Changes in oxidative stress and cellular immunity serum markers in attention-deficit/hyperactivity disorder.

AIMS: Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder with an etiopathogeny not fully understood. According to the prevailing view, the main factors contributing to the disorder are prefrontal dopamine deficiency and central dopaminergic dysfunction, but the factors/mechanisms involved in the brain dysfunction and its consequences are not well known. We suggest that changes in oxidative metabolism and cellular immunity may be involved. In this study, we aimed to investigate whether there are associations between ADHD and changes in serum levels of nitric oxide synthase (NOS), xanthine oxidase (XO), glutathione S-transferase (GST) and paraoxonase-1 (PON-1) activities, which are important markers of oxidative stress, and adenosine deaminase (ADA) activity, marker of cellular immunity. METHODS: The study sample consisted of 35 child or adolescent patients diagnosed with ADHD according to DSM-IV-TR criteria. Thirty-five healthy subjects were also included in the study as controls. Venous blood samples were collected, and NOS, XO, GST, PON-1 and ADA activities were measured. RESULTS: NOS, XO and ADA activities of the patients were significantly higher than those of the controls. GST and PON-1 activities of the patients were significantly lower than those of the controls. CONCLUSIONS: Changes in oxidative metabolism and cellular immunity may have a role in the etiopathogenesis of ADHD.

Comparing brain magnetic resonance spectroscopy findings of pediatric treatment-naive obsessive-compulsive disorder patients with healthy controls.

OBJECTIVE: It is believed that biochemical alterations in different brain regions are involved in the pathophysiology of obsessive-compulsive disorder (OCD) in children and adolescents. The aim of this study was to explore possible metabolic variations between pediatric OCD cases and healthy controls in brain regions which were implicated in OCD pathophysiology. METHOD: Children and adolescents between 8 and 16 years of age with OCD (n:15) and case matched healthy controls (n:15) were recruited for the study. After detailed clinical and neuropsychological evaluations, all subjects underwent the multiregional magnetic resonance spectroscopy (MRS) procedure with a long echo time (TE:135). RESULTS: Significantly lower n-acetylaspartate (NAA) ratios in the left inferior frontal gyrus, right occipital grey matter, left anterior cingulate cortex and lower choline (Cho) ratios in right and left anterior cingulate cortex and higher Cho ratio in left lenticular nucleus was observed in the OCD group. Also we found a negative correlation between OCD duration and left insular cortex NAA/Cho ratio. CONCLUSION: We found significant metabolic alterations in the brain regions which were implicated in OCD pathophysiology. Lower NAA and Cho ratios in anterior cingulate cortex and lower NAA ratios in the left inferior fronyal gyrus containing lateral orbitofrontal cortex can be possibly related to higher activation in OCD patients. Also further studies of the occipital lobes and insula should be continued in OCD.

Nonmedical healing methods: knowledge and behavior among parents of children with mental health problems.

This study examined knowledge and behavior concerning nonmedical healing methods used by parents whose children present with mental health problems and to determine the factors affecting this behavior. Knowledge of a variety of nonmedical health methods was found to be more common than use of such methods. Among those expressing knowledge of such methods, religious procedures were found to be more common than those that are nutrition related. Also, nonmedical healing method use increased as the mother's age decreased. We found a significant relationship between nonmedical healing method--using behavior and a positive family history of nonmedical healing method usage. Education about mental health problems and their treatment is very important, especially for young mothers. Increased understanding about nonmedical healing methods among health care providers will improve the patient-family-provider relationship.

Increased serum levels of epidermal growth factor in children with autism.

The etiology of autism is unclear, however autism is considered as a multifactorial disorder that is influenced by neurological, environmental, immunological and genetic factors. Growth factors, including epidermal growth factor (EGF), play an important role in the cellular proliferation and the differentiation of the central and peripheral nervous system. In this study we hypothesized that EGF may play a role in the pathophysiology of autism and examined serum EGF levels in children with autism. We measured serum levels of EGF in the 27 autistic children and 28 age- matched normal controls. The serum levels of EGF in the subjects with autism were significantly higher than those of normal control subjects. However, there were no correlations between serum EGF levels and clinical variables in the subjects with autism. This is the first report demonstrating the increased serum levels of EGF in children with autism. This study suggests that increased levels of EGF might have an importance in the pathophysiology of autism.

Oxidative imbalance in child and adolescent patients with attention-deficit/hyperactivity disorder.

Various psychological, social, genetic, and biochemical factors are thought to be involved in the aetiology of attention-deficit/hyperactivity disorder (ADHD). However, few studies have evaluated the biochemical basis of ADHD. In the present study, we evaluate whether levels of nitric oxide pool (NO+NO(2)(-)) and malondialdehyde (MDA) oxidants as well as superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) antioxidant enzyme activities are associated with ADHD. The sample population consisted of thirty-five child or adolescent patients diagnosed with ADHD according to DSM-IV-TR criteria. Thirty-five healthy subjects also were included in the study as controls. Venous blood samples were collected, and NO pool and MDA levels as well as SOD, GSH-Px, and CAT activities were measured. NO and MDA levels of the patients were significantly higher than the controls. GSH-Px activities of the patients were significantly lower than the controls. CAT activities of the patients were higher than the controls; however, the difference was not statistically significant. There were no significant differences in SOD activity between the patient and control groups. Remarkably high levels of NO pool and MDA oxidants as well as low GSH-Px activities suggest an oxidative imbalance in paediatric patients with ADHD. CAT activities may be increased in response to increased oxidant levels.

[Validation of the Turkish versions of the short-form Conners' teacher and parent rating scales]. / Conners Kisa Form Ogretmen ve Ana Baba Derecelendirme Olçeklerinin Geçerligi.

