Conduct Disorder In Adolescents Research Articles

Neurotoxic effects of triclosan in adolescent mice: Pyruvate kinase M2 dimer regulated Signal transducer and activator of transcription 3 phosphorylation mediated microglia activation and neuroinflammation

Triclosan (TCS), a commonly used antibacterial agent, is associated with various harmful effects on mammalian neurodevelopment, particularly when exposed prenatally. This study investigated the impact of long-term exposure to TCS on the prefrontal cortex development in adolescent mice. We evaluated the motor ability, motor coordination, and anxiety behavior of mice using open field tests (OFT) and elevated cross maze tests (EPM). An increase in movement distance, number of passes through the central area, and open arm retention time was observed in mice treated with TCS. Hematoxylin eosin staining and Nissl staining also showed significant adverse reactions in the brain tissue of TCS-exposed group. TCS induced microglia activation and increased inflammatory factors expression in the prefrontal cortex. TCS also increased the expression of pyruvate kinase M2 (PKM2), thereby elevating the levels of PKM2 dimer, which entered the nucleus. Treatment with TEPP46 (PKM2 dimer nuclear translocation inhibitor) blocked the expression of inflammatory factors induced by TCS. TCS induced the phosphorylation of nuclear signal transducer and activator of transcription 3 (STAT3) in vivo and in vitro, upregulating the levels of inflammatory cytokines. The results also demonstrated the binding of PKM2 to STAT3, which promoted STAT3 phosphorylation at the Tyr705 site, thereby regulating the expression of inflammatory factors. These findings highlight the role of PKM2-regulated STAT3 phosphorylation in TCS-induced behavioral disorders in adolescents and propose a reliable treatment target for TCS.

Examination of quality of life and psychiatric symptoms in childhood Graves' disease.

The aim of our study is to examine the emotional, behavioral problems, and psychiatric symptoms of children diagnosed with Graves' disease (GD), to assess their quality of life, and to compare with control group. The research was planned as a cross-sectional study and included 16 patients with GD (13 female and three male) and 29 healthy children for control group (19 female and 10 male). Sociodemographic form, Pediatric Quality of Life Inventory, Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), Strengths and Difficulties Questionnaire (SDQ), Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S), and Affective Reactivity Index scale were applied to the children and their families. Eighty one percent of GD group (GG) (n=13, mean age 15.1±2.2) and 66 % of control group (CG) (n=19, 14.6±2.2) were girls. No significant difference was found between GG and CG in terms of quality of life, anxiety, and depression scores. GG had higher scores in affective reactivity index, SDQ-P total score, and T-DSM-IV-S total scores (p values 0.039; 0.009; 0.023, respectively). While no significant difference was detected in the T-DSM-IV-S-inattention and hyperactivity scores, significantly higher scores were detected in oppositional defiance and conduct disorder scores (pvalues 0.172; 0.294; 0.019; 0.027, respectively). In children with GD, irritability, oppositional defiant, and conduct disorder symptoms have been detected. Children with these mental health symptoms experience behavioral and emotional difficulties in their daily lives. It is important to follow up children with GD for possible comorbid psychiatric disorders.

Comorbidity of dual pathology and behavioral disorders in adolescence

Comorbidity of dual pathology and behavioral disorders in adolescence

Prepoznavanje problema u ponašanju kod dece predškolskog uzrasta iz ugla vaspitača

Introduction. The research problem is formulated in the form of research questions: can educators recognize problems in the behavior of preschool children, and are they sufficiently competent to undertake planning actions related to the prevention and suppression of externalized and internalized problems in the behavior of preschool children? Objectives. The goal of the research was to determine whether educators can recognize problems in the behavior of preschool children and take measures to overcome these problems. Methods. The research was conducted in January 2023 on a sample of 124 educators from the areas of Bačka and Banat. The teacher's assessment of the recognition of problems in the behavior of preschool children was examined with the Scaler - RBDCPA-EP constructed for the purposes of this research (a = .822). It consists of three subtests: 1) recognition of behavioral problems in preschool children; 2) informing parents and professional associates about observed problems in the behavior of preschool-age children; and 3) taking action to narrow down behavioral problems. Results. The results of the research show that problems in the behavior of preschool-age children can be predictive factors that show behavioral disorders in adolescence. Conclusion. It is concluded that, besides the primary role of educators, it is necessary to undertake a series of planned actions so that preschool institutions provide optimal support for children with behavioral problems and their families.

