This study examined the relationship between perpetrator type, abuse characteristics, and psychological and functional outcomes in sexually abused children and adolescents. The sample included 340 victims aged 6-18 evaluated in a tertiary forensic psychiatry clinic. Standardized instruments assessed depression, anxiety, trauma symptoms, attention-hyperactivity, and school refusal. Disclosure delay, depressive symptoms, and school refusal differed significantly by perpetrator type. Intrafamilial and relative-perpetrated abuse was associated with longer disclosure delays and higher depression levels. Anxiety, trauma severity, and attention-hyperactivity did not differ. Findings highlight the clinical and forensic importance of perpetrator identity and relational proximity in post-abuse psychological and functional outcomes.

Depression in sexually abused youth has a complex etiology involving various mechanisms related to adverse familial psychosocial factors and the severity of childhood sexual abuse (CSA). This study aimed to identify mediating mechanisms between CSA severity, adverse familial psychosocial factors and depressive symptoms in Turkish children and adolescents who have experienced sexual abuse. The files of 340 CSA cases, aged 6-18, who applied to the forensic outpatient clinic between 2014-2020 were retrospectively evaluated. Psychiatric diagnoses were made according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Depressive symptoms were evaluated through clinical examinations and Children's Depression Inventory (CDI). Sexual abuse severity was measured with the Sexual Abuse Severity Score (SASS) algorithm based on the information obtained from files. Both intrafamilial violence (IFV) (B = 2.67, 95%CI [0.56-4.77]) and chaotic family environment (CFE) (B = 2.57, 95%CI [0.43-4.72]) had significant effects on CDI scores under significant and full-mediating effects of verbal/physical coercion (B = 1.16, 95%CI [0.17-2.81] for IFV→CDI; B = 1.44, 95%CI [0.24-3.34] for CFE→CDI) and qualitative severity of sexual abuse (B = 0.91, 95%CI [0.17-2.06] for IFV→CDI; B = 1.04, 95%CI [0.14-2.44] for CFE→CDI). However, total SASS had no significant mediation in the relationship between adverse familial psychosocial factors and CDI scores. These findings provide evidence that both IFV and CFE appear to have significant associations with depressive symptoms, within the significant mediating roles of both verbal/physical coercion and qualitative severity of sexual abuse.

Aim: Childhood cancers are life-threatening diseases which are universally distressing and potentially traumatic for children and their families at the time of diagnosis, during treatment, and beyond. Materials and Methods: Thirty-nine child patients between the ages of 0-18 years receiving treatment in a pediatric oncology hospital for various pediatric cancers who consented to participate in this study were recruited. The participants were assessed via Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition/K-SADS-PL-DSM-5 for ages 6-18 by a trained and certified child and adolescent psychiatrist. The clinical assessments of patients aged 0-5 years were completed by a trained child and adolescent psychiatrist in agreement with the DSM-5 and the standard principles of psychiatric interview for the pediatric population. The previous and current psychiatric diagnoses of the participants were recorded. The Quality-of-Life Scale for Children was administered to the participants and their caregivers at the first interview and at the 6th month of follow-up. Results: While no significant differences were observed in the quality of life of children with a novel pediatric cancer diagnosis and children with cancer recurrence/ongoing treatment per their own reports, the parents reported significant improvement in the quality of life of those children who had a novel cancer diagnosis after six months. Conclusion: The parents’ and their children’s reports were highly correlated, and this association remained significant in multiple linear regression analyses for both the initial interviews and the follow-ups. The parents’ reports on their children’s quality of life appear to be reliable in accurately predicting their children’s quality of life in the clinical setting.

Objectives: Economic and social burdens lead caregivers to psychopathologies that affect their childrens' undergoing cancer treatment.In this study, we aimed to evaluate the effect of caregivers on the mental health of children and adolescents receiving inpatient treatment for cancer. Materials and Methods: In this study, 44 patients who received inpatient treatment at Ege University Tülay Aktaş Oncology Hospital between March 2019 and March 2020 and who accepted participation were included.The diagnoses of the patients were made according to the Affective Disorders and Schizophrenia Interview Schedule for School-Age Children-current and lifelong version which is a semi-structured interview and according to the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders.Symptom Checklist-90-Revised (SCL), Parental Attitude Research Instrument (PARI), and Hospital Anxiety-Depression Scale (HADS) were applied to the caregivers.

Aim:This study aimed to understand how the pandemic has affected the mental health of adolescents with a previous psychiatric diagnosis.Materials and Methods:Fifty-nine patients aged 12-18 years who had been previously followed up in the adolescent mental health unit were included in this study. The participants were interviewed via telephone between June-July, 2020 and December, 2020-January 2021. Their socio-demographic data, psychiatric diagnoses and the previous Clinical Global Impression (CGI) scores were obtained from the patient files. The clinical global follow-up scale was scored by the interviewing physician.Results:Past CGI scores before the pandemic were significantly greater for those participants with more than one psychiatric condition (p=0.024). For those participants with more than one psychiatric condition, the difference between the CGI scores prior to the pandemic and during the early stages of the pandemic were significant (p=0.004). The total satisfaction scores for telepsychiatry services assessed via the telemedicine evaluation form were statistically higher for those participants with a single psychiatric disorder (p=0.023). The past and early pandemic CGI scores were found to be inversely correlated with the telemedicine evaluation form with r=-0.338, p=0.019, r=-0.353 p=0.014, respectively.Conclusion:The present study offers a perspective for adolescent mental health during the pandemic, underlining the importance and caveats of healthcare delivery to the youth with mental health problems during lockdown.

Objective: Coronavirus disease-2019 (COVID-19) changed the status-quo in psychiatric interview with the advent of telemental health practices, save for a select group of patients; forensic psychiatric interviews among them. The present study aimed to identify the predictors of completing forensic psychiatric evaluations mandated by the judicial authorities in the hospital setting during the COVID-19 outbreak. Method: Twenty-six patients who had completed an initial forensic psychiatric assessment and were required to complete a child and adolescent forensic psychiatry board interview during the height of the COVID-19 pandemic were recruited. Their records were retrospectively examined, sociodemographic data, Beck Depression Inventory (BDI), the Screen For Child Anxiety Related Disorders (SCARED), and Wecshler Intelligence Scale for Children-revised scores were recorded and analyzed. Results: Statistical analysis revealed an association between conduct disorder and concomitant substance use with missed appointments, and maternal employment and completed interviews. BDI and SCARED total scores showed no difference between the patients who missed or completed their mandatory forensic psychiatry board assessment. BDI individual items of loss of pleasure (item 4), suicidality (item 9), and loss of interest (item 12) were associated with missed appointments. Conclusion: The results of this study support the established relationship between conduct problems and depressive symptoms, and this demographic group may be among the most affected by the limitation of access to mental health services during the COVID-19 pandemic, as they are already less likely to seek help overall.

Today, atypical neuroleptics are being used for treatment of child and adolescents disorders which are called resistant treatment schizophrenia, autistic disorder with several behaviour disabilities, schizophrenic disorders, affective disorders and Tourette disorder. Clozapine, olanzapine and risperidone are the most useful atypical neuroleptics. In this paper recent studies which are being investigated, atypical neuroleptics’s endication, efficacy and safety in childhood were reviewed. Çocuk ve ergenlerde atipik nöroleptiklerin kullanım alanları Çocuk ve gençlerde, tedaviye dirençli şizofrenik bozukluklarda ve otistik bozukluklardaki davranış bozukluğu semptomlarının tedavisinde atipik nöroleptiklerin kullanımı güncel bir konu haline gelmiştir. Çocuklarda en sık kullanılan atipik nöroleptikler klozapin, olanzapin ve risperidondur. Bu yazıda atipik nöroleptiklerin çocuklarda kullanım alanları, etkinlikleri ve güvenirlikleri irdelenmeye çalışılmıştır.

