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.

The probable role of adrenomedullin and nitric oxide in childhood attention deficit hyperactivity disorder.

BACKGROUND: The role of adrenomedullin hormone, which has been shown to be associated with many psychiatric disorders, in the etiology of ADHD and its relation to disease is not yet known. AIM: In this study, it was aimed to compare plasma adrenomedullin and nitric oxide (NO) levels of newly diagnosed, treatment-naive patients with ADHD with healthy children. METHODS: A total of 45 children with ADHD and 45 healthy children were included. The Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS), a semi-structured interview, was applied to all cases by child and adolescent psychiatrist. Age and gender matched participants who admitted to the hospital for any other reasons without any psychiatric diagnosis according to K-SADS were selected as a control group. Sociodemographic data form and The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale-parental form were applied to the all groups. NO and adrenomedullin levels were analysed by ELISA method with specific commercial kits. RESULTS: There was no statistically significant difference in NO and adrenomedullin levels, neither between the groups nor ADHD subtypes. A positive correlation between adrenomedullin and NO levels was found in both the case (r = 0.659) and the control groups (r = 0.494). CONCLUSIONS: Besides being the first study to evaluate adrenomedullin levels to elucidate the etiology of childhood ADHD as well as NO, significant differences was not found between the case and the control groups in terms of NO and adrenomedullin levels.

Pathological Internet Use, Aggression, and Cyberbullying in Children and Adolescents With Attention Deficit Hyperactivity Disorder.

Objective: The aim of this study was to evaluate the relationship between pathological internet use, aggression, and cyberbullying/victimization in children with attention deficit hyperactivity disorder. Methods: Male children (10-18 years old) with attention deficit hyperactivity disorder (n = 30) and without any diagnosis (n = 30) were evaluated using Questionnaire of Computer/Internet Use of Children and Adolescents (Children-Adolescent Form and Parent Form), Children's Aggression Scale-Parent Version, Young Internet Addiction Scale, and Cyber Bullying and Online Aggression Survey Instrument. Results: Weekly internet/computer using time, Young Internet Addiction Scale scores, Children's Aggression Scale-Parent Version scores were higher in the attention deficit hyperactivity disorder group. When all participants included in the study were compared for the availability of rules related to the PC/internet use at their homes, it was determined that there were rules by 53.3%, and the rate of setting rules was higher in the control group than attention deficit hyperactivity disorder group. There is a high level of positive correlation between Internet Addiction Scale score and duration in internet use in the attention deficit hyperactivity disorder group. Those who experienced cyberbullying throughout their lives were at a higher rate in the attention deficit hyperactivity disorder group compared to the control group. "Physical aggression without provoking" subgroup of Children's Aggression Scale-Parent Version is correlated with cyberbullying in the attention deficit hyperactivity disorder group and cyber victimization in the control group. Conclusion: Children with attention deficit hyperactivity disorder have higher levels of aggression and pathological internet use than healthy controls, but there is no difference between cyberbullying and victimization. Cyberbullying/victimization is independent of diagnosis. For this reason, it is necessary to create awareness and preventive measures of cyberbullying.

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.

Long-acting Injectable Risperidone Use in an 11-Years-Old Bipolar Child.

Early-onset bipolar disorder is difficult for child psychiatrists in terms of both diagnosis and treatment. The proper diagnostic evaluation is negatively impacted by the atypical clinical manifestation and rapid cycling pattern of the disease, together with common comorbidity with attention-deficit hyperactivity disorder and anxiety disorder. In addition to poor insight, nonadherence to treatment, poor family coping skills, and insufficient child psychiatric inpatient units make clinicians unsuccessful in following up and treating such patients. Risperidone is a commonly used atypical antipsychotic it has been approved for the treatment of manic and mixed episodes of bipolar disorder even in 10-17-year-old patients, and it is commonly used. It has a long-acting injectable formulation. Studies on its long-acting form in younger children are limited. In this case presentation, the diagnostic procedure in an 11-year old child with bipolar disorder will be presented. Long-acting injectable risperidone use in the case of nonadherence to treatment and observed side effects will be discussed.

Assessment of suicidality in children and adolescents with diagnosis of high functioning autism spectrum disorder in a Turkish clinical sample.

