Reducing Test Anxiety During the COVID-19 Pandemic: A Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy.

Educational assessments can affect students' mental health, particularly during a pandemic. Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) are widely efficacious for reducing test anxiety, as well as general anxiety and rumination. However, the effectiveness of these two therapies for students during COVID-19 is unclear. We measured the effectiveness of ACT and CBT for managing test anxiety, general anxiety, and rumination during COVID-19 for 77 students taking Türkiye's national university entrance exam, assigned to either the ACT or CBT psychoeducation programs. Both programs reduced test anxiety, general anxiety, and rumination, and showed similar levels of effectiveness. This suggests that ACT and CBT are both important for improving students' mental health during COVID-19 and either may be beneficial.

Reduced Cortical Thicknesses of Adolescents with Bipolar Disorder and Relationship with Brain-derived Neurotrophic Factor.

Background: Cortical thickness (CT) and brain-derived neurotrophic factor (BDNF) were widely investigated in bipolar disorder (BD). Previous studies focused on the association between the volume of subcortical regions and neurotrophic factor levels. Objective: In this study, we aimed to evaluate the association of the CT in youth with early-onset BD with BDNF levels as a potential peripheral marker of neuronal integrity. Method: Twenty-three euthymic patients having a clinical diagnosis of BD and 17 healthy subjects as an age-matched control group with neuroimaging and blood BDNF levels were found eligible for CT measurement. A structural magnetic resonance scan (MRI) and timely blood samples were drawn. Results: Youth with BD exhibited lower cortical thickness in caudal part of left (L) middle frontal gyrus, right (R) paracentral gyrus, triangular part of R inferior frontal gyrus, R pericalcarine region, R precentral gyrus, L precentral gyrus, R superior frontal gyrus and L superior frontal gyrus when compared to healthy controls. The effect sizes of these differences were moderate to large (d=0.67-0.98) There was a significant correlation between BDNF levels with caudal part of the R anterior cingulate gyrus (CPRACG) in adolescents with BD (r=0.49, p=0.023). Conclusion: As a special region for mood regulation, the CT of the caudal part of the R anterior cingulate gyrus had a positive correlation with BDNF. Regarding the key role of CPRACG for affective regulation skills, our results should be replicated in future follow-up studies, investigating a predictive neuroimaging biomarker for the early-onset BD.

Parent rated bedtime resistance and comorbidity may predict levels of attention among Turkish children diagnosed with ADHD in on-line education classes during the COVID-19 outbreak.

OBJECTIVE: This study aimed to compare the attention levels, of Turkish children and adolescents with Attention Deficit/ Hyperactivity Disorder (ADHD) in on-line education classes with healthy controls. METHODS: This study is a cross-sectional, internet-based, case-control study that recruited 6-18 years old patients diagnosed with ADHD and receving treatment and healthy controls from eight centers. The measurements used in the study were prepared in the google survey and delivered to the participants via Whatsapp application. RESULTS: Within the study period, 510 children with ADHD and 893 controls were enrolled. Parent- rated attention decreased significantly in both groups during on-line education classes due to COVID-19 outbreak (p<0.001; for each). Children and adolescents with ADHD had significantly elevated bedtime resistance, problems in family functioning difficulties than control children according to parental reports (p=0.003; p<0.001; p<0.001, respectively). Furthermore, bedtime resistance and comorbidity significantly predicted attention levels in on-line education. CONCLUSION: Our findings may underline the need to augment student engagement in on-line education both for children without attention problems and those with ADHD. Interventions shown to be effective in the management of sleep difficulties in children as well as parent management interventions should continue during on-line education.

Sluggish Cognitive Tempo Self Report Scale (SCT-SR): Development and Initial Validation Study.

OBJECTIVE: Sluggish Cognitive Tempo (SCT) is a psychological construct consisting of daydreaming, confusion, slowness in movements, lethargy, and low motivation. It is important to develop a self-report scale to evaluate SCT symptoms in children and adolescents in order to meet the following needs; (1) Considering the closeness of SCT symptoms with internalized symptoms, it can provide more reliable information, (2) It allows information to be obtained from multiple informants, and (3) The main symptoms of SCT include subjective experiences such as daydreaming and mind wandering that may be difficult to observe from the outside. Therefore, it was aimed to develop a self-report SCT scale. METHOD: A total of 467 adolescents and 178 parents participated in the study. Data were collected with scales. RESULTS: The scale consists of 20 items and a single factor. Factor loadings were between 0.60 and 0.81. CONCLUSION: Sluggish Cognitive Tempo Self-Report Scale is a valid and reliable self-report scale.