Research has suggested that patients with depression have deficits in social cognition, however they provide limited data regarding adolescent depression. Moreover, the relationship of social cognition with clinical features and quality of life is less studied. This study investigated social cognition in depressive adolescents and the correlations of social cognition with clinical features and quality of life. Thirty-five depressed adolescents and 37 healthy controls were assessed. Emotion perception and decoding ToM, quality of life and clinical variables were evaluated. No significant differences were found between depression and control groups regarding social cognitive tests. The results indicated that examined clinical features were not correlated significantly with social cognitive tests. Results suggest that social cognitive abilities are not disturbed in adolescents with first depressive episode.

Objective: In this study, we aimed to evaluate socio-demographic properties, diagnoses and drug use of children and adolescents with type 1 diabetes. Methods: The records of 21 patients, admitted to Ege University Faculty of Medicine Children’s Hospital Pediatric Endocrinology Department and consulted by Child and Adolescent Psychiatry were evaluated. Results: The majority (61.9 %) of the patients were female and the mean age of the subjects was 14.6±3.2. The majority (66.7 %) of the patients had depressive symptoms and were under antidepressant treatment. Conclusion: Psychiatric disorders are commonly seen in children and adolescents with type one diabetes. These patients mostly use antidepressant treatment

Amaç: Bu çalışmada okul öncesi yaş grubunda olup psikiyatrik takibi devam eden çocukların COVID-19 pandemisi ile ilgili uyum süreci ve psikiyatrik belirtilerindeki değişikliklerin Teletıp sistemi ile değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışmaya psikiyatrik takibi devam eden okul öncesi yaş grubundaki hastalar alınmıştır. Randevu günlerinde Teletıp sistemi aracılığıyla görüşülerek covıd-19 pandemisi ile ilgili uyum sürecini değerlendirmek amacıyla araştırmacılar tarafından hazırlanan anket soruları sorulmuş ve kaydedilmiştir. Pandemi ve pandemi öncesi dönemdeki hastalık şiddetlerini değerlendirmek için Klinik Global İzlenim-Hastalık Şiddeti (KGİ-Şiddet) ölçeği kullanılmıştır Bulgular: Çalışmamıza dahil edilen 51 hastanın %27,5’i kız, %72,5’i erkektir. Yaş ortalaması 4,42±1,15’tir. Psikiyatrik tanılarda birinci sırada Otizm Spektrum Bozukluğu (%52,9), ikinci sırada Dikkat Eksikliği / Hiperaktivite Bozukluğu (%21,6), üçüncü sırada ise Hafif Düzeyde Mental Retardasyon (%13,7) yer almaktadır. Pandemi döneminde gözlenen birincil değişiklik olarak olguların %25,5’i sinirlilikte artış, %19,6’sı kaygıda artış bildirmiştir. Hastaların uyku ve beslenme rutinleri sorgulandığında %54,9’u uyku, %39,2’si beslenme ile ilgili değişiklik bildirmiştir. Hastaların pandemi öncesindeki KGİ-Şiddet puanı 3,37±0,87, pandemi dönemindeki ise 3,74±0,89 olarak değerlendirilmiştir. Sonuç: Okul öncesi yaş grubunda en sık saptanan yakınmalar sinirlilik, kaygı artışı ile uyku ve beslenme düzeni değişiklikleri olmuştur. Çalışmamız pandemi sürecinden etkilenme düzeylerini tespit etmek açısından yol gösterici olmuş ve çocuklara yaş gruplarına uygun bilgilendirmeler yapılmasının, Teletıp yolu ile tedavi ve takiplerinin devam etmesinin gerekliliği vurgulamıştır.

