Adolescent Psychiatry Outpatient Clinic Research Articles

School Refusal and Determinants: Parental Psychopathology, Family Functioning, Attachment and Temperament

ABSTRACTIn the current study investigated the psychopathologies of parents, family functioning, child temperament characteristics, and attachment of kindergarten and primary school‐age children who were brought to the child and adolescent psychiatry outpatient clinic due to school refusal behavior. Fifty‐two children with school refusal and 64 children without school refusal and their parents participated in the current study. School Refusal Assessment Scale, Systemic Family Functionality Scale(SFFS), Family Harmony Scale(FHS), Kerns Secure Attachment Scale(KSAS), Temperament Scale for Children(TSC), and Depression Anxiety Stress Scales(DASS) for parents were used. It was determined that, compared to children without school refusal, the children with school refusal had lower KSAS score(mother)(p = 0.049), higher DASS‐stress and anxiety(mother) scores(p = 0.014 and p = 0.020, respectively), lower TSC‐Responsiveness/Reactivity subscale score (p = 0.005), lower SFFS‐intrafamilial support and SFFS‐intrafamilial connection scores (p = 0.002 and p < 0.001, respectively), and lower FHS‐total score (p = 0.002). It was determined that school refusal was 11 times more common in children who had difficulty adjusting to school in previous years. Each point increase in the SFFS‐intrafamilial connection score reduced school refusal by 30%. In the current study shows that among the interventions required for treatment, the family should also be targeted in addition to the child and adolescent. Therefore, it is essential to identify factors such as parents' psychopathology and their roles in the family, family functioning, and family harmony in school refusal. Because parents play a crucial role in both the development and maintenance of school refusal, using more parent‐targeted strategies or techniques is necessary to improve interventions.

Comparisons between obsessive-compulsive disorder and trichotillomania in terms of autistic traits and repetitive behaviors in adolescents

Background Our study aims to reveal the relationship between autistic traits and repetitive behaviors in adolescents diagnosed with obsessive-compulsive disorder and trichotillomania and to compare them to healthy controls. Method A total of 100 adolescents, 33 of whom were diagnosed with obsessive-compulsive disorder, 32 of whom were diagnosed with trichotillomania and 35 healthy controls, aged 11-18 years, who applied to a Child and Adolescent Psychiatry Outpatient Clinic between February 2023 and July 2023, were included in the study. Participants were evaluated with the Autism Spectrum Quotient (AQ)-Adolescent, Repetitive Behavior Scale-Revised (RBS-R), Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and Clinical Global Impression Scale-Severity (CGI-S). SPSS 25.0 program was used in the analysis. p < 0.05 was accepted as the significance level. Results It was found that adolescents diagnosed with obsessive-compulsive disorder and trichotillomania had higher autistic trait levels compared to healthy controls, while there was no significant difference between the obsessive-compulsive disorder and trichotillomania groups. While stereotypic, routine, sameness, and restricted repetitive behaviors were more common in the obsessive-compulsive disorder and trichotillomania groups as opposed to healthy controls, it was found that compulsive behavior was more common in the obsessive-compulsive disorder group, and self-injurious behavior was more common in the trichotillomania group compared to healthy controls. Conclusion The findings of our study indicate that adolescents diagnosed with trichotillomania, similar to those with obsessive-compulsive disorder, have a higher level of autistic traits and repetitive behaviors. The authors believe it is crucial to focus on the social skill difficulties these adolescents may be experiencing.

