Context: A significant subset of autistic children exhibit abnormal isolated epileptiform discharges (IEDs) in the absence of clinical epilepsy. The etiological significance of such IEDs is under much debate. Aims: The aim is to study the relationship between IEDs with risk factors, clinical severity, behavioral problems, and social-quotient and follow-up for the occurrence of new seizures. Settings and Design: This study was a prospective double-blind comparative study of autistic children with and without IEDs. Subjects and Methods: All autistic children attending Child Psychiatry Department of tertiary care postgraduate teaching hospital in April 2013 were included in the study. Electroencephalography, risk factors, and clinical severity were assessed. The same cohort of 72 children was followed for 2 years and reassessed. Statistical Analysis Used: Independent sample t -test, Chi-square test, Pearson correlation, and linear by linear association were the statistical methods used. Results: Twenty-four (42%) of the followed up sample exhibited IEDs. 10.52% had converted to clinical seizures within the follow-up period. While there was no difference between risk factors and age at diagnosis between the IED and non-IED groups, there was a significant difference between disease severity, behavioral problems and social quotient between the groups. Conclusions: IED in a subgroup of autistic children point to more severe illness, severe behavioral problems, and severe social impairment over a 2-year follow-up period. Can IED be considered a neurobehavioral endophenotype in autism?
Specific Learning Disorder (SLD) is one of the common diagnoses often encountered in psychiatry(1). As with many neurodevelopmental disorders early identification, specific intense remediation, appropriate management of comorbid conditions, coordination with teachers and parents and engaging the child long-term are the mainstay of management of SLD. Each of these steps pose unique challenges due to the inherent complexity of SLD, lack of uniform, standardised curriculum and testing methods, wide regional variations in definition, assessment and certification in SLD, strained relationship between professionals of various disciplines and lack of custommade tools for screening, assessment and follow-up in native (Indian) languages(2).
BACKGROUND Cognitive disturbances in schizophrenia is well characterized and is believed to be the core feature in determining the long term social, vocational and community functioning. The aim and objective of the current study is to compare the cognitive functioning of a sample of patients experiencing their first episode of schizophrenia with that of normal controls. MATERIALS AND METHODS Consecutive patients attending outpatient services of department of psychiatry in a tertiary care post graduate teaching hospital were screened for study inclusion. Based on the selection criterion, thirty-four patients who were experiencing their first episode of schizophrenia and 30 normal age, gender and education matched controls from the community were included in the study. Mini-plus, structured diagnostic instrument was used to diagnose Schizophrenia and The Positive and Negative Syndrome Scale for schizophrenia was utilized to measure psychopathology. Semi-structured questionnaire was used for occupational functioning, duration of untreated illness and sociodemographic indices. Specific cognitive tests measuring speed of processing, vigilance, working memory, executive functioning, new learning ability were used for assessment. Real world social functioning was assessed through social functioning index. RESULTS There were significant differences between the 2 groups in terms of cognitive functioning. Cases showed consistently poorer performance in all domains. Social functioning was related to specific cognitive indices and negative symptoms. CONCLUSION Working-memory (visual), set shifting and new learning ability (visual) significantly correlated with social functioning after controlling for education. Targeted interventions focusing visual memory and mental flexibility may be beneficial in improving social functioning in schizophrenic illness.
Specific Learning Disorder (SLD) is one of the common diagnoses often encountered in psychiatry(1). As with many neurodevelopmental disorders early identification, specific intense remediation, appropriate management of comorbid conditions, coordination with teachers and parents and engaging the child long-term are the mainstay of management of SLD. Each of these steps pose unique challenges due to the inherent complexity of SLD, lack of uniform, standardised curriculum and testing methods, wide regional variations in definition, assessment and certification in SLD, strained relationship between professionals of various disciplines and lack of custommade tools for screening, assessment and follow-up in native (Indian) languages(2).
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