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Objective: We aimed to evaluate asthma control status, drug compliance and anxiety levels of children and their parents who were followed up with the diagnosis of asthma during the COVID-19 pandemic.Material and Methods: Sixty-seven children aged between 8-12 years diagnosed with asthma and their parents were prospectively recruited to the study. A questionnaire including demographic features such as age, gender, asthma medications and questions about COVID-19 prepared according to a 5-point Likert scale was conducted to the parents. Children completed the State-Trait Anxiety Inventories for Children (STAI-C) scales, and childhood asthma control test(c-ACT). Parents also fulfilled STAI scales. Results: The mean age of the patients was 9.5±1.2 years, the median follow-up period for asthma (C-ACT) was 36 (21-66) months, and 45 (67.2%) were male. Most of the children were using their asthma medication regularly. Children’s STAI-C state and trait anxiety scores showed a statistically significant positive correlation with parents’ STAI state and trait anxiety scores. The anxiety levels of parents who thought that they would get the disease and that there would be no effective treatment and vaccine against COVID-19 were found to be higher.Conclusion: During the pandemic period, regular asthma follow-up and drug compliance are very important controlling asthma symptoms in children. Considering the effects of the pandemic in children with asthma, psychosocial evaluations during outpatient controls may have positive effects on children’s mental health and disease control., Amaç: Çalışmamızda astımlı çocuklarda ve ailelerinde yeni tip coronavirüs hastalığı (COVID-19) döneminde astım kontrol durumları, ilaç uyumları ve kaygı düzeylerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya en az altı aydır astım tanısıyla izlenen 8-12 yaş arası 67 çocuk ve ebeveynleri dahil edilmiştir. Ebeveynlere yaş, cinsiyet, astım ilaçları gibi demografik özellikleri ve 5’li Likert ölçeğine göre hazırlanmış COVID-19 ile ilgili soruları içeren anket yapılmıştır. Ayrıca çocukluk çağı astım kontrol anketi (AKT) ve kaygı düzeyini değerlendirmek için çocuklara Çocuklar İçin Durumluk-Sürekli Kaygı Envanteri (Ç-DSKE), ebeveynlere de Erişkinler için Durumluk-Sürekli Kaygı Envanteri (DSKE) uygulanmıştır.Bulgular: Hastaların ortalama yaşı 9.5±1.2 yıl, astım takip süresi ortancası (çeyrekler arası aralık) 36 (21-66) aydı ve 45’i (%67.2) erkekti. Çocukların çoğu astım ilaçlarını düzenli kullanıyordu. Çocukların Ç-DSKE durumluk ve sürekli kaygı puanları, ebeveynlerin DSKE durumluk ve süreklik kaygı puanlarıyla istatistiksel olarak anlamlı pozitif yönde korelasyon gösteriyordu. Hastalığı geçireceğini, COVID-19’a karşı etkili tedavi ve aşı bulunamayacağını düşünen ebeveynlerin kaygı düzeyleri daha yüksek bulundu. Çocukların cinsiyeti, astım takip süreleri, astım kontrol durumları, düzenli takibe gelme ve astım ilacını düzenli kullanmasına göre gruplandırılarak karşılaştırıldığında yine çocuk Ç-DSKE ve ebeveynlerin DSKE skorları arasında fark yoktu.Sonuç: Pandemi döneminde düzenli kontrol ve ilaç uyumu çocuklarda astım semptomlarının kontrol altına alınmasında son derece önemlidir. Astımlı çocuklarda pandeminin etkileri de göz önünde bulundurularak poliklinik kontrolleri sırasında psikososyal değerlendirilmelerinin yapılması çocukların ruh sağlığı ve hastalık kontrolü üzerinde olumlu etkileri olabilir.

To evaluate the quality of life and anxiety level of school-age children with chronic cough, and changes with treatment.Patients aged between 6-18 years with a chronic cough were included in this study. A control group was designed, and the scale scores were compared with each other.The mean age of the 82 patients was 10.9 ± 3.8 years, 62 (75.6%) had at least one specific cough marker. Forty patients (48.8%) were diagnosed with asthma. At their first visit, the psychosocial health scores and the total scale scores (sum of physical and psychosocial total scores) were lower than the control group for both patients and parents. After the resolution of cough, their scores increased to the same level with the control group. It was also found that the level of anxiety was significantly higher than in the control group both before treatment and after the resolution period (p0.001 and =0.008, respectively).Asthma was the leading cause of chronic cough. Quality of life is impaired in children with chronic cough. Anxiety level in these patients increases and after symptoms improve, continues to be higher than that of healthy children.

Aim:Dietary factors are considered one of the possible environmental risk factors for attention-deficit hyperactivity disorder (ADHD). The aim of this study was to demonstrate the relationship between ADHD and celiac disease (CD) and non-celiac gluten sensitivity (NCGS) in children.Materials and Methods:In this prospective study, children with ADHD, aged 6-18 years, were asked about the presence of gastrointestinal symptoms and their relationship with gluten intake with a previously prepared questionnaire form. Also, they were screened for CD [anti-tissue transglutaminase immunoglobulin (Ig) A and total IgA] and NCGS (anti-gliadin IgA/IgG antibodies).Results:Of the 117 children (76% male), the mean age was 9.2±2.4 years. Ninety-six patients (82%) had no gastrointestinal complaints. There was no relationship between gluten intake and complaints in the patients who had constipation (12.8%), recurrent abdominal pain (2.5%), dyspeptic symptoms (1.7%), and irritable bowel syndrome (0.8%). None of the patients had anti-tissue transglutaminase IgA or IgG positivity. Only 1 (0.8%) patient had anti-gliadin IgA, and 6 (5.1%) patients had anti-gliadin IgG positivity. There was no relation between the presence of symptoms and anti-gliadin IgG positivity (p=0.08).Conclusion:There was no increase in the frequency of CD and NCGS in children with ADHD.

