Neurotrophic factor levels and executive functions in children of parents with bipolar disorder: A case controlled study.

BACKGROUND: In the current study, it was aimed to evaluate neurotrophic factor levels and their relationship with executive functions in high-risk children and adolescents (high-risk group) whose parents were diagnosed with bipolar disorder (BD) but not affected by any psychiatric disease,and in order to determine possible vulnerability factors related to the disease. METHODS: The study sample consisted of 32 high-risk group and 34 healthy controls. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Adaptation (KSADS-PL-T), Stroop Test, Serial Digit Learning Test (SDLT) and Cancellation Test to evaluate executive functions were administered to all participants by the clinician.Serum levels of neurotrophic factors were measured using commercial enzyme linked immunosorbent assay kits. RESULTS: Serum BDNF, NT-3, NT-4 levels and SDLT scores were significantly lower in the high-risk group for BD compared to the healthy control group. A moderate negative correlation was found between BDNF levels and the Cancellation Test scores in the high-risk group. In addition to these results, the odds ratios of age, NT-4, SDLT scores for being in the risky group in terms of BD diagnosis were 1.26, 0.99 and 0.86 respectively. LIMITATIONS: This was a cross-sectional study. Causality between study results is therefore difficult to establish. The relatively small sample size of the study is another limitation. CONCLUSION: The results of the present study suggest that BDNF, NT-3, NT-4 may play a role in the physiopathology of BD and may be associated with impaired executive function areas such as attention and response inhibition in the high-risk group.

The relationship between executive functions and chronotype in healthy siblings of children with autism spectrum disorder.

The aim of this study is to examine executive functions in healthy siblings of children with autism spectrum disorder (ASD) and to evaluate the relationship between chronotype and executive functions (EF). This study included 40 healthy siblings (case group) of children with ASD and 40 healthy controls. Executive functions were evaluated by Stroop Test, Serial Digit Learning Test (SDLT) and Cancellation Test (CT). Children's Chronotype Questionnaire (CCTQ) and Autism Spectrum Screening Questionnaire (ASSQ) were administered to parents. It was determined that the Stroop Test and CT performances of the case group were significantly worse than the control group. There was no difference in SDLT. It was determined that the total CCTQ score of the case group was significantly higher. In addition, a significant positive correlation was found between the chronotype total score and the number of false targets in the second part of CT. In the logistic regression analysis; the chronotype total score, Stroop test fifth part correction number and CT fourth part error number were determined as possible factors in the differentiation of the case and control groups. More studies are needed to evaluate the relationship between executive functions and chronotype in siblings of children with ASD.

The Effect of Internet Addiction and Emotion Regulation on Trauma Reactions During the COVID-19 Pandemic in Adolescents With Anxiety Disorder.

ABSTRACT: In this study, we examined the relationship among trauma reactions, anxiety severity, Internet addiction (IA), and emotion regulation difficulties during the COVID-19 pandemic in adolescents with anxiety disorders. The sample of study consisted of 63 adolescents aged 12 to 18 years who were diagnosed with AD and their parents. IA scores and emotional regulation difficulties were significantly higher in the group with pathological trauma reactions than the group exhibiting nonpathological trauma reactions. The trauma scores of adolescents with AD were correlated with IA, emotional regulation difficulties, and anxiety scores. The results of mediation analysis found that IA was the full mediating factor in the relationship between anxiety and trauma scores and a partial mediating factor in the relationship between emotional regulation difficulties and trauma scores. As a result, monitoring adolescents' Internet use not exceeding healthy levels and developing and strengthening emotion regulation skills can help protect against trauma during the COVID-19 pandemic.

Perceived Expressed Emotion and Irritability in Adolescents With Attention-Deficit/Hyperactivity Disorder Inattentive Type: The Moderating Effect of Subtype.

