symptoms as a part of chronic tic disorder will be useful in increasing the quality of life and self-esteem of these children.

[Sociodemographic/Clinical characteristics and risk factors associated with chronic tic disorders]

OBJECTIVE

This study aimed to investigate comorbidity, and sociodemographic and clinical characteristics in children and adolescents with Tourette's syndrome (TS) and chronic motor or vocal tic disorder (CMVTD), and to determine the predictors of tic disorders.

MATERIALS AND METHODS

In all, 57 children and adolescents with TS and CMVTD were compared with a control group. Data were obtained using the Yale Global Tic Severity Scale (YGTSS), Turgay DSM-IV-Based Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Children's Depression Inventory (CDI), Screen for Child Anxiety-Related Disorders (SCARED), Maudsley Obsessive-Compulsive Inventory (MOCI), and Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL).

RESULTS

Mean age of the patients was 10.5 ± 2.4 years. In all, 56 (98.2%) of the patients had simple motor tics, 50 (87.7%) had complex motor tics, and 43 (75.4%) had vocal tics. Self-injurious behavior was observed in 24 (42.1%) patients. In total, 46 (80.7%) of the patients had ≥1 comorbid disorder. Among the observed comorbid disorders, attention deficit-hyperactivity disorder (ADHD) was the most common (observed in 40.4% of the patients), followed by obsessive-compulsive disorder (OCD) (19.3%). A higher-level of maternal education and absence of ADHD were associated with a reduction in the risk of a tic disorder. A family history of psychiatric disorder increased the risk of a tic disorder 5.61-fold, and nail biting increased the risk of a tic disorder 8.2-fold. Every 1-unit increase in CDI score increased the risk of a tic disorder by 12%.

CONCLUSION

Chronic tic disorders (CTDs) are often accompanied by other psychiatric disorders. Both child- and family-related factors are associated with the risk of developing a tic disorder. Determination of both the protective and risk factors would be beneficial for improving the mental health of the general public.