Objectives:Substance Use Risk Profile scale (SURPS) measuring the personality traits associated with susceptibility to substance use is a valid and reliable questionnaire. In the validity and reliability study of the Turkish adaptation for SURPS, the factor structure was determined by the explanatory factor analysis but the theoretical suitability of this structure to the personality traits (anxiety sensitivity, lack of self-contentment, sensation seeking and impulsivity) could not be confirmed. In this study, it was aimed to test the theoretical suitability of the factor structure by confirmatory factor analysis (CFA).Materials and Methods:The universe of our study was the sample consisting of 875 adolescents aged between 14 and 19 years with a mean age of 15.58 (±1.03) years for the Turkish validity and reliability study of the SURPS. The sample of our study was determined as 436 adolescents chosen from participants in the universe by stratified sampling method. IBM AMOS ver. 23.0 program was used in the verification of the factor structure of the 23-item 4-factor scale with CFA. In evaluating the fit of the model, chi-square/degree of freedom (chi-square/sd), Goodness of Fit index (GFI), Adjusted Goodness of test (AGFI) and root mean square of error approximation (RMSEA) goodness of fit indices were calculated.Results:Standardized factor loads obtained with CFA were found between 0.31 and 0.86. In order to further improve the fit of the model, the relationship between errors related to the items 7 and 23, and 3 and 12 suggested by the modification indexes was defined. The chi-square/sd, RMSEA, GFI and AGFI values from calculated goodness of fit indices were determined as 3.305, 0.058, 0.91 and 0.89, respectively.Conclusion:With our findings, it was observed that the model showed a good fit with the theory, and the construct validity of the 23-item 4-factor scale was supported.

INTRODUCTION[|]In this study, it is aimed to do a cross-sectional evaluation of treatment preferences in tic disorders in a clinical sample.[¤]METHODS[|]The hospital records of cases diagnosed with tic disorders who were admitted to our clinic between May 2013 and June 2014 were retrospectively reviewed. SPSS 17.0 program was used to evaluate the data. The level of significance was accepted as p

Objective:Pediatric bipolar disorder (BD) is a highly morbid disorder which is associated with impairments in social, academic, and family functioning. Despite its great impact on public health, the literature is scarce regarding the studies examining the clinical phenomenology of BD in children and adolescents.Methods:A retrospective chart review of 113 children and adolescents’ files (ages 13-18 years) who were consecutively admitted to our inpatient clinic between March 2012 and November 2014 and diagnosed as having BD type I or BD type II was made. The diagnoses were based on DSM-IV-TR criteria. A sociodemographic and clinical data form was created by the authors and was filled out for each patient by the authors themselves.Results:Totally 113 adolescents (71 male, 42 female) were included in the study. Mean age of the sample was 16.054±1.23 (range=13-18) years. Mean age of onset of BD was 15.04±1.74 (range=9-17) years. The first mood episode was manic in 60% of patients, depressive in 27.3%, mixed in 10.9% and hypomanic in 1.8% of patients. Of the patients, 23.4% had a suicide attempt history, 48.2% had a previous referral to a psychiatry clinic before the onset of BD. History of substance/alcohol use was present in 27.4% of the patients. Of the patients, 84.9% were using combination treatments.Conclusion:High rates of suicide attempt, substance use and significant functional impairment found in our study sample indicate that early recognition and intervention of BD, specialized educational programs and occupational support for these children and adolescents seem indispensable.

INTRODUCTION[|]In addition to the relationship between substance use and personality, the personality traits such as hopelessness, anxiety sensitivity, impulsivity, and sensation seeking are known to be particularly predictive of later substance misuse. These personality traits can be used as markers to provide early prevention intervention against substance use disorders. The present study aims to evaluate the relationship of the personality traits to substance use disorders (SUDs).[¤]METHODS[|]The sample for the first analysis consisted of 13-18-year-old outpatients with SUDs (n=30), outpatients with any psychiatric disorders other than SUDs (n=30), and community-based non-matched healthy controls (n=30). And then, the analysis for comparison among SUDs patient group and another healthy control group matched for age and sex (n=30) was repeated to minimize bias because of the gender heterogeneity in the groups. Substance abuse-related personality traits were measured with the Substance Use Risk Profile Scale (SURPS). Also, Beck Hopelessness Scale, the State-Trait Anxiety Inventory, Barratt Impulsivity Scale and Arnett Inventory of Sensation Seeking were used as data collection tools. Using independent samples t-test or one-way ANOVA and Tukey posthoc tests among two or more groups, the relationship was evaluated.[¤]RESULTS[|]Results show that there is no clear relationship between substance use disorders, and substance abuse-related personality traits measured by SURPS, with significant limitations. [¤]DISCUSSION AND CONCLUSION[|]Our study is the first study assessing this relationship in a sample of Turkish adolescents. Further studies should be planned to determine whether the result of our study reflects objective reality or is affected by the limitations. [¤]

