Evaluation of SLC6A2 and CYP2D6 polymorphisms' effects on atomoxetine treatment in attention deficit and hyperactivity disorder.

BACKGROUND: There is insufficient replicated data to establish a relationship between the polymorphisms of SLC6A2 and CYP2D6 and the treatment responses of atomoxetine (ATX) in ADHD. We focused on evaluating the effect of top-line single nucleotide polymorphisms (SNPs) in SLC6A2 and CYP2D6 on the ATX treatment response in attention deficit and hyperactivity disorder (ADHD). METHODS: Of 160 patient records, 34 patients who met the inclusion criteria were evaluated to determine the relationship between genotypes of ten SNPs (six of SLC6A2 and four of CYP2D6) and ATX treatment response. Additionally, the connection between SNPs of CYP2D6 and the severity of side effects associated with ATX was analyzed in 37 patients, including the 34 study patients, and three patients discontinued because of ATX-dependent side effects. RESULTS: All six polymorphisms we studied in SLC6A2 were associated with the treatment response of ATX. Clinical improvement in oppositional defiant disorder symptoms of patients with ADHD was only observed in carriers of the homozygous "C" allele of rs3785143 (podd = 0.026). We detected an association between higher CGI-side-effect severity scores and the "TT" genotype of rs1065852 polymorphism in CYP2D6 (p = 0.043). CONCLUSIONS: The findings of this study suggest that genotypes of polymorphisms within the SLC6A2 and CYP2D6 may play an influential role in treatment response or the severity of side effects associated with ATX in ADHD patients.

Assessment of attitude of parents towards adolescents with Internet gaming disorder.

BACKGROUND: The determination of the protective and risk factors associated with Internet gaming disorder (IGD) is among the most important pathways to the development of prevention strategies for IGD. Previous research has shown that familial factors are associated with IGD. In our study, we aimed to assess the parental attitude of adolescents with IGD and investigate psychiatric comorbidity. METHODS: We assessed family structure, family relationship, parental attitude (in a bi-directional assessment), and psychiatric comorbidity in 50 adolescents aged 12-18 years who meet DSM-5 criteria for IGD in comparison with the control group. Parental attitudes were assessed with the Parental Attitude Research Instrument (filled by the mother) and the Parenting Style Inventory (filled by adolescents). RESULTS: Our findings suggest that according to mothers' opinions there were no significant differences in the subscale scores between the IGD group and the control group. On the other hand, acceptance-involvement and psychological autonomy subscale scores of the PSI filled by adolescents were found to be significantly lower in the IGD group. Limit setting in areas other than the Internet was significantly lower in the IGD group. High rates of psychiatric comorbidity were also found in adolescents with IGD. CONCLUSIONS: Our study identified that adolescents with IGD perceived their parents "cared less about them" and "minded less on their autonomy" compared with the control group. Our survey demonstrated that parental attitudes may be among the risk factors for IGD and the presence of psychiatric comorbidity may affect the management of IGD.

Impact of end-stage renal disease on psychological status and quality of life.

BACKGROUND: The aim of this study was to assess depression, anxiety, and quality of life (QOL) in a cohort of children and adolescents with end-stage renal disease (ESRD), to compare these findings with healthy controls, and to evaluate the association between these psychological symptoms, QOL, and clinical variables related to ESRD. METHODS: Thirty-two children and adolescents 8-18 years of age were enrolled in the study. The sociodemographic data were evaluated. Questionnaires were used to evaluate the psychological status and QOL of the patients and healthy controls. RESULTS: There was a significant difference in mean depression score, which was significantly higher for the ESRD patients. Mean state anxiety score was significantly lower for ESRD patients than for controls. Regarding QOL score, there were significant differences between the ESRD patients and control groups for both child-rated and parent-rated QOL scores, which were significantly lower for ESRD patients. Trait anxiety was a negative predictor of all subscales of the Pediatric Quality of Life Inventory 4. CONCLUSIONS: End-stage renal disease was related to significant morbidity and poorer QOL. The assessment and enhancement of QOL and comorbid psychiatric disorders in ESRD should be a part of disease management.