The current study aimed to investigate perceived expressed emotion (EE) and irritability among adolescents with inattentive and combined type attention-deficit/hyperactivity disorder (ADHD-I and ADHD-C, respectively), and to assess whether the subtype plays a moderating role in the relationship between perceived EE and irritability. The current cross-sectional, case-control study comprised 37 adolescents with ADHD-I, 62 adolescents with ADHD-C, and 58 age- and sex-matched adolescents without ADHD. After controlling for confounding factors, adolescents with ADHD-C were found to exhibit significantly higher levels of perceived lack of emotional support than adolescents with ADHD-I (p = 0.029). Results of moderation analysis showed ADHD subtype to be a moderating factor in the relationship between perceived EE and irritability. [Journal of Psychosocial Nursing and Mental Health Services, 60(10), 11-20.].

Regulatory T cells in children with attention deficit hyperactivity disorder: A case-control study.

OBJECTIVE: The pathophysiology of attention deficit hyperactivity disorder (ADHD) are still not fully elucidated. Immune system dysregulation has emerged as a major etiological focus as a result of the high comorbidity of allergic disease, inflammatory biomarkers, and genetic research. The present study aimed to evaluate peripheral lymphocyte subpopulations and regulatory T cells (Tregs) in children with ADHD. METHODS: This single-center cross-sectional case-control study assessed 49 children with ADHD and 35 age- and gender-matched healthy children aged 7-12 years (9.10 ± 2.37 and 9.45 ± 2.13, respectively). The participants were screened for psychopathology using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, while the severity of ADHD symptoms was measured by means of the distracted-Continuous Performance Test. Peripheral lymphocyte subpopulations and Tregs were analyzed with flow-cytometry. RESULTS: There is no significant difference in peripheral blood lymphocyte subsets between ADHD and control groups The children diagnosed with ADHD exhibited significantly higher levels of CD3+ CD4+ CD25+ Foxp3+ (Tregs) than the healthy control subjects (8.23 ± 2.09 vs. 6.61 ± 2.89; z = 2.965, p = .004). The Tregs cell (Exp(B) = 1.334; p = .042; CI = 1.011-1.761) levels were determined to be statistically significant according to regression analysis and were associated with an increased probability of ADHD. CONCLUSION: Elevated Treg levels were linked to an increased likelihood of ADHD. This study suggested that changes in immune regulatory cells represent an important part of research in treatment of ADHD.

Chronotypes, sleep problems and trauma reactions in adolescents with anxiety disorders during the COVID-19 pandemic.

This study aims to investigate the relationship between chronotype preferences/sleep problems and trauma symptoms during the COVID-19 outbreak of adolescents diagnosed with Anxiety Disorder (AD) in the pre-COVID-19 period. The sample of this study consisted of 71 adolescents with AD. Trauma symptoms were evaluated using the Children's Event Impact Scale (CRIES-13); sleep habits were assessed using the Pittsburgh Sleep Quality Index (PSQI); and chronotype was evaluated using the Children's Chronotype Questionnaire (CCQ). The CRIES-13 arousal scores and PSQI sleep latency scores were significantly higher in the eveningness type group compared with the non-eveningness type group. The CRIES-13 arousal scores of adolescents with AD were related to the CCQ and PSQI scores. In linear regression analysis, sleep problems were found to be an associated factor on the CRIES-13 scores. The findings of the present study suggest that during the COVID-19 pandemic, the chronotype may play an important role in the adversities experienced by adolescents with AD. In addition, it was thought that the association between sleep problems and trauma in adolescents with AD who spent a lot of time in the home environment during the pandemic period needs further evaluation.

A Case Study on EEG Analysis: Embedding Entropy Estimations Indicate the Decreased Neuro-Cortical Complexity Levels Mediated by Methylphenidate Treatment in Children with ADHD.

