Blood Count Parameters as Inflammation Indicators in Children and Adolescents Diagnosed with Depressive Disorder.

Aim: There is increasing evidence that immunological and inflammatory dysfunctions play an essential role in the initiation and progression of major psychiatric disorders. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume can be used as markers of systemic inflammation in different diseases. We aimed to investigate these blood count parameters in children and adolescents diagnosed with major depressive disorder. Methods: Designed as a case-control study, our sample consisted of patients aged 9-16 years referred to Child and Adolescent Psychiatry and pediatrics outpatient clinics for the first time and diagnosed with major depressive disorder according to Diagnostic and Statistical Manual of Mental Disorders, 5th edition diagnostic criteria, and healthy children and adolescents matched at a ratio of 1 to 2. Data of 58 cases and 90 healthy controls evaluated between 01.07.2019 and 01.07.2020 were included. Results: Platelet-to-lymphocyte ratio values were significantly higher in the case group. No significant difference was found between patient and control groups regarding other blood count parameters. When depression group was compared in terms of all parameters as those who committed suicide and those did not, significant difference was found between the 3 groups in terms of platelet-to-lymphocyte ratio values. The intergroup difference in platelet-to-lymphocyte ratio was found between the depression group without suicide and the control group. No significant relationship was found between other parameters and Children's Depression Inventory Scale scores. We determined a cut-off value of 112.5 for platelet-to-lymphocyte ratio (with sensitivity of 70% and specificity of 63%). Conclusion: Platelet-to-lymphocyte ratio might be an important parameter in the clinical follow-up of major depressive disorder.

DSM-5 Level 2 Sleep Disorders Scale Validity and Reliability of Turkish Form (Form for Children Aged 11-17 Years and Parent Form for Children Aged 6-17 Years).

INTRODUCTION: This study aimed to assess the validity and reliability of Turkish version of DSM-5 Level 2 Sleep Disorders Scale. METHOD: The scale was prepared by translation and back translation of DSM-5 Level 2 Sleep Disorders Scale. Study groups consisted of a clinical sample that contained cases that had sleep related problems and treated in a child and adolescent psychiatry unit and also a community sample. In the assessment process, child and parent forms of DSM-5 Level 2 Sleep Disorders Scale and also Children's Sleep Habits Questionnaire-Turkish version (CSHQ) and Pittsburgh Sleep Quality Index (PSQI) were used. As for reliability analyses, internal consistency coefficient and item-total score correlation analysis, test-retest reliability; and for validity analyses, explanatory factor analysis and for concurrent validity, correlation analyses with Children's Sleep Habits Questionnaire-Turkish version (CSHQ) and Pittsburgh Sleep Quality Index (PSQI) were made. RESULTS: In reliability analyses, Cronbach's alpha internal consistency coefficient values were found to be very highly reliable regarding child and parent forms. Item-total score correlation coefficients were high for child form while medium and high for parent form; indicating a statistical significance. As for construct validity, two factors were maintained that would count for 74.1% of the variance in child form and 66.9% of the variance in parent form. It was seen that positive and negative statements weighed on two different factors. As for concurrent validity, child and parent form of the scale showed significant correlation with Children's Sleep Habits Questionnaire-Turkish version (CSHQ) and Pittsburgh Sleep Quality Index (PSQI). CONCLUSION: It was found that Turkish version of DSM-5 Level 2 Sleep Disorders Scale could be utilized as a valid and reliable tool both in clinical practice and for research purposes.

Treating an Adolescent with Long QT Syndrome for Bipolar Disorder: A Case Presentation.

OBJECTIVES: Long QT syndrome (LQTS) is described as the development of sudden syncope attacks or death as a result of ventricular tachycardia (VT) episodes that might be observed as elongated QT interval in electrocardiography (ECG). Implantable Cardioverter Defibrillator (ICD) is recommended as first-line treatment for the condition in guidelines. We aimed to present an adolescent recently diagnosed with Bipolar Disorder (BD) who had LQTS that was treated with ICD, discussing her follow up and treatment along with relevant literature. METHODS: Psychiatric assessment of the case that applied to our child psychiatry unit due to manic symptoms were carried out by using Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) criteria. Symptom severity was monitored via Young Mania Rating Scale scores (YMRSS). RESULTS: The case met criteria for Bipolar Disorder Type I (BD-I). She had improvement in her mood symptoms with treatment regimen as risperidone 3 mg/day, valproate 1000 mg/day and lorazepam 1 mg/dayi after her 2-week follow up as well as no reported ICD activity, reflecting fine cardiac functions and rhythm. CONCLUSIONS: LQTS is a serious health issue for children and adolescents diagnosed with BD. This condition should be kept in mind especially in cases where familial risk factors are present and precautions need to be maintained upon required assessments. These cases need to be closely monitored due to risk factors related to both BD and LQTS, in a multidisciplinary fashion, involving both psychiatry and cardiology divisions.

