Child Psychiatric Disorders Research Articles

2.52 New Potential Pharmacological Targets for Childhood Psychiatric Disorders Through Differential Modulation of Glutamate Receptors

2.52 New Potential Pharmacological Targets for Childhood Psychiatric Disorders Through Differential Modulation of Glutamate Receptors

Characterizing patterns of substance use in trauma exposed youth

ObjectivePrevious work investigating the impact of childhood trauma on substance use and co-occurring psychiatric disorders has primarily been conducted in adults or on specific trauma types. This limits understanding of traumas impact in childhood and how different types of traumas play a role. We sought to characterize substance use in a sample of trauma-exposed youth in the context of psychiatric comorbidities. Method1152 youth from the Texas Childhood Trauma Research Network (TX-CTRN) that were exposed to at least one trauma meeting DSM-5 Criterion A were assessed for current substance use and psychiatric diagnoses. Latent class analysis was used to identify patterns of substance use. To characterize these patterns, we examined if demographics, number of trauma types experienced, or childhood psychiatric disorders predicted class membership. ResultsWe identified four primary patterns of substance use: Non-use (66.1%), predominantly alcohol use (19.7%), predominantly cannabis use (4.5%), and polysubstance use (9.7%). Compared to the non-users, polysubstance users tended to be older, Non-Hispanic White, have experienced more types of trauma. They were also more likely to have fulfilled diagnostic criteria for suicidality and ADHD. Comparisons among the substance using classes were more nuanced. ConclusionThe findings highlight the need for universal assessments of trauma, substance misuse, and mental health symptoms in youth as the presence or absence of their co-occurrence has implications for treatment.

A depressão inerente à obesidade infantil: Revisão integrativa de literatura

Background. Depression is a very common psychiatric disorder in children with childhood obesity (OI) at school age and adolescence, since this pathology is a chronic disease that has increased in recent years, including in the pediatric population, and has become a public health problem. Objective. To assess the likelihood of developing depression as a result of childhood obesity. Also, to verify the most frequent causes. Methods. This is an integrative review, whose research was carried out through the Scientific Electronic Library Online (Scielo), Medical Literature Analysis and Retrieval System online (MEDLINE) and Elsevier via ScienceDirect platforms in search of scientific articles to analyze data and prepare the study, with the target audience being between 5 and 17 years old. The research took place between September and November 2020. Results. A high incidence of developing depression in obese children and adolescents was found, with a higher prevalence in females. Conclusion. It is therefore of the utmost importance to discuss the psychological consequences of obesity in pediatrics, as this disease brings comorbidities and affects mental health, developing, for example, depression.

Nerve Growth Factor and Angiotensin Converting Enzyme 2 Levels in Children with Neurodevelopmental Disorders

Objective Neurodevelopmental disorders (NDDs) are the most common psychiatric disorders in childhood, and there are many factors in their etiology. In recent years, many biomarkers have been studied to elucidate the etiology of these disorders. In this study, it was aimed to investigate the levels of nerve growth factor (NGF) and angiotensin converting enzyme 2 (ACE2) in attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID). Methods The study included 74 children with NDDs (the number of patients in ADHD, ASD and ID groups were 24, 25 and 25 respectively) and 30 healthy controls (HCs). Serum NGF and ACE2 levels were studied with ELISA kits, also complete blood count (CBC), levels of fasting glucose and serum lipids were assessed. Results ACE2 levels were found to be lower in NDD group than HCs in girls. In boys with ASD, triglyceride levels were significantly higher than other groups. Also a positive correlation was found between ACE2 and NGF levels when all sample assessed together. Conclusions This study is a premise for investigating ACE2 and NGF in NDDs. The role of these markers in ADHD, ASD, ID and other NDDs and their associations with gender should be assessed by studies in which both larger sample groups and more disorders.

