Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Child and Adolescent Mental Health Services (CAMHS) in a lower-middle income country: A survey from Sri Lanka.(SAGE Publications, 2023) Rohanachandra, Y.M.; Chandradasa, M.; Dahanayake, D.M.A.No abstract availableItem The Children of Afghanistan need urgent mental health support.(Elsevier, 2022) Shoib, S.; Essar, M.Y.; Saleem, S.M.; Legris, Z.; Chandradasa, M.No abstract availableItem Psychopathology among war-affected children and lessons from Sri Lanka on culturally relevant management(Science Forecast Publications LLC, 2018) Chandradasa, M.; Champika, L.Due to armed conflicts, family networks are disrupted with displacement, morbidity, death and ongoing threat to human lives. Children are directly and indirectly affected by conflict-related turmoil physically and mentally. Sri Lanka, an island nation in the Indian Ocean suffered an armed conflict lasting three decades causing more than 60,000 deaths. Elbert et al found that 92% of the minority Tamil children they surveyed in Northern Sri Lanka had experienced traumatizing events such as shelling and bombing and 25% met criteria for PTSD. Children in the South were also impacted by a continuous threat to their own and their parents’ lives due to frequent militant attacks, which included suicide bombers. Sri Lankan experience shows that culturally adapted psychotherapeutic interventions are effective for treating children with psychological trauma related to war and natural disasters. Child mental health professionals from other countries may find the Sri Lankan experience useful for planning their interventions.Item Child and youth mental health in post-war Sri Lanka(Royal College of Psychiatrists, 2017) Chandradasa, M.; Kuruppuarachchi, K.A.L.A.Sri Lanka's civil war and the tsunami in 2004 had enormous psychological impacts on the country's children. Tackling these issues has been difficult due to the lack of specialists in child and adolescent psychiatry. The end of the war in 2009 opened new avenues for the development of mental health services for children and youth in Sri Lanka. The year 2016 was historic in that the first board-certified child and adolescent psychiatrists assumed services in the country, after training in Australia.Item 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.Item 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).