Peer Bullying and Psychiatric Diagnoses in Adolescents with Nonsuicidal Self-Injury

Objectives The aim of this study was to determine the comorbid psychiatric diagnoses, peer bullying rates and NSSI characteristics in adolescents who engage in self-injuring behavior. Materials and Methods This case-controlled cross-sectional study was conducted between 1 March 2020 and 1 May 2021 in the Child and Adolescent Psychiatry and Paediatrics outpatient clinic of a hospital in the Southeastern Anatolia region of Turkey. The data of 50 adolescents with NSSI and 60 adolescents without NSSI attending school were compared. The data in the study were obtained using sociodemographic form prepared by the researchers, the Affective Disorders and Schizophrenia Interview Schedule for School-Age Children—Present and Lifetime Version—Dsm–5, Peer Bullying Scale Adolescent Form and Self-Injurious Behaviour Assessment Inventory. Results Fifty adolescents (70% female) with a mean age of 15.4 years (S.D. = 1.4) with NSSI were included as case group and 60 adolescents (66.7% female) with a mean age of 15.5 years (S.D. = 1.3) without NSSI were included as control group. Banging/hitting self was the most common NSSI method, while affect regulation was the most common function. In the case group, verbal, isolation and damage to belongings among the victim subtypes in the last year were found to be significantly higher than in the control group. It was found that there was a positive correlation between the variety of self-injury methods and bullying exposure scores in adolescents with NSSI. Depression disorders, anxiety disorders, oppositional defiant disorder, attention deficit hyperactivity disorder, conduct disorder, and post-traumatic stress disorder diagnoses were found to be more prevalent in the group with NSSI. Conclusions Based on the finding, it was found that psychiatric diagnoses are more common in adolescents with NSSI, peer bullying subtypes are seen at a higher rate, and as bullying scores increase, the variety of NSSI methods also increases. It is thought that providing psychiatric evaluation and treatment for adolescents with NSSI, establishing cooperation with school and family for peer bullying, developing preventive mental health policies and effective intervention programmes may be beneficial.

Abuse and Neglect of Children With Specific Learning Disorders in Türkiye: A Case-Control Study.

Although it is often stated that children with special needs are at risk of being abused and neglected, research conducted on the abuse of children with specific learning disorders (SLDs) is limited. This case-control study aims to compare exposure to neglect and abuse among children diagnosed with SLDs (case group) and children with typical development (control group). The study included children aged 6 to 12 years who were referred to the Child and Adolescent Psychiatry Outpatient Clinic and Pediatric Clinic of a hospital in Türkiye. The data collection process included 196 participants and lasted for 7 months in 2020. Based on the analysis of the data collected with the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Turkish Version (K-SADS-PL-T) and the Abuse Assessment Questionnaire, we determined that children with SLDs were physically and emotionally abused more than the children of the control group. In addition, they witnessed violence between their parents more than the control group. Physical abuse, emotional abuse and witnessing family violence were identified as significant predictors for SLD. The presence of SLDs is a significant risk factor for children to be exposed to abuse even in the absence of ADHD as a comorbidity.

CHARACTERISTICS AND PATTERNS OF PSYCHIATRIC ILLNESS AMONG CHILDREN AND ADOLESCENTS AT A TERTIARY CARE HOSPITAL IN KARACHI PAKISTAN

Objective To assess the patterns of psychiatric illness among children and adolescents presented at psychiatric clinic of a public sector teaching hospital in Karachi, Pakistan. Study Design A cross sectional study Place and Duration of the study The study was conducted at the Child and Adolescent Psychiatry outpatient clinic of the National Institute of Child Health (NICH) in Karachi, during February 2019 to October 2019. Methodology Using consecutive, non-probability sampling, all male and female participants, age less than 18 were recruited from the study setting. Data collection was done using a pre-designed semi-structured proforma. The data was analyzed using descriptive statistics. Results A total of 250 pediatric patients visiting the psychiatric clinic were enrolled in this study. These included 161 (64.4%) males and 89 (35.6%) females. Mean age was 9.55 ±3.374 years. 31 (12.4%) patients reported directly to the psychiatry clinic while 160 (64%) patients were referred from pediatric medicine clinics. The remaining 59 (23.6%) patients were referred from adult psychiatry clinics. 126 (50.4%) were diagnosed to have stress and related disorders, 85 (34%) patients were diagnosed with neurodevelopmental disorders. About 5 (2%) patients were diagnosed with psychotic and mood disorders, 34 (13.6%) were diagnosed with other nonspecific disorders. Conclusion The study reveals a male predominance among children and adolescents at a public sector hospital, with a high referral rate from pediatricians. The diverse mental health issues include stress, neurodevelopmental, and other diagnoses, highlighting the need for deeper investigation and targeted clinical attention.

Being the Mother of a Special Child: Resilience and Marital Adjustment in Mothers of Children with Autism Spectrum Disorder.

This study aims to examine the levels and the relationship between resilience and marital adjustment in mothers of a child diagnosed with autism spectrum disorder. Seventy mothers with a child diagnosed with autism spectrum disorder who have been followed up in the Child and Adolescent Psychiatry Outpatient Clinic of Bakırköy Training and Research Hospital for Psychiatry Neurology and Neurosurgery and 74 mothers with a typically developing child to form the control group were included in the study. The Childhood Autism Rating Scale was applied to assess the severity of autism symptoms in children. Sociodemographic form, Beck Depression Scale and Beck Anxiety Scale were applied. The Psychological Resilience Scale for Adults was used to assess resilience. The Marital Adjustment Scale was applied to evaluate the participants' marital adjustment. The level of resilience (P < .001) and marital adjustment (P = .002) in mothers of children with autism spectrum disorder were found to be lower when compared to mothers with a typically developing child. There is a negative correlation between the level of resilience and the severity of autism (P = .002) (r = -0.361). A positive correlation was found between marital adjustment and resilience (P < .001) (r = 0.465). High levels of depressive symptoms (P = .003), low marital adjustment (P = .003), and low educational level were found to be predictive of low resilience (P = .044). Taking advantage of the fact that resilience is a dynamic process, there is a need to develop strategies to increase resilience in mothers of children with autism spectrum disorder, which will also give rise to individual and marital well-being.

Adolescent smoking patterns: Associations with sociodemographic factors, cyberbullying, and psychiatric diagnoses in an outpatient clinical sample

There is a scarcity of research on smoking in adolescents within a clinical (outpatient) sample, and there is no existing knowledge on the relationship between cyberbullying and smoking in this population. The primary aim of this study is to determine the prevalence of smoking among adolescents in a clinical sample. Additionally, it aims to examine the potential associations between smoking status and factors such as socioeconomic characteristics, psychiatric diagnoses, and cyberbullying levels. A cross-sectional study was performed on 200 adolescents who visited a tertiary child and adolescent psychiatry outpatient clinic. Participants were assessed using the DSM-5 based psychiatric evaluation, the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-DSM-5 Turkish Adaptation (K-SADS-PL-DSM-5-T), the Revised Cyber Bullying Inventory-II, and the Fagerström Test for Nicotine Dependence. The study found that 21% of the sample consisted of regular smokers, with a higher prevalence observed among older adolescents. The prevalence of depression and disruptive behavior disorders was significantly greater in the smoking group compared to other groups (p:0.043, p < 0.001, respectively). There was a significant difference in the scores for the cyberbullying bully subdimension among smokers (p = 0.013). The results of the multinomial logistic regression analysis indicated significant associations between smoking and age, maternal smoking status, friends smoking status, and a diagnosis of disruptive behavior disorder (p < 0.05 for all variables). This study reveals a significant prevalence of adolescent smoking in an outpatient clinic. These findings highlight the necessity of implementing focused smoking cessation interventions for this specific population.

The effect of internalized stigmatization on care burden in adolescent psychiatric patients and their parents.

