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Tourette syndrome (TS) is a childhood-onset neurodevelopmental disorder characterized by several motor and phonic tics.In this study, we aimed to compare activated regulatory T cell (Treg) values between patients with TS/chronic tic disorder (CTD) and age- and sex-matched healthy controls (HCs).Patients with TS/CTD and age- and sex-matched HCs were included in the study. The severity of the disease was evaluated using the Yale Global Tic Severity Scale. CD4The study included 48 patients diagnosed with TS/CTD (36 males and 12 females, mean age: 11.58 ± 2.61) and 24 HCs (18 males and 6 females, mean age: 11.63 ± 2.60). The TS/CTD group had significantly higher activated regulatory T percentile with respect to the T helper value compared to the HCs (Our results suggest that Tregs may have a role in the pathogenesis of TS/CTD.

BEYAZYUZ, MURAT/0000-0002-5770-344X; Potas, Nihan/0000-0002-0393-3135 WOS: 000445634300023 PubMed: 30053573 Attention Deficit and Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders in childhood and causes significant functional impairments in children. Behavioral genetic and molecular genetic studies have provided significant evidence in terms of highlighting the etiology of ADHD. Folate deficiency during pregnancy is an established risk factor for ADHD. Polymorphisms in the Methyltetrahydrofolate Reductase (MTHFR) encoding gene, such as A1298C and C667T, are associated with the decreased bioavailability of folate, and this condition can act like folate deficiency. In the literature, no study has investigated MTHFR polymorphisms in mothers of children with ADHD. Sixty-four children diagnosed with ADHD and their mothers as well as 40 healthy children and their mothers participated in this study. MTHFR polymorphisms were investigated in all participants. Comparison of the C677C and A1298C MTHFR polymorphisms in children with and without ADHD revealed no significant differences. We found that the maternal C677C_CT genotype counts, both observed and expected values, were significantly different from those based on Hardy-Weinberg Principle Analysis in the ADHD group. The most important result of this study was that maternal C677C MTHFR gene polymorphisms are significant risk factors in for ADHD, and we argue that children with ADHD are exposed to folate deficiency, even if their mothers received a sufficient amount of folate during pregnancy. This result also highlights one of the genetic factors of ADHD. Further studies should be performed to confirm this finding. Tekirdag Namik Kemal University Scientific Research Community [NKUBAP.02.GA.16.067] Present study was supported by Tekirdag Namik Kemal University Scientific Research Community (NKUBAP.02.GA.16.067).

Health-care workers exposed to coronavirus19 disease could be psychologically stressed. The objective of this study is to assess the anxiety, depression levels, and psychological resilience of physicians working during the Covid-19 outbreak and to evaluate the related factors that are associated with their psychological resilience.The sample of this descriptive study was composed of medical doctors and dentists. The data were obtained online between April 13-23, 2020 through a survey prepared by the researchers. In addition, a questionnaire about the participants' sociodemographic characteristics, the Psychological Resilience Scale and Hospital Anxiety Depression Scale (HAD-A/HAD-D) was given.The average age of the 671 participants was 44.0 ± 9.0 years. Psychological resilience scores were significantly higher in those who had children, who had worked for 15 years or more, and who had received training about COVID-19 (p 0.05). Depression scores were higher among women and in those who reported having a chronic disease, whose workload increased after the outbreak, and who had physical contact with COVID-positive patients. The anxiety scores were also higher among women and in those whose workload had increased and who had contact with COVID-positive patients (p 0.05). The physicians with scores below the cutoff point on the HAD-D/HAD-A had significantly higher scores on the Psychological Resilience Scale (p 0.05).Depression and anxiety levels were found to be significantly lower in physicians with greater psychological resilience. Psychological and social support of all health-care workers, especially physicians, is important in the struggle with the pandemic. It is thought that determining the variables related to psychological resilience in health-care workers will be a guide for psychosocial services.

