Alarming serum antiprotease levels in axial spondyloarthritis.

Objectives: The objective was to assess the serum levels of secretory leukocyte protease inhibitor (SLPI) and elafin in individuals diagnosed with axial spondyloarthritis (AxSpA) and analyze their diagnostic significance and correlation with disease activity. Patients and methods: The case-controlled, cross-sectional study was conducted between August 2021 and April 2023. Sixty patients diagnosed with AxSpA (n=60) were classified according to imaging results as nonradiographic AxSpA (nr-AxSpA [n=30]; 15 males, 15 females; median age: 30 years; range, 27.6 to 34.1 years) and radiographic AxSpA (r-AxSpA [n=30]; 19 males, 11 females; median age: 33 years; range, 30.6 to 38.1 years), forming two patient groups (the nr-axSpA and r-axSpA groups). A total of 30 age- and sex-matched healthy controls (16 females, 14 males; median age: 33 years; range, 29.2 to 37.1 years) were included. Demographic data, laboratory, and clinical characteristics of the participants were recorded. Results: There was no significant difference between SLPI and elafin serum levels in the disease groups. SLPI and elafin levels in AxSpA and nr-AxSpA groups were significantly higher compared to the control group (p<0.05). Based on receiver operating characteristic analysis, the diagnostic values of both parameters were found to be significant in the Ax-SpA and nr-AxSpA groups (p<0.05). There was no significant correlation between serum levels of SLPI and elafin and disease activity parameters. Significant positive correlations were found between SLPI and elafin in both the nr-AxSpA (p<0.05, r=0.870) and r-AxSpA (p<0.05, r=0.725) groups. Conclusion: The levels of SLPI and elafin were found to be significantly elevated in patients with AxSpA, particularly in those with nr-AxSpA, compared to the control group. Therefore, SLPI and elafin can be used as therapeutic biomarkers for the diagnosis of AxSpA and nr-AxSpA. However, no relationship was found with disease activity.

Comparison of Diagnosis Experiences of Adolescent and Young Adult Polycystic Ovary Syndrome Patients.

STUDY OBJECTIVE: The manner in which an individual experiences a polycystic ovary syndrome (PCOS) diagnosis may affect prognosis and vary with age. This study aimed to evaluate and compare the diagnosis experiences of adolescent and young adult PCOS patients. METHODS: PCOS patients from the same institution were divided into two groups according to age and clinic (adolescents diagnosed in the adolescent medicine clinic and young adults diagnosed in the obstetrics and gynecology clinic). Patients completed a questionnaire designed to assess the information and support received during diagnosis, their satisfaction with this information, existing concerns regarding PCOS symptoms, and support requirements. RESULTS: Thirty-six patients were included in each group. Among the participants, 52.8% of the adolescents and 63.9% of the young adults reported that they had consulted more than one specialist before receiving a diagnosis. We found that 83.3% of adolescents and 63.9% of young adults were satisfied with their overall PCOS diagnosis experience. The highest ratio of information given in both groups was related to medical treatment (88.9% in both groups), and the lowest ratios were associated with emotional support (13.9% vs.5.6%). Irregular menstruation was reported to be the most disturbing concern in both groups (94.4% vs.86.1%), and the biggest difference between the two groups was related to body dissatisfaction, which was observed more in adolescents (33.3% vs 5.6%). CONCLUSION: While overall diagnosis experiences and satisfaction levels were similar across both groups, we identified distinct differences that may warrant attention to address age-specific needs and preferences.

The impact of the prolonged COVID-19 pandemic on adolescents with eating disorders: a follow-up study from Türkiye.