The purpose of this study was to determine the effect of internalized stigma perceived by adolescents with mental disorders and their families, on the burden of care on their families. The study was conducted in a descriptive and correlational desing with adolescents and their parents who applied to the child and adolescent psychiatry outpatient clinic between March 1 and June 1, 2022. A total 101 adolescents and 101 parents who met the sampling criteria and agreed to participate in the study. Only 1 parent per adolescent was included in the study. It was found that the mean age of the adolescents was 15.05 ± (1.80), 57.4% were female and 56.4% were secondary school graduates, and 26.7% of the adolescents, all of whom were unemployed, were diagnosed with a mood disorder, 50.5% had received outpatient treatment previously, and 22.8% had chronic diseases. It was found that the mean age of the parents who participated in the study was 45.53 ± (6.48), 77.1% were female and 28.7% were secondary school graduates. Also, 22.8% of the parents had a chronic disease, 28.7% had a chronic disease in their family and 32.7% had another family member in need of care, and 17.0% of the parents had received training on mental disorders previously. It was found that the parents' total means ZBI score was 42.74 ± (11.92). When the ZBI total scores were examined in terms of sociodemographic variables, no significant differences were found between the groups according to the variables. There was only a weak, positive and significant relationship between the age of the parents and in the present study, it was found that adolescents with mental disorders and their families experienced internalized stigmatization and this stigmatization increased the care burden on parents. Mental health and psychiatric nurses can facilitate this population's access to treatment by planning and implementing psychosocial interventions to reduce the internalized stigma of children and adolescents and their families.

Investigation of Sociodemographic and Clinical Characteristics of Forensic Cases Admitted to a Child and Adolescent Psychiatry Outpatient Clinic in Şanlıurfa

Objective: In this study, we aimed to evaluate the sociodemographic and clinical characteristics of children and adolescents for whom forensic reports were requested by judicial authorities for various reasons. Materials-Methods: The records of 110 cases referred to our hospital’s Child and Adolescent Psychiatry Department for forensic psychiatric evaluation between January 2022 and December 2022 were evaluated retrospectively. Sociodemographic data of the cases, clinical diagnoses, contents of forensic events, and forensic report decisions were included in the analyses. Results: The mean age of the 110 patients participating in the study was 14.5 ± 2.9 years and 68.2% (n=75) of the cases were male. The judicial authorities directed the cases most frequently (n=53) for evaluating discrimination under the Turkish Penal Code 31/2, and it was determined that crime against property (41.5%) was committed most frequently. Considering the distribution of perpetrator and victim status by gender, a significant difference was found between the two genders (p&amp;lt;0.001). Conclusion: Determining regional differences regarding individual and familial characteristics of child and adolescent forensic cases may contribute to the determination of factors that may adversely affect children's mental health and to the development of preventive mental interventions.

Düzce İli’nde Çocuk ve Ergen Psikiyatri Polikliniğine Başvuran Çocuk ve Ergenlerin Sosyodemografik ve Klinik Özellikleri

Aim: In our study, it was aimed to examine the sociodemographic characteristics, symptoms, psychiatric disorders of children and adolescents who applied for the first time to a university hospital child and adolescent psychiatry outpatient clinic.&#x0D; Material and Methods: The files of 724 children and adolescents who applied to our outpatient clinic were reviewed retrospectively. 211 patients evaluated for the first time in our outpatient clinic were included in the study. Sociodemographic characteristics, first admission complaints, psychiatric diagnoses and treatments of the patients were evaluated.&#x0D; Results: The mean age of the patients included in the study were 9.90±4.07 years. It was determined that 117 (55.5%) of the patients had a previous psychiatric diagnosis. The most common complaints at presentation were attention deficit/hyperactivity (45%), irritability (20.4%), and fear-anxiety (15.2%). It was determined that 191 (90.5%) of the patients had at least one psychiatric disorders and 49 (23.2%) had at least two psychiatric disorders. The most common psychiatric disorders were ADHD (54.9%), AD (20.4%), BD (10.4%) and MDD (8.3%). It was determined that 46% of the patients received psychiatric treatment, and methylphenidate (62.9%) was the most common use.&#x0D; Conclusion: In our study, the most common complaint of the patients was attention deficit/hyperactivity, and the most common diagnosis was ADHD. Our results are similar to other studies. The presence of comorbidity increases the severity of the disorders and causes serious deterioration in psychosocial functionality. Diagnoses between genders and comorbidities should be carefully evaluated in patients applying to child and adolescent psychiatry.

Student Threats of Violence Often Signal Underlying Psychiatric Disorders

Student Threats of Violence Often Signal Underlying Psychiatric Disorders

Parents' Awareness of Bullying Involvement in Relation to Physician Practices: Implications for Practice Modifications.

Background Bullying is a complex abusive behavior with potentially serious consequences. Persons who bully and those who are bullied have consistently been found to have higher levels of depression, suicidal ideation, physical injury, distractibility, somatic problems, anxiety, poor self-esteem, and school absenteeism than those not involved with bullying. Objectives To our knowledge, no study has compared physicians' practices of bullying prevention across different hospital settings and the effect of these practices on parents' level of awareness. This article represents a subset (phase I) of the inter-departmental quality improvement study for comparing practices of healthcare professionals regarding bullying prevention between the pediatric outpatient clinic and child & adolescent psychiatry outpatient clinic, and parents' awareness about provider's anti-bullying practices. Methods Phase I was conducted as a cross-sectional study with the target population of adolescents (age 12-17 yrs) and corresponding guardians, seeking care from healthcare providers (residents, fellows and attendings) in the child & adolescent outpatient psychiatry clinic and pediatric outpatient clinic. It targeted both patients and providers, with adolescents/guardians completing questionnaire about bullying experiences, physician's anti-bullying practices during past healthcare visits and adolescent Peer Relations Instrument. Providers answered questions about bullying assessing practices, level of self-preparedness and limitations. Results Data were analyzed in SAS 9.2 (SAS Institute Inc., Cary, NC) and SPSS (IBM Corp., Armonk, NY) and Chi-square tests were used for analyses of variables, and cross-comparing results for particular subsets. A total of 150 questionnaires were distributed. Among the provider surveys, self-reported level of preparedness (on a scale of 1-5; 1- least, 5-most) for assessing bullying was more in Psychiatry providers (Median 4, Mean 4.1) as compared to Pediatric providers (Median 3, Mean 2.9). In the first evaluation, very unprepared, unprepared and neutral (1, 2, 3) responses were contrasted with prepared to very prepared responses (4,5).The second evaluation excludes the neutral responses (3) and tests responses for the unprepared group (1,2) with the prepared group (4,5).The first evaluation resulted in Chi-Squared = 6.810, significant at p = 0.05 and the second evaluation resulted in Chi-squared = 4.774, also significant at p = 0.05. Conclusions This study identifies differences in healthcare professional's anti-bullying practices and helps in identifying limiting factors. This identification of the practice gap helps in developing interventional strategies to improve the assessment of bullying situations across specialties.

Factors Associated with Anxiety Disorders in Chinese Children with Autism Spectrum Disorder in Hong Kong

Background: Autism Spectrum Disorder (ASD) is a pervasive neurodevelopment disorder characterised by impairment in social communication and presence of restricted, repetitive patterns of behaviour, interests, or activities. A growing body of research has shown that children with ASD experience significantly greater anxiety levels than typically developing children. Anxiety disorders have been found to be one of the most prevalent psychiatric comorbidities in this population of children and are associated with debilitating psychosocial impairment. Objective: This study aimed to examine factors associated with anxiety disorders among Chinese children diagnosed with ASD in Hong Kong. Methods: This cross-sectional study was conducted at a child and adolescent psychiatry outpatient clinic from August 2019 to April 2020. The sample consisted of one hundred thirty-two subjects aged 6 to &lt;12 years who had a diagnosis of ASD. Structured interviews and questionnaires including the Diagnostic Interview Schedule for Children, Parenting Stress Index-Short Form, Parenting Styles and Dimensions Questionnaire and a socio-demographic questionnaire were administered for the assessment of anxiety disorders and their associated factors. Results: Greater qualitative deficits in reciprocal social interaction skills, attention-deficit/hyperactivity disorder and maternal mood disorder were found to be significantly associated with anxiety disorders in children with ASD. Conclusion: Anxiety disorders are prevalent among children with ASD. Early recognition and identification of comorbid anxiety disorders are necessary in the diagnostic process of ASD. This study enriches our understanding of the factors associated with anxiety disorders in this population of children. For future research directions, furthering our understanding on the aetiological pathways, course of illness, and outcome of anxiety disorders in autistic children is highly warranted.