Amac: Son yillarda Dikkat Eksikligi Hiperaktivite Bozuklugu (DEHB) ve obezite birlikteligi ile ilgili calismalar artmistir. Bu gozden gecirmede DEHB ve obezite arasindaki potansiyel iliskinin, literatur esliginde sistematik olarak incelenmesi amaclanmistir. Yontem: DSM-IV ya da DSM-5 olcutleri esas alinarak Ingilizce ve/veya Turkce olarak yazilmis, PUBMED veri tabaninda Ocak 1990-Aralik 2017 tarihleri arasinda yayimlanan, olgu sunumlari, sistematik derlemeler ile meta-analizler disinda kalan makalelerden tam metnine ulasilabilenler calismaya dahil edilmistir. Bulgular: Ampirik olarak elde edilen kanitlar, DEHB tanili olgularin beden agirliklarinin beklenenden daha agir oldugunu gostermektedir. Ayrica, gozden gecirilmis calismalarin tamamina yakini ozellikle obezite kliniklerinde tedavi goren obez hastalarin DEHB prevalansinin da beklenenden daha yuksek olabilecegini dusundurmektedir. DEHB ile obezite arasindaki potansiyel iliskinin altta yatan mekanizmalarina bakildiginda; DEHB, anormal yeme davranislari yoluyla obeziteye yol acabilir, obez hastalarda yeme bozuklugu ile iliskili durtusellik DEHB'ye katkida bulunabilir veya altta yatan ortak mekanizmalar (norobiyolojik islev bozukluklari vs) bu iki bozuklugun bir arada gorulmesine yol aciyor olabilir kanaati olusmaktadir. Sonuc: Obezite ile DEHB arasindaki olasi komorbiditeyi ve bu birlikteligin altinda yatan muhtemel mekanizmalari anlamak icin ampirik temelli calismalara ihtiyac vardir. Ileride yapilacak calismalar, her ikisi de morbidite riski yuksek tanilar olan DEHB ve obezite icin gerekli saglik politikalarinin duzenlenmesi ve bu olgularin yasam kalitelerinin artirilmasi acisindan yararli olacaktir.

Background Symptomatic COVID-19 cases in children occur mostly in those with primary immunodeficiency (PID), chronic lung diseases, and heart disease. Guidelines recommend that patients with PID continue to use their regular medication during the pandemic. Objectives This study aimed to evaluate anxiety related to COVID-19 in the parents of patients receiving intravenous immunoglobulin (IVIG) treatment in our hospital and to evaluate the effect of their anxiety on the continuity of treatment. Methods The parents of the patients who underwent IVIG therapy in our clinic during the pandemic (between May 15, 2020 and July 1, 2020) were included in our study. Results Twenty-seven patients with PID whose IVIG therapy was initiated before the pandemic and 29 non- PID control subjects were included in the study. All patients received IVIG treatment in our clinic continued treatment during the pandemic at the same dose intervals. Parents in the IVIG group had significantly higher state (p=0.003) and trait (p=0.003) anxiety scores compared to control parents. IVIG group showed statistically significant higher scores in Beck depression inventory, than the control group (p=0.002). Conclusions The parents of PID patients who needed to come to the hospital for IVIG therapy had higher anxiety levels than the parents of similar aged children who presented to our clinic for different complaints between the same dates. Despite their concerns, the parents of all patients under IVIG therapy maintained treatment continuity at the recommended treatment intervals. None of our immunodeficient patients who presented for treatment during the pandemic contracted COVID-19 infection during our study.

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.

Davranim bozuklugu dogru yontemlerle mudahaleler gerektiren, cocuk ya da ergenin sadece kendisini degil, yakin cevresini hatta yasadigi toplumu olumsuz etkileyebilen bir ruhsal bozukluktur. Bozuklugun cocukluk- ve ergenlik-baslangicli iki sekli bulunmaktadir. Iliskili risk ve koruyucu faktorler dikkate alinarak bozukluga yonelik tedavi yontemleri gelistirilmistir. Cocukluk-baslangicli davranim bozuklugunun tedavisinde cocuk-, anne-baba- ve okul-eksenli uygulamalar yer alirken, ergenlik-baslangicli olaninin tedavisinde bu yontemlere ek olarak kismi yatis programlari, kurumsal uygulamalar ve diger toplumsal unsurlar bulunur. Cocukluk-baslangicli davranim bozuklugunda sosyal ogrenme kuramini esas alan “aile-odakli” uygulamalar, ergenlik-baslangicli olaninda ergene yonelik “ihtiyaclar-, duyarlilik- ve risk-ilkesi” esas alinarak uygulanan “ergen-odakli” mudahaleler etkili yontemler olarak gorunmektedir. Kisa ve uzun vadeli etkinlik acisindan, ergen-okul- ya da toplum-odakli mudahaleleri es-zamanli kullanan “aile-odakli” yaklasimlar en etkin tedaviler olarak gorunmektedir (ergen-okul-bileseni de bulunan aile-odakli uygulamalar icin kisa donem etkinlik d=0.20-0.52; takiplerde d=0.01-0.95; toplum-bileseni bulunan aile-odakli uygulamalar icin kisa donem etkinlik d=0.25-0.62; takiplerde d=0.41-0.58). Yuksek riskli ve yasca ileri ergenler tedaviyle daha iyi ilerlemeler kat edebilirken, cinsel suclari bulunan ergenler digerlerine gore tedavilerden daha az fayda gormektedirler. Secilmis ergenlerde (suc isleme, sosyoekonomik duzey) diger yontemler kullanilabilir.

Objective: Major Depressive Disorder (MDD) is an important mental health disorder that is common in adolescence. In our study, it was aimed to evaluate depression severity, treatment methods and clinical features of adolescents who were followed up and treated with MDD diagnosis. Methods: Between January and December 2015, 350 adolescent patients between 12-18 years of age who consulted with child and adolescent psychiatry clinic and diagnosed by unipolar MDD according to DSM-5 was reviewed. The sociodemographic and clinical features of these cases were evaluated. SPSS 17.0 was used for statistical evaluation. Results: MDD was diagnosed in 350 (7.5%) of 4,646 adolescents who applied to the outpatient clinic during the 1-year period. Girls were 75.4% of the sample. When the cases were classified in terms of severity of depression, it was found that 45.7% of the whole sample was mild, 44.3% was middle and 10% was severe MDD and the girls were higher in all groups. Pharmacotherapy was applied in 81.7% of the sample, 15.1% of psychotherapies, 3.1% of the combination of pharmacotherapy and psychotherapy. Selective serotonin reuptake inhibitors (SSRIs) alone were preferred in 87.4% of the cases. Somatoform disorder (dissociative and conversion disorder) and bereavement reaction were significant for the combined use of pharmacotherapy and psychotherapy. At least one adverse event was detected in 8.8% of the cases. Discussion: Compatibly the literature, in adolescence MDD diagnosis was significantly more common in females in all severity groups. SSRIs monotherapy is mostly used as the first option in treatment. Our study will contribute to the related literature in terms of involving wide sampling, treatment and severity evaluation in adolescents with MDD; but generalization may not be appropriate because of the the study’s cross-sectional and situation determination nature

