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Biomedical subjects

K Sayal

Publications and source records attributed to K Sayal.

8 recordsLinked to original sources

Parent ratings of school behaviour in children at risk of attention deficit/hyperactivity disorder.

OBJECTIVE: To investigate whether parents are accurate informants of child hyperactivity symptoms and impairment at school. METHOD: Parents of a community sample of 93 children with pervasive hyperactivity completed rating scales about their child's behaviour at home and school. These were compared with teacher ratings. RESULTS: Parent ratings about school correlate more closely with parent (home) than teacher ratings. Such ratings systematically under-estimate teacher ratings and are influenced by the child's behaviour at both home and school as well as parental mental health. However, a parental report of impairment for the child at school is likely to be accurate. CONCLUSION: There are limitations in relying on parental accounts of school behaviour if teacher ratings are unavailable. As such ratings may under-identify children with ADHD and discrepancies between parent and teacher ratings may reflect actual differences in behaviour, this suggests that ratings are required from both sets of informants.

Attention Deficit Disorder with Hyperactivity↗

Case study: bipolar disorder after head injury.

A case of bipolar disorder subsequent to a mild head injury in a 15-year-old girl is reported. Review of the literature indicates that this is an extremely rare outcome. Lack of adequate follow-up studies makes it difficult to accurately predict type and severity of psychiatric outcome. Assessment and management involves ongoing consideration of both organic and psychosocial factors even after initial negative investigations.

Adolescent↗

Neurodevelopmental antecedents of early-onset bipolar affective disorder.

BACKGROUND: Developmental impairments have been identified as a risk factor for early-onset schizophrenia. Affective symptoms are more common in children and adolescents with disordered neurodevelopmental than in healthy controls. AIMS: To test the hypothesis that severe early-onset mood disorders are associated with developmental antecedents. METHOD: We retrospectively identified 38 adolescent cases (15 female, 23 male; mean age 14.4 years, range 11-18) who met ICD-10 Research Diagnostic Criteria for a manic episode, bipolar affective disorder or psychotic depression, and 41 controls (25 female, 16 male, mean age 14.2 years, range 11-18) with depression but without psychotic features. RESULTS: Cases were significantly more likely to have experienced delayed language, social or motor development (OR 5.5, 95% CI = 1.4-21.6, P = 0.01), in particular those who develop psychotic symptoms (OR 7.2, 95% CI = 1.8-28.6, P = 0.003). CONCLUSIONS: Compared to early-onset unipolar depression, neurodevelopmental antecedents are over-represented in early-onset bipolar disorder. The validity of this finding was supported by contemporaneous IQ scores that are not subject to the same potential biases as case-note ratings.

Adolescent↗

Parents anticipating misbehaviour: an observational study of strategies parents use to prevent conflict with behaviour problem children.

Research on the role of parenting styles in the development of disruptive behaviour problems has focused primarily on how parents handle conflict once it has occurred. This home observational study examined strategies used by 52 mothers to prevent conflict with 3-year-olds. It was predicted that mothers of children with behaviour problems would use fewer "positive" strategies to resolve conflict, and would use reactive rather than pre-emptive strategies. Results showed frequency of positive strategies did not differ between the groups. Mothers of children with behaviour problems were less likely to use pre-emptive, and more likely to use reactive, strategies. Further analysis showed child conduct problems, rather than other characteristics, best discriminated pre-emptive from reactive strategy users. Follow-up of a subsample found that reactive strategies at age 3 predicted age 5 behaviour problems, even after controlling for age 3 behaviour problems.

Attitude↗

Antidepressant interactions with warfarin.

The interactions between warfarin and antidepressants can have potentially serious consequences resulting from enhanced or reduced anticoagulant activity. Information about such interactions was obtained from a Medline and hand search of the published literature, and by directly contacting manufacturers. The different classes of antidepressants are discussed in turn. The possible mechanisms are considered with particular reference to the cytochrome p450 system. From currently available data on the newer antidepressants our conclusions are that citalopram, nefazodone and sertraline may be relatively less likely to interact with warfarin. Fluoxetine, fluvoxamine, paroxetine and moclobemide appear to have the highest potential of the antidepressants for interactions. There is insufficient data on venlafaxine to make a prediction. The clinical implications of these findings are discussed and specific recommendations for International Normalized Ratio monitoring are suggested.

Animals↗