Objective: Complexity analysis is a method employed to understand the activity of the brain. The effect of methylphenidate (MPH) treatment on neuro-cortical complexity changes is still unknown. This study aimed to reveal how MPH treatment affects the brain complexity of children with attention deficit hyperactivity disorder (ADHD) using entropy-based quantitative EEG analysis. Three embedding entropy approaches were applied to short segments of both pre- and post- medication EEG series. EEG signals were recorded for 25 boys with combined type ADHD prior to the administration of MPH and at the end of the first month of the treatment. Results: In comparison to Approximate Entropy (ApEn) and Sample Entropy (SampEn), Permutation Entropy (PermEn) provided the most sensitive estimations in investigating the impact of MPH treatment. In detail, the considerable decrease in EEG complexity levels were observed at six cortical regions (F3, F4, P4, T3, T6, O2) with statistically significant level (p < .05). As well, PermEn provided the most meaningful associations at central lobes as follows: 1) The largeness of EEG complexity levels was moderately related to the severity of ADHD symptom detected at pre-treatment stage. 2) The percentage change in the severity of opposition as the symptom cluster was moderately reduced by the change in entropy. Conclusion: A significant decrease in entropy levels in the frontal region was detected in boys with combined type ADHD undergoing MPH treatment at resting-state mode. The changes in entropy correlated with pre-treatment general symptom severity of ADHD and conduct disorder symptom cluster severity.

The relationship between irritability and autism symptoms in children with ASD in COVID-19 home confinement period.

OBJECTIVE: This study investigated the impact of COVID-19 home confinement on autism spectrum disorder (ASD) symptoms and irritability in children and adolescents with ASD. METHOD: The study participants included 46 drug-naive children aged 4-17 years diagnosed with ASD. Parents of the participants completed the Autism Behaviour Checklist (AuBC) and Affective Reactivity Index (ARI) scales for both normal conditions and COVID-19 home confinement. RESULTS: All subscale scores for AuBC (sensory, relating, body and object use, language, and social and self-help) and ARI scores significantly increased during the COVID-19 home confinement period (P < .05). The participants' irritability and ASD symptoms were significantly worse during the COVID-19 outbreak and home confinement period compared to normal conditions. The variables that predicted irritability were the social and self-help subscales of AuBC. DISCUSSION: These results have alerted us of the importance of focusing on the symptoms such as irritability exhibited by extremely vulnerable populations during disease outbreaks and of the necessity of developing new strategies to avoid such adverse outcomes in similar situations.

Are Maternal Personality Traits an Etiological Factor in Adolescents with Functional Chest Pain?

BACKGROUND: In the etiology of functional chest pain (FCP), parental personality traits are worth considering in the context of the biopsychosocial model. The αlpha factor sub-dimension of the five-factor personality model (5FPM) includes agreeableness, conscientiousness, and neuroticism. There is increasing evidence that this dimension may be related to psychosomatic diseases. It was aimed to investigate how maternal personality traits affect adolescents with FCP. The hypothesis was determined that adolescents diagnosed with FCP can have lower quality of life and be more depressive/anxious and their mothers can have factor-α personality traits and be more depressive/anxious. METHODS: The sample of this single-center, cross-sectional, case-control study consisted of 25 adolescents with FCP and their parents. The control group consisted of 35 age and sex matched healthy adolescents and their parents. Psychopathology was screened using the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) and psychiatric comorbidities were excluded. The Child Depression Inventory (CDI), the Spielberger State-Trait Anxiety Inventory (STAI), and KINDL forms were completed by the adolescents. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Five-Factor Personality Inventory short form (FFPI) were completed by the parents. RESULTS: Mothers of adolescents with FCP scored significantly higher compared with mothers of healthy controls in agreeableness and conscientiousness and scored significantly lower in neuroticism. Higher levels of mothers' neuroticism scores were associated with higher CDI and STAI-1 scores in FCP group. Agreeableness (Exp (B) = 10.097; p = .004; confidence interval [CI] = 2.049-49.745) and conscientiousness (Exp (B) = 16.414; p = .011; CI = 1.902-141.682) were statiscally significant in regression model. CONCLUSIONS: This study showed for the first time that mother's alpha factor personality traits may be one of the factors that contribute to the presence of FCP.

The relationship between chronotype, sleep, and autism symptom severity in children with ASD in COVID-19 home confinement period.