Amaç: Bu çalışmada kronik tıbbi hastalığı olan psikiyatrik takipteki çocuk ve gençlerin pandemi ile ilgili uyum süreci ve psikiyatrik belirtilerindeki değişikliklerin Teletıp uygulaması ile değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya, Konsültasyon Liyezon Polikliniği’nde takipli, 0-18 yaş arasındaki olgular dahil edilmiştir. Olgular randevularının oldukları gün ve saatlerde, Teletıp yolu ile aranarak ebeveyn ve kendileri ile psikiyatrik görüşme yapılıp son durumları değerlendirilmiştir. Pandemi ile ilgili uyum sürecini araştırmak amacıyla araştırmacılar tarafından hazırlanan anket soruları olgu ve ailelerine sorulmuş, cevapları olgu veri formuna kaydedilmiştir. Olguların pandemi öncesi Klinik Global İzlenim (KGİ) ölçeği puanları dosyalarındaki bilgilere göre, pandemi dönemindeki KGİ puanları da telefonla yapılan görüşme sonucuna göre kaydedilmiştir. Bulgular: Çalışmamıza katılan olguların %49’u (n=25) kız, %51’i (n=26) ise erkektir. En sık görülen kronik tıbbi hastalıklar nörolojik (%21,6, n=11) ve metabolik-genetik (%21,6, n=11) hastalıklar olarak tespit edilmiştir. Olgularımızda pandemi öncesi tespit edilen psikiyatrik tanılarda birinci sırada Dikkat Eksikliği/ Aşırı Hareketlilik Bozukluğu (%35,3), ikinci sırada Depresyon Bozuklukları (%17,6) ve Anlıksal Gelişimsel Bozukluk (Ağır Olmayan) (%17,6) gelmektedir. Olguların pandemi öncesi KGİ puanı 2,62±0,59, pandemi sürecindeki KGİ puanı 2,90±0,80 olarak değerlendirilmiştir. Aradaki fark istatistiksel olarak anlamlıdır (p=0,003). Evde sağlık çalışanı olup olmaması ve yakınlarında hastalıktan etkilenen birey olup olmaması ile KGİ puanı arasında anlamlı bir fark saptanmamıştır (p>0,05). Sonuç: Çalışmamız kronik tıbbi hastalığı olan ve psikiyatrik takipteki olgularda, pandemi sürecinde ruh sağlığının olumsuz etkilendiğini, sinirlilik ve kaygı gibi belirtilerde artma olduğunu ve immatür davranışlar, uyku düzeninde değişiklik gibi yeni ruhsal belirtilerin eklendiğini göstermesi bakımından önemlidir.

Objective: The aim of the presented study is to evaluate the adaptive process and psychiatric symptoms in the 7-12 age group followed-up with telemedicine interviews during the height of the pandemic. Method: Patients between the ages of 7-12 who were followed up in our outpatient clinic were called by telemedicine service at the appointment date. The questionnaire prepared by the researchers in order to investigate the adaptation process to the pandemic was administered, the answers provided by the patients and their families were recorded in the case data form together with Clinical Global Impression (CGI) Scale score appraised by the interviewing psychiatrist. Medical records pertaining to each patient were also reviewed, their psychiatric diagnoses, according to DSM 5 criteria and CGI scores recorded in their last face-to-face interviews during the pandemic period, were included in the case data form. Results: Fifty patients were included in the study. The mean age of the participants was 9.14±1.61 years. Attention deficit hyperactivity disorder (60%) was the most common psychiatric diagnosis detected in the participants before the pandemic, followed closely by anxiety and related disorders (20%) and specific learning difficulty (16%). The CGI scores of the cases before, and during the pandemic were 2.72±0.75, and 2.92±0.94, respectively. The difference between the mean scores was statistically significant (p=0.024). Conclusion: Our study emphasizes the importance of follow-up by telemental health practices in cases where face-to-face psychiatric interviews are not applicable, i.e., due to the risk of transmission of COVID-19 disease during the current pandemic

