Mehmet Fatih Ceylan

Oxidative stress in children and adolescents with anxiety disorders

BACKGROUND Anxiety disorders are common in children and adolescents, and they can significantly impair quality of life. Genetic, neurobiological, neurochemical, and psychological factors are believed to play a role in the etiopathogenesis of anxiety disorders. Recent evidence suggests that the pathophysiology of anxiety disorders may be associated with oxidative stress. In this study, we investigated whether there are associations between children with anxiety disorders and total oxidant/antioxidant status. METHODS The experimental group consisted of 40 patients (children and adolescents) with anxiety disorders. An age- and gender-matched control group composed of 35 healthy subjects was also assessed. Venous blood samples were collected and total antioxidative status (TAS), total oxidative status (TOS), and the oxidative stress index (OSI) were determined. RESULTS Both the TOS and the OSI of the experimental group were significantly higher than those of the control group. There were no significant differences in TAS between the experimental and control groups. LIMITATIONS The main limitation of our study was the small sample size. CONCLUSIONS This study suggests that oxidative balance is impaired in children with anxiety disorders. Oxidative stress may play a role in the etiopathogenesis of anxiety disorders, and TOS may be a useful diagnostic tool in this context.

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 celluler 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.

Serum nerve growth factor (NGF) levels in children with attention deficit/hyperactivity disorder (ADHD)

Attention deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioral disorder of childhood. The etiopathogeny of ADHD has not been totally defined. Recent reports have suggested a pathophysiological role of neurotrophins in ADHD. In this study, we evaluated serum levels of nerve growth factor (NGF) in patients with ADHD. The sample population consisted of 44 child or adolescent patients diagnosed with ADHD according to DSM-IV criteria; 36 healthy subjects were included in the study as controls. Venous blood samples were collected, and NGF levels were measured. The mean serum NGF levels of the ADHD patients were significantly higher than those of the controls. Age and gender of the patients were not correlated with serum NGF levels. There were no significant differences in NGF levels among the combined and predominantly inattentive subtypes of ADHD. Our study suggests that there are higher levels of serum NGF in drug naive ADHD patients, and that increased levels of NGF might have an important role in the pathophysiology of ADHD.

Lipid peroxidation markers in children with anxiety disorders and their diagnostic implications

Abstract Objective Numerous factors, including genetic, neurobiological, neurochemical, and psychological factors, are thought to be involved in the development of anxiety disorders. The latest findings show that the pathophysiology of anxiety disorders might be associated with oxidative stress and lipid peroxidation; however, no studies have so far investigated lipid peroxidation markers in children with anxiety disorders. Serum levels of lipid hydroperoxide (LOOH) are a reliable marker of lipid peroxidation. Paraoxonase and arylesterase are two enzymes that protect against such peroxidation, and might also be diagnostic markers. In this study, we investigated whether there are associations between anxiety disorders and lipid peroxidation markers in children, and assessed the diagnostic performance of these markers. Methods The study group consisted of 37 patients (children and adolescents) with anxiety disorders. A control group, matched for age and gender, was composed of 36 healthy subjects. Venous blood samples were collected, and LOOH levels and paraoxonase and arylesterase activity were measured. Results LOOH levels were significantly higher in the anxiety disorders group than in the control group. There were no significant differences in paraoxonase or arylesterase activities between the patient and the control groups. Discussion Lipid peroxidation or oxidative damage might play a role in the aetiopathogenesis of anxiety disorders. LOOH may be a potential biological marker for anxiety disorders in children.

Increased levels of serum neopterin in attention deficit/hyperactivity disorder (ADHD).

Attention deficit/hyperactivity disorder (ADHD) is the most frequently occurring neuropsychiatric disorder in childhood with an etiology that is not fully understood. A number of reviews that have addressed the neurobiology of ADHD have focused on imaging and genetics. Relatively little attention has been given to factors/mechanisms involved in the brain dysfunction. We suggest that changes in cellular immunity may be involved. Neopterin is a good indicator of cellular immunity, and we evaluated serum levels of neopterin in patients with ADHD. The study group consisted of 49 patients with ADHD. An age- and gender-matched control group was composed of 31 healthy subjects. Venous blood samples were collected, and the levels of neopterin were measured. The levels of neopterin were significantly higher in ADHD than in the comparison subjects. Cellular immunity may have a role in the etiopathogenesis of ADHD.