Psychometric properties of the Teenage Executive Functioning Inventory in a Turkish sample of adolescents: deficits in working memory and inhibition among adolescents.

The Teenage Executive Functioning Inventory (TEXI) is a measurement tool that consists of two subscales, working memory and inhibition, and allows both self and parent rating. This study aimed to examine the psychometric properties of the Turkish version of TEXI in a sample of 184 parents and 476 adolescents aged 11 and 18 years and to measure the relationship between executive functions and mental health problems, including attention deficit hyperactivity disorder and major depressive disorder and anxiety disorders. Confirmatory factor analyses showed acceptable/good fit indices and confirmed the two-factor structure for both the adolescent and parent forms. Test-retest results and Cronbach's alpha coefficient showed that the scale had high reliability. The results also showed that deficits in executive functions were associated with various mental health problems in adolescents. The findings demonstrated that a Turkish translation of the TEXI is a valid and reliable tool for evaluating the executive functions of adolescents.

Association of Dissociation with Suicide Attempt and Non-Suicidal Self Injury in Adolescents with a History of Sexual Abuse.

Objective: Dissociative symptoms are considered risk factors for suicide and non-suicidal self-injury (NSSI). In this study, the relationship between suicidal behaviors and NSSI with dissociative symptoms in adolescents with a history of Child Sexual Abuse (CSA) was investigated. Methods: A total of 100 adolescents with a history of CSA were evaluated with a detailed forensic psychiatric interview. Dissociative symptoms were measured with the self-report Adolescent Dissociative Experiences Scale (A-DES) and the parent-reported Child Dissociative Checklist (CDC). Results: While dissociative symptoms did not differ between adolescents with and without suicide attempts (CDC; p = .068 and A-DES; p = .060), they were significantly higher in adolescents with non-suicidal self-harming behavior (CDC; p < .001 and A-DES; p = .001). Suicide attempts and NSSI were more common in those who reported genital touching as a type of sexual abuse (respectively, p = .003; p = .048). In regression analysis; history of psychiatric treatment (OR = 9.09 [95% CI = 1.52, 54.29]) and NSSI (OR = 8.18 [95% CI = 2.01, 33.23]) were independently associated with suicide attempts. In addition, parent-reported dissociative symptoms (CDC scores) (OR = 1.27 [95% CI = 1.06, 1.53] and suicide attempt (OR = 8.09 [95%CI = 1.96,33.42] showed independent association with NSSI. Conclusions: Dissociative symptoms may be predictive factors for NSSI and should be considered in risk assessment of adolescents with a history of CSA.

Videoconference anxiety: Conceptualization, scale development, and preliminary validation.

As a result of the COVID-19 pandemic, activities involving a large part of life have started to be carried out via videoconferencing. Videoconferencing can be disadvantageous for individuals with social anxiety due to increased social presence, decreased mutual understanding, and awkward communication. The authors aimed to develop a scale to explore the difficulties experienced by individuals with social anxiety during videoconferencing. A total of 598 children and adolescents participated in the study. The data were collected with the Sociodemographic Information Form, the Videoconference Anxiety Scale, and the Liebowitz Social Anxiety Scale. According to exploratory factor analysis, the scale consisted of 25 items and a single factor. Factor loads were between 0.62 and 0.81; the single factor explained 52.95% of the variance. This study shows that the Videoconference Anxiety Scale is a valid and reliable instrument for Turkish children.

The prevalence and severity of misophonia in the Turkish population and validation of the Amsterdam Misophonia Scale-Revised.

The Amsterdam Misophonia Scale-Revised (AMISOS-R) is a self-report scale that measures the presence and severity of symptoms experienced in response to specific auditory stimuli. This cross-sectional, descriptive study aims to evaluate psychometric properties of the AMISOS-R in the Turkish language and to examine psychosocial factors associated with misophonia. A total of 374 individuals (female/male: 154/220) between 15 and 45 years of age were included in the study. Confirmatory factor analysis showed that the fit indices were at a good level, and they supported the single-factor structure. Test-retest results and Cronbach's alpha coefficient showed that the scale had high reliability. Misophonia scores were also found to be moderately correlated with obsessive-compulsive disorder and neuroticism. The AMISOS-R was found to be a valid and reliable tool to evaluate misophonia in the Turkish language.

Psychometric properties of the Cognitive Behaviour Therapy Scale for Children and Young People (CBTS-CYP) in a Turkish sample.