This study aimed to investigate the relationship between chronotype preference/sleep problems and symptom severity of children with Autism spectrum disorder (ASD) during the confinement and social isolation of the COVID-19 outbreak. This study included 46 drug-naive children aged 4-17 y diagnosed with ASD. The Autism Behavior Checklist (AuBC), Children's Sleep Habits Questionnaire (CSHQ), and Children's chronotype questionnaire (CCQ) were filled out before and at the end of the COVID-19 mandated home confinement by the children's parents. Children with ASD during the home confinement reported higher chronotype scores, i.e., eveningness chronotype, sleep problems, and autism symptom scores compared to the normal non-hone confinement state. The chronotype score and sleep problems of children with ASD during the home confinement period varied according to the AuBC score. The sleep problems of the children with ASD during the home confinement period mediated the relationship between chronotype score and severity of autism symptoms. It is essential to validate the role of the mediator effect of sleep problems and chronotype in larger samples of children with ASD with restricted to home confinement during the pandemic period. If sleep problems can be controlled with parental education, pharmacotherapy, and psychotherapeutic interventions, the impact on children with ASD of home confinement can be reduced.

Chronotypes and trauma reactions in children with ADHD in home confinement of COVID-19: full mediation effect of sleep problems.

This study aimed to investigate the relationship between chronotype preference/sleep problems and symptom severity of children with Attention Deficit Hyperactivity Disorder (ADHD) during the COVID-19 outbreak and to assess the chronotype preference/sleep problems that may play a mediating role in the relationship between the reactions to trauma and severity of ADHD symptoms. The sample of this single-center cross-sectional study consisted of 76 children with ADHD and their parents. Trauma symptoms were evaluated with the Children's Impact of Event Scale (CRIES-8); sleep habits were assessed using the Children's Sleep Habits Questionnaire (CSHQ); and chronotype was assessed using the Children's Chronotype Questionnaire (CCQ). There were significant differences in CRIES-8 and CSHQ scores between the eveningness type group and the non-eveningness type group. The CRIES-8 scores of children with ADHD were related to the CCQ and CSHQ scores and severity of ADHD symptoms. In mediation analyses, sleep problems were found to be the full mediating factor in the relationship between CRIES-8 scores and severity of ADHD symptoms and the relationship between CCQ scores and the severity of ADHD symptoms. Our findings indicate that chronotype plays an important role on the negative effects of home confinement of ADHD children during the COVID-19 outbreak. The role of the full mediator of sleep problems in the path from cognition to the behavior of young ADHD and non-ADHD children confined to the home environment during the pandemic period requires further assessment.

Risky cyber behaviors in adolescents with depression: A case control study.

OBJECTIVE: This study aimed to compare adolescents diagnosed with major depressive disorder (MDD) and healthy adolescents with regard to cyberbullying, cyber victimization, internet addiction, and digital game addiction. MATERIALS AND METHODS: This cross-sectional study was performed in Selçuk University Hospital. The study sample consisted of 34 adolescents with MDD and 39 controls without any psychopathology. A socio-demographic data form, the Cyber bullying Scale (CBS), Cyber Victimization Scale (CVS), Cyber bullying Sensibility Scale (CBSS), Internet Addiction Scale (IAS), Digital Game Dependence Scale (DGA-7), and Children's Anxiety and Depression Scale-Refurbished (RCADS) were administered to all participants. RESULTS: CBS, CVS, IAS and DGAS-7 scores of the MDD group were significantly higher than those of the control group. The significant differences persisted even after controlling for confounding factors such as age, gender, socio-economic level, and parental educational levels with MANCOVA. A strong positive correlation existed between CBS and CVS scores, and higher IAS scores were associated with higher CBS scores in the MDD group. CBSS scores negatively correlated with DGAS-7 scores in the MDD group. LIMITATIONS: Due to the cross-sectional design of this study, conclusions about causality remain speculative. CONCLUSION: This study demonstrated the importance of assessing problems related to the online environment in the presence of depression in adolescents. Our results suggested that evaluating the use of technology with a view to the potential for cyber bullying and cyber victimization as well as internet addiction and addiction to digital games may be necessary as a holistic approach in the follow-up of adolescent depression.

Olanzapine-Associated Pisa Syndrome in an Autistic Adolescent.

