A comparison of clinical characteristics and course predictors in early- and childhood-onset schizophrenia.

AIM: The aim of this study was to compare the clinical characteristics of childhood-onset schizophrenia (COS) and early-onset schizophrenia (EOS) during the first- episode psychosis and the stable period, to examine psychopharmacological treatment approaches, and to investigate potential predictive factors for prognosis. METHODS: Demographic, clinical, and psychopharmacological therapy data for 31 patients diagnosed with COS and 66 with EOS were retrieved from the file records in this multicenter study. Symptom distribution and disease severity and course were evaluated twice, in the acute psychotic stage and in the latest stable phase, during follow-up using the positive and negative syndrome scale (PANSS) and clinical global impression (CGI) scales. RESULTS: A statistically significant difference was observed between the groups' CGI improvement rates and median last stable stage PANSS positive, negative, and general psychopathology symptom scores (p = .005, p = .031, p = .005, and p = .012, respectively). Premorbid neurodevelopmental disorder and obsessive-compulsive disorder and comorbidities were more common in the COS group (p = .025 and p = .030, respectively), and treatment required greater multiple antipsychotic use in that group (p = .013). When the independent variables affecting the difference between pre- and post-treatment PANSS scores were examined using linear regression analysis, the model established was found to be statistically significant (F = 5.393; p = .001), and the group variable (p = .024), initial disease severity (p = .001), and socioeconomic level (p = .022; p = .007) emerged as predictive factors for the disease course. CONCLUSION: Although early diagnosis and treatment is an important factor in improving prognosis in schizophrenia, more specific predictors for schizophrenia need to be identified. Additionally, preventive programs and pharmacological methods need to be developed in children with neurodevelopmental problems, particularly those from low socioeconomic status families.

Evaluation of corneal endothelial cell morphology off and on treatment by specular microscopy in children and adolescents with attention deficit hyperactivity disorder.

PURPOSE: To determine the structure and properties of corneal endothelial cells in children and adolescents with ADHD who received methylphenidate treatment at least six months. METHOD: The prospective, observational study included 33 eyes of 33 patients diagnosed with ADHD who received methylphenidate treatment for at least six months, 33 eyes of 33 patients newly diagnosed with ADHD who did not start medication treatment, and 33 eyes of 33 healthy individuals. Average cell density, coefficient of variation, maximum cell area, normal cell area, minimum cell area, average cell area, and hexagonality ratio values were evaluated by non-contact specular microscopy. The parameters recorded in all three groups were compared. RESULTS: The average age of children in the ADHD + MPH, ADHD, and control groups is 9 ± 1.7, 8.9 ± 2.3, and 8.9 ± 1.8 years, respectively. (p > 0.05) The average MPH treatment dose is 0.94 ± 0.19 mg/kg, the average daily MPH intake is 34.12 ± 14.04 mg, and the average duration of use of MPH is 24.03 ± 12.46 months. Central corneal thickness (CCT) was measured as an average of 540.45 ± 31.23 in the ADHD + MPH group, 540.61 ± 29.69 in the ADHD group, and 546.58 ± 27.72 in the control group. (p = 0.499) The average coefficient of variation (CV) values were measured as 25.48 ± 4.22 in the ADHD + MPH group, 26.12 ± 3.48 in the ADHD group, and 26.12 ± 3.64 in the control group. (p = 0.491) The average hexagonality ratio (%) (HEX) values were measured as 69.45 ± 8.41 in the ADHD + MPH group, 68.21 ± 6.82 in the ADHD group, and 68.91 ± 7.97 in the control group. (p = 0.892) No statistically significant difference was observed between all three groups in terms of all parameters. CONCLUSION: Methylphenidate treatment administered for at least six months with a diagnosis of ADHD did not have a toxic effect on the corneal endothelium.

Continuation of Treatment in Children With ADHD: A Multicenter Turkish Sample Study.

OBJECTIVES: The aim of this study was to investigate the variables that may affect treatment continuation in children aged 6 to 12 years who were newly diagnosed with ADHD. METHODS: A total of 132 children diagnosed with ADHD and their parents participated in the study. Sociodemographic and clinical risk factors affecting continuation of treatment were examined using logistic regression analysis. RESULTS: Multiple model examination revealed that greater age increased the risk of treatment discontinuation 1.824 times (p = .003) while a lower total length of paternal education increased the risk of discontinuation (1/0.835) 1.198 times (p = .022). Other variables emerging as significant in the univariate model lost that significance in the multiple model. CONCLUSIONS: Understanding the variables associated with medication discontinuation in ADHD in different populations and taking these variables into account in the development of health policies, will be useful in improving the long-term devastating effects of the disorder.