BACKGROUND: Cognitive behavioural therapy (CBT) training is highly demanded by clinicians; however, a standardized competence assessment for professionals working with children and young people (CYP) can be problematic. Psychometric tools used for this purpose are typically adult oriented measures. AIM: The present study provides psychometric properties of the Cognitive Behaviour Therapy Scale for Children and Young People (CBTS-CYP) derived from a comparative analysis with the Cognitive Therapy Scale (CTS). METHOD: The CBTS-CYP was used alongside CTS in a CBT supervision training course, consisting of a cohort of 51 therapists. A total of 36 audio/video recorded full CBT sessions were assessed for the purpose of determining CBT competence and adherence to the theory and model. The training involved a total of 80 hours of supervision in 10 meetings via an online videoconferencing platform between July 2020 and February 2021. RESULTS: Face validity and inter-rater reliability of CBTS-CYP were high, with the intraclass correlation values being good (0.60-0.74) or excellent (0.74 and above); the correlations of each CBTS-CYP and CTS items were significant; internal consistency of the scale showed that Cronbach alpha values for total-scale and its two subdimensions were above .93. For a cut-off score of 55 out of 90, sensitivity reached 90.73% and specificity 90.73%. A score of 2 points or above from any single item could be considered as the second minimum criterion for competence. CONCLUSIONS: CBTS-CYP offers a valid and reliable scale to evaluate the competence and adherence quality of CBT sessions with children and adolescents.

Identifying clinical and psychological correlates of persistent negative symptoms in early-onset psychotic disorders.

Persistent negative symptoms (PNS) contribute to impairment in psychosis. The characteristics of PNS seen in youth remained under-investigated. We aimed to demonstrate clinical, treatment-related, and psychosocial characteristics of PNS in early-onset schizophrenia-spectrum disorders (EOSD). 132 patients with EOSD were assessed with Positive and Negative Symptom Scale, Brief Negative Symptom Scale, Calgary Depression Scale for Schizophrenia, and Simpson-Angus Scale. Parenting skills and resilience were evaluated using Parental Attitude Research Instrument and Child and Youth Resilience Measure-12. Longer duration of untreated psychosis (DUP) and prodromal phase were found in primary and secondary PNS groups, compared to the non-PNS group. The primary PNS group was characterized by earlier age-onset, lower smoking rates, and more common clozapine use. Resilience and egalitarian/democratic parenting were negatively correlated with symptoms related to motivation/pleasure and blunted expression. More blunted expression-related symptoms and longer DUP in the first episode significantly predicted primary/secondary PNS at follow-up. Using the data from total negative symptom scores and DUP, Receiver Operating Characteristic analyses significantly differentiated primary/secondary PNS groups from the non-PNS counterparts. PNS associated with blunted expression and low motivation/pleasure in the first episode could persist into clinical follow-up. Effective pharmacological treatment and psychosocial interventions are needed in youth.

Psychometric Properties of the Sluggish Cognitive Tempo Scale in a Turkish Sample of Children and Adolescents.

Sluggish Cognitive Tempo (SCT) has been proposed as a serious problem of attention, however there no validated psychometric measures for its evaluation in Turkish in a community sample. The present study aimed to examine the psychometric characteristics of the first SCT scale in Turkish in children and adolescents. A total of 418 children and adolescents between the ages of 6-18 years (9.83±2.8) were recruited. The data was obtained from parents using Sluggish Cognitive Tempo Scale and Strengths and Difficulties Questionnaire. The SCT scale-Turkish form demonstrated very good internal homogeneity (Cronbach's α = .90), good test-retest reliability (r = .98), good concurrent validity (r range = .35- .65) and good construct validity. Goodness of fit indices were found to be acceptable and statistically significant associations were found between SDQ and SCT scales. The SCT scale is a valid and reliable instrument in Turkish children and adolescents.

Effect of Impairment on the Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder in a National Survey: Nation-Wide Prevalence and Comorbidities of ADHD.

OBJECTIVE: This study aimed to determine the prevalence and comorbidities of attention-deficit hyperactivity disorder (ADHD) by evaluating a large-scale nation-wide sample of children. METHOD: The inclusion criterion was being enrolled as a 2nd, 3rd, or 4th-grade student. A semi-structured diagnostic interview (K-SADS-PL), DSM-IV-Based Screening Scale for Disruptive Behavior Disorders, and assessment of impairment (by both parents and teachers) were applied to 5,842 participants. RESULTS: The prevalence of ADHD was 19.5% without impairment and 12.4% with impairment. Both ADHD with and without impairment groups had similar psychiatric comorbidity rates except for oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses. Impairment in the ADHD group resulted in significantly higher ODD and CD diagnoses. CONCLUSION: Even when impairment is not described, other psychiatric disorders accompany the diagnosis of ADHD and may cause impairment in the future. Impairment in the diagnosis of ADHD significantly increases the likelihood of ODD and CD.

