Frequency of Anxiety, Depression, and Irritability Symptoms in Children During the COVID-19 Outbreak and Potential Risk Factors Associated With These Symptoms.

ABSTRACT: The aim of this study was to determine the frequency of anxiety, depression, and irritability symptoms in children during the COVID-19 outbreak and to investigate the associated factors of these symptoms. This study was conducted with 1071 children aged 6 to 17. Results showed that 49.9% of the participants had anxiety symptoms, 29.5% had depression symptoms, and 51.4% had irritability symptoms. Low age was a potential risk factor for anxiety symptoms. Female sex was a potential risk factor for anxiety and depression symptoms. A COVID-19 death in the family or environment was a potential risk factor for depression and irritability symptoms. Exposure to COVID-19 information on television and on the internet was a potential risk factor for anxiety, depression, and irritability symptoms. In conclusion, this study revealed that the COVID-19 outbreak may have serious effects on the mental health of children, and the study highlighted potential risk factors.

Anxiety, depression and post-traumatic stress disorder symptoms in adolescents during the COVID-19 outbreak and associated factors.

INTRODUCTION: Outbreaks of infectious diseases have negative effects on mental health. Currently, there is very little information about the psychological effects of the COVID-19 pandemic on adolescents and associated factors affecting their mental health. The aim of the present study is to determine the severity of anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in adolescents during the COVID-19 outbreak, and to investigate the associated factors with these symptoms. METHODS: The present study was conducted with a total of 447 adolescents. Psychiatric symptoms were evaluated by the use of DSM-5 Level 2 Anxiety Scale, DSM-5 Level 2 Depression Scale and National Stressful Events Survey PTSD Short Scale. The association between age, gender, residential area, presence of COVID-19 in the participant, presence of COVID-19 in the family or environment and psychiatric symptoms were evaluated with linear regression analysis. RESULTS: The mean age of participants was 15.06, and 38.3% of the participants were men and 61.7% were women. The rate of participants with moderate or high levels of anxiety, depression and PTSD symptoms was 28%, 37.6% and 28.5%, respectively. High age and living in an urban area were associated with increased anxiety, depression and PTSD symptoms. In addition, female gender was associated with increased depression symptoms, and the presence of COVID-19 in the family or environment was associated with increased anxiety symptoms. CONCLUSION: The present study shows that adolescents have serious levels of anxiety, depression and PTSD symptoms during the COVID-19 pandemic. These results emphasise the need for mental health interventions that are appropriate for the characteristics of this age group.

The Relationship between Online Sexual Solicitation and Internet Addiction in Adolescents.

The purpose of this study is to investigate the association between online sexual solicitation (OSS) and internet accessibility, usage, and addiction in adolescents. The study was conducted with 48 adolescents who had been exposed to OSS and 48 age- and sex-matched adolescents who had not been exposed to OSS. Internet addiction (IA) was determined by the Young Internet Addiction Scale. The groups were compared in terms of socio-demographic characteristics, internet access facilities, internet use characteristics, psychiatric disorders, and IA. The results showed that the duration of daily internet use, the purpose of internet use, and the rate of IA were significantly higher in the OSS-exposed group than in the control group. Depressive disorder and post-traumatic stress disorder were more common in the OSS group than in the control group. Results revealed that the association between OSS and IA is independent of psychiatric disorders. In conclusion, the evaluation of adolescents exposed to OSS, in terms of IA and the measures and interventions to be taken in this regard, will contribute to the prevention of new exposures. Additionally, considering that OSS may be among the possible negative consequences of IA, evaluating adolescents with IA in terms of OSS will provide significant benefits.

Association of Reactive-Proactive Aggression and Anxiety Sensitivity with Internalizing and Externalizing Symptoms in Children with Attention-Deficit/Hyperactivity Disorder.

This study evaluates the associations among the symptoms of anxiety, depression, and disruptive behavioral disorders (DBD) in the context of their relationships with reactive-proactive aggression and anxiety sensitivity in children with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 342 treatment-naive children with ADHD. The severity of ADHD and DBD symptoms were assessed via parent- and teacher-rated inventories. Anxiety sensitivity, reactive-proactive aggression and severity of anxiety and depression symptoms of children were evaluated by self-report inventories. According to structural equation modeling, depression and anxiety scores had a relation with the DBD scores through reactive-proactive aggression. Results also showed a negative relation of the total scores of anxiety sensitivity on DBD scores, while conduct disorder scores had a positive relation with anxiety scores. This study suggests that examining the relations of reactive-proactive aggression and anxiety sensitivity with internalizing and externalizing disorders could be useful for understanding the link among these disorders in ADHD.

