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Aims: This study aimed to evaluate the mental health of mothers of children with attention deficit hyperactivity disorder (ADHD) after distance learning measures during the Coronavirus disease-2019 (COVID-19) pandemic, considering factors that may influence their well-being. Methods: In a cross-sectional design, the levels of burnout, depression, anxiety, stress, coping strategies, social support, and perceived changes in mental health among the mothers were assessed using the Maslach Burnout Inventory (MBI), Depression Anxiety Stress Scale-21 (DASS-21), Brief Coping Orientation to Problems Experienced Inventory, Multidimensional Scale of Perceived Social Support Scale, and Global Rating of Change (GRC) scale. Furthermore, the mothers completed the Atilla Turgay Scale (T-DSM-IV-S) to evaluate their perceptions of their children's ADHD and behavioral problems. Results: Of the 72 mothers (mean age: 42.46±6.73 years, mean children age: 11.39±3.12 years), 50%, 44.4%, and 43.1% had depression symptoms, anxiety, and stress, respectively. According to the GRC, most mothers (67%) reported deterioration in mental well-being compared with the pre-pandemic period. The strongest correlations were between the subscales of T-DSM-IV-S and the total MBI score (r=0.51, p<0.001), DASS-21 score (r=0.35, p=0.003), and GRC score (r=-0.40, p=0.004), particularly with the inattention subscale. Child's attention deficit score, maternal education level, maladaptive coping level, and frequency of outdoor activities were identified as predictors of GRC. Conclusions: This study showed that the distance learning during the COVID-19 pandemic was associated with deteriorated mental health among mothers of children with ADHD. The mother's maladaptive coping strategies, frequency of outdoor activities, education level, and attention deficit level were identified as independent predictors of deteriorated mental health in mothers. [ABSTRACT FROM AUTHOR]

Background: Adjustment disorder (AD) in individuals suffering from end‐stage organ failure can negatively impact treatment adherence and overall quality of life. Previous research focusing on adults has suggested that AD might serve as a precursor to major mental disorders. However, although it is frequently used as a diagnosis in consultation‐liaison psychiatry, our understanding of AD in pediatric transplant candidates remains limited. Therefore, the objective of this study is to assess AD and identify its associated risk factors among children who are candidates for heart, kidney, and liver transplantation. Methods: Data were collected retrospectively from a cohort of 155 children, aged between 6 months and 18 years (mean age 9.4), who had undergone consultations for child and adolescent psychiatry at a hospital with a transplant center within the past 10 years. Results: The predominant diagnosis among children assessed during the pre‐transplant period was AD (20%), with the subtype "with depressed mood" being the most commonly observed (35.5%). Organ type and length of hospital stay were identified as significant independent predictors of AD. Being a heart transplant candidate was determined as the strongest predictor of AD among children who underwent consultations with child and adolescent psychiatry within the population of transplant candidates. Conclusions: The study found that AD was the most common diagnosis among transplant candidates who underwent psychiatric consultations. Additionally, the study identified the length of hospital stay and the type of organ needed as independent predictors of AD. Screening for AD by considering risk factors may provide an opportunity for early intervention before the occurrence of major mental disorders in transplant candidates. [ABSTRACT FROM AUTHOR]

Background: We conducted a review of all studies comparing clinical aspects of alcohol withdrawal syndrome (AWS) between men and women. Methods: Five databases (PubMed, Cochrane, EMBASE, Scopus and Clinical Trials) were searched for clinical studies using the keywords "alcohol withdrawal syndrome" or "delirium tremens" limited to "sex" or "gender" or "sex difference" or "gender difference." The search was conducted on May 19, 2023. Two reviewers selected studies including both male and female patients with AWS, and they compared males and females in type of AWS symptoms, clinical course, complications, and treatment outcome. Results: Thirty-five observational studies were included with a total of 318,730 participants of which 75,346 had AWS. In twenty of the studies, the number of patients presenting with or developing AWS was separated by sex, resulting in a total of 8,159 (12.5%) female patients and a total of 56,928 (87.5%) male patients. Despite inconsistent results, males were more likely than females to develop complicated AWS [delirium tremens (DT) and AW seizures, collective DT in Males vs. females: 1,792 (85.4%) vs. 307 (14.6%), and collective seizures in males vs. females: 294 (78%) vs. 82 (22%)]. The rates of ICU admissions and hospital length of stay did not show sex differences. Although variable across studies, compared to females, males received benzodiazepine treatment at higher frequency and dose. One study reported that the time from first hospitalization for AWS to death was approximately 1.5 years shorter for males and males had higher mortality rate [19.5% (197/1,016)] compared to females [16% (26/163)]. Conclusion: Despite the significant heterogeneity of the studies selected and the lack of a focus on investigating potential sex differences, this review of clinical studies on AWS suggests that men and women exhibit different AWS manifestations. Large-scale studies focusing specifically on investigating sex difference in AWS are needed. [ABSTRACT FROM AUTHOR]

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Background: This study aims to translate the Pediatric Transplant Rating Instrument (P‐TRI) to conduct a validity and reliability study on Turkish children and define a cutoff value of this scale. Method: A total of 151 pediatric kidney transplant patients were included in the study. The files of the patients were reviewed by two clinicians, and the scale was filled for inter‐rater reliability. One of the clinicians filled the scale again after one month for intra‐rater reliability. Glomerular filtration rate (GFR) and creatinine values were used for predictive validity. A GFR below <60 ml/min/1.73 m2 and creatinine up to 3.0 mg/dl was defined as risk factors. Results: Correlation of P‐TRI with GFR (r =.252, p =.003) and creatinine (r = −.249, p =.002) was performed, and the internal consistency of the scale items as measured by Cronbach's alpha coefficient was found to be 0.825. When the test was performed again, the intra‐class correlation coefficient was found as.922 for intra‐rater reliability and as.798 for inter‐rater reliability. For both creatinine and GFR, the best cutoff point for the total score was found to be 66.5. Conclusions: Patients who received P‐TRI above 66.5 could be at risk in the post‐transplant period. Identification of these patients before transplantation and following these young people more closely will aid in the prevention of serious consequences. The reliability and validity scores are satisfactory for use in transplantation clinics for psychosocial evaluation and compliance in Turkish pediatric renal transplantation patients. [ABSTRACT FROM AUTHOR]

Red ear syndrome is defined as mostly unilateral burning pain and redness of external ear. It has two forms idiopathic and secondary. Idiopathic red ear syndrome is mostly seen in young people and associated with migraine. Secondary red ear syndrome is more frequent in adults and releated with cervical disorder. Our patient was a 10 year old boy diagnosed with attention deficit hyperactivity disorder (ADHD) and spesific learning disorder. He had a complaint of redness in his ear, following the atomoxetine treatment for ADHD. The redness was appearing after taking atomoxetine in 1 hour. The redness in his ear was unilateral and lasted in 4 hours. Sometimes headaches were accompanied with red ear. After atomoxetine treatment was ceased the redness and the headache in his ear were dissappered. In the pathophysiology of red ear sydrome there is a disregulation of sympathic outflow. Atomoxetine has a high selectivity for noradrenergic receptors and also has an effect on periferic noradrenergic receptors. Atomoxetine could change the sympathic vasodilation/vasoconstruction balance and cause red ear. Although the red ear is not a life threating situation, it could cause discomfort and anxiety, so the clinicians should keep in mind red ear syndrome while using atomoxetine. To our best knowledge this is the first red ear case associated with atomoxetinein literature. [ABSTRACT FROM AUTHOR]

Objectives: The ratio of the index finger (2D) to the ring finger (4D) is different in males and females. This ratio (2D:4D) has been investigated in a variety of diseases, including autism, schizophrenia, attention deficit hyperactivity disorder, and anxiety disorders. The aim of this study was to investigate the 2D:4D ratio in children and adolescents with obsessive compulsive disorder and to detect any differences in that ratio between participants with obsessive compulsive disorder and a healthy control Material and Methods: The study included 30 children and adolescents diagnosed with obsessive compulsive disorder between ages 7-17 and 90 age-sex matched controls. After the psychiatric evaluations; finger lenghts were measured with a digital compass. Results: Girls with obsessive compulsive disorder had greater 2D:4D ratios in their right and left hands than the control group. Although there was no statistically significant difference, the 2D:4D ratio in the right hand was greater in the obsessive compulsive disorder group than in the control group. Conclusion: With relation to obsessive compulsive disorder, some differences were detected in 2D:4D ratios of patients with obsessive compulsive disorder and control groups but there were no statistically significant results except for that of girls with obsessive compulsive disorder. Further studies are needed to fully understand the relationship between obsessive compulsive disorder and the 2D:4D ratio. [ABSTRACT FROM AUTHOR]

Objective: Obsessive compulsive disorder (OCD) and autism share some common features, such as repetitive behaviors. Second finger to fourth finger ratio (2d: 4d) is thought to be associated with prenatal androgen exposure and differs between the sexes and 2d:4d ratio is reported to be more "masculine like features" in autism. The aim of this study is to compare OCD and autism that display common features in terms of 2d: 4d ratio and finger lengths. Methods: This study included 15 boys diagnosed with OCD, 12 boys diagnosed with Pervasive Developmental Disorder (PDD), and 54 healthy boys with no psychiatric disorders between the ages of 6 and 18 years. The diagnoses of OCD and PDD were reached after detailed clinical evaluations according to DSM IV-TR criteria. After the evaluation, the children's and adolescents' hand length, hand width, and finger lengths were measured with a digital compass. Results: In this study, we found no statistically significant difference between the control, OCD, and PDD groups regarding the right and left 2d: 4d ratio. Whereas in the PDD group, we found that the right hand second and third fingers and the left hand second, third, and fourth fingers were shorter than the fingers of those in the control group. We also found that left hand length was shorter in the PDD group than in the OCD group and the second finger of the right hand and third finger of left hand was shorter in the PDD group than in the OCD and control groups. Conclusion: In this study, we did not observe any differences between the OCD, PDD, and control groups in terms of 2d: 4d ratio; however, we found that that some finger lengths were shorter in the PDD group than in the control group. This result may be a dysmorphological sign that could be screened in the PDD group, but we need further research with larger sample sizes to confirm its significance. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion The aim of this study was to compare the clinical characteristics of childhood‐onset schizophrenia (COS) and early‐onset schizophrenia (EOS) during the first‐ episode psychosis and the stable period, to examine psychopharmacological treatment approaches, and to investigate potential predictive factors for prognosis.Demographic, clinical, and psychopharmacological therapy data for 31 patients diagnosed with COS and 66 with EOS were retrieved from the file records in this multicenter study. Symptom distribution and disease severity and course were evaluated twice, in the acute psychotic stage and in the latest stable phase, during follow‐up using the positive and negative syndrome scale (PANSS) and clinical global impression (CGI) scales.A statistically significant difference was observed between the groups' CGI improvement rates and median last stable stage PANSS positive, negative, and general psychopathology symptom scores (p = .005, p = .031, p = .005, and p = .012, respectively). Premorbid neurodevelopmental disorder and obsessive‐compulsive disorder and comorbidities were more common in the COS group (p = .025 and p = .030, respectively), and treatment required greater multiple antipsychotic use in that group (p = .013). When the independent variables affecting the difference between pre‐ and post‐treatment PANSS scores were examined using linear regression analysis, the model established was found to be statistically significant (F = 5.393; p = .001), and the group variable (p = .024), initial disease severity (p = .001), and socioeconomic level (p = .022; p = .007) emerged as predictive factors for the disease course.Although early diagnosis and treatment is an important factor in improving prognosis in schizophrenia, more specific predictors for schizophrenia need to be identified. Additionally, preventive programs and pharmacological methods need to be developed in children with neurodevelopmental problems, particularly those from low socioeconomic status families. [ABSTRACT FROM AUTHOR]

Giriş: Kırmızı kulak sendromu sıklıkla bir taraflı olarak görülen, dış kulakta yanma hissi ve kızarıklıkla giden bir durumdur. İdiyopatik ve ikincil olarak görülebilir. İdiyopatik formları sıklıkla gençlerde görülür ve migren ile ilişkili olabilir. İkincil formları ise erişkinlerde daha sık görülür ve servikal bozukluklarla ilişkilendirilebilir. Yöntem: Bu olgu sunumunda atomoksetin kullanımından sonra kulağında kızarıklık yakınması başlayan dikkat eksikliği hiperaktivite ve özgül öğrenme güçlüğü olan bir erkek hasta sunulmuştur. Bulgular: On yaşındaki erkek hasta unutkanlık, öğrenme güçlüğü, dalgınlık yakınmaları ile polikliniğimize başvurdu. Yapılan psikiyatrik muayene ve tetkikler sonucunda dikkat eksikliği hiperaktivite bozukluğu ve özgül öğrenme güçlüğü olan hastaya 18 mg/gün atomoksetin başlandı, 43 mg/güne çıkılması planlandı. Atomoksetin kullanımı ile hastada tek taraflı kulak kızarıklığı yakınması başladı. Kızaran taraf değişmekle birlikte, ortalama dört saat içinde sonlanıyordu. Bazen kulaktaki kızarıklığa başağrısı da eşlik ediyordu. Yakınmaları süren hastanın kullandığı atomoksetin kesildi, yerine uzun etkili metilfenidat başlandı. Atomoksetin kesildikten sonra hastanın yakınmaları yinelemedi. Tartışma: Kırmızı kulak sendromunun patofizyolojisinde sempatik akımda olan disregülesyondan söz edilir. Atomoksetin noradrenerjik reseptörler üzerine seçici etkisi olan, dikkat eksikliği hiperaktivite bozukluğu tedavisinde kullanılan, uyarıcı olmayan bir ajandır. Merkezi noradrenerjik reseptörlerin yanı sıra, periferik noradrenerjik reseptörler üzerine de etkisi vardır. Atomoksetin sempatik vazokonstruksiyon ve vazodilatasyon dengesinde değişikliğe yol açabilir, bu durum da kırmızı kulak sendromuna neden olabilir. Bu durum her ne kadar ciddi bir yan etki olmasa da, yaşam kalitesini bozabilir, hastada sıkıntıya neden olabilir. [ABSTRACT FROM AUTHOR]

Giriş: Amerika Pediatri Birliği, okul öncesi dönemde televizyon izleme, telefon kullanma ve internette vakit geçirme ile ilgili bir kısım sınırlamalar önermiştir. Bu sınırlamalardan biri, iki yaşından küçük çocukların hiç televizyon izlememesi gerektiğidir. İki yaşından sonra ise, televizyonun belli bir saat sınırlandırmasıyla izlenmesi önerilmekte ve izleme sırasında etkileşimin sürmesi önemsenmektedir. Yöntem: Türkiye'de televizyon, telefon ve internet kullanımının hangi düzeyde olduğunun belirlenmesi amacıyla çeşitli kreş, oyun evi ve bölümümüze başvuran hastaların sosyodemografik özellikleri, medya ile ilgili ilişkileri kısa anket sorularıyla incelenmiştir. Bulgular: Çalışma %54.3'ü kız, %45.7'si erkek olan toplam 151 çocukla yapılmıştır. Örneklemin yaş ortalaması 5'tir. Televizyon izlemeye başlama ortalama yaşı 21 aydır. Yedi çocuk henüz televizyon ile tanışmamıştır. Ortalama telefon ile tanışma yaşı 37 aydır. On dokuz çocuk henüz telefon ile tanışmamıştır. Ortalama internetle tanışma yaşı 43 aydır. Yirmi iki çocuk henüz internetle tanışmamıştır. Televizyonla geçirilen süre ortalama 2.28 saat, telefonla geçirilen süre ortalama 0.83 saat ve internetle geçirilen süre ortalama 0.95 olarak belirlenmiştir. Medyanın kullanım amacı %47 oranında eğlence amaçlıdır. Ailelerin sadece %3.3'ü çocuğuna eğitici programlar izletmektedir. Medya kullanımı annenin çalışıp çalışmamasından bağımsız olmaktadır. Çocukların uyku ve beslenme düzeninin bozuk olması televizyon izleme yaşını düşürmektedir (p<0.001). Tartışma: Çoğu kez sessiz bakıcı olarak adlandırılan televizyon, anneler için zaman zaman çocuk bakımı için kullanılan bir araçtır. Çocuklara zarar vermemesi için topluma zararlı yanları ve nasıl yararlı hale getirilebileceği anlatılmalıdır. [ABSTRACT FROM AUTHOR]