The Substance Use Risk Profile Scale (SURPS) was developed as a self-report measure to screen four high-risk personality dimensions (hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) that predict specific patterns of vulnerability to substance use and other problematic behavior. The scale has previously been shown to have adequate psychometric properties in various other languages. The aim of the present study was to evaluate the psychometric properties of the Turkish version of the SURPS. A cross-sectional total sampling design was adopted in which 875 Turkish participants took part (mean age 15.58 years, SD = 1.03). Using exploratory factor and correlational analyses, the internal consistency, test–retest reliability, construct validity, and concurrent validity were evaluated. The SURPS demonstrated good psychometric and construct validity. The results provide clear evidence that the Turkish version of the SURPS is valid and reliable. The Turkish version of the SURPS may become an important tool for daily clinical practice and clinical research.

INTRODUCTION: This study aimed to evaluate the relation between psychiatric diagnoses and internet usage in a clinical sample of adolescents and determine the pattern of internet use. METHODS: Adolescents aged 13-17 years who admitted to a child-adolescent psychiatry outpatient clinic for some emotional or behavioral problems were included. Psychopathologies were evaluated via clinicial interview and sociodemographic form and internet addiction scale were applied to be fulfilled. p

Objective Specific learning disorder (SLD) is a neurodevelopmental disorder frequently seen in childhood with deficits in many areas of functioning. Although the etiology of SLD is known to be multifactorial, research findings are limited. In this study, we aimed to compare the serum levels of brain-derived neurotrophic factor (BDNF) in children with SLD to healthy children to find out whether BDNF has a role in the pathophysiology of SLD. Method The study included 30 children between the ages of 7-12, diagnosed with SLD and 30 age and gender matched healthy controls. The groups were tested on the Affective Disorders and Schizophrenia Interview Schedule for School-age Children-Now and Lifetime Form (K-SADS-PL), the Wechsler Intelligence Scale for Children-revised form (WISC-R), the Teacher Information Form (TIF) and the Specific Learning Difficulty Battery (SLDB). Results No difference the serum BDNF levels in children with SLD and the healthy controls. BDNF levels did not correlate with the WISC-R scores and reading rate in the SLD group. Conclusion An association was not determined between SLD and and serum BDNF levels. Our study was the first to investigate this relationship and provided preliminary data on this topic. There is a need for further studies with large patient groups of phenotypic homogeneity.

While suicide can occur throughout the lifespan, worldwide suicide is the second leading cause of death among young people aged between 15 and 29 years. The aim of this multicentre study, conducted in Austria, Germany and Turkey, is to investigate the transcultural differences of suicide attempts among children and adolescents with and without migration background. The present study is a retrospective analyses of the records of 247 young people, who were admitted after a suicide attempt to Emergency Outpatient Clinics of Departments of Child and Adolescent Psychiatry of the collaborating Universities including Medical University of Vienna, Charite University Medicine Berlin and Cerrahpasa School of Medicine and Bakirkoy Training and Research Hospital for Mental Health in Istanbul over a 3-year period. The results of the present study show significant transcultural differences between minors with and without migration background in regard to triggering reasons, method of suicide attempts and psychiatric diagnosis. The trigger event intra-familial conflicts and the use of low-risk methods for their suicide attempt were more frequent among patients with migration background. Moreover among native parents living in Vienna and Berlin divorce of parents were more frequent compared to parents living in Istanbul and migrants in Vienna. These results can be partly explained by cultural differences between migrants and host society. Also disadvantages in socio-economic situations of migrants and their poorer access to the healthcare system can mostly lead to acute and delayed treatments. Larger longitudinal studies are needed to understand better the impact of migration on the suicidal behaviour of young people. Medical University of Vienna; Medical Scientific Fund of the Mayor of the City of Vienna [12001] Open access funding provided by Medical University of Vienna. This study was funded by the Medical Scientific Fund of the Mayor of the City of Vienna (Number of Grant: 12001).

Information on psychological problems and affecting factors in children hospitalized with the suspicion or diagnosis of COVID-19 is limited. We aimed to screen the psychiatric symptoms of children hospitalized with COVID-19 in Ankara City Children`s Hospital and evaluate the caregivers` depression, anxiety, stress, and resilience levels during hospitalization.Among the children and adolescents hospitalized in Ankara City Children`s Hospital between 1 May 2020 and 31 May 2020 due to the diagnosis of COVID-19, those who agreed to participate in the study were included. The Strengths and Difficulties Questionnaire (SDQ), the Depression Anxiety Stress Scale-21 (DASS- 21) scale, and the Brief Resilience Scale (BRS) were used to determine the symptoms.The mean age of study group (n = 49) was 8.7 ± 5.0 years, 59.2% (n = 29) were girls. The mean children`s SDQ-externalizing problems scores were higher in the COVID-19 positive mothers group than the COVID-19 negative mothers` group. The SDQ-total score was positively and strongly correlated with the DASS total score, DASS-depression score, and DASS-anxiety score. BRS scale scores were negatively correlated with the SDQtotal, externalizing, and DASS-21scale scores.COVID-19 positivity in mothers could be associated with externalizing problems in children. The high resilience of caregivers of inpatients seems to be related to less psychopathology in children. During hospitalization, caregivers` psychological evaluation and psychosocial support may be important for preventive child mental health.

