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Antidepressant-like effects of the xanthine oxidase enzyme inhibitor allopurinol in rats. A comparison with fluoxetine

Allopurinol is a xanthine oxidase enzyme inhibitor that is widely used for the treatment of hyperuricemia and gout. The activity of tryptophan 2,3-dioxygenase, which metabolizes tryptophan (TRP), is decreased by xanthine oxidase inhibitors, causing TRP levels in the body to be increased. Increases in TRP levels in the brain might have antidepressant effects. The purpose of this study is to evaluate the antidepressant effects of allopurinol compared to those of fluoxetine, which is a proven antidepressant. Thirty-two Wistar albino male rats were divided into four groups (control, 10mg/kg fluoxetine, 50mg/kg allopurinol, 50mg/kg allopurinol+10 mg/kg fluoxetine; n=8 per group), and forced swimming tests were performed before and after 14days of drug administration. Serotonin, 5-hydroxyindolacetic acid and uric acid levels were measured in blood samples after the final treatment. When allopurinol and fluoxetine were administered separately, a decrease in the duration of immobility and an increased duration of swimming were observed in the forced swimming test. The results showed similar antidepressant efficacies between allopurinol and fluoxetine. However, we found no statistically significant difference in the antidepressant effect of the combined therapy versus single drug therapy.

Effects of adenoidectomy/adenotonsillectomy on ADHD symptoms and behavioral problems in children

OBJECTIVES In children, the most common reason of upper airway obstruction (UAO) is adenotonsillar hypertrophy. In literature, the adverse effects of UAO and obstructive sleep apnea syndrome on behavior and attention in children have been reported in several articles. However, the methods used for the evaluation of behavioral disorders have not been standardized in those studies. The aim of this study was to investigate the behavioral and attention characteristics of children before and after adenoidectomy/adenotonsillectomy using an internationally valid method. METHODS A total of 41 patients, between 6 and 11 years of age and having a medical history of UAO for at least one year for which adenotonsillectomy procedure was indicated, were enrolled in the study. The patients were evaluated for signs of attention/behavioral disorders by a child-adolescent psychiatrist and Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children: Present and Lifetime Version (K-SADS-PL) and The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), before and at the 6th month following the operation. RESULTS In the preoperative period, a psychiatric disorder was identified by K-SADS-PL in 41.4% (n =1 7) of patients. Of these, 11 patients had attention deficit hyperactivity disorder (ADHD), 6 had enuresis nocturna, and 2 had separation anxiety disorder. Pre- and postoperative mean scores in T-DSM-IV-S parent scale were 31.3 ± 8.5 and 20.2 ± 10.3, respectively, and this difference was statistically significant (p < 0.001). CONCLUSION The relationship of UAO and attention/behavioral disorders should be taken into consideration by child-adolescent psychiatrists together with ENT specialists and a multidisciplinary approach is important for the treatment team.

Investigation of alexithymia, depression and childhood ADHD symptom levels in parents of children with ADHD

Objective: The aim of this study was to compare the severity of alexithymia, depression and childhood attention deficit hyperactivity disorder (ADHD) symptoms in the biological parents of children with ADHD and to investigate the relationship between scale scores. Methods: Sixty-four children diagnosed with ADHD according to the DSM-5 criterion based on clinical interview and Schedule of Affective Disorders and Schizophrenia Interview for School Children and their parents who admitted to Adnan Menderes University Department of Child and Adolescent Mental Health Outpatient Clinic and 64 children who did not have a psychiatric diagnosis and their parents admitted to Pediatrics Outpatient Clinic between January 2015 and December 2015 were included. Parents filled out socio-demographic data form, DSM-IV-Based Child and Adolescent Disruptive Behavior Disorders Screening and Rating Scale-parent form (T-DSM-IV-S), Wender-Utah Rating Scale, Toronto Alexithymia Scale (TAS-20), and Beck De-pression Inventory. Results: It was found that childhood ADHD symptom levels and present depressive symptom levels in parents of children with ADHD were higher than the control group. There were no significant differences between the two groups in terms of alexithymia levels. In addition, there was a positive moderate correlation be-tween total score, hyperactivity subscale, opposition defiant disorder subscale of T-DSM-IV-S and difficulty de-scribing feelings, total and difficulty identifying feelings subscale scores of TAS-20 whereas there was no significant relationship between total score and subscale scores of T-DSM-IV-S and TAS-20 externally-oriented thinking. Discussion: Results showed that parents of children with ADHD whose hyperactivity and opposing defiant symp-tom severity are high, are more likely to experience difficulty in describing and identifying feelings. Additionally, due to the high severity of depressive symptoms in parents of children with ADHD, we believe that investigation the presence of mental disorders in parents and the implementation of appropriate parental intervention programs will contribute positively to the success of follow-up and treatment of children with ADHD

