Autism spectrum disorder and physical activity

Aim: The aim of the study is to examine the relationship between autism spectrum disorder and physical activity in depth. Findings: Autism was first defined by Bleuler, but the history of autism as a term began with the founding of the first pediatric psychiatry clinic by Kanner. Later, autism was defined and revised in the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (APA) in various periods before currently being expressed by criteria, ratings, and classifications. In 2013, the term autism spectrum disorder (ASD) began to be used. According to data from the Centers for Disease Control and Prevention, ASD is a continuously increasing situation with the incidence of 1 in 54 children according to 2020 data. The increasing incidence and difficulties experienced in many areas by individuals with ASD like deficiencies ​Extended English summary is in the end of Full Text PDF (TURKISH) file. Özet Amaç: Araştırmanın amacı, otizm spectrum bozukluğu ve fiziksel aktivite ilişkisini derinlemesine incelemektir. Bulgular: İlk defa Beuler tarafından tanımlanan otizm teriminin; Kanner’in çocuk psikiyatri kliniğini kurması ile birlikte tarihsel süreç içerisinde kullanılmaya başlandığı görülmektedir. Sonraki süreçlerde otizm özellikle Amerikan Psikiyatri Birliği Ruhsal Bozuklukların Tanısal ve İstatistiksel El Kitabında (APA) çeşitli dönemlerde tanımlanmış ve çeşitli revizyonlar yapılarak günümüze gelen kriterleri, dercelendirmeleri, sınıflandırmaları ile ifade edildiği görülmektedir. 2013 yılında otizm spektrum bozukluğu (OSB) olarak kullanılmaya başlanmıştır. Hastalık Kontrol Önleme Merkezi’nin verileri kapsamında OSB, 2020 verilere göre 54 çocukta 1 olarak görülme sıklığı sürekli artan bir durum olarak karşımıza çıkmaktadır. Sıklığının artması ve OSB’li bireylerde yaşanan çeşitli, sözel ya da sözel olmayan iletişim davranışlarında eksiklikler, kalıplaşmış ya da kısıtlayıcı motor hareketler gibi birçok alandaki aksaklıklar bireylerin yaşamlarını olumsuz yönde etkilemekte ve fiziksel aktiviteye katılımlarında ise birer engel olarak karşımıza çıkmaktadır. OSB’li bireylerin her açıdan daha sağlıklı birer birey olmalarında fiziksel aktivitenin önemli bir etkisi bulunmaktadır. Sonuç: Tüm bireyler için katılımı önemli olan fiziksel aktivite, OSB’li bireylerin motor becerilerinden, psikolojik, sosyal ve aile yaşantısına kadar etki eden pek çok alanda önemli katkılar sağlamaktadır. Bu olumlu etkiler özellikle OSB’li bireylerin yaşam kalitesine önemli ölçüde etki etmektedir.

Telehealth May Reduce Rural-Urban Disparities in Accessing Pediatric Psychiatry Services: A Case Study of Trends in Central Ohio from 2020 to 2021 (Preprint)

BACKGROUND The rural-urban disparities in access to child behavioral health services are well known and are further exacerbated by the COVID-19 pandemic related restrictions on travel and in person visits. Fortunately, regulatory flexibilities allowed rapid transition of telehealth to reduce contagion while maintaining continuity of care. However, there has been contradicting evidence on whether telehealth narrows the rural-urban gap. OBJECTIVE To examine the telehealth utilization trends and no-show rates between urban vs rural areas for pediatric psychiatry visits after the public health emergency was declared. METHODS Using 2020-2021 electronic health records (EHR) data from the psychiatry department at a large urban academic pediatric hospital, we calculated the telemedicine utilization rates by patient’s residence area (urban vs rural). We used two proportions z-tests to examine whether the observed differences in no-show rates among 4 types of visit (urban office visit, urban telemedicine visit, rural office visit, and rural telemedicine visit) were statistically significant. RESULTS Telemedicine utilization rates (~80%) are comparable in urban and rural areas. The average no-show rates for telemedicine visits were around 17% for both urban and rural patients, while the average no-show rates for office visits were around 20% for urban patients and fluctuated between 15% and 36% for rural patients. Two proportions z-tests indicated that, for rural patients, telemedicine visits had significantly lower no-show rates than office visits between Sept 2020 and Feb 2021, but such difference turned insignificant after March 2021. CONCLUSIONS Telehealth improved access to child psychiatric services for rural families when primary delivery of services was telehealth-based. Returning to in-person only options and limiting telehealth access would be detrimental to behavioral health outcomes of rural children that have been traditionally underserved. CLINICALTRIAL N/A

Childhood Trichotillomania: A Case and a Review of the Available Evidence-Based Pharmacologic Therapies.

