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Pharmacogenetic studies involving Carboxylesterase 1 (CES1), Latrophilin-3 (LPHN3), and Catechol-O-methyltransferase (COMT) revealed individual differences regarding therapeutic response in children with attention deficit hyperactivity disorder (ADHD) under methylphenidate (MPH) treatment. This study aimed to evaluate MPH's association with the adverse effect status in children and its relationship with CES1, LPHN3, and COMT in the Turkish population. The study included 102 children and adolescents with ADHD, who were categorized as responders, or the adverse effect group based on their treatment response. The Naranjo Adverse Drug Reaction Probability Scale evaluated the presence and severity of adverse effects. Saliva sample was taken from the patients and genotype distribution of CES1 rs3815583, CES1 rs2307227, LPHN3 rs6551665, LPHN3 rs1947274, LPHN3 rs6858066, LPHN3 rs2345039, and COMT rs4680 were examined. In the adverse effect group, instances of carrying the GG genotype in CES1 rs2307227, having G vs. T genotype and GG vs. GT were significantly higher. In LPHN3 rs2345039, carrying the C genotype vs. G was associated with a serious adverse effect. In COMT rs4680, individuals with the AA or GG genotype were significantly higher in the adverse effect group. Our study suggests a relationship between genetic polymorphisms and the side effect status in children receiving MPH., (© 2025 Wiley Periodicals LLC.)

Aim: Mental disorders affect approximately 15%-20% of childhood. However, due to various factors, these individuals do not benefit sufficiently from mental health services. Therefore, psychiatry emergency services become a key system in the need of psychiatric care for these children. This study aims to reveal the factors that predict recurrent admissions in children and adolescents admitted to the emergency department of a psychiatric hospital and the tendencies of clinicians during management., Methods: In our study, the data of patients aged 0-18 years who applied to the emergency department between 1 March 2022 and 01 March 2023 were scanned retrospectively. Participants who applied once were included in the 'single applicant' group, whereas patients who applied two or more times were included in the 'repeated applicants' group., Results: A total of 1563 emergency applications were recorded by 785 different patients. A total of 62.2% of the patients visited the emergency department once, while 37.8% applied two or more times. Non-suicidal self-injury, delusion/hallucination, irritability and depression were significantly higher in recurrent applicants (P < 0.05). Psychotic disorder, bipolar disorder, major depression and borderline personality traits were significantly frequent in these patients (P < 0.05). Additionally, it was determined that the number of psychiatric diagnoses, referral time, need for chemical restraint, having a diagnosis of psychotic disorder or borderline personality traits increased the likelihood of recurrence., Conclusions: Our results indicate some special risk factors that increase the likelihood of recurrent emergency admissions in children and adolescents. Further research with larger sample sizes may elucidate the unique needs of these children in order to use of community resources beneficially., (© 2024 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

Abstract: Anxiety comorbidity in bipolar disorder (BD) is important and thus significantly affects the course of BD and its outcomes. The treatment of generalized anxiety disorder comorbid with BD involves certain challenges, as antidepressant medications, which are standard in the treatment of anxiety disorder, have the risk of shifting to manic episodes and rapid cycling. In this case report, the response to agomelatine treatment in generalized anxiety disorder comorbid with bipolar 1 disorder was evaluated., Competing Interests: Conflicts of Interest and Source of Funding: The authors have no conflicts of interest to declare., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: : This study from Istanbul aimed to compare the child and adolescent psychiatric admissions and diagnosis rates between the first 3 months of the pandemic, the previous 3 months in the same year, and the same months in the previous year., Methods: : Children and adolescents were grouped according to the admission dates. Group A, between March 11 and June 1, 2020; Group B, between January 1 and March 11, 2020; and Group C, between March 11 and June 1, 2019. Only clinical interviews and diagnoses according to Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) interview were included., Results: : Autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD)/tic disorder, and intellectual disability (ID) diagnoses were higher in group A than in groups B and C (for ASD, 6.4%, 4.3%, and 3.6%; for OCD/tic disorder, 2.9%, 1.8%, 1.7%; for ID, 3.7%, 2.5%, and 2.1%, respectively) ( P < .001). Attention-deficit hyperactivity disorder (ADHD) diagnosis was higher in group A than in only group B (59.8% and 49.7%, respectively) ( P < 0.001). Depression was higher in group A than in only group C (4.1% and 2.2%, respectively) ( P < .001). Conduct disorder (CD) diagnosis was lower in group A than in only group B (3.6% and 6.4%, respectively) ( P < .05)., Conclusion: : Child psychiatry diagnosis rates were found to change significantly during the initial phase of the pandemic period. Among the referrals, ASD, OCD, Tic disorder, ID, ADHD, and depression admissions were significantly higher. The rate of pediatric neurodevelopmental disorders, particularly ASD, increased during the initial phase of the COVID-19 pandemic., Competing Interests: Declaration of Interests: The authors have no conflicts of interest to declare., (2024 authors.)