OBJECTIVES: The objective of this study is to report a case of Pisa syndrome due to olanzapine use in an autistic adolescent. METHODS: The patient was a 12-year-old adolescent girl who was taking olanzapine for autism-related behavioral problems. Abnormal posture and balance problems appeared in the third month of olanzapine treatment. The patient was diagnosed as having Pisa syndrome after clinical evaluation. Biperiden was started on the patient whose complaints continued despite olanzapine treatment was stopped. Patient's complaints regressed with biperiden treatment. RESULTS: According to our knowledge, there is no an autistic adolescent case of Pisa syndrome previously reported in the literature. Further studies are needed to clarify the etiology and treatment of Pisa syndrome. CONCLUSIONS: In patients with balance problems and abnormal posture as a result of olanzapine use, the clinician should keep in mind Pisa syndrome.

The relationship between chronotype and obesity in children and adolescent with attention deficit hyperactivity disorder.

Children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) have a high prevalence of obesity, but the relationship between these two problems is not clear. Chronotype preferences may be one of the possible mechanisms underlying the link between ADHD and obesity. This is the first study to investigate whether chronotype preferences are a mechanism linking ADHD symptoms to obesity in children and adolescents. This cross-sectional study included 110 drug-naive children and adolescents aged 7-17 years with ADHD. The Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) was used to diagnose ADHD or to exclude psychiatric comorbidity. The Conners' Parents Rating Scale-Revised Short Version (CPRS-RS) and Children's Chronotype Questionnaire (CCQ) were used to assess the severity of ADHD symptoms and chronotype preferences. Body mass index (BMI) was calculated and classified according to national age- and gender-specific reference values. The participants were divided into three groups as normal weight (<85%, n = 38), overweight (85%-95%, n = 30) and obesity (>95%, n = 42) according to their BMI percentile. There were statistically significant differences between the three groups in terms of chronotype preference (p = .000). Morningness preference was 86.84% in the normal BMI group and 26.19% in the obese BMI group. Eveningness preference was 7.89% in the normal BMI group and 61.90% in the obese BMI group. There was a correlation between the BMI percentile scores and the morningness/eveningness scale (M/E) scores. Moreover, there was a correlation between the BMI percentile scores and the oppositional and ADHD index scores. According to logistic regression analysis, the odds ratio of having evening type for obesity was 5.66 and the odds ratio of having morning type for normal weight was 13.03. Independently from ADHD symptoms, eveningness was directly related to obesity and morningness was directly related to normal weight. Prospective studies should be performed to better understand the relationship between ADHD, overweight/obesity and chronotype.

Psychopathology, quality of life, and related factors in children with celiac disease / Psicopatologia, qualidade de vida e fatores relacionados em crianças com doença celíaca

Abstract Objective: This study aimed to survey children with celiac disease (CD) for psychiatric disorders, determine the possible factors that predict psychopathology, and analyze health-related quality of life and possible factors that could affect the quality of life. Methods: In this study, all children completed the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime Version - Turkish Version (K-SADS-PL-T), as well as the Pediatric Quality of Life Inventory (PedsQL) for the 8-12 age group, and a sentence completion test. A face-to-face interview was performed with the parents of the participants to inform them about the study. Results: This study included 52 children with celiac disease in the age range of 8-12 years, and 40 healthy children. The mean age of the study group was 10.36 ± 0.36 years, and 31 (59%) of them were females. The mean age of the control group was 10.35 ± 0.46 years and 24 (60%) of them were females. The mean subscale scores of the Pediatric Quality of Life Inventory were significantly lower in children with celiac disease when compared to the control group (p < 0.05). There was at least one psychiatric disorder in the 26 (50%) children with celiac disease. Conclusions: This study has shown once more that celiac disease is associated with some psychiatric signs/diagnoses, and that it decreased quality of life. Further studies are needed to determine the factors that could reduce the psychiatric signs. It is apparent that those studies would contribute new approaches to improve diagnosis, treatment, and quality of life.

Resumo Objetivo: Neste estudo, foram avaliadas crianças com doença celíaca (DC) para verificar a existência de transtornos psiquiátricos, determinar os possíveis fatores que predizem psicopatologia e analisar a qualidade de vida relacionada à saúde e possíveis fatores que podem afetá-la. Métodos: Neste estudo, todas as crianças responderam à Entrevista para Transtornos Afetivos e Esquizofrenia em Crianças em Idade Escolar - Versão Presente e ao Longo da Vida - Versão Turca (K-SADS-PL-T), bem como ao Inventário Pediátrico de Qualidade de Vida (PedsQL) da faixa de 8-12 anos e ao teste de completar sentenças. Uma entrevista presencial foi feita com os pais dos participantes para informá-los sobre o estudo. Resultados: Este estudo incluiu 52 crianças com DC entre 8 e 12 anos e 40 crianças saudáveis. A idade média do grupo de estudo era de 10,36 ± 0,36 anos e 31 deles (59%) eram do sexo feminino. A idade média do grupo de controle era de 10,35 ± 0,46 anos e 24 deles (60%) eram do sexo feminino. Os escores médios das subescalas do PedsQL foram significativamente menores em crianças com DC quando comparados com o grupo de controle (p < 0,05). Havia pelo menos um transtorno psiquiátrico em 26 (50%) crianças com DC. Conclusões: Este estudo mostrou mais uma vez que a DC está associada a alguns sintomas/diagnósticos psiquiátricos e reduziu a qualidade de vida. São necessários estudos adicionais para determinar os fatores que podem reduzir os sintomas psiquiátricos. Está claro que esses estudos contribuiriam com novas abordagens para melhorar o diagnóstico, o tratamento e a qualidade de vida.

Psychopathology, quality of life, and related factors in children with celiac disease.

OBJECTIVE: This study aimed to survey children with celiac disease (CD) for psychiatric disorders, determine the possible factors that predict psychopathology, and analyze health-related quality of life and possible factors that could affect the quality of life. METHODS: In this study, all children completed the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime Version - Turkish Version (K-SADS-PL-T), as well as the Pediatric Quality of Life Inventory (PedsQL) for the 8-12 age group, and a sentence completion test. A face-to-face interview was performed with the parents of the participants to inform them about the study. RESULTS: This study included 52 children with celiac disease in the age range of 8-12 years, and 40 healthy children. The mean age of the study group was 10.36±0.36 years, and 31 (59%) of them were females. The mean age of the control group was 10.35±0.46 years and 24 (60%) of them were females. The mean subscale scores of the Pediatric Quality of Life Inventory were significantly lower in children with celiac disease when compared to the control group (p<0.05). There was at least one psychiatric disorder in the 26 (50%) children with celiac disease. CONCLUSIONS: This study has shown once more that celiac disease is associated with some psychiatric signs/diagnoses, and that it decreased quality of life. Further studies are needed to determine the factors that could reduce the psychiatric signs. It is apparent that those studies would contribute new approaches to improve diagnosis, treatment, and quality of life.

Attention Deficit Hyperactivity Disorder and oxidative stress: A short term follow up study.

In this study, we aimed to investigate total antioxidative status (TAS) and total oxidative status (TOS) of plasma and antioxidant enzymes such as paraoxonase (PON), stimulated paraoxonase (SPON), arylesterase (ARES) and thiols in plasma of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD). In the second step. this study aimed to reveal the possible effects of ADHD treatment on these parameters. Fifty-six patients with ADHD and 52 healthy controls were involved in this study. Venous blood samples were collected and oxidative and antioxidative parameter's were studied. In the second phase of the study, blood samples were taken from patients using medication. Pre-treatment oxidative stress index (OSI) values and the plasma TOS levels of the patients with ADHD were statistically higher than those of the control group. The plasma thiol levels of the patients with ADHD were significantly lower than the control group. The post-treatment plasma antioxidative parameter's levels were significantly higher than the pre-treatment levels. The post-treatment oxidative stress index value was significantly lower than the pre-treatment value. Therefore, oxidative metabolism was found to be impaired in children and adolescents with ADHD. It was also determined that methylphenidate repairs the oxidative balance by increasing antioxidant defence mechanisms.