Videoconferencing-based cognitive behavioral therapy for youth with anxiety and depression during COVID-19 pandemic.

The need for psychosocial intervention programmes to address the negative consequences of the COVID-19 pandemic and its associated lockdown restrictions on the mental health of young people is evident. Using a within subject pretest-posttest design, this study aimed to evaluate the effects of online Cognitive Behavioural Therapy (CBT)-based anxiety and depression management psychoeducation programmes on mental health and coping skills in youth ages 14-20. The Demographic Information Form, Revised Child Anxiety Depression Scale, and KidCope were administered before and after the psychoeducational programme to assess programme outcomes. The results indicate significant decreases in levels of anxiety, significant decreases in avoidance of anxiety-provoking situations and significant increases in coping skills following the online CBT Anxiety Management Psychoeducation Program. A significant decrease in depression scores was noted among the online CBT Depression Management Psychoeducation Program participants. Although these results should be interpreted cautiously due to limitations of the study (e.g., no control group, high attrition), they suggest that psychological prevention or intervention programmes may be beneficial for young people who are physically unable to go to school or who cannot interact face-to-face with social support networks.

Turkish Adaptation and Validation of Behavioral Inhibition Questionnaire Parent Form.

Background: Behavioral inhibition has been proposed as a temperamental risk factor for the development of childhood anxiety disorders universally; however, there is no validated instrument for, especially, its evaluation in Turkish children. This study aimed to examine reliability and validity of the Turkish version of Behavioral Inhibition Questionnaire parent form for children aged 3-7 years. Methods: Around 250 mothers or fathers of 3-7 years old children were recruited from non-clinical population to collect responses to the questionnaires. The sample was created by reaching 3 schools at preschool or elementary grade for the purpose of providing the questionnaires filled about the student and/or his/her little sisters and brothers by their parents; questionnaires were sent out to parents and then gathered. Parents were asked to fill sociodemographic data form, Behavioral Inhibition Questionnaire parent form, Children Behavior Questionnaire, and Strengths and Difficulties Questionaire parent form in order to perform convergent and divergent validity analyses. Results: As a result of reliability analysis, total Cronbach alpha coefficient for Behavioral Inhibition Questionnaire was determined as 0.92 with strong reliability. The internal consistency coefficients for Behavioral Inhibition Questionnaire subscales also showed strong reliability with alphas ranging between 0.81 and 0.87 except for the performance (α = 0.69) and physical challenges (α = 0.19) subscales of which some items were excluded due to item-total correlations and confirmatory factor analysis results. In the validity assessment analyses, confirmatory factor analysis demonstrated that Behavioral Inhibition Questionnaire has a construct validity with 5 factors loaded on the 2-second order main factors and one third-order final factor (root mean square error = 0.032, root mean square residual = 0.153, Comparative Fit Index = 0.978, Goodness of Fit Index = 0.915, and Turker-Lewis Index = 0.970). While the strongest correlations with the overall Behavioral Inhibition Questionnaire score were found for 2 main subscales, inhibition to social novelties (r = 0.926, P < .001) and situational novelties (r = 0.928, P < .001), similarly peers (r = 0.848, P < .001) and new situations (r = 0.898, P < .001) subscales, had strong correlations with the overall Behavioral Inhibition Questionnaire score. The weakest correlation with overall Behavioral Inhibition Questionnaire score was observed for physical challenges subscale even though this subscale displayed moderate association (r = 0.454, P < .001). A good convergent validity was determined accompanied by significant moderate positive correlations with Children Behavior Questionnaire shyness and Strengths and Difficulties Questionnaire internalizing scales. An adequate divergent validity was also demonstrated based on significant positive mild to moderate correlations with Children Behavior Questionnaire impulsivity, Children Behavior Questionnaire smiling/laugh, Strengths and Difficulties Questionnaire prosocial scales, and non-significant correlation with Strengths and Difficulties Questionnaire externalizing scale. Conclusion: The study demonstrated that the Turkish version of the Behavioral Inhibition Questionnaire parent form is an effective tool with good reliability and validity among 3-7 years old children.

Conducting research on building psychosocial support for Syrian refugee families in a humanitarian emergency.

BACKGROUND: This case study describes research, which is located in Turkey, where more than 750,000 Syrian refugees reside autonomously in Istanbul. The research developed and pilot tested a novel model for helping urban refugee families with limited to no access to evidence-based mental health services, by delivering a transdiagnostic family intervention for common mental disorders in health and non-health sector settings using a task-sharing approach. This case study addresses the following question: What challenges were encountered in developing and piloting a low intensity trans-diagnostic family support intervention in a humanitarian emergency setting? DISCUSSION: The rapidly growing scale of humanitarian crises requires new response capabilities geared towards addressing populations with prolonged high vulnerability to mental health consequences and limited to no access to mental health, health, and social resources. The research team faced multiple challenges in conducting this research in a humanitarian emergency setting including: 1) Non-existent or weak partnerships geared towards mental health research in a humanitarian emergency; 2) Lack of familiarity with task-sharing; 3). Insufficient language and cultural competency; 3) Fit with families' values and demands; 4) Hardships of urban refugees. Through the research process, the research team learned lessons concerning: 1) building a coalition of academic and humanitarian organization partners; 2) investing in the research capacity building of local researchers and partners; 3) working in a community-collaborative and multi-disciplinary approach. CONCLUSION: Conducting research in humanitarian emergency settings calls for innovative collaborative and multidisciplinary approaches to understanding and addressing many sociocultural, contextual, practical and scientific challenge.

Peer Victimization in Preadolescent Children With ADHD in Turkey.

The present study aims to investigate peer victimization and its relationship with comorbid psychiatric diagnoses and quality of life (QoL) among children with attention deficit hyperactivity disorder (ADHD). Study sample consisted of 66 children with ADHD (mean age = 8.6 ± 1.1 years) and age- and gender-matched 66 controls (mean age = 8.5 ± 1.3 years). In self-reports, the ADHD group reported significantly higher rates of victimization and bullying than the non-ADHD group. Verbal and physical forms of victimization and bullying were the most prevalent forms in both groups; however, exclusion from peer groups, which is named as relational bullying, was the most significantly differing type between two groups. QoL parameters did not significantly differ between the children involved in bullying and those not involved, except for the lower physical QoL in victimized children in the control group. In conclusion, peer victimization was significantly more prevalent in the ADHD group than the non-ADHD group. Preventive measures are needed for peer victimization, especially for children with ADHD.

Parental psychological distress associated with COVID-19 outbreak: A large-scale multicenter survey from Turkey.

AIMS: Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. METHODS: A large-scale multicenter online survey was completed by the parents (n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers-HCW [18.2%] vs. others), geographical (Istanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. RESULTS: Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p < .001), a mother (odds ratio 1.67, p < .001), and a younger parent (odds ratio 0.98, p = .012); living with an adult with a chronic physical illness (odds ratio 1.38, p < .001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p = .043), positive psychiatric history (odds ratio 1.29, p < .001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p < .001; vs. odds ratio 2.61, p < .001) were independently associated with significant parental distress. CONCLUSIONS: Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit.

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.

Duration of Breastfeeding, Bottle-Feeding, and Parafunctional Oral Habits in Relation to Anxiety Disorders Among Children.

OBJECTIVE: The aim of the present study is to investigate the duration of breastfeeding in relation to various parafunctional oral habits in children with anxiety disorders. MATERIALS AND METHODS: The study includes 195 children and adolescents with anxiety disorders and age- and gender-matched 255 healthy control subjects. Diagnoses were made with semistructured interview (K-SADS). Information about breastfeeding and parafunctional oral habits was investigated via a questionnaire prepared for the study. RESULTS: The mean age was 11.50 ± 2.50 years for clinical group and 11.27 ± 2.33 years for controls. Fifty-four percent of the clinical group and 56% of the control group were female subjects. Duration of exclusive (4.72 ± 2.86, 5.55 ± 2.36; p = 0.002) and total breastfeeding (12.38 ± 10.32, 15.89 ± 9.09; p < 0.001) was significantly lower and duration of bottle-feeding (22.30 ± 19.54, 16.64 ± 12.79; p = 0.005) was higher than controls in the clinical group. Duration of exclusive breastfeeding was significantly correlated with duration of bottle-feeding (r = -0.263, p < 0.001) and duration of pacifier use (r = -0.249, p = 0.001). Multiple regression analysis showed that duration of exclusive breastfeeding (ß = 0.88, p = 0.006) and bottle-feeding (ß = 1.02, p = 0.005), as well as various oral habits, was associated with diagnosis of an anxiety disorder. CONCLUSION: Nutrition methods in early years of life may result in long-term consequences regarding anxiety disorders for children. Clinicians should encourage parents for a shorter duration of bottle-feeding and a longer duration of exclusive breastfeeding.

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.