Objective: This study aimed to compare the attention levels, of Turkish children and adolescents with Attention Deficit/ Hyperactivity Disorder (ADHD) in on-line education classes with healthy controls., Methods: This study is a cross-sectional, internet-based, case-control study that recruited 6-18 years old patients diagnosed with ADHD and receving treatment and healthy controls from eight centers. The measurements used in the study were prepared in the google survey and delivered to the participants via Whatsapp application., Results: Within the study period, 510 children with ADHD and 893 controls were enrolled. Parent- rated attention decreased significantly in both groups during on-line education classes due to COVID-19 outbreak (p<0.001; for each). Children and adolescents with ADHD had significantly elevated bedtime resistance, problems in family functioning difficulties than control children according to parental reports (p=0.003; p<0.001; p<0.001, respectively). Furthermore, bedtime resistance and comorbidity significantly predicted attention levels in on-line education., Conclusion: Our findings may underline the need to augment student engagement in on-line education both for children without attention problems and those with ADHD. Interventions shown to be effective in the management of sleep difficulties in children as well as parent management interventions should continue during on-line education., Competing Interests: No conflict of interest was declared by the authors., (© Copyright 2023 by Istanbul Provincial Directorate of Health.)

Aims: Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds., Methods: A large-scale multicenter online survey was completed by the parents ( n  = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers-HCW [18.2%] vs. others), geographical (İstanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds., Results: Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p  < .001), a mother (odds ratio 1.67, p  < .001), and a younger parent (odds ratio 0.98, p  = .012); living with an adult with a chronic physical illness (odds ratio 1.38, p  < .001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p  = .043), positive psychiatric history (odds ratio 1.29, p  < .001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p  < .001; vs. odds ratio 2.61, p  < .001) were independently associated with significant parental distress., Conclusions: Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit.

Objective: To investigate the association of sluggish cognitive tempo (SCT) with autistic traits (ATs) and anxiety disorder symptoms among children with attention-deficit/hyperactivity disorder (ADHD)., Methods: A total of 195 children with a DSM-5 diagnosis of ADHD were included. The Barkley Sluggish Cognitive Tempo Scale (BSCTS) was used to measure SCT symptoms. Other study measures included the Autism Spectrum Quotient (AQ), Screen for Child Anxiety and Related Disorders (SCARED), Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S), and Conners' Teacher Rating Scale (CTRS-R)., Results: The frequency of SCT was 30.3% (n=59) in the whole group. Those with SCT had higher total AQ and SCARED scores. Significant associations and correlations were also found between SCT and certain subscores of AQ and SCARED. According to the linear regression model, the total score and social skills, attention switching, and imagination scores of AQ, as well as generalized anxiety and panic/somatic scores of SCARED and the total and inattention scores of parent T-DSM-IV, were predictive of SCT total score (p < 0.05)., Conclusions: SCT is associated with ATs and anxiety disorders. Children with ADHD and SCT symptoms should be screened for such conditions.

Background: Priapism is a persistent unwanted erection that is not linked with sexual stimulation. A number of previous case reports have shown priapism with methylphenidate (MPH) use, especially in adolescence and preadolescence period. In all of these cases, the unwanted erections ceased after the medication was discontinued and no further attention-deficit hyperactivity disorder medication was initiated. Hereby, we present the case of a boy who had priapism episodes with MPH, which resolved with switching to atomoxetine (ATX)., Case Report: A 5-year, 10-month-old medically healthy boy was diagnosed with attention-deficit hyperactivity disorder and was prescribed methylphenidate immediate-release (10 mg/d). Two weeks later, his family communicated and reported penile erection episodes since the initiation of MPH. With the suspect of a medication-induced adverse reaction, MPH was discontinued and priapism resolved within a week. Thereafter, 10 mg/d of ATX was initiated. Four-week follow-up with ATX treatment revealed that the medication was tolerated well, and priapism or any other adverse effect was not reported., Conclusions: This case report suggests that ATX may be safely used in some children who experienced priapism with MPH. Future studies are needed to clarify the risk factors and etiologic mechanisms of this adverse reaction.

Aim: To investigate prevalence and patterns of psychiatric disorders in young subjects with Internet addiction (IA)., Methods: Subjects were taken from a sample of patients, aged 10-18 years old, referred to Istanbul Medical Faculty, Child and Adolescent Psychiatry Department due to a variety of behavioral and emotional problems alongside problematic Internet use. Inclusion criteria included IQ ≥70 and score ≥80 on Young's Internet Addiction Scale (YIAS). Psychiatric comorbidity was assessed using the Turkish version of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version., Results: Subjects were 45 boys (75%) and 15 girls (25%) with an age range of 10-18 years old (mean age, 13.38 ± 1.79 years). A total of 60% (n = 36) had been using Internet for ≥5 years. Mean hours/week spent on the Internet was 53.7 (range, 30-105 h) and the average YIAS score was 85. All subjects (100%) had at least one and 88.3% (n = 53) had at least two comorbid psychiatric disorders. The frequency of diagnostic groups were as follows: behavioral disorder, n = 52 (86.7%); anxiety disorder, n = 43 (71.7%); mood disorder, n = 23 (38.3%); elimination disorder, n = 16 (26.7%); tic disorder, n = 10 (16.7%); and substance use disorder, n = 4 (6.7%). The most common psychiatric disorders were attention-deficit hyperactivity disorder (n = 53; 83.3%), social phobia (n = 21; 35.0%) and major depressive disorder (n = 18; 30.0%)., Conclusion: High rates of psychiatric comorbidity, particularly behavioral, anxiety and mood disorders were found in young subjects with IA. Because the presence of psychiatric disorders may affect the management /prognosis of IA, assessment should include that for other psychiatric disorders., (© 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.)