Plasma Methylphenidate Levels in Youths With Attention Deficit Hyperactivity Disorder Treated With OROS Formulation.

BACKGROUND: There are limited studies investigating the relationship between oral release osmotic system-methylphenidate (OROS-MPH) doses and plasma methylphenidate (MPH) concentrations in children and adolescents. The aim of this study was to investigate the relationship between the doses of OROS-MPH and the plasma levels of the drug. We also examined the effects of the other drugs including aripiprazole, risperidone, fluoxetine, and sertraline on the levels of the MPH in the plasma. METHODS: The files of 100 attention deficit hyperactivity disorder (ADHD) subjects (76 male, 24 female) who were diagnosed as ADHD according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition criteria, were screened. The ages of subjects were between 6 and 18 years (mean = 11.5 ± 3.8 years). Plasma MPH levels were determined by high-performance liquid chromatography-tandem mass spectrometry assay. RESULTS: Daily mean OROS-MPH dose used in ADHD children was 0.7 ± 0.2 mg/kg (range: 0.3-1.3 mg/kg). The mean plasma OROS-MPH was 11.6 ± 7.3 ng/mL (range: 0.5-43.4 ng/mL). There was no group difference in the mean plasma MPH and dose-related MPH levels between the groups that used any additional drug including aripiprazole (n = 25), risperidone (n = 10), fluoxetine (n = 16), sertraline (n = 10), and did not use these drugs (P > 0.05). There was a positive correlation between the OROS-MPH doses (mg/kg) and the blood MPH levels (Pearson correlation = 0.40; P < 0.001). The plasma levels of MPH were found to be less than 13 ng/mL in 65% of the subjects. CONCLUSIONS: Our findings point to the fact that plasma levels of MPH show a wide range of changes at similar doses, correlate positively with the doses and, as expected, are not affected by using risperidone, sertraline, fluoxetine, and aripiprazole. Therapeutic drug monitoring may help to optimize MPH dose in patients not responding to treatment or in those experiencing serious side effects, but not in routine clinical practice. The presence of intermediate dose formulations such as 45-mg tablets for OROS-MPH may contribute to the optimization.

A comparison of the social cognition and neurocognitive characteristics of adolescents with suicide behavior, adolescent with depression and healthy controls.

INTRODUCTION: Deficits in neurocognition and social-cognition have been suggested to be an endophenotype for suicidal behavior. We aimed to compare the social-cognition and neurocognitive characteristics of adolescents diagnosed with depression with and without suicidal behavior and to investigate whether these functions predict suicide. METHOD: Adolescents diagnosed with Major Depressive Disorder (MDD) with suicidal behavior (n = 42); MDD without suicidal behavior (n = 44) and age- and sex-matched controls (n = 43) were included. The University of Pennsylvania Computerized Neurobehavioral Test Battery and Autism Spectrum Screening Questionnaire (ASSQ) were used to evaluate social-cognition and neurocognitive characteristics. RESULTS: Several neurocognitive domain values of MDD groups, were significantly different from the control group. Neutral emotion recognition task (p = 0.025) and ASSQ scores were found to be significantly impaired in the patient groups (p < 0.001). Logistic regression analysis showed that, only the increase in the Suicide Probability Scale score was found to be significant as a risk factor predicting suicide (p = 0.007, OR: 1.246). CONCLUSION: While the neurocognitive and social-cognitive performances of adolescents with MDD were significantly lower than the control group, these performances in the two depression groups were similar. When the predictors of suicidal behavior were examined, it was found that only the increase in suicidal ideation scores predicted suicide.

A multi-dimensional assessment of internet gaming disorder in children and adolescents: A case-control study.