The Psychometric Properties of the General Phubbing Scale in Adolescents

Purpose: Numerous studies indicate that the use of smartphones among adolescents has increased recently. Studies on phubbing generally focus on how parental phubbing affects adolescents. This study aims to contribute to the literature by revealing the validity and reliability of the scale measuring phubbing behavior in adolescents.&#x0D; &#x0D; Material and Methods: The sample included 206 adolescents aged 12-17 who applied to Pamukkale University Medical Faculty Hospital Child and Adolescent Psychiatry Outpatient Clinics and Kırıkkale Yüksek İhtisas Hospital Child and Adolescent Psychiatry Outpatient Clinic.&#x0D; &#x0D; Results: To evaluate the construct validity of the General Phubbing Scale (GPS) in adolescents, first and second level confirmatory factor analyses were performed. The data model fit was shown to be at an acceptable level. The general phubbing was negatively related to social connectedness and positively related to internet addiction. Test-retest analysis indicated that the subdimensions nomophobia, interpersonal conflict, self-isolation, problem acceptance, and total score were 0.82, 0.80, 0.71, 0.66 and 0.81, respectively. The coefficients of internal consistency for the subdimensions of nomophobia, interpersonal conflict, self-isolation, problem acceptance, and total score were 0.78, 0.85, 0.92, 0.77, and 0.94. Furthermore, it has been shown that the GPS structure was identical for both genders.&#x0D; &#x0D; Conclusion: This study demonstrated that the GPS can be used as a valid and reliable measurement tool for determining general phubbing levels for the clinical adolescent sample.

Motivational Interviewing Technique As a Means of Decreasing Vaccine Hesitancy in Children and Adolescents During the COVID-19 Pandemic

IntroductionVaccine hesitancy is a known phenomenon predating the COVID-19 pandemic. Vaccine hesitancy is a significant factor effecting the control and spread of the COVID-19 Virus. Hesitancy of parents choosing not to vaccinate their children is studied here. Also studied is the effect of a brief motivational interviewing intervention on the parent’s decision to vaccine their child, or not. What was found was a myriad of beliefs and values in the parents, and varied reactions and outcomes in response to the motivational interviewing.ObjectivesThe aim of our study is to determine whether motivational interviewing techniques can be used as an effective tool to educate patients and their families about the benefits of vaccination against COVID-19 and increase vaccinations rates. In our urban community hospital-based child and adolescent psychiatry outpatient clinic, we found a high level of vaccine hesitancy among our patient population. As motivational interviewing is an evidence-based approach to addressing ambivalence and behavior change, we sought to engage parents with this approach.MethodsThis is a quality improvement project where chart review of all pediatric patients currently enrolled in our clinic was performed to determine which patients are unvaccinated for COVID-19. Telephone contact was made to reach parents to obtain verbal consent and to deliver the intervention consisting of standardized motivational interview techniques followed by brief educational points about the vaccines. Follow up calls were made one week later to determine whether there was any change in readiness to consider vaccination on a scale from 1-10. We reached a total of 29 parents on initial outreach, and 11 parents during the follow up phase. Many were lost to follow up due to unavailability or refusal to participate further.ResultsParents (N = 11, 5- African American, 6- Hispanic) reported on their decision to have their child (mean age=12.2, 55% Female) receive the covid-19 vaccine. Preliminary findings show an increase in readiness on a scale from 1-10 to receive the vaccine following a one week interval post intervention (t(10)=2.096, p=.06), with the most common barriers that subjects endorsed being fear of side effects, skepticism regarding the speed at which the vaccines were developed, and wanting to allow their children to decide for themselves.ConclusionsWe found that there was an overall improvement in vaccine hesitancy following our intervention, though it did not cross the threshold of statistical significance. We also identified common reasons given for hesitancy within our community. Motivational interviewing is a promising intervention to address vaccine hesitancy. Further study is warranted as expanding the reach of such interventions could lead to more robust data as well as broader vaccine acceptance.Disclosure of InterestNone Declared

Health promotion partnership to promote physical activity in Swedish children with ASD and ADHD.