High monocyte level and low lymphocyte to monocyte ratio in autism spectrum disorders

Objective: This study aims to investigate the level of peripheral blood mononuclear cells and their ratios which may point to the immunological mechanisms involved in the etiopathogenesis of ASD. Method: The complete blood count parameters of the 45 ASD cases were compared with those of healthy controls.Childhood Autism Rating Scale (CARS) was performed to measure the disease severity. Results: The monocytes of ASD group were significantly higher; and the lymphocyte-to-monocyte ratio (LMR) was lower than the controls’. LMR and neutrophil-to-lymphocyte ratio were found to be predictors of ASD. The decrease in LMR (B: −0.744; P=0.035; CI: −1.431 to −0.056) and the increase in age (B: 0.432; P=0.045; CI: 0.011–0.853) were related to high CARS scores in linear regression analyses. Conclusions: The results of this study support the role of altered immune cell counts and ratios in ASD. A high monocyte level and low LMR may have diagnostic values in autism.

Which psychiatric symptoms of the mother are related with preschool child’s emotional and behavioral problems?

Which psychiatric symptoms of the mother are related with preschool child’s emotional and behavioral problems? Objective: In this study, it is aimed to explore mother’s which psychiatric symptoms are related to child’s internalizing and externalizing problems. Method: The study group consisted of the mothers of 4-6 years old children, who were referred to Yildirim Beyazit University, Yenimahalle Training and Research Hospital, Child and Adolescent Outpatient Clinic. The control group consisted of 4-6 years old children who have never referred to a child and adolescent psychiatry clinic and their mothers. The mothers filled in the Child Behavior Check List 4-18 (CBCL/4-18), and Symptom Check List-90-R (SCL-90-R). The data were compared with the control group. Results: The study sample consisted of 61 children in the case group, age-matched 55 control children and their mothers. The most common referral complaint was delayed speech (34.4%). There were clinically significant internalizing disorders in 29 (49.2%) children from the study group and 5 (9.4%) from the control group and significant externalizing disorders in 18 (30.5%) children from the study group and 3 (5.7%) from the control group. The correlation analysis revealed that all emotional and behavioral problems of the children were significantly related to the psychiatric symptoms of the mothers. Psychiatric symptom scores of the mothers of children with internalizing and externalizing problems were found significantly higher than the scores of the mothers of children without problems. Conclusion: Mother’s psychiatric symptoms are seen to be related to internalizing and externalizing problems of the child, independent of Psychiatric diagnosis. The fact that any psychiatric symptom of the mother would have an emotional or behavioral reciprocation on the child has to be taken into account by the clinician.

Erratum to: Effectiveness, Adverse Effects and Drug Compliance of Long-Acting Injectable Risperidone in Children and Adolescents

Although the use of oral risperidone in children and adolescents has been well studied, there is little information on the intramuscular use of long-acting injectable risperidone (LAIR). The aims of this study were to investigate the effectiveness and adverse effects of LAIR in children and adolescents with conduct disorder, bipolar disorder, and schizophrenia. In total, 42 patients (age range 12–17 years) who were non-adherent to oral antipsychotic drugs, received 25 mg of LAIR intramuscularly every 2 weeks. The drug was administered at least four times and up to 66 times (median drug use: 9.50 times). The effectiveness and adverse effects of the treatment were examined. There was an improvement in 13 (92.8%) of the 14 patients diagnosed with bipolar disorder, in 25 (78.1%) of 32 patients diagnosed with conduct disorder and in one (50%) of two patients diagnosed with schizophrenia. Six patients had comorbid conduct disorder and bipolar disorder. Totally, 81% of the patients improved with LAIR. Weight-gain, daytime somnolence, muscle stiffness and spasms, impaired concentration, and fatigue were the most common side effects through the whole sample. Menstrual problems were common in girls. In the study, 57.1% of the patients continued to receive their injections regularly until the end of the treatment, under physician control. A total of 16.7% discontinued the treatment due to non-adherence. The LAIR treatment was terminated in 26.2% of the patients, due to weight-gain, dystonia, and galactorrhea. In children and adolescents with conduct disorder, bipolar disorder and schizophrenia who show noncompliance with oral drugs, LAIR may improve treatment compliance. LAIR is a reliable treatment in terms of its effectiveness. Weight-gain, dystonia, and galactorrhea were the adverse effects that were responsible for LAIR treatment cessation.