The effect of anabolic androgenic steroids on heart rate recovery index and electrocardiographic parameters in male bodybuilders.

BACKGROUND: The control of the cardiovascular system depends on the autonomic nerve system. Chronic anabolic andorogenic steroids (AAS) use causes sympathovagal imbalance and increases sympathetic nerve activity. OBJECTIVE: The reduction in heart rate from the peak exercise rate following the end of the exercise stress test is known as the heart rate recovery index (HRRI). Several methods have been utilized to assess myocardial repolarization, such as QT interval (QT), corrected QT interval (QTc), and T-wave peak-to-end interval (Tp-e interval). Based on a growing number of data a higher Tp-e/QT ratio is linked to malignant ventricular arrhythmias, and an increased Tp-e interval may correlate with the transmural dispersion of repolarization. Our hypothesis is that the use of chronic AAS was decrease HRRI during maximal exercise and increased risk of cardiac arrhythmias and sudden cardiac death. METHODS: This study included 44 male bodybuilders, with an average age of 29.7 ± 8.14 years, divided into AAS abuse [AAS users (n = 21) and AAS nonuser (n = 23)]. RESULTS: The first (p = 0.001) and second minute (p = 0.001) HRRI of the subjects with AAS users were significantly lower than those of the control group. Additionally, HRRI after the third (p = 0.004) and fifth minutes (p = 0.007) of the recovery period were significantly lower in AAS group compared with the control group. Who used AAS had significantly higher QT, QTc, Tp-e, Tp-e/QT, and Tp-e/QTc values than non-users (all p = 0.001). CONCLUSIONS: Chronic AAS use has been shown to cause sympathetic dominance, which may be a pro arrhythmic state.

Cognitive functioning of adolescents using Methamphetamine: The impact of inflammatory and oxidative processes.

BACKGROUND: Methamphetamine is a substance that causes neurotoxicity and its use is increasing in recent years. Literature highlights cognitive impairment resulting from Methamphetamine use. The aim of the present study is to evaluate the relationship between cognitive impairment and inflammatory processes in adolescents with Methamphetamine use disorder. METHODS: The study included 69 adolescents aged 15-19 years, comprising 37 participants with Methamphetamine Use Disorder and 32 healthy controls. Central Nervous System Vital Signs was used to detect cognitive impairment. Childhood Trauma Questionnaire-33 and The Children's Depression Inventory scales were used. In addition, venous blood was collected from the volunteers. Biochemical parameters (IL-1beta, IL-6, TNF-a, BDNF, FAM19A5, TAS, TOS) were analyzed. RESULTS: Our study showed that (I) IL-6 and TNF-a levels of Methamphetamine users were lower than the healthy group; (II) BDNF levels of Methamphetamine users were higher than the healthy group; (III) mean Neurocognitive Index in cognitive tests of Methamphetamine using adolescents was negatively correlated with duration of Methamphetamine use and BDNF levels. CONCLUSIONS: Our study suggests that Methamphetamine use may have a negative effect on cognitive functions.

In-Hospital Outcomes of ST-Segment Elevation Myocardial Infarction in COVID-19 Positive Patients Undergoing Primary Percutaneous Intervention. / Desfechos Hospitalares do Infarto do Miocárdio com Supradesnivelamento do Segmento ST em Pacientes Positivos para COVID-19 que Passaram por Intervenção Percutânea Primária.

BACKGROUND: Concomitant coronavirus 2019 (COVID-19) infection and ST-segment elevation myocardial infarction (STEMI) are associated with increased adverse in-hospital outcomes. OBJECTIVES: This study aimded to evaluate the angiographic, procedural, laboratory, and prognostic differences in COVID-19-positive and negative patients with STEMI undergoing primary percutaneous coronary intervention (PCI). METHODS: A single-center, retrospective, observational study was conducted between November 2020 and August 2022 in a tertiary-level hospital. According to their status, patients were divided into two groups (COVID-19 positive and negative). All patients were admitted due to confirmed STEMI and treated with primary PCI. In-hospital and angiographic outcomes were compared between the two groups. Two-sided p-values < 0.05 were accepted as statistically significant. RESULTS: Of the 494 STEMI patients enrolled in this study, 42 were identified as having a positive dagnosis for COVID-19 (8.5%), while 452 were negative. The patients who tested positive for COVID-19 had a longer total ischemic time than did those who tested negative for COVID-19 (p=0.006). Moreover, these patients presented an increase in stent thrombosis (7.1% vs. 1.7%, p=0.002), length of hospitalization (4 days vs. 3 days, p= 0.018), cardiogenic shock (14.2% vs. 5.5 %, p= 0.023), and in-hospital total and cardiac mortality (p<0.001 and p=0.032, respectively). CONCLUSIONS: Patients with STEMI with concomitant COVID-19 infections were associated with increased major adverse cardiac events. Further studies are needed to understand the exact mechanisms of adverse outcomes in these patients.