The probable role of adrenomedullin and nitric oxide in childhood attention deficit hyperactivity disorder

Abstract Background: The role of adrenomedullin hormone, which has been shown to be associated with many psychiatric disorders, in the etiology of ADHD and its relation to disease is not yet known. Aim: In this study, it was aimed to compare plasma adrenomedullin and nitric oxide (NO) levels of newly diagnosed, treatment-naive patients with ADHD with healthy children. Methods: A total of 45 children with ADHD and 45 healthy children were included. The Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS), a semi-structured interview, was applied to all cases by child and adolescent psychiatrist. Age and gender matched participants who admitted to the hospital for any other reasons without any psychiatric diagnosis according to K-SADS were selected as a control group. Sociodemographic data form and The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale-parental form were applied to the all groups. NO and adrenomedullin levels were analysed by ELISA method with specific commercial kits. Results: There was no statistically significant difference in NO and adrenomedullin levels, neither between the groups nor ADHD subtypes. A positive correlation between adrenomedullin and NO levels was found in both the case (r = 0.659) and the control groups (r = 0.494). Conclusions: Besides being the first study to evaluate adrenomedullin levels to elucidate the etiology of childhood ADHD as well as NO, significant differences was not found between the case and the control groups in terms of NO and adrenomedullin levels.

A Retrospective Study of Long Acting Risperidone Use to Support Treatment Adherence in Youth with Conduct Disorder

Objective Risperidone has been widely used to control aggression and conduct disorder (CD) in youth; however, treatment compliance is a major problem in CD. Our aim is to evaluate the effectiveness and tolerability of long-acting risperidone (LAR) in treating nonadherent cases. Methods The medical records of children and adolescents who had CD and were nonadherent to conventional drugs and psychosocial interventions (and therefore taking LAR) were reviewed. Informed consent on offlabel use of LAR was obtained from the parents. Clinical Global Impression (CGI) Severity (CGI-S) and CGI-Improvement scales were used and baseline and end points were compared. Results The study comprised 14 children and adolescents (5 girls, 9 boys). All had comorbid disorders: substance use disorder (n=8), attention deficit hyperactivity disorder (n=6), and major depression (n=2). Mean duration of LAR use was 3.1 months (1.5–8 months). We observed significant improvements in the baseline and endpoint CGI-S scores for CD in all but one patient (Z=−3.198; p<0.001). Only mild adverse effects were observed: weight gain (n=2), sedation (n=1), leg cramps (n=1), and increased appetite with no weight gain (n=1). Conclusion LAR is effective and tolerable for patients with CD who can’t be medicated with oral preparations due to non-adherence to treatment. Even short-term LAR use is effective to get compliance. As CD predicts numerous problems in adulthood, appropriate treatment is crucial. To our knowledge, this is the first study on LAR use in youth with CD. The use of LAR deserves careful consideration and further controlled studies are needed to confirm our findings.

Investigation of the relationship between monoamine oxidase A enzyme gene polymorphism and the development of conduct disorder in sexually abused cases

Objective: Our aim in this study is to investigate whether there is a relationship between monoamine oxidase A (MAO-A) gene polymorphisms in sexually abused cases with or without conduct disorder (CD). Methods: Cases were recruited from sexually abused girls (n=52) aged between 13 and 18 who admitted to child psychiatry outpatient clinic. Psychiatric diagnoses were performed by using Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version according to DSM-IV by child psychiatrist. Blood samples were taken from participants and single nucleotide polymorphisms (SNPs) (rs1799835, rs1137070 and rs2072743) were analyzed to detect MAO-A gene polymorphism at Department of Medical Genetics. Results: There was no statistically significant difference between groups with or without CD in terms of rs1799835, rs1137070 and rs2072743 SNPs. Besides, no difference was detected between alleles, genotype frequencies of SNPs and three determined haplotypes in groups with (n=10) or without (n=42) CD in the whole sample. Conclusion: MAO-A gene polymorphism role in the development of CD did not differ between the groups with or without CD in sexually abused cases. It is known that there are a number of factors that play a role of development of CD rather than a diversification of a single gene.

NÖROGELİŞİMSEL PSİKİYATRİK BOZUKLUKLARIN DOĞUM MEVSİMİ İLE İLİŞKİSİNİN İNCELENMESİ

Amac: Norogelisimsel psikiyatrik hastaliklarin etiyolojik nedenleri arasinda dogum mevsiminin yer alabilecegi ve D vitamini eksikligi ve enfeksiyonlarin patogenezde rol oynadigi ileri surulmektedir. Mevcut verilerde tutarsizliklar olmasina ragmen, ulkemizde dogum mevsimi iliskisini inceleyen calismalar kisitlidir. Bu calismada, dikkat eksikligi hiperaktivite bozuklugu (DEHB), tik bozuklugu, obsesif kompulsif bozukluk (OKB) ve otizm spektrum bozuklugunu (OSB) iceren cocukluk cagi norogelisimsel bozukluklar ile dogum mevsimi arasindaki iliskinin arastirilmasi amaclanmistir. Gerec ve yontem: Universite hastanesi cocuk ve ergen psikiyatrisi poliklinigine 01 Ocak 2014- 1 Ocak 2015 tarihleri arasinda ilk kez basvuran olgularin dosyalari degerlendirildi. Dogum mevsimleri, aldiklari psikiyatrik tanilar, dogum sekli ve zamani geriye donuk olarak incelendi. Norogelisimsel psikiyatrik bozukluk grubuna OKB, OSB, tik bozuklugu tanisi alan olgular dahil edildi. Kontrol grubuna norogelisimsel bozukluk sayilmayan anksiyete bozukluklari, depresyon, enurezis, enkoprezis ve uyum bozuklugu tanisi olan olgular alindi. Dogum mevsimi acisindan gruplar karsilastirildi. Bulgular: Toplam 616 olgunun %29,2’si (n=180) kiz, %70,8’i erkekti. Tum olgularin %89,1’inin zamaninda dogdugu belirlendi. DEHB tanisi alan olgularin en fazla yazin (%30,3), OSB tanisi alanlarin kisin (%32,9), tik bozuklugu olanlarin ilkbahar (%29) ve OKB olgularinin kis (%36,8) mevsiminde dogmus olduklari belirlendi. Ancak tanilar ve mevsimler arasinda istatistiksel olarak anlamli fark yoktu (p>0.05). Norogelisimsel bozukluklar ile kontrol grubu arasinda da dogum mevsimleri arasinda anlamli bir iliski bulunamadi (p>0.05). Sonuc: Calismamizda norogelisimsel psikiyatrik hastalik tanilari ile dogum mevsimi arasinda iliskisi saptanmamistir. Dogum mevsimselligini kiyaslamak icin daha buyuk hasta gruplarini iceren ve etkili olabilecek prenatal ve perinatal riskler, D vitamini seviyesi, anne beslenme durumu gibi diger karistirici faktorlerin incelendigi daha kapsamli arastirmalara ihtiyac vardir.

Evaluation of child and adolescent forensic cases within one year in Aydın city, in Turkey -

Objective: The aim of this study was to investigate the features related with the referral reasons, sociodemographic features, diagnoses of mental disorders, treatment processes and criminal profiles of all the child and adolescent forensic cases who were referred to forensic medicine and child and adolescent psychiatry (CAP) clinics by judicial authorities to get forensic report in Aydin city as well as was to inference the general profile of this city for this age bracket. Methods: All the data from child and adolescent forensic cases referred to forensic medicine and CAP clinics throughout the year in order to be examined for a forensic report have been retrospectively analyzed. Results: One hundred and fifty of total 272 cases were female (42.3%) and 157 were male (57.7%) and the average age was determined as 13.46±2.3. All the cases were analyzed according to the crime types or referral reasons; 147 of them due to drifting into crime while 85 cases were referred due to sexual abuse. In the cases referred to CAP clinics, sexual abuse was the most populated reason with the number of 85 (31.6%). The most common referral reasons of the cases drifting into crime were theft and malicious injury with the numbers of 77 (52.4%) and 26 (17.7%) respectively among 147 cases. The most common mental disorder was the post-traumatic stress disorder among sexual abuse cases. Fifty percent point six of those cases have been initiated treatment however only 37.2% of the cases were detected as maintaining the treatment. Conclusion: The first step in the fight against child and adolescent forensic cases being sexually abused and drifted into crime is consciousness of the individual and familial characteristics of those children and the differences of these among other regions. New efforts which will be carried out in collaboration with health care institutions and other related departments are required in order to maintain psychiatric treatment and follow-up during the process of bringing those children to healthy individuals in society.