The role of cognitive disengagement syndrome in non-suicidal self-injury among adolescents with attention deficit hyperactivity disorder.

AIMS: We aimed to investigate the relationship between Cognitive Disengagement Syndrome (CDS) and non-suicidal self injury (NSSI) in adolescents with attention deficit hyperactivity disorder (ADHD). METHODS: A semi-structured psychiatric interview and an NSSI screening questionnaire were conducted. Questionnaires assessing CDS (with daydreamer, sleepy, and slow subdimensions), depression, anxiety, self-esteem, emotion regulation, coping strategies, and loneliness were administered. RESULTS: Among 104 participants (n: 63, 60.6% girls), the combined type of ADHD was the most common (66.3%), and 35 adolescents (27 girls) were in the NSSI+ group. Although only depression and ADHD were found to be predictors of NSSI in ADHD, CDS was associated with many risk factors of NSSI in ADHD: depression, anxiety, emotion dysregulation, low self-esteem, and emotion-oriented coping ways. After controlling for the effects of cognitive problems/inattentiveness, depression, and anxiety, CDS still correlated with low self-esteem and emotion dysregulation. The daydreamer and slow sub-dimensions of CSD differed between NSSI+ and NSSI- groups, while sleepy did not. CONCLUSIONS: CDS is associated with several relevant factors, indirectly relating it to self-harm in ADHD. CDS increases the vulnerability to mental health changes that could lead to NSSI in adolescence with ADHD.

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.

The role of mindfulness on the psychological aspects of anorexia nervosa.

OBJECTIVE: Emotion regulation, perfectionism, and rumination are perