The relationship between sleep quality and chronotype differences and urticaria severity in patients with chronic spontaneous urticaria.

INTRODUCTION: Chronic spontaneous urticaria (CSU) is characterized by persistent or recurrent pruritic lesions that last more than 6 weeks. Patients with CSU may experience sleep disturbances, particularly due to itching. Biological rhythms (chronotypes) are categorized as morningness, intermediate, and eveningness types. This study evaluates the relationship between sleep quality, chronotype, and disease severity in CSU patients. METHODS: The study included 53 CSU patients and 50 healthy controls. A sociodemographic data form was completed, and the disease severity was determined utilizing the Urticaria Activity Score over 7 days (UAS7). The Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI) scales as well as the Morningness-Eveningness Scale (MEQ) were applied to the participants. RESULTS: The CSU group had a significantly higher body mass index (BMI) than that of the healthy control group. In terms of sleep and chronotype scales, compared to the control group, the CSU group had higher ISI scores as well as subscale scores on the PSQI subscales, with the exception of habitual sleep efficiency and total PSQI scores. There was no difference between MEQ scores. In the correlation analysis, the UAS7 and PSQI total scores were found to be correlated, whereas in the logistic regression analysis the estimated relative risk of BMI and PSQI total score for CSU was found to be 1.13 and 1.45, respectively. CONCLUSIONS: When dealing with CSU patients, it is necessary to conduct a sleep quality assessment as part of a holistic evaluation.

Relationship between Traumatic Experiences, Circadian Preference and ADHD Symptoms in Adolescents with ADHD Residing in Institutional Care: A Controlled Study.

Circadian preference, describes biological and behavioural characteristics that influence the ability to plan daily activities according to optimal waking times. It is divided into three main categories: morning, evening and intermediate. In particular, the evening chronotype is associated with conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and Post Traumatic Stress Disorder (PTSD). This study was conducted in three groups aged 14-18 years: The first group consisted of 34 adolescents diagnosed with ADHD who had been in institutional care for at least two years and had not used medication in the last six months. The second group included 29 adolescents with ADHD living with their families who had not used medication in the last six months. The third control group consisted of 32 healthy adolescents. The study utilized sociodemographic data forms, the Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) to measure ADHD symptoms, the Childhood Chronotype Questionnaire (CCQ), and the Childhood Trauma Questionnaire (CTQ). In institutionalized adolescents with diagnosed ADHD, ADHD and disruptive behavior symptoms were more severe. Increased trauma scores were associated with higher ADHD and disruptive behaviour symptom severity and evening chronotype. In the conducted mediation analysis, evening chronotype was identified as a full mediator in the relationship between trauma symptoms and ADHD symptoms, while it was determined as a partial mediator in the relationship between trauma symptoms and PTSD symptoms. In conclusion, traumatic experiences in institutionalized adolescents with diagnosed ADHD may exacerbate ADHD and disruptive behavior symptoms. Evening chronotype is associated with ADHD and disruptive behavior symptoms, and therefore, the chronotypes of these adolescents should be assessed. Chronotherapeutic interventions may assist in reducing inattention, hyperactivity, and behavioral problems.

The Relationship Between Adolescents' Perception of Family Emotional Atmosphere and Acne Severity, Self-Esteem, and Quality of Life in Adolescents Diagnosed with Acne Vulgaris.

OBJECTIVE: Acne vulgaris, a prevalent chronic condition among adolescents, significantly impacts patients' quality of life and self-esteem. Our aim was to investigate whether how adolescents perceive their family emotional atmosphere has an impact on their acne severity, quality of life, and self-esteem. MATERIALS AND METHODS: This study included 118 patients with acne vulgaris who completed various assessments, including a sociodemographic data form, the Acne Quality of Life Scale, the Hospital Anxiety and Depression Scale, the Shortened Level of Expressed Emotion Scale (SLEES) and, the Rosenberg Self-Esteem Scale. The Global Acne Grading System is performed by an experienced dermatologist to determine the severity of acne. RESULTS: Out of 118 patients, 78 (66.1%) were female and 40 (33.9%) were male. The mean age of patients was 15.2 ± 1.3 years. There was a positive correlation between the severity of acne and the levels of perceived intrusiveness subscores of SLEES (P = .021, r = 0.212). Significant correlations were also observed among quality of life scores, anxiety and depression levels, lack of emotional support (LES) scores, and self-esteem levels. The initial linear regression analysis demonstrated that the level of LES subscores of SLEES and levels of anxiety and depression were predictors of self-esteem. In the second regression analysis, anxiety and depression levels were identified as significant predictors of quality of life. CONCLUSION: The perceived family emotional atmosphere may be an important factor in evaluating the severity of acne as well as the self-esteem and quality of life of adolescent patients with acne vulgaris.