BACKGROUND: Internet gaming disorder (IGD) leads to social disturbances and isolation, neglect of daily responsibilities, behavioral disorders, and physical impairments. OBJECTIVE: This study aimed to investigate the effect of IGD on spine biomechanics, range of motion in the neck and low back, and lung functions and respiratory muscle strength in children and adolescents. METHODS: Sixty-four children and adolescents with IGD (Group I) and 41 healthy controls (Group II) were included in the study. The outcomes were assessed with the Visual Analogue Scale (VAS), Internet Addiction Scale, active range of motion (AROM) in the neck and lumbar spine, posture and spinal alignment, lung function tests, and respiratory muscle strength. RESULTS: There is a significant difference in pain intensity at rest, during activity, and daily sitting time between groups (p < 0.05). Craniovertebral angle, shoulder asymmetry, thoracic kyphosis angle, cervical extension and rotation, and right lumbar rotation significantly decreased in Group I than in Group II (p < 0.05). Besides, the PEF, FEF 25-75%, and respiratory muscle strength were lower in Group I than in Group II (p < 0.05). With a multiple linear regression model, MEP, FEV1, and weekly time spent playing online games were significant predictors of internet addiction intensity (R2 = 0.28; p = 0.02, p = 0.01, and p < 0.001, respectively). CONCLUSION: Postural misalignment and increased sedentary time cause physical health deterioration and negatively affect lung functions in children and adolescents with IGD. Consequently, considering both psychological and physical health is necessary to assess the problematic nature of internet gaming. A comprehensive assessment and multidisciplinary team approach is essential to managing the IGD.

Internalized stigma and traumatizing effects of psychiatric hospitalization in adolescents: Is there any difference between being hospitalized in adult or adolescent inpatient psychiatric services?

OBJECTIVE: Psychiatric hospitalization serves as a critical treatment modality. However, hospitalization may pose risks of traumatization or stigma. This study primarily examined the internalized stigma and traumatizing effects of psychiatric hospitalization on adolescents. Additionally, the treatment of adolescents within adult inpatient psychiatric services may yield differing stigmatization and posttraumatic stress disorder (PTSD) symptomatology. Hence, the secondary objective was to discern the variance in stigmatization and PTSD symptoms between adolescents treated in adult inpatient psychiatric services (AIPS) and those in child and adolescent inpatient psychiatric services (CAIPS). METHOD: The cohort consisted of patients from Akdeniz University's Adult Psychiatry Inpatient Service (n = 29) and Uludag University's Child and Adolescent Psychiatry Inpatient Service (n = 28), matched for age and gender. Assessments using the Child Posttraumatic Stress Disorder-Reaction Index and the Internalized Stigma Scale for Children and Adolescents (ISSCA) were conducted 6 months after discharge. RESULTS: 36.8% and 10.5% of adolescents exhibited "mild" and "very severe" PTSD symptoms, respectively. Adolescents treated in CAIPS had higher Child Posttraumatic Stress Disorder-Reaction Index scores than those in AIPS. However, there was no significant difference between the AIPS and CAIPS groups regarding ISSCA-self and ISSCA-perceived scores. CONCLUSIONS: The current findings underscore that psychiatric hospitalization can lead to traumatic experiences in adolescents, especially those treated in CAIPS. Providing informed care and emotional support during hospitalization could bolster resilience and facilitate recovery among these individuals. While adolescents are sometimes placed in AIPS, it is crucial that professionals are adequately trained and supported in managing this vulnerable population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Aripiprazole Used to Treat Capgras Syndrome in an Adolescent Diagnosed With Autism.

OBJECTIVES: This report discusses the emergence, clinical appearance, and treatment of the rare entity Capgras syndrome (CS) in an adolescent diagnosed with autism. METHODS: After a brief introduction to the CS, we conduct a detailed description of the case and review, after a search on the PubMed database, the known pathophysiology, psychiatric disorders associated with the onset of this syndrome, and the management of CS. RESULTS: Capgras syndrome generally emerges during the course of delusional disorder, schizophrenia, or mood disorders, and for reasons such as neurological, infectious, or endocrinological diseases, drug intoxications, or deprivation. We encountered no previous reports of CS developing during the course of autism. There are no prospective studies concerning the treatment of the syndrome. However, antipsychotic drug use is primarily recommended in treatment. Antipsychotic drug therapy was therefore planned for the treatment of delusion, a psychotic symptom, in this case. The atypical antipsychotic aripiprazole was used based on the presence of accompanying diagnosis of autism, and the patient's body mass index and age. A relatively high dose of aripiprazole was required for the first psychotic attack in our patient. However, a good level of response was achieved within the expected time frame. In addition, no marked adverse effects were observed. CONCLUSIONS: Aripiprazole seems to be an effective and well-tolerated antipsychotic drug in the treatment of CS accompanying autism.