Objective: To compare the prevalence and correlates of overweight (OW) and obesity (OB) between autism spectrum disorder (ASD), intellectual disability (ID), and attention deficithyperactivity disorder (ADHD) and to investigate which variables significantly contribute to OW/OB in each group. Methods: Of 267 cases (96 with ASD, 80 with ID, and 91 with ADHD) aged 2-18 years, body mass index (BMI) percentiles, birth weight, food reward usage, weekly screen and physical activity time, and psychotropics used were recorded. Results: OB (OB + OW) prevalence was 22.9 % (36.4 %) in ASD; 22.5 % (40 %) in ID; and 17.6 % (27.5 %) in ADHD. Although the ADHD group had the highest rate of stimulant usage (chi 2 = 69.605, p < 0.001), physical activity attendance (chi 2 = 49.751, p < 0.001), and the lowest anti-psychotic (chi 2 = 69.142, p < 0.001), and anti-depressant usage (chi 2 = 7.219, p < 0.001) than ID/DD or ASD, BMI percentile of the participants did not differ between the groups (H(2) = 1.652, p = 0.43). In hierarchical logistic regression analysis, in ASD, food reward (OR = 4.65, 95 %Cl = 1.25-17.19) and the number of psychotropics used (OR = 2.168, 95 %Cl = 1.07-4.36) were significantly related to the risk of OW/OB. In ADHD, each drugs administered and a 1-kilogram elevation in birth weight was associated with a 4.09 and 2.82 increased risk for OW/OB. Conclusion: OW/OB is prevalent in children with neurodevelopmental disorders regardless of their diagnosis. Our findings showed that food rewards put a higher risk for OW/OB in ASD than administering a psychotropic. It could be better to use other positive reinforcements other than edible ones to prevent OW/OB in these children.

Objective: The aim of this study was to examine the sociodemographic characteristics, psychiatric diagnoses and factors associated with psychiatric diagnoses of children and adolescents who are victims of sexual abuse. Method: The files of 92 children and adolescents aged between 0-18 who were referred to University Hospital Child and Adolescent Psychiatry Forensic Policlinic between January 2017 and December 2019 due to sexual abuse were evaluated retrospectively. Psychiatric diagnoses of the cases were made according to DSM 5 diagnostic criteria. Intellectual capacity of the cases was evaluated according to the latest verison of Wechsler Intelligence Scale for Children. Results: In our study, 78 (84.8%) cases were female and 14 (15.2%) were male. Mean age of the cases was 14.1±3.88 years. The most common type of sexual abuse was touching (52.2%, n=48). There was a psychiatric diagnose in 50 (54.3%) of them. The most common psychiatric diagnoses were posttraumatic stress disorder (n=29, 31.5%) and major depressive disorder (n=25, 27.2%). The rate of psychiatric diagnosis was significantly higher in cases exposed to coercion and violence (p=0.032). In 32 cases (34.8%), it was determined that the abuser was within the family. Conclusion: Sexual abuse has an effect on child’s development throughout life.In our study, the rate of psychiatric diagnosis was high. It is very important to provide the necessary psychiatric support to the victims of sexual abuse. With the studies to be done in this area, awareness can be increased and necessary precautions can be taken.

Objective: In this study, we aimed to evaluate the impact of Covid-19 pandemic on children with neurodevelopmental disorders through Tele-Medicine system. Method: Children aged between 7-18 years old with neurodevelopmental disorders were evaluated. On the routine control visit day, they and their parents were called by phone via the Tele-Medicine system and a questionnaire prepared by the researchers was applied to evaluate the compliance process to the pandemic. The disease severity of the cases was evaluated by the Clinical Global Impression Scale. Results: In our study, 17.6% of the cases were girls and 82.4% were boys. The average age is 11.66±3.46 years. In this study 51% of the cases were diagnosed with Autism Spectrum Disorder;47.1% with Intellectual Disability and 17.6% with Special Learning Disorder. The comorbidity of Attention Deficit and Hyperactivity Disorder was found to be 49%. Increased anxiety is reported by 25.5% of the cases, appetite and nutritional problems by %37.3 and sleep pattern changes by 62.7%. Pre-pandemic score of Clinical Global Impression Scale was evaluated as 3.82±0.81, and the score during the pandemic as 4.09±0.87. Discussion: It was found that, in the early period of the Covid-19 pandemic, the most common problems of the cases with neurodevelopmental disorder were the sleep pattern changes, appetite and nutritional problems and increased anxiety. It is thought that our findings will guide psychosocial support interventions for children and adolescents with developmental problems during the pandemic. © 2021 ANP Publishing. All rights reserved.