Gender Differences in Sexually Abused Children and Adolescents: A Multicenter Study in Turkey.

The purpose of this study was to examine gender-based differences in abuse-related characteristics and post-abuse psychiatric disorders among sexually abused children and adolescents. The researchers retrospectively examined files, judicial reports, and social examination reports of 1,250 sexually abused youth cases. Results showed that boys were more often victimized by penetration, force, and physical violence. Incidence of sexual abuse by family members, familiar persons, and multiple persons was higher among girls. In addition, a higher rate of major depressive disorder as well as alcohol consumption and cigarette smoking were found in sexually abused girls. No difference was observed between boys and girls in terms of post-traumatic stress disorder, conduct disorder, and other mental disorders. Intellectual disability was more frequent in boys.

An examination of the sociodemographic and psychiatric characteristics of children who have suffered penetrative and non-penetrative sexual abuse in Malatya, Eastern Turkey.

Penetrative and nonpenetrative sexual abuse can cause short- and long-term psychiatric problems in victims. This study aimed to examine the sociodemographic characteristics and psychiatric diseases of children in Malatya, eastern Turkey, according to whether the abuse was penetrative or nonpenetrative. A retrospective examination was conducted on the records of 115 cases of sexual abuse that had been referred to judicial authorities from January 1, 2012-July 30, 2019. The subjects were evaluated by a committee formed of 5-7 separate specialized department faculty members. It was determined that 51.3% (n = 59) of the cases had suffered nonpenetrative sexual abuse, and 48.7% (n = 56) had suffered penetrative sexual abuse. The majority of the perpetrators were known to the child from their close environment. A psychiatric diagnosis was made by the committee in 20.3% (n = 12) of the nonpenetrative cases and in 42.9% (n = 24) of the penetrative cases. There was a significant difference between penetrative and nonpenetrative sexual abuse in terms of psychiatric diagnoses. Of the cases of penetrative sexual abuse, 87.5% (n = 14) had attempted suicide. As a result, early diagnosis of sexual abuse, which has devastating effects on mental health in the early and late periods before it penetrates, can reduce the devastating effects on the child. For this reason, it is crucial for doctors, psychologists, social workers, and teachers who work with children to be informed about this issue.

The relationship between smoking, alcohol, and substance abuse and psychiatric diseases among adolescents treated in a child and adolescent psychiatry inpatient unit.

BACKGROUND: This study aimed to investigate the prevalence of smoking, alcohol, and substance abuse disorders among adolescents hospitalized in a university hospital child and adolescent psychiatry inpatient unit with different diagnoses, and to determine the rates of these disorders according to the mental illness diagnosis groups. METHODS: The study was conducted with 346 adolescents aged 12-18 who had been hospitalized with any psychiatric diagnosis between September 2016 and January 2020 in the child and adolescent psychiatry inpatient unit. The study considered the psychiatric diagnoses, based on the results of the DSM-5-based psychiatric interview; sociodemographic and clinical characteristics; the psychopathology history of first-degree relatives; comorbidities; length of hospital stay; income levels, and smoking, alcohol, and substance abuse. RESULTS: Twenty-four percent (n=83) of the participants had been smoking for 18 months or longer, 6.9% (n=24) were using alcohol, and 1% (n=28) were substance abusers. When the diagnosis distributions were examined, smoking was found to be higher in those with depressive disorders and trauma and related disorders, while smoking, alcohol, and substance use were found to be higher in the disruptive behavior disorder group. Smoking was found to be significantly lower in the obsessive-compulsive disorder group. CONCLUSIONS: Smoking, alcohol, and substance use among inpatient children and adolescents may worsen their existing psychopathology, so health professionals working in this field should consider this situation.

Problematic internet gaming in adolescents, and its relationship with emotional regulation and perceived social support.