The Reliability and Validity of the Turkish Version of Smartphone Impact Scale.

The Smartphone Impact Scale (SIS) was originally developed in English to determine the cognitive, affective, social, and behavioral impacts of smartphones. This study aimed to translate and cross-culturally adapt the SIS instrument into Turkish and investigate its psychometric properties. Two hundred and sixty-four young and middle-aged adults (186 females) with a mean age of 36.24 years (SD = 14.93; range, 18-65 years) were included. For cross-cultural adaptation, two bi-lingual translators used the back-translation procedure. Within a 5-to-7-day period after the first assessment, the participants completed the Turkish version of SIS (SIS-T) to evaluate test-retest reliability. Cronbach's alpha (α) was used to assess internal consistency. The correlation between the Turkish version of the Smartphone Addiction Scale (SAS-T) and the Nottingham Health Profile was determined to check the validity. The SIS-T had a high-level internal consistency (α = 0.86) and test-retest reliability (ICC2,1 = 0.56 to 0.89 for subscales). The SIS-T subscales were correlated with the SAS-T (r = 0.31 to 0.66, p < 0.01), indicating a good concurrent validity. The results show that the SIS-T is semantically and linguistically adequate to determine smartphones' cognitive, affective, social, and behavioral impacts on young and middle-aged adults. Good internal validity and test-retest reliability of the SIS-T were defined to evaluate the impacts of smartphones among Turkish-speaking young and middle-aged adults.

Psychomotor agitation and irritability in adolescents with manic episode: Clinical data from three inpatient units.

OBJECTIVES: We aimed to investigate the characteristics of adolescents with Bipolar disorder-I with irritability and agitation (Mania+IA) compared to those without irritability and agitation (Mania-IA) in a multi-center representative sample. METHODS: Data of 145 patients from three tertiary-care inpatient units between 2016 and 2021 were obtained. Psychomotor agitation was defined as a score of ≥3 on the YMRS "Increased Motor Activity--Energy" item, irritability as a score of ≥4 on the YMRS 'irritability' item, and severity anchors of speech and thought disturbance on the YMRS '6 and 7' items. RESULTS: Previous manic episodes (p = 0.013), involuntary hospitalization (p = 0.006), psychotic features (p = 0.001), formal thought disorder (p = 0.010) and aggressive/disruptive behavior (p = 0.021) were more frequent in the Mania+IA group. Conversely, depressive episodes (p = 0.006) and family history of depression (p = 0.024) were more frequent in the Mania-IA group. The Mania+IA had poorer functioning at the time of discharge. CONCLUSIONS: Irritability and agitation were closely related to complications, psychotic symptoms and thought disorder. Assessment and monitoring of psychomotor agitation and irritability may help child and adolescent psychiatrists to predict clinical difficulties and appropriate interventions.

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.

The investigation of foot structure within children who have attention-deficit hyperactivity disorder: a case-controlled study.