BACKGROUND: At the onset of the pandemic, we conducted a study on adolescents with eating disorders (EDs) and found no deterioration in ED symptoms. The objective of this subsequent study was to conduct a follow-up evaluation of the same cohort and investigate the consequences of the prolonged pandemic. METHODS: This longitudinal study was conducted one year after the first study between May 2021 and June 2021 with 37 adolescents aged 12-18 years (pre-existing EDs). The reassessment included an evaluation of sociodemographic and clinical characteristics, the impact of pandemic-related restrictions on ED behaviors, well-being, and quality of life. All the participants underwent a re-administration of the ED examination questionnaire (EDE-Q), Beck Depression Inventory, the State Anxiety Inventory for Children, and the Maudsley Obsessive Compulsive Inventory. RESULTS: No significant difference was observed in the EDE-Q scores or the ED examination questionnaire scores between the initial (T1) and subsequent (T2) study. The ED-related quality of life was seen to have slightly improved in the later stage. While depression (T1: 18, T2: 15, p=0.883) and obsession scores (T1: 11, T2: 14, p: 0.536) showed no disparity between the studies, anxiety scores (T1: 38, T2: 43, p:0.011) exhibited a significant increase. CONCLUSIONS: Consistent with the early phase, no exacerbation of ED symptoms in adolescents was observed during the later stages of the pandemic. Close clinical monitoring during the pandemic might have been protective against the deteriorating effects of the pandemic. During social isolation, it is important to monitor adolescents with EDs continously for depression and anxiety.

Sexual dysfunction and associated factors in Behçet's disease: a case-control study.

Sexual health is an important part of a healthy life. The aim of this study is to define Behçet's sexual dysfunction and the factors affecting it. Sixty-nine patients with Behçet's disease (BD) and 74 healthy controls were included in the study. International Index of Erectile Function (IIEF), the Female Sexual Function Index (FSFI), the Beck Depression Inventory (BDI), and the Short Form Health Survey (SF-36) were filled out by patients and healthy control group (HCG). Follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin and estradiol or testosterone levels according to gender were measured in Behçet's patients. The rate of sexual dysfunction and its relationship with gonadal hormones, Beck depression and SF 36 subgroups were evaluated in Behçet's patients. Sixty-nine patients with BD (mean age 39.55 ± 11.7) and 74 HCG (mean age 36.9 ± 6.84) were included in the study. Sexual dysfunction was observed in 74% (49) of BD and 59.5% (44) of HCG (p = 0.047). Prolactin level is within normal limits in all patients. Although there are abnormal levels of gonadal hormones, no relationship was found with sexual dysfunction. Depression especially is more prevalent compared to the healthy population (p = 0.016). The presence of depression negatively affects sexual life. Depression, SF 36 physical role limitations, energy vitality, vitality and mental health were associated with sexual dysfunction in patients with Behçet's disease. Sexual dysfunction was associated with the presence of depression and SF-36 subscales in Behçet's patients.

Beliefs and Predictors of Negative Attitudes Toward Obesity Among Turkish Healthcare Professionals: Assessing the Bias with Sub-group Analysis.

AIM: This study aimed to examine Turkish healthcare professionals' beliefs and predictors of negative attitudes toward obesity and to investigate whether those beliefs and negative attitudes differ per their profession and sociodemographic and familial variables. METHOD: In this cross-sectional study, healthcare professionals (n = 495) working in four hospitals of Ankara completed a sociodemographic questionnaire and two self-report scales: the Attitudes Toward Obese Persons Scale and the Beliefs About Obese Persons Scale. Data were collected during May, 2018. RESULTS: Female healthcare professionals had significantly higher (p = 0.03) positive attitude scores than males, and nurses had significantly higher (p = 0.04) Beliefs About Obese Persons Scale scores than physicians, representing their belief that obesity is not under the control of the individual. The Attitudes Toward Obese Persons Scale scores of university hospital healthcare professionals were significantly higher (p = 0.00) than those of public hospital and private hospital healthcare professionals, and Attitudes Toward Obese Persons Scale scores of healthcare professionals who have a family member with a chronic disease were significantly higher (p = 0.027) than those who do not. CONCLUSION: The work experience, spending more time with a patient, and having a member of the family with a chronic illness lead to a more positive attitude toward people with obesity. This result emphasizes the importance of interventions that promote sensitive and empathic communication skills.

Does fibromyalgia affect physical activity due to pain?