Amaç: Ergenlik dönemindeki intihar girişimi, tüm dünyada yaygın bir halk sağlığı sorunudur. İntihar davranışı için biyolojik, psikolojik ve sosyal olmak üzere pek çok risk faktörü bulunmaktadır. Ergen intiharlarında, intiharla ilişkili davranışlarla ebeveyne güvensiz bağlanmanın ilişkisi çeşitli çalışmalarda gösterilmiştir. Ülkemizde ergenlerde bağlanma ve intihar girişimi arasındaki ilişkiyi inceleyen az sayıda araştırma bulunmaktadır. Bu çalışmada, intihar davranışı olan ve olmayan ergenlerde anneye bağlanma ve intihar davranışıyla ilişkili diğer faktörlerin incelenmesi amaçlanmıştır.Yöntem: İntihar girişimi nedeniyle bir eğitim araştırma hastanesine başvuran 49 ergen çalışma grubu olarak, intihar girişim öyküsü bulunmayan 47 sağlıklı ergen ise kontrol grubu olarak çalışmaya alındı. Tüm katılımcılara sosyodemografik veri formu, Çocuklar için Depresyon Ölçeği (ÇGÖ), Ebeveyn ve Arkadaşlara Bağlanma Envanteri- Kısa Formu (EABE-KF), İntihar Davranışı Ölçeği (İDÖ), Güçler ve Güçlükler Anketi-Ergen Formu (GGA) verildi ve Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi- Şimdi ve Yaşam Boyu Şekli uygulandı. Bulgular: İntihar girişimi grubunda %81.6 oranında psikopatoloji saptandı. İntihar girişiminde bulunan grubun, GGA akran sorunları alt ölçeği dışındaki tüm alt ölçeklerinin (duygusal, davranışsal, hiperaktivite, dışavurum ve içeatım) puan ortalamaları, ÇDÖ puan ortalamaları, İDÖ toplam puan, İDÖ-1, İDÖ-2 ve İDÖ-4 puan ortalamaları sağlıklı kontrollerden istatistiksel olarak anlamlı düzeyde daha yüksekken, EABÖ anne bağlanma ölçek ortancası anlamlı düzeyde daha düşüktü. İDÖ toplam, İDÖ-1 ve İDÖ-2 ve İDÖ-4 puanları ile ÇDÖ puanı ve GGA toplam puanı ve tüm alt ölçek puanları arasında pozitif korelasyon, EABÖ anne bağlanma alt ölçeği puanı ile ise negatif korelasyon saptandı. Lojistik regresyon analizinde, EABÖ anne bağlanma ölçek puanları İDÖ toplam ve İDÖ-4 puanlarını yordamakta idi.Tartışma: İntihar grubunda anneye bağlanma puanlarının düşük olması güvensiz bağlanmanın intihar davranışı için önemli bir risk faktörü olabileceği şeklindeki yazınla uyumludur. İntihar girişimi olan ergenlerde anneye bağlanma, intiharın ciddiyeti ve gelecekteki intihar niyetini yordamaktadır. Ebeveyn-ergen bağlanmasını iyileştirecek yaklaşımlar, intiharın önlenmesi açısından önemli rol oynayabilir. Bu alanda ileri çalışmalara gereksinim bulunmaktadır., Objective: Adolescent suicide attempt is a common public health problem all over the world. There are many biological, psychological and social risk factors for suicidal behavior. In adolescent suicides, the relationship between suicidal behaviors and insecure attachment to parents has been shown in various studies. In our country, there are few studies examining the relationship between attachment and suicide attempt in adolescents. In this study, we aimed to investigate other factors related to mother attachment and suicidal behavior in adolescents with and without suicidal behavior.Methods: Of 49 adolescents who admitted to a training and research hospital for suicide attempt were included in the study group and 47 healthy adolescents whose no history of suicide attempt were included. All participants were applied a sociodemographic data form, Children's Depression Inventory (CDI), Inventory of Parents and Peer Attachment-Short Form (IPPA-SF), Suicidal Behavior Scale (SBS), Strengths and Difficulties Questionnaire-Adolescent Form (SDQ-A) and Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (K-SADS).Results: Psychopathology was found in 81.6% of the suicide attempts group. The mean scores of all the subscales (emotional, behavioral, hyperactivity, expression and introductory) of the group attempting suicide except the GGA peer problems subscale, the mean scores of CDI, the total score of SBS and SBS-1, SBS-2 and SBS-4 subscale scores were significantly higher and the median IPPA-SF scale was significantly lower than that of the healthy control group. There was a positive correlation between total score of SBS, SBS-1, SBS-2, SBS-4, CDI, SDQ total score and its all subscale scores whereas a negative correlation was found with IPPA-SF maternal attachment subscale score. In the logistic regression analysis, the IPPA-SF mother attachment scale scores was predicted by SBS total score and SBS-4 subscale score.Discussion: The low attachment scores to the mother in the suicide group are consistent with the literature that insecure attachment may be an important risk factor for suicidal behavior. In adolescents with suicide attempts, attachment to the mother predicts the seriousness of suicide and the intention of future suicide. Approaches to improve parent-adolescent attachment may play an important role in preventing suicide. Further studies are needed in this field.