The impairments in motor performance could be related to the foot structure in children with attention-deficit/hyperactivity disorder (ADHD) while considering the close relationship between foot structure and lower extremity alignment. This study aimed to investigate the foot structure and its relationships between disease severity, physical activity and psychiatric traits in children with ADHD. Children with ADHD (n = 50; mean age: 12.02 ± 1.83 years) and typically developing peers (n = 30; mean age: 12.86 ± 2.56 years) were included. The static footprint analysis was collected by using digital images. The ImageJ program was used to calculate Clarke's angle, Staheli arch index (SAI) and Chippaux-Smirak index (CSI). The Turgay DSM-IV disruptive behavior disorders rating scale (T-DSM-IV-S), physical activity questionnaire for older children (PQ-C), children's depression inventory and state-trait anxiety inventory for children were all used to assess symptoms of ADHD, physical activity, depression, stress and anxiety, respectively. Approximately 52-53% of children with ADHD had mild to severe flatfoot, while only 8-13% of typically developing peers had flatfoot based on SAI and CSI (P = 0.01). Significant correlation was found between Clarke's angle and PQ-C (r = 0.21, P = 0.04). Besides, T-DSM-IV-S was significantly correlated with SAI (r = 0.24, P = 0.01) and CSI (r = 0.25, P = 0.01) in children with ADHD. Children with ADHD had a significantly greater tendency of flatfoot compared to typically developing peers. Besides, the deterioration of the foot structure of children with ADHD was associated with disease severity.

Long-Term Effects of Lithium Use on Children and Adolescents: A Retrospective Study from Turkey.

Background: The aim of this study was to evaluate the long-term effects of lithium treatment on white blood cell (WBC) count, serum creatinine, and thyroid-stimulating hormone (TSH) levels in children and adolescents with bipolar disorder (BD) and non-BD in a Turkish children and adolescent sample. Methods: The study is based on retrospective chart review. Children and adolescent patients with BD and non-BD prescribed lithium in a mental health and neurological disorders hospital between 2012 and 2017 were included in the study. Data were collected from the electronic medical files. Laboratory values for WBC count, serum creatinine, and TSH levels at baseline within the week before the onset of lithium, and at 1st, 3rd, 6th, and 12th month of treatment were recorded. Results: A total of 143 patients (82 females, 61 males; 100 BD, 43 non-BD) aged 9-18 were included. Non-BD diagnoses were psychotic and schizoaffective disorders, unipolar depression, attention-deficit/hyperactivity disorder, conduct disorder, severe mood dysregulation syndrome, borderline personality disorder, and autism. Mean age of the participants were 15.90 ± 1.16 years for the bipolar group and 14.88 ± 1.79 years for the nonbipolar group. Patients with BD reported more adverse effects. There was a statistically significant increase in WBC counts and TSH levels at any time point. A statistically significant elevation in serum creatinine was found at 3rd and 12th month of treatment. During the course of lithium treatment, WBC counts exceeded 13,000 in 14 (9.8%) patients, and TSH levels exceeded 5.5 mU/L in 41 patients (28.6%). Twenty-one (14.68%) patients were started on thyroxin replacement. Basal TSH levels and duration of the lithium treatment were higher in the participants with TSH levels exceeding 5.5 mU/L. Lithium maximum dose, lithium blood level, basal TSH level, and duration of treatment were higher in the participants receiving thyroxin replacement. No patients had serum creatinine levels exceeding the normal reference values. Conclusion: Our study suggests that lithium is a generally safe and tolerable agent for children and adolescents with BD and non-BD; however, close monitoring of thyroid functions particularly in patients with a higher basal TSH level and longer duration of lithium use is important.

Relationship of Temperament Differences with Diagnosis, Severity and Accompanying Psychiatric Symptoms in Autism Spectrum Disorder.

Introduction: Temperament differences were shown in children with autism spectrum disorder (ASD); however, associations of temperament with ASD severity and accompanying psychiatric symptoms have yet to be studied. Methods: We evaluated 58 ASD-diagnosed children's temperaments through disorder severity and psychiatric symptoms and compared them with 58 typically developed children. We utilized the Children's Behavior Questionnaire-Short Form, The Strengths and Difficulties Questionnaire (SDQ). The Childhood Autism Rating Scale (CARS) was used to evaluate psychiatric symptoms and ASD severity levels of children. Results: Negative affect, effortful control, and perceptual sensitivity were found lower in ASD-diagnosed children and decreased with ASD severity. Effortful control was also found negatively correlated with scores of behavioral problems, hyperactivity, and total difficulties. Besides, anger/frustration was found predictive for conduct and peer problems, and total difficulty scores. Conclusion: Further studies are needed to verify and expand these pioneer findings.