Validity and Reliability of the Turkish Version for DSM-5 Level 2 Anger Scale (Child Form for Children Aged 11-17 Years and Parent Form for Children Aged 6-17 Years).

INTRODUCTION: This study aimed to assess the validity and reliability of the Turkish version of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Level 2 Anger Scale. METHODS: The scale was prepared by translation and back translation of DSM-5 Level 2 Anger Scale. Study groups consisted of a clinical sample of cases diagnosed with depressive disorder and treated in a child and adolescent psychiatry unit and a community sample. The study was continued with 218 children and 160 parents. In the assessment process, child and parent forms of DSM-5 Level 2 Anger Scale and Children's Depression Inventory and Strengths and Difficulties Questionnaire-Parent Form were used. RESULTS: In the reliability analyses, the Cronbach alpha internal consistency coefficient values were found very high regarding child and parent forms. Item-total score correlation coefficients were high and very high, respectively, for child and parent forms indicating a statistical significance. As for construct validity, one factor was maintained for each form and was found to be consistent with the original form of the scale. As for concurrent validity, the child form of the scale showed significant correlation with Children's Depression Inventory, while the parent form showed significant correlation with Strengths and Difficulties Questionnaire-Parent Form. CONCLUSION: It was found that the Turkish version of DSM-5 Level 2 Anger Scale could be utilized as a valid and reliable tool both in clinical practice and for research purposes.

Limb lengths of primary school children in a city from western region of Turkey.

Anthropometry has been used for the assessment of growth at different ages. Among the anthropometric measurements, weight, height, arm circumference, and lower and upper limb lengths are of the most important criteria showing the development of children in school age. The aim of the present study was to measure the lengths of upper (arm, forearm, hand) and lower (thigh, leg, foot) limbs of children studying in primary schools of Aydin, a city in the western region of Turkey, and to assess the differences according to the gender (female, male) and living areas (urban, rural). In different age groups, many differences were observed when compared for gender and area. Differences were also seen when compared with the other studies done in different part of Turkey. The data was the first one for the region and it might be useful for further regional studies or for national comparisons. More studies designed with bigger sample sizes that cover many cities belonging to the same region of the country are needed. In addition to cross-sectional studies, longitudinal studies may give more useful knowledge for understanding the growth of children.

Intestinal parasites prevalence and related factors in school children, a western city sample--Turkey.

BACKGROUND: Intestinal parasitic infections are amongst the most common infections worldwide. Epidemiological research carried out in different countries has shown that the social and economical situation of the individuals is an important cause in the prevalence of intestinal parasites. Previous studies in Turkey revealed a high prevalence of intestinal parasitic infection. The objectives of the current study were to determine the prevalence of intestinal parasitic infections in Aydin among 7-14 years old school children and to identify associated socio-demographic and environmental factors, behavioral habits and also related complaints. METHODS: Multistage sampling was used in the selection of the study sample. A questionnaire, cellulose adhesive and a stool specimen examination were done. RESULTS: A total of 456 stool specimens were collected. 145 students (31.8%) were infected with one or more intestinal parasites. 29 (6.4%) of the students were infected more than one parasite, 26 (5.7%) with two parasites and 3 (0.7%) with three parasites. The three most common were E. vermicularis, G. intestinalis and E. coli. Intestinal parasite prevalence was higher in rural area, in children with less than primary school educated mother, in children who use hands for washing anal area after defecation, and in children who use toilet paper sometimes or never. The relation between child health and mother education is well known. Children were traditionally taught to wash anal area by hand. Toiler paper usage was not common and might be due to low income or just a behavioral habit also. Most of the complaints of the study population were not significantly related with the intestinal parasitic infection. CONCLUSIONS: Intestinal parasitic infection is an important public health problem in Aydin, Turkey. Rural residence, mother education less than primary school, sometimes or never usage of toilet paper, and washing anal area by hands after defecation were the significant associations. Interventions including health education on personal hygiene to the students and to the parents, especially to mothers are required. The ratio of uneducated women should be declined with specific programs. A multisectoral approach is needed.