OBJECTIVES: The aim of this case-control study was to evaluate the physical activity levels of patients with fibromyalgia syndrome (FMS) and to assess a possible relation between physical activity and FMS characteristics. METHODS: Seventy patients with FMS and 50 age-gender-matched controls were included. Pain was evaluated using the visual analog scale. The Fibromyalgia Impact Questionnaire (FIQ) scoring system was used for the evaluation of the impact of FMS. Furthermore, for assessing the physical activity in our participants, we used the International Physical Activity Questionnaire (IPAQ). The Mann-Whitney U and Pearson's correlation tests were used for group comparisons and correlation analyses. RESULTS: The patients presented significantly less transportation-related, recreational, and total physical activity levels, besides reporting significantly less time spent walking and less time spent in vigorous activities than controls (p<0.05). Furthermore, there was a negative correlation between pain and the scores of self-reported moderate or vigorous physical activity (r=-0.41, p<0.01) in patients. However, we could not find any correlation between FIQ and IPAQ scores. CONCLUSION: Patients with FMS are physically less active than healthy individuals. This reduced activity seems to be associated with pain, but not with the impact of the disease. In the management of the patient with FMS, considering the patient's physical activity behavior negatively affected by pain may contribute to holistic approach to the patients.

Could the Systemic Immune Inflammation Index Predict Diagnosis, Recovery Time, Hypothyroidism, and Recurrence Rates in Subacute Thyroiditis?

Purpose: Subacute thyroiditis (SAT) is a non-infectious inflammatory disease of the thyroid. The Systemic Immune-Inflammation Index (SII), also known as an easy economical marker, correlates with the severity of inflammatory responses. We aimed to evaluate the clinical significance of the SII and to compare it to other inflammatory markers in terms of diagnosis, recovery time, and recurrence of SAT. Patients and Methods: The current non-interventional observational prospective study was performed at Outpatient Department of Endocrinology, Erzurum Training and Research Hospital. Sixty-nine patients with SAT and fifty-nine healthy individuals in total were enrolled in our study. The follow-up period was 6-12 months for all patients regarding treatment response, recurrence, and hypothyroidism. Results: The SII level was found to be significantly higher at the time of diagnosis in the SAT group compared to the control group (p=0.000). There was a significant positive correlation between the SII and SAT recovery time (p=0.000), particularly in patients receiving methyl prednisolone treatment (p=0.002). SII was not found to be significantly associated with hypothyroidism and recurrence in patients with SAT (p=0.261, p=0.568). However, compared to the ones without recurrence, thyroid stimulating hormone (TSH) and erythrocyte sedimentation rate levels at the time of diagnosis were found to be higher in those patients with recurrence (p=0.035, p=0.046). Conclusion: SII is a low-cost, widely available, universal indicator of inflammatory processes in SAT. It could provide many benefits in the follow-up process and the selection of aggressive anti-inflammatory treatment by estimating recovery time. SII, as a practical biomarker, may be a new diagnostic and prognostic tool for SAT.

Social Connectedness Matters: Depression and Anxiety in Transgender Youth During the COVID-19 Pandemic.

BACKGROUND: Gender-affirming and supportive relations for transgender youth are considered protective in terms of mental health. AIM: To describe how transgender youth perceived changes in their gender expression, in the course of the gender-affirming path, and the effect of social connectedness and social support on depression and anxiety during the pandemic. METHODS: In this cross-sectional study, transgender youth completed an online survey developed to evaluate the perceived changes in gender expression and affirmation path that occurred during COVID-19 and the age-stratified lockdown. Furthermore, we aimed to investigate the effect of social connectedness and social support on depression and anxiety in this population during the pandemic. The participants completed the following scales: Social Connectedness Scale Revised (SCS-R), Multidimensional Scale of Perceived Social Support (MSPSS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI). The effect of lockdown on life conditions, gender expression, social and medical gender-affirming path, social connectedness, social support, depression, and anxiety levels were examined. Linear regression analyses were performed to evaluate the relationships between BDI and STAI scores and other variables. OUTCOMES: The relationship between the levels of perceived social connectedness, and social support, the pandemic-related changes in living conditions and depression and anxiety scores were calculated. RESULTS: A total of 49 transgender youth with a mean age of 20.53 ± 1.86 years were enrolled. Participants reporting discomfort at the place they live and who had difficulties concerning gender expression and affirmation had higher depression and anxiety scores and perceived lower social support from their family. Social connectedness score was a significant negative predictor of depression severity, whereas social connectedness and social support were both significant negative predictors of anxiety severity. CLINICAL IMPLICATIONS: Our results show increased adversity for transgender youth when connectedness with supportive people is diminished. During the COVID-19 pandemic, social connectedness and social support perceived by transgender youth are associated with better mental health. STRENGTHS AND LIMITATIONS: This is one of the first studies to evaluate the changes that occurred during the COVID-19 pandemic in transgender youth with relation to social support and connectedness, during an age-stratified lockdown. The main limitations were the small study size, skewed gender ratio and that the study sample came from a single gender clinic. CONCLUSION: As social connectedness and social support are significant predictors of depression and anxiety severity, special attention is needed to increase contact and support for transgender youth during the pandemic. Tüzün Z, Basar K, Akgül S. Social Connectedness Matters: Depression and Anxiety in Transgender Youth During the COVID-19 Pandemic. J Sex Med 2022;19:650-660.

