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.
