Objective: This study examined the psychiatric and medical characteristics of children and adolescents receiving health protection measures and explored their associations with maltreatment types, self-injurious behaviors, and suicide attempts. Method: Medical records of 331 children and adolescents followed under health protection measures at a single tertiary care hospital were retrospectively reviewed. Data were collected using a standardized file review form that included sociodemographic variables, psychiatric diagnoses, child protection characteristics, and risk factors. Psychiatric diagnoses were established according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Statistical analyses compared diagnostic distributions across maltreatment subgroups and examined associations with self-injurious behavior and suicide attempts. Results: Of the 331 included cases, 235 children (71.0%) underwent psychiatric evaluation. Diagnostic distributions were analyzed within this subgroup. Among children exposed to neglect (n=161), intellectual disability (29.8%), attention-deficit/ hyperactivity disorder (28.6%), and conduct disorder (24.2%) were the most prevalent diagnoses. Major depressive disorder was significantly more common among children exposed to physical abuse (50.0%; p<0.001), whereas major depressive disorder (37.5%; p=0.008) and social anxiety disorder (18.8%; p=0.003) were more frequent in the extrafamilial sexual abuse group. Self-injurious behaviors and suicide attempts were observed across maltreatment groups, with significant associations between self-injury and intrafamilial sexual abuse and between suicide attempts and physical and emotional abuse. Girls exhibited higher rates of both self-injurious behavior and suicide attempts than boys (p<0.01). Neurological (26.0%) and endocrine (8.5%) disorders were the most common non-psychiatric medical conditions. Conclusion: Children referred to a tertiary care facility under health protection measures demonstrated a high burden of psychiatric morbidity. Diagnostic patterns varied according to maltreatment type, highlighting the need for trauma-informed, multidisciplinary care.
Objective: Phubbing-defined as the act of ignoring people in one's physical environment in favorof engaging with a smartphone- has become increasingly prevalent among adolescents. While social media use is often central to this behavior, the psychological mechanisms underlying phubbing remain insufficiently explored. This study aimed to investigate the relationships between phubbing behavior, social media addiction, emotion regulation difficulties, and social anxiety in adolescents. It was hypothesized that social media addiction would predict phubbing both directly and indirectly through emotional and social factors. Method:The sample consisted of 125 adolescents aged 12-17 years who attended a child and adolescent psychiatry outpatient clinic in Turkiye. Standardized self-report measures were used to assess phubbing behavior, social media addiction, emotion regulation difficulties, and social anxiety. Correlation and mediation analyses were conducted using SPSS and Hayes' PROCESS Macro (Models 4 and 6), with 5,000 bootstrap resamples applied to test indirect and serial effects. Results: Social media addiction, emotion regulation difficulties, and social anxiety were all positively and significantly associated with phubbing behavior. Mediation analyses indicated that both social anxiety and emotion regulation difficulties partially mediated the relationship between social media addiction and phubbing.The serial mediation model further suggested that social media addiction may be linked to phubbing through increased social anxiety and subsequent emotion regulation difficulties. Conclusion: These findings highlight a potential interplay between digital habits and emotional functioning in adolescents. Phubbing may be understood not only as a behavioral outcome of digital engagement but also as a maladaptive coping strategy shaped by emotional vulnerabilities. Preventive interventions targeting emotion regulation and social media use may help reduce phubbing-related social difficulties.
Objective: Growing evidence suggests that unipolar mania (UM) may represent a distinct clinical condition rather than a subtype of bipolar disorder (BD). The present study aimed to compare the sociodemographic characteristics, clinical features, and psychosocial functioning of euthymic patients with UM or bipolar I disorder (BD-I) and healthy control subjects. Method: This cross-sectional study included euthymic patients with UM (n=58), BD-I (n=58), and healthy control subjects (n=58). Diagnoses were established according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, and euthymia was confirmed using the Young Mania Rating Scale, Beck Depression Inventory, and Positive and Negative Syndrome Scale. Psychosocial functioning was assessed using the Functioning Assessment Short Test (FAST) in all groups and the Bipolar Disorder Functioning Scale (BDFS) in the UM and BD-I groups. Sociodemographic and clinical data were collected using a structured form. Group comparisons were conducted using appropriate parametric and nonparametric statistical analyses. Results: Both patient groups demonstrated significantly impaired psychosocial functioning compared with healthy controls across all FAST subdomains (p<0.05). On the BDFS, patients with UM showed better emotional functioning and less social withdrawal than patients with BD-I (p<0.05); however, total functioning scores did not differ significantly between groups (p>0.05). Clinically, UM was characterized by manic-predominant onset, higher rates of mood-congruent psychotic symptoms, longer episode duration, and more frequent hospitalizations. Suicidal behavior and total number of mood episodes were higher among patients with BD-I (p<0.05). In the final logistic regression model, mood-congruent psychotic symptoms during the first episode were independently associated with UM relative to BD-I, whereas a history of suicide attempts was associated with lower odds of UM (p<0.05). Conclusion: Although both groups exhibited functional impairment, patients with UM demonstrated relatively better emotional and social functioning than those with BD-I. These findings suggest that UM may be associated with a distinct functional profile, with potential implications for prognosis and treatment planning. Incorporating functional outcomes into the clinical assessment of UM may help optimize therapeutic strategies and improve long-term psychosocial outcomes.
Objective:This study aimed to compare individuals applying to the health board for firearm possession and carrying licenses in terms of various sociodemographic and clinical parameters and to examine whether effective symptom profiling could be achieved in this specific population using self-report rating scales. Method:The study included 170 consecutive first-time applicants (155 men and 15 women) aged 21-68 years. Applicants for firearm possession and carrying licenses were divided into two groups and underwent a detailed psychiatric interview, including psychiatric history and mental status examination. Past medical records were reviewed through the national "e-Nabız" health database. Eligibility was restricted to individuals without a documented psychiatric diagnosis within the previous five years or psychotropic medication use within the previous six months. Participants also completed a case report form and a screening battery consisting of the Beck Depression Inventory, Beck Anxiety Inventory, State-Trait Anger Expression Inventory, and Barratt Impulsiveness Scale to evaluate symptom profiles. Results:The difference in gender distribution between the two groups was statistically significant (p=0.029). A statistically significant difference was also found between the possession and carrying license groups regarding reasons for firearm acquisition (p<0.001). The most common reason in the possession group was inheritance or transfer from a relative or friend (31.8%), whereas in the carrying group the most common reason was employment in occupations perceived to endanger personal safety (32.9%). In both groups, no participant scored above the established cut-off values for depression, anxiety, impulsivity, or trait anger. Conclusion:The findings indicate clear differences in firearm acquisition motives between applicants for possession and carrying licenses. In high-stakes licensing contexts, applicants may present socially acceptable justifications for firearm acquisition, thereby limiting the interpretive value of self-reported statements. Self-report screening instruments alone may not reliably identify clinically meaningful symptom profiles in this legally and clinically sensitive setting. Conclusions based solely on applicant declarations may therefore lack sufficient scientific validity, and corroboration through official documentation may assist clinicians in contextualizing evaluations.
Objective:Cancer-related fatigue (CRF) is highly prevalent among breast cancer survivors. This study aimed to identify CRF subgroups in breast cancer survivors using latent profile analysis (LPA) and to examine the effects of rumination on CRF through anxiety, depression, and fear of cancer recurrence. Method:A total of 201 women diagnosed with early-stage breast cancer completed standardized assessments of fear of cancer recurrence, rumination, anxiety, depression, and cancer-related fatigue. Latent profile analysis was conducted to identify distinct CRF profiles, and differences in psychological variables across groups were examined. Mediation analyses were performed using the PROCESS macro with bootstrapping (5,000 samples) to test indirect effects. Results:LPA identified three distinct profiles: low (50.2%), moderate (37.3%), and high (12.4%). The model demonstrated excellent classification quality (entropy=0.80; average posterior probabilities=0.89-0.93). Participants in the high-CRF group reported significantly higher levels of rumination, anxiety, depression, and fear of recurrence than those in the other two groups (all p<0.001, η2=0.10-0.30). Multinomial regression analysis showed that depression, anxiety, and fear of cancer recurrence significantly predicted membership in the high-CRF group. Mediation analyses indicated that rumination predicted CRF indirectly through depression (b=0.07, 95% confidence interval (CI) [0.01, 0.15]), anxiety (b=0.20, 95% CI [0.05, 0.34]), and fear of recurrence (b=0.17, 95% CI [0.04, 0.30]), jointly accounting for 32.6% of the total effect. Conclusion:The findings suggest that fear of recurrence, anxiety, and depression may increase vulnerability to CRF. The results also underscore the importance of targeting transdiagnostic processes such as rumination in psychological interventions for breast cancer survivors.
Objective: This study aimed to compare levels of alexithymia, psychological problems, emotion regulation difficulties, and disordered eating behaviors between adolescents with type 1 diabetes mellitus (T1D) and healthy controls and to examine the relationship among these factors. Method: The study was conducted at Ankara Bilkent City Hospital and included 115 adolescents aged 12-18 years, comprising 64 adolescents with T1D and 51 healthy controls. All participants completed the Alexithymia Questionnaire for Children (AQC), Difficulties in Emotion Regulation Scale (DERS), Strengths and Difficulties Questionnaire (SDQ), and Eating Disorder Examination Questionnaire (EDE-Q). Adolescents with diabetes were additionally assessed using the Diabetes Eating Problem Survey-Revised (DEPS-R), and their hemoglobin A1c (HbA1c) levels from the previous six months were recorded. Results: No differences were found between adolescents with T1D and healthy controls in total scores on the AQC, DERS, SDQ, and EDE-Q. Female participants and adolescents with psychiatric disorders had higher DEPS-R score. DEPS-R scores were positively correlated with total SDQ, DERS, and AQC scores, as well as body mass index (BMI), and negatively correlated with maternal education level. Multiple linear regression analysis revealed that SDQ total difficulties scores and BMI were associated with higher DEPS-R scores. Conclusion: These findings suggest that disordered eating behaviors in adolescents with T1D may be associated with psychological difficulties and higher BMI. Addressing these factors is important in the clinical management of adolescents with diabetes.
Objective:The aim of this study was to evaluate the occupational characteristics of civil aviation cabin crew and pilots who received medical or surgical treatment for lumbar or cervical disc herniation and to compare these characteristics with those of healthy controls, with a particular emphasis on age, sex, and cumulative flight time. Method:In this retrospective study, civil aviation cabin crew members and pilots presenting with low back and/or neck pain were compared with healthy controls matched for age and sex. Sociodemographic characteristics (age and sex), occupational characteristics (years of service, cumulative flight time, and type of flight duty), treatments modalities, and magnetic resonance imaging (MRI) findings were recorded and analyzed. Results:The mean age of affected personnel was 42.37±10.3 years (pilots: n=8, cabin crew: n=11), with the highest proportion of cases occurring in the 40-55-year age group. Males accounted for 73.7% of the surgical treatment group compared with 28.8% of the non-surgical treatment group. The rate of surgical treatment was significantly higher among personnel with cumulative flight times exceeding 15,000 hours, particularly among male pilots. Regression analyses demonstrated that male sex, age greater than 45 years, and cumulative flight time exceeding 15,000 hours were independently associated with an increased likelihood of requiring surgical intervention. Conclusion:Our findings indicate that male sex, advancing age (particularly >45 years), and longer cumulative flight time are the primary risk factors associated with surgical treatment for lumbar and cervical disc herniation among civil aviation personnel. These results highlight the importance of early monitoring and preventive strategies for individuals at increased risk.
Objective:Brexpiprazole (BRX) is an antipsychotic used as an adjunctive agent in the treatment of major depressive disorder. We aimed to evaluate the effectiveness of BRX in treatment-resistant depression (TRD). Method:This study was conducted between May 1, 2024 and January 1, 2025. Medical records of patients who were started on BRX as adjunctive treatment for TRD were retrospectively reviewed. Patient files containing sociodemographic data and scores from the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Global Assessment Scale (GAS) were included in the analysis. Results:A total of 30 patients were included in the study. The mean age was 32.50±11.38 years (range: 18-63), and 63.3% (n=19) were female. The median BRX dose was 2 mg/day. Of the 30 patients, 20 (66.7%) continued treatment regularly. Among those who discontinued treatment, three patients stopped due to akathisia, two due to sedation, and two due to an urgent need for electroconvulsive therapy. For the 20 patients who continued treatment, scale scores were reassessed during follow-up visits between weeks 4 and 8. A significant improvement was observed in both BDI scores (32.05±8.96 vs. 12.45±9.74; p<0.001) and BAI scores (28.00±10.07 vs. 12.75±10.83; p=0.001) after treatment. Meanwhile, no significant change was observed in body weight (73.05±20.93 kg vs. 75.30±20.32 kg; p=0.123). Among patients whose GAS scores indicated moderate functioning before BRX treatment, 80% (n=16) achieved good functioning after treatment. Conclusion:BRX may be an effective adjunctive treatment option for patients with TRD, with potential benefits for anxiety symptoms and overall functioning. Although some patients experienced weight gain, this effect did not appear to be clinically significant in our sample.