Environmental Factors Related to Quality of Life of Parents of Children with Autism Spectrum Disorder : A Scoping Review

Introduction: Concerns about the quality of life (QoL) of parents of children with autism spectrum disorder have been raised by previous study. Policy decision-makers and healthcare professionals can be better informed about the environmental factors associated with parental QoL, which will enhance outcomes for both parents and children. The objective of this review is to perform a comprehensive review that assessed the environmental relevant factors associated with quality of life (QoL) of parents of ASD children (under 18 years old). Methodology: To identify the environmental factors associated with parental QoL, a scoping review was conducted using the Arksey and O'Malley original and enhanced framework. Three electronic data bases (PubMed, Scopus & WOS) and reference list checks were used in the search. Results: Social support, family support, residential condition and access to services were all factors linked to parental quality of life in this group. Conclusion: The review clarified environmental factors as one of variables that have association with parental QoL. The results of this analysis also highlighted potential areas of support that have implications on future policy and practices. Keywords : environmental factors, autism spectrum disorder, quality of life, parents, children References CDC. Prevalence of autism spectrum disorders--Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. MMWR Surveill Summ. 2012;61(3):1-19. CDC. Prevalence of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveill Summ. 2014;63(2):1-21. Elsabbagh M, Divan G, Koh Y-J, Kim YS, Kauchali S, Marcín C, et al. Global Prevalence of Autism and Other Pervasive Developmental Disorders. Autism Research. 2012;5(3):160-79. McTiernan A, Leader G, Healy O, Mannion A. Analysis of risk factors and early predictors of challenging behavior for children with autism spectrum disorder. Research in Autism Spectrum Disorders. 2011;5(3):1215-22. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008;47(8):921-9. Bolton PF. Medical conditions in autism spectrum disorders. Journal of Neurodevelopmental Disorders. 2009;1(2):102-13. Khanna R, Madhavan SS, Smith MJ, Patrick JH, Tworek C, Becker-Cottrill B. Assessment of Health-Related Quality of Life Among Primary Caregivers of Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders. 2011;41(9):1214-27.

Risk factors associated with higher scores in internalizing and externalizing behaviors in Chilean preschoolers.

Early detection of behavioral disorders in children is necessary for intervention. Available data show a high prevalence of child and adolescent psychiatric disorders in Chile (22.5%), but behavioral problems in younger children have not been evaluated. This work assesses behavioral disorders in preschoolers and their association with sociodemographic variables of the family and the child. The data was collected during the impact assessment of the Biopsychosocial Development Support Program "Chile Crece Contigo", using a multistage and representative random sample of 1377 preschoolers, aged between 30 and 48 months, who attended public health services. Homes were visited to apply a questionnaire and the Child Behavior Checklist (CBCL, 1.5-5 years). Results: Multivariable regression model for total raw scores shows that child's age, the number of chronic diseases in the child, and history of exposure to mother's alcohol consumption in pregnancy, remain significant when adjusted for all variables included (R2 of 17.8% and η2 of .19 (95% CI: .14-.22)). In externalizing and internalizing explanatory models, child's chronic diseases and a higher score of authoritarian beliefs about parenting show the two largest effect sizes. These results add to the evidence of urgent problems in preschool mental health.

Effect of Mahapaishacika Ghrta in the Management of ADHD - Case Series

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most commonly diagnosed childhood psychiatric disorder. It is a neuro-developmental disorder characterized by problems in paying attention and hyperactivity–impulsivity which is inappropriate for the age of the child. Children with ADHD have been found to have Cognitive deficits, lower IQ, Impaired social relationships with in the family and with peers as well as poor study skills and lower academic achievement. The disease most commonly affects the children of age group 6 to 12. Despite being most commonly studied and diagnosed mental disorder in children, the cause is yet not known in majority cases. W.H.O. (World Health Organization) estimated that it affected 39 million people as of 2013. ADHD prevalence is estimated to be 5% for the Indian pediatric population. 5 to 7% children are getting affected with similar rates in various countries. It is found more commonly in boys than in girls (ratio 3:1). In Ayurveda, disorders related to psychiatric and behavioral disturbances are discussed under the chapter of Unmada. The cardinal features of ADHD resemble features of Vata-pitta predominant Unmada. This disorder affects mind as well as body because of having Adhishṭhana in both Sharīra and Mana. Five diagnosed cases of ADHD from OPD of Manassanthi, Vaidyaratnam P S Varier Ayurveda College, Kottakkal, were given Mahapaishacika Ghrta in a dose of 10ml twice daily 1 hour after food for 1 month period. Severity of symptoms was assessed by using Conner’s Revised Rating Scale on 0th day, 16th day, 31st day and after 15 days. There was a significant improvement in the Conner’s Revised Rating Scale after Ayurvedic management and follow up.

Diagnostic efficiency and psychometric properties of CBCL DSM-oriented scales in a large sample of Chinese school-attending students aged 5–16

BackgroundChildren and adolescents are vulnerable to various psychiatric disorders during the critical phase of individual development. In China, the child behavior checklist (CBCL) is a widely employed psychometric questionnaire for assessing children and adolescents. However, further validation of the psychometric properties and diagnostic effectiveness of the CBCL DSM-oriented scales is necessary. These scales were developed based on DSM diagnosis and require evaluation using a substantial sample of Chinese individuals. MethodsThis study involved the analysis of a substantial dataset consisting of 72,109 samples collected from five provinces in China. Data was gathered using the CBCL (Parent Rating Scale), and rigorous assessments of reliability and validity were conducted. The mini-international neuropsychiatric interview for children and adolescents (MINI-KID) and the diagnostic and statistical manual of mental disorders-IV (DSM-IV) interview were employed to diagnose the participants. To ensure the accuracy of the diagnoses, receiver operating characteristic curve (ROC curves) were utilized, and the Youden Index was calculated to determine the appropriate diagnostic cut-off point for each specific target diagnosis. ResultsThe study included a total sample of 72,109 cases, out of which 19,782 cases underwent MINI-KID assessment and structured or semi-structured interviews based on DSM-IV to clarify the diagnosis. Reliability and validity analyses showed that the reliability of the subscales and total scales was good, except for Anxiety Problems. The Cronbach's alpha for the CBCL DSM-oriented scales was 0.92. In addition, the validity of all scales was good (CFI = 0.80). For the sample with a clear diagnosis, all five subscales of the CBCL DSM-oriented scales showed fair diagnostic efficiency for the target diagnosis. Among them, the area under curves (AUC) of Mood disorder, Anxiety, Attention deficit and hyperactivity disorder (ADHD), Oppositional defiant disorder (ODD) and Conduct disorder (CD) are 0.80, 0.74, 0.75, 0.74, 0.74. Among the three sample groups, the highest diagnostic efficiency was found in Affective Problems to Mania. The diagnostic cut-off point for each subscale on target diagnoses was clearly defined. ConclusionOverall, the reliability, validity and diagnostic efficiency of CBCL DSM-oriented scales in Chinese children and adolescents were within acceptable limits. In addition, we used ROC curves and cut-off points to predict the cut-off values of common child and adolescent psychiatric disorders mentioned in the CBCL DSM-oriented scales. This provides an important reference for the clinical application of the CBCL DSM-oriented scales in Chinese samples.

Role of Panchbhautika Taila Nasya in Socio-Behavioral Disorders - Ayurveda Perspective

Socio-behavioural disorders have a profound impact on affected individuals lives and society at large. The conventional treatment for child and adolescent psychiatric disorders often involves psychopharmacology, which may be associated with adverse side effects. Ayurveda, an ancient traditional system of medicine, offers a multidimensional therapeutic strategy to address these disorders. According to the classics, the unstable status of Mana, Indriya and Atma leads to many socio-behavioural disorders. To address this challenge, Ayurveda have given a multidimensional approach including Medhya rasayanas, Panchakarma procedures like Nasya and nonmedical treatment including Achara rasayana (rejuvenation through the right code of conduct) and Satvavajaya chikitsa. Panchbhautika taila nasya is mentioned in Kashyap samhita for increasing the strength of sensory organs This research article explores the efficacy of Ayurvedic Nasya therapy, particularly Panchbhautik Taila Nasya, as a potential intervention to enhance cognitive function and mitigate socio-behavioural abnormalities.

Fathers in the spotlight: parental burden and the effectiveness of a parental skills training for anorexia nervosa in mother–father dyads

PurposeResearch on the engagement of fathers in the treatment of childhood psychiatric disorders is scarce. This study aims to investigate differences between mothers and fathers of adolescents with anorexia nervosa regarding parental burden and effectiveness of a parental skills training.MethodsNinety-one mother–father dyads caring for a child with anorexia nervosa participated in an 8-week parental skills training and completed a set of questionnaires assessing parental psychopathology, eating disorder related burden, caregiver skills and expressed emotion at baseline and post-intervention.ResultsFathers showed lower levels of general psychological distress, depression, anxiety and eating disorder related burden as well as lower emotional overinvolvement compared to mothers. The skills training was effective in reducing parental psychopathology, eating disorder-related burden and emotional overinvolvement as well as in increasing caregiver skills with no differences between mothers and fathers. However, session adherence and the willingness to practice skills between the sessions were slightly lower in fathers.ConclusionsThese findings show that fathers are a great resource for the child’s eating disorder treatment as they may counterbalance maternal emotional overinvolvement and over-protection. Furthermore, this is the first study demonstrating that fathers can profit from a parental skills training for anorexia nervosa in a similar way as mothers.Level IIIEvidence obtained from well-designed cohort or case–control analytic studies.

