Adjustment disorder and its risk factors during the solid organ pre-transplant period for children: A retrospective analysis of the last 10 years.

BACKGROUND: Adjustment disorder (AD) in individuals suffering from end-stage organ failure can negatively impact treatment adherence and overall quality of life. Previous research focusing on adults has suggested that AD might serve as a precursor to major mental disorders. However, although it is frequently used as a diagnosis in consultation-liaison psychiatry, our understanding of AD in pediatric transplant candidates remains limited. Therefore, the objective of this study is to assess AD and identify its associated risk factors among children who are candidates for heart, kidney, and liver transplantation. METHODS: Data were collected retrospectively from a cohort of 155 children, aged between 6 months and 18 years (mean age 9.4), who had undergone consultations for child and adolescent psychiatry at a hospital with a transplant center within the past 10 years. RESULTS: The predominant diagnosis among children assessed during the pre-transplant period was AD (20%), with the subtype "with depressed mood" being the most commonly observed (35.5%). Organ type and length of hospital stay were identified as significant independent predictors of AD. Being a heart transplant candidate was determined as the strongest predictor of AD among children who underwent consultations with child and adolescent psychiatry within the population of transplant candidates. CONCLUSIONS: The study found that AD was the most common diagnosis among transplant candidates who underwent psychiatric consultations. Additionally, the study identified the length of hospital stay and the type of organ needed as independent predictors of AD. Screening for AD by considering risk factors may provide an opportunity for early intervention before the occurrence of major mental disorders in transplant candidates.

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.

Can we identify "at-risk" children and adolescents for poor transplant outcomes in the psychosocial evaluation before solid organ transplantation? The reliability and validity study of Pediatric Transplant Rating Instrument (P-TRI) in Turkish pediatric renal transplant patients.

BACKGROUND: This study aims to translate the Pediatric Transplant Rating Instrument (P-TRI) to conduct a validity and reliability study on Turkish children and define a cutoff value of this scale. METHOD: A total of 151 pediatric kidney transplant patients were included in the study. The files of the patients were reviewed by two clinicians, and the scale was filled for inter-rater reliability. One of the clinicians filled the scale again after one month for intra-rater reliability. Glomerular filtration rate (GFR) and creatinine values were used for predictive validity. A GFR below <60 ml/min/1.73 m2 and creatinine up to 3.0 mg/dl was defined as risk factors. RESULTS: Correlation of P-TRI with GFR (r = .252, p = .003) and creatinine (r = -.249, p = .002) was performed, and the internal consistency of the scale items as measured by Cronbach's alpha coefficient was found to be 0.825. When the test was performed again, the intra-class correlation coefficient was found as .922 for intra-rater reliability and as .798 for inter-rater reliability. For both creatinine and GFR, the best cutoff point for the total score was found to be 66.5. CONCLUSIONS: Patients who received P-TRI above 66.5 could be at risk in the post-transplant period. Identification of these patients before transplantation and following these young people more closely will aid in the prevention of serious consequences. The reliability and validity scores are satisfactory for use in transplantation clinics for psychosocial evaluation and compliance in Turkish pediatric renal transplantation patients.

Screen media exposure in pre-school children in Turkey: the relation with temperament and the role of parental attitudes.

BACKGROUND: Electronic media have become an important element in the lives of modern children. Devices like televisions, smartphones and tablets are widely used by some parents in order to manage hyperactive, stubborn and impulsive children who need high-intensity stimuli. Consequently, a child`s temperament and parental attitudes affect the duration and frequency of 3-7-year-old children`s screen (television-smartphone-internet) use. Based on this information, the objective of the present study was to evaluate the relation between screen media exposure, the child`s temperament and parental attitudes in 3-7-year-old children. METHODS: The participants of this study were 210 children of 3 to 7 years of age. Rothbart`s Child Behavior List was used to assess temperament; the Parenting Attitude Research Instrument was used to determine the parental attitudes. Screen media exposure assessment questionnaire, which included questions about the age the child started using the TV, smartphone and/or internet, and the duration of their daily usage, were filled in with the children`s parents. RESULTS: It was found that the increase in activity level, approach and discomfort was negatively correlated to the age the child started watching television, while shyness was positively related to the same phenomenon. The scores of the discomfort temperament subscale had a direct relation to the duration of watching television. Background television is negatively related to attention, inhibitory control, and perceptual sensitivity. Dependency, marital conflict and strictness and authoritarianism parameters were found to be positively related to the duration of playing with a smartphone. Also, in this study we found that negative temperament characteristics adversely affected screen media exposure and poor parenting styles worsen this relationship. CONCLUSIONS: Both temperament and parenting styles affect screen media exposure. In addition, it was understood that parenting styles also affect the relation between temperament and screen exposure. Parental information programs on this subject can eliminate the lack of information related to early screen media exposure in preschool children.