The effects of the COVID-19 lockdown on adolescents with an eating disorder and identifying factors predicting disordered eating behaviour.

AIM: To evaluate the impact of the COVID-19 lockdown on adolescents with eating disorders (ED) and identify factors predicting ED behaviour. METHOD: This study took place during an age-stratified lockdown for those under 20 years in Turkey. Participants completed a survey developed to evaluate the effects of the lockdown on ED behaviour, well-being and quality of life (QoL) and additionally the eating disorder examination questionnaire (EDE-Q), and scales for depression, anxiety and obsessive-compulsive behaviour. The relationship between the EDE-Q-global score and other variables related to ED was examined. Linear regression analysis was performed to examine the predictive power of these variables on ED behaviour. RESULTS: Thirty-eight ED patients with a mean age of 15.12 ± 1.56 years were included in the study. Of participants, 42.1% reported feeling an improvement in ED symptomatology, 71.0% reported none or rare conflict with parents due to eating, 39.5% reported often or always complying with their meal plan. Of participants, 92.0% agreed to 'understanding the value of being healthy' and stated realizing that 'they were in control' due to the pandemic. Of participants 36.9% scored 'bad' for both overall and ED related QoL. In the stepwise regression analysis depression score had the highest predictive value for ED behaviour. CONCLUSION: Almost half of the participants felt an improvement in their ED and a majority reported rare parental conflict. However, less than half reported meal plan compliance. As depression had the highest positive predictive value for ED behaviour additional screening for depression during the pandemic maybe warranted in ED patients.

Menstrual Suppression in Gender Minority Youth

The purpose of this case series was to evaluate menstrual suppression in sex assigned at birth female adolescents identifying as male or gender non-conforming. A retrospective chart review of four gender minority youth (GMY), age 14-17, was performed for gender identity history, type and success of menstrual suppression, method satisfaction, side effects and improvement in menstrual distress. Menstrual suppression was successful in three patients, one patient discontinued use due to side effects that caused an increase in gender dysphoria. Menstrual distress and bleeding pattern improved in the majority of GMY in this series but side effects, as well as contraindications, may limit their use. In conclusion, menstrual dysphoria can be life-threatening for GMY and it is important that clinicians consider menstrual suppression in GMY with menstrual dysphoria. This series emphasizes the importance of individualized treatment plans.

Is Ramadan fasting correlated with disordered eating behaviours in adolescents?

This study aimed to examine the cross-sectional relationship between Ramadan fasting as a spiritual factor with prolonged hunger and disordered eating behaviors. The study was conducted in June 2016 (11th-29th days of Ramadan) and consisted of 238 fasting and 49 non-fasting adolescents. Risk of disordered eating was evaluated using the Eating Attitudes Test-26 (EAT-26) and Three Factor Eating Questionnaire-R18 (TFEQ-R18). Body image dissatisfaction was rated with Stunkard's Figure Rating Scale (FRS). Nutritional status was assessed using a 24-hour dietary recall. There was no significant difference between energy intake, EAT-26 and TFEQ-R18 scores (except the emotional eating sub-scores) between the groups. FRS revealed that the comparisons of their "ideal" and self were not significantly different between the groups whereas the gap between the figures they think healthy and closest to self was significantly higher amongst non-fasting adolescents. Two-hundred and two (97.5%) adolescents reported fasting for religious purposes whereas only 8 (3.4%) for losing weight. The EAT-26 total scores were in the pathological range in 39 (16.8%) adolescents who fasted for religious purposes. This study suggests that motivation of adolescents to fast during Ramadan was due to spiritual decisions rather than weight control or other factors and Ramadan fasting was not correlated with disordered eating behaviors or body image dissatisfaction.