Homoeopathy for Reducing Disruptive Behavioural Symptoms in Children with Conduct Disorder-

Background: Conduct disorder (CD) and associated antisocial behaviour is one of the most common behavioural problems in children and young people that lead to considerable burden for the patients themselves, their family and society. There is scarcity of literature for effectiveness of homoeopathic medicines in childhood psychiatric disorders such as CD.
 Summary of cases: 10 children diagnosed as CD, five each from Child psychiatry OPD and Peripheral camp at a Children’s home were treated with individualized homoeopathic medicines. All the cases were assessed at baseline and successive visits with Conduct Disorder Rating Scale (CDRS)- Parent version and the results are summarized. There was a marked reduction of disruptive behaviour and improvement in the general condition of the children.
 Conclusion: The analysis of 10 cases generates a preliminary evidence for usefulness of individualized homoeopathic medicines in the management of CDs. Studies with appropriate designs are indispensable to corroborate the evidence.

Mental health and help-seeking of parents of children with psychiatric illness

Background: A child with significant mental health problems evokes significant stress for the parent. We interviewed parents about their help-seeking experiences for the child's problem and assessed them for common mental health problems. Objectives: To study parental mental health in the presence of psychiatric illness in their child and to document pathways of care traversed before reaching the Psychiatrist Materials and Methods: After Institutional Ethics Committee's permission, we assessed the parents of 35 children coming to child psychiatry Out-patient Department. A semi-structured proforma and Depression Anxiety Stress Scale–21 (DASS-21) were used. A descriptive analysis of continuous and nominal variables was done, followed by comparative statistics. Results: Thirteen out of 35 parents (37.14%) had significant mental health problems,10 of them were moderate to severe. Distressed parent often had a child above 12 years of age (7 out of 10). Multiple nonmedical help-seeking was common. This was often due to lack of information than due to stigma. More boys than girls were seen in the patient population. Diagnoses in children varied; Neurodevelopment disorders were seen in 45.7%. We found parental mental health was worse in the case of primary psychiatric disorders in children like anxiety and mood disorders than neurodevelopment disorders. Conclusion: A significant number of parents have stress-related and neurotic symptoms after the onset of psychiatric illness in their child. Fathers who have significant mental health issues should be cared for. We can routinely screen for parental psychopathology in child psychiatric cases for better outcomes and to provide better family support.

Functional Brain Network Connectivity Changes in Children and Adolescents with Attention- Deficit Hyperactivity Disorder: A Resting-State Brain Functional Magnetic Resonance Imaging Study

Background: ADHD is one of the most common psychiatric disorders in children and adolescents. Altered functional connectivity has been associated with ADHD symptoms. This study aimed to investigate abnormal changes in the functional connectivity of resting-state brain networks (RSNs) among children and adolescents with different subtypes of ADHD.
 Methods: This study was performed on 50 participants Group A: included 30 children and adolescents with ADHD Group B: included 20 normal typically developing controls. All participants aged between 7 and 16 years. All study patients. All participants underwent a neuropsychological assessment by applying the DSM-5 criteria to them. All study children and adolescents will undergo a R-fMRI examination, including Blood oxygenation level dependent BOLD-MRI and pulsed Arterial spin labeling MRI (PASL-MRI).
 Results: According to Conner’s Rating scale, there was a significant difference between ADHD subtypes and severity. Children with combined subtype were more likely to have severe degree in both teacher and parent editions of Conner’s Rating Scale. On the other hand, children with inattentive subtype had less severe degrees by both teacher and parent edition. There were a statistically significance difference between both genders as regard ADHD severity according to Conner’s Rating scale (Teacher and parent editions) (P value = 0.049, 0.028 respectively). Males were significantly affected by moderate and severe type compared to females whose affection were mostly mild and moderate. According to CBCL, most of ADHD children had low competence parameters. There was a statistically significant difference (P value < 0.001) on the type of ADHD and social competence in the studied children, where the lowest parameters were found in children with hyperactive type.
 Conclusion: There was a statistically significant difference on the type of ADHD and social competence, where the lowest parameters were found in children with hyperactive type.

1401-P: Psychotropic Drug Use in Children and Adolescents with Type 1 Diabetes

Psychiatric disorders in children and adolescents with type 1 diabetes (T1D) have caught increasing attention. While psychotropic drugs offer great value in managing psychiatric symptoms, their adverse effects engender considerable controversy regarding their use in pediatric patients, let alone in those with T1D. Despite the topic’s high visibility, little evidence exists on the patterns of psychotropic drug use in pediatric T1D patients. We thus conducted this cohort study of 3,720,381 children and adolescents (13,191 [0.36%] had T1D) using several Swedish national registers. We examined the trends and patterns (prescription source and treatment duration) of psychotropic drug use and estimated the risk of initiating psychotropic drugs after T1D onset. We found that psychotropic drug use increased significantly in children and adolescents with T1D from 2006 to 2019 (Figure 1), with ADHD medications, SSRI, hypnotics and anxiolytics among the most used ones. The primary prescription source was psychiatric care, and treatment durations were mostly <12 months (except for ADHD medications). Children and adolescents with newly-onset T1D had a higher risk of initiating any psychotropic drug (hazard ratio 1.29, 95%CI 1.20-1.38) than their peers without T1D. Our findings highlight the need for risk/benefit studies of psychotropic drugs among young users with T1D to inform future research and guideline development. Disclosure S.Liu: None. T.Lagerberg: None. J.F.Ludvigsson: Research Support; Janssen Pharmaceuticals, Inc., MSD Life Science Foundation. M.Taylor: None. B.Donofrio: None. P.Lichtenstein: None. S.Gudbjörnsdottir: None. A.Butwicka: None. Funding Swedish Research Council (2017-00788)

Studies on Genetic Environment Influences on the Development of Childhood Psychiatric Disorders: A Review

This research article review the key types of genetic research design, methodology involved and emerging and established finding in relation to child and childhood psychiatric disorders, and finally genetic factors seems especially important for autism and attention deficit hyperactivity disorder. (Thapar and McGuffin, 2008)1 Twin and adoption study design are now being used to examine gene environment interplay, the effects of environment risk factors co-morbidity phenotype definition and development change Liu et al (2006)11 The ways in which specific gene variant excert risk effects at cellular and biological system are proving to highly competitive (Moffitt et al, 2005).2 Finally, molecular genetic studies also high light the importance of gene environment interply, which seems to be especially important in depression and wide anti social behavior. Liu. et al)11, owen et al 2005)12 , Moffitt, et al, (2005)2

Effectiveness of an Educational Filmmaking Project in Promoting the Psychological Well-Being of Adolescents with Emotive/Behavioural Problems.

Evidence suggests that adolescents respond positively to simple, early interventions, including psychosocial support and educational interventions, even when offered in non-clinical settings. Cinematherapy can help manage life challenges, develop new skills, increase awareness, and offer new ways of thinking about specific problems. This pilot trial was conducted in Italy, aiming to investigate the effects of a six-week filmmaking course on the psychological well-being of adolescents (N = 52) with emotional/behavioural problems and neurodevelopmental disorders. At the end of the project, most participants showed improvements mostly in social skills, such as social cognition (p = 0.049), communication (p = 0.009), and motivation (p = 0.03), detected using the SRS Social Responsiveness Scale. In addition, social awareness (p = 0.001) increased in all patients. Statistically significant differences resulted in four sub-scales of Youth Self-Report Scale: withdrawn/depressed (p = 0.007), social problems (p = 0.003), thought problems (p < 0.001), and rule-breaking behaviour (p = 0.03); these results showed a decrease in emotional and behavioural problems. This study is an innovative therapeutic and educational approach based on the filmmaking art. This research can offer an empirical basis for the effectiveness of alternative therapeutic tools in child and adolescent psychiatric disorders. At the same time, it can be replicated in broader contexts (e.g., school and communities) to promote children's psychological well-being.

Atomoxetine Versus Combination of Methylphenidate Plus Fluoxetine for Management of Anxiety Disorders in ADHD Children: A Randomized Clinical Trial

Background: Attention-deficit/hyperactivity disorder (ADHD) is the most common psychiatric disorder in childhood. Concurrent anxiety disorders have turned into a challenging issue for psychiatrists. Numerous medications have been applied with controversial responses. Objectives: The current study aimed to compare the efficacy of the combination of methylphenidate (MPH) and fluoxetine (FLX) versus atomoxetine (ATX) in the symptoms and function of ADHD children with concurrent anxiety disorders. Methods: The current randomized clinical was conducted on 76 outpatient children with concurrent ADHD and anxiety disorder within 2020 - 2021. The patients were divided into two equal groups. The first group was treated with MPH (5 mg twice daily) plus FLX (10 - 20 mg daily); nevertheless, the second group received ATX with a dose of 1.4 mg/kg. The Conner’s Parents Rating Scale (CPRS), Screen for Child Anxiety Related Emotional Disorders (SCARED), and Children’s Anxiety Impact Scale-Child (CAIS-C) were applied to assess anxiety at the baseline and 1 month and 4 months after the interventions. Results: The mean age of the studied population was 9.26 ± 1.92 years (range: 6 - 12 years), and 46 subjects (57.89%) were male. The significant trends of improvement in both groups, regardless of the interventions in the assessments of all the scales, were noted (P &lt; 0.001 for all the scales); however, the comparison of the groups revealed no differences in the CPRS (P = 0.397), SACRED (P = 0.663), and CAIS-C (P = 0.683). Conclusions: Based on the findings of this study, as ATX alone was as effective as MPH plus FLX for controlling anxiety disorders among ADHD children, ATX is preferred to apply fewer daily medications.

Detection of ADHD from EEG signals using new hybrid decomposition and deep learning techniques

Objective. Attention deficit hyperactivity disorder (ADHD) is considered one of the most common psychiatric disorders in childhood. The incidence of this disease in the community draws an increasing graph from the past to the present. While the ADHD diagnosis is basically made with the psychiatric tests, there is no active clinically used objective diagnostic tool. However, some studies in the literature has reported development of an objective diagnostic tool that facilitates the diagnosis of ADHD. Approach. In this study, it was aimed to develop an objective diagnostic tool for ADHD using electroencephalography (EEG) signals. In the proposed method, EEG signals were decomposed into subbands by robust local mode decomposition and variational mode decomposition techniques. These subbands and the EEG signals were fed as input data to the deep learning algorithm designed in the study. Main results. As a result, an algorithm has been put forward that distinguishes over 95% of ADHD and healthy individuals through using a 19-channel EEG signal. In addition, a classification accuracy of over 87% was obtained by the proposed approach of EEG signal decomposition followed by data processing in the designed deep learning algorithm. Significance. The findings of the current research enrich the literature based on originality and proposed method can be used as a clinical diagnostic tool in the near future.

Concordance between admission and discharge diagnosis of a child and adolescent psychiatry inpatient unit.

Psychiatry is arguably the most medical practice that is affected by culture. The pediatric literature is sparse with respect to the differences between child psychiatric units in different cultures and different countries. In this study, we aim to investigate the discordance between admission diagnosis and discharge diagnosis for child psychiatric disorders. A retrospective analysis was conducted on 206 patients admitted to a university hospital inpatient child and adolescent psychiatry unit in Ontario, Canada. The data extracted from electronic charts were age, gender, DSM-IV-based diagnosis at admission, living arrangement before admission, length of stay (minimum one day), post-discharge diagnosis, and post-discharge outcomes. There was 75% agreement with the discharge diagnosis. We found strong negative and positive associations between conduct disorder at discharge and the prescription of antipsychotics (+), antidepressants (-), and stimulants (-), and there was a strong association between a conduct disorder (CD) diagnosis and medication-free status. The powerful effect size of stimulant medication was specific to the association between a primary diagnosis of ADHD (vs. not-ADHD) and stimulant medication (c2=127.5, df=1, phi=0.79, P<0.0001). We have found a significant agreement between admission and discharge diagnosis. It is suggested that the inpatient stay helped to refine the formulation and to improve the child's well-being.

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.