Browsing by Author "Wijetunge, S."

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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.
Factors influencing a career in child and adolescent psychiatry: Views of psychiatry trainees in Sri Lanka
(Elsevier, 2022) Rohanachandra, Y.M.; Dahanayake, D.M.A.; Chandradasa, M.; Wijetunge, S.
No abstract available
A Juvenile sex offender with Attention Deficit Hyperactivity Disorder
(BbW Publisher, 2018) Chandradasa, M.; Hettiarachchi, D.; Fernando, R.; Gunathilake, M.; Wijetunge, S.; Tennakoon, A.
BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder manifesting in early life. These children are more vulnerable to sexual abuse as victims and offenders. This is a case report of a teenager with previously undiagnosed ADHD presenting with an alleged act of sexual offending. CASE REPORT: According to the 14-year-old accused, he has engaged in penetrative anal intercourse with another schoolmate. that similar past incidents had involved a teenage male relative and insertion of foreign bodies to his anus repeatedly by him. On assessment the accused had features of inattention, such as difficulty in sustaining attention, failing to finish work and features of impulsivity, such as difficulty waiting for his turn and intruding on others. He was diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental disorders (DSM 5) clinical criteria which were supported by the Sinhalese adaptation of the Swanson, Nolan and Pelham questionnaire. The assessment of the non-verbal intelligence was in the normal range, but his school performance was far below the average. DISCUSSION: Undiagnosed ADHD contributes to academic impairment and inappropriate sexual behaviour. It is possible that the described adolescent’s impulsiveness and inattention contributed to his academic failure and risky sexual behaviour. Early detection and proper management of this disorder may have reduced the risk of such behaviour in him.
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).
Psychometric properties of the Sinhala version of the Swanson, Nolan, and Pelham rating scale (SNAP-IV) parent form in healthy children and children with ADHD
(Elsevier, 2023) Abhayaratna, H.C.; Ariyasinghe, D.I.; Ginige, P.; Chandradasa, M.; Hansika, K.S.; Fernando, A.; Wijetunge, S.; Dassanayake, T.L.
OBJECTIVE: The present study aimed to translate and adapt the Parent Form of the MTA Version of the Swanson, Nolan, and Pelham ADHD/ODD rating scale (SNAP-IV) into Sinhala and examine its psychometric properties. METHOD: The MTA version of the SNAP-IV was translated into the Sinhala language by adhering to the WHO translation and adaptational process. The final Sinhala SNAP-IV (S-SNAP-IV) was administered to parents of 412 healthy children and adolescents (age: 6-18 years), and 272 children and adolescents with ADHD (age: 4-19 years). Internal consistency and factor structure of the S-SNAP-IV were determined in each sample. RESULTS: Conforming to that of the original English version, the S-SNAP-IV showed a three-factor structure (inattention, hyperactivity/impulsivity, and oppositional defiant disorder) in each sample, except for three item deviations (10,11, and 13) in the healthy sample. The S-SNAP-IV showed excellent internal consistency in the total sample (Cronbach's alpha = 0.97), healthy sample (Cronbach's alpha = 0.90), and the clinical sample (Cronbach's alpha = 0.94). The S-SNAP-IV also showed good discriminative validity: Only 1.5% of the healthy sample exceeded the cut-off scores in any domain, whereas all newly diagnosed, unmedicated children were S-SNAP-IV positive in at least one domain. CONCLUSIONS: The findings suggest that the three-factor model fits the S-SNAP-IV, and it clearly distinguishes children with ADHD from non-ADHD children. We conclude that the S-SNAP-IV possesses satisfactory psychometric properties-consistent with the MTA English version and its translations into other languages-making it a reliable and valid instrument for screening children with ADHD.
Serious bodily harm related to Obsessions from Sri Lanka
(Zagreb, 2017) Chandradasa, M.; Champika, L.; Hettiarachchi, D.; Wijetunge, S.; Mendis, J.
Silver Russell syndrome: A suspected syndromic child in Sri Lanka presenting with recurrent head-banging associated with force-feeding
(Sri Lanka College of Psychiatrists, 2024-10) Vidyatilake, P.; Kodikaraarachchi, D.; Chandradasa, M.; Wijetunge, S.
No abstract available