Comparison of cognitive and behavioural problems and psychiatric diagnoses in preterm born children between 6-13 years old / Comparación de problemas cognitivos y conductuales y diagnósticos psiquiátricos en niños prematuros entre 6 y 13 años

Introduction: Despite the increased survival rates follow up studies of preterm born children have documented increased prevalence of neurodevelopmental disabilities and cognitive deficits. By using psychiatric assessment, we aimed to evaluate cognitive functions by comparing preterm born babies according to the week of gestation by comparing the scores of the Wechsler Intelligence Scale for Children-Revised Form (WISC-R) in childhood. Material and methods: Children with a history of birth as preterm babies between 1998-2004 were included in the study. The children born between 27-36 weeks, currently 6-13 years old were admitted to the study. The controls consisted of healthy children chosen from the nearest primary school. The WISC-R test was administered to all children. Classification was made according to gestational age. The comparison of cognitive functions was performed by comparing the WISC-R scores of the preterm group and the control group. Results: 238 children were included in our prospective study. (case group: 175 children, control group: 63 children). Because of the comparison of the WISC-R scores of the preterm and control groups, the WISC-R verbal score and WISC-R total score were found to be statistically significant between the preterm and control groups. In the analysis made according to the gestation age, no statistical significance was found between the WISC-R Verbal, WISC-R performance, and WISC-R total scores according to the week of gestation. No statistically significant difference was found in terms of previous and current psychiatric diagnoses. Conclusions: While the WISC-R score was, found to be statistically significantly higher in the case group compared to controls. Our results differed from those in the literature that preterm children had a lower WISC-R score and it indicates the need to investigate this situation by further studies, even by different tests (AU)

Introducción: A pesar del aumento de las tasas de supervivencia, los estudios de seguimiento de niños prematuros han documentado una mayor prevalencia de discapacidades del neurodesarrollo y déficits cognitivos. Mediante el uso de la evaluación psiquiátrica, nuestro objetivo fue evaluar las funciones cognitivas comparando los bebés prematuros según la semana de gestación comparando los puntajes de la Escala de inteligencia de Wechsler para niños-Forma revisada (WISC-R) en la infancia. Material y métodos: Se incluyeron en el estudio niños con antecedentes de parto prematuro entre 1998-2004. Los niños nacidos entre 27 y 36 semanas, actualmente de 6 a 13 años, fueron admitidos en el estudio. Los controles consistieron en niños sanos elegidos de la escuela primaria más cercana. La prueba WISC-R se administró a todos los niños. La clasificación se hizo de acuerdo a la edad gestacional. La comparación de las funciones cognitivas se realizó comparando las puntuaciones WISC-R del grupo de prematuros y el grupo control. Resultados: 238 niños fueron incluidos en nuestro estudio prospectivo. (grupo de casos: 175 niños, grupo de control: 63 niños). Debido a la comparación de las puntuaciones de WISC-R de los grupos de control y de prematuros, se encontró que la puntuación verbal de WISC-R y la puntuación total de WISC-R eran estadísticamente significativas entre los grupos de control y de prematuros. En el análisis realizado según la edad de gestación, no se encontró significancia estadística entre las puntuaciones del WISC-R Verbal, WISC-R de rendimiento y WISC-R total según la semana de gestación. No se encontraron diferencias estadísticamente significativas en términos de diagnósticos psiquiátricos previos y actuales. Conclusiones: Si bien la puntuación WISC-R fue estadísticamente significativamente mayor en el grupo de casos en comparación con los controles (AU)

Predictive Value of Slow and Fast EEG Oscillations for Methylphenidate Response in ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder and is characterized by symptoms of inattention and/or hyperactivity and impulsivity. In the current study, we obtained quantitative EEG (QEEG) recordings of 51 children aged between 6 and 12 years before the initiation of methylphenidate treatment. The relationship between changes in the scores of ADHD symptoms and initial QEEG features (power/power ratios values) were assessed. In addition, the children were classified as responder and nonresponder according to the ratio of their response to the medication (>25% improvement after medication). Logistic regression analyses were performed to analyze the accuracy of QEEG features for predicting responders. The findings indicate that patients with increased delta power at F8, theta power at Fz, F4, C3, Cz, T5, and gamma power at T6 and decreased beta powers at F8 and P3 showed more improvement in ADHD hyperactivity symptoms. In addition, increased delta/beta power ratio at F8 and theta/beta power ratio at F8, F3, Fz, F4, C3, Cz, P3, and T5 showed negative correlations with Conners' score difference of hyperactivity as well. This means, those with greater theta/beta and delta/beta powers showed more improvement in hyperactivity following medication. Theta power at Cz and T5 and theta/beta power ratios at C3, Cz, and T5 have significantly classified responders and nonresponders according to the logistic binary regression analysis. The results show that slow and fast oscillations may have predictive value for treatment response in ADHD. Future studies should seek for more sensitive biomarkers.

The altered promoter methylation of oxytocin receptor gene in autism.

Autism spectrum disorder (ASD) is one of the lifelong existing disorders. Abnormal methylation status of gene promoters of oxytonergic system has been implicated as among the etiologic factors of ASDs. We, therefore, investigated the methylation frequency of oxytocin receptor gene (OXTR) promoter from peripheral blood samples of children with autistic features. Our sample includes 66 children in total (22-94 months); 27 children with ASDs according to the DSM-IV-TR and the Childhood Autism Rating Scale (CARS) and 39 children who do not have any autistic like symptoms as the healthy control group. We investigated the DNA methylation status of OXTR promoter by methylation specific enzymatic digestion of genomic DNA and polymerase chain reaction. A significant relationship has been found between ASDs and healthy controls for the reduction of methylation frequency of the regions MT1 and MT3 of OXTR. We could not find any association in the methylation frequency of MT2 and MT4 regions of OXTR. Although our findings indicate high frequency of OXTR promoter hypomethylation in ASDs, there is need for independent replication of the results for a bigger sample set. We expect that future studies with the inclusion of larger, more homogeneous samples will attempt to disentangle the causes of ASDs.

Psychiatric disorders and their association with burn-related factors in children with burn injury.

BACKGROUND: The aim of this study was to assess psychiatric disorders and their association with burn-related factors in a population of Turkish children with burns. METHODS: Thirty-one children admitted to the Cerrahpasa Medical Faculty Burn Unit between January 2013 and August 2013 were first assessed by the plastic surgeon, and then those with psychological symptoms were referred to a child psychiatrist, and the records were analyzed retrospectively. RESULTS: The percentage of burned area to Total Body Surface Area (TBSA) ranged between 2-60% (mean, 17.3%). Nineteen patients (61.3%) had a psychiatric diagnosis, which included acute stress disorder (ASD) (n=15), depression (n=3), posttraumatic stress disorder (n=2, comorbid with depression), and delirium (n=1). The percentage of burned area to TBSA was associated with the presence of psychopathology and ASD. Further, psychopathology was associated with the number of burned major body regions. CONCLUSION: Pediatric burn patients are at risk of developing psychopathology. The children with a greater percentage of burned area to TBSA and more burned body regions have the greatest risk of psychopathology. Surgeons have an important role in patient referral for psychiatric interventions, so that psychiatric disorders can be prevented as early as possible.