OBJECTIVES: Considering that suicide is one of the most common reasons of adolescent death worldwide, there is a lack of clinical awareness on suicidal behaviors of children and adolescents with autism spectrum disorder (ASD). The present study aims to assess the rate of suicidality (suicidal ideation, behaviors and attempts) and associated risk factors for suicidality in high functioning ASD. METHODS: Medical records of 55 adolescents (six girls, 49 boys), aged between 7-20 years, with diagnosis of ASD were reviewed. The participants were all able to speak fluently and had no significant limitations in intellectual functioning. Clinical assessment of participants was carried out on the basis of Diagnostic and Statistical Manual of Mental Disorders 4th Edition, Text Revision criteria and Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Eskin's Suicide Screening Questionnaire and sociodemographic data form including detailed history of suicidal behaviors were used. The study group was also divided into suicidal and non-suicidal groups for the purpose of comparing the results. RESULTS: The rate of suicidal behaviors was 29% and suicide attempt was 12.7%. Types of suicidality were behaviors (43.7%), thoughts (37.5%), and verbal declarations (18.7%). A number of bizarre acts were recorded. Rates of comorbid psychiatric disorders such as mood disorders, anxiety disorders and disruptive behaviors were 23.6%, 43.6% and 65.4% respectively. Groups with the psychotic features, positive family history for suicidal behaviors and completed suicide showed more suicidality than the non-suicidal group. CONCLUSION: Consistent with the previous findings, rate of suicidality is higher in individuals with ASD. The type of suicidal behaviors showed some differences compared to typically developing individuals. The presence of psychotic features and positive family history for suicidality may be risk factors for suicidality in children and adolescents with ASD. To prevent suicide and implement protective health care systems, identifying the population at risk is crucial.

Assessment of sleep problems and related risk factors observed in Turkish children with Autism spectrum disorders.

Sleep problems are common and difficult to manage in children with autism spectrum disorders (ASD). Another major adverse impact of sleep problems is that they exacerbate behavioral problems. To assess sleep problems and possible behavioral risk factors in detail, we aimed to compare sleep habits of children with ASD, with healthy children. The relationship between sleep difficulties and concomitant behavioral problems such as repetitive behaviors, hyperactivity, and social withdrawal were also examined. Hundred and seventeen children and adolescents including 64 with the diagnosis of ASD and 53 healthy subjects were enrolled in the study. Diagnostic Interview for ASD was performed according to DSM-IV-TR. Socio-demographical data form and childhood autism rating scale were filled by researchers. Aberrant behavior checklist (ABC), child behavior checklist and pediatric sleep questionnaire (PSQ) were completed by the parents of the children. Children with ASD had higher frequency of sleep problems, snoring, breathing problems, behavioral problems compared with healthy children (for all parameters; P < 0.001). A positive correlation was identified between the total score of PSQ and the total score of ABC (P < 0.05, Spearman correlation coefficient: 0.347). Sleep latency was prolonged in children with ASD compared with healthy subjects (P < 0.001). In accordance with the current literature, children with ASD were subject to sleep problems significantly more than the control group. Identified risk factors for sleep problems in ASD children were behavioral factors such as stereotypies, self-mutilation, hyperactivity, and social withdrawal. Autism Res 2016, 9: 536-542. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

An examination of the symptoms of anxiety and parental attitude in children with hemophilia.

BACKGROUND/AIM: Hemophilia is an inherited disease with serious repercussions. Psychiatric symptoms are frequently seen in children and adolescents with hemophilia. The aim of this study was to assess symptoms of anxiety in children with hemophilia and parental attitude towards children with hemophilia. MATERIALS AND METHODS: 42 boys were assessed according to child and adolescent psychiatry. Anxiety symptoms and parental attitude were obtained by the State-Trait Anxiety Scale, the Self-Report for Childhood Anxiety Related Disorders (SCARED) and the Parent Attitude Research Instrument (PARI). RESULTS: The mean age was 11.6 ± 2.5 (range; 7-16). State anxiety scores (44.02 ± 6.9) were higher than trait anxiety scores (32.7 + 7.5). The most interesting results were high scores related to overprotective mothering (47.9 ± 9.7) and the application of strict discipline (39.4 ± 9.1). The total SCARED scores obtained were (23.25 ± 11.3). CONCLUSION: Assuring a high quality of life is important for children and adolescents with chronic illness. Quality of life is negatively affected by psychiatric symptoms (e.g. anxiety symptoms, depression, intra-familial stress symptoms) in children with hemophilia. This study suggests that high anxiety scores and problems related to parental attitude can be seen in children and adolescents with hemophilia. These problems caused by parental attitude and anxiety symptoms should be considered in the treatment of hemophilia.