OBJECTIVES: We aim to determine serum oxytocin, vasopressin levels and examine parent characteristics in children diagnosed with social anxiety disorder (SAD). METHODS: Thirty four children diagnosed with SAD and 34 mothers were compared with a healthy control group (21 control children and their mothers) in this case–control study. Assessment performed via State-Trait Anxiety Inventory (STAI), Symptom Checklist-90 (SCL-90), Parental Attitude Research Instrument (PARI), Beck Depression Inventory (BDI), Liebowitz Social Anxiety Scale (LSAS) and Social Anxiety Scale for Children-Revised (SASC-R). Serum samples collected for detection of oxytocin and vasopressin levels. RESULTS: The distribution range of vasopressin levels were found statistically higher in control group than SAD group (p = 0,002). Additionally results showed no statistically significant differences according to the mean levels of serum oxytocin and vasopressin between groups. The scores of STAI-C, SASC-R and democratic attitudes/egalitarianism subscales of PARI were found significantly higher in children with SAD. Similarly we reported that mean scores of SCL-90 scale, LSAS and SCL-90 subscales were higher in mothers of patients group. CONCLUSIONS: Although significantly lower distribution range of vasopressin levels was found in SAD patients, mean oxytocin and vasopressin levels were not associated with SAD etiology. Additionally psychopathologies particularly anxious behaviour in mothers may contribute SAD development in early period of childhood.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders in children and the pathophysiology remains obscure. Some studies show that lipid imbalances are associated with ADHD etiology. We studied the association of serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride (TG) levels in ADHD. We examined 88 children aged 8-12 years who were diagnosed with ADHD and 88 healthy children. The exclusion criteria were as follows: obesity, any psychotropic use in the last 3 months, presence of a chronic disease and/or malignancy, history of medically treated lipid metabolism disease in family members, intelligence quotient (IQ) 70, and comorbidities, with the exception of oppositional defiant disorder. The sample was evaluated using a semi-structured clinical assessment interview and Conners' rating scales. Despite controlling for age, sex, and body mass index (BMI) variables, the total cholesterol and LDL levels were significantly higher in the ADHD group than the levels of healthy controls, whereas the TG and HDL cholesterol levels were similar among groups. Conners' rating scales, reflecting symptom severity, and total cholesterol, TG, HDL, and LDL levels of the ADHD group were not correlated. The study results support the difference in serum lipid and lipoprotein profiles of children with ADHD compared with healthy controls. This difference is thought to be related with changes in oxidant/antioxidant balance states in ADHD.

EgeUn###, 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.

Amac: Ergenler arasinda akran zorbaligi evrensel bir sorundur. Calismada klinik orneklemde ergenlerde akran zorbaliginin demografik degiskenler, siber zorbalik, siber magduriyet ve ofke ifade tarzlariyla iliskisinin incelenmesi amaclanmistir. Gerec ve Yontemler: Cocuk psikiyatri poliklinigine basvuran 61 ergen calismaya alindi. Sosyodemografik form, Surekli Ofke ve Ofke Tarz Olcegi, Akran Zorbaligi Belirleme Olcegi-Ergen Formu, Siber Zorbalik Olcegi ve Siber Magduriyet Olcekleri kullanildi. Ergenlerde psikopatoloji varligi DSM-5 olcutleri esas alinarak yapilan klinik degerlendirme ile belirlendi. Bulgular: Calismaya katilan 61 ergenin %57.4’u kizdi. Yas ortancasi 15 yildi (min=11, maks= 18 yil). Ergenlerin %27.9’u magdur, %45.9’u hem zorba hem magdur ve %4.9’u zorba olarak tanimlandi. Diger siniflandirmayla ergenlerin %78.7’sinin zorba/magdur dongusunde olduklari saptandi. En sik gorulen zorbalik turu; sozel zorbalik (%37.7), en sik gorulen magduriyet turu ise fiziksel magduriyetti (%60.7). Protez varligi magdur grubunda anlamli duzeyde yuksek bulundu (p=0.041). Zorbaligin orta ergenlikte anlamli duzeyde yuksek (p=0.026), zorbalarin akademik basarisinin daha kotu oldugu bulundu (p=0.008). Magdurlarin babalarinin anlamli olarak dusuk duzeyde egitim almis olduklari saptandi (p=0.036). Hem zorba hem magdur grupta; siber zorbalik, Surekli Ofke ve Ofke Tarz Olcegi ofke disa alt olcegi ve ofke ice alt olcegi puanlari, zorbaliga karismayan grubun puanlarina gore anlamli duzeyde yuksek bulundu (sirasiyla; z=- 3.167, p=0.003; z=-3.735, p=

Objective: There are studies showing that there is a significant relationship between ADHD and obesity. However the number of studies conducted on this topic is limited in our country. It is aimed to evaluate obesity frequency, distribution of psychiatric comorbidity and food addiction in children and adolescents with ADHD who applied to our outpatient clinic. Methods: Our sample size was planned to represent Ankara city and power analysis revealed that a sample of 369 individuals would be sufficient for the representation. Our sample consisted of 400 children aged between 8-16 years who applied to our clinic between June 15, 2016 and June 15, 2017 and diagnosed as ADHD. All cases were administered a semi-structured clinical assessment interview (K-SADS-PL) and a sociodemographic data form. Body mass index (BMI) of all subjects was calculated. The Conners Parent Rating Scale, The Conners Teacher Rating Scale and the Yale Food Addiction Scale for Children (YFAS-C) were used. According to age and sex, weight percentiles between 85-94 percentiles was defined as overweight, ≥95 percentile was defined as obese. SPSS 17.0 was used for statistical analysis, p

ABS TRACT: Insignificant effects of atomoxetine on thyroid functions in children and adolescents with attention deficit and hyperactivity disorder in short term Objective: In this study, we aimed to explore the effects of atomoxetine on thyroid functions in children and adolescents with attention deficit hyperactivity disorder. Methods: A retrospective chart review was done to evaluate the thyroid function tests of patients diagnosed with attention deficit hyperactivity disorder and treated with only atomoxetine. The thyroid function tests of 38 subjects, from both before atomoxetine was started and during an effective dose of atomoxetine treatment, were found from the patient charts and compared statistically. Results: There were no statistically significant differences between the baselines levels of thyroidstimulating hormone (TSH), free T4, and free T3 values and those during an effective dose of atomoxetine treatment. In one subject, four weeks after atomoxetine was started and titrated to the effective dose, an insignificant increase in TSH was observed, which decreased to the normal range after the discontinuation of the atomoxetine treatment. Conclusion: Therapeutic doses of atomoxetine do not seem to change thyroid functions in children and adolescents with attention deficit hyperactivity disorder.

