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.

A Comprehensive Assessment of Long-Term Complications in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.

INTRODUCTION: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome are rare severe hypersensitivity reactions that lead to epithelial sloughing. Studies investigating the chronic multisystem effects of these syndromes and assessing patients in terms of quality of life (QOL), depression, and anxiety in the pediatric population are limited. In this study, we aimed to investigate the long-term effects of these diseases from a multisystem perspective. METHOD: Sixteen pediatric patients diagnosed with SJS, TEN, and SJS/TEN overlap syndrome were evaluated between September 2020 and March 2021. Physical and eye examinations were performed. To evaluate QOL and psychological status, Children's Dermatology Life Quality Index (CDLQI), Screen for Child Anxiety-Related Emotional Disorders (SCARED), and Children's Depression Inventory (CDI) were conducted. The patients' general characteristics, symptoms, and examination findings at their first admission were retrospectively obtained from the hospital's electronic records. RESULTS: Nineteen percent of the patients were female (n = 3). There were 7 patients (44%) with the diagnosis of SJS, 5 patients (31%) with TEN, and 4 patients (25%) with SJS/TEN overlap. The median follow-up time of the subjects was 6.5 years. The most common sequelae in the chronic period were skin changes (n = 13, 81%). Hyperpigmentation was the most common skin change (n = 9, 56%). In the last evaluation, 9 cases had eye involvement. In two cases, eye examination was normal in the acute phase, while ocular involvement was present in the chronic period. In 4 (50%) patients, there was height and/or weight percentile loss. Three patients' SCARED scores and 2 patients' CDI scores were high. According to the CDLQI survey, SJS, TEN, or SJS/TEN overlap syndrome had a small to moderate effect on the QOL in the 43% (n = 6) of the patients. The ANA values of 3 patients (60%) were positive at the follow-up and negative at the first admission. CONCLUSION: SJS, TEN, and SJS/TEN overlap syndrome may cause sequelae even after a long time of the onset of the disease. Patients' QOL and psychological status can be affected negatively. Ocular symptoms may develop in the follow-up, even without involvement in the acute period. Patients with SJS, TEN, and SJS/TEN overlap syndrome should be followed up in the chronic period and approached multidisciplinary.

The effects of emotional freedom techniques on coping with premenstrual syndrome: A randomized control trial.

PURPOSE: The present study evaluated the efficacy of Emotional Freedom Techniques (EFT), commonly called "tapping," for premenstrual (PMS) symptoms. DESIGN AND METHODS: This study was conducted with the participation of 50 nursing students who scored 111 or higher on the Premenstrual Syndrome Scale (PMSS). The students in the experimental group were instructed to apply EFT. FINDINGS: There were statistically significant differences between the mean depressive affect, fatigue, nervousness, sleep-related changes, and swelling subscale scores and the PMSS total scale score of the experimental group measured during the pretest and posttest (p < 0.05). PRACTICE IMPLICATIONS: The results demonstrate the efficacy of EFT in reducing PMS symptoms. As a fast and efficient self-treatment method, EFT can be easily implemented as a nonpharmacological intervention.

Relationship of Depression, Anxiety and Stress Levels with Religious Coping Strategies Among Turkish Pregnant Women During the COVID-19 Pandemic.

The aim of this study was to investigate the depression, anxiety, stress levels, and religious coping strategies of Turkish pregnant women during the COVID-19 pandemic. Of the pregnant women involved in this study (N = 327), 74.6% were concerned about their health, whereas 85.9% had concerns about the health of the fetus during the COVID-19 pandemic. It was found that 19.9% had extremely severe depression, 97.9% had extremely severe anxiety, and 52.3% had severe stress symptoms. Religious coping scores of the pregnant women included in the study were found to be high. There was a weak positive correlation between positive religious coping and depression and a very weak negative correlation between negative religious coping and depression.

Validity and Reliability of the Turkish Version of Screening Tool on Distress in Fertility Treatment (SCREENIVF).

BACKGROUND: Women diagnosed with infertility and receiving infertility treatment reported high levels of depressive symptoms, anxiety and distress. Infertile women should first be screened for psychosocial risks. Psychosocial care interventions should be planned according to their needs. The aim of this methodologically designed study was to test the validity and reliability of the Screening Tool on Distress in Fertility Treatment's (SCREENIVF) Turkish version in infertile women. SUBJECTS AND METHODS: The present study included 323 women diagnosed with nulliparous and undergoing fertility treatment. Women filled in the descriptive characteristics questionnaire, The Copenhagen Multi-Centre Psychosocial Infertility-Fertility Problem Stress Scale (COMPI-FPSS) and the SCREENIVF. RESULTS: To examine the contribution of the items to the scale, six items with an insufficient contribution to the scale were removed from the scale as a result of the item-total score correlation values (Corrected item-total correlation <0.25). The item-total score correlation coefficients and subscale-total score correlation coefficients obtained for each subscale ranged from 0.31 to 0.98. According to the regression equation formed in line with the multivariate linear regression model that will model the linear relationship between COMPI-FPSS, which is a scale equivalent to the subscale of the SCREENIVF, the total scores of the subscale were statistically significant predictors of the scores obtained from COMPI-FPSS, and (F=161.281, p<0.001) multiple explanatory coefficients were 77.2%. Cronbach's alpha coefficient was 0.77 and accepted to be reliable. 16% of the women participating in this study were above the cut-off scores concerning anxiety and depression, 13.9% acceptance, 8.2% hopelessness and 2% social support. The scale consisted of five subscales and 28 items. CONCLUSION: The findings indicate that the Turkish version of SCREENIVF is a valid and reliable measurement tool that can be used in the routine assessment regarding psychosocial aspects in the infertility treatment process.

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T).

AIM: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. METHOD: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. RESULTS: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. CONCLUSION: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.

Emotional freedom techniques and breathing awareness to reduce childbirth fear: A randomized controlled study.

BACKGROUND: Emotional freedom techniques (EFT) and breathing awareness (BA) are applicable during labour. The present study aimed to determine the effectiveness of EFT and BA in the reduction of childbirth fear. MATERIALS AND METHODS: This randomized controlled study included 120 pregnant women, of whom the EFT, BA and control groups. The women in the EFT and BA groups were offered their intervention in the latent, active and transition phases of labour. RESULTS: There was no significant difference in the sociodemographic and obstetric factors between the groups (p > 0.05). The Subjective Units of Distress Scale in active and transition phases were significantly lower in the EFT group. The difference in the scores for the Wijma Delivery Expectancy/Experience Questionnaire (version B) between the groups was significant (p < 0.001). CONCLUSION: Both EFT and BA were observed to be beneficial in clinical practice; the EFT was found to be more effective and permanent.

Prevalence of Childhood Affective disorders in Turkey: An epidemiological study.

AIM: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. METHODS: This study was conducted as a part of the "The Epidemiology of Childhood Psychopathology in Turkey" (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. RESULTS: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. CONCLUSION: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.

Preventing Child Sexual Abuse: Body Safety Training for Young Children in Turkey.

The "Body Safety Training Program" is an education program aimed at ensuring children are informed about their body and acquire self-protection skills. In this study, a total of 83 preschoolers were divided into experimental and control groups; based on a power analysis, 40 children comprised the experimental group, while 43 children comprised the control group. The "Body Safety Training Programme" was translated into Turkish and content validity was determined regarding the language and cultural appropriateness. The "What If Situations Test" (WIST) was administered to both groups before and after the training. Mann-Whitney U Test, Kruskal-Wallis Variance Analysis, and the Wilcoxon Signed Ranks Test were used to compare between the groups and the Spearman correlation analysis was used to determine the strength of the relationship between the dependent and independent variable. The differences between the pretest and posttest scores for the subscales (appropriate recognition, inappropriate recognition, say, do, tell, and reporting skills), and the personal safety questionnaire (PSQ) score means for the children in the experimental group were found to be statistically significant (p < .001). The posttest-pretest difference score means of the experimental group children for WIST saying, doing, telling and reporting, total skills, and PSQ were found to be statistically significant as compared to that of the control group (p < .05). The "Body Safety Training programme" is effective in increasing the child sexual abuse prevention and self-protection skills in Turkish young children.

Determining the Appropriateness of the "What If" Situations Test (WIST) with Turkish Pre-Schoolers.

Measurement instruments are needed to assess the child's sexual abuse prevention program. The purpose of the study was to determine the reliability and validity of the WIST (What If Situations Test) for Turkish culture. Participants were children of the 3-6 age group attending pre-school education institutions and the sample size was identified by means of a power analysis. Seventy children were identified as the sample with 0.85 power and 0.05 type I error according to the power analysis. Language validity, content validity, internal validity coefficient (Cronbach alpha coefficient), and test-retest analyses were conducted in terms of validity and reliability in the scope of efforts for adaptation to Turkish culture. Firstly, Kendall W = 0.83 was the score for the expert opinions concerning the content validity of the language validity scale. It was found that the Cronbach alpha coefficients were between 0.68 and 0.90 for the scale sub-dimensions of appropriate and inappropriate recognition, saying, doing, telling, and reporting. The test-retest reliability of the scale was found to be r = 0.89 and the test-retest reliabilities for the sub-dimensions (appropriate recognition, inappropriate recognition, say skills, do skills, tell skills, and reporting skills) were between r = 0.48 and r = 0.92. The test-retest reliability for the Personal Safety Questionnaire (PSQ), as having complimentary items to the WIST, was found to be r = 0.82. The reliability and validity analysis of the 'What If' Situations Test (WIST), used to evaluate pre-schoolers' skills regarding self-protection against sexual abuse, showed that the Test's adaptation to Turkish culture was reliable and valid.

The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients.

OBJECTIVE: Type 1 diabetes mellitus (T1DM) is a chronic disease which ranks third in children under age 16 years. Expressed emotion (EE) is a term that indicates a specific family climate including lack of emotional support (LES), irritability, and emotional over-involvement. It is known that the family environment is highly important for glycemic control in diabetic adolescents. In this study, the relationship between perceived EE and glycemic control in adolescents diagnosed with T1DM not accompanied by psychopathology were investigated. METHODS: The study included 49 adolescents with T1DM and 50 adolescents as a control group. Adolescents with psychopathology and intellectual disability were excluded from the study. Perceived EE was measured by the Shortened Level of Expressed Emotion Scale (SLEES) and blood sugar regulation was assessed by HbA1c levels. RESULTS: The adolescents with T1DM showed a significant difference in perceived EE (p=0.020) and LES (p=0.014) when compared with the control group. When diabetic adolescents were compared among themselves, the diabetic adolescents with poor glycemic control perceived greater EE (p=0.033) and less emotional support (p=0.049). In regression analyses, the predictive power of mother's educational level, the employment status of mothers and the subscale "LES" of SLEES combined to explain HbA1c level was determined to be 37.8%. CONCLUSION: The strong relationship between perceived EE and glycemic control showed us that perceived EE can hinder treatment compliance without causing psychopathology. For this reason, it is recommended that not only patients with psychopathology, but all diabetic adolescents receive psychosocial support and family interventions.

Relationship between Symptoms of Disruptive Behavior Disorders and Unsafe Internet Usage in Early Adolescence.

INTRODUCTION: Children and adolescents are at the highest risk for negative effects of internet usage. Risk taking and erroneous decision making have been described as major behavioral characteristics of patients with attention deficit hyperactivity disorder (ADHD). ADHD and its association particularly with oppositional defiant disorder/conduct disorder are correlated with risk-taking behaviors. This study was conducted to evaluate how disruptive behavior disorder symptoms are associated with internet usage, particularly unsafe internet usage, in early adolescents. METHODS: A sample of 1389 secondary school students was invited to the survey. All children were given an invitation letter and Conners' Parent Rating Scale (CPRS) forms were sent to their parents. The accepted participants filled in questionnaire forms, which consisted of questions interrogating demographic information and internet usage habits. RESULTS: Responses indicated that 27.4% (n=249) of the participants encountered unwanted content unintentionally and nearly one-third (n=280, 30.4%) had chatted online with people they did not know. Additionally, respondents who had more severe ADHD symptoms were more likely to report surfing online mainly for the purpose of chatting than respondents with milder ADHD symptoms. Students with comparatively higher attention deficit scores were also significantly more likely to report meeting in person with strangers they knew only from internet chatting. Analyses have demonstrated the presence of a significant difference between study participants with and without conduct disorder as for internet overusage or meeting with their internet acquaintances. CONCLUSION: This study suggests that there may be a significant relation between ADHD symptoms, conduct disorder and pathological and unsafe internet usage. Evaluating adolescents with ADHD and conduct disorder with this risk in mind is important in the development of both preventive and interventional strategies.

Depression and anxiety in child and adolescents with follow-up celiac disease and in their families.