Parental attachment and childhood trauma in adolescents engaged in non-suicidal self-injury.

AIM: In this study, it was aimed to compare parental attachment and childhood traumas in adolescents with NSSI with healthy peers. METHODS: Fifty adolescents aged 14-18 years with lifetime NSSI and 56 healthy peers were included in the study. Inventory of Statements About Self-injury (ISAS), The Parental Bonding Instrument (PBI) and Child Trauma Questionnaire (CTQ-28) scales were used. RESULTS: Eighty-two percentage of the NSSI group and 70% of the control group were girls. The mean age was 15.6 ± 1.1 years in the NSSI group and 15.3 ± 0.9 years in the control group. There was no significant difference between the groups in terms of age and gender. The NSSI group had more negative scores than the control group in terms of childhood traumas and attachment characteristics to both mother and father. The analyses showed that mother PBI care/control and sexual abuse score had a relationship with both ISAS Autonomic Functions and ISAS Social Functions scores. CONCLUSIONS: These results suggest that secure attachment with the mother may be protective for both the autonomic and social functions of the NSSI. Therefore, interventions for dysfunctional parental attachment may prevent the development of NSSI.

Evaluation of carotid intima media thickness as an early marker of atherosclerosis in children and adolescents with autism spectrum disorder: a case-control study.

There are studies reporting different results on whether there is an increased incidence of cardiovascular problems in autism spectrum disorder (ASD). The aim of this study was to examine carotid intima-media thickness (cIMT), an early marker of atherosclerosis in children and adolescents with ASD. This single-center case-control study was conducted in a tertiary care hospital. Eighty-five children (36 children with autism and 49 healthy controls) aged 6-18 were enrolled. After a clinical interview, Children's Global Assessment Scale (CGAS) and Autism Behavior Checklist (ABC) were filled out and laboratory measures were collected for ASD group. Anthropometric measurements (height, weight, waist and hip) of each participant were assessed. The cIMT was measured with an ultrasound probe on both sides of the neck. Age, gender, body mass index percentile and waist/hip ratio adjusted right/left common carotid arteries IMT and right/left bulb IMT were statistically significantly higher in the autism group than controls (0.45 ± 0.01 mm and 0.55 ± 0.01 mm, respectively, p < 0.001). We performed multiple linear regression analysis to determine statistically significant related factors of the cIMT in ASD. Early onset of autism symptoms were related with high carotid IMT (ß = -0.496, p = 0.01). These findings suggest that atherosclerosis may begin earlier in children with ASD, which is one of the most common neurodevelopmental disorders in childhood. The cIMT measurement, which is an easy and noninvasive method in the cardiovascular assessment and follow-up can be recommended for clinical use for individuals with ASD.

The effect of sleep disturbance on social cognition in drug-naïve children with attention deficit and hyperactivity disorder.

BACKGROUND: A wide variety of psychiatric conditions are associated with social cognitive deficits. The relationship between social cognition and many factors, especially executive functions (EF), has been examined, but there is no study examining sleep and social cognition in children with attention deficit activity disorder (ADHD). It is important to find new approaches and intervention areas to improve their social cognitive skills. The main hypothesis of our study was that sleep disturbance would predict lower social cognition scores. We hypothesized that sleep disturbances and EF impairment could predict lower social cognitive performance. METHODS: Eighty-five children aged 7-12 years with drug-naïve ADHD were included in the study. Reading the Mind in the Eyes Test (RMET) and Faux Pas Recognition Test (FPRT) were used for social cognition performance; Stroop test was used for executive function performance. Sleep disturbance was evaluated with Children's Sleep Habits Questionnaire (CSHQ), ADHD severity with Conners Parent Rating Scale (CPRS). Hierarchical multiple regression analyses were performed to determine predictive factors of the FPRT and RMET. RESULTS: Age, gender, and comorbidity were included at step 1, CPRS-RS score was included at step 2, Stroop test part V score was included at step 3, CSHQ total score and sleep duration were included at step 4. Lower sleep disturbance score on CSHQ was associated with higher social cognition FPRT score (p = 0.014). There was no significant relationship between CSHQ and social cognition RMET score. Lower EF score on Stroop test part V was associated with higher social cognition FPRT score (p = 0.002) and higher social cognition RMET score (p < 0.001). CONCLUSION: These results showed that sleep disturbance and EF are both associated with social cognitive impairment, sleep particularly with the cognitive component. Identifying sleep problems in children with ADHD may provide helpful information in understanding and treating social cognitive impairments. This study is the first to draw attention to the relationship between sleep and social cognition.

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.