Factors contributing to higher caregiving burden in Turkish mothers of children with autism spectrum disorders.

OBJECTIVES: The aim of this study was to explore the caregiver burden and related factors such as expressed emotion (EE), social support, life satisfaction, dyadic adjustment, post-traumatic growth, and socio-demographic characteristics of mothers with autism spectrum disorder (ASD) children. METHODS: Sixty-two mothers of children with autism spectrum disorder and 60 mothers of typically developing children completed the Zarit Burden Scale, the Multidimensional Scale of Perceived Social Support, the Satisfaction with Life Scale, the Dyadic Adjustment Scale, the Expressed Emotion Scale, and the Post-Traumatic Growth Inventory. The Autism Behavior Checklist was used to examine the severity of autistic behaviors. A socio-demographic data form was applied to the subjects. Participants were recruited in Autistic Children Education Center, homes, and workplaces. Correlation analysis, independent-samples t-tests, post hoc Mann-Whitney U , and SEM tests were conducted for statistical analyses. RESULTS: Higher maternal caregiving burden was associated with lower life satisfaction and higher level of disability in Turkish children with ASD. Also, higher life satisfaction of mothers with ASD children was related to higher social support and dyadic adjustment, and lower EE. According to the SEM analysis, disability percentages, autism-related behaviors in children, and poor dyadic adjustment were significant predictors of caregiving burden in these mothers which in turn resulted with higher EE and poor life satisfaction. CONCLUSIONS: There are several studies that have investigated the distress in parents of children with developmental disabilities in general, but caregiving burden in ASD was not evaluated elsewhere in detail. These mothers need professional guidance and psychosocial support during the parenting process. Further studies that aim to investigate the whole family, including the father and the siblings, are also necessary.

The impact of CYP2C19 polymorphisms on citalopram metabolism in patients with major depressive disorder.

WHAT IS KNOWN AND OBJECTIVE: Genetic variations in drug-metabolizing enzyme genes change drug pharmacokinetics and response. CYP2C19 is a clinically important enzyme that metabolizes citalopram (CIT). The objective of this study was to determine CYP2C19 genetic polymorphisms and to evaluate the impact of these polymorphisms on the metabolism of citalopram in a sample of the Turkish population. We also assessed *17 polymorphism in healthy subjects in this population. METHODS: The CYP2C19 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism method (209 healthy individuals and 50 patients for CIT metabolism), and the plasma concentrations of CIT and demethylcitalopram (DCIT) were quantified by high-performance liquid chromatography. RESULTS AND DISCUSSION: The CYP2C19*1 and *17 allele frequencies for the patient group and the healthy group were 71·0%, 18·0% and 81·1%, 18·9%, respectively. There was no significant difference between the two groups (P > 0·05). The mean plasma concentrations and the mean dose-corrected (C/D) plasma levels of DCIT were significantly higher in patients with the CYP2C19*1/*1 genotype compared to patients with CYP2C19*1/*2 and CYP2C19*2/*2 genotypes (P < 0·05). Furthermore, the mean metabolic ratio (MR, CIT/DCIT) was also significantly higher in the CYP2C19*1/*2 + CYP2C19*2/*2 genotypes (P < 0·05). On the other hand, plasma CIT, DCIT concentrations and M/R value in the CYP2C19*1/*1 genotypes were no different to those of the CYP2C19*1/*17 genotypes (P > 0·05). WHAT IS NEW AND CONCLUSION: Our data suggest that CYP2C19*17 polymorphism does not have a significant effect on CIT metabolism. In contrast CYP2C19*2 polymorphism has a prominent role and is likely to contribute to interindividual variability in CIT metabolism in vivo at therapeutic doses.

Oral trail making task as a discriminative tool for different levels of cognitive impairment and normal aging.

The Trail Making Test (TMT) is a useful measure of executive dysfunction in elderly subjects. This study aims to investigate the discriminative validity of the oral version of the TMT (OTMT), which can be administered to subjects with visual or motor disabilities, in elderly patients with Mild Cognitive Impairment (MCI; n = 30), Alzheimer's disease (AD; n = 30), and healthy controls (HCs; n = 25). The WAIS-R Digit Span Backwards Subscale, written form of the Trail Making Task, the Clock Drawing Test, the AD Assessment Scale-Cognitive Subscale, and the OTMT were also administered to all participants in order to examine the concurrent validity of the OTMT. The OTMT part B discriminated between patients with MCI, AD, and HC correctly. The OTMT completion time was not correlated with age, but was negatively correlated with education. In conclusion, the OTMT (mostly part B) is a valid and practical measurement tool for different levels of cognitive impairment, especially for patients with visual or motor disabilities for whom the classical written form is not feasible.

Assessment of sexual dysfunction in patients with Parkinson's disease: a case-control study.

BACKGROUND: Sexual dysfunction (SD) in patients with Parkinson's disease (PD) has not been very well studied, as most of the research has methodological restrictions like having no control group, using invalid assessment tools, unidimensional investigation of sexual functions and inclusion of males/females only. This study aimed to examine different sexual functions in patients with PD and compare with matched non-parkinsonian controls by using a valid instrument. Predicting factors of SD in PD were also investigated. METHODS: The sample consisted of 45 patients with PD and 45 age- and sex-matched healthy controls. Sexual functions were evaluated by Arizona Sexual Experiences Scale (ASEX). RESULTS: Female patients had reduced sexual drive and they were less satisfied with orgasm, while male patients had easier orgasms than did the controls. Regression analysis identified increased age and female sex predictive of reduced sexual drive and sexual arousal. Ability to reach orgasm and satisfaction with orgasm were associated with female sex, while erection/lubrication was associated with marital status. The severity and duration of PD, as well as the severity of anxiety and depression were not associated with SD. CONCLUSION: Using ASEX in the detection of SD in PD might be important in directing patients to further evaluation and treatment.