Introduction: Subtle neurocognitive deficits have been recently observed in Acute Lym-phoblastic Leukemia (ALL) survivors.Aim: We aim to assess the neurocognitive functions of ALL survivors who had been treated with chemotherapy only using two different protocols, and to identify treatment-related risk factors.Patients and Methods: We carried a multicenter study involving 3 pediatric oncology centers on 100 children who were treated for ALL. Fifty patients were treated by the modified Children’s Cancer Group (CCG) 1991 protocol with low dose methotrexate and 50 children were treated by Total XV protocol with high dose methotrexate. Fifty healthy children were included as a control group. Psy-chometric assessment using Arabic version of Wechsler intelligence scale for children (WISC III) was performed for all patients and controls.Results: Patients had significantly lower mean full scale IQ, performance IQ and verbal IQ than con-trols. Patients ≤ 5 years at diagnosis had significantly lower mean full scale IQ and performance IQ than patients>5 years at diagnosis, while the verbal IQ showed no significant difference between both age groups. Female patients had significantly lower mean full scale IQ, performance IQ and verbal IQthan males. Patients who received Total XV protocol with high dose methotrexate had significantly lower mean full scale IQ, performance IQ and verbal IQ than patients who received modified CCG 1991 protocol with low dose methotrexate.Conclusions: CNS directed chemotherapy might appear to affect neurocognitive functions in chil-dren with ALL, which is more significant in young children at diagnosis, in girls and in those receiv-ing high dose methotrexate.
Multiple risk factors contribute to cognitive impairment in children with β-thalassemia major. For a more refined understanding of this issue, we attempted to evaluate cognitive function in β-thalassemia major patients and identify the relationship between possible cognitive dysfunction and the following: demography, transfusion and chelation characteristics, iron overload, and disease complications. We studied 100 β-thalassemia major children and 100 healthy controls who matched well in terms of age, sex, and socioeconomic status. All participants underwent psychometric assessment using Wechsler Intelligence Scale for Children-Third Edition, Arabic version. The mean Full-Scale IQ and Performance IQ of patients were significantly lower than those of controls, whereas no significant difference was found for Verbal IQ. No significant relationship existed between IQ and any of the assessed parameters. We concluded that Performance IQ, not Verbal IQ, was significantly affected in β-thalassemia major patients, but there was no clear association between IQ and any of the parameters.
Background: High rates of history of childhood attention deficit hyperactivity disorder (ADHD) symptoms have been found in obsessive-compulsive disorder (OCD) adults. Both, when comorbid, cause the clinical course to be unfavorable, more susceptibility to substance use, and a bad response to treatment. We planned to assess the impact of childhood ADHD symptoms on OCD adults and the effect of this on clinical characteristics and comorbidities of the disorder. Results: Our cross-sectional investigation uncovered that 44% of the OCD patients had childhood ADHD symptoms. Patients with childhood ADHD manifestations with at present grown-up ADHD had more elevated amounts of depression, anxiety, and impulsiveness. OCD patients with child ADHD symptoms but not continued symptoms till adulthood versus those without child ADHD symptoms had higher levels of depression, anxiety, and impulsiveness and more severe OCD symptoms. Conclusion: ADHD in adults with OCD is associated with some features impairing the clinical picture including higher levels of anxiety, depression, and impulsiveness reflecting more chronic illness. A childhood history of ADHD symptoms, even if not continued till adulthood, caused more impulsiveness, more severe OCD symptoms, and more anxiety and depression comorbidity.
Background: Obsessive-compulsive disorder (OCD) and attentiondeficit and hyperactivity disorder (ADHD) frequently coexist. Childhood ADHD symptoms have negative impact of on the clinical presentation of OCD. Our aim is to evaluate the prevalence of childhood ADHD symptoms among OCD patients and the effect of this on clinical characteristics of the disorder. Methods: We applied the Structured Clinical Interview for (DSM-5 to diagnose OCD on 100 OCD patients fulfilling our inclusion criteria .The Arabictranslated and validated version of the Wender Utah Rating Scale (WURS), was used to retrospectively assess childhood ADHD symptoms.The severity of OCD was assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), severity of depression was assessed by the Hamilton Depression Rating Scale-17 (HDRS) and severity of anxiety was assessed by the Hamilton Anxiety Rating Scale (HAM-A). Barratt Impulsiveness Scale-11 (BIS-11) was used to assess impulsiveness . The adult ADHD was measured by the adult ADHD self-report scale Symptom Checklist. Results: 44% of the OCD patients had ADHD symptoms since childhood. Patients with childhood ADHD symptoms had an earlier onset of OCD, higher levels of depression, anxiety and impulsiveness. The scores of the Y-BOCS did not differ significantly between those having and not having childhood ADHD symptoms. Conclusion: Childhood history of ADHD symptoms is common in adult OCD patients. Childhood ADHD symptoms are associated with an earlier age of OCD, more severe depression, anxiety and higher impulsiveness.
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