Children with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) have a higher risk of inactivity, and efforts to promote physical activity among this population have been limited. Physical activity on prescription (PAP) may be a suitable tool for motivating participation in physical activity among children with these diagnoses. However, PAP calls for synergy and partnership between health care and other sectors of the community. The aim of this study was to describe a health promotion partnership for physical activity targeting children with ASD or ADHD. Data were obtained through individual interviews with professionals at CAP (n = 11) and three focus-group interviews with coaches from local sports clubs. We used the Bergen Model of Collaborative Functioning as the theoretical framework and used qualitative content analysis as the method of analysis to study partnerships between professionals from the Child and Adolescent Psychiatry outpatient clinic (CAP) and coaches from local sport clubs. The findings demonstrate that the partnerships included both positive and negative processes. Although the two partners shared values regarding the project, such as working for a good cause for the children and seeing the potential in the collaboration, there were doubts about sharing common resources and uncertainties about the sustainability of the PAP project. Challenges remain and further research is needed into developing, monitoring and evaluating health promotion partnerships when promoting physical activity for all.

Evaluation of Sociodemographic and Clinical Characteristics of Children Diagnosed with Selective Mutism in Child and Adolescent Psychiatry Outpatient Clinic

Evaluation of Sociodemographic and Clinical Characteristics of Children Diagnosed with Selective Mutism in Child and Adolescent Psychiatry Outpatient Clinic

Anksiyete Bozukluğu Tanılı Ergenlerin Belirtileri Açısından Ergen-Ebeveyn Uyumu

Aim: Considering the role of the parent in the children and adolescent's access to treatment, it is important that the symptoms are adequately noticed by the parents. In this study, it was aimed to examine the adolescent-parent agreement in terms of symptoms of adolescents with anxiety disorder.&#x0D; Material and Method: 100 adolescents who applied to the child and adolescent psychiatry outpatient clinic and were diagnosed with anxiety disorder according to the DSM-5 diagnostic criteria were included in the study. In the study, the sociodemographic form and the Revised Child Anxiety and Depression Scale (RCADS) adolescent and parent form were used for data collection.&#x0D; Results: When the parent and adolescent forms of RCADS were compared, the adolescent scores were significantly higher than the parents in all subscales and scale total scores, except for the separation anxiety subscale. The ICC (95% CI) value between the parent and adolescent forms of RCADS ranged from 0.06 to 0.74.&#x0D; Conclusion: In our study, it was found that adolescents scored their symptoms higher than their parents, and the correlation between parent-child reporting was low-moderate. Age, gender, comorbidity, and parental psychopathology were among the factors affecting adolescent-parent agreement.

A Case of Landau-Kleffner Syndrome with Autism Spectrum Disorder Symptoms Improved After Corticosteroid Treatment

Çok nadir rastlanan bir çocukluk-çağı hastalığı olan Landau-Kleffner Sendromu (LKS), elektroensefalogramdaki (EEG) epileptiform etkinlik ile ilişkili edinsel afazidir. Landau-Kleffner Sendromu’nun klinik görünümü bazı çocuklarda Otizm Spektrum Bozukluğu’na (OSB) benzeyebilir. Bu yazıda Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları (ÇRS) polikliniğine OSB belirtileri ile başvuran, ancak nörolojik tetkikler sonucunda LKS tanısı konulan, LKS medikal tedavisi sonrası nöropsikiyatrik semptomlarında belirgin düzelme gösteren bir vaka sunulmuştur. Dört yaş yedi aylık erkek çocuk, konuşmada gerileme, sosyal iletişimde azalma ve tekrarlayıcı davranış kalıpları şeklindeki yakınmaları ile ÇRS polikliniğine getirilmiştir. İlk olarak OSB tanısı konulmuş ve Çocuk Nöroloji’ye yönlendirilmiş olan vakanın yapılan nörolojik değerlendirmeleri sonrasında, hastaya LKS tanısı konulmuş ve antiepileptik tedavi başlanmıştır. Üç ay kadar kullanılan konvansiyonel antiepileptik tedaviden fayda görmeyen hastaya kortikosteroid tedavi başlanmış ve 1 ay içerisinde konuşma regresyonunda ve LKS’ye bağlı olan OSB belirtilerinde klinik olarak azalma görülmüştür, 3 ay içinde ise bu belirtilerde belirgin düzelme olduğu gözlenmiştir. Bu makalede, LKS’de konvansiyonel antiepileptik tedavi ile bilişsel ve dil fonksiyonlarında ve EEG patolojisinde düzelme olmayan vakalarda kortikosteroid tedavisiyle hem nöropsikiyatrik semptomlarında hem de EEG bulgularında hızlı düzelme sağlanabileceği bildirilmiştir. Alanyazında, LKS’de bilinen tedavilerin konuşma regresyonunu düzeltmede etkili olduğuna yönelik daha fazla bilgi olmakla birlikte, LKS’ye bağlı ortaya çıkan OSB belirtilerini azaltmasına yönelik çok az vaka bildirimi vardır.