Umbrella Review of the Global Prevalence of Conduct Disorder in Children and Adolescents.

With the ever-increasing prevalence of mental health issues worldwide, a robust synthesis of existing epidemiological data on the prevalence of Conduct disorder (CD) in children and adolescents is needed to strengthen the knowledge base. This quantitative umbrella review aims to provide a robust synthesis of evidence on the prevalence of CD children and adolescents from meta-analytic systematic reviews. We searched PubMed, Web of Science, PsychINFO, and Scopus to identify relevant articles. The study protocol has been registered with PROSPERO (CRD42023447620). The methodological quality of the studies was evaluated by using a Measurement Tool to Assess Systematic Reviews (AMSTAR). Invariance variance weighted random-effect meta-analysis was performed to pool prevalence estimates from the included articles. Seven meta-analyses, encompassing 138 primary studies and slightly over 48 million CD cases were included in this umbrella review. The quantitative analysis of these studies found a pooled prevalence of CD 3.0% (95%CI 2.0-5%) in children and adolescents, based on random effect meta-analyses. In a stratified analysis, the prevalence estimate of CD was 2.6 times higher in boys compared to girls. Evidence from our quantitative umbrella review showed that the prevalence of CD is relatively high in children and adolescents with boys 2.6 times more likely to experience the disorders when compared to girls. Our findings underlie that attention should be given to preventing, identifying, and treating CD in children and adolescents.

Behavioral health and legal system involvement among transition-age youth in foster care: a longitudinal analysis of youth in California

ABSTRACT Research shows that young people in foster care experience high levels of behavioral health problems that may lead to life obstacles, including legal system involvement (LSI) during the transition to adulthood. However, few longitudinal studies have examined LSI among foster youth from a behavioral health perspective during the transition to adulthood. To understand adolescent behavioral health conditions associated with adult LSI, we used longitudinal survey data of young people in foster care (n = 540) to compare the prevalence of different behavioral health disorders (age 17) between youth who later reported LSI and those who did not (ages 19–21). We also examined associations between adolescent behavioral health disorders and adult LSI, accounting for other covariates. We find that compared to those who did not, youth who reported later LSI in early adulthood had significantly higher rates of four behavioral health disorders at age 17: alcohol use, drug use, conduct disorder, and oppositional defiant disorder. Regression results showed drug use disorder at age 17 to be a particularly strong predictor of later LSI after accounting for other covariates. Many individuals experience various risk factors for LSI, including behavioral health needs. We discuss implications for practice, policy, and research in the child welfare context.

Comparison of Toxoplasma Gondii IgG Antibody Levels in Children and Adolescents with OCD and ADHD with Healthy Controls: A Cross-Sectional Study

Objective: This study was aimed to examine if there is a relation between IgG levels of T. gondi and OCD or ADHD symptoms. Method: Of 42 children with OCD, 31 with ADHD and 28 healthy control were included. Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Moudsley Obession-Compulsion Inventory (MOCI), Child Depression Inventory (CDI), and Screen of Children for anxiety related disorders (SCARED), The Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) and The Conners’ Parent Rating Scale-48 (CPRS-48) were applied. Toxo gondii IgG values ≥3.0 IU/mL were considered to be reactive. SPSS 17.0 was used for analysis. p<.05 was accepted as significant. Results: The mean age was 12.1 years. Of 56.4% (n = 57) were boys. Depression and anxiety symptoms were similar in OCD and controls, but were significantly lower in ADHD. All children with OCD had negative (100%) for IgG levels of T. gondii, whereas 78.6% of controls and 90.3% of children with ADHD had negative for IgG levels of T. gondii. Toxo IgG seropositivity of the control was significantly higher than that of the OCD. Toxo IgG levels were positively correlated with Turgay’s ADHD-Conduct disorder subscale scores in ADHD group (r=.650, p<.001). In the OCD and the control groups, there was no correlation between IgG levels and CDI, SCARED, ADHD scales (for all variables, p>.05). Conclusion: To conclude, this study did not verify a relationship between the seropositivity of T. gondii with OCD and ADHD. Further studies are needed longitudinal follow-up and extended series of patients.