Introduction Parental psychopathology has been defined in respect of psychopathological development in early childhood. This study aimed to investigate the effects of parental psychopathologies on social and emotional problems in the age range of 1-3 years and to determine children at risk. Methods The study data were obtained from the 2009 Early Childhood Mental Health Profile taking population distribution into consideration with the properties representing Turkey. The primary caregiver of the child completed the Psychiatric Evaluation Form for 1-3 years, the Brief Infant-Toddler Social Emotional Assessment (BITSEA), the Ages and Stages Questionnaire (ASQ), and the Brief Symptom Inventory (BSI) for themselves. Machine learning models used for prediction. The performance of prediction models was evaluated with the ten-fold cross-validation method. Area Under Curve (AUC) values were calculated with Receiver Operating Characteristic (ROC) curves to evaluate the performance of each model. Results The evaluation was made of the data of 2775 children, comprising 1507 (54.3%) males and 1268 (45.7%) females with a mean age of 26.19±9.11 months (range, 10-48 months). A total of 106 children were identified as at risk, as they were above the clinical cut-off point (1.5 standard deviations) of the BITSEA points and below the cut-off points of any one of the developmental areas of the ASQ. Modeling was applied to the data of these 106 children. The Support Vector Machines (SVM) model was selected for prediction with the automatically optimized highest AUC value. Weighting for the SVM algorithm showed mothers' BSI scores, fathers' education and health problems, duration of breastfeeding, unplanned pregnancy are significant for predicting BITSEA-problem scores in the model. Conclusion To be able to understand the complex relationship with parental psychopathology and behavioral problems, machine learning methods were used successfully in this study. Further studies with more massive data sets, more extended follow-up periods, and stronger algorithms will be able to identify risk groups earlier and allow early interventions to be implemented.

10th International Congress on Psychopharmacology & 6th International Symposium on Child and Adolescent Psychopharmacology[Abstract:0110] [Addiction]Cessation of cigarette smoking in adolescents: s...

Sahin, Berkan/0000-0003-4699-3418; Usta, Mirac Baris/0000-0002-1573-3165 WOS: 000424948600002 PubMed: 29171317 Objective: In literature, recent evidence has shown that the hypothalamic-pituitary-adrenal (HPA) axis can be dysregulated in patients with post-traumatic stress disorder (PTSD) and HPA axis hormones may predict the psychotherapy treatment response in patients with PTSD. In this study, it was aimed to investigate changing cortisol and DHEA-S levels post-eye movement desensitization and reprocessing (EMDR) therapy and the relationship between treatment response and basal cortisol, and DHEA-S levels before treatment.Method: The study group comprised 40 adolescents (age, 12-18 years) with PTSD. The PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Post-traumatic Stress Reaction Index (CPSRI) and the blood cortisol and DHEA-S were measured with the chemiluminescence method before and after treatment. A maximum of six sessions of EMDR therapy were conducted by an EMDR level-1 trained child psychiatry resident. Treatment response was measured by the pre- to post-treatment decrease in self-reported and clinical PTSD severity.Results: Pre- and post-treatment DHEA-S and cortisol levels did not show any statistically significant difference. Pre-treatment CDI scores were negatively correlated with pre-treatment DHEA-S levels (r: -0.39). ROC analysis demonstrated that the DHEA-S/cortisol ratio predicts treatment response at a medium level (AUC: 0.703, p: .030, sensitivity: 0.65, specificity: 0.86).Conclusion: The results of this study suggested that the DHEA-S/cortisol ratio may predict treatment response in adolescents with PTSD receiving EMDR therapy. The biochemical parameter of HPA-axis activity appears to be an important predictor of positive clinical response in adolescent PTSD patients, and could be used in clinical practice to predict PTSD treatment in the future. Ondokuz Mayis UniversityOndokuz Mayis University [PYO.TIP.1904.16.002] The present study was sponsored by Ondokuz Mayis University with the project number PYO.TIP.1904.16.002.

Bozkurt, abdullah/0000-0002-8359-6131; Sahin, Berkan/0000-0003-4699-3418 WOS: 000502778500004 Introduction: Epigenetic changes in the pathogenesis of neurodevelopmental disorders, including prenatal and early life exposures, are becoming as appealing as hereditary genes. This study aimed to investigate possible pre-pubertal environmental and developmental risk factors for children with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and Specific Learning Disorder (SLD). Methods: The study included 98 children (24 ADHD, 24 SLD, 26 ASD, 20 controls) aged 7-12 years. The diagnostic evaluation was based on the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders and Schedule for Affective Disorders and Schizophrenia for School-age Children-present version. Parents completed socio-demographic data form for clinical evaluation, and The Wechsler Children's Intelligence scale was used to assess cognitive skills. Results: In our study, low parental education level, parental unemployment, low-income, and history of psychiatric disorders in first-degree relatives were associated with SLD risk, prematurity, and early self-regulation difficulties were associated with ASD risk, and history of allergy was associated with ADHD risk. Conclusion: In this study, the presence of many different risk factors that play a possible role in neurodevelopmental disorders suggests that further epigenetic studies arc needed.