The effects of parental and peer factors on psychiatric symptoms in adolescents with obesity.

PURPOSE: The aim of this study was to examine the relationships among psychiatric symptoms, effect of beliefs and attitudes of parents about obese people and victimization or bullying in obese adolescents. METHODS: The study group included 110 obese or overweight adolescents and 55 adolescents of normal weight as the control group. All adolescents completed the Brief Symptom Inventory (BSI) and Traditional Bullying Scale. The parents completed the Attitudes Toward Obese Persons (ATOP) Scale and Beliefs About Obese Persons (BAOP) Scale. RESULTS: The BSI subscale scores for depression were significantly higher in the study group. There was no significant relationship found between psychiatric symptoms of obese or overweight adolescents and the ATOP and BAOP scores of parents. When victims, bullies/victims, bullies and those not included in any group among obese or overweight adolescents were examined, psychiatric symptoms of victims and bullies/victims were significantly higher. CONCLUSIONS: The results of this study suggest that the clinical treatment of obesity is not just a matter of diet and exercise but additionally dealing with issues of depression and anxiety. A very satisfactory result of the study was that parents of obese or overweight adolescents did not show an increased weight bias. This study has also shown the association between negative social and psychological ramifications, as the study group was more likely to be the victims and perpetrators of bullying behaviors than their normal-weight peers. LEVEL OF EVIDENCE: Level III, case-control analytic study.

Relationship Between Morbidity and Mortality and HbA1c Levels in Diabetic Patients Undergoing Major Surgery.

OBJECTIVE: To investigate the relationship between the preoperative HbA1c levels and the complications and mortality rates in the postoperative period in patients with diabetes undergoing a major surgical treatment. STUDY DESIGN: Descriptive study Place and Duration of Study: Deparment of Internal Medicine, Adana Numune Research and Training Hospital, Turkey, from January 2015 to December 2016. METHODOLOGY: Diabetic patients, who underwent major surgery (a large resection) having preoperative HbA1c levels, were considered. A total of 1,013 patients, whose file data were completely accessed, were included in the study. Preoperative HbA1c levels of the patients and complications seen within the first 7 and first 30 days postoperatively were recorded. RESULTS: Fourty-nine (4.8%) of the patients were exitus in the hospital, while 964 (95.2%) of the patients were discharged. Preoperative HbA1c levels of the patients were found to be predictive marker of mortality and complications in the first 7 and 30 days postoperatively (p <0.001). CONCLUSION: HbA1c levels are important in preoperative surgical risk assessment in diabetic patients. Better provision of long-term glycemic control in patients planned elective surgery and have low levels of HbA1c may significantly reduce postoperative mortality and complications.

Obesity without comorbidity may also lead to non-thyroidal illness syndrome.

BACKGROUND: Obesity mediates a series of operations in the body by increasing the production of proinflammatory cytokines. Cytokines play an important role in the development of non-thyroidal illness syndrome (NTIS). OBJECTIVES: The aim of this study was to investigate the association between obesity and NTIS. MATERIAL AND METHODS: A total of 423 subjects were included. The study group was comprised of 219 obese patients without any comorbid disease and the control group was comprised of 204 healthy subjects. Body mass index (BMI), thyroid hormone levels, high-sensitivity C-reactive protein (hs-CRP) levels, erythrocyte sedimentation rate (ESR), complete blood count, and other biochemical parameters were measured. Frequencies of NTIS were calculated. MedCalc 12.5 software program (MedCalc, Ostend, Belgium) was used for statistical analysis. RESULTS: Groups were statistically different according to BMI (p < 0.001). The mean BMIs of the study and the control group were 34.6 ±5.0 kg/m2 and 22.6 ±1.8 kg/m2, respectively. Obese patients had higher serum hs-CRP levels, ESR and white blood cells (WBC) levels (0.99 ±3.17 mg/L vs 0.39 ±1.09 mg/L; 17.2 ±10.6 mm/h vs 12.6 ±8.0 mm/h; 7.8 ±2.1 103/µL vs 6.9 ±1.5 103/µL, respectively; p < 0.001). There were 21 (9.5%) obese patients with NTIS, while there were none NTIS cases in the control group. The difference was statistically significant (p < 0.001). There was a strong association between obesity and NTIS (odds ratio (OR) = 44.2, confidence interval (CI) = 95% 2.66-736.3; p = 0.0082). CONCLUSIONS: Inflammation, which is strongly associated with adipose tissue, may lead to NTIS in obese patients without any comorbid disease.

Clinical features and subjective/physiological responses to emotional stimuli in the presence of emotion dysregulation in attention-deficit hyperactivity disorder.

INTRODUCTION: Emotion dysregulation (ED) has long been recognized in clinical descriptions of attention-deficit hyperactivity disorder (ADHD), but a renewed interest in ED has advanced research on the overlap between the two entities. Autonomic reactivity (AR) is a neurobiological correlate of emotion regulation; however, the association between ADHD and AR remains unclear. Our aim was to explore the clinical differences, AR, and subjective emotional responses to visual emotional stimuli in ADHD children with and without ED. METHOD: School-aged ADHD children with (n = 28) and without (n = 20) ED, according to the definition of deficiency in emotional self-regulation (DESR), and healthy controls (n = 22) were interviewed by using the Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime version (K-SADS-PL) to screen frequent psychopathologies for these ages. All subjects were evaluated with Child Behavior Checklist 6-18 (CBCL), the Strengths and Difficulties Questionnaire (SDQ), the McMaster Family Assessment Device (FAD), the School-Age Temperament Inventory (SATI), and Conners' Parent Rating Scale (CPRS-48), which were completed by parents. To evaluate emotional responses, the International Affective Picture System (IAPS) and the subjective and physiological responses (electrodermal activity and heart rate reactivity) to selected pictures were examined. RESULTS: Regarding clinically distinctive features, the ADHD+ED group differed from the ADHD-ED and the control groups in terms of having higher temperamental negative reactivity, more oppositional/conduct problems, and lower prosocial behaviors. In the AR measures, children in the ADHD+ED group rated unpleasant stimuli as more negative, but they still had lower heart rate reactivity (HRR) than the ADHD-ED and control groups; moreover, unlike the two other groups, the ADHD+ED group showed no differences in HRR between different emotional stimuli. CONCLUSION: The presented findings are unique in terms of their ability to clinically and physiologically differentiate between ADHD children with and without ED.

Design and Development of a Miniaturized Percutaneously Deployable Wireless Left Ventricular Assist Device: Early Prototypes and Feasibility Testing.

The current left ventricular assist devices (LVADs) are limited by a highly invasive implantation procedure in a severely unstable group of advanced heart failure patients. Additionally, the current transcutaneous power drive line acts as a nidus for infection resulting in significant morbidity and mortality. In an effort to decrease this invasiveness and eliminate drive line complications, we have conceived a wireless miniaturized percutaneous LVAD, capable of being delivered endovascularly with a tether-free operation. The system obviates the need for a transcutaneous fluid purge line required in existing temporary devices by utilizing an incorporated magnetically coupled impeller for a complete seal. The objective of this article was to demonstrate early development and proof-of-concept feasibility testing to serve as the groundwork for future formalized device development. Five early prototypes were designed and constructed to iteratively minimize the pump size and improve fluid dynamic performance. Various magnetic coupling configurations were tested. Using SolidWorks and ANSYS software for modeling and simulation, several geometric parameters were varied. HQ curves were constructed from preliminary in vitro testing to characterize the pump performance. Bench top tests showed no-slip magnetic coupling of the impeller to the driveshaft up to the current limit of the motor. The pump power requirements were tested in vitro and were within the appropriate range for powering via a wireless energy transfer system. Our results demonstrate the proof-of-concept feasibility of a novel endovascular cardiac assist device with the potential to eventually offer patients an untethered, minimally invasive support.

[Assessment of Adolescent Attachment Styles Via Narrative Responses To the Thematic Stimulus]. / Ergen Baglanma Biçimlerinin Tematik Uyaranlara Verilen Öyküsel Tepkiler Araciligiyla Degerlendirilmesi.