OBJECTIVES: To investigate factorial and criterion validity as well as reliability of the Turkish translations of the 28-item Conners' Teacher Rating Scale (CTRS) and 48-item Conners' Parent Rating Scale (CPRS), which both measure attention deficit, hyperactivity, and conduct problems in children, through a series of studies conducted with either normal or clinical samples. METHOD: Normal sample data for the teacher and parent rating scales were collected at several elementary schools in Ankara through 2 different studies. The teacher rating scale sample consisted of 1539 pupils rated by their teachers, and the parent scale sample consisted of 954 pupils rated by their parents. The clinical sample consisted of 270 children diagnosed with attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ADD), and/or conduct disorder (CD), who were rated by a child psychiatrist on a DSM-IV criteria form, as well as by their parents and teachers on the respective Conners' rating scales (CRS). The patients' clinical criteria scores related to these diagnostic categories were used to evaluate, and if necessary, to modify item content of the corresponding subscales. RESULTS: Turkish versions of the CTRS and CPRS demonstrated good internal consistency as indicated by Cronbach's alpha coefficients of .95 and .90, respectively. Factor analytical data from the normal sample studies supported the construct validity of both Turkish CRS despite non-differentiation of the conduct factor from the hyperactivity factor on the teacher scale. The clinical criteria scores suggested the necessity of adapting the item content of all the subscales, except the hyperactivity subscale. CONCLUSION: The adapted and original subscales of the CRS Turkish forms demonstrated such psychometric properties that they could be employed in assessing attention deficit and disruptive behavior disorders in Turkish children.

Multicomponent attention deficits in attention deficit hyperactivity disorder.

The aim of this study was to examine the specific aspects of attention, such as selective attention, sustained attention, and short-term memory in children with attention deficit hyperactivity disorder, combined subtype (ADHD-C). A total of 40 children with a diagnosis of ADHD from the 4th edition of the Diagnostic and Statistical Manual, aged 6-11 years old were compared with 40 controls matched for age and gender on a battery of tests. Short-term memory span and attention was measured by Visual Aural Digit Span Test-Revised. Stroop test and the Turkish version of Cancellation Test were used to assess selective and sustained attention, respectively. In order to check for factor structure in two groups on the test scores, principal component analysis was conducted for both groups separately. Relative to the comparison children, children with ADHD showed significant deficits on tests that are related to different aspects of attention. The results are consistent with the theories explaining the biological basis of ADHD by scattered attention networks in the brain, which have reciprocal dynamic interactions. Further comparative studies are needed to elucidate whether the cognitive processes that are known to be assessed by these tests are specific to ADHD.

[Family functioning and psychosocial characteristics in children with attention deficit hyperactivity disorder with comorbid oppositional defiant disorder or conduct disorder]. / Dikkat Eksikligi Hiperaktivite Bozuklugu Olan Cocuklarda Karsit Olma-Karsi Gelme Bozuklugu/Davranis Bozuklugu Es Hastalaniminda Aile Islevleri ve Psikososyal Degiskenlerin Karsilastirilmasi.

OBJECTIVE: To compare the parental sociodemographic characteristics, prenatal and postnatal developmental variables, IQ and behavioral disturbances as well as family functioning and current psychiatric disorders in the parents of children with attention deficit hyperactivity disorder (ADHD) and the parents of children with ADHD and comorbid oppositional defiant disorder (ODD) or conduct disorder (CD). METHOD: The sample consists of 92 children in the 6-11 age range, diagnosed with ADHD and ADHD with comorbid ODD/CD using DSM-IV diagnostic criteria. Parents completed the Child Behavior Checklist (CBCL) 4-18 and the Family Assessment Device (FAD) and were interviewed for current psychiatric treatment and alcohol consumption. RESULTS: 69.6% of the sample was diagnosed with ADHD and 30.4% with ADHD + ODD/CD. There were no differences between the two groups with respect to age, intelligence, characteristics of the neonatal period, age of walking and age of speech. Children with ADHD and comorbid ODD/CD had high CBCL subscale scores except for the social withdrawal and sexual problems subscales. Maternal depression and paternal drinking problems were high in the ADHD+ODD/CD group. The families of children with ADHD+ODD/CD also scored high at the level of 'unhealthy functioning' in the Roles and Behaviour Control subscales of the FAD. CONCLUSION: The treatment of children diagnosed with ADHD with comorbid ODD / CD should include parental treatment and intervention addressing parental skills.

The prevalence of parasomnias in preadolescent school-aged children: a Turkish sample.

STUDY OBJECTIVES: To survey the prevalence of parasomnias in a population of children aged 7 to 11 years and to determine whether parasomnias are associated with medical and neurobehavioral properties. DESIGN: Parents and children completed a pediatric sleep questionnaire that contains 27 items developed by the authors to assess parasomnias in children. Parents and children were also interviewed about the children's medical and sociofamilial history, schooling, psychological difficulties, medication intake, and the history of psychomotor and psychosocial development. SETTING: NA PARTICIPANTS: 971 preadolescent school-aged children from 4 locations in Turkey participated in the study. RESULTS: We found a 14.4% prevalence of parasomnia in preadolescent school-aged children. Almost every sixth child had about at least 1 parasomnia. When we examined parasomnias separately, bruxism, nocturnal enuresis, and night terrors were the most common parasomnias among both girls and boys. The prevalence of parasomnias was higher in the 9- and 10-year-old age groups than in the other age groups. Girls and boys did not differ. Children with parasomnias had higher rates of past physical illness, delays in toilet raining, behavior disturbances, adjustment problems, and learning difficulties. CONCLUSIONS: These results suggest that the prevalence of parasomnias was high in the 9- and 10-year-old age groups. Parasomnias are associated with a history of physical illness and neurobehavioral abnormalities.