Parent rated bedtime resistance and comorbidity may predict levels of attention among Turkish children diagnosed with ADHD in on-line education classes during the COVID-19 outbreak.

OBJECTIVE: This study aimed to compare the attention levels, of Turkish children and adolescents with Attention Deficit/ Hyperactivity Disorder (ADHD) in on-line education classes with healthy controls. METHODS: This study is a cross-sectional, internet-based, case-control study that recruited 6-18 years old patients diagnosed with ADHD and receving treatment and healthy controls from eight centers. The measurements used in the study were prepared in the google survey and delivered to the participants via Whatsapp application. RESULTS: Within the study period, 510 children with ADHD and 893 controls were enrolled. Parent- rated attention decreased significantly in both groups during on-line education classes due to COVID-19 outbreak (p<0.001; for each). Children and adolescents with ADHD had significantly elevated bedtime resistance, problems in family functioning difficulties than control children according to parental reports (p=0.003; p<0.001; p<0.001, respectively). Furthermore, bedtime resistance and comorbidity significantly predicted attention levels in on-line education. CONCLUSION: Our findings may underline the need to augment student engagement in on-line education both for children without attention problems and those with ADHD. Interventions shown to be effective in the management of sleep difficulties in children as well as parent management interventions should continue during on-line education.

Comparison of Inflammation Markers and Severity of Illness Among Patients With COVID-19, Acute Psychiatric Disorders and Comorbidity.

BACKGROUND AND OBJECTIVES: Neutrophil, lymphocyte counts, lactate dehydrogenase (LDH), D-dimer, fibrinogen, and comorbid illness are associated with the course and prognosis of COVID-19. However, the course of acute severe psychiatric disorders overlapping with COVID-19 infection was not investigated and remained as an unclarified research area. This study aimed to demonstrate inflammatory markers and the course of patients suffering from both conditions. METHODS: Thirty-eight inpatients with COVID-19 and comorbid acute psychiatric disorders (COVID-19+PD), 31 inpatients with COVID-19, and 38 inpatients with an acute psychiatric disorder (PD) were included in the study. Neutrophil, lymphocyte counts, serum ferritin, lactate dehydrogenase (LDH), D-dimer, fibrinogen, Systemic immune-inflammation index (SII), neutrophil/lymphocyte ratio (NLR), and C-reactive protein (CRP) were compared to evaluate inflammation levels. RESULTS: Patients with SARS-CoV-2 infection had older age compared to the PD group. CALL (Comorbidity, age, lymphocyte, lactate dehydrogenase) scores which predict the progression risk in patients with COVID-19 pneumonia, of both COVID-19 groups were found similar. The COVID-19+PD had higher SII in the study sample. Additionally, the COVID-19+PD group had higher NLR, ferritin, and CRP levels than those of the PD group. CONCLUSIONS: The prognosis of COVID-19 is not worse when accompanied by a psychiatric disorder. Laboratory assessment can guide clinicians to distinguish those infected with SARS-CoV-2 within psychiatric inpatient units. The biochemical assessment did not robustly support higher inflammatory levels in the comorbid COVID-19 and psychiatric disorder group compared to the COVID-19 group.

Decreased Functioning and Contents of Worries Associated with Anxiety or Depression Symptom Levels Within Patients Hospitalized with COVID-19 Infection.

BACKGROUND: High levels of anxiety and depression symptoms have been reported in patients with COVID-19 compared to the general population. These symptoms were related to variables such as gender, age, and education level with anxiety/depression levels. We aimed to determine the relationship between anxiety and depression symptoms and epidemic-related decreased functioning, worry, and quality of life (QoL). SUBJECTS AND METHODS: The study included 238 hospitalized participants due to COVID-19 and 168 participants who were hospitalized for reasons other than COVID-19. The Hospital Anxiety and Depression Scale (HADS), Short Form 36 (SF-36) QoL Scale, and questionnaires prepared by the researchers were applied. The effects of current worries, impairment in QoL, and decreased functioning during quarantine on levels of anxiety and depressive symptoms were investigated by implementing multiple linear regression analyzes. RESULTS: Our study results suggested the anxiety and depression levels of patients with COVID-19 were not higher than those in the internal medicine inpatient unit at the same time. Worries about transmission to others, uncertainty, social media news, and health anxiety increased the psychiatric symptoms of participants with COVID-19. Disruptions in social relationships and health also have an effect on anxiety/depression symptom levels. Conversely, results indicated losses and worries in occupation and finance did not significantly affect mental symptoms. CONCLUSION: Worries about transmission to others, uncertainty and health anxiety are closely related to anxiety and depression among patients with COVID-19. There is a need for research in the mental health field for the later stages of the pandemic in different cultures.

Mental Health Support Program for Healthcare Professionals in a Pandemic Hospital in Turkey and Its Results on Anxiety, Depression, Insomnia and Sexual Disorders.

BACKGROUND: The COVID-19 pandemic has put enormous stress on the health care workers, threatening not only their physical health but also their mental well-being. No mental health support program (MHSP) addressing depression and anxiety in healthcare workers (HCWs), has been shown to be effective in Turkey previously. We aimed to measure the effect of our MHSP among healthcare workers who applied for psychological help associated with the COVID-19 pandemic. SUBJECTS AND METHODS: An MHSP has been created for healthcare professionals working in a pandemic hospital during the COVID-19 period. Health workers were recruited between July and September 2020. Anxiety, depression, and insomnia levels were evaluated with HAM-A (Hamilton Anxiety Scale), HDRS (Hamilton Depression Scale), and Insomnia Severity Index (ISI) before and after the intervention. Sexual complaints were questioned by a consultant psychiatrist. MHSP (n=31), and treatment as usual (TAU, n=27) groups were compared using repeated-measures ANOVA. RESULTS: Sociodemographic data, medical history of COVID-19, and psychiatric diagnoses were similar between the groups. There was no difference in baseline HAM-A, HDRS, and ISI scores (p>0.05). At the end of the study, there was a significant difference between study groups regarding anxiety scores (For post-treatment, MHSP=8.0±2.6 vs. TAU=17.9±3.1, p<0.001) and depression symptoms (For post-treatment, MHSP=8.8±2.7 vs. TAU=20.0±2.4, p<0.001) but not in insomnia levels (For post-treatment, MHSP=6.5±2.4 vs. TAU=7.3±2.4, p=0.499). Likewise, both groups reported similar levels of improvement in reduced sexual drive. CONCLUSIONS: Our study results suggest that the MHSP effectively alleviates the psychiatric complaints of healthcare professionals. It is recommended to have mental support teams for healthcare professionals in hospitals.

Parental psychological distress associated with COVID-19 outbreak: A large-scale multicenter survey from Turkey.

AIMS: Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. METHODS: A large-scale multicenter online survey was completed by the parents (n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers-HCW [18.2%] vs. others), geographical (Istanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. RESULTS: Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p < .001), a mother (odds ratio 1.67, p < .001), and a younger parent (odds ratio 0.98, p = .012); living with an adult with a chronic physical illness (odds ratio 1.38, p < .001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p = .043), positive psychiatric history (odds ratio 1.29, p < .001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p < .001; vs. odds ratio 2.61, p < .001) were independently associated with significant parental distress. CONCLUSIONS: Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit.