Browsing by Author "Rohanachandra, Y."

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A Comparative study on medical comorbidities among children with autism spectrum disorder and controls in a children’s hospital.
(Sri Lanka College of Paediatricians, 2017) Chandradasa, M.; Rohanachandra, Y.; Dahanayake, D.; Hettiarachchi, D.; Gunathilake, M.; Fernando, R.; Wijetunge, S.
INTRODUCTION: Autism spectrum disorder (ASD) is a neurodevelopmental disorder, in which medical disorders are known to occur higher than in the general paediatric population. This may indicate either that the neurodevelopmental disorder is acting as a risk factor or sharing a common pathophysiological mechanism with the medical disorder. We could not access any publications focusing on medical comorbidities in autism from Sri Lanka. OBJECTIVE: To compare the prevalence and types of medical comorbidities between children with ASD and outpatient controls presenting to a children’s hospital in Sri Lanka. METHOD: This was an observational analytical study using a case control design. Seventy three consecutive new enrolments diagnosed as ASD at the child psychiatric services of Lady Ridgeway Hospital were recruited to the study group. An age and gender matched group of children presenting to the outpatient department with minor physical problems were recruited as the comparison group. The presence of a medical disorder was determined retrospectively by perusal of medical records. RESULTS: The prevalence of febrile seizures, epilepsy, bronchial asthma, atopic dermatitis and recurrent gastrointestinal symptoms in the child were higher in the ASD group compared to the control group. The differences of the rates between groups for bronchial asthma and recurrent gastrointestinal symptoms were statistically significant. Also, pregnancy induced hypertension and gestational diabetes mellitus in the mother was higher in ASD group. CONCLUSIONS: The probability of co-occurrence of certain medical disorders is significantly higher in children with ASD (neurological, respiratory, gastrointestinal and dermatological disorders) in comparison to controls.
Experience of required foreign specialist training: The lived experiences of Sri Lankan trainee child and adolescent psychiatrists in Australia
(Elsevier, 2021) Chandradasa, M.; Dahanayake, D.; Rohanachandra, Y.
No Abstract Available
A One year follow up study of persistent motor tic disorder treated with risperidone in a children’s hospital in Sri Lanka
(Sri Lanka College of Paediatricians, 2017) Chandradasa, M.; Hettiarachchi, D.; Rohanachandra, Y.; Wijetunge, S.
INTRODUCTION: Transient tics are common in children. In persistent motor tic disorders, single or multiple motor tics persist for more than a year. OBJECTIVE: To determine the one year outcome of persistent motor tic disorder treated with risperidone in a group of Sri Lankan children. METHOD: New patients presenting to the Child and Adolescent Mental Health Services of the Lady Ridgeway Hospital for Children in Colombo were screened for tics. Diagnosis was made by a consultant psychiatrist according to the Diagnostic and Statistical Manual of mental disorders 5th edition (DSM-5). The children were prospectively followed up for a period of one year with monthly assessments. Patients treated solely with oral risperidone from the beginning were analysed. In all children dose of risperidone ranged from 0.25-2 mg/day. Of all children with tics, only children with persistent motor tic disorder were included in the follow up. The symptom severity was measured using the Yale Global Tic Severity Scale (YGTSS). A reduction of the YGTSS score by 35% was considered as a satisfactory response to treatment. The presence of comorbid psychiatric disorders was assessed clinically as well as by using the Swanson, Nolan and Pelham teacher and parent rating scale 4th version and Yale Brown obsessive compulsive scale. Ethical approval was obtained from the ethical review committee of the Lady Ridgeway Hospital. RESULTS: Of the screened patients, 123 children were diagnosed with a persistent motor tic disorder at the beginning of the study. Of these, 17 were excluded because of irregular attendance at the monthly assessments and 3 were excluded as the diagnosis was changed to Tourette syndrome due to the detection of new symptoms. Eye blinking and shoulder shrugging were the commoner tic types in participants. Attention deficit hyperactivity disorder was the commonest comorbid psychiatric disorder. After 12 months follow up, 78.6% of participants responded to risperidone with a predefined 35% lessened tic severity score according to the YGTSS. The percentage of children with comorbid ADHD who had responded to risperidone at 35% YGTSS score reduction was significantly low compared to the children without ADHD (p<0.05). There was no statistically significant difference in the treatment response according to age, gender, complexity of tics or type of tics. CONCLUSIONS: After one year follow up, 79% of children with persistent motor tic disorder responded satisfactorily to risperidone. The percentage of children with comorbid ADHD who responded satisfactorily to risperidone was significantly low compared to the children without ADHD (p<0.05).
Psychological wellbeing and mental health amongst medical undergraduates: A descriptive study assessing more than 1,000 medical students in Sri Lanka
(London Avenue Publishing Co, 2022) Dahanayake, D.; Rajapakse, H.; Wickramasinghe, A.; Chandradasa, M.; Rohanachandra, Y.; Perera, S.; Nillo, A.M.; Molodynski, A.