FUNDAMENTO: A infecção concomitante por coronavírus 2019 (COVID-19) e o infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST) estão associados ao aumento de desfechos adversos hospitalares. OBJETIVOS: O estudo teve como objetivo avaliar as diferenças angiográficas, de procedimentos, laboratoriais e prognósticas em pacientes positivos e negativos para COVID-19 com IAMCSST submetidos à intervenção coronária percutânea primária (ICP). MÉTODOS: Realizamos um estudo observacional retrospectivo e unicêntrico entre novembro de 2020 e agosto de 2022 em um hospital de nível terciário. De acordo com o seu estado, os pacientes foram divididos em dois grupos (positivo ou negativo para COVID-19). Todos os pacientes foram internados por IAMCSST confirmado e foram tratados com ICP primária. Os desfechos hospitalares e angiográficos foram comparados entre os dois grupos. P-valores bilaterais <0,05 foram aceitos como estatisticamente significativos. RESULTADOS: Dos 494 pacientes com IAMCSST inscritos nesse estudo, 42 foram identificados como positivos para COVID-19 (8,5%) e 452, como negativos. Os pacientes que testaram positivos para COVID-19 tiveram um tempo isquêmico total maior do que os pacientes que testaram negativos para COVID-19 (p = 0,006). Além disso, esses pacientes apresetaram um aumento na trombose de stent (7,1% vs. 1,7%, p = 0,002), no tempo de internação (4 dias vs. 3 dias, p = 0,018), no choque cardiogênico (14,2% vs. 5,5%, p = 0,023) e na mortalidade hospitalar total e cardíaca (p <0,001 e p = 0,032, respectivamente). CONCLUSÕES: Pacientes com IAMCSST com infecções concomitantes por COVID-19 foram associados ao aumento de eventos cardíacos adversos maiores. Mais estudos são necessários para compreender os mecanismos exatos dos desfechos adversos nesses pacientes.

Desfechos Hospitalares do Infarto do Miocárdio com Supradesnivelamento do Segmento ST em Pacientes Positivos para COVID-19 que Passaram por Intervenção Percutânea Primária / In-Hospital Outcomes of ST-Segment Elevation Myocardial Infarction in COVID-19 Positive Patients Undergoing Primary Percutaneous Intervention

Resumo Fundamento A infecção concomitante por coronavírus 2019 (COVID-19) e o infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST) estão associados ao aumento de desfechos adversos hospitalares. Objetivos O estudo teve como objetivo avaliar as diferenças angiográficas, de procedimentos, laboratoriais e prognósticas em pacientes positivos e negativos para COVID-19 com IAMCSST submetidos à intervenção coronária percutânea primária (ICP). Métodos Realizamos um estudo observacional retrospectivo e unicêntrico entre novembro de 2020 e agosto de 2022 em um hospital de nível terciário. De acordo com o seu estado, os pacientes foram divididos em dois grupos (positivo ou negativo para COVID-19). Todos os pacientes foram internados por IAMCSST confirmado e foram tratados com ICP primária. Os desfechos hospitalares e angiográficos foram comparados entre os dois grupos. P-valores bilaterais <0,05 foram aceitos como estatisticamente significativos. Resultados Dos 494 pacientes com IAMCSST inscritos nesse estudo, 42 foram identificados como positivos para COVID-19 (8,5%) e 452, como negativos. Os pacientes que testaram positivos para COVID-19 tiveram um tempo isquêmico total maior do que os pacientes que testaram negativos para COVID-19 (p = 0,006). Além disso, esses pacientes apresetaram um aumento na trombose de stent (7,1% vs. 1,7%, p = 0,002), no tempo de internação (4 dias vs. 3 dias, p = 0,018), no choque cardiogênico (14,2% vs. 5,5%, p = 0,023) e na mortalidade hospitalar total e cardíaca (p <0,001 e p = 0,032, respectivamente). Conclusões Pacientes com IAMCSST com infecções concomitantes por COVID-19 foram associados ao aumento de eventos cardíacos adversos maiores. Mais estudos são necessários para compreender os mecanismos exatos dos desfechos adversos nesses pacientes.