Anxiety and Somatic Symptoms in Children and Adolescents Diagnosed with Attention-Deficit Hyperactivity Disorder.

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition typified by inattention, hyperactivity, and impulsivity. Comorbid psychiatric disorders are common among children and adolescents with ADHD. In this study, it was aimed to examine anxiety and somatic symptoms in children and adolescents with ADHD and the effect of methylphenidate treatment on these symptoms. Three groups were formed, consisting of 37 children and adolescents diagnosed with ADHD and received methylphenidate treatment, 37 newly diagnosed, treatment-naive children and adolescents with ADHD diagnosis, and 37 children and adolescents without the diagnosis of ADHD. The symptoms of ADHD in children were examined by using the DSM-IV-based child and adolescent behavior disorders screening and rating scale, the symptoms of anxiety were examined by using the screen for child anxiety-related disorders (SCARED), and somatic symptoms were examined by using the DSM-5 level 2 somatic symptom scale. In the newly diagnosed, treatment-naive with ADHD group, anxiety and somatic symptoms were found to be significantly higher compared to the ADHD group with methylphenidate treatment and the non-ADHD group. It was shown that the symptoms of panic disorder, generalized anxiety, and social phobia were observed more in the newly diagnosed, treatment-naive with ADHD group compared to the treatment group with ADHD. It was determined that children and adolescents diagnosed with ADHD had more anxiety and somatic symptoms. Anxiety and somatic symptoms increased as the severity of ADHD symptoms increased. Anxiety and somatic symptoms were lower than in ADHD children receiving methylphenidate treatment. Clinicians should keep in mind to evaluate anxiety and somatic symptoms in children and adolescents with ADHD before the treatment.

Body-Focused Repetitive Behavior Disorders in Children and Adolescents: Clinical Characteristics and Treatment Outcomes in a Naturalistic Setting

Body-focused repetitive behavior disorders, including trichotillomania (hair-pulling disorder) and excoriation (skin picking) disorder, typically emerge in early adolescence, but little is known about the clinical characteristics and treatment outcomes of these disorders in young people, particularly in real-world clinical settings. Participants were 63 children and adolescents (51 girls; age range 9–17) with a diagnosis of trichotillomania (n = 33) and/or skin-picking disorder (n = 33) attending a specialist outpatient clinic in Stockholm, Sweden. Demographic and clinical characteristics were gathered at the initial assessment. Of the 63 assessed youths, 56 received manual-based behavior therapy mainly focusing on habit reversal training, which was combined with medication when deemed appropriate. The mean clinician-reported trichotillomania and skin-picking disorder symptom severity at baseline (n = 63) was in the moderate range. We observed high rates of psychiatric comorbidity (63.5%) and use of psychiatric medication (54.8%). For the 56 individuals undertaking treatment at the clinic, mixed-effects regression models showed a significant decrease in symptom severity from baseline to posttreatment, with gains maintained up to the 12-month follow-up. Substantial and durable improvements were also seen on self-reported symptoms, self-reported depression, and global functioning. Specialist care should be made more widely available to improve the prognosis and quality of life of young people with trichotillomania and skin-picking disorder.

Депресивні розлади у підлітків: клінічна феноменологія, поведінкові еквіваленти психопатології депресивного спектра, особливості перебігу

The informative value of behavioral patterns of depressive behavior disorder in adolescents in age and gender aspects is determined. It is proved that many variants of behavioral disorders in adolescents with depressive disorders indicate the complex nature of the formation of behavioral disorders coexistence relations which determines the practical value of specific preventive and therapeutic programs developing.

