Objectives: Attention-deficit/hyperactivity disorder (ADHD) is the most frequent neurobehavioural disorder in childhood. ADHD is associated with impaired academic performance, cognitive, and emotional deficits. Moreover, comorbid oppositional defiant disorder (ODD) is leading to more severe impairment in social performance. Social cognition involves recognition, encoding, and interpretation of emotions from faces. Basic facial expressions that include sadness, happiness, anger, disgust, fear, and surprise are the easiest emotions to recognize. We aimed to demonstrate facial expression recognition impairments that might occur more frequently in children with co-occurring ADHD/ODD than patients with ADHD only. Thus, children with the co-occurrence of ODD may suffer more severely from social and behavioural difficulties. Methods: Forty patients diagnosed with ADHD and/or co-occurring ADHD/ODD according to DSM-IV-TR criteria were compared with a parallel (by gender, age, and educational state) 11 healthy children as a control group in this study. Clear facial images of each emotion were used as well as two additional sets of photos include 50% blurred images and cropped eye images were added as distractors then all images represented with black and white tone for emotion recognition task via facial expression. Angry expressions presented as target expressions. DSM-IV-Based Screening and Rating Scale for Children and Adolescents with attention deficit and disruptive behaviour disorders, the Conners' Teachers Rating Scale/ Revised Long Form and the Conners' Parent Rating Scale/Revised Long Form were used to provide diagnostic objectivity. Results: Control group statistically performed better than ADHD group on recognition of emotional facial expressions. Results showed no statistically significant differences between the ADHD and ADHD/ODD group on recognition of emotional facial expressions. However, according to results of emotion recognition task via facial expressions, there were statistically significant differences between pure ADHD and comorbid ADHD+ODD groups in happy and neutral expressions. ADHD/ODD group tend to attribute more meaning to neutral facial expressions. Additionally there was statistically significant difference between control group and ADHD group according to recognition of angry expressions. There were statistically significant differences between the groups according to recognition of sad expressions in all clear, blurred, and eye photographs. Conclusions: Difficulties in recognizing emotional facial expressions were observed in children with ADHD. A statistically significant association was established between presence of ADHD and impaired recognition of facial emotion expressions independent from the scores of the disruptive behaviour rating scale. Comorbid ODD was not associated with recognition of emotional facial expressions including angry expressions. Recognition of angry expressions was not found as a predictor for disruptive behaviour disorders.
Divalproex sodium/valproic acid (VPA) is an antiepileptic drug which is frequently prescribed in neurology and psychiatric clinics. Common side effects of VPA are side effects of the digestive system, weight gain, tremor, sedation, hematologic side effects and hair loss. Valproate-induced hyperammonemia is almost seen in 50% of patients treated with VPA, some of which may develop encephalopathy. Valproate-induced hyperammonemic encephalopathy (NE) is a well-known subject and there are numerous publications in the current literature. Although there is substantial evidence for this side effect in patients with neurological disorders, the data in the psychiatric area are limited. When we look at publications, it seems that VHE is seen more often because it starts earlier in psychiatric patients, but we think that it is often missed. Here, we presented five cases in which we followed up and treated with VHE diagnosis in our clinic within one year and other reports published previously in a table.
OBJECTIVES: We aim to determine serum oxytocin, vasopressin levels and examine parent characteristics in children diagnosed with social anxiety disorder (SAD). METHODS: Thirty four children diagnosed with SAD and 34 mothers were compared with a healthy control group (21 control children and their mothers) in this case-control study. Assessment performed via State-Trait Anxiety Inventory (STAI), Symptom Checklist-90 (SCL-90), Parental Attitude Research Instrument (PARI), Beck Depression Inventory (BDI), Liebowitz Social Anxiety Scale (LSAS) and Social Anxiety Scale for Children-Revised (SASC-R). Serum samples collected for detection of oxytocin and vasopressin levels. RESULTS: The distribution range of vasopressin levels were found statistically higher in control group than SAD group (p = 0,002). Additionally results showed no statistically significant differences according to the mean levels of serum oxytocin and vasopressin between groups. The scores of STAI-C, SASC-R and democratic attitudes/egalitarianism subscales of PARI were found significantly higher in children with SAD. Similarly we reported that mean scores of SCL-90 scale, LSAS and SCL-90 subscales were higher in mothers of patients group. CONCLUSIONS: Although significantly lower distribution range of vasopressin levels was found in SAD patients, mean oxytocin and vasopressin levels were not associated with SAD etiology. Additionally psychopathologies particularly anxious behaviour in mothers may contribute SAD development in early period of childhood.
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