Factors related to diagnostic persistence of attention deficit/hyperactivity disorder in Turkish children and adolescents.

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is one of the most frequently occurring mental disorders in children and adolescents. The purpose of this study was to determine diagnostic persistence three years after the first clinical evaluation and to investigate the factors relating to diagnostic persistence in children and adolescents with ADHD. METHODS: The study included 183 children and adolescents who were evaluated in the first admission. Of 183 children and adolescents, 142 children and adolescents were evaluated in the second admission and only the data of 142 children and adolescents were analysed in the study. Diagnostic persistence was defined as having met the full criteria for ADHD on second evaluation. Symptom severity of ADHD was determined using the Turgay DSM-IV-based Child and Adolescent Behavior Disorders Screening and Rating Scale-Parents Form (T-DSM-IV-S). Intelligence level was assessed through the Wechsler Intelligence Scale for Children-Revised. RESULTS: Of the children included in the study, 77.5% (n = 110) were determined to have ADHD diagnostic persistence. Low intelligence levels, younger age and higher T-DSM-IV-S inattention and conduct disorder scores were associated with diagnostic persistence. ADHD diagnosis in children and adolescents tends to continue at high rates. CONCLUSIONS: Determination of the risks related to ADHD diagnostic persistence may contribute to improved treatment planning and interventions.

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.

Oxytocin system social function impacts in children with attention-deficit/hyperactivity disorder.

To investigate relationships between the polymorphisms and social functioning of children with Attention Deficit/Hyperactivity Disorder (ADHD), according to the polymorphism of three oxytocin receptor (OXTR) genes (rs53576, rs13316193, and and rs2268493). A total of 198 children-studying in the same primary and secondary school and matched in terms of age and gender (99 ADHD, 99 control)-were included in this study. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version was administered to establish the clinical diagnosis. The Social Reciprocity Scale (SRS) was applied to evaluate social functioning. The total genomic DNA was isolated from buccal mucosa samples. No significant differences were determined between the ADHD and control groups in terms of rs2268493, rs13316193, and rs53576 genotype distribution (P = 0.078, P = 0.330, and P = 0.149, respectively). However, the control group T allele frequency in the OXTR Single Nucleotide Polymorphism (SNP) rs2268493 was significantly higher than the ADHD group (P = 0.024). Compared to the control group, the ADHD group had a higher score on the SRS scale (SRS total; Z = -21,135, P < 0.001). No significant difference existed in the SRS scale scores between the children with the T/T genotype and the C allele in the ADHD group (SRS total; Z = -0.543, P = 0.587). The allele distribution of the OXTR gene SNP rs2268493 was significantly different in the ADHD group, compared to the control group. This observation is important in understanding the underlying biological infrastructure in ADHD and developing treatment modalities.

Fine motor skills in children with rolandic epilepsy.

This study aimed to evaluate fine motor skills in children with rolandic epilepsy (RE). The research included 44 children diagnosed with typical RE and 44 controls matched in terms of age, gender, and level of education. Fine motor skills were evaluated with the Purdue Pegboard Test, and intelligence was measured with the Wechsler Intelligence Scale for Children. After controlling for the effect of intelligence on fine motor skills, the results showed that the children with RE did not perform as well as the controls in the PPT dominant hand, both hands, and assembly subtests. Epileptic focus, treatment status, type of antiepileptic treatment, age at the time of the first seizure, time since the last seizure, and total number of seizures did not affect motor skills. Rolandic epilepsy negatively affected fine motor skills regardless of the children's level of intelligence.

Effects of COVID-19 Outbreak on Children's Mental Health: A Comparative Study with Children Diagnosed and Isolated from Their Parents.