WOS: 000504845000007 Objective: Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) are practical inflammation parameters. In bipolar disorder (BD) and major depressive disorder (MDD), these parameters were reported higher than in healthy controls (HC). We aim to compare NLR, PLR, MLR in HC and patients with MDD and BB-manic episode. Method: Forty-six patients with MDD and 43 patients with BD hospitalized between 2013 and 2017 and 40 HC were included in the study. White blood cell, neutrophil, lymphocyte, platelet, and monocyte numbers were entered retrospectively from complete blood counts made at the time of admission, and NLR, PLR, and MLR were calculated from these. Results: NLR and PLR were revealed higher in MDD than HC. NLR and neutrophil values were higher in BD than HC, and there was a positive correlation between NLR and hospitalization period of patients with BD. Conclusion: Findings of our study supported the inflammation hypothesis for MDD and BD in adolescents. Larger-scale studies are necessary to confirm these findings.

Usta, Mirac Baris/0000-0002-1573-3165; Sahin, Berkan/0000-0003-4699-3418 WOS: 000481832500012 OBJECTIVE Studies show partial improvements in some core symptoms of Autism Spectrum Disorders (ASD) in time. However, the predictive factors (e.g. pretreatment IQ, comorbid psychiatric disorders, adaptive, and language skills, etc.) for a better the outcome was not studied with machine learning methods. We aimed to examine the predictors of outcome with machine learning methods, which are novel computational methods including statistical estimation, information theories and mathematical learning automatically discovering useful patterns in large amounts of data. METHOD The study the group comprised 433 children (mean age: 72.3 +/- 45.9 months) with ASD diagnosis. The ASD symptoms were assessed by the Autism Behavior Checklist, Aberrant Behavior Checklist, Clinical Global Impression scales at baseline (T0) and 12th (T1), 24th (T2), and 36th (T3) months. We tested the performance of for machine learning algorithms (Naive Bayes, Generalized Linear Model, Logistic Regression, Decision Tree) on our data, including the 254 items in the baseline forms. Patients with

Background We investigated the shared and non-shared perinatal risk factors for autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD) in a clinical sample. Additionally, we compared these groups regarding pre/postpartum maternal stress and the duration of breastfeeding. Methods Children aged 3–18 years old with ASD (n = 100) were compared with age- and gender-matched children with ADHD (n = 100) and with age- and gender-matched healthy controls (n = 80). Results Prematurity of the neonate and maternal stress/depressive mood in pregnancy were common risk factors shared by ASD and ADHD. Postpartum maternal depressive mood may be more specific to ASD, while shorter duration of breastfeeding may be related to ADHD. Conclusions ASD and ADHD may have some perinatal features in common. Identification of perinatal factors for ASD and ADHD carries clinical implications in terms of primary prevention.

WOS: 000368337500014 PubMed: 28360746 Introduction: The purpose of this study was to investigate the psychiatric consequences of sexual abuse and its associated factors in children and adolescents referred to our child and adolescent psychiatry clinic from official medico-legal units. Methods: All victims of sexual abuse (n=590) aged 1-18 (mean: 13.56 +/- 3.38) referred from forensic units to Ondokuz Mayis University Child and Adolescent Psychiatry Clinic over a period of 2 years [boys: 83 (14.1%); girls: 507 (85.9%)] were included. Child and adolescent psychiatry and forensic medicine specialists evaluated all the cases. The Wechsler Intelligence Scale for Children-Revised Form (WISC-R) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T) were applied. Results: Abuse-related psychiatric diagnoses (of which 45.9% were major depressive disorder and 31.7% were post-traumatic stress disorder cases) were made in 75.2% of the cases. In 80.3% of the cases, the perpetrators were known to their victims [incest, n=91 (15.1%)], and intercourse took place in 48.8%. Although gender and age were not significantly associated with the appearance of any psychiatric disorders, severity of abuse (e.g., intercourse; p=.006), additional physical assault (p

BEYAZYUZ, MURAT/0000-0002-5770-344X WOS: 000462505300020 PubMed: 30617449 Attention deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders of childhood and characterized by inattention, hyperactivity, and impulsivity. ADHD is a neurodevelopmental disorder, and its etiology has not yet been determined precisely. Orexin A is thought to play an important role in different forms of learning, memory, and attention. Despite its importance in attention and learning, no study has investigated serum orexin levels in patients with ADHD. In the present study, we aimed to compare serum orexigenic neuropeptides such as orexin A and orexin B, neuropeptide Y, and ghrelin between drug naive children with ADHD and healthy children. Fifty-six drug-naive children with ADHD and 40 healthy controls were enrolled in the study. After comparison of serum orexin A and orexin B, neuropeptide Y, and ghrelin, we found that serum orexin A levels were significantly lower in the ADHD group (p = 0.001). Furthermore, serum orexin A levels were compared between ADHD subgroups. Orexin A levels were significantly lower in the inattentive subtype compared with the hyperactive subtype and combined subtype (p = 0.009). Our results indicate that orexin A might be a neurobiological etiological factor in ADHD, particularly associated with attention symptoms. The present study is the first to demonstrate decreased serum orexin A levels in drug-naive children with ADHD. Further studies are needed to confirm our results and to show the effects of treatments involving orexin A in patients with ADHD. Tekirdag Namik Kemal University Scientific Research Community [NKUBAP.02, 17.09] The present study was supported by Tekirdag Namik Kemal University Scientific Research Community (Grant Number: NKUBAP.02.GA.17.09)

