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    Effects of Maternal Symptom Ratings and Other Clinical Features on Short-Term Treatment Response to OROS Methylphenidate in Children and Adolescents with ADHD in a Naturalistic Clinical Setting
    (Kure Iletisim Grubu A S, 2016) Cop, Esra; Oner, Ozgur; Yurtbasi, Pinar; Munir, Kerim
    Objective: To investigate the effect of Attention Deficit Hyperactivity Disorder (ADHD), antisocial behavior and anxiety/depression ratings of mothers, and child and adolescents' age, gender, ADHD subtype, and comorbidity on one-month drug treatment response to OROS methylphenidate in ADHD in a naturalistic setting. Methods: The analyses included 223 subjects (191 boys, 32 girls; age 6-15 years, mean: 9.4) treated with OROS methylphenidate (18-72 mg/day, mean: 31 mg/d; 0.4-1.4 mg/kg/d) for one-month. Treatment response was defined as larger than 25% or more decrease in pre-treatment the Conners Parent Rating Scale (CPRS) or the Conners Teacher Rating Scale (CTRS) total scores and the Clinical Global Impression improvement with drug treatment 3 (minimally improved) or higher. Maternal ADHD, antisocial behavior and anxiety/depression ratings were obtained by the Adult Self Rating (ASR). Logistic regression analyses were computed in order to calculate the effects of gender; age; ADHD subtype; comorbid anxiety disorder, learning disorder, oppositional defiant/conduct disorder; maternal ASR Anxiety/Depression, ADHD and Antisocial scores. Results: 35.2% of subjects had statistically significant 25% or more decrease in pretreatment CPRS total scores and 38.6% of subjects had statistically significant 25% or more decrease in pretreatment CTRS total scores. The subjects with comorbid anxiety disorder had the poorest drug response. Maternal self-reported antisocial and anxiety/depressive symptomatology were statistically significantly associated with worse response to treatment in terms of CPRS (respectively, OR= 0.83, 95% CI: 0.75-0.92, p< 0.01; OR= 0.95, 95% CI: 0.9-0.99, p< 0.05) and CTRS total scores (OR= 0.9, 95% CI: 0.82-0.99, OR= 0.95, 95% CI: 0.91-1, p< 0.05). Baseline rating scores were also important predictors of drug treatment response. Effects of age, gender and maternal ADHD were not statistically significant. Conclusion: ADHD children and adolescents with comorbid anxiety disorders and those whose mothers have more self-reports of antisocial and depressive symptoms showed less favorable short-term response to OROS-MPH. These subjects may require further attention and additional interventions to augment treatment with OROS methylphenidate.
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    Genetic testing in children with autism spectrum disorders
    (Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2015) Cop, Esra; Yurtbasi, Pinar; Oner, Ozgur; Munir, Kerim M.
    Objective: The aim of this study was to investigate karyotype abnormalities, MECP2 mutations, and Fragile X in a clinical population of children with Autism Spectrum Disorders (ASD) using The Clinical Report published by the American Academy of Pediatrics. Methods: Ninety-six children with ASD were evaluated for genetic testing and factors associated with this testing. Results: Abnormalities were found on karyotype in 9.7% and in DNA for fragile X in 1.4%. Karyotype abnormalities include inv(9)(p12q13); inv(9)(p11q13); inv(Y)(p11q11); Robertsonian translocation (13; 14)(8q10q10) and (13,14)(q10q10); 9qh+; Yqh+; 15ps+; deletion 13(p11.2). Conclusion: Genetic testing should be offered to all families of a child with an ASD, even not all of them would follow this recommendation. Although karyotype and FRAXA assessment will yield almost 10% positive results, a detailed history and physical examination are still the most important aspect of the etiological evaluation for children with ASD. Also, it is important to have geneticists to help in interpreting the information obtained from genetic testing.