OBJECTIVE: The COVID-19 outbreak has negatively affected children in many ways. This study aimed to compare the psychological responses of children exposed to different levels of stress during the COVID-19 outbreak. METHODS: The anxiety levels, negative thoughts, and quality of life of COVID-19-positive children with COVID-19-positive parents (Child+ group, n=17), COVID-19-negative children who are separated from COVID-19-positive parents (Parent+ group, n=59), and a control group (n=64) were compared. The participants completed the Screen for Child Anxiety and Related Disorders (SCARED), Children's Negative Cognitive Errors Questionnaire (CNCEQ), and Pediatric Quality of Life Inventory (PedsQL). RESULTS: The statistical analysis revealed that the Parent+ group recorded higher SCARED and CNCEQ scores and lower PedsQL scores in comparison with the control group. No statistically significant difference was found between the scores of the Child+ and control groups. Furthermore, high CNCEQ scores and low PedsQL scores in the Parent+ group predicted an increase in their SCARED scores. CONCLUSION: Our study indicates that separating children from their parents during the COVID-19 outbreak negatively influences their mental health and increases their anxiety levels.

Evaluating Factors Related to Health Anxiety in COVID-19 Patients.

Background: The COVID-19 outbreak affects both the physical and mental health of individuals and society. This study investigates the factors related to health anxiety in COVID-19 patients and explores their sociodemographic-, disease-, and treatment-related factors, trait anxiety, and characteristics of secure or insecure attachment. Methods: The sample consisted of 420 individuals aged 18-65 years and diagnosed with COVID-19 between March 15 and May 15, 2020. The participants completed a sociodemographic data form and the Health Anxiety Inventory (HAI), Adult Attachment Scale (AAS), and State-Trait Anxiety Inventory (STAI). Results: Hierarchical regression analysis revealed that female gender, presence of chronic physical diseases, presence of mental health problems, and high AAS insecure attachment scores significantly predicted high HAI scores. Moreover, results indicated that the model explained approximately 21% of variance in HAI scores. Conclusions: Factors such as gender, presence of chronic physical diseases, presence of mental health problems, and attachment style influence health anxiety. Determining the appropriate factors that cause health anxiety can contribute to the implementation of protective measures for mental health and to the application of effective interventions for individuals who develop mental problems.

Factors related with unintentional injuries in children with newly diagnosed attention-deficit/ hyperactivity disorder.

The aim of the present study was to investigate the factors associated with unintentional injury in children newly diagnosed with attention-deficit/hyperactivity disorder (ADHD). One thousand four hundred and thirty children between the ages of 6 and 18 who were diagnosed with ADHD for the first time in child psychiatry outpatient clinics were included in the present study. The socio-demographic information of the children, their developmental histories, chronic physical health conditions, comorbid psychiatric disorders, and information obtained via the Turgay DSM-IV-based Child and Adolescent Disorders Screening and Rating Scale were examined retrospectively. It was determined that 12.8% of the children (n D 183) experienced unintentional injury. It was established that age, male gender, disruptive behavioural problems, and low education levels among mothers were predictive of unintentional injuries. The results of the present study suggest that behavioural problems accompanying ADHD and comorbid psychiatric disorders are important in terms of unintentional injuries.

Factors related with unintentional injuries in children with newly diagnosed attention-deficit/hyperactivity disorder.

The aim of the present study was to investigate the factors associated with unintentional injury in children newly diagnosed with attention-deficit/hyperactivity disorder (ADHD). One thousand four hundred and thirty children between the ages of 6 and 18 who were diagnosed with ADHD for the first time in child psychiatry outpatient clinics were included in the present study. The socio-demographic information of the children, their developmental histories, chronic physical health conditions, comorbid psychiatric disorders, and information obtained via the Turgay DSM-IV-based Child and Adolescent Disorders Screening and Rating Scale were examined retrospectively. It was determined that 12.8% of the children (n = 183) experienced unintentional injury. It was established that age, male gender, disruptive behavioural problems, and low education levels among mothers were predictive of unintentional injuries. The results of the present study suggest that behavioural problems accompanying ADHD and comorbid psychiatric disorders are important in terms of unintentional injuries.

Early-married and sexually abused girls differ in their psychiatric outcomes.

Early marriage and sexual abuse are the two of the most frequent types of childhood abuse. Although early marriage is also a type of sexual abuse, it is associated with different physical, social, and mental outcomes than sexual abuse alone. The purpose of this study was to compare early-married girls and sexually abused girls who were referred for forensic evaluation in Turkey in terms of their sociodemographic characteristics, mental disorder rates, and mental symptom severity. We included 63 adolescent girls for whom a judicial report had been demanded and who were under 15 years old when they were married but were not yet 18 years old during the evaluation (15.51±0.78) and 72 sexually abused adolescent girls between 14 and 18 years old (15.80±1.10) in this study. Following a psychiatric evaluation, the study participants completed the Child Posttraumatic Stress Disorder Reaction Index (CPTS-RI) and the Brief Symptom Inventory (BSI). We used the Windows SPSS 16.0 software program to assess the results. At least one psychiatric disorder was determined in 44.4% of the early-married and 77.8% of the sexually abused cases (p<0.001). A diagnosis of PTSD or ASD was observed in 11.1% of the early-married cases and in 54.2% of the sexually abused victims (p<0.001). MDD was determined in 33.3% of the early-married cases and 56.9% of the sexually abused cases (p=0.006). The CPTS-RI scores of the sexually abused victims were higher than those of the early-married cases (p<0.001). All of the subscale scores of the BSI were higher in the sexually abused adolescents than in the early-married cases (p<0.001). Although early marriage has severe physical, social and mental outcomes, it is not as severe as sexual abuse in terms of psychiatric disorder rates and the psychiatric symptom severity it causes.

Medication persistence in Turkish children and adolescents with attention-deficit/hyperactivity disorder.

OBJECTIVE: The aim of this study was to investigate medication persistence in Turkish children and adolescents with attention-deficit/hyperactivity disorder (ADHD). The effects of sociodemographic characteristics, symptom severity of ADHD, comorbidity, and treatment-related factors influencing medication persistence in children diagnosed with ADHD were studied. METHODS: Medication persistence over a continuous 12 month period was evaluated for 877 children and adolescents between 6 and 18 years of age, who were diagnosed with ADHD for the first time and started to receive medication. Medication persistence was determined according to whether or not taking the prescribed medication continued for 12 months after the initiation of treatment. Whereas the symptom severity of ADHD was assessed by using the Turgay Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV)-based Child and Adolescent Behaviour Disorders Screening and Rating Scale-Parents Form (T-DSM-IV-S), perceived medication efficacy after the first treatment was evaluated by the Clinical Global Impressions-Improvement Scale (CGI-I). RESULTS: In this study, medication persistence over a continuous 12 month period occurred at a rate of 30.2% (n=265) in the subjects studied. The hierarchical regression analysis conducted in this research revealed that younger age, higher hyperactivity/impulsivity symptom severity, use of long-acting methylphenidate, addition of another ADHD medication, addition of other psychotropic medications, absence of side effects, and perceived medication efficacy were associated with successful medication persistence over a continuous 12 month period. CONCLUSIONS: Understanding the factors that affect medication persistence in ADHD may improve treatment efficacy and symptom control, while minimizing future risks.

[Alterations in social reciprocity in attention-deficit hyperactivity disorder]. / Dikkat eksikligi hiperaktivite bozuklugunda sosyal cevaplilikta görülen degisiklikler.

OBJECTIVE: Social interactions in children with attention deficit-hyperactivity disorder (ADHD) are inappropriate and such social problems may originate from a failure to attend to the appropriate cues of affect. The present study aimed to determine the factors predictive of social reciprocity in ADHD and their relationship to sociodemographics. MATERIALS AND METHODS: Participants were required to interpret emotional cues depicted in pictures of facial expressions with a test that was adopted from the Reading Mind in the Eyes Test (RMET). Diagnoses were established based on the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). Moreover, a detailed sociodemographic form, the Child Behavior Checklist (CBCL), and the Social Reciprocity Scale (SRS) were used for assessment. RESULTS: This study included 133 children; 64 in the ADHD group and 69 in the control group. There wasn't a significant difference in mean age between the ADHD group (13.22 ± 1.28 years) and control group (12.97 ± 1.27 years). In all, 50% of the ADHD group and 49.3% of the control group were male. The mean RMET score was significantly lower in the ADHD group than in the control group (ADHD group: 20.52 ± 3.95; control group: 23.70 ± 3.55) and the mean SRS score was significantly higher in the ADHD group than in the control group (ADHD group: 65.84 ± 18.83; control group: 36.04 ± 16.32). In the ADHD group attention problems and lower level of ability to interpret emotional facial expressions were predictive of impaired social reciprocity. CONCLUSION: The findings show that both the ability to decode facial expressions and social reciprocity were impaired in the ADHD group. These findings highlight the difficulty children with ADHD have with social functioning and interpretation of emotions based on facial expressions.

