Estimation of the Development of Depression and PTSD in Children Exposed to Sexual Abuse and Development of Decision Support Systems by Using Artificial Intelligence.

The most common diagnoses after childhood sexual abuse are Post-Traumatic Stress Disorder and depression. The aim of this study is to design a decision support system to help psychiatry physicians in the treatment of childhood sexual abuse. Computer aided decision support system (CADSS) based on ANN, which predicts the development of PTSD and Major Depressive Disorder, using different parameters of the act of abuse and patients was designed. The data of 149 girls and 21 boys who were victims of sexual abuse were included in the study. In the designed CADDS, the gender of the victim, the type of sexual abuse, the age of exposure, the duration until reporting, the time of abuse, the proximity of the abuser to the victim, number of sexual abuse, whether the child is exposed to threats and violence during the abuse, the person who reported the event, and the intelligence level of the victim are used as input parameters. The average accuracy values for all three designed systems were calculated as 99.2%. It has been shown that the system designed by using these data can be used safely in the psychiatric assessment process, in order to differentiate psychiatric diagnoses in the early post-abuse period.

Anxiety, depression and post-traumatic stress disorder symptoms in adolescents during the COVID-19 outbreak and associated factors.

INTRODUCTION: Outbreaks of infectious diseases have negative effects on mental health. Currently, there is very little information about the psychological effects of the COVID-19 pandemic on adolescents and associated factors affecting their mental health. The aim of the present study is to determine the severity of anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in adolescents during the COVID-19 outbreak, and to investigate the associated factors with these symptoms. METHODS: The present study was conducted with a total of 447 adolescents. Psychiatric symptoms were evaluated by the use of DSM-5 Level 2 Anxiety Scale, DSM-5 Level 2 Depression Scale and National Stressful Events Survey PTSD Short Scale. The association between age, gender, residential area, presence of COVID-19 in the participant, presence of COVID-19 in the family or environment and psychiatric symptoms were evaluated with linear regression analysis. RESULTS: The mean age of participants was 15.06, and 38.3% of the participants were men and 61.7% were women. The rate of participants with moderate or high levels of anxiety, depression and PTSD symptoms was 28%, 37.6% and 28.5%, respectively. High age and living in an urban area were associated with increased anxiety, depression and PTSD symptoms. In addition, female gender was associated with increased depression symptoms, and the presence of COVID-19 in the family or environment was associated with increased anxiety symptoms. CONCLUSION: The present study shows that adolescents have serious levels of anxiety, depression and PTSD symptoms during the COVID-19 pandemic. These results emphasise the need for mental health interventions that are appropriate for the characteristics of this age group.

Psychiatric morbidity in children and adolescents with dermatological disorders.

BACKGROUND: Understanding the existence of a cycle, where psychological disturbances cause skin diseases and in turn, skin diseases cause psychological disorders, provides the basis for good dermatological practice. OBJECTIVE: The aim of this case-control study is to examine the psychiatric morbidity of dermatological disorders in children and adolescents with no history of psychiatric disorders. METHOD: In this study, 502 participants (251 patients and 251 healthy individuals) were evaluated according to DSM-IV criteria. All participants were interviewed and evaluated using the Turkish version of the Kiddie Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (K-SADS-PL) and the State-Trait Anxiety Inventory for Children (STAI-1 and STAI-2), the Childhood Depression Inventory (CDI), adolescent and parent forms of the Strengths and Difficulties Questionnaire (SDQ-A and SDQ-P) and a questionnaire evaluating child's level of school success. RESULTS: Our results indicated that the rates of general psychiatric comorbidity, mood disorders, anxiety disorders, and adjustment disorders were significantly higher in the study group compared to the control group. The CDI, STAI-1, STAI-2, and SDQ (and subscales) scores were significantly higher in the study group. Moreover, psychiatric comorbidity was higher in inflammatory and allergic dermatoses compared to other dermatological subgroups. Having a dermatological disease restricts physical activity thus increasing the risk of psychiatric comorbidity. CONCLUSIONS: Investigating the education, attitudes, and awareness of dermatologists about psychocutaneous disorders might contribute to the development of new educational strategies and elicit appropriate biopsychosocial approaches.

Is contrast sensitivity a physiological marker in attention-deficit hyperactivity disorder?

Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood-onset psychiatric disorders. Although the etiology is complex and has not yet been clarified, dopamine is thought to play a role in the etiology. Methylphenidate (MPH) is a psychostimulant drug used as first-line treatment for ADHD and it inhibits dopamine and norepinephrine reuptake transporters. Dopamine also has an effect on retina and contrast sensitivity. Despite evidence indicating the effects of dopamine on contrast sensitivity, the results of studies examining contrast sensitivity in ADHD patients are inconsistent. Also, no studies have been encountered examining the possible effect of MPH on contrast sensitivity. The hypotheses of this study are that children with ADHD who have not used MPH will have lower contrast sensitivity levels than the members of the control group, that contrast sensitivity levels increase after the use of MPH, and that contrast sensitivity is a potential physiological marker for ADHD. The study was conducted with 30 children with ADHD and 30 children without ADHD. Psychiatric evaluations of the participants were conducted with the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime-Turkish version, Conner's Parent Rating Scale-Revised Short form and the Turgay DSM-IV-based Child and Adolescent Behavioral Disorders Screening and Rating Scale. Photopic contrast sensitivity was measured using the Functional Acuity Contrast Test (FACT). Results showed that FACT mean values of the control group were significantly higher than those of the ADHD group (pre-treatment) in all spatial frequencies. In four spatial frequencies (CPD 1.5, 3, 12 and 18), the FACT mean values of the control group were significantly higher than the ADHD group (during the OROS-MPH treatment). At all spatial frequencies, the mean values of the ADHD group during the OROS-MPH treatment were significantly higher than before the OROS-MPH treatment. In conclusion, the present study showed that contrast sensitivity is low in children with ADHD and increases significantly after OROS-MPH medication, but still did not reach the levels of the children without ADHD. Our findings suggest that contrast sensitivity may be a potential physiological marker in ADHD.

Determining the probability of juvenile delinquency by using support vector machines and designing a clinical decision support system.

It is a known fact that individuals who engaged in delinquent behavior in childhood are more probable to carry on similar behavior in adulthood. If the factors that lead children to involve in delinquency are defined, the risk of dragging children into crime can be detected before they are involved in crime and delinquency can be prevented with appropriate preventive rehabilitation programs, in the early period. However, given that delinquent behavior occurs under the influence of multiple conditions and factors rather than a single risk factor; the need for diagnostic tools to evaluate multiple factors together is obvious. Artificial intelligence-based clinical decision support systems have already been used in the field of psychiatry as well as many other fields of medicine. In this study, we assume that thanks to artificial intelligence-based clinical decision support systems, children and adolescents at risk can be detected before the criminal behavior occurs by addressing certain factors. In this way, we anticipate that it can provide psychiatrists and other experts in the field.

Prevalence of Childhood Affective disorders in Turkey: An epidemiological study.

AIM: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. METHODS: This study was conducted as a part of the "The Epidemiology of Childhood Psychopathology in Turkey" (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. RESULTS: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. CONCLUSION: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.

Gender Differences in Sexually Abused Children and Adolescents: A Multicenter Study in Turkey.

The purpose of this study was to examine gender-based differences in abuse-related characteristics and post-abuse psychiatric disorders among sexually abused children and adolescents. The researchers retrospectively examined files, judicial reports, and social examination reports of 1,250 sexually abused youth cases. Results showed that boys were more often victimized by penetration, force, and physical violence. Incidence of sexual abuse by family members, familiar persons, and multiple persons was higher among girls. In addition, a higher rate of major depressive disorder as well as alcohol consumption and cigarette smoking were found in sexually abused girls. No difference was observed between boys and girls in terms of post-traumatic stress disorder, conduct disorder, and other mental disorders. Intellectual disability was more frequent in boys.

Malnutrition and Obesity in Children With ADHD.

OBJECTIVE: Low threshold of dissatisfaction and frustration in child and adolescent patients with ADHD lead to changes in dietary pattern with contribution to the development of obesity and other nutritional disorders. METHODS: A total of 362 patients with the diagnosis of ADHD and 390 children without any chronic disease were included to the study. We evaluated the anthropometric measurements for all cases. RESULTS: The overweight/obese cases according to weight for height (WFH) and body mass index scores were more likely in ADHD cases than control group. Malnourished cases according to WFH were more common in ADHD cases. Patients with weight standard deviation scores between <-2 and >2 were significantly higher in ADHD cases than the control group patients. CONCLUSION: Frequency of malnutrition and overweight/obese patients was found higher in ADHD cases compared with control group, and this situation suggested that ADHD is a risk factor for the development of eating disorders.

Testosterone levels of children with a diagnosis of developmental stuttering.

BACKGROUND: Stuttering is defined as a disruption in the rhythm of speech and language articulation, where the subject knows what he/she wants to say, but is unable to utter the intended word or phrase fluently. The effect of sex on development and chronicity of stuttering is well known; it is more common and chronic in males. We aimed to investigate the relationship between developmental stuttering and serum testosterone levels in this study. MATERIALS AND METHODS: In this study, we evaluated a total of 50 children (7-12 years of age); eight (16%) were female and 42 (84%) were male. Twenty-five children who stutter and 25 typically fluent peers with the same demographic properties (ages between 7 years and 12 years) were included in this study. The testosterone levels of the two groups were determined in terms of nanogram per milliliter (ng/mL) by enzyme-linked immunosorbent assay. The difference between the means of the two groups was analyzed. RESULTS: The medians of the testosterone levels of the stutterer and control groups were determined as 20 ng/mL (range =12-184 ng/mL) and 5 ng/mL (range =2-30 ng/mL), respectively. Testosterone levels of the stutterer group were significantly higher than in the control group (P=0.001). Besides, there was a significant correlation between the severity of the stuttering and testosterone levels in the stutterer group (P=0.0001). CONCLUSION: The findings of this study show that testosterone may have an effect on the severity of developmental stuttering and on the clinical differences between sexes. However, further investigations are needed to show that testosterone may play a role in the etiology of developmental stuttering.

Frequency of celiac disease in attention-deficit/hyperactivity disorder.

OBJECTIVE: Although it is well known that celiac disease (CD) is associated with neurologic disorders, association with psychiatric problems is not well defined. In this report, we aimed to detect CD prevalence in patients with attention-deficit hyperactivity disorder (ADHD). METHODS: A total of 362 patients between the ages 5 and 15 years with the diagnosis of ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnostic criteria and 390 sex- and age-matched healthy children were included in the present study. Serum levels of tissue transglutaminase (tTg) immunoglobulin (Ig) A and IgG were studied in both groups. Serum IgA levels were also studied in patients with positive tTG IgG for the exclusion of selective IgA deficiency. Endoscopic duodenal biopsy was provided in seropositive patients, whose parents approved the procedure. Biopsy samples were evaluated according to Marsh-Oberhuber classification. RESULTS: tTg IgA was positive in 4 patients with ADHD (1.1%). Endoscopic duodenal biopsy was suggestive of CD in one of them (0.27%). tTg IgA was positive in 3 of control group patients (0.8%). Duodenal biopsy of the only patient from control group, who underwent upper gastrointestinal endoscopy, revealed normal intestinal mucosa. CONCLUSIONS: The seropositivity rates for CD were found similar in ADHD and control groups. Thus, neither routine screening for CD nor empirical recommendation of gluten-free diet seems necessary in children with ADHD.

Paediatric trauma patients and attention deficit hyperactivity disorder: correlation and significance.

INTRODUCTION: Trauma is one of the leading reasons for emergency department (ED) visits in children. Hyperactivity, inattentiveness and impulsiveness may contribute to injury proneness. The aim of this study was to evaluate the prevalence and role of attention deficit hyperactivity disorder (ADHD) in children with trauma. METHODS: Trauma patients aged 3-17 attending the ED were included in the study group. Parents were informed after medical care had been given to their children, and demographic data and information about the trauma were collected. Later, parents were asked to complete the Conners' Parent Rating Scales-Revised questionnaire for ADHD symptoms. The control group consisted of children of similar age and sociocultural characteristics who attended the hospital for reasons other than trauma. Cases in which the child apparently had no active role in the trauma or where the parents did not complete the Conners' Parent Rating Scales-Revised questionnaire were excluded from the study. RESULTS: Fifty-five children were included in the study group (mean age 7.49 (range 3-14; SD 3.3); 33 (60%) were male). The control group was statistically similar to the study group. The most common trauma mechanism was falls (n=31, 56.4%). All the subscale scores were significantly higher in the study group, and previous trauma-related ED visits were associated with significantly higher subscale scores. CONCLUSION: The data suggest that children who make repeated trauma-related ED visits have a predisposition to ADHD, and they may benefit from screening for this disorder while in the ED.