The relationship of quality of life and acne severity with chronotype and insomnia in patients with acne vulgaris.

This study aimed to examine the relationship between acne severity and quality of life, insomnia, and chronotype. This study included 151 patients diagnosed with acne vulgaris, aged 18-30 years. A sociodemographic data form was completed by the clinician, and acne severity was evaluated using the Global Acne Grading System (GAGS). The Visual Analogue Scale (VAS), Acne Quality of Life Scale (AQLS), Hospital Anxiety Depression Scale (HADS), Insomnia Severity Index (ISI), and Morningness-Eveningness Questionnaire (MEQ) were completed by the participants. There was a significant difference between the MEQ scores of the participants who were divided into three groups according to the severity of global acne, as mild, moderate, and severe. In the post hoc analysis, the MEQ scores of the patients with mild acne were determined to be significantly higher than the scores of the patients with moderate and severe acne. A statistically significant negative correlation was observed between the GAGS scores and the MEQ scores. In addition, a statistically significant positive correlation was found between the participants' ISI scores and AQLS scores. Considering the variables related to chronotype and sleep in the treatment planning for patients with acne vulgaris may be appropriate within the scope of integrative treatment.

Regulatory T cells in children with attention deficit hyperactivity disorder: A case-control study.

OBJECTIVE: The pathophysiology of attention deficit hyperactivity disorder (ADHD) are still not fully elucidated. Immune system dysregulation has emerged as a major etiological focus as a result of the high comorbidity of allergic disease, inflammatory biomarkers, and genetic research. The present study aimed to evaluate peripheral lymphocyte subpopulations and regulatory T cells (Tregs) in children with ADHD. METHODS: This single-center cross-sectional case-control study assessed 49 children with ADHD and 35 age- and gender-matched healthy children aged 7-12 years (9.10 ± 2.37 and 9.45 ± 2.13, respectively). The participants were screened for psychopathology using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, while the severity of ADHD symptoms was measured by means of the distracted-Continuous Performance Test. Peripheral lymphocyte subpopulations and Tregs were analyzed with flow-cytometry. RESULTS: There is no significant difference in peripheral blood lymphocyte subsets between ADHD and control groups The children diagnosed with ADHD exhibited significantly higher levels of CD3+ CD4+ CD25+ Foxp3+ (Tregs) than the healthy control subjects (8.23 ± 2.09 vs. 6.61 ± 2.89; z = 2.965, p = .004). The Tregs cell (Exp(B) = 1.334; p = .042; CI = 1.011-1.761) levels were determined to be statistically significant according to regression analysis and were associated with an increased probability of ADHD. CONCLUSION: Elevated Treg levels were linked to an increased likelihood of ADHD. This study suggested that changes in immune regulatory cells represent an important part of research in treatment of ADHD.

The relationship between irritability and autism symptoms in children with ASD in COVID-19 home confinement period.

OBJECTIVE: This study investigated the impact of COVID-19 home confinement on autism spectrum disorder (ASD) symptoms and irritability in children and adolescents with ASD. METHOD: The study participants included 46 drug-naive children aged 4-17 years diagnosed with ASD. Parents of the participants completed the Autism Behaviour Checklist (AuBC) and Affective Reactivity Index (ARI) scales for both normal conditions and COVID-19 home confinement. RESULTS: All subscale scores for AuBC (sensory, relating, body and object use, language, and social and self-help) and ARI scores significantly increased during the COVID-19 home confinement period (P < .05). The participants' irritability and ASD symptoms were significantly worse during the COVID-19 outbreak and home confinement period compared to normal conditions. The variables that predicted irritability were the social and self-help subscales of AuBC. DISCUSSION: These results have alerted us of the importance of focusing on the symptoms such as irritability exhibited by extremely vulnerable populations during disease outbreaks and of the necessity of developing new strategies to avoid such adverse outcomes in similar situations.

The Relationship of Comorbid Overweight-Obesity With Cold Executive Functions, Verbal Short-Term Memory, and Learning in Attention Deficit Hyperactivity Disorder.