WOS: 000457389500014 PubMed: 30334117 High stress levels and impairment of physical/mental health in parents can delay early and effective intervention in autism. The purpose of this study was to examine relations between the clinical characteristics of children diagnosed with autism spectrum disorder (ASD) and caregiver burden, and anxiety and depression levels. Seventy cases under monitoring at the Namk Kemal University Medical Faculty Child and Adolescent Psychiatric Polyclinic with a diagnosis of ASD, and their principal caregivers, were included in the study. The Autism Behavior Checklist (ABC), Beck Depression Inventory (BDI), Beck Anxiety Inventory, and the Zarit Caregiver Burden Scale were completed. At multiple regression analysis, autism symptom severity and caregiver depressive symptom levels emerged as significant predictors of total caregiver burden scores. Only the ABC language subscale score had a determining effect on caregiver burden (r=0.51, r(2)=0.26, p=0.04). ABC body and object use subscale scores were identified as the symptom cluster affecting depression and anxiety scores (r=0.25, r(2)=0.06, p=0.03 and r=0.28, r(2)=0.08, p=0.01). Our findings show that ASD symptom severity and depressive symptoms in the caregiver are the most important factors giving rise to the caregiver burden, and that the main ASD symptom cluster affecting the caregiver burden was problems associated with language development. Better understanding of variables impacting on the caregiver burden will increase the quality of psychosocial services for caregivers.

WOS: 000363942500005 PubMed: 26075920 The current study examined the rate and psychiatric correlates of sexual abuse involving the use of digital technologies by the offender in a wide sample of juvenile victims. Sociodemographic, abuse, and psychiatric characteristics of 662 sexually abused children and adolescents were evaluated. Of these, 93 reported that digital devices were used by the offender in several ways to facilitate the sexual abuse. The offender-victim relationship was initiated through the Internet in 39 victims. Involvement of digital technologies in sexual abuse was significantly associated with penetrative and recurrent form of sexual abuse commited by multiple offenders with coexisting violence. Additionally, victims of sexual abuse with a digital component were 4.21 times more likely to develop any psychopathology, 3.77 times more likely to have depression, and 2.14 times more likely to have post-traumatic stress disorder as a result of sexual abuse. These results indicated that the offender's use of digital technology may aid the initiation and facilitaion of the sexual abuse of youths and may relate to more severe outcomes. This study revealed the importance of raising the awareness of professionals and the community about the potential risks associated with digital technologies and sexual abuse. Mental health professionals should consider this additional form of victimization, especially when dealing with sexual abuse victims.

Usta, Mirac Baris/0000-0002-1573-3165 WOS: 000426058400003 Object: Due to the low number of children and adult psychiatric clinics serving in our country, there is limited data in this age group in the literature. In this study, it was aimed to determine the factors affecting the duration of admission in children and adolescents receiving treatment in Samsun Ondokuz Mayys University Medical Faculty Psychiatry Clinic. Methods: Hospital records of 194 children and adolescents aged between 11 and 18 years who were hospitalized at Ondokuz Mayys University Psychiatric Service between January 2013 and December 2015 were retrospectively reviewed. ANOVA and logistic regression analyzes were performed for clinical and sociodemographic data that could effect hospitalization times and multiple admission. Results: 138 of the patients were female and 56 were male. Major depressive disorder patients (n: 79, 41.1%) and the average duration of hospitalization were 8.43 days. The group with the longest mean duration of admission was the Psychotic Disorder group (n: 17, mean: 19.92 days, p: 0.01). In logistic regression analysis for multiple risk factors, Female gender (OR: 2.02) and MDD diagnosis (OR: 1.51) were found to be risk factors for multiple admission. Discussion: In our study, it was observed that the presence of Major Depresive Disorder and female gender was a risk factor for multiple admission. Clinical and sociodemographic features of the disease can be predictive of hospitalization within the treatment plan.