1. Abstract Background: Trichotillomania is a self-induced psychocutaneous dermatosis that is considered an impulse control disorder associated with obsessive-compulsive features. The disorder is characterized alopecia caused by repetitive pulling of own hair which cause irregular shape areas, partially devoid of hair. Treatment of the condition is generally unsatisfactory, because the condition is commonly resistant to treatment and relapse is common. Patients and methods: The case of girl with persistent alopecia of several months despite several treatments by several dermatologists was studied. The available evidence-based pharmacologic therapies that can be useful for the child’s condition was reviewed. Results: A thirteen-year old girl was referred to pediatric psychiatry clinic at the Children Teaching Hospital of Baghdad Medical City because of persistent alopecia of several months despite several treatments by several dermatologists. The parents didn’t give clues to any a psychosocial stress in the family. Although the parents were finding at several occasions tufts of hair in the bed of girl when awakening her at the morning, they were surprised to learn that her condition is self-induced. The girl was rather shy and denied pulling her hair. Examination of her scalp showed irregular shape areas, partially devoid of hair suggesting trichotillomania. The patient was not from Baghdad and there was no pediatric psychiatry service in the province where she came from. It was not possible to the girl a cognitive behavioral therapy in a busy tertiary center, nor was this convenient to her family. The need for a pharmacologic therapy was clearly demanded. Review of the available research evidence suggests that monotherapy of trichotillomania is not consistently effective and combination of therapies is more likely to be successful. Conclusion: Trichotillomania remains a challenging psychiatric condition with no first- line medications universally approved. The available evidence suggests that monotherapy of trichotillomania is not consistently effective and combination of therapies is more likely to be successful. The combination of a safer antidepressant, clomipramine with a safer neuroleptic, risperidone with or without the addition of N-acetylcysteine represents the current evidence-based recommendation for the pharmacologic treatment of childhood trichotillomania.

Psychotic-like experiences in conduct disorders – a case report

Psychotic symptoms in children and adolescents are an important and, at the same time, interesting issue. Current ICD-10 and DSM-5 criteria for mental disorders obviously fail to exhaust the richness of psychopathologies and to fully describe patient’s experiences. Differentiation of psychotic experiences is of particular importance in pediatric psychiatry. A number of phenomena that can be classified as psychotic either occur as a variant of normal or, as reported in studies, have no clinical significance. We describe a case of an adolescent who, with a thoughtless use of criteria, could have been easily diagnosed with schizophrenia; however, a more thorough interview and observation allowed for identification of the phenomenology of psychotic symptoms in the course of conduct disorders. The paper discusses the differential diagnosis, which allowed for the diagnosis of dissociative and conduct disorders in the described patient.

Differentiation of Healthy Individuals from Those with Autism Spectrum Disorders using Information Graph of Complementary Opposites

This study aimed to examine the brain signals of children with Autism Spectrum Disorder (ASD) and use a method according to the concept of complementary opposites to obtain the prominent features or a pattern of EEG signal that represents the biological characteristic of such children. In this study, 20 children with the mean±SD age of 8±5 years were divided into two groups of normal control (NC) and ASD. The diagnosis and approval of individuals in both groups were conducted by two experts in the field of pediatric psychiatry and neurology. The recording protocol was designed with the most accuracy; therefore, the brain signals were recorded with the least noise in the awake state of the individuals in both groups. Moreover, the recording was conducted in three stages from two channels (C3-C4) of EEG ( referred to as the central part of the brain) which were symmetrical in function. In this study, the Mandala method was adopted based on the concept of complementary opposites to investigate the features extracted from Mandala pattern topology and obtain new features and pseudo-patterns for the screening and early diagnosis of ASD. The optimal feature here was based on different stages of processing and statistical analysis of Pattern Detection Capability (PDC). The PDC is a biomarker derived from the Mandala pattern for differentiating the NC from ASD groups.

Case Studies in Pediatric Psychiatry: An Approach to Deep Learning and Experience Acquisition.

It has been disturbingly observed that many learners in the field of medicine, both undergraduate and postgraduate levels may have satisfactory information acquisition in their fields of study, but fail to use it appropriately when it comes to clinical practice. One of the important roles of instructors and professional trainers in the field of medicine is to encourage learners to adopt deep learning approaches by making the studied materials interesting and design a curriculum and assessment methods that encourage understanding which help in establishing and creating experience. Deep learning is mostly motivated by the interest in understanding the studied materials and the need to interpret the presented knowledge during the course. Comprehension is the main intention and focus of the learners adopting deep learning [1-3]. This special article presents authentic real case studies in child psychiatry aiming at encouraging the learners of this field to adopt deep learning by making these cases interesting with real patients’ photos. These cases which represents major referrals in at the pediatric psychiatry clinic are designed to make comprehension is the essential outcome of learning.