BACKGROUND AND OBJECTIVES:Acute disseminated encephalomyelitis (ADEM) is an immune-mediated, inflammatory and demyelinating disorder of the central nervous system. There have been a few studies in recent years on the fact that these cases have neurocognitive impairment. The purpose of this study is to evaluate the neurocognitive outcome and quality of life in cases with ADEM.METHODS:Eleven cases who were on follow-up between 2008 and 2017 were included in the study, systemic, neurological and psychiatric examinations were done. All magnetic resonance images were re-evaluated. The neuropsychiatric evaluation was performed by clinical examination and psychometric scales; (1) The Pediatric Quality of Life Inventory 4.0, (2) Child Behavior Checklist, (3) Children`s Depression Inventory, (4) The Wechsler Intelligence Scale for Children-Revised and (5) Continuous Performance Test. The cases in our study underwent neuropsychiatric evaluation 3-42 months after the diagnosis of ADEM had been established.RESULTS:Nine cases (81.8%) fully recovered without neurologic deficit. One case (9.1%) had a psychiatric disorder. During follow-up, cognitive and psychiatric problems were encountered in half of the cases (54.5%). Most of the cases with basal ganglia involvement (80%) displayed attention deficit and cognitive problems.CONCLUSION:In particular, cases with basal ganglia involvement should be followed carefully in terms of attention and cognitive problems.

Objective: The aim of this study was to investigate the factors associated with involvement in crime by examining the sociodemographic characteristics and psychiatric evaluation results of juvenile delinquents. Method: Files of 185 patients aged 12-18 years, were examined. Psychiatric diagnoses of the cases were made according to the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders-5. The intellectual capacity was evaluated with the Wechsler Intelligence Scale (WISC-R) for Children-New Version and Thematic Apperception Test was used for getting an idea about their inner conflicts, emotions and psychological needs. Results: In our study, 93.0% (n=172) of the cases were male and 53.0% of the cases were dropped out of school. The most common crime type was theft (40.0%, n=74). There was a recurrent crime history in 31.4%. WISC-R Total IQ scores were significantly lower in the cases with recurrent crime history (p<0.001, 60.26±20.72). Psychiatric diagnosis was found in 61.1% and there was a significantly higher rate of psychiatric disorders in cases with a history of crime (p=0.011). The theme of offensiveness, aggression and anger in the Thematic Apperception Test was statistically significantly higher in those with a previous crime history (p=0.004). Conclusion: In our study, finding a relationship between recurrent crimes and psychopathology is meaningful. Psychiatric follow-up and treatment are important in terms of reducing the probability of committing crimes again and bringing them to the society.

Prodromal symptoms of bipolar disorder (BD) and early onset schizophrenia spectrum disorder (EOSSD) overlap. To date, there has been no study directly comparing the prodromal stage of both disorders. Thus, the current study is aimed at determining which prodromal symptom clusters differentiate BD and EOSSD. One hundred twenty one adolescents (33 BD-1, 30 EOSSD, 58 healthy controls) were evaluated for the presence of 79 prodromal symptoms, divided into 7 prodromal symptom clusters. Great than 2 subsyndromal manic symptoms and ADHD comorbidity were significantly more specific for BD than schizophrenia; brief limited intermittent psychotic symptoms (BLIPS) were more likely to be part of EOSSD. In contrast, attenuated psychotic symptoms, and negative symptoms were not specifically related to the diagnosis of EOSSD. In conclusion, subsyndromal manic symptoms, BLIPS, and ADHD might be useful for predicting the trajectory of an emerging affective disorder versus schizophrenia and thus valuable for early detection, and intervention strategies.