Usta, Mirac Baris/0000-0002-1573-3165 WOS: 000408778900007 PubMed: 28856844 …

WOS: 000345108400003 Objective: The effects of serotonin and/or noradrenaline re-uptake inhibitors on memory have been investigated in various clinical and pre-clinical studies. However, contradictory results have been reported. In this study, the effect of the selective noradrenaline re-uptake inhibitors atomoxetine and reboxetine, a tricyclic antidepressant, amitriptyline, and a selective serotonin re-uptake inhibitor, paroxetine, on learning and memory were examined alone or in combination with scopolamine in mice using a passive avoidance task. Methods: Male Balb-C mice (25-30 g) were used. Reboxetine (10 mg/kg), atomoxetine (5 mg/kg), paroxetine (10 mg/kg) and amitriptyline (10 mg/kg) were investigated alone or in combination with scopolamine (1 mg/kg). A passive avoidance task was used to evaluate memory function. Acquisition time was recorded on the first day and retention time on the second (after 24 h). All drugs and saline were administered intraperitoneally 30 min prior to testing in order to evaluate retention time. Results: None of the drugs or saline impaired retention time when administered alone; however, scopolamine significantly impaired retention time (p=0.003). Reboxetine, atomoxetine and paroxetine all resulted in a marked improvement in retention time in combination with scopolamine. A combination of amitriptyline and scopolamine also significantly reduced retention time (p=0.013). Conclusion: Our results suggest that the effect of atomoxetine and reboxetine on improving memory deficit may be attributed to their inhibition of noradrenaline re-uptake. The effect of paroxetine on improving memory deficit may arise from enhanced serotonergic activity. Amitriptyline's lack of positive effect on memory deficit may be due to its own anticholinergic effect. Further studies using the same models and animal species are needed to clarify the mechanisms of the effects of each drug.

Objective: The purpose of this study was to establish whether there was any relationship between diagnosis of ADHD and various problematic life events in parents of children monitored with a diagnosis of ADHD. Method: Two hundred forty nine parents of 167 children followed-up with a diagnosis of ADHD and 146 healthy controls with no diagnosis of ADHD in their children or themselves were included. DSM-IV diagnostic criteria were used in diagnostic evaluation. Diagnostic criteria recommended for DSM-V and ADHD symptom assessment scales (Wender Utah Rating Scale-25, Adult Attention Deficit Hyperactivity Disorder Self-Report Scale) were also used. Problematic life events were recorded on a data form prepared by the authors. Results: Parents meeting a diagnosis of ADHD experienced nearly all problematic life events at a higher level compared to parents not meeting that diagnosis and to the healthy controls. Conclusion: Parents of children diagnosed with ADHD are exposed to a high, lifelong level of ADHD-associated life events. These parents should be evaluated in terms of diagnosis of ADHD.

Diagnoses of patients referring to a child and adolescent psychiatry outpatient clinic Objective: The aim of the present study is to identify the diagnoses of patients who referred to a child and adolescent psychiatry outpatient clinic. Method: Medical records of 538 patients referred to the Children and Adolescent Psychiatry outpatient clinic at Gulhane Military Medical School, between January 2009 and June 2009 were studied retrospectively. Results: It was found that the patients were mostly male and within 7 to 18 years of age. It was also determined that three quarters of patients had at least one diagnosis and the diagnosis rate in children between the ages of 0-6 was 50 percent. Comorbid diagnoses were found in 13.7 percent of all cases and they were mainly in the attention deficit hyperactivity disorder (ADHD) group. The most common diagnoses were ADHD, generalized anxiety disorder, mental retardation, depression and enuresis, respectively. The most common diagnosis in all age subgroups was ADHD. While the most common diagnoses in boys are ADHD, mental retardation, generalized anxiety disorder, enuresis and depression respectively, they were ADHD, generalized anxiety disorder, depression, mental retardation and enuresis in girls. Conclusion: To know the most common diagnoses, diagnosis differences within genders and possible diagnoses for certain age groups will be useful for improving child and adolescent psychiatry services.

Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are both lifelong neurodevelopmental conditions that begin in early childhood, and there are suggestions that insufficient breastfeeding may be related to development of either ASD or ADHD. In the present study, we compared breastfeeding durations of ASD and ADHD groups with each other and with healthy controls. The study included 98 children 3–18 years of age with ASD, 96 ageand gender-matched children with ADHD, and 79 ageand gender-matched healthy controls. Subjects with ASD or ADHD were recruited from among outpatients of the Department of Child and Adolescent Psychiatry, Ondokuz Mayis University Medical Hospital, Samsun, Turkey. The diagnoses of ASD and ADHD were established by interviews with patients and parents based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria. Demographic features and duration of breastfeeding were evaluated by a questionnaire that was prepared by the authors and completed by the mothers of participants. The mean age of the ASD group was 8.73 – 3.86 years (77% boys, 23% girls), that of the ADHD subjects was 8.80 – 1.98 years (71% boys, 21% girls), and that of the healthy control group was 8.45 – 4.61 years (78% boys, 22% girls). There were no significant differences among groups regarding age/gender of children, maternal age at birth, and education of parents. The mean duration of breastfeeding was significantly shorter in the ADHD group (9.10 – 7.847 months) compared with the ASD (12.18– 10.480 months) and healthy control (12.99– 8.658 months) groups ( p = 0.005). We also evaluated the rates of children who were never breastfed and those who continued breastfeeding at 1 month, 3 months, 6 months, 12 months, and 24 months of age. The rate of children who were never breastfed was significantly higher in the ADHD group (9.6%) compared with the healthy control group (1.3%) ( p= 0.034). The ADHD group showed significantly lower rates of exclusive breastfeeding at 1, 3, and 6 months of age than the other groups. At 1 month of age, 84% of children with ADHD were still breastfed, whereas 93% of the ASD group were breastfed, and 98% of the healthy controls were breastfed ( p= 0.001). At 3 months of age, 71% of the ADHD group were still breastfeeding compared with 78% in the ASD group and 88% in the healthy control group ( p= 0.025). By 6 months of age, breastfeeding rates were as follows: 50% in the ADHD group, 58% in the ASD group, and 72% in the healthy control group ( p= 0.012). The ASD group did not show any significant differences regarding mean duration and rates of breastfeeding compared with either the ADHD or healthy control group. The rates of breastfeeding were similar in all groups at 1 and 2 years of age. The results are summarized in Table 1. Breastfeeding has promoting effects on mental and motor development of the newborn. This preliminary study noted that children with ADHD were more likely to be less breastfed, especially during the first 6 months after birth, compared

Dundar, Cihad/0000-0001-9658-2540 WOS: 000348437700008 PubMed: 25066376 This study investigated the characteristics of abuse suffered by children, the dimensions of the psychiatric effects associated with abuse, and the factors affecting these. One thousand two cases aged under 18, exposed to sexual abuse, and referred over a 7-year period were assessed. Girls represented 80.8% of cases, and the numbers rose with age. The aggressors were all male, and 88.2% were known to their victim. Approximately half the children were exposed to sexual abuse involving penetration. Psychological pathology was identified in 62.1%. Female gender, the presence of penetration, physical violence, and incest significantly increased the development of psychological pathology. Levels of awareness in people close to and trusted by the child must be raised to minimize the adverse effects of trauma in the long term, preventive measures must be taken, and medical and social support units from which victims can receive assistance need to be established.

WOS: 000421442700004 Factors related to methylphenidate response in children with attention deficit/ hyperactivity disorder: a retrospective study Objective: We aimed to explore the predictive value of clinical features and self-concept on methylphenidate (MPH) response in children with attention deficit/hyperactivity disorder (ADHD). Methods: The study had a naturalistic design where the results were analyzed retrospectively. ADHD and comorbidity were diagnosed by Schedule for Affective Disorders and Schizophrenia for School-Age Children Present Lifetime Version (K-SADS-PL). At the baseline assessment, parents completed Turgay DSM-IV Disruptive Disorders Rating Scale (T-DSM-IV-S) and Child Behavior Check List (CBCL); teachers were given T-DSM-IV-S, CBCL. The children completed Piers-Harris Children's Self-Concept Scale (PHSCS), Children's Depression Inventory (CDI), and Screen for Child Anxiety Related Emotional Disorders (SCARED). Following 4-8 weeks of MPH treatment, the parents completed T-DSM-IV-S and the clinician completed Clinical Global Impression-Improvement scale (CGI-I). This study included 54 children (18 girls, 36 boys; mean age 9.32 +/- 0.21 years old). The sample was divided in "good responders" (GR) and "poor responders" (PR) regarding the response criteria defined by authors. Results: The PR group had significantly higher rates of anxiety disorders, higher internalizing scores and lower PHSCS scores compared to GR. Comorbid anxiety disorders, elimination disorders and negative self-concept were found to predict poor MPH response by multiple regression analysis. Conclusions: The results point to the need for additional interventions in the presence of comorbid anxiety, incontinence or poor self-concept in children with ADHD.