Psychiatric and Neurocognitive Evaluation Focused on Frontal Lobe Functions in Rolandic Epilepsy.

INTRODUCTION: In this study, we aimed to assess the behavioral problems, psychiatric disorders and neurocognitive functions focusing on frontal lobe functions in children with rolandic epilepsy (RE) and compare them with a control group. METHOD: 31 children with RE, aged between 8 and 13,5 years were compared with a control group matched for age, sex and socioeconomic status. Behavioral problems were assessed by the Child Behavior Checklist (CBCL) and psychiatric diagnoses were established by using the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version. The Wechsler Intelligence Scale for Children-Revised (WISC-R), Wisconsin Card Sorting Test (WCST) and the Stroop Color and Word Test (SCWT) were applied in both groups of children. RESULT: The RE group presented more psychiatric disorders than the control group. Verbal and total IQ scores in the RE group were lower than in the control group. Although the groups did not differ from each other in WCST scores, children with RE displayed lower performance in SCWT. The RE group had a higher externalizing score and higher total scores in CBCL. CONCLUSION: It was concluded that RE did not affect basic frontal lobe functions significantly, had negative effects on attention and IQ performance and increased behavioral problems and psychiatric disorders.

Psychiatric disorders and characteristics of abuse in sexually abused children and adolescents with and without intellectual disabilities.

The purpose of this study was to compare sexually abused children and adolescents, with and without intellectual disabilities (ID), in terms of post-abuse psychiatric disorders, features of the sexual abuse, and sociodemographic characteristics. The study included sexually abused children aged 6-16 years, who were sent to three different child mental health units for forensic evaluation; there were 102 cases (69 girls and 33 boys) with ID and 154 cases (126 girls and 28 boys) without ID. Researchers retrospectively examined the files, social examination reports, and the judicial reports of the cases. It was determined that in the group with ID, sexual abuse types including penetration and contact had higher rates, they were exposed to more frequent repeated abuses, the abuses were revealed with their own reports at a later period and lower rates, and post-abuse pregnancies were more frequent. It was also determined that the abuser was a familiar person and a family member at lower rates and more than one abuser was encountered more frequently, compared to the group without ID. While no difference was determined between the two groups in terms of the frequency of post-abuse post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), conduct disorder (CD) was observed more frequently in the group with ID. This study emphasizes that sexual abuse, which is an important problem in individuals with ID, has different features and effects.

Prevelance of mental disorders and associated factors in institutionalized 3-5 year old children.

OBJECTIVE: In this study, we aimed to determine the prevelance and severity of mental disorders in institutionalized children between the ages of 3-5 years, investigate the factors associated with the mental disorders and compare these findings with the data of a community sample composed of children who were raised by their own families. METHOD: Thirty-four children raised in three institutions in Kocaeli were compared with an age- and sex-matched community sample. Children were assessed according to DSM-IV diagnostic criteria. The Socio-demographic information form, and Early Childhood Inventory-4 (ECI-4) parent scale were used for data collection. RESULTS: Children that were reared in institutions had evidence of higher rates of mental disorders. In institution-reared children, symptom severity of attention deficit hyperactivity disorder, reactive attachment disorder, oppositional deficient disorder, and pervasive developmental disorder were higher than the community subjects. Age, time spent with father, duration of institutionalization, number of siblings, number of hospital admissions because of physical symptoms and presence of abuse before institutional care were determined to be predictive factors for psychiatric symptoms. CONCLUSION: These findings revealed that institutionalized children are at risk for mental disorders and protective measures are as important as instutional care for these children. Our results suggest that essential steps should be taken to protect the mental health of children in institutional care.