DiGeorge Syndrome (DGS) is the most seen microdeletion syndrome and its prevalance varies from 1/4000 to 1/6000. Over embriogenesis, a deletion of an approximately 3 Mb frame from 22q11.2 results in this syndrome and its clinical features varies from congenital heart and gross vessels anomalies, hypocalcemia, respiratory problems, leucomotor or urogenitale system anomalies, hearing loss, to developmental delay. Alongside different clinical features and phenotypes, these patients should be followed up on psychiatric symptoms and disorders such as speech delay, specific learning difficulties (SLD), mental retardation, attention deficit hyperactivity disorder (ADHD), autism, anxiety, depression and even schizophrenia and other pcychotic disorders. This case, diagnosed with partial DGS and followed by immunology, cardiology, endocrinology and neurology departments, admitted to our clinic on account of his difficulties in learning and inattention. The patient was diagnosed with ADHD and SLD, then pharmacotherapy and individual educational programme were planned. The insufficient expression of the catecolamine-O-methyltransferase (COMT) gene located in the 22q11.2 gene could very well play a role in both the etiology of ADHD and SLD. There is still no clear causative relation between these, so there is a need to clarify this with further studies. As seen in our case, the patients with DGS and having some inattention or learning difficulties are needed to be examined by the child psychiatrists. Treatment protocols related to these patients' symptoms would be evaluated with a multidisciplinary attitude.

Mucopolysaccharidosis type III (MPS-III, Sanflippo syndrome) is one of the lysosomal storage diseases characterized by four different enzymes playing a role in catabolism of heparan sulfate substance. Type IIIB (Sanflippo B), one of them, is characterized by alpha-N-acetylglucosaminidase (NAGLU) enzyme deficiency and results in accumulation and storage of heparan sulfate in central nervous system, and then emerges itself with developmental deficiency, coarse facial features, delay in speech, mental retardation, hyperactivity, impulsivity, aggressive and disruptive behaviors, difficulty in establishing social relations, aimless hand movements, inadequate eye contact, and sleep disturbances. There are a few studies related to the treatment of neuropsychiatric symptoms of these patients. In this case, atomoxetine treatment added was shown to be effective, safe and tolerable, because risperidone treatment that the patient took was not effective in hyperactivity symptoms. A 12-year-old girl, diagnosed with MPS type IIIB (NAGLU deficiency; OMIM# 252920) when she was 5 years old, was admitted to our clinic with symptoms of hyperactivity, short span of attention, aggressive behavior, and quasi-autistic symptoms such as aimless hand movement, with risperidone use at 1.5 mg/day for approximately 1 year. After clinical and psychometric examinations, she was diagnosed with “mild mental retardation” and “attention deficit hyperactivity disorder”. Atomoxetine was added at a dose of 0.5 mg/kg/day to her risperidone treatment and its dosage was gradually increased up until to 1.4 mg/kg/day. Over the follow-up period, her attention deficit and hyperactivity disorder (ADHD) symptoms were ameliorated, reported by both her teachers and her parents via rating scales of ADHD. Her hyperactivity and irritability levels were noticed as decreased and improved over evaluation process throughout clinical interviews. Through atomoxetine treatment process, there was not any adverse effect. Int J Clin Pediatr. 2016;5(1):15-18 doi: http://dx.doi.org/10.14740/ijcp237w

ObjectivesThe aims of this cross-sectional study were to assess the prevalence of Internet addiction (IA) in a clinical sample of adolescents with attention-deficit hyperactivity disorder (ADHD) and to detect the moderating effects of co-occurring oppositional defiant disorder/conduct disorder (ODD/CD) on the association between ADHD and IA.MethodsThe study group comprised 119 adolescent subjects who were consecutively referred to our outpatient clinic with a diagnosis of ADHD. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was completed by parents, and subjects were asked to complete the Internet Addiction Scale (IAS).ResultsThe IAS results indicated that 63.9% of the participants (n = 76) fell into the IA group. Degree of IA was correlated with hyperactivity/impulsivity symptoms but not with inattention symptoms. As compared to the ADHD-only group (without comorbid ODD/CD), ADHD + ODD/CD subjects returned significantly higher scores on the IAS.ConclusionsAs adolescents with ADHD are at high risk of developing IA, early IA detection and intervention is of great importance for this group. In addition, adolescents with ADHD + ODD/CD may be more vulnerable to IA than those in the ADHD-only group and may need to be more carefully assessed for IA.

Since conduct disorder is a mental disturbance deteriorating not only children or adolescents’ functioning but both their close environment and even the whole society they live in, it is crucially important to be treated with effective interventions. There is mainly child, family and school-oriented interventions for childhood-onset conduct disorder and treatments of adolescent-onset conduct disorder include community and institutional practices in addition to adolescent, family and school-oriented interventions. Approaches to childhood-onset conduct disorder based on social learning theory, and interventions of adolescent-onset conduct disorder built on “needs, responsivity and risk principles” seem to be effective treatment modalities. Family-oriented approaches using concurrently either adolescent school-oriented interventions or society-oriented programs appear to be the most effective treatments for short-term and long-term outcomes. Adolescents with high risk and advanced age seem to have better progress with interventions whereas sexual offenders are less likely to benefit from treatment than the other conduct pathologies., Davranım bozukluğu doğru yöntemlerle müdahaleler gerektiren, çocuk ya da ergenin sadece kendisini değil, yakın çevresini hatta yaşadığı toplumu olumsuz etkileyebilen bir ruhsal bozukluktur. Çocukluk-başlangıçlı davranım bozukluğunun tedavisinde çocuk, anne-baba ve okul eksenli uygulamalar yer alırken, ergenlik-başlangıçlı olanının tedavisinde bu yöntemlere ek olarak kısmi yatış programları, kurumsal uygulamalar ve diğer toplumsal unsurlar bulunur. Çocukluk-başlangıçlı davranım bozukluğunda sosyal öğrenme kuramını esas alan “aile odaklı” uygulamalar, ergenlik-başlangıçlı olanında ergene yönelik “ihtiyaçlar, duyarlılık ve risk ilkesi” esas alınarak uygulanan “ergen odaklı” müdahaleler etkili yöntemler olarak görünmektedir. Kısa ve uzun vadeli etkinlik açısından, ergen, okul ya da toplum odaklı müdahaleleri eş-zamanlı kullanan “aile odaklı” yaklaşımlar en etkin tedaviler olarak görünmektedir. Yüksek riskli ve yaşça ileri ergenler tedaviyle daha iyi ilerlemeler sağlarken, cinsel suçları bulunan ergenler diğerlerine göre tedavilerden daha az fayda görmektedirler.

