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Murat Altın,1 Gamze Ergil Altın,2 Bengi Semerci3 1Department of Psychiatry, Medical Park Gaziosmanpasa Hospital, 2Department of Psychiatry, Boylam Psychiatry Institute, 3Department of Psychiatry, Bengi Semerci Institute, Istanbul, Turkey Objective: Although adult attention deficit hyperactivity disorder (ADHD) often persists beyond childhood, daily clinical practices and transition of adult patients with ADHD into adult mental health services in Turkey are not well studied. The aim of this study was to provide data about the presentation of adult patients with ADHD and evaluate the treatment strategies of Turkish adult psychiatrists based on their personal clinical experience in different hospital settings.Methods: A cross-sectional online survey to be filled out by Turkish adult psychiatrists was designed and administered in May 2014. The survey focused on the treatment environment, patterns of patient applications and transition, treatment strategies, and medication management for adults with ADHD.Results: Significant differences were observed in the number of adult patients with ADHD in follow up, and a significant positive correlation was found between number of adult patients with ADHD in follow up and the clinician’s opinion about their level of self-competence to treat adult ADHD. A significant portion of adult psychiatrists have not received any information about their adult ADHD patients’ treatment during childhood. The most preferred medical treatment was stimulants and the majority of the participants always preferred psychoeducation in addition to medication treatment. A majority of participants did not define themselves competent enough to treat and follow up adult patients with ADHD.Conclusion: The findings of this study indicate the need to increase the knowledge, skills, and awareness of adult psychiatrists about adult ADHD. In addition, a more collaborative working relationship between child and adolescent psychiatrists and adult psychiatrists with a definite transition policy is required in order to help patients with ADHD more effectively. Keywords: attention deficit hyperactivity disorders, transition, treatment strategies

Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness. Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated. Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated? Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD. (c) 2018 The Author(s). Published by Elsevier Masson SAS.

Objective: In children referred for forensic reports by juvenile courts, particularly as psycho-sexual maturation starts in the initial phases of adolescence, actions defined as criminal by society may be expected to have been committed. These actions, which are frequently the results of unconscious impulses and sometimes affectations, are crimes in the general sense for this reason; great care is required when determining the presence of the ability of children to perceive the legal meaning and consequences of crimes that they commit and their ability to channel their behaviors. The aim of this present study is to examine the mental problems in children driven to committing crimes and the preparation of forensic reports in a Turkish forensic sample. Methods: Children referred by courts to Van Regional Training and Research Hospital Outpatient Clinics of Pediatric Psychiatry between 2013 and 2014 for forensic expert reports evaluating their ability to perceive the legal meaning and consequences of criminal behavior, and their ability to control their behaviors. Seventy-four children were evaluated retrospectively, with interviews of approximately 45 minutes on The Diagnostic and Statistical Manual of Mental Disorders in order to determine psychiatric diagnosis. Results: After evaluations, 26% of children and adolescents were found to possess the ability to perceive the legal meaning and consequences of the crime they had committed and have the ability to control their behaviors, while 27% could perceive the legal meaning and consequences but could not control their behavior, and 47% did not have the ability to perceive the legal meaning and consequences of the crime they had committed and to control their behaviors. Conclusions: The ability to perceive the meaning and consequences of crime and to direct one’s behaviors are affected by pathologies related with the family and the child.

Purpose: Juvenile delinquency is a serious and common problem. To date, several studies have focused on possible psychosocial risk factors for delinquency among youths and on the implications of childhood mental illness on child criminality. However, the literature on prevalence of psychopathology and predictors of crime severity among delinquent youths in Turkey is sparse. Therefore, the aim of this study was to show the associations between crimeseverity and psychosocial factors such as gender, age, criminal history, concomitant attention deficit hyperactivity disorder (ADHD) and other comorbid psychiatric conditions, along with behavioral problem domains of Child Behavior Checklist (CBCL). Participants and methods: This analytical cross-sectional study sample consisted of 52 individuals (30 females and 22 males) who were sent to a pilot detention facility in Istanbul, Turkey. The participants' age ranged from 8 to 18 years (M = 13.4; SD = 2.9). Self-rating scales were administered in an interview format, and the crime severity information was provided by participants' admission documents. Results: No differences were found in terms of gender, age, children's past history of crime and substance abuse. However, family crime history was significantly higher in the high severity crime group (P=0.026). Having one or more comorbid psychiatric disorder was associated with high crime severity(P=0.018). The most common psychiatric disorders were found to be ADHD, oppositional defiant disorder, conduct disorder (CD) and anxiety disorder. Conclusion: Findings suggest that a family history of crime comes across as a very strong predictor of severity of crime. Among psychiatric factors, ADHD and CD were associated with commitment of more severe crimes in delinquent youths in our sample. Anxious/depressed traits as depicted by CBCL are found to be associated with less severe crimes., Koç University