Abstract Background Concomitant coronavirus 2019 (COVID-19) infection and ST-segment elevation myocardial infarction (STEMI) are associated with increased adverse in-hospital outcomes. Objectives This study aimded to evaluate the angiographic, procedural, laboratory, and prognostic differences in COVID-19-positive and negative patients with STEMI undergoing primary percutaneous coronary intervention (PCI). Methods A single-center, retrospective, observational study was conducted between November 2020 and August 2022 in a tertiary-level hospital. According to their status, patients were divided into two groups (COVID-19 positive and negative). All patients were admitted due to confirmed STEMI and treated with primary PCI. In-hospital and angiographic outcomes were compared between the two groups. Two-sided p-values < 0.05 were accepted as statistically significant. Results Of the 494 STEMI patients enrolled in this study, 42 were identified as having a positive dagnosis for COVID-19 (8.5%), while 452 were negative. The patients who tested positive for COVID-19 had a longer total ischemic time than did those who tested negative for COVID-19 (p=0.006). Moreover, these patients presented an increase in stent thrombosis (7.1% vs. 1.7%, p=0.002), length of hospitalization (4 days vs. 3 days, p= 0.018), cardiogenic shock (14.2% vs. 5.5 %, p= 0.023), and in-hospital total and cardiac mortality (p<0.001 and p=0.032, respectively). Conclusions Patients with STEMI with concomitant COVID-19 infections were associated with increased major adverse cardiac events. Further studies are needed to understand the exact mechanisms of adverse outcomes in these patients.

Should pediatric cardiologists refer all patients with unexplained chest pain to a psychiatrist?

OBJECTIVE: The present study aimed to investigate the relationship between unexplained chest pain in children with parents' mental problems, parental attitudes, family functionality, and the child's mental problems. MATERIAL AND METHOD: A total of 433 children (between 11 and 18 years of age) applied to the Pediatric Cardiology Outpatient Clinic due to chest pain in the last year. A clinical interview was conducted by a child psychiatrist with 43 patients and 33 controls included in the study due to unexplained chest pain. RESULTS: Family history of physical illness was significantly higher in the chest pain group. When evaluated in terms of psychosocial risk factors, life events causing difficulties, derangement in the family, loss of a close person, and exposure to violence were statistically significantly higher in the group with chest pain. Mental disorders were observed in 67.4% of the children in the chest pain group as a result of the clinical interview. The total score of the DSM-5 somatic symptoms scale, which evaluates other somatic complaints in the chest pain group, was also significantly higher. When the family functions of both groups were evaluated, communication, emotional response, behaviour control, and general functions sub-dimensions were statistically significantly higher in families in the chest pain group. CONCLUSION: We recommend that psychiatric evaluation be included in diagnostic research to prevent unnecessary medical diagnostic procedures in children describing unexplained chest pain, as well as to prevent the potential for diagnosing mental disorders in both children and adults.

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.

Prevalence of different echocardiographic abnormalities in a large Turkish workers population.

OBJECTIVE: We aimed to investigate the echocardiographic characteristics of workers with resting major electrocardiography (ECG) anomalies and risk factors of sudden cardiac death in the large Turkish workers population in different heavy industry sectors. METHODS: Between April 2016 and January 2020, 8668 consecutive ECGs were obtained and interpreted during health examinations of working in Istanbul, Turkey. ECGs were classified as major, minor anomaly, and normal according to the Minnesota code criteria. The workers with major anomaly on ECGs, recurrent syncope attacks, and family history (FH) of sudden or inexplicably death under the age of 50 and with a positive FH of cardiomyopathy were also referred to further transthoracic echocardiographic (TTE) examination. RESULTS: The mean age of the workers was 30.47 ± 9.4 years, most of them were male (97.1%) and under the age of 30 (54.2%). Major ECG changes were detected in 4.6%, and minor anomalies were 28.3%. A total of 663 workers were referred to our cardiology clinic for advanced TTE examination, but only 578 (87.17% of the selected) attended the appointment. Four hundred and sixty-seven (80.7%) echocardiography examinations were within normal limits. Echocardiographic imaging revealed abnormal findings in 98 cases (25.7%) in the ECG abnormalities group, three (4.4%) in the syncope group, and 10 (7.6%) in the positive FH group (p < .001). CONCLUSIONS: This work demonstrated the ECG findings and echocardiographic features of a large sample of Turkish workers from high-risk employment sectors. This is the first study conducted in Turkey on this subject.

Clinical Practices and Experiences about Screen Time: From the Perspective of Child and Adolescent Psychiatrists in Turkey - An Online Survey.

Background: Both mental and physical preventable health problems related to screen time (ST) in children and adolescents are increasing. It is important that psychiatrists have awareness to prevent problems in this area. Objective: The aim of our study was to evaluate the child psychiatrists' awareness about ST, their interventions for ST, and to what extent the recommendations of the associations are implemented. Method: All child and adolescent psychiatrists in the country who could be reached via smartphone were invited to participate in the study. Child and adolescent psychiatrists were included regardless of whether they had attended any ST courses/panels. Data were collected through an online questionnaire. A total of 302 physicians volunteered for the study. Results: It was determined that very few child and adolescent psychiatrists had attended an ST course/training in the past or followed any guidelines. A statistically significant difference was found between physicians who received training/courses and those who did not in terms of informing patients and offering interventions (p<0.05). Similarly, a significant difference was found between those who followed the guidelines and those who did not. Conclusion: Raising awareness, increasing psychiatrist participation in trainings, and following guidelines can increase the effectiveness of ST interventions, in order to achieve good results.

Which factors affect internalized stigmatization in adolescents with mental disorders?

PURPOSE: The aim of this descriptive study was to determine the factors affecting internalized stigmatization of adolescents with mental disorders. METHOD: The study data were collected in a university hospital between August 1, 2020 and July 30, 2021 (n = 123), using a Personal information form and the Internalized Stigmatization of Mental Illness-Adolescent Form (ISMI-AF). RESULTS: Gender and the number of hospitalizations were determined to be independent variables with explanatory power in the ISMI-AF, and in the model created with these variables, it was determined that these variables explained 18% of the change in the total points of the ISMI-AF. CONCLUSIONS: It could be recommended that psychosocial programs are developed with the aim of decreasing internalized stigmatization and increasing the psychological resilience of adolescents.

Relationship of herpesvirus (HSV1, EBV, CMV, HHV6) seropositivity with depressive disorder and its clinical aspects: The first study in children.

Infections can lead to the onset of mood disorders in adults, partly through inflammatory mechanisms. However pediatric data are lacking. The aim of this study is to evaluate the relationship between depressive disorder and seropositivity of herpes virus infections in children. The sample group consisted of patients diagnosed with depressive disorder according to DSM-5 diagnostic criteria and healthy volunteers, being between 11 and 18 years with clinically normal mental capacity. All children completed DSM-5-Level-2 Depression Scale, DSM-5-Level-2 Irritability Scale, DSM-5-Level-2 Sleep Scale, DSM-5-Level-2 Somatic Symptoms Scale. The levels of anti-HSV1-IgG, anti-CMV-IgG, anti-EBNA, and anti-HHV6-IgG were examined in all participants. Patients with an antibody value above the cut-off values specified in the test kits were evaluated as seropositive. The mean age was 15.54 ± 1.57 years in the depression group (DG), 14.87 ± 1.76 years in the healthy control group (CG). There were 4 boys (11.2%), 32 girls (88.8%) in the DG, 9 boys (21.9%) and 32 girls (78.04%) in the CG. There was no statistically significant difference between the groups in terms of the presence of seropositivity of HSV1, CMV, EBV, and HHV6. HHV6 antibody levels were significantly higher in the DG (p = 0.000). A significant positive correlation was found between HHV6 antibodies and DSM-5 level-2 somatic symptoms scale score. HHV6 antibody levels were found to be significantly higher in patients with existing suicidal ideation in the DG (n = 13) compared to those without existing suicidal ideation in the DG (p = 0.043). HHV6 persistent infections may be responsible for somatic symptoms and etiology of suicidal ideation in childhood depressive disorder.

Electrocardiographic Findings and Anomaly Frequency in Turkish Workers Groups: A Cross-sectional and Observational Study.

OBJECTIVE: Although electrocardiography scanning is routinely performed during the employ ment of employees in business sectors and during periodic controls, there is no large-scale study in our country that scans these electrocardiography data. The purpose of this study was to analyze the resting electrocardiography properties and basal clinical characteristics of the worker groups in a wide age range working in different business lines in the heavy industry sector. METHODS: Between April 2016 and January 2020, 9102 consecutive electrocardiographs were obtained during health examinations of working in Istanbul. In this study, 8607 electrocardio graphs suitable for interpretation were included. Electrocardiographs were classified by 2 dif ferent cardiologists as major, minor anomaly, and normal according to the Minnesota code criteria. RESULTS: Average age of the population was 30.47 ± 9.4 and 97% were males. A completely normal ECG was detected in 67.6%. Major electrocardiograph changes were detected in 4.6%, and minor anomalies were detected in 28.3%. Being 50 years older (P < .001) and working in a heavy chemical industry (P=,014) was found to be associated with major anomaly on elec trocardiograph. In the multiple logistic regression analysis, the business line and electrocardio graph were found to be independently associated with major and minor anomalies (P=,022) Conclusion: This study shows the electrocardiography findings of a large sample of Turkish workers from high-risk employment sectors. Electrocardiograph abnormalities were observed more frequently in heavy chemical industry and those who were 50 years and older. This is the first study conducted in Turkey on this subject.

Anxiety in Paediatric Patients Diagnosed with COVID-19 and the Affecting Factors.

OBJECTIVE: Children may be greatly affected by events that increase stress in individuals in general and are reported as the vulnerable groups during the coronavirus disease-19 (COVID-19) pandemic. But most of the studies in the literature investigating the mental effects of the pandemic on children were conducted with healthy children and limited study has evaluated the effect on children diagnosed with COVID-19. The aim of this study is to determine the anxiety level in paediatric patients diagnosed with COVID-19 and the affecting factors. METHODS: This descriptive study was conducted with 292 children aged 8-18 years who were diagnosed with COVID-19. Data were collected using the Descriptive Characteristics Questionnaire and the Screen for Child Anxiety Related Emotional Disorders (SCARED). Interviews were held by phone. RESULTS: Males were 51.4% of participants, the mean age was 16.04 ± 1.93. 84.1% of them had a chronic disease; the transmission source was family/relatives/friends for 41.1%. By social isolation, 49.3% were affected and 33.2% were affected by disease symptoms the most in this process. The most common symptoms were headache (61.6%), and asthenia (59.9%). Mean anxiety scale score was 25.5 ± 14.37. The effect of gender, number of symptoms and transmission source on anxiety score was significant (p < 0.05). CONCLUSION: Paediatric patients diagnosed with COVID-19 were found to have high anxiety levels. It is recommended to re-evaluate the duration of children's social participation and support the management of COVID-19 symptoms that affect their anxiety level.

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.

[Maternal Attitudes, Irritability, Problem Solving Skills and Decision Making in Adolescents with Substance Use: Case-control Study]. / Madde Kullanan Ergenlerin Problem Çözme, Karar Verme Becerileri, Duygusal Tepkisellik Düzeyleri ve Anne Tutumlarinin Degerlendirilmesi: Olgu-Kontrol Çalismasi.

OBJECTIVE: Multiple risk factors affect the emergence of substance use disorders among adolescents and their families. To the best of our knowledge, the effects of irritability, problem solving, decision making skills and maternal attitudes on the severity of the substance use have not been evaluated on the same population. We aimed to evaluate the presence and the effects all of these variables on the severity of substance dependence. METHOD: The study included 40 adolescents, between 14 and 17 years of age, consulting the Child and Adolescent Mental Health and Diseases outpatient clinics with complaints of substance use and 40 age and gender matched healthy controls. The diagnoses were based on the DSM-5 diagnostic criteria. Both groups completed a sociodemographic questionnaire, the Parent Attitude Research Instrument (PARI), the Adolescent Decision Making Questionnaire (ADMQ), the ProblemSolving Inventory (PSI) and the DSM-5 Level 2 Irritability Scale. The patient group were also tested on the Addiction Profile Index for Adolescents (API-AF). RESULTS: Problem solving skills scores of the patients were lower and the scores on the irritability scale completed by the patients and their parents were higher as compared to the control group. Complacency (indifference) in decision-making predicted the severity of the addiction. As the complacency in decision-making increased, the severity of addiction also increased. CONCLUSION: Our results indicated that problem solving and decisionmaking skills and irritability levels of the adolescents together with the family attitudes, affect substance use disorder in adolescence. These variables should be considered in preventive and therapeutic approaches.

Thiol/disulfide homeostasis in medication-naive children and adolescents with obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) causes significant psychic distress and affects children's social and academic functioning. Approximately 80% of OCD cases begin in childhood. Earlier onset is associated with more severe OC symptoms, poorer treatment response, and a more unfavorable clinical course. A particular oxidative stress marker, thiol/disulfide homeostasis, using a new, comparatively inexpensive, easily calculated, easily accessible, repeatable, and fully automated method was investigated between pediatric patients diagnosed with OCD and a healthy control group in this study. This study is the first to address this subject in pediatric patients with OCD and aims to contribute to our knowledge of the etiopathogenesis and treatment of pediatric OCD. The study included children with OCD (n = 35, 52.2%) (drug free, comorbidity free) between 11 and 18 years of age and age- and sex-matched healthy controls (n = 32, 47.8%). The total thiol (p = 0.025) and disulfide (p = 0.001) levels and the disulfide/native thiol (p = 0.001) and disulfide/total thiol ratios (p = 0.001) were significantly different between the groups. Also, in the patient group, biochemical analysis revealed that the disulfide level (p = 0.05) and the disulfide/native thiol (p = 0.034) and disulfide/total thiol ratios (p = 0.039) differed significantly according to the presence of a family history of psychiatric disorders. Consequently, the results of our study show that thiol/disulfide homeostasis may affect the etiopathogenesis of pediatric OCD and can be utilized as a new method when evaluating oxidative stress.

Depression, loneliness and factors influencing in Syrian refugee children.

AIMS: About 3.5 million Syrian refugees are living within the borders of Turkey. This study examined depression, loneliness and factors influencing refugee children who live outside the camps and attend school in Turkey. METHODS: This was a descriptive study in Sanliurfa, which has the second highest refugee population in Turkey. The sample consisted of 535 students attending 6-8 grades in five schools randomly selected of 18 schools located in the city centre where the Syrian children received their education. Data were collected using the Sociodemographic Characteristics Question Form, the Depression Scale for Children and the UCLA Loneliness Scale. Data were analysed by IBM spss v23. The percentage, average and standard deviation were determined. A linear regression analysis was used to examine the independent variables affecting loneliness and depression scores, and the Backward method was used to include independent variables in the model. Significance level was considered as P < .05. RESULTS: The average age of the children was 13.22 ± 1.33 years and 57.9% female. The average UCLA Loneliness Scale score was 42.95 ± 7.77. About 42% of the children received ≥19 on the depression scale, and 65% of them received ≥40 on the UCLA Loneliness Scale. Independent variables affecting depression score and UCLA loneliness score were analysed by a linear regression analysis. The linear regression model established for depression and UCLA loneliness score was obtained as statistically significant (P < .001). CONCLUSION: Depression and loneliness scores were relatively high in children, particularly those exposed to the devastating impacts of war. These results will make significant contributions to the planning of services to be provided for this group of children.

High Depression Symptoms and Burnout Levels Among Parents of Children with Autism Spectrum Disorders: A Multi-Center, Cross-Sectional, Case-Control Study.

The diagnosis of autism spectrum disorder (ASD) in a child affects family processes, increases parenting stress and marital conflicts, and may lead to parental psychopathology. It may also affect the prognosis for their children. The aim of this study is to determine depression and burnout levels as well as their predictors among parents of children with ASD compared with those of healthy children. We also sought to evaluate rate of complementary and alternative medicine (CAM) interventions among parents and explore the associations of this phenomenon in an exploratory fashion. 145 children with ASD and 127 control children were enrolled along with their mothers and fathers. Beck Depression Inventory and Maslach Burnout Inventory were used to evaluate parents' depression symptoms and burnout levels. Symptoms of children with ASDs were evaluated according to the Childhood Autism Rating Scale by the clinicians. Family, child and CAM variables were screened by means of a sociodemographic data form. Descriptive, bivariate and correlation analyses were used in statistical evaluations. Predictors of burnout were evaluated with multiple regression analysis. Burnout and depression levels among parents of children with ASD were significantly elevated compared to controls. Burnout levels of mothers were significantly elevated compared to fathers while depression scores of fathers were significantly elevated compared to mothers. Maternal burnout was significantly predicted by presence of functional speech in child while paternal burnout was significantly predicted by paternal vocation. Maternal depression was associated with paternal depression, lack of speech in child and attendance of child to special education services. Paternal depression was associated with autistic symptom severity and maternal depression. More than half the parents sought CAM interventions. Education level did not affect search for CAM interventions while both maternal and paternal psychopathology and presence of epilepsy among children increased use of CAM methods. Psychological support should be provided to both mothers and fathers of a child receiving a diagnosis of ASD. Addressing parents' burnout and stress levels and facilitating their negotiation of knowledge on etiology and treatments for ASD may be beneficial for the family unit as a whole.