Dynamic Thiol/Disulphide Homeostasis in Children and Adolescents with Non-Autoimmune Subclinical Hypothyroidism.

OBJECTIVE: To evaluate the thiol/disulphide homeostasis in children with non-autoimmune subclinical hypothyroidism (SHT). SUBJECTS AND METHODS: Thiol/disulphide homeosta sis, involving native thiol (SH), disulphide (SS), and total thiol (SS + SH), was evaluated in 60 children and adolescents who were negative for thyroid auto-antibodies (anti-thyroid peroxidase, anti-thyroglobulin) and had a thyroid-stimulating hormone (TSH) value of > 5 mIU/L, and in 40 sex- and age-matched healthy control subjects who were negative for thyroid autoantibodies and had normal TSH levels. Lipid profiles and urine iodine levels were also determined. RESULTS: SH (466 ± 32.8 vs. 462 ± 32.1 µmol/L p = 0.59), SH + SS (508 ± 34.0 vs. 506 ± 32.7 µmol/L, p = 0.81), SS (21 ± 5.5 vs. 22 ± 5.8 µmol/L, p = 0.41), SS/SH (4.5 ± 1.2 vs. 4.8 ± 1.3%, p = 0.36), SS/SH + SS (4.1 ± 1.0 vs. 4.3 ± 1.1%, p = 0.36) and SH/SH + SS (91 ± 2.1 vs. 91 ± 2.1%, p = 0.31) levels were similar in children with SHT and control subjects (p > 0.05). There was no difference between total cholesterol, triglyceride, and low-density lipoprotein levels in SHT patients and controls. No difference was detected between the patients with or without iodine deficiency in the SHT group in terms of thiol/disulphide homeostasis parameters. CONCLUSION: The status of dynamic thiol/disulphide homeostasis did not change in children and adolescents with non-autoimmune SHT. Future studies are needed for the evaluation of oxidative stress in patients with long-standing non-autoimmune SHT.

Relationship of childhood headaches with preferences in leisure time activities, depression, anxiety and eating habits: A population-based, cross-sectional study.

OBJECTIVES: The objective of this article is to determine the relationship between headache frequency and socio-demographic data, personal characteristics, habits, daily activities, daily loss of ability, depression and anxiety in the headache subtypes in the pediatric population. PATIENTS AND METHODS: Our sample group was composed of approximately 5355 children aged between 9 and 18 years. An eight-stage questionnaire was administered to the children. In the second stage of the study, headache subtypes were created according to the ICHD-II criteria. The resulting data were compared according to the results of the headache subtypes. RESULTS: In school-age children, the prevalence of recurrent headaches was 39.4%, and the prevalence of migraine was 10.3%. The subjects with migraine mostly preferred sedentary activities in their leisure time, and preferred less exercise than the subjects with the other headache types. The PedMIDAS score of the children who preferred to play sports was significantly lower than those who did not prefer to play sports. In the group that preferred reading books, an opposite relationship was found. In overweight and obese migraine sufferers, other types of headache were found to be significantly higher. CONCLUSIONS: In the management of treating childhood headaches, the association of psychiatric comorbidities should be considered. To minimize disability, children should be directed to more useful physical activities.

Mothers' alexithymia, depression and anxiety levels and their association with the quality of mother-infant relationship: a preliminary study.

OBJECTIVE: To evaluate the relationship between mothers and their developmentally normal infants in terms of maternal alexithymia, depression and anxiety, and marital satisfaction. METHODS: Fifty children between 18 and 48 months of age, and their mothers, were referred consecutively to the Infant Mental Health Unit of Ankara University School of Medicine, Department of Child and Adolescent Psychiatry. The sociodemographic features of the families and the depressive symptoms, anxiety, marital satisfaction and alexithymia levels of the mothers were assessed. The relationships between children in normal developmental stages and their mothers were evaluated and rated using a structured clinical procedure. RESULTS: There was a negative correlation between the mothers' alexithymia scores and the quality of the mother-infant relationship (p < 0.05). Mothers with high alexithymia showed higher depression and lower relationship qualities than mothers with low alexithymia, according to the correlation analysis. When depression and anxiety were controlled, high alexithymia levels were predictive of a low, impaired mother-infant relationship. CONCLUSION: Since alexithymia is a trait-like variable which has a negative correlation with impairment in a mother-infant relationship, it must be investigated in the assessment of mothers' interactions with their babies.

The assessment of serum lipid profiles of children with attention deficit hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders in children and the pathophysiology remains obscure. Some studies show that lipid imbalances are associated with ADHD etiology. We studied the association of serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride (TG) levels in ADHD. We examined 88 children aged 8-12 years who were diagnosed with ADHD and 88 healthy children. The exclusion criteria were as follows: obesity, any psychotropic use in the last 3 months, presence of a chronic disease and/or malignancy, history of medically treated lipid metabolism disease in family members, intelligence quotient (IQ) < 70, and comorbidities, with the exception of oppositional defiant disorder. The sample was evaluated using a semi-structured clinical assessment interview and Conners' rating scales. Despite controlling for age, sex, and body mass index (BMI) variables, the total cholesterol and LDL levels were significantly higher in the ADHD group than the levels of healthy controls, whereas the TG and HDL cholesterol levels were similar among groups. Conners' rating scales, reflecting symptom severity, and total cholesterol, TG, HDL, and LDL levels of the ADHD group were not correlated. The study results support the difference in serum lipid and lipoprotein profiles of children with ADHD compared with healthy controls. This difference is thought to be related with changes in oxidant/antioxidant balance states in ADHD.

A Child with Kabuki Syndrome and Autism Spectrum Disorder.

Kabuki syndrome (KS) is characterized by skeletal abnormalities, short stature, characteristic facial features, postnatal growth delay, and mental retardation. There are only a few case reports that present the coexistence of KS with autism spectrum disorder (ASD) in the literature. Herein we present the case of a boy with KS and ASD and discuss the possible shared etiologies. A 4-year-old boy was brought by his parents with complaints of no speech, hyperactivity, enuresis complex, temper tantrum, self-injury, and harming people or objects. We determined the lack of speech and eye contact, stereotypical behavior, and impaired social interaction and diagnosed him with autism and severe mental retardation via a psychiatric assessment. He had been followed up by pediatricians until he was 2 years old. Pediatricians noted his long eyelids with eversion of the lateral third of the lower eyelid, depressed nasal tip, short stature, long palpebral fissures, brachydactyly, and fetal finger pads in their physical examination. The boy who has an operated ventral septal defect and seizures was diagnosed with KS when he was 5 years old. We recommended his parents to apply to a special education agency and kindergarten for him. Our case is a new example of the coexistence of KS and ASD in addition to the very few cases in the literature. Genetic analyses conducted in the existence of specific genetic syndromes, such as KS, may provide opportunities for understanding the genetic etiology of ASD and new scope in terms of novel treatment approaches.

Antiepileptic treatment in a child with Landau Kleffner syndrome: a case report.

INTRODUCTION: Landau-Kleffner Syndrome is a rare childhood disorder characterized by acquired aphasia and epileptiform EEG abnormalities. Hyperactivity and attention problems are common in LKS, and symptoms of Autism Spectrum Disorders (ASDs) may also coexist. Many different treatments have been used for LKS, with varying rates of success. In particular, the effects of antiepileptic drug treatment on acquisition of language have been inconsistent. To the best of our knowledge the literature does not include any reports on the effect of antiepileptic drug treatment on ASD symptoms in patients with LKS. Herein we report a boy with LKS whose ASD symptoms markedly improved in response to antiepileptic treatment. CASE: A boy aged 3 years 10 months presented to the department of child and adolescent psychiatry due to lack of social interaction, decreased eye contact, stereotypic hand movements, and language regression. The patient was diagnosed as LKS and valproic acid (VAL) treatment was started. The patient was followed-up regularly and after 3 months of treatment with VAL substantial improvement was observed in problematic behaviors, and language and social skills. DISCUSSION: In the presented LKS case rapid improvement in autism symptoms was observed in response to antiepileptic drug treatment. The patient's reacquisition of speech and rapid improvement in social skills with antiepileptic treatment are important findings. It may be possible to effectively treat ASD symptoms in patients with LKS with early diagnosis and appropriate antiepileptic treatment.

A Case of Carbonic Anhydrase Type 2 Deficiency Syndrome with Autistic Disorder.

Carbonic Anhydrase Type II Deficiency Syndrome (CADS) is a disease with an autosomal recessive inheritance that mainly includes characteristics of osteopetrosis, renal tubular acidosis and cerebral calcification. Pathological fractures, poor vision due to cranial nerve pressure, wide forehead, disproportionate mouth and jaw, physical and mental developmental delay are other features. In this paper, we present the case of a patient who was referred to our department with a diagnosis of CADS and diagnosed with autistic disorder after a psychiatric evaluation. We performed a detailed literature search, however, we did not find any report of co-existence of CADS (osteopetrosis intermediate type) and autistic disorder.

Underinvolved relationship disorder and related factors in a sample of young children.

BACKGROUND AND AIMS: The interaction between the infant and the caregiver is stated to be very important in the development of a child. When there is inadequacy of interaction, several emotional and developmental problems can emerge. We aimed to investigate the socio-demographic and clinical features of children diagnosed with Underinvolved Relationship Disorder according to the DC:0-3R classification system. STUDY DESIGN AND METHODS: Four hundred and fifty seven children aged between 1 and 59 months, who had been admitted to an infant mental health clinic were assessed using the DC:0-3R classification system and the whole sample was divided into two groups, the group in which Underinvolved Relationship Disorder between the child and the caregiver had been detected (URD), and the group in which this had not been detected (NURD). These two groups were compared with regard to socio-demographic features, reasons for referral, primary diagnoses, relational disorders, medical/developmental conditions, psychosocial stressors and the Parent-Infant Relationship Global Assessment Scale (PIRGAS) scores of children. RESULTS: Language delay, insufficient social interaction and aggression were found to be significantly more frequent reasons for referral in URD. Disorders of Relating and Communicating (equivalent to the Pervasive Developmental Disorders in DSM IV) and Deprivation/Maltreatment Disorder were more frequent primary diagnoses, Verbally or Physically Abusive Relationship Disorder was significantly more frequent relational disorder in URD. Mild and moderate mental retardation were significantly more frequent in URD, and social environment, educational/child care and health-care access challenges were found to be more frequent psychosocial stressors in the parents of URD. The Mean PIRGAS scores were significantly lower in URD connoting that the parent-infant relationship is poorer. CONCLUSIONS: The diagnosis of Underinvolved Relationship Disorder according to the DC:0-3R classification system is related to some developmental and psychosocial problems.