Giriş: 15 Temmuz 2016 akşamı saat 22 sularında Türk Silahlı Kuvvetleri mensubu bir kısım asker Türkiye'de bir darbe girişimine kalkışmıştır. Darbe girişimi sonrası 240 şehit, 1440 yaralı olduğu bildirilmiştir. Darbe girişimleri ve sonrasında oluşan olağan dışı koşullar hem erişkinler, hem de çocuklar için travmatik bir yaşantı olmuştur. Bu olgu sunumunda bu etkilenmenin daha iyi anlaşılması için darbe girişimi sonrası başvuran iki olgu incelenmiştir. Olgu 1: On beş yaşında, erkek hasta. Lise ikinci sınıfa geçmiş, iki kardeşin ikincisi. Darbe girişiminden bir gün sonra başlayan çarpıntı, nefes alamama, baş ağrısı, baş dönmesi, bayılacak gibi olma, nesnelerin kendine doğru geliyor gibi olduğunu hissetme, boğazda düğümlenme yakınmaları başlamış. Olgu 2: On altı yaşında kız hasta. Lise son sınıfa geçmiş, ailenin tek çocuğu. Darbe girişiminden beş gün sonra evde yalnız kalırken, evde öleceği korkusuyla çarpıntı ve nefes darlığı yakınması olmuş. Kimse bana yardım edemeyecek korkusu yaşamış. Tartış-ma: Travmatik olay kişinin ölümle veya ölüm tehdidi ile karşılaşması durumudur; kendisinin veya başkasının fiziksel bütünlüğü tehdit altındadır. Aynı zamanda kişinin başka bir yakınının başına örseleyici bir olay geldiğini duyması da, örseleyici olayların ayrıntılarıyla tekrar tekrar karşı karşıya kalmak da travmatik olmaktadır. Travmatik olay örüntüsü, topluma olan etkileri ve yaş, travmanın ruhsal sonuçlarını etkilemektedir. [ABSTRACT FROM AUTHOR]

Giriş: Bebeklik ve erken çocukluk dönemi olarak adlandırılan 0-4 yaşları arası beyin gelişimi açısından kritik bir dönemdir. Birçok psikiyatrik bozukluk bu dönemde ilk belirtilerini vermeye başlar. Psikiyatrik bozuklukların yanı sıra, dönemsel sıkıntıların sağlıklı bir şekilde çözülmesi de çocuk ruh sağlığı açısından büyük bir önem taşır. Yöntem: Bu çalışmada 2015 yılı başından 2016 Ağustos ayına kadar olan 19 aylık dönemde Başkent Üniversitesi Ankara Hastanesi Çocuk Psikiyatrisi Polikliniği'ne başvuran 0-4 yaşları arasındaki çocukların özellikleri ve tanı dağılımları incelenmiştir. Hastaların dosya bilgileri geriye dönük olarak taranmıştır. Bulgular: Bu dönemde 197 erkek ve 112 kız olmak üzere toplam 309 hastanın polikliniğimize başvurduğu görülmüştür. Olguların sekizinin (%2.6) 1-12 ay, 59'unun (%19.1) 13-24 ay, 99'unun (%32) 24-36 ay ve 143'ünün (%46.3) 26-48 ay aralığında olduğu görülmüştür. Olguların DSM-5 tanı sınıflamasına göre 97'sine (%31.4) genel gelişimsel gecikme, 37'sine (%12) otizm spektrum bozukluğu, 24'üne (%7.8) dil bozukluğu, 14'üne (%4.5) dikkat eksikliği hiperaktivite bozukluğu, 14'üne (%4.5) anksiyete bozukluğu, 11'ine (%3,5) karşıt olma karşı gelme bozukluğu, dokuzuna (%3) uyum bozukluğu ve dokuzuna (%3) uyku-uyanıklık bozukluğu tanılarının konduğu görülmüştür. Olguların 76'sının (%24.6) döneme özgü sorunlar nedeniyle danışmanlık almak amacıyla başvurduğu saptanmıştır. Geriye kalan olgulara ise, diğer psikiyatrik tanıların konduğu görülmüştür. Tartışma: Bebeklik ve erken çocukluk döneminde başvuranların büyük bir kısmını genel gelişimsel gecikme, otizm spektrum bozukluğu ve dil bozukluğu olmak üzere gelişimsel bozuklukların oluşturduğu görülmüştür. Gelişimsel bozuklukların erken dönemde tanısı ve tedavisi ileriki dönemde oluşabilecek yeti yitiminin önlenmesi açısından önem taşımaktadır. Bunun yanı sıra, danışmanlık almak amacıyla başvuran ailelerin oranı koruyucu psikiyatrik uygulamaların önemini bir kez daha göstermiştir. [ABSTRACT FROM AUTHOR]