ABSTRACT: The aim of this study was to investigate the relationship between comorbid obesity/overweight and cold executive functions, verbal short-term memory, and learning in children with attention deficit and hyperactivity disorder (ADHD). Our study was conducted on 100 drug-naive participants, including 70 patients with ADHD and 30 healthy controls. In our study, patients diagnosed with ADHD were divided into two groups according to body mass index as above the 85th percentile and at or below the 85th percentile. Cold executive functions were evaluated by the Stroop Test (ST) and Cancellation Test (CT). Serial Digit Learning Test (SDLT) was administered to measure verbal short-term memory and learning capacity. To evaluate the severity of ADHD objectively, the parents completed the Conners' Parents Rating Scale-Revised Short Version (CPRS-RS). There was no statistically significant difference in ST, SDLT, CT scores, and CPRS-RS subscale scores between the two groups with ADHD. This study show that overweight/obesity comorbid with ADHD may not be associated with cold executive functions, verbal short-term memory, learning, or ADHD symptom severity.

The relationship between chronotype, sleep, and autism symptom severity in children with ASD in COVID-19 home confinement period.

This study aimed to investigate the relationship between chronotype preference/sleep problems and symptom severity of children with Autism spectrum disorder (ASD) during the confinement and social isolation of the COVID-19 outbreak. This study included 46 drug-naive children aged 4-17 y diagnosed with ASD. The Autism Behavior Checklist (AuBC), Children's Sleep Habits Questionnaire (CSHQ), and Children's chronotype questionnaire (CCQ) were filled out before and at the end of the COVID-19 mandated home confinement by the children's parents. Children with ASD during the home confinement reported higher chronotype scores, i.e., eveningness chronotype, sleep problems, and autism symptom scores compared to the normal non-hone confinement state. The chronotype score and sleep problems of children with ASD during the home confinement period varied according to the AuBC score. The sleep problems of the children with ASD during the home confinement period mediated the relationship between chronotype score and severity of autism symptoms. It is essential to validate the role of the mediator effect of sleep problems and chronotype in larger samples of children with ASD with restricted to home confinement during the pandemic period. If sleep problems can be controlled with parental education, pharmacotherapy, and psychotherapeutic interventions, the impact on children with ASD of home confinement can be reduced.

Risky cyber behaviors in adolescents with depression: A case control study.

OBJECTIVE: This study aimed to compare adolescents diagnosed with major depressive disorder (MDD) and healthy adolescents with regard to cyberbullying, cyber victimization, internet addiction, and digital game addiction. MATERIALS AND METHODS: This cross-sectional study was performed in Selçuk University Hospital. The study sample consisted of 34 adolescents with MDD and 39 controls without any psychopathology. A socio-demographic data form, the Cyber bullying Scale (CBS), Cyber Victimization Scale (CVS), Cyber bullying Sensibility Scale (CBSS), Internet Addiction Scale (IAS), Digital Game Dependence Scale (DGA-7), and Children's Anxiety and Depression Scale-Refurbished (RCADS) were administered to all participants. RESULTS: CBS, CVS, IAS and DGAS-7 scores of the MDD group were significantly higher than those of the control group. The significant differences persisted even after controlling for confounding factors such as age, gender, socio-economic level, and parental educational levels with MANCOVA. A strong positive correlation existed between CBS and CVS scores, and higher IAS scores were associated with higher CBS scores in the MDD group. CBSS scores negatively correlated with DGAS-7 scores in the MDD group. LIMITATIONS: Due to the cross-sectional design of this study, conclusions about causality remain speculative. CONCLUSION: This study demonstrated the importance of assessing problems related to the online environment in the presence of depression in adolescents. Our results suggested that evaluating the use of technology with a view to the potential for cyber bullying and cyber victimization as well as internet addiction and addiction to digital games may be necessary as a holistic approach in the follow-up of adolescent depression.

Olanzapine-Associated Pisa Syndrome in an Autistic Adolescent.

OBJECTIVES: The objective of this study is to report a case of Pisa syndrome due to olanzapine use in an autistic adolescent. METHODS: The patient was a 12-year-old adolescent girl who was taking olanzapine for autism-related behavioral problems. Abnormal posture and balance problems appeared in the third month of olanzapine treatment. The patient was diagnosed as having Pisa syndrome after clinical evaluation. Biperiden was started on the patient whose complaints continued despite olanzapine treatment was stopped. Patient's complaints regressed with biperiden treatment. RESULTS: According to our knowledge, there is no an autistic adolescent case of Pisa syndrome previously reported in the literature. Further studies are needed to clarify the etiology and treatment of Pisa syndrome. CONCLUSIONS: In patients with balance problems and abnormal posture as a result of olanzapine use, the clinician should keep in mind Pisa syndrome.