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Neuropsychiatric Comorbidities In Tuberous

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Neuropsychiatric Comorbidities In Tuberous Question: Discuss About The Neuropsychiatric Comorbidities In Tuberous?   Answer: Introduction Neuropsychiatric comorbidities is the examination process of various coexisting illness in patients with mental disorders including the behaviors they exude (Hirschtritt et al, 2015). Various conditions such as tuberos sclerosis complex (TSC), management spectrum disorders (ASD), intellectual disability etc. are in most of the cases characterized in the patients in the process. TSC formed the center of focus of study for the neuropsychiatric comorbidities in the children. In connection to that, TSC is a dominant autosomal condition that result from the transmutation of either TSC1 or TSC2 gene (De Vries et al, 2015). This study was conducted to determine the prevalence of neurological illness in children who have already been examined with tuberous sclerosis complex (TSC). The investigation focused on frequencies of some of the coexisting disorders in children with TS; the disorders include ASD, ADHD and OCD. Most of the previous researches show that in the higher percentage of patients with TS also display characteristics of the presence of other neurological symptoms disorders. Method Of Data Collection Data is important in making a proof of the claim valid through full leverage of the so collected data (William et al, 2016). A sample is a proportion of a population of the subject of discussion (Gelman et al, 2014). A sample is always used to give the representation of the characteristics of the entire population (Davidson et al, 2013). In this study therefore, patients diagnosed with TS was the target and from the clinic records, a sample of 67 children patients’ records were examined making our sample size to be (67).  Though the population of children in the clinic who were examined with TS was not disclosed, the suitable sample size is supposed to cover at least 30% of the entire population (Desu, 2012). In our case healthcare, we were certain that sample size of 67 children was good enough to estimate the population’s characteristics and to obtain the statistic that will suitably represent the population parameter of the neuropsychiatric comorbidities in children with TS. There are various methods that can be employed in the collection of data from the participants which can either be primary or secondary data collection methods (Cleary et al, 2014). In this study, the type of data collected was secondary. As a result therefore, the data was obtained through the review of the patients’ records in the clinic for patients who were examined with TS. Frequency tables were used in representation of data using statistical package for social sciences (SPSS).   Results Of The Study Table 1: Demographic information of the children sampled in the clinic Variable statements Frequency Percentage Gender boy 35 52.2 girl 32 47.8 Age (Months) 15 to 45 12 17.9 46 to 75 9 13.4 76 to 105 7 10.4 106 to 135 12 17.9 136 to 165 9 13.4   166 to 195 18 26.9 Out of te children’s records checked from the clinic report of children examined with TS, 52.2% of the sample were boys while the remaining 47.8% were girls. Age was also a factor of concern that was considered and they were recorded as follows; 17.9% of those who were diagnosed to have had TS were 15 to 45 months age, 13.4% of the sample were 46 to 75 months, 10.4% from the records showed that they were 76 to 105 months, 17.9% from the clinic report records showed that the children were 106 to 135 months, as well, 13.4% of the children from the report records showed that they were 136 to 165 months and finally the children with age of 166 to 195 months were represented by 26.9% of the total sample extracted from the clinic report records Table 2: Children with Mental retardation   Frequency Percent Valid Percent Cumulative Percent   no 34 50.7 50.7 50.7 yes 33 49.3 49.3 100.0 Total 67 100.0 100.0   In the clinic report, the records showed that the doctors were also interested in knowing the mental retardation of the children who were diagnosed with TS. In response to that, the children who were diagnosed with TS and had no mental retardation were represented by 50.7% of the total sampled children from the clinic while on the other hand, 49.3% of the records showed the children who were diagnosed with TS and had mental retardation too. Table 3: Mental Retardation Stage   Frequency Percent Valid Percent Cumulative Percent   yok 35 52.2 52.2 52.2 border 4 6.0 6.0 58.2 mild 22 32.8 32.8 91.0 modarate 3 4.5 4.5 95.5 serious/heavy 3 4.5 4.5 100.0 Total 67 100.0 100.0     Fifty two point two percent of the samples from the clinic report records showed that the children were on yok stage of mental retardation, 6% of the sample were at the border stage of mental retardation, 32.8% of the sample from the clinic report represented children with mental retardation at the mild stage, 4.5% of represented children whose mental retardation stage was moderate and finally, another 4.5% from the report represented children whose mental retardation stage was serious and or heavy. Table 4: Children Diagnosed with ASD   Frequency Percent Valid Percent Cumulative Percent   no 54 80.6 80.6 80.6 yes 13 19.4 19.4 100.0 Total 67 100.0 100.0   Furthermore, data from the report showed that 80.6% of the children sampled were not as well diagnosed with autism spectrum disorder (ASD) while on the other hand, 19.4% of the data from the clinic report showed that some children were indeed diagnosed with ASD as a coexisting condition with the TS in those particular children. Table 5: Different Psychopathology on children   Frequency Percent Valid Percent Cumulative Percent   no 40 59.7 59.7 59.7 yes 27 40.3 40.3 100.0 Total 67 100.0 100.0   From the data source, it was revealed that psychopathology was not conducted on children represented by 59.7% while the remaining 40.3% of the children in the clinic report showed that they had psychology conducted on them. Table 6: Specific psychopathology except autism and mental retardation   Frequency Percent Valid Percent Cumulative Percent   no 39 58.2 58.2 58.2 internalization disorders (anxiety disorder – depression) 4 6.0 6.0 64.2 externalization disorders (adhd–behaviordis – oppositional disorder) 19 28.4 28.4 92.5 spesific learning disorders 5 7.5 7.5 100.0 Total 67 100.0 100.0     Fifty eight point two percent represented the children who had no specific psychopathology except autism and mental retardation as from the records, as 6% represented those children with internalization disorders including (anxiety disorder-depression), 28.4% from the sampled records represented children with externalization disorders (adh-behaviordis-oppositional disorder) and 7.5% represented children with specific learning disorders. Table 7: Used Psychiatric Drugs   Frequency Percent Valid Percent Cumulative Percent   no 55 82.1 82.1 82.1 yes 12 17.9 17.9 100.0 Total 67 100.0 100.0   Out of the patients who were diagnosed with TS in the clinic, the data from the records showed that 82.1% were not using psychiatric drugs in the management of their conditions against 17.9% of the children who had psychiatric drugs used on them to manage their conditions. Table 8: Types of Psychiatric Drugs Used   Frequency Percent Valid Percent Cumulative Percent   no 56 83.6 83.6 83.6 antipsychotics 7 10.4 10.4 94.0 antidepressan 4 6.0 6.0 100.0 Total 67 100.0 100.0   The hospital health practitioners were as well interested in recording the types of psychiatric drugs used on their patients, to the concern, the clinic report recorded that 83.6% of the children had no psychiatric drugs used in the management of their conditions, 10.4% represented the children whose conditions were being managed by use of antipsychotic drugs and 6% represented the children who had their conditions managed by use of antidepressant drugs.   Discussion Of The Results Demographic data is important in almost all research activities since they help the communities in their future preparations and plans to eliminate biasness in terms of gender, age or social class in the society (Hahn et al, 2016). In this study therefore, it helped to show the extent to which boys or girls were affected with the comorbid disorders as a result of TS. In regards to gender in the demographic information, it is clear from the clinic sample that the number of boys was slightly higher than that of girls as they had small percentage margin between their percentage representations showing that both genders were prevalent to TS though with male children having the higher risk chances. Furthermore, the results from this study showed that in as much as their a belief that TS suffering patients also suffer other neurological disorders, the highest percentage from the clinic report represented by 50.7% showed that those children who were diagnosed with TS were not having mental retardation as opposed to those who showed suffering from both TS and mental retardation represented by 49.7%. With this kind of percentage from the clinic report, it can be concluded that almost half of those diagnosed with TS will as well respond positively to mental retardation. Out of the children who turned to be having mental retardation, a substantial percentage of them represented by 32.8% had their mental retardation at mild stage and therefore manageable as opposed to 9% who were at moderate and severe/heavy stages. The majority of the children from the clinic report records indicated that they were not diagnosed with ASD as represented by 80.6% against only 19.4% who were diagnosed with both TS and ASD. It is therefore and evident from this that not in all cases should patients diagnosed with TS will as well show to have ASD as there are relatively low chances of such occurrence as from the results (Wilde et al, 2018). Most of the children as displayed from the report were not taken through psychopathological process as represented by 58.2% with a relatively higher percentage of the children taken through externalization disorders psychopathology at 28.4% with some few of them taken through internalization disorders test at 6% and the rest were taken through specific learning disorder test at 7.5%. In managing the condition of the children, drugs were not used in majority of them represented by 82.1% against only 17.9% who had their conditions managed by using psychiatric drugs such as antipsychotics at 10.4% and antidepressants at 6%.  From the data, the psychiatric drugs that were popularly used in the management of the children’s conditions was antipsychotics as opposed to antidepressants which were also used but not as much as compared to its counterpart.   References Cleary, M., Horsfall, J., & Hayter, M. (2014). Data collection and sampling in qualitative research: does size matter?. Journal of advanced nursing, 70(3), 473-475. Davidson, T. L., Hargrave, S. L., Swithers, S. E., Sample, C. H., Fu, X., Kinzig, K. P., & Zheng, W. (2013). Inter-relationships among diet, obesity and hippocampal-dependent cognitive function. Neuroscience, 253, 110-122. Desu, M. M. (2012). Sample size methodology. Elsevier. De Vries, P. J., Whittemore, V. H., Leclezio, L., Byars, A. W., Dunn, D., Ess, K. C., … & Jansen, A. (2015). Tuberous sclerosis associated neuropsychiatric disorders (TAND) and the TAND Checklist. Pediatric neurology, 52(1), 25-35. Gelman, A., Carlin, J. B., Stern, H. S., Dunson, D. B., Vehtari, A., & Rubin, D. B. (2014). Bayesian data analysis (Vol. 2). Boca Raton, FL: CRC press. Hahn, R. A., Wetterhall, S. F., Gay, G. A., Harshbarger, D. S., Burnett, C. A., Parrish, R. G., & Orend, R. J. (2016). The recording of demographic information on death certificates: a national survey of funeral directors. Public Health Reports. Hirschtritt, M. E., Lee, P. C., Pauls, D. L., Dion, Y., Grados, M. A., Illmann, C., … & Cath, D. C. (2015). Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA psychiatry, 72(4), 325-333. Jensen, C. M., & Steinhausen, H. C. (2015). Comorbid mental disorders in children and adolescents with attention-deficit/hyperactivity disorder in a large nationwide study. ADHD Attention Deficit and Hyperactivity Disorders, 7(1), 27-38. Wilde, L., Wade, K., Eden, K., Moss, J., Vries, P. J., & Oliver, C. (2018).Persistence of self?injury, aggression and property destruction in children and adults with tuberous sclerosis complex.Journal of intellectual disability research. William Jr, M., Glover, S., & Prawitt, D. (2016). Auditing and assurance services: A systematic approach. McGraw-Hill Education.

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