Objective Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in adolescence, however, the etiology has not been described. Neuropeptide Y (NPY) is one potential factor that may be involved in the etiology of ADHD. The goal of this study was to evaluate NPY levels in children with ADHD and compare the findings to healthy controls. Methods Forty-eight ADHD patients and 40 healthy controls were included in this study. The age range of ADHD patients was 6 to 16 years. All patients were diagnosed according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Results The NPY levels of children with ADHD were compared to healthy controls but were not significantly different (t (86)= -0.887, p= 0.378). NPY levels were similar (F= 0.191, p= 0.826) between ADHD presentations, and included 8 children with predominantly hyperactive-impulsive type (14.3%), 14 children with predominantly inattentive type (30.4%), and 26 children with a combined type (55.4%). There was also no difference between ADHD patients using medical treatment, ADHD patients not using medical treatment, and control subjects in terms of NPY levels (F= 0.572, p= 0.566). There was a significant positive correlation between age and NPY levels in the ADHD group (r= 0.349, p= 0.015). Conclusion This study demonstrated that the NPY levels of ADHD subjects were not different than those of controls. Future studies with homogeneous phenotypes and a larger sample population are needed.

GOKCEN, CEM/0000-0003-3824-5890; Topal, Zehra/0000-0001-8397-5636; Tural, Umit/0000-0002-1593-2180; Unal, Fatih/0000-0001-8386-9884; Acikel, Burak/0000-0002-8964-9513; Erden, Semih/0000-0002-7723-9584; Kilic, Birim Gunay/0000-0002-4566-2564; Ucar, Halit Necmi/0000-0002-2706-7454; CELIK, GONCA/0000-0001-6101-0796; Gunes, Serkan/0000-0002-8247-2145; Isik, Umit/0000-0001-6006-3247; Coskun, Murat/0000-0002-4808-5870; Tufan, ALI EVREN/0000-0001-5207-6240; Donmez, Yunus Emre/0000-0002-7785-2805; Ceri, Veysi/0000-0001-6152-0227; Uzun, Necati/0000-0003-3381-2331; Hesapcioglu, Selma Tural/0000-0002-4816-0228; Kandemir, Hasan/0000-0002-1138-4973; Gormez, Vahdet/0000-0002-2704-9520 WOS: 000439557000070 PubMed: 29936389 Aim: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. Methods: This study was conducted as a part of the "The Epidemiology of Childhood Psychopathology in Turkey" (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. Results: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. Conclusion: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.

Background The aim of this study was to examine the effects of atomoxetine on heart rhythm using 12-lead electrocardiography (ECG) and 24 h Holter monitoring. Methods Children and adolescents who were diagnosed with attention deficit–hyperactivity disorder according to DSM-IV-TR were referred to a pediatric cardiology clinic for cardiologic examination before and after 4 or 5 weeks of atomoxetine treatment. Cardiac examination, complete blood count, biochemistry, thyroid function tests, 12-lead ECG and 24 h Holter monitoring were performed routinely in all patients. Each subject underwent 24 h Holter ECG monitoring before atomoxetine was started and after 4 or 5 weeks of effective dose atomoxetine treatment. Results Forty-one patients were included in this prospective study. No statistically significant change was found in QT, QTc or QT interval dispersion or blood pressure before and after 4 or 5 weeks of atomoxetine treatment. There was a statistically significant increase in heart rate (both during the day and at night) and QRS duration, and a statistically significant decrease in P wave dispersion. Three patients had rhythm disturbances. All of these three patients were asymptomatic and none of these arrhythmias reached clinical significance. Conclusion Atomoxetine did not cause significant changes in ECG or Holter variables. In two patients, who had undiagnosed subclinical extrasystoles, extra beats were increased after 4th week of treatment, but still remained clinically insignificant. Before and after atomoxetine treatment, listening to the heart sounds for a longer time, may help clinicians to notice an extra beat. If an extra beat is identified then 24 Holter monitoring is recommended.

Catatonia and differential diagnosis in adolescence: a case report Catatonia is a motor dysregulation syndrome with main symptoms and signs such as mutism, posturing, stupor, motor rigidity, hyperalertness, refusal to eat or drink, and hypokinesis. Recognizing catatonia in children and making a differential diagnosis is important in terms of investigations required as well as for determining the treatment protocol. The present paper discusses the differential diagnosis of catatonia presentation and the clinical characteristics of a 17-year-old male case who was initially followed as inpatient in our clinic for catatonia presentation, though his diagnosis did not become definite within this period. Approximately one year later, he was readmitted to our clinic being pre-diagnosed with bipolar disorder-manic attack because of symptoms such as talking excessively, hyperactivity, irritability, and insomnia.

Aim: We aimed to investigate the characteristics of children and adolescents presented to the psychiatric emergency service (PES) of a mental health hospital.Materials and Methods: Medical records of patients under 18 years of age were reviewed for the first psychiatric emergency visit during a 1-year period.Results: The mean age was 15.82 years and 65.8% (n=711) were female. The most presenting symptoms were suicidal ideation (21.0%; most for girls) and homicide/ violence toward others (20.7%; most for boys). The mean duration of symptoms was 265.36 days. The most common diagnoses were conduct disorder (16.7%; most for boys) and conversion disorder (15.5%; most for girls). Of the patients, 51.7% never used any mental health services before. The rate of prior use of mental health service was significantly higher in patients presenting with homicide/violence toward others and self-harm and lower in patients presenting with anxiety and somatic symptoms (p