Mentalization in female adolescents with non-suicidal self-injury and alexithymic and depressive features in their parents.

BACKGROUND: Non-suicidal self-injury (NSSI) is a condition with debilitating consequences. We aimed to assess the mentalization skills of female adolescents with NSSI and parents who showed alexithymia and depressive symptoms. METHOD: Ours was a case-control study. Thirty adolescents with NSSI were recruited into the case group, 31 adolescents were recruited into the control group. Reading the Mind in the Eyes Test (RMET) and the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime Version (K-SADS-PL) were applied. The Inventory of Statements about Self-Injury was used. The Toronto Alexithymia Scale (TAS-20) and Beck Depression Inventory (BDI) were given to parents. RESULTS: There were no significant differences between two groups for RMET and parental TAS-20 scores. Maternal BDI scores were found to be significantly higher in the NSSI group. There were no significant differences for paternal BDI. RMET scores correlated negatively with maternal BDI scores. Major depression was found to be the most common diagnosis in the NSSI group. CONCLUSION: Because maternal depressive features seem to be related to NSSI, a detailed psychiatric examination of mothers should be carried out. Studies with larger samples or different designs are needed for a better understanding of the mentalization in NSSI.

Relationships between family functioning, parenting and peer victimization in adolescent depression: A cross-sectional study.

OBJECTIVE: Major depressive disorder (MDD) in adolescence is a prevalent mental health problem with a complex etiology and a rising incidence. The aim of the study investigated functioning of family, attitudes of parents, and peer victimization in adolescents with MDD and to compare those with healthy adolescents. METHODS: The study was designed as a multi-center, cross-sectional, case-control study. 98 adolescents diagnosed with MDD and 99 healthy controls were recruited for the study. Beck depression inventory, parental attitude research instrument (PARI) tool, family assessment device (FAD), and multidimensional peer victimization scale (MPVS) were applied to all participants. Descriptive, correlational, and bivariate group comparisons were used in analyses. RESULTS: The average ages of adolescents with MDD and control adolescents were 14.7 (S.D.=1.5) and 15.0 (S.D.=1.6) years, respectively. Females formed 74.5% of youth with MDD (vs. 70.3% of controls). The groups were similar in terms of socio-demographic features (all p>0.05). Adolescents with MDD had significantly elevated scores in FAD subscales except problem solving, PARI rejection of homemaking, marital conflict, and authoritarian subscales, and all MPVS subscales. Adolescents with MDD also displayed significant positive correlations between all MPVS subscales and FAD subscales except FAD problem-solving. CONCLUSION: This cross-sectional, multi-center study suggests that family dysfunction and peer victimization may be higher in youth with MDD. Although cross-sectional design precludes evaluation of causality, it may be prudent to evaluate family functions as well as peer victimization of depressed youth.

Relationships Between Theory of Mind (ToM) and Attachment Properties in Adolescent with Social Axiety Disorder.

INTRODUCTION: Studies have suggested that attachment styles are associated with social anxiety disorder (SAD). Recent studies found that individuals with a diagnosis of SAD were significantly impaired relative to healthy controls on tasks of theory of mind (ToM). We aimed to investigate the association of ToM and attachment styles in adolescents diagnosed with SAD in this study. METHODS: Drug-naïve 42 adolescents diagnosed with SAD and aged between 12 to 18, without psychiatric comorbidity were enrolled in the patient group. Forty-two adolescents in the same age range without any psychiatric disorders were matched as the healthy control group. The diagnosis was made by experienced clinicians using the Kiddie and Young Adult Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version and diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. The severity of SAD symptoms was evaluated with the Social Anxiety Scale for Adolescents. ToM was evaluated with Reading the Mind in the Eyes task and faces test. Parent and Peer Attachment Inventory was used for assessing attachment properties. RESULTS: Adolescents with SAD compared to healthy control groups have more difficulties both in Reading the Mind in the Eyes task and faces test. We found a statistically significant decrease in peer and parent attachment scores when compared with SAD and healthy controls (p<0.05). A negative correlation between the severity of SAD and both ToM tasks and attachment has been found. CONCLUSIONS: The results of this study indicate that ToM deficits and insecure attachment style may play an important role in the etiology and treatment of SAD in adolescents.

