Streptococcal Serology in Children With Stuttering.

Introduction: Stuttering is a pronunciation disorder represented by repetitive perpetuations, duplications, or freezes of spoken words or syllables, as well as nervousness and cognitive shunning. Group A beta-hemolytic Streptococcus (GABHS) can lead to pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). Many case reports have proposed that stuttering is the result of a PANDAS, and that it can be identified together with Tourette syndrome, which shares many clinical characteristics with stuttering. Aim: The purpose of this study was to examine the association between streptococcal serology and stuttering in children. Method: The participants in this study are 26 children who stutter (CWS; mean age = 8.3 + 3.1 years) and 25 children who do not stutter (CWNS; mean age = 9.2 + 2.9 years). Participants were matched in terms of age (±3 months) and gender. We analyzed serum antistreptococcal antibodies [antistreptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and antistreptokinase] in both groups. Results: In the CWS group, ASO, anti-DNase B, and antistreptokinase were significantly higher than in the CWNS group (P < .0001, P < .0001, P < .0001). Conclusion: The higher serum antistreptococcal antibody amounts in CWS suggest that an increased autoimmune response against GAHBS may be the etiology of childhood stuttering. It has been suggested that CWS should be examined for autoimmune reactions, especially to GAHBS.

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T).

AIM: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. METHOD: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. RESULTS: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. CONCLUSION: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.

Prevalence of Childhood Affective disorders in Turkey: An epidemiological study.

AIM: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. METHODS: This study was conducted as a part of the "The Epidemiology of Childhood Psychopathology in Turkey" (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. RESULTS: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. CONCLUSION: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.

A nationwide study of social-emotional problems in young children in Turkey.

We aimed to assess the prevalence of social-emotional problems of Turkish children in early childhood and to understand their association with various bio-psycho-social risk factors, in order to establish guidelines in planning training programs for parents and professionals. Data from a representative sample of 1507 boys (54.3%) and 1268 girls (45.7%) aged 10-48 months were collected. The primary caregivers (mothers=91.4%) completed the Brief Infant-Toddler Social and Emotional Assessment (BITSEA), the Brief Symptom Inventory (BSI) and a form designed to gather information about various bio-psycho-social risk factors. Based on the caregiver terms, a total of 1626 children (60.1%) were reported to experience social-emotional problems. However, based on the BITSEA-problem clinical (1.5 SD) cut-off scores, 9.3% (9.1% of boys; 9.5% of girls) of all children were found to experience social-emotional problems. The variables, that showed a significant association with BITSEA-problem scores in pairwise comparisons, were entered in logistic regression analysis to determine the variables that predict the group with scores of above clinical cut-point. Higher total score of BSI of the primary caregiver, being separated from the mother for more than a month, and lower income of the family were found to be significant predictors of social-emotional problems. Caregiver reports highlight that maternal variables of mothers' psychological well-being, education and access to sources of support are closely related to the social-emotional wellbeing of their off-spring. The findings obtained from this study may be used for detection of prioritized domains in terms of management of preventive mental health services.

Fixed drug eruption against rupatadine fumarate.

Second generation of antihistaminics have better therapeutic efficacy and more predictable pharmacological responses at lower doses than older compounds. However, new compounds have a reduced adverse reaction profile; clinicians can also encounter some unexpected adverse effects of these newer compounds. We report the first case of fixed drug eruption of rupatadine fumarate, which was confirmed by oral provocation test.

Neuropsychiatric symptoms, quality of sleep and quality of life in patients diagnosed with nasal septal deviation.

OBJECTIVES: This study aims to evaluate the psychiatric symptoms, quality of sleep, quality of life and the predictive factors affecting quality of sleep in patients diagnosed with nasal septal deviation (NSD). PATIENTS AND METHODS: Forty male patients (mean age 22.3±1.4 years; range 21 to 26 years) who admitted to the otorhinolaryngology (ORL) clinic of the Agri Military Hospital and diagnosed with NSD as a result of a through ORL examination between February 2009 and April 2009 and 36 healthy volunteer (mean age 21.7±1.0 years; range 21 to 25 years) controls, were included in this study. Pre- and postoperative evaluations were performed using the Quality of Life Scale (Short Form-36/SF-36), the Pittsburgh Sleep Quality Index (PSQI) and the Symptom Check List Revised (SCL-90-R). RESULTS: All patients and controls completed pre- and postoperative evaluations. No complications occurred. There was a statistically significant difference between the groups in the quality of sleep measures, in the SCL-90-R subscales of somatization, obsession, interpersonal sensitivity, depression, anxiety, phobic anxiety, hostility, paranoid thought, and psychoticism, additional scales and in physical health dimension of SF-36 Quality of Life Scale. CONCLUSION: Psychiatric symptoms are more common in patients with nasal septal deviation when compared to healthy controls. The impairments in nasal breathing in patients with NSD may cause a decline in the physical dimension of quality of life and a marked impairment in sleep quality.

Is there a relationship between attention deficit/hyperactivity disorder and manic symptoms among children with mental retardation of unknown etiology?