WOS: 000336522300009 PubMed: 24206098 …

Murat Yüce,1 Süleyman Salih Zoroglu,2 Mehmet Fatih Ceylan,3 Hasan Kandemir,4 Koray Karabekiroglu5 1Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey; 2Department of Child and Adolescent Psychiatry, Medical Faculty of Istanbul, Istanbul University, Istanbul, Turkey; 3Department of Child and Adolescent Psychiatry, Dr Sami Ulus Children's Hospital, Ankara, Turkey; 4Department of Child and Adolescent Psychiatry, Faculty of Medicine, Harran University, Sanliurfa, Turkey; 5Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey Objective: We aimed to determine distribution and diversities of psychiatric comorbidities in children and adolescents with attention deficit/hyperactivity disorder (ADHD) in terms of age groups, sex, and ADHD subtype. Materials and methods: The sample included 6–18 year old children and adolescents from Turkey (N=108; 83 boys, 25 girls) diagnosed with ADHD. All comorbid diagnoses were determined based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version assessment. Results: 96.3% of the cases were found to have at least one psychiatric comorbid diagnosis. The most frequent psychiatric comorbid disorder was oppositional defiant disorder (69.4%) followed by anxiety disorders (49%) and elimination disorders (27.8%). Disruptive behavior disorders were more common in ADHD-combined type. Depression and anxiety disorders were more common in girls. Separation anxiety disorder and elimination disorder were more common in children, whereas depression, bipolar disorder, obsessive–compulsive disorder, and social phobia were more common in the adolescents. Conclusion: According to our results, when a diagnostic tool was used to assess the presence of comorbid psychiatric disorders in children and adolescents diagnosed with ADHD, almost all cases had at least one comorbid diagnosis. Therefore, especially in the clinical sample, ADHD cases should not be solely interpreted with ADHD symptom domains, instead they should be investigated properly in terms of accompanying psychiatric disorders. Keywords: attention deficit/hyperactivity disorder, psychiatric comorbidity, child, adolescent

WOS: 000348845400006, PubMed: 28360651, Introduction: The differential features of childhood-onset obsessive compulsive disorder (OCD) compared to adult-onset OCD are being more of a focus of attention in recent years. The aim of this study was to determine the clinical and neuropsychological profiles of children and adolescents diagnosed with childhood-onset OCD and to investigate the association between the duration, severity, comorbidity, and family history of the disorder and clinical and neuropsychological functional impairments. Methods: Thirty-five OCD patients (patient group) and 35 healthy control subjects (control group) between 8-15 years of age were included. To investigate the neuropsychological profiles, the Wisconsin Card Sorting Test (WCST), Stroop Test, and Continuous Performance Test (CPT) were applied. To assess the clinical and behavioral profiles, the Children's Depression Inventory (CDI), Conner's Parent Rating Scale (CPRS-48), and the Yale Brown Obsessive Compulsive Scale (YB-OCS) and Yale Global Tic Severity Rating Scale (YGTSRS) were given. Results: Based on the performance in the WCST, Stroop Test, and SPT, the results of the study reveal that childhood-onset OCD patients have statistically significant worse performance compared to healthy controls in terms of executive functions, sustained attention, and motor inhibition tasks. Excluding the comorbid diagnoses, childhood-onset OCD patients did not show a difference in behavioral problems, but they had higher levels of anxiety compared to healthy controls. Conclusion: The findings of this study reveal that independent of the duration, severity, comorbid problems, and anxiety levels, the disorder itself is associated with worse performance in executive functions, attention, and motor inhibition processes, and a positive family history of OCD is an important risk factor. Long-term follow-up studies with patients diagnosed with childhood-onset OCD would be a logical next step in order to determine the cause-effect relation between the disorder and cognitive impairments.