The Turkish version of the childhood bladder and bowel dysfunction questionnaire (CBBDQ): Cross-cultural adaptation, reliability and construct validity.

BACKGROUND/AIMS: Bladder and bowel dysfunction (BBD) are both prevalent health problems in pediatric population. The CBBDQ is a parent-reported tool to evaluate and quantitatively assess bladder and bowel dysfunction symptoms in pediatric patients. This study was designed for the translation the CBBDQ into Turkish and the cultural adaptation of CBBDQ for the use among 5-12-year-old children. Moreover, another aim of this study was that the determination of the reliability and construct validity of the Turkish version. The main hypothesis of our study was that the translation and cultural adaptation of the CBBDQ into Turkish language, so that Turkish parents could understand it. Additionally, we estimated that the Turkish version would have eventual internal consistency and test-retest reliability and admissible construct validity. MATERIALS AND METHODS: The CBBDQ was guideline driven translated into Turkish language and administered two times to the parents of children with one week interval to assess test-retest reliability. The internal consistency was determined by using Cronbach's α value and the test-retest reliability was calculated by using the inter-rater correlation coefficient. For the estimation of construct validity, the Dysfunctional Voiding and Incontinence Scoring System (DVISS) and Pediatric Quality of Life Inventory (PedsQL) in 5-7, 8-12 years old children were used as the external criterias. RESULTS: The participants were parents of 5-12-year-old children. The internal consistency was 0.83 that was the Cronbach's α value which reflects a good result. The Turkish-CBBDQ5-12y and the DVISS showed a satisfactory level correlation (r=0.64 P<0.001). There was not any correlation between the Turkish-CBBDQ5-12y and the PedsQL-General Health and PedsQL-Psychological Health (r=-0.17, P=0.1 and r:0.12 P=0.25, respectively). CONCLUSION: The Turkish-CBBDQ5-12y version is a reliable and valid instrument in terms of the content and construction and can be confidently used in clinical practice.

Oppositional defiant disorder/conduct disorder co-occurrence increases the risk of Internet addiction in adolescents with attention-deficit hyperactivity disorder.

Objectives The aims of this cross-sectional study were to assess the prevalence of Internet addiction (IA) in a clinical sample of adolescents with attention-deficit hyperactivity disorder (ADHD) and to detect the moderating effects of co-occurring oppositional defiant disorder/conduct disorder (ODD/CD) on the association between ADHD and IA. Methods The study group comprised 119 adolescent subjects who were consecutively referred to our outpatient clinic with a diagnosis of ADHD. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was completed by parents, and subjects were asked to complete the Internet Addiction Scale (IAS). Results The IAS results indicated that 63.9% of the participants (n = 76) fell into the IA group. Degree of IA was correlated with hyperactivity/impulsivity symptoms but not with inattention symptoms. As compared to the ADHD-only group (without comorbid ODD/CD), ADHD + ODD/CD subjects returned significantly higher scores on the IAS. Conclusions As adolescents with ADHD are at high risk of developing IA, early IA detection and intervention is of great importance for this group. In addition, adolescents with ADHD + ODD/CD may be more vulnerable to IA than those in the ADHD-only group and may need to be more carefully assessed for IA.

Salivary alpha amylase levels in youths with anxiety disorders.

It is suggested that salivary alpha-amylase (sAA) may be a marker of sympathoadrenal medullary system activity. Thus, it can be a possible relationship sAA and anxiety disorders. The aim of this study is to investigate sAA in children and adolescents with anxiety disorders and healthy controls. Thirty drug-free youths, aged 8-16 years, who were diagnosed as any anxiety disorders and 36 healthy controls with similar socio-demographic characteristics were included in this study. The sAA was found to be significantly increased in anxiety group compared to control group. However, there was no correlation between sAA and any anxiety scores of the scales. Present study suggested that anxiety disorders in youths may be associated with increased autonomic activity.