Technological developments and the increased use of the internet have created some risks for adolescents, including problematic internet gaming (PIG). The aim of this study is to investigate the role of age, gender, emotional dysregulation and perceived social support in PIG. The study was conducted with 1,291 adolescents. Participants completed the game addiction scale (GAS), difficulties in emotion regulation scale (DERS), and multidimensional scale of perceived social support (MSPSS) under the observation of their teachers. According to the results of the GAS, participants were divided into two groups: those with PIG and those without PIG. The effect of age, gender, DERS scores, and MSPSS scores on PIG was investigated using stepwise logistic regression analysis. The mean age of participants was 14.7 years and the frequency of PIG was 13.5% (n = 144). The frequency of PIG was significantly higher in males than in females. The results showed that male gender, high emotional dysregulation and low perceived social support were significantly associated with PIG. The present study indicate that PIG is highly observed in adolescents, especially in males, and as in other behavioral addictions, emotional dysregulation and perceived social support can play an important role in PIG.

Neutrophil-lymphocyte and Platelet-lymphocyte Ratios among Adolescents with Substance Use Disorder: A Preliminary Study.

OBJECTIVE: Substance use disorder (SUD) is a serious public health problem affecting both the individual and the society, and substance use-related deaths and disability have been shown to increase gradually. Recent etiologic studies have reported that there is a relation between inflammatory parameters and psychiatric disorders. The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) used as an indicator of inflammation have been shown to be increased in various psychiatric disorders. In this study, we aimed to investigate the NLR and PLR in adolescents with SUD. METHODS: This study was conducted by retrospectively examining the records of 55 male adolescents who were followed up with SUD in a child and adolescent psychiatry outpatient clinic between November 2019-June 2020. Patients who had comorbid psychiatric disorder were included, and those who received any psychotropic medication were excluded. A total of 61 healthy male adolescents in the same age range without any psychiatric disorders were recruited as a control group. Neutrophil-lymphocyte-platelet counts were noted retrospectively from complete blood tests, and NLR-PLR were calculated. RESULTS: The NLR and PLR of adolescents with SUD were significantly higher than the healthy adolescents (p < 0.01, p < 0.01, respectively). In addition, conduct disorder, depression, and attention deficit/hyperactivity disorder, which were determined as the most common comorbid psychiatric disorders had no effects on NLR (p = 0.513, p = 0.584, p = 0.394, respectively) and PLR (p = 0.210, p = 0.346, p = 0.359, respectively). CONCLUSION: The results of current study indicate that inflammatory processes may have a key role in the pathophysiology of SUD.

Assessment of suicide probability and related factors in male incarcerated adolescents; a sample of reformatory center in Turkey.

OBJECTIVE: Suicidal behavior in adolescents is an important public health problem, and it ranks first among the causes of prison deaths in incarcerated adolescents(IAs). The aim of this study is to determine the probability of suicide and associated risk factors in IAs. METHOD: Seventy-one male adolescents in a reformatory center were contrasted with a matched group of 71 male adolescent with no psychiatric disorder and no criminal record. Suicidal probability and psychiatric symptomatology were assessed with the Suicide Probability Scale, SA-45 Questionnaire, respectively. RESULTS: It was determined that the probability of suicide was higher in IAs, and depression and hostility symptoms, the presence of another individual involved in delinquency in family had predictive effects. It was also found that there was a positive correlation between the probability of suicide and the number of delinquencies, the number of incarceration, and a negative correlation between attending to school or work while in reformatory and being visited by relatives while in reformatory. CONCLUSIONS: The results suggest that when assessing suicide risk for IAS, it may be useful to pay attention to those with symptoms of depression or hostility, those with multiple delinquencies or entrance to reformatory, and those who have family members involved in delinquency.

Is contrast sensitivity a physiological marker in attention-deficit hyperactivity disorder?

Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood-onset psychiatric disorders. Although the etiology is complex and has not yet been clarified, dopamine is thought to play a role in the etiology. Methylphenidate (MPH) is a psychostimulant drug used as first-line treatment for ADHD and it inhibits dopamine and norepinephrine reuptake transporters. Dopamine also has an effect on retina and contrast sensitivity. Despite evidence indicating the effects of dopamine on contrast sensitivity, the results of studies examining contrast sensitivity in ADHD patients are inconsistent. Also, no studies have been encountered examining the possible effect of MPH on contrast sensitivity. The hypotheses of this study are that children with ADHD who have not used MPH will have lower contrast sensitivity levels than the members of the control group, that contrast sensitivity levels increase after the use of MPH, and that contrast sensitivity is a potential physiological marker for ADHD. The study was conducted with 30 children with ADHD and 30 children without ADHD. Psychiatric evaluations of the participants were conducted with the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime-Turkish version, Conner's Parent Rating Scale-Revised Short form and the Turgay DSM-IV-based Child and Adolescent Behavioral Disorders Screening and Rating Scale. Photopic contrast sensitivity was measured using the Functional Acuity Contrast Test (FACT). Results showed that FACT mean values of the control group were significantly higher than those of the ADHD group (pre-treatment) in all spatial frequencies. In four spatial frequencies (CPD 1.5, 3, 12 and 18), the FACT mean values of the control group were significantly higher than the ADHD group (during the OROS-MPH treatment). At all spatial frequencies, the mean values of the ADHD group during the OROS-MPH treatment were significantly higher than before the OROS-MPH treatment. In conclusion, the present study showed that contrast sensitivity is low in children with ADHD and increases significantly after OROS-MPH medication, but still did not reach the levels of the children without ADHD. Our findings suggest that contrast sensitivity may be a potential physiological marker in ADHD.

Online sexual solicitation in adolescents; socio-demographic risk factors and association with psychiatric disorders, especially posttraumatic stress disorder.

Technological developments and increased use of the internet created some risks for adolescents, such as online sexual solicitation (OSS). The aim of this study is to examine the sociodemographic risk factors of OSS and the association between OSS and psychiatric disorders in a psychiatric clinical sample. The study was conducted with 189 adolescents. The psychiatric evaluation was performed with DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th ed.) based psychiatric interviews and the Strengths and Difficulties Questionnaire was used. OSS was defined by questions that are used in previous studies and that predict exposure to OSS. The participants were divided into two groups and compared. In addition, the Child Post-Traumatic Stress Disorder Reaction Index was answered by the participants who exposed to OSS. The prevalence of OSS was determined as 21.1%. Depressive disorder, borderline personality disorder, and secondary psychiatric diagnosis are significantly higher in adolescents who exposed to OSS. The rate of post-traumatic stress disorder (PTSD) development after exposure to OSS was determined as 57.8%. These results indicate that OSS is a severe trauma that occurs at a high rate, and it is associated with psychiatric problems, especially PTSD.

The relationship between prenatal testosterone and developmental stuttering in boys.

Dönmez YE, Özcan Ö, Bilgiç A, Miniksar DY. The relationship between prenatal testosterone and developmental stuttering in boys. Turk J Pediatr 2019; 61: 193-199. Stuttering is a multi-factorial speech disorder characterized by various dysfluencies in the beginning and/or smooth flow of speech. Its incidence is about 1% in the general population, with 80% of stuttering cases seen in children aged three to eight years. The etiology of developmental stuttering has not been precisely explained. Several researchers report that neurological factors, especially atypical lateralization of the speech and language processes, play an important role in the etiology of stuttering. Various hypotheses suggest that prenatal testosterone causes atypical hemispheric lateralization. The aim of this study was to investigate the role of prenatal testosterone in the etiology of developmental stuttering by the use of the ratio of secondand fourth-digit lengths (2D:4D). Totally 133 boys (49 boys who stutter and 84 boys who do not stutter) were included in the study. The age range of children participating in the study was determined as 2-12 years. In the comparative evaluation conducted between the stuttering group and the control group in terms of their right 2D:4D and left 2D:4D ratios, it was found that the left 2D:4D ratio of the patients was significantly higher than that of the control group. We are of the opinion that prenatal testosterone may play a role in the etiology of developmental stuttering. The present study is the first study in the literature to reveal a relationship between prenatal testosterone and developmental stuttering.

Management of Hepatotoxicity Induced by the Use of Olanzapine.

Numerous drugs cause hepatotoxicity clinically or biologically. Neuropsychiatric drugs constitute 16% of these drugs. The occurrence of hepatotoxicity induced by the use of olanzapine is expressed by the researchers. In such cases, generally the dose of olanzapine is reduced or the drug is completely discontinued and the treatment of the patient fails. The aim of this study is to report the case for whom elevated liver enzymes were observed but the process was managed without changing treatment dose and drug and to discuss this case with literature information. The present study has characteristics of being the first in the literature concerning management of the process.