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.

Evaluation of Depression, Anxiety, and Sleep Quality in Children Diagnosed With COVID-19.

ABSTRACT: COVID-19 has affected individuals of all age groups, both physically and mentally. We aimed to determine anxiety and depression in children diagnosed with COVID-19. Fifty children aged 8 to 18 years diagnosed with COVID-19 were included in the study. The children were evaluated the revised Child Anxiety and Depression Scale, STAI form TX-I (state anxiety inventory), and STAI form TX-II (trait anxiety inventory). Child Sleep Habits Questionnaire was applied for one of the parents according to three different periods. The periods were established as before the pandemic, during the illness-quarantine process, and after the quarantine. We observed the highest scores for depression-anxiety and the poorest sleep quality during the quarantine period. The scores for depression-anxiety were lower, and sleep quality scores were higher in the prepandemic period compared with after the quarantine period. Measures should be taken to protect mental health for children with COVID-19.

Elevated neurotensin levels among obese adolescents may be related to emotion dysregulation and impulsivity: a cross-sectional, case-control study

Obesity can affect 5.0 % of children worldwide, especially among the economically disadvantaged.1 It may affect children across all age groups and there seems to be a temporal trend of increase within the last 40 years.1,2 The current consensus is that pediatric obesity may arise due to interactions between biological, developmental, behavioral, genetic and environmental factors.3 The ongoing COVID-19 pandemic may also contribute to the emergence and persistence of pediatric obesity.4 Neurotensin (NT) is a 13 amino acid peptide secreted from the enteroendocrine cells in the small intestine and the central nervous system.5 It may modulate the dopaminergic, serotonergic and glutamatergic function in the nigro-striatal and meso-cortical limbic systems and may have an anorexigenic effect via the lateral hypothalamic region.6,7 Various pre-clinical studies suggest that it may have a role in anorexia as a response to stress, emergence of anxiety- like behavior, hedonic eating, reward/ reinforcement and memory.8-11 A recent review suggested that NT may have therapeutic potential12 and another study suggested that elevated levels of its precursor may predict weight gain and associated metabolic abnormalities among children.13 Butler et al. (2015) found that plasma NT levels were elevated among children with PraderWilli syndrome characterized by hyperphagia via decreasing gastric motility.14 Available studies suggest that pediatric obesity at least in a subgroup of patients may be associated with elevated levels of anxiety, impulsivity and emotional eating.15-17 Despite the importance of NT functioning in those constructs, no study up to now has evaluated the relationships between NT levels and anxiety, impulsivity and emotion regulation among obese children. [...]in this study, we aimed a) to compare serum NT levels among obese and healthy adolescents b) to compare self-reported emotion regulation, anxiety and impulsivity scores among obese and healthy adolescents, and c) to investigate the relation of NT with emotional regulation, anxiety and impulsivity among obese adolescents. Obese adolescents with a body mass index (BMI) >95 percentile and healthy adolescents with a BMI between 3 and 85 percentiles, according to the data of Turkish National Growth Charts [A], who had similar age and gender distribution and admitted for routine control were enrolled in the study.19 Patients with underlying endocrine (hypothyroidism, Cushing syndrome, etc.) or non-endocrine (hypothalamic dysfunction, drug use, syndromic diseases) pathologies were excluded from the study. Anthropometric Evaluation Height (cm), body weight (kg) and waist circumference (cm) of all cases included in the study were measured after an overnight fast in the morning.