OBJECTIVE: The aim of this research is to develop a new protocol with a projective test and qualitative assessment approach for investigating mental representations effective for the formation of attachment styles and to examine its psychometric properties. METHOD: Thirty-three adolescents who admitted to the Division of Adolescent Medicine of Hacettepe University participated to the study. The Adolescent Attachment Protocol (AAP) and Relationship Styles Questionnaire (RSQ) were used. RESULTS: The ICC scores among judges for Adolescent Attachment Protocol (between 0.78 and 0.87) were found statistically significant. Principle component analysis revealed that four main dimensions (Self, Other, Avoidance, and Dependency) are gathered under one factor that predicted 63% of the main change. It has been determined that similarity of the attachment classifications done by Adolescent Attachment Protocol and Relationship Styles Questionnaire were %58. Qualitative evaluations pointed out a considerable differentiation between secure and insecure attachment styles in terms of themes. CONCLUSION: The psychometric properties of newly developed Adolescent Attachment Protocol according to self-report scale and its strength and weakness to assess mental representations is discussed in the light of the relevant literature.

The effect of gynecomastia on body image perception and gender roles in adolescents.

The aim of our study was to evaluate the effect of gynecomastia on body image perception and gender roles in adolescents. Forty-seven adolescents with gynecomastia and 63 healthy adolescents were enrolled in the study. The Body Image Perception Scale (BIPS) and the Bem Gender Role Inventory (BGRI) were administered to the study group after the first evaluation and also one month later. The percentage of adolescents with a BIPS score lower than the median was higher in the study group than in the control group, although there was no significant difference. Additionally, considering the single item "my breasts," it was observed that body image perception disturbance existed mostly, if not entirely, in relation to this body part. After detailed information regarding gynecomastia was given during the first clinical session, the BIPS score improved at the one-month follow-up, emphasizing the importance of informing and educating patients regarding this condition. BGRI results showed that gender roles of patients with gynecomastia are not influenced in the feminine direction.

Identity status and attachment in adolescents with attention deficit hyperactivity disorder.

Identity and attachment are two concepts of different theories that might be related and that are developmentally very important in adolescence. The aim of this study was to explore the sense of identity, attachment styles and their relation in a group of adolescents with attention deficit hyperactivity disorder (ADHD). Thirty-four adolescents who were diagnosed with ADHD in childhood were reevaluated at the age of 13-16 years. The comparison group consisted of age- and gender-matched adolescents without a psychiatric disorder. The Sense of Identity Assessment Form (SIAF) and the Relationship Scales Questionnaire (RSQ) were used to examine the sense of identity and attachment styles of adolescents, respectively. Compared to adolescents without a psychiatric disorder, adolescents with ADHD, independent of the presence of a comorbid psychiatric disorder, had a similar identity formation process; however, adolescents with ADHD and a comorbid psychiatric disorder experienced more preoccupied attachment styles. Comorbid psychiatric disorders seem to be related to the insecure attachment patterns in adolescents with ADHD.

Comorbidity and continuity of attention deficit hyperactivity disorder (ADHD) from childhood to adolescence in Turkey.

The aim of this study was to examine clinical outcomes, psychiatric comorbidity and neuropsychological characteristics in Turkish adolescents with an attention deficit hyperactivity disorder (ADHD) diagnosis in childhood. A total of 45 children with ADHD diagnosis and 28 children with a psychiatric diagnosis other than ADHD in a 1-year cohort of 7-10-year-olds were reevaluated 6 years later using Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version and Wechsler Intelligence Scale for Children-Revised and Stroop Test TBAG version. This study shows that the clinical outcomes and the comorbidity patterns for ADHD from childhood to adolescence in Turkey are similar to reported rates in the Western countries. In the ADHD group, 75.6 % still has impairing ADHD symptoms and 46.6 % has comorbid psychiatric disorders. The main difference is anxiety disorders being the most common comorbid disorders (37.8 %) in Turkish ADHD youth. These findings stress the high comorbidity associated with ADHD and support the importance of assessment and treatment for ADHD and comorbidities during adolescence.