BACKGROUND: Studies from around the world have shown higher rates of anxiety, depression, alcohol and other drug use, and burnout in medical students. AIMS: The aim of this study was to identify the socio-demographic factors and severity of difficulties Sri Lankan medical students face regarding psychological wellbeing and burnout. METHOD: This one-off survey used a cross-sectional design, assessing substance use, psychological wellbeing, and burnout using the CAGE, GHQ-12, and OLBI. The survey was open to all medical students in six universities in Sri Lanka. Chi-square analysis was used to assess the statistical significance related to categorical dependent variables and one-way ANOVA for continuous dependent variables. RESULTS: A higher prevalence of diagnosed mental health conditions was found following admission to the medical course in comparison prior to admission. Sixty-two percent of students had a score of more than 2 on the GHQ-12 indicating caseness. The OLBI identified exhaustion in 79% of students. The CAGE questionnaire was positive in 4.8% of students. CONCLUSIONS: Only a small proportion of students are recognizing their mental health difficulties and seeking help. Further understanding is required as to why this is, as well as re-evaluation of the demands of the curriculum. Effective ways of regularly identifying and providing practical and evidence-based support for mental health problems in medical and other undergraduates need to be identified and introduced. KEYWORDS: Sri Lanka; Wellbeing; burnout; medical students.
Self-harm in children and adolescents who presented at emergency units during the COVID-19 pandemic: An international retrospective cohort study
(Elsevier, 2023) Wong, B.H.; Cross, S.; Zavaleta-Ramírez, P.; Bauda, I.; Hoffman, P.; Ibeziako, P.; Nussbaum, L.; Berger, G.E.; Hassanian-Moghaddam, H.; Kapornai, K.; Mehdi, T.; Tolmac, J.; Barrett, E.; Romaniuk, L.; Davico, C.; Moghraby, O.S.; Ostrauskaite, G.; Chakrabarti, S.; Carucci, S.; Sofi, G.; Hussain, H.; Lloyd, A.S.K.; McNicholas, F.; Meadowcroft, B.; Rao, M.; Csábi, G.; Gatica-Bahamonde, G.; Öğütlü, H.; Skouta, E.; Elvins, R.; Boege, I.; Dahanayake, D.M.A.; Anderluh, M.; Chandradasa, M.; Girela-Serrano, B.M.; Uccella, S.; Stevanovic, D.; Lamberti, M.; Piercey, A.; Nagy, P.; Mehta, V.S.; Rohanachandra, Y.; Li, J.; Tufan, A.E.; Mirza, H.; Rozali, F.; Baig, B.J.; Noor, I.M.; Fujita, S.; Gholami, N.; Hangül, Z.; Vasileva, A.; Salucci, K.; Bilaç, Ö.; Yektaş, Ç.; Cansız, M.A.; Aksu, G.G.; Babatunde, S.; Youssef, F.; Al-Huseini, S.; Kılıçaslan, F.; Kutuk, M.O.; Pilecka, I.; Bakolis, I.; Ougrin, D.
OBJECTIVE: To compare psychiatric emergencies and self-harm at emergency departments (EDs) 1 year into the pandemic, to early pandemic and pre-pandemic, and to examine the changes in the characteristics of self-harm presentations. METHOD: This retrospective cohort study expanded on the Pandemic-Related Emergency Psychiatric Presentations (PREP-kids) study. Routine record data in March to April of 2019, 2020, and 2021 from 62 EDs in 25 countries were included. ED presentations made by children and adolescents for any mental health reasons were analyzed. RESULTS: Altogether, 8,174 psychiatric presentations were recorded (63.5% female; mean [SD] age, 14.3 [2.6] years), 3,742 of which were self-harm presentations. Rate of psychiatric ED presentations in March to April 2021 was twice as high as in March to April 2020 (incidence rate ratio [IRR], 1.93; 95% CI, 1.60-2.33), and 50% higher than in March to April 2019 (IRR, 1.51; 95% CI, 1.25-1.81). Rate of self-harm presentations doubled between March to April 2020 and March to April 2021 (IRR, 1.98; 95% CI, 1.68-2.34), and was overall 1.7 times higher than in March to April 2019 (IRR, 1.70; 95% CI, 1.44-2.00). Comparing self-harm characteristics in March to April 2021 with March to April 2019, self-harm contributed to a higher proportion of all psychiatric presentations (odds ratio [OR], 1.30; 95% CI, 1.05-1.62), whereas female representation in self-harm presentations doubled (OR, 1.98; 95% CI, 1.45-2.72) and follow-up appointments were offered 4 times as often (OR, 4.46; 95% CI, 2.32-8.58). CONCLUSION: Increased pediatric ED visits for both self-harm and psychiatric reasons were observed, suggesting potential deterioration in child mental health. Self-harm in girls possibly increased and needs to be prioritized. Clinical services should continue using follow-up appointments to support discharge from EDs. DIVERSITY & INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.