Serum peripheral markers for inflammation in adolescents with anorexia nervosa.

BACKGROUND: There is a limited number of studies comparing the levels of inflammation in adolescent patients with anorexia nervosa (AN) and healthy controls based on complete blood count and platelet parameters. METHODS: This study is a retrospective cross-sectional analysis of 53 drug-naive patients with AN and 53 healthy controls. RESULTS: Significant differences were observed for WBC (white blood cell), neutrophil, MCV (mean corpuscular volume), MCH (mean corpuscular haemoglobin) and neutrophils/lymphocytes ratio (NLR) between the study groups. Patients with AN had lower WBC, neutrophiles and NLR values. But there was no difference between the groups in terms of inflammation-related platelet parameters. A strong positive correlation between BMI (body mass index) and PLT (platelet), PCT (plateletcrit) was determined in the patient group (r = 0.454, p = 0.001; r = 0.386, p = 0.007). Inflammation-related parameters may increase as BMI increases with nutrition and weight restoration. CONCLUSIONS: The present study provides further evidence for level of inflammation in these patients does not increase during the acute period, unlike other mental diseases.

Executive functions in adolescents with gender dysphoria.

Aim: Aim of this study is evaluating EF by performing neurocognitive tests, and to identify gender-related differences in EF between adolescents with and without GD.Methods: 8 Female-to-Male transgender adolescents (FtMs), and 14 Male-to-Female transsexual adolescents (MtFs) (Gender Dysphoria Group, GDG) and 29 boys, 21 girls (Control Group, CG), were tested in a cross-sectional study, using the Wisconsin Card Sorting Test (WCST), Controlled Oral Word Association Test (COWAT), and Stroop Color and Word Test (SCWT). The psychiatric diagnoses were established by using the KD-SADS.Results: Among GDG 72.7%, had at least one psychopathology. There weren't any significant differences in, estimated IQ scores, or WCST subtest scores between the 2 groups. COWAT total word count and SCWT-5 total duration test scores were better in the CG.Conclusion: CG had better performance on verbal fluency and response inhibition whereas no differences found on set shifting abilities. In consideration of the existence of EF-related impairment in adolescents with GD, appropriate support and interventions are expected to improve their adaptation skills and comorbid psychopathologies. These results should be interprete cautiously and additional larger scale studies are needed to obtain more comprehensive data related to gender differences in EF of adolescents with GD.

Adolescents with Gender Dysphoria had high rates of co-morbid psychopathology.The control group had significantly better response inhibition and verbal fluency scores than the GD group.There were no significant difference in set shifting abilities between two groups.

The Impact of the COVID-19 Pandemic on Pediatric Mental Health Emergency.

OBJECTIVE: The aim of this study was to compare pre/post-coronavirus disease 2019 pandemic changes in mental health-related visits to the pediatric emergency department. MATERIALS AND METHODS: We conducted a retrospective analysis of all mental health-related pediatric emergency department visits to a tertiary general hospital between June and September 2019, 2020, and 2021. We described pre/post-coronavirus disease 2019 changes in the use of pediatric emergency departments, such as timing of visits, sex discrepancies, diagnostic distribution, discharge planning, and others. RESULTS: Compared with the corresponding months before the pandemic (n = 187), mental health-related pediatric emergency department visits decreased by 20.8% in June-September 2020 (n = 148) and increased by 12.2% in 2021 (n = 210). The distributions of age, sex, timing of visits, reasons for presentations, hospitalization, and outpatient clinic appointment rates were not statistically significant between the years. Self-harm in females and aggression/violence in males were the most common reasons for presentation to pediatric emergency departments in each year. In the post-pandemic period, ambulance use and patients referred by other hospitals for psychiatric consultation increased, while the completion time of consultations decreased (P < .05). The frequency of attention-deficit hyperactivity disorder and depression decreased, but obsessive-compulsive disorder and anxiety disorders were more common in the post-pandemic period than in the corresponding months before the pandemic (P < .05). CONCLUSION: Our results suggest that the coronavirus disease 2019 pandemic resulted in a significant change in mental health-related visits to the pediatric emergency department. Those in the groups with reduced visits may be at risk for delayed access to treatment for their mental and behavioral difficulties.

Are neurocognitive abilities and social cognition related to social and role functioning in familial high risk group for psychosis?