Mental retardation (MR) is common and lifelong. In children and adolescents with MR, the rate of attention deficit/hyperactivity disorder (ADHD) and bipolar disorder is higher than that in the general population. However, there are no previous sufficient data that exist in establishing a relationship between ADHD and manic symptoms. The aim of the present study was to examine the relationship between manic symptoms and ADHD as well as oppositional-defiant disorder (ODD) and conduct disorder (CD) in children with MR of unknown etiology (MR-UE). A total of 167 children with MR-UE attending a rehabilitation and training school in Erzurum, Turkey, were included in the study. We administered the Child Disruptive Behavior Screening and Rating Scale related to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the Young Mania Rating Scale-Parent Version (P-YMRS) to parents. The age range of children and adolescents with MR-UE was between 5 and 21 years, with a mean age of 11.13 ± 3.75 years. In total, 5.8% of children and adolescents with MR-UE showed a border intelligence quotient (IQ), with 58.4% having a mild IQ, 29.2% having a moderate IQ, and 6.6% having severe IQ. According to the Child Disruptive Behavior Screening and Rating Scale related to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 40.1% of children and adolescents with MR-UE had inattention, 19.9% had hyperactivity, 28.7% had ODD, and 13.3% had CD. A total of 7.2% of the children and adolescents with MR-UE had probable mania, and 1.8% had mania according to Young Mania Rating Scale-Parent Version. A positive correlation existed between the mean scores of Young Mania Rating Scale-Parent Version and the mean scores of inattention, hyperactivity, ODD, and CD (P = .000). Hyperactivity and ODD were predictors of being manic/probably manic. Diagnosing psychiatric disorders in children and adolescents with MR-UE is difficult but essential for better functioning. Manic symptoms and disruptive behaviors as well as ADHD symptoms were prevalent among children and adolescents with MR-UE and hyperactivity, and oppositional-defiant symptoms were predictors of manic symptoms in these patients.

Prevalence of orthorexia among medical students in Erzurum, Turkey.

Orthorexia is a new term about eating behavior disorder and consists of pathologic obsession for biologically pure foods, free of herbicides, pesticides, and other artificial substances. It is not an independent diagnostic category, but it has some similarities with other eating disorders. This study was conducted to examine the orthorexia among 878 medical students. Of 878 students, 464 (52.8%) were male and 359 (40.9%) were female. The mean age, height, weight, and body mass index were 21.3 +/- 2.1 years, 171.0 +/- 8.5 cm, 65.6 +/- 12.3 kg, 22.4 +/- 2.99, respectively. The rates of the ORTO-11 scores between 0 and 15 was 1.9%; between 16 and 30, 57.5%; and between 31 and higher, 21.1%. There were 17 students with a score of 0 to 15. The mean score for the ORTO-11 test was 27. There were statistically significant differences between age, sex, and smoking habit of the students. In the male students, there was a statistically significantly higher tendency for orthorexia (P = .001), and there was a statistically significant difference between the age groups for tendency for orthorexia (P = .025). In logistic regression analysis, age, sex, Eating Attitude Test-40 (EAT-40), and height affected the ORTO-11 scores.

Munchausen's Syndrome.

Although the differential diagnosis of hemoptysis is extensive, consideration of a factitious cause is rarely contemplated. Factitious hemoptysis is uncommon in children. We report a dramatic case of factitious hemoptysis in a 12-year-old girl. The features of Munchausen's syndrome are also reviewed.

The impact of adenotonsillectomy on attention-deficit hyperactivity and disruptive behavioral symptoms.

OBJECTIVE: The objective of this study is to investigate the impact of adenotonsillectomy on the neuropsychology of children using the Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-Scale). MATERIALS AND METHODS: Thirty children admitted to an otolaryngology clinic for treatment of sleep-disordered breathing or recurrent tonsillitis and who underwent adenotonsillectomy were included the study. All parents completed the T-DSM-IV-Scale before surgery and after 3 months of surgery. The T-DSM-IV-Scale consists of four sub-scales: inattention, hyperactivity, oppositional-defiant disorders, and conduct disorders. SPSS 15 por Windows was used to evaluate the datas. RESULTS: Of the 30 children, 17 (56.7%) were boys and13 (43.3 %) were girls. The age range was between four and fourteen years, and the mean age was 6.6±2.6 years. The most common complaints of the children in their first admission to the otorhinolaryngology clinic were snoring (n = 25, or 83.3%), breathing from the mouth (n = 25, or 83.3%), stuffiness (n = 16, or 53.3%), post-nasal drip (n = 15, or 50%), halitosis (n = 14, or 46.7%), and odontoprisis (n = 12, or 40%). We found a statistically significant difference between the mean scores of the inattention, hyperactivity, oppositional-defiant disorders, and conduct disorder sub-scales of T-DSM-IV-Scale before and three months post-tonsillectomy (P<0.05). CONCLUSION: In SDB inattention, hyperactivity and other neurobehavioral problems can be seen. This may cause a delay in accurate diagnosis and treatment. Children having neurobehavioral problems such as inattention, hyperactivity, oppositional-defiant disorders, and conduct disorder symptoms can be assessed for sleep-disordered breathing. After adenotonsillectomy, these neurobehavioral problems can improve without psychiatric medication; thus, adenotonsillectomy may have a positive impact on the neurobehavioral problems of children with sleep-disordered breathing.