The Relationship Between Body Mass Index Emotional Behavioral Problems and Prosocial Behaviours in Children and Adolescents

Çocuk ve ergen psikiyatrisi polikliniklerine başvuran çocuk ve ergenlerin beden kitle indekslerinin araştırılması ve bunların prososyal özellikler, duygusal ve davranışsal sorunlar ile olası ilişkisinin araştırılması, bir halk sağlığı sorunu olan obezitenin eşlik eden olumsuz etkilerini daha iyi anlamak ve çözümü için öneriler sunmak için önemlidir. Çalışmamızın amacı, çocuk ve ergen psikiyatrisi polikliniğine başvuran çocuk ve ergenlerin BKİ z-skoru ile prososyal becerileri, duygusal davranış sorunları arasındaki ilişkileri incelemektir. Çalışmamıza Bursa Uludağ Üniversitesi Tıp Fakültesi Hastanesine Haziran 2021-Eylül 2021 ayları arası Çocuk ve Ergen Psikiyatrisi polikliniğine başvurmuş 130 çocuk ve ergen hasta dâhil edilmiştir. Çalışma prosedürü, yazılı bilgilendirilmiş onam veren tüm katılımcılara sözlü olarak da anlatılmıştır. Çalışmanın etik kurul kararı Uludağ Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan alınmıştır. Hastalara tanısı; Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Şekli (ÇDŞG-ŞY) DSM-5 yarı yapılandırılmış görüşmesi Türkçe formu ile konulmuştur. Bireylerin duygusal güçlükleri ve prosoyal özellikleri, Güçler-güçlükler Anketi–Ebeveyn ölçeği ile değerlendirilmiştir. Hastaların BKİ ise aynı hemşire tarafından boy ve kilo ölçümleri ile yapılacaktır. Çalışmaya katılan çocuk ve ergenlerin yaş ortalaması 11.9+-3.74’dır.Cinsiyetlere göre bakıldığında katılımcıların %53,4 kız (n:63) kız cinsiyetindeydi. Çalışmaya katılanların %5,9 (n=7) obez, %12,7’i (n=15) aşırı kilolu, %12,7’si (n=42) normal kilolu, %37,3’ü (n=44) zayıf, %8.5’u (n=10) aşırı zayıf,olarak saptanmıştır. Cinsiyetler arasında obezite açısından fark izlenmedi (p=0,72). Çalışmamız pandemi döneminde başvuran ergenlerin prososyal özelliklerinin ve beden kitle indeksi ve, duygusal davranışsal sorunlar ve hastalıkları arasındaki ilişkiyi inceleyen bir çalışma olması bakımından önemlidir. Çocuk ve ergenlerde obezitenin yol açtığı olası sorunların tanınması eşlik edebilecek ruhsal sorunların öngörülmesi ve erken müdahalenin yapılması açısından önemlidir. Ayrıca uygun gereksinimlerin tanınması ve karşılanması koruyucu ruh sağlığı açısından önem taşımaktadır. Bu anlamda risk faktörlerini tanımlayan ve araştıran çalışmaların artması toplum sağlığı açısından önemli yer tutar.