functional outcome in late adolescence/early adulthood of patients with autism spectrum disorder and its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional study.

The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported "good" or "very good" outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education.

Patients with autism in the emergency department: cause of admissions and challenges.

Objective: This study aims to understand the presentations of autism spectrum disorder (ASD) patients in a tertiary hospital's emergency department (ED) in Turkey, and the difficulties of families face in the ED. Method: Clinical characteristics of ASD patients who presented to the ED between 1 January 2015 and 15 November 2020 were obtained by retrospective file review. The caregivers of the patients who had presented to the ED in 2020 were interviewed by a phone call. Results: There were 740 applications of 224 patients (192 boys, 32 girls). Almost half of the patients were between 0 and 5 years old. Respiratory problems were the most common cause of admissions in all age groups. The second common reasons for ED visits were gastrointestinal problems in 0-5 years old, traumatic injuries/poisoning in 6-12 years old, and epilepsy/syncope in 13-17 years old. Psychiatric problems were less common (2.7%) than other reasons for admission. The most challenging issue for children was "the crowded waiting area, and the long waiting period" and followed by "physical restraint imposed on the child," "noise," and "bright light." Conclusion: As the clinicians' awareness and use of more accurate diagnostic tools have increased, the ASD prevalence has gradually increased. To increase the quality of healthcare services for these patients, awareness studies and new interventions are needed.

Depression, anxiety, and sleep quality in childhood onset systemic lupus erythematosus and relationship with brain-derived neurotrophic factor.

BACKGROUND: The association between brain-derived neurotrophic factor (BDNF) and systemic lupus erythematosus (SLE) is controversial, and no study investigated the clinical associations of BDNF in patients with childhood onset systemic lupus erythematosus (cSLE). In this study, we aimed to investigate the serum levels of BDNF in patients with cSLE and examine whether a relationship of BDNF exists among depression, anxiety, and sleep quality. METHODS: Thirty patients and age-sex matched healthy controls were included. Depression, anxiety, sleep quality and quality of life were assessed by relevant questionnaires. Disease activity was assessed according to the SLE disease activity index (SLEDAI) and serum BDNF level was measured by the enzyme-linked immunosorbent assay method. RESULTS: Serum BDNF level was significantly lower in cSLE patients than healthy controls (21981 vs 29905 pg/mL, p = 0.001) and significantly decreased level was observed in active cSLE (SLEDAI >0), then those with SLEDAI = 0 (17110 vs 26852 pg/mL, p = 0.005). Although the scores of the depression, anxiety, sleep quality and quality of life questionnaires were strongly correlated with each other, no correlation was observed with serum BDNF levels. CONCLUSIONS: In patients with cSLE, serum level of BDNF was significantly decreased compared to healthy controls. Our results suggest that serum BDNF levels were not associated with the presence of anxiety, depression and poor sleep quality and might be dictated by the pathophysiological process of SLE rather than mood disorders.

Oxidative Stress and Serum S100B Levels in Adolescents with First-Episode Drug-Naive Unipolar Depression.

BACKGROUND: Unipolar depression is common among adolescents and has high recurrence rates. Studies conducted with adults show that oxidative stress plays a role in etiology of depression but studies with adolescent patients are limited. In addition, baseline S100B level in adult patients with depression is considered as a marker of response to treatment. The purpose of this study was to measure the levels of serum S100B, Malondialdehyde (MDA), total oxidant status (TOS), and total antioxidant status (TAS), which have not been previously investigated in adolescent patients with first-episode, drug-naive unipolar depression, and to investigate the relationship of these parameters with disease severity and patient-specific variables. SUBJECTS AND METHODS: This study was conducted with 37 adolescents diagnosed with unipolar depression and 37 healthy peers. Participants were asked to fill out the Beck Depression Scale, Screen for Child Anxiety Related Disorders, and suicide probability questionnaires. After this procedure, 5 cc blood was collected from the adolescents and serum S100B, MDA, TOS, and OSI levels measured. RESULTS: Serum S100B, MDA, TOS, and OSI levels were higher and TAS level was lower in patients than their healthy peers. There was no relationship between the patients' severity of depression or suicide probability and these parameters. The serum S100B, MDA, TOS, and OSI levels of female patients were higher than their healthy peers, but the TAS level was not different. Male patients had higher TOS and OSI levels and lower TAS levels than their healthy peers. CONCLUSIONS: The results show that increased serum S100B, MDA, TOS and OSI levels may contribute to etiology of depression regardless of gender. The gender-specific increase in S100B and MDA levels, which were significantly increased in female adolescent patients but not in males, should be supported by further follow-up studies.

Changes in adolescent mental health during the covid pandemic.