Hostile and threatening interpretation biases in adolescent inpatients are specific to callous-unemotional traits and social anxiety

Psychopathological syndromes, such as disruptive behavior and anxiety disorders in adolescence, are characterized by distorted cognitions and problematic behavior. Biased interpretations of ambiguous social situations can elicit both aggressive and avoidance behavior. Yet, it is not well understood whether different interpretation biases are specific to different syndromes, or whether they can co-occur. We assessed both hostile and threatening interpretation biases in identical social situations, and proposed that they are uniquely related to callous-unemotional (CU) traits and social anxiety, respectively. We also explored the role of gender and age herein. The sample consisted of 390 inpatients between 10 and 18 years of age with a variety of psychiatric disorders. Hostile and threatening interpretations were assessed with the Ambiguous Social Scenario Task (ASST) consisting of 10 written vignettes. Both CU-traits and social anxiety were assessed with self-report questionnaires. Results showed that, overall, CU-traits were related to more hostile interpretations, whereas social anxiety was related to more threatening interpretations. In addition, in boys, hostile and threatening interpretations correlated significantly positive with each other. Age was not related to interpretation biases. Together, these results generally support the content-specificity of interpretation biases in concepts relevant to disruptive behavior disorders and anxiety disorders, and indicate that different interpretation biases can co-occur specifically in boys.

The Proposed Specifiers for Conduct Disorder (PSCD) in Iranian School-Attending Adolescents: A Multi-Informant Validation Study of the PSCD Parent- and Youth Self-Report Versions

The Proposed Specifier for Conduct Disorder (PSCD) was developed to measure the broad psychopathy construct with grandiose-manipulative, callous-unemotional, daring-impulsive, and conduct disorder subscales. This study tested the psychometric properties of Persian parent-and-child self-report PSCD versions with 974 parents (86% mothers) and children/adolescents (46.5% boys) dyads. Results showed that with some modifications the proposed hierarchical four-factor structure for both PSCDs was confirmed and was found to be invariant across gender. Across versions, all PSCD scores were internally consistent and demonstrated expected correlations with parent-reported externalizing problems, anxiety/depression, and poor school performance, supporting the PSCDs scores’ validity. This study also is the first to examine and establish acceptable to excellent parent-child agreement of PSCD scores. Finally, all PSCD child-report scores offered small though significant incremental validity over their corresponding PSCD parent-version scores in predicting parent-reported conduct problems and proactive aggression. Findings indicated that both Persian PSCDs may hold promise for assessing psychopathy components in Iranian school-attending adolescents and generating additional research on this topic.

L’expansion de la « dysphorie de genre » : un phénomène social ou psychologique ?

ObjectivesAny clinician cannot fail to wonder about the notion of “gender dysphoria” as a disease or as a disorder. The review of the few international epidemiological studies on gender transition requests leads to an attempt to “decipher” the reasons for the exponential growth of this new clinical category. Is it a psychopathological or a social phenomenon, or both? We will examine separately the cases of children and adolescents. Children experiencing hesitations about their sexual identity tend to give up requests for transitions; as for teenagers (12 girls for every boy), they seem to be largely influenced by social networks. We will position ourselves strictly on the clinical and deontological level, to defend medical ethics, at a distance from the ideological considerations disseminated by the media. Starting from the recognition of the very strong increase in France of requests to “change sex/gender” in children and adolescents in recent years, we will note that this claim of “gender dysphoria” is presented differently by children before and after puberty. From a clinical point of view, it is necessary to understand that gender dysphoria would be the result of different identification processes for children and adolescents; it also presents as a gendered behavior like other known behavioral disorders in adolescence. The objective of this article is therefore to decipher this pandemic phenomenon and to question it as a social rather than a medical phenomenon. We must then recommend great caution in medical procedures, sometimes irreversible, on these children. MethodBased on an analysis of the international literature, we focused on international epidemiological studies and on the scarce data available to us in France. We compare these data with those from testimonies of adolescents in the process of “identity transition” or “detransition” in France and in other countries, because the complaints and claims are identical. These data were collected and studied until the end of 2021. These data and testimonies will be confronted with our knowledge in the domain of child and adolescent psychiatry and psychoanalysis, the latter being a theoretical construction of childhood sexuality. ResultsThe results drawn from the analysis of these testimonies and from existing epidemiological studies show, firstly, that a fundamental distinction must be made between the phenomenon of “gender dysphoria” in children and in adolescents. The evolution of the demands is drastically different in terms of volume and environmental causality. Secondly, in adolescence, this demand for a change of identity indisputably concerns a very large majority of girls. Finally, this demand, therefore sexualized, can be seen as a fragile identity, added to other pathologies. It should also be considered with demands regarding identity and the impact of propaganda on social networks towards youth. DiscussionThese new demands for changes in gender identity should be discussed before administering lifelong medical and surgical treatments that have not proven their effectiveness and harmlessness, as is the case in Sweden and the U.K. Our discussion here focuses on some clinical and epidemiological elements that allow us to consider these new demands for recognition of “gender dysphoria” from adolescents as a “social epidemic” phenomenon. We will discuss the notion of gender and identification in children and adolescents, along with the frequent and worrying “associated disorders.” A reflection on the particular question of the body will lead us to question the refusal of the feminine in the 21st century. we will also consider the impact of the choice of treatment and support provided, before concluding with a reflection on the requests of adolescent girls. ConclusionsWe recall the importance of providing global psychological, psychodynamic, and psychiatric care for all these children. We recommend acting with the necessary prudence and ethics at these stages of life, and we defend the necessity for all children to develop thanks to the normal evolution of their chosen identifications. The diagnosis of “gender dysphoria” should not be understood as a diagnosis that would bind the child or adolescent in a gender (whether desired or not, conversion therapy is now forbidden in France), but, on the contrary, should allow the child or adolescent to be accompanied towards an emancipation in the face of these gender stereotypes in which he or she is most often trapped, or even kidnapped. Because the body is not sick, it is necessary to protect it against any deleterious transformation. But above all, by avoiding any stigmatization of identity, we can allow the child as well as the adolescent to reappropriate the image of her/his body and thus a psychic and anatomical unity. To thus preserve the freedom of choice amongst the multiple adult sexualities with which s/he will have to deal later on. It is obviously for lack of this protective psychological accompaniment that these young people prematurely put an end to any genital sexual life (homo- or heterosexual or other).

Conduct disorder in female adolescents: evidence from the FemNAT-CD Project.

Conduct Disorder is a diagnosis associated with behaviors at risk for the health and development of the subject, with high social costs and with serious consequences for the adolescent's life context. This disorder is predominantly found in the male population. However, girls with Conduct Disorder often have particularly severe and pervasive symptoms, with a high psychiatric comorbidity. The purpose of this article is to summarize the objectives of the project "FemNAT-CD", in order to promote greater knowledge of the clinical characteristics of females who show a Conduct Disorder in adolescence. This paper will describe studies related to FemNAT-CD project concerning neuro-biological, neuro-cognitive and clinical characteristics of Conduct Disorder in female adolescents as well as new psychotherapeutic and pharmacological approaches.

Validação do Conduct Disorder Screener entre jovens portugueses

Conduct Disorder (CD) may be related to persistent and severe delinquency be-haviors in adolescence. It can last into adulthood and be a precursor to Antisocial Personality Disorder. Considering the strong consensus regarding the need for prevention and early intervention in youths with CD, due to the negative impact they have on society, the Conduct Disorder Screener (CDS) can fill a significant gap in quickly obtaining relevant data on CD in adolescents and make an im-portant contribution to their research in our Country. The aim of the present study was to validate the CDS in a total sample of Portuguese adolescents (N = 601; M age = 15.95 years; SD = 1.05 years; range = 13-18 years) subdivided in forensic male group, school male group and school female group. The scale showed ade-quate psychometric characteristics, namely in terms of a one-dimensional facto-rial structure, internal consistency by Cronbach's alpha and Omega coefficient, convergent validity, divergent validity, criterion validity and known-groups va-lidity. Considering the obtained results, it is justified to use it in a forensic and school context to identify Conduct Disorder in Portuguese adolescents.

Hospitalization for mental and behavioral disorders in adolescents in Brazil, 2008-2017

Resumo Introdução Internações por transtornos mentais e comportamentais não são ocorrências raras em adolescentes. Estima-se que aproximadamente 30% dos adolescentes brasileiros sejam acometidos por transtornos mentais. Objetivo Analisar a evolução das internações por transtornos mentais e comportamentais em adolescentes brasileiros de 2008 a 2017. Método Estudo ecológico de séries temporais utilizando dados do Sistema de Informações Hospitalares do Sistema Único de Saúde e do IBGE. As variáveis utilizadas foram regiões de residência, sexo, faixa etária e grupos de diagnósticos. A tendência do coeficiente de internação foi analisada através da regressão de Prais-Winsten utilizando o Stata 14.0. Resultados Houve 152.465 internações no período; o coeficiente de internação hospitalar reduziu na região Nordeste de 27,75 a 23,16 por 100 mil habitantes (Coef = -0,0070; -1,6%), aumentou de 13,70 a 21,61 por 100 mil habitantes no Norte (Coef = 0,0192; 4,5%) e nas regiões Sul, Sudeste e Centro-oeste houve tendência estável. Verificou-se tendência crescente de internações entre as mulheres (Coef = 0,0136; 3,2%), e por transtornos do humor [afetivos] (0,0266; 6,33%) e outros transtornos mentais e comportamentais (0,0295; 7,03%). Conclusão Estudos epidemiológicos como este ajudam a fornecer informações úteis para o planejamento de serviços de prevenção e tratamento primário, secundário e terciário voltados à saúde mental, especialmente entre crianças e adolescentes.

Systematic Review of Environmental and Psychosocial Risk Factors associated with Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder in Children and Adolescents.

In the majority of cases, attention deficit hyperactivity disorder (ADHD) is accompanied by one or more comorbid disorders, with the oppositional defiant disorder (ODD) being one of the most frequently diagnosed comorbid disorders. There is a lack of systematic reviews addressing the evidence for an association between the independent environmental and psychosocial risk factors associated with ADHD, ODD, and Conduct Disorder (CD). This study aims to determine the link between ADHD and ODD/CD, specifically in terms of the most up-to-date environmental and psychosocial risk factors in the development of these illnesses. Eleven studies were included in this systematic review. Among these, ten studies involved environmental risk factors, and only one involved socioeconomic risk factors as exposure. Of the ten studies highlighting the environmental risk factors, six studies reported perinatal risk factors, three reported Atopic diseases as exposure measures, and one involved exposure to energy and coffee drinks. We have found that the most common risk factors associated with ADHD, ODD and CD in Europe and North America were Perinatal risk factors. In contrast, the risk factors of Atopic diseases were more common in Asia. Most of the studies included in our systematic review fall within the scope of environmental risk factors were perinatal risk factors and atopic diseases are the most common risk factors. However, only one article highlighted the association of socioeconomic risk factors as an exposure. Our review results suggest the need for more research focused on psychosocial risk factors for ADHD and comorbid ODD/CD. Further research is required with the primary objective of investigating this association in greater depth and examining the possible mechanisms at varying levels is needed.

The Effects of Child and Adolescent Attention Deficit / Hyperactivity Disorder and Associated Executive Function Deficits on Family Functioning

Objective: In this study, we aimed to investigate the effects of ADHD and associated executive dysfunctions on family functioning and enrolled children aged between 8- 17 years old diagnosed with ADHD at the study center. The control group was formed of children attending well-child visits at the study center. Method: Executive functions were measured via the Stroop test- TBAG form while the Family Assessment Device (FAD) was used to assess family functioning. Diagnoses were ascertained with K-SADS-PL and symptom severity was reported by parents via the Turgay DSM-IV–Based Child and Adolescent Behavior Disorders Screening and Rating Scale. Descriptive, bivariate, and multivariate methods were used in analyses. P was set at 0.05 (Holm-Bonferroni procedure was used to control for family-wise error rate). Results: Families of children with ADHD performed significantly worse compared to controls in communication, affective responses, affective involvement, behavior control and general functioning. FAD- affective involvement scores of families of girls with ADHD were significantly elevated compared to males. ADHD subtypes, comorbidity and their interaction did not display significant effects on family functioning. Correlation analyses revealed that severity of oppositional and conduct disorder symptoms affected family functioning in various domains. In regression analyses, selective and focused attention and resistance to interference domains of Stroop-TBAG test did not significantly predict family functioning, although there was a signal that processing speed in resistance to interference domain may be important. Conclusion: ADHD diagnosis in children may affect multiple domains of family functioning. Parents of female children with ADHD may experience greater family dysfunction, especially in affective involvement. Severity of oppositionality and behavior problems rather than subtypes and comorbidity seem to affect family functioning in ADHD. Contributions of different facets of executive functions to family functioning in ADHD should be evaluated with different neuropsychological tasks.

Antipsychotics in the Management of Disruptive Behavior Disorders in Children and Adolescents: An Update and Critical Review.

Disruptive behaviour disorders (DBDs) in childhood include conduct disorder (CD) and oppositional defiant disorder (ODD). Though psychological therapies are considered to be the first-line treatment for DBDs, many patients require adjunctive pharmacotherapy for the control of specific symptoms, such as aggression. Three prior systematic reviews have examined the evidence for the use of antipsychotics in DBDs and have concluded that their efficacy is marginal and limited by adverse effects. This paper has two objectives: (i) to summarize the findings of existing systematic reviews of antipsychotics for the management of DBDs in children and adolescents (2012-2017), and (ii) to provide an update to these reviews by examining recent clinical trials of antipsychotics in this population, published in the period from 2 January 2017 to 10 October 2022. The PubMed, Scopus and ScienceDirect databases were searched for relevant citations using the search terms "disruptive behaviour disorder", "oppositional defiant disorder", "conduct disorder" and their variants, along with "antipsychotic", "atypical antipsychotic" and the generic names of all currently approved atypical antipsychotics. Six relevant trials were identified during this period, including five randomized controlled trials and one naturalistic open-label trial. These trials were critically evaluated in terms of outcome measures, efficacy and safety. Overall, the data from these trials suggests that of all available antipsychotics, risperidone appears to be effective in the short-term management of DBDs. All available antipsychotics are associated with significant metabolic adverse effects in this population. These results are discussed in the light of global trends towards increasing off-label prescription of antipsychotic medication in children and adolescents and of recent literature on the neuropharmacology of aggression in this patient population. The need for rational, short-term use of these drugs is highlighted, as well as the importance of post-marketing surveillance for long-term or severe adverse events.

Evaluation of the Relationship Between Head Trauma and Attention-Deficit/Hyperactivity Disorder in Primary School Children Admitted to the Emergency Department.

Head trauma causes a significant number of deaths as well as temporary and permanent disabilities every year. In this study, the prevalence of attention-deficit/hyperactivity disorder (ADHD) in primary school children who visited the emergency department (ED) for mild head trauma and the role of ADHD in mild head trauma of this age group were investigated. It was performed with 134 children of primary school age (6-12 years) who were admitted to the ED with mild head trauma and 134 children (control group) who presented with complaints other than head trauma. Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was used to evaluate the children for suspected ADHD. According to this scale, some children were referred to the child and adolescent psychiatry department (CAPD) for further evaluation. At the CAPD outpatient clinics, the children who were referred from the ED were examined in detail according to the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition , for possible diagnosis of ADHD. After evaluation of their sociodemographic characteristics and the ADHD test scores that were recorded, the diagnosis of ADHD in these children was established or ruled out. It was observed that 41 of the 134 children (30.60%) who presented to the ED with mild head trauma and 12 of the 134 children (8.96%) in the control group were diagnosed with ADHD ( P = 0.0001). When ADHD is corrected for sex, 29 of the 41 cases (70.7%) diagnosed with ADHD were boys and 12 (29.3%) were girls ( P = 0.000). According to the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition , when the patients who had been diagnosed with ADHD were grouped according to the ages of the children, no statistically significant difference was found between the groups in terms of ADHD ( P = 0.097). The prevalence of ADHD has been found to be higher in children of primary school age who present to the ED with mild head trauma. Hence, it can be deduced that the diagnosis of childhood ADHD increases the risk of presenting to the ED with head trauma. We believe that it is very important to keep the possible diagnosis of ADHD in mind and to refer that cases to the CAPD in case of high clinical suspicion, especially in primary school boys who are admitted to the ED with mild head trauma. We believe that in this way, morbidity and mortality due to head trauma in this age group can be significantly reduced.