BACKGROUND/AIMS: Earlier research has indicated a positive association between Celiac disease and some mental disorders in both adults and children. The aim of this study was to explore the diet compliance and depression and anxiety levels of pediatric celiac children and their families after a gluten-free diet. MATERIALS AND METHODS: A total of 30 celiac pediatric patients (17 children [57%] and 13 adolescents [43%]) were enrolled in the study, and 20 healthy controls (11 children [55%] and 9 adolescents [45%]) were studied as controls. Depression was assessed with the Children's Depression Inventory (CDI) form, and anxiety was assessed with the Screen for Child Anxiety Related Disorders (SCARED) form. Diet compliance was measured with a diet compliance form, and the families were asked to complete the Beck Depression Measurement (BDI) form for depression and the State-Trait Anxiety Inventory I-II (STAI-I and STAI-II) forms for anxiety. RESULTS: There was no significant difference in depression and anxiety between pediatric celiac patients consuming a gluten-free diet and the healthy control group. We observed no difference in depression and anxiety in the Celiac CD group patients. Diet compliance was 73.3% in the study group. CONCLUSION: The depression and anxiety levels of pediatric celiac patients and their parents did not differ from those in the healthy group.

How parental attitudes affect the risky computer and Internet usage patterns of adolescents: a population-based study in the Bursa District of Turkey.

BACKGROUND: We aimed to evaluate the computer usage patterns of adolescents and to determine the effects of family life and parental attitude on these patterns. METHODS: This was a descriptive, cross-sectional, population-based survey that included 935 children between 11 and 16 years of age who were students in the second level of primary school and their parents as well. The following instruments were used in the survey: student and parent questionnaires on computer usage patterns and the Parental Attitude Research Instrument (PARI) to assess parental attitudes towards child-rearing and family life. RESULTS: Of the study population, the majority of the students had a computer in their homes and spent a lot of time on the Internet. Parental control over the amount of time spent on the Internet and the websites that were visited had sometimes limited and contradictory effects on computer usage among the students. A democratic parental attitude was the best approach. Using the computer as a reward or punishment had a negative impact on the children's computer usage patterns. CONCLUSIONS: Although parents are confused concerning the benefits and harms of the Internet for their children and not certain how to manage their children's use of the computer and safe navigation of the Internet, a democratic parental attitude appears to be the best approach for reaching the most beneficial computer usage patterns for students.

Perceived parental acceptance/rejection and psychopathology in a group of sexually abused children/adolescents.

AIM: To investigate perceived maternal acceptance/rejection in a group of sexually abused children/adolescents. Quality of the relationship between caregiver and child has been linked to many behavioral and emotional problems of childhood. For those children/ adolescents subject to sexual abuse, perceived parental acceptance/ rejection is an important component of well being. METHODS: A total of 28 abused children/adolescents and their mothers participated in the study. The victims were sent by the court to the Uludag University Child and Adolescent Psychiatry Department for psychiatric evaluation. Numerical variables are presented with mean and standard deviation, categorical variables were presented as frequencies and percentages. Nonparametric correlation analysis was used for the relationship between psychological adjustment and perceived parental acceptance of children. RESULTS: The results of the study show that there was a significant correlation among child and mother reports of perceived acceptance. Children/adolescents also displayed more psychological adjustment than maladjustment. According to the Children's Depression Inventory, 15 victims were depressed and 13 were not. There was no remarkable difference between depressed and non-depressed subjects in terms of depression scores. Overall, the results of the study showed that both abused children/adolescents and their mothers perceived a positive relationship as measured by Perceived Parental Acceptance and Rejection Questionnaire-Control scores. CONCLUSION: The findings suggested that a well-established, healthy emotional bond is resilient to challenges, as was the case in the sexually abused children/adolescents of the study.

Use of complementary and alternative medicine and the anxiety levels of mothers of children with chronic diseases.

AIMS: This study aimed to determine the use of complementary and alternative medicine (CAM) by mothers with a chronically ill child and their anxiety levels. METHODS: This study used a descriptive design. The study was conducted with 135 mothers of a chronically ill child at a general pediatric and oncology unit in Uludag University Hospital, Bursa, Turkey. A questionnaire, including sociodemographic items and the State-Trait Anxiety Inventory, were given to the mothers. RESULTS: In the study, 42.29% of the mothers reported using one or more CAM therapies for their child with a chronic disease, including herbal medicine, taking the child to hodja (prayers), a special diet, and a special massage. The mothers experienced anxiety and the presence of a disease within the close family circle increased the anxiety level of the mothers. CONCLUSION: Herbs and other alternative supplements were used by some children with a chronic disease in Turkey. The most commonly used CAM therapies included oral herbal medicine, taking the child to hodja, massage, and diets. Therefore, it is important to consider the implications of the popularity of complementary therapies. Most of the mothers used more than one of these therapies for their child and the anxiety level of the mothers was found to be moderate.