Are the illness severity and treatment efficacy of the patients followed in the child psychiatry inpatient service during the pandemic period different from the "normal" period?

Objective: COVID-19 pandemic poses a serious threat to health systems and inpatient treatment units. With the increase in the size of the pandemic, it has become a difficult process to carry out routine treatment services. In this study we aimed to compare the clinical profile, illness severity and length of hospitalization of the patients who were hospitalized in the child psychiatry inpatient service during the normal and the pandemic period. Method: The patients who were treated in the child psychiatry inpatient service during the the pandemic period (n=19), and previously normal period (n=149) were compared in terms of clinical profile, illness severity and length of hospitalization. Psychiatric diagnoses were assessed using the K-SADS-PL (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). The Clinical Global Impressions-Severity scale (CGI-S) was applied to all patients in both groups at hospitalization and discharge point. Results: We found that median level of CGI-S hospitalization scores in pandemic period was significantly higher than normal period. A significant negative correlation was found between CGI-S discharge scores and length of hospitalization during pandemic period. In addition, a significant difference was found between the groups in terms of the rate of anxiolytic drugs used. Discussion: Anxiety levels of people may increase in disasters such as pandemics, wars, earthquakes. During the pandemic period, patients with higher clinical severity of illness are treated in inpatient treatment units. In these cases, it is important to continue inpatient management without interruption, along with infection-preventive measures.

Child and Adolescent Forensic Psychiatry Experiences During the COVID-19 Pandemic

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.

The impacts of COVID-19 pandemic on children with neurodevelopmental disorder

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.

The impacts of COVID-19 pandemic on children with neurodevelopmental disorder

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.

The Effect of The Covid-19 Pandemic On The Adaptation Process and Psychiatric Symptoms of Children Aged 7-12: A Telemedicine Study

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.