The effect of long-term use of methylphenidate on cardiac autonomic functions and ventricular arrhythmogenesis: a prospective case-control study.

OBJECTIVE: We aimed to assess cardiac autonomic balance with heart rate variability by using 24-hour Holter electrocardiography and also to assess susceptibility to ventricular arrhythmias by using microvolt T wave alternance in children with attention deficit hyperactivity disorder. METHOD: This study was conducted with age- and gender-matched groups of 40 patients taking long-acting methylphenidate for more than a year and 55 healthy controls. Heart rate variability analysis for cardiac autonomic functions and microvolt T wave alternance measurements for susceptibility to ventricular arrhythmias were evaluated by 24-hour Holter electrocardiography. RESULTS: The mean age 10.9 ± 2.7 years, mean duration of therapy 22.76 months, and mean methylphenidate doses were 37.64 mg/day. The study group had considerably higher rMSSD, higher HF, and a lower LF/HF ratio (respectively, p : 0.02, p : 0.001 and p : 0.01). While parasympathetic activity parameters were elevated, sympathetic activity parameters were low during the sleep period. Increase in the microvolt T wave alternance values of the study group was not found to be statistically significant (p > 0.05). CONCLUSION: In children taking long-acting methylphenidate, the autonomic balance was shown to be in favour of the parasympathetic system. Determination of the vulnerability to life-threatening ventricular arrhythmias has been evaluated for the first time in children with attention deficit hyperactivity disorder. Accordingly, microvolt T-wave alternance values give the notion that drug use is safe.

Prenatal, perinatal, postnatal risk factors, and excess screen time in autism spectrum disorder.

BACKGROUND: The aim of this study was to investigate pre-, peri-, and postnatal factors, screen time in a group of patients with autism spectrum disorder (ASD) and age and sex-matched clinical controls to evaluate risk factors specific to ASD. METHODS: The study included 211 ASD patients (177 boys, 34 girls; mean age 44.3 ± 13.0 months) and 241 (190 boys, 51 girls; mean age 44.6 ± 14.1 months) age and sex group matched clinical controls. Non-ASD diagnoses were expressive language disorder (n = 135, 56.0%), intellectual disability (n = 15, 6.2%), attention deficit-hyperactivity disorder (n = 6, 2.4%), oppositional disorder (n = 6, 2.4%), and other behavioral or emotional problems (no diagnosis; n = 79, 32.8%). A sociodemographic data form was used to collect data regarding pre-, peri-, and postnatal factors and total daily screen exposure. RESULTS: According to our findings, maternal severe psychological stress and depression during pregnancy, and maternal postpartum depression were more frequent in the ASD group (p = 0.005, p = 0.035, and p = 0.001 respectively). There was a statistically significant difference between groups with regards to maternal any medication use during pregnancy (p = 0.004). The mean duration of daily screen exposure was higher in the ASD group (9.90 ± 5.10 h) compared to non-ASD children (4.46 ± 3.40 h; p < 0.001). A ROC curve showed that 8.5 h and above total daily screen exposure (AUC = 0.808 [95% CI: 0.769-0.848], p < 0.001; 55% sensitivity, 90.5% specificity) is likely to be associated with increased risk for ASD. CONCLUSION: Our study suggests that prenatal maternal psychological stress, prenatal and postpartum depression, and excess exposure to screen might be related to an increased risk for ASD.

Life in Family Buildings as a unique environment in Turkey.

Family building (FB) is a building where residents of different flats are close relatives. Being quite common in metropolitan areas, these unique psychosocial environments remain underexamined. We aimed to research into the interactions within the family and psychosocial features of FBs. One hundred and one children living in FBs and FB-experiences of their parents were assessed by semi-structured interviews using K-SADS-PL. Mothers scored their satisfaction from FB-lifestyle in the scale of 0-100. The sample consisted of 35 girls and 66 boys. Mean age was 108±37.4 months. ADHD and anxiety disorders were the common diagnoses. Eighty-two families lived with paternal relatives. Number of relativeneighbors in the building changed between 2-10. Forty-one mothers scored ≤50 for their satisfaction; 58% believed FBs affected their children's symptoms negatively. Examining the perceived advantages and disadvantages of FBs, 'extreme criticism' and 'social support' were the decisive items to predict mothers' satisfaction levels. Having both positive and negative effects, FB-lifestyle seem to complicate interpersonal relations within the family. This study has revealed some preliminary findings, but further studies are required in the field.

Demographic and clinical characteristics associated with a history of bizarre delusions in a cross-diagnostic sample of individuals with psychotic disorders.

Bizarre delusions (BizD) are not specific to schizophrenia (SZ) and can be found in other psychotic disorders. However, to date, there are no studies investigating socio-demographic and clinical characteristics associated with BizD across the psychosis spectrum. In this study 819 subjects with a diagnosis of SZ (n = 250), schizoaffective disorder (SZA) (n = 228) and bipolar I disorder (BD) (n = 341) were included. Patients with history of BizD and with no BizD were compared with respect to socidemographic and clinical variables, and predictors of BizD were explored. Patients with BizD were less educated, less likely to be married, had higher Positive and Negative Syndrome Scale (PANSS) negative scores and lower Young Mania Rating Scale scores. Younger age, SZ and SZA diagnoses, higher PANSS positive scores, presence of reference delusions, tactile and olfactory hallucinations were predictors. Our results indicate that BizD are associated with higher illness severity, lower functionality and specific set of symptoms.