AIMS: In this study, we aimed to compare neurocognitive abilities and social cognitive features among adolescent offspring of psychotic individuals and healthy controls. METHODS: The study sample was composed of offspring of patients with psychotic disorders (n = 30), the high risk group (HR), and age and sex matched healthy controls (n = 32) the Control Group (CG). The psychiatric diagnoses were established by using the KD-SADS. Strengths and Difficulties Questionnaire adolescent and parent forms (SDQ-A, SDQ-P) were used. General functioning status were evaluated by The Children's Global Assessment Scale (CGAS) and Global Functioning Scale: Social and Role Functioning. Wisconsin Cart Sorting Test, Controlled Oral Word Association Test, California Verbal Learning Test, Stroop Colour and Word Test and Trail Making Tests A and B were used to assess neurocognitive abilities; to assess social cognition and empathy skills DANVA-2 and Bryant Empathy Scale were used, respectively. RESULTS: Among HR 53.33% had at least one psychopathology. SDQ-A, SDQ-P scores were significantly higher, and CGAS, social and role functioning scores were significantly lower in HR. Neurocognitive test scores were significantly worse except for SCWT scores in the HR. No significant differences were obtained in social cognition. A variety of the neurocognitive abilities were significantly correlated with the role functioning. In regression analyses, the most predictive scores were WCST total correct scores and role functioning score. CONCLUSIONS: HR group showed more impairments in neurocognition, social, role and overall functioning, whereas there was no significant difference in terms of social cognition. Disturbances in neurocognition were correlated with impairments in role functioning.

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.

An Analysis of Admissions to a Refugee Child Mental Health Unit in the Context of the COVID-19 Pandemic.

BACKGROUND: To examine the admissions to a refugee child outpatient mental health unit in the COVID-19 pandemic and to compare them with the pre-pandemic period. METHODS: This retrospective observational study, planned through the hospital information system and patient files, included the 1-year number of outpatient unit admissions, sociodemographic, and clinical data. RESULTS: Before the COVID-19 pandemic (March 2019-February 2020), a total of 2322 patients (local and refugee) applied to the same unit, and 236 (10.1%) of these patients were refugees. Since the commencement of the COVID-19 pandemic in Turkey (March 2020-February 2021), 1209 patients applied, and 10.4% (n = 126) of them were refugees. While 19.66 ± 6.31 refugees applied per month in the pre-pandemic period, this number decreased to 10.50 ± 5.31 during the pandemic period (p = 0.01). During the pandemic period, there was a significant decrease in the number of female refugee patient admissions. In addition, while admissions for external disorders increased significantly during the pandemic period (x2 = 13.99, p = 0.001), admissions for internal disorders decreased significantly (x2 = 4.54, p = 0.03). CONCLUSIONS: The decrease in the mental health unit demands with the pandemic may lead to negative consequences in the long term. To determine mental health and psychological needs of patients during the outbreak will greatly contribute to the pandemic management process.

An overview of the mental and physical health status and post-migration psychosocial stressors of refugee toddlers and preschoolers.

PURPOSE: Although thousands of refugee children are being born in resettlement areas, few studies have described the mental and physical status in early childhood. We aimed to study the mental, physical status, and post-migration psychosocial stressors of refugee toddlers and preschoolers. DESIGN AND METHODS: The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood was used to assess psychiatric disorders, parent-child relational context, physical health conditions, psychosocial and environmental stressors, and developmental competencies of children who were evaluated at the clinic site. This study was a retrospective examination of these health records. Seventy participants were divided into two groups: children born during resettlement in Turkey and children born in Syria. The Syria group consisted of 33 participants aged 66.73 ± 13.05 months. The Turkey group consisted of 37 participants aged 38.78 ± 16.82 months. FINDINGS: In both groups, children suffered from a wide range of mental and physical disorders and a variety of psychosocial stressors. Monthly income and resettlement time in the Turkey group were more statistically significant (χ2 = 10.611, p = 0.014; χ2 = 5.976, p = 0.050). Also in the Turkey group, parents and siblings had significantly more mental health problems (χ2 = 4.39, p = 0.04; χ2 = 5.38, p = 0.02). PRACTICE IMPLICATIONS: Child and adolescent mental health workers need to be aware of the specific needs of this particular age group of refugees. Social, economic, and policy efforts are needed to improve the living conditions of refugee children.

Coping and psychopathology in children with malignancy and bronchiectasis.