WOS: 000297959300004 Fluoxetine for the treatment of childhood and adolescence social phobia: factors playing a role in efficacy Objective: The aim of this study was to investigate the stepwise efficacy, after 8 and 12 weeks of fluoxetine treatment, on social anxiety disorder (SAD) in 7 to 17 year-old children and adolescents (n=40) and to explore the variables that determine the response to treatment. Method: The study had a naturalistic design where the results were analyzed retrospectively. The baseline measures included the Clinical Global Impression-Severity, the Self-Report for Childhood Anxiety Related Disorders, the Social Anxiety Scale for Children-Revised (SASC-R), and the maternal Liebowitz Social Anxiety Scale. At 8 and 12 weeks, patients were rated on the Clinical Global Impression-Improvement, while children and adolescents completed the Self-Report for Childhood Anxiety Related Disorders. Results: Fluoxetine was significantly effective for SAD and well tolerated. The beneficial effect increased over time. A multiple regression model was constructed to determine the best linear combination of age, presence of a comorbid anxiety disorder, baseline SASC-R scores, duration of SAD, maternal social anxiety scores, and family history for depression and anxiety disorders. This combination of variables significantly predicted the SASC-R scores at 12 weeks (F(6,99)=91.5, p=0.01). Conclusion: The results of this study reveal that fluoxetine is effective and well tolerated for the acute treatment of social anxiety disorder in children and adolescents. The results suggest that younger age, lower baseline social anxiety scores, absence of a family history for depression and/or anxiety disorders, and lower maternal social anxiety scores predict a better outcome. Although overlapping anxiety symptoms of comorbid disorders may persist, the improvement of SAD is more likely when the children or adolescents have a comorbid anxiety disorder.

WOS: 000242884800005 PubMed: 17131050 Objective To investigate the current situation of Child and Adolescent Psychiatry (CAP) training in European countries. In addition, current agenda of different organizations in order to harmonize the training across Europe are reported. Method In order to collect data for this descriptive documentation on CAP training in European countries, we have communicated with "European Union of Medical Specialists Section on Child and Adolescent Psychiatry" (UEMS-CAP) and "The European Federation of Psychiatric Trainees" (EFPT) representatives of each country via e-mail. In addition, we used UEMS and EFPT annual forum minutes and web sites of national CAP societies to validate the data. Result The structure of CAP training has many differences between 34 European countries. For instance, in 32.4% of the countries, CAP is not a specialty in its own right but is mostly linked to general psychiatry. After medical school, the minimum training duration to become a CAP specialist ranges between 12 and 96 (mean: 59.71 +/- 17.1) months. While, a trainee should pass an examination to begin CAP training in 37.9% of the countries, 64.7% have an examination to graduate and both is the case in 29.7% of the countries. Conclusion By the year 2006, European countries still have large differences in the structure of CAP training. It is assumed that the same holds true for content of training, which was not the focus of this documentation. UEMS-CAP, ESCAP (European Society of Child and Adolescent Psychiatry) and EFPT are the major bodies that have to manage the harmonization of CAP training across Europe. The obligatory conditions of a fruitful training, the high quality of teachers and teaching facilities, essential ingredients of an efficient training programme, are prone to be determined by evidence-based evaluations in the process of harmonization.

AYDIN, MURAT/0000-0001-7374-229X; Ozgen, Ilker Tolga/0000-0001-6592-9652 WOS: 000269607100008 PubMed: 19636200 Objective: We aimed to investigate the differences in emotional and behavioral problems and to explore the association between the level of psychiatric problems and the metabolic control in Type 1 diabetes. Methods: The children with Type 1 diabetes (no.=42) and the "healthy" control group (no.=42), their parents and endocrinology specialist completed the forms prepared for the study. The parents completed the Child Behavioral Checklist (CBCL/4-18). Results: The groups had significant differences in CBCL-activities (p0.05). Discussion: The parents of children with Type 1 diabetes reported emotional and behavioral problems significantly more. We did not find any significant association between the level of metabolic control and the emotional and behavioral problems. (J. Endocrinol. Invest. 32: 325-329, 2009) (C)2009, Editrice Kurtis

Background: Infantile colic is a common problem of early infancy. There is limited data on the relation between postpartum maternal psychological problems and colic. Aim: To investigate whether infantile colic is associated with postpartum mood disorders or insecure adult attachment style of the mother. Methods: Seventy eight mothers and newborns were enrolled in this prospective, longitudinal study. Maternal depressive symptoms were screened with Edinburgh Postpartum Depression Score ( EPDS) and maternal anxiety was assessed with State- Trait Anxiety Inventory ( STAI). The Adult Attachment Scale was used to determine the attachment style of the mother. Infantile colic was defined according to Wessel criteria. Results: Infantile colic was present in 17 infants ( 21.7%); 12.9% of the mothers had an EPDS >= 13. The mean EPDS of the mothers whose infants had infantile colic ( 10.2 +/- 6.0) was significantly higher than that of the mothers of infants without colic ( 6.3 +/- 4.0). Among infants with infantile colic, 62.5% had mothers who had insecure attachment style, whereas only 31.1% of mothers had insecure attachment when the infant did not have infantile colic. Conclusion: Postpartum maternal depressive symptoms and insecure attachment style are associated with infantile colic. Screening and early intervention of postpartum depression might promote the health of both the mother and infant.