BACKGROUND: Previous pandemics around the world have shown that negative emotions are intensified in individuals when restrictions are imposed on human daily life activities. This study aims to draw attention to the pandemic-specific factors that might be associated with the severity of depression, anxiety, and COVID-19 phobia of high school students. METHODS: A total of 1,431 high school students aged 14 to 18 years were invited to participate in thisstudy using online survey forms. They were asked to fill out a questionnaire about themselves and the changes in their lives during the pandemic. They completed the COVID-19 Phobia Scale (C19P-S) and the Revised Children's Anxiety and Depression Scale (RCADS). RESULTS: Findings showed that being a girl is an increased risk factor for anxiety, depression, and COVID-19 phobia. In addition, following the official daily COVID-19 data and having a healthcare professional in the building of residence are significant risk factors for COVID-19 phobia. Having a psychiatric disorder, having a chronic disease, losing anyone due to COVID-19 infection, undergoing a COVID-19 diagnostic test, and meeting friends in person are increased risk factors for anxiety or depression during the pandemic. CONCLUSIONS: Changes in adolescents' lives caused by the COVID-19 pandemic are negatively affecting their mental health. Studies are needed to maintain the mental well-being of adolescents under the conditions of this pandemic.

Serum nesfatin-1, ghrelin, and lipid levels in adolescents with first episode drug naïve unipolar depression.

Background: Major depressive disorder (MDD) is a mental health and emotional disorder that affects children and adolescents worldwide. This study aimed to evaluate serum nesfatin-1, ghrelin, and lipid levels as biological markers of adolescent MDD and their relationship with the severity of depression-anxiety and suicide risk in MDD. Methods:This study included 37 drug naïve adolescents between the ages of 12 and 18 who were diagnosed with a first episode MDD according to the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) and DSM-V diagnostic criteria. Thirty-three healthy adolescents between the ages of 12 and 18 were included as the control group. The Children's Depression Inventory (CDI), Screen for Child Anxiety Related Disorders (SCARED), and Suicide Probability Scale (SPS) were used to evaluate the subjects in the MDD and control groups. In the first stage, serum nesfatin-1, ghrelin, and lipid levels were compared between the adolescents diagnosed with MDD and the control group. Next, the correlations between these levels and the CDI, SCARED, and SPS scores were evaluated. Results: Nesfatin-1 levels were significantly lower in the MDD group than the control group (p < 0.001) A positive correlation was found between the nesfatin-1 levels and the SPS scores. Conclusions: This is the first study to evaluate nesfatin-1 levels in adolescent depression, suggesting that nesfatin-1, ghrelin, total cholesterol, and low-density lipoprotein cholesterol (LDL) levels can be used as biomarkers in child-adolescent MDD. However, it is evident that further studies with larger samples and post-treatment measurements are needed.

Traumatic Childhood Experiences and Psychiatric Outcomes of Adolescent Mothers in Turkey.

The present study aimed to define the sociodemographic characteristics of adolescent mothers in Turkey as well as to compare their traumatic childhood experiences and their depression and anxiety levels with those of adult mothers. Sixty-eight mothers participated in this cross-sectional study. The frequency of traumatic childhood experiences and the severity of depression and anxiety symptoms among the adolescent mothers were found to be significantly lower than among the adult mothers, except for emotional neglect. The severity of anxiety symptoms was found to be significantly higher in those adolescent mothers who did not intend to become pregnant and who live with their own family or in institutional care than in those who live with their partner and/or his family. This is the first study to evaluate the traumatic childhood experiences of adolescent mothers in Turkey. Further, this cross-sectional study demonstrates that the initial psychiatric assessment of adolescent mothers who intended to become pregnant might reflect their level of psychiatric wellbeing. It is clear that additional policies concerning the prevention of adolescent pregnancy and the follow-up of adolescent mothers need to be developed in Turkey.

Knowledge, attitudes, and experience of child and adolescent psychiatrists in Turkey concerning pediatric electroconvulsive therapy.

OBJECTIVE: Electroconvulsive therapy (ECT) is a treatment modality in children that can be life-saving but is rarely preferred. In this study, we aimed to evaluate the knowledge, experience, and attitudes of child and adolescent psychiatrists (CAPs) in Turkey about pediatric ECT and to draw attention to possible gaps and needs regarding this treatment in the child and adolescent psychiatric policies of Turkey. METHOD: An electronic survey was prepared and shared with child and adolescent psychiatric residents and specialists. The participants were asked about their residency training, clinical experience, and opinion about ECT. The obtained data were entered in SPSS Statistics 23.0. Descriptive analyses and chi-squared tests were applied. RESULTS: One hundred and ninety-one CAPs filled in the questionnaire, 28.8% of whom assessed their knowledge level as "I have no knowledge." Only 34% of them stated that their patients, most of whom had mood disorders, schizophrenia, and catatonia, had received ECT before. Four of these patients were under 12 years old. Sixty-six percent of the participants suggested that ECT was safe in adolescents, whereas only 5.8% held this view for prepubertal children. The most common reason for physicians not to apply ECT was "lack of means to apply ECT," and 92.7% stated that opportunities should be provided for pediatric ECT treatment by the hospital administration. CONCLUSION: This is the first data to present the knowledge and attitudes of CAPs in Turkey about ECT. The results suggest that physicians need to have more knowledge about ECT.