AIM: We aimed to evaluate the coping styles and social support perceived by the children with two different chronic diseases (cancer and bronchiectasis), their mothers' coping styles and compare them with a control group without any chronic physical or psychiatric disorder. METHODS: Our sample consisted of 114 children and adolescents, with an age range from 9 to 15 years. The data were collected by using schedule for affective disorders and schizophrenia for school-age children-present and lifetime version, kid-coping orientation to problems experienced (Kid-COPE), social support appraisals scale (SSAS), and COPE. RESULTS: All three groups were similar with respect to age and sex distribution. Around 50% to 60% of the children in both patient groups had a psychiatric diagnosis. Remarkably, 30% of the children had an internalizing disorder. The most commonly used coping style by the mothers was religious coping in all groups. Kid-COPE scores did not significantly differ between groups. The scores on Family and Friend subscales of SSAS in the bronchiectasis group were significantly lower when compared with those of participants in hematology-oncology and control groups. CONCLUSION: Chronic medical illnesses may have a similar psychological impact on children regardless of disease-specific clinical presentations and outcomes. Future studies need to focus on identifying protective and risk factors that potentially mediate psychosocial well-being.

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.

Impact of psoriasis in the quality of life of children, adolescents and their families: a cross-sectional study

Abstract: Background: Psoriasis is a chronic and inflammatory disease that impairs quality of life and causes psychological symptoms. Despite the high prevalence of psoriasis in pediatric patients, studies investigating the impact of psoriasis in the quality of life of children, adolescents and families are sparse. Objective: To investigate the impact of psoriasis in the quality of life of children and adolescents with psoriasis and their families and to determine depression and anxiety levels of the patients. Methods: A total of 58 patients with psoriasis aged 7-18 years (median age: 11) and a family member of each patient were included in the study. Children's Dermatology Life Quality Index (CDLQI), Family Dermatology Life Quality Index (FDLQI), Children's Depression Inventory (CDI) and State-Trait Anxiety Inventory for Children (STAIC) were used in the study. Results: The median PASI score of the patients included in the study was 1.8. The median CDLQI and FDLQI scores in the study groups were 5 and 10, respectively. The median CDI score, STAIC-state and STAIC-trait scores of the patients were 6, 28 and 32.5, respectively. Study limitations: Lack of a control group and patient assessment of disease severity. Relatively mild disease severity of the subjects. Conclusions: Psoriasis has a negative impact in the quality of life of children, adolescents and their families, even in the presence of mild disease. Considering that impairment in quality of life may be associated with psychosocial morbidity, a combined approach with medical therapy, family counseling and quality of life assessment may be beneficial in this patient group.

Impact of psoriasis in the quality of life of children, adolescents and their families: a cross-sectional study.

BACKGROUND: Psoriasis is a chronic and inflammatory disease that impairs quality of life and causes psychological symptoms. Despite the high prevalence of psoriasis in pediatric patients, studies investigating the impact of psoriasis in the quality of life of children, adolescents and families are sparse. OBJECTIVE: To investigate the impact of psoriasis in the quality of life of children and adolescents with psoriasis and their families and to determine depression and anxiety levels of the patients. METHODS: A total of 58 patients with psoriasis aged 7-18 years (median age: 11) and a family member of each patient were included in the study. Children's Dermatology Life Quality Index (CDLQI), Family Dermatology Life Quality Index (FDLQI), Children's Depression Inventory (CDI) and State-Trait Anxiety Inventory for Children (STAIC) were used in the study. RESULTS: The median PASI score of the patients included in the study was 1.8. The median CDLQI and FDLQI scores in the study groups were 5 and 10, respectively. The median CDI score, STAIC-state and STAIC-trait scores of the patients were 6, 28 and 32.5, respectively. STUDY LIMITATIONS: Lack of a control group and patient assessment of disease severity. Relatively mild disease severity of the subjects. CONCLUSIONS: Psoriasis has a negative impact in the quality of life of children, adolescents and their families, even in the presence of mild disease. Considering that impairment in quality of life may be associated with psychosocial morbidity, a combined approach with medical therapy, family counseling and quality of life assessment may be beneficial in this patient group.

Sleep habits, parasomnias and associated behaviors in school children with attention deficit hyperactivity disorder (ADHD).

Considerable clinical data support an association between sleep problems and attention deficit hyperactivity disorder (ADHD). We aimed to investigate the sleep habits, associated parasomnias and behavioral symptoms in primary school children with ADHD. Forty primary school children with a clinical diagnosis of ADHD and 40 age-sex-matched healthy community controls were recruited. The Children's Sleep Habits Questionnaire providing information regarding sleep habits and nighttime and daytime symptoms was used. About 22% of children with ADHD (versus 2.9% of the controls) needed their parents to accompany them while going to sleep (p: 0.008). Transitional objects were needed by 8.1% of ADHD children in contrast to 2.9% of controls. Nightmares, overactivity during sleep, habitual snoring, and bed-wetting were significantly higher in the ADHD group. ADHD children needed significantly more time to go to sleep on school days (p < 0.02). Children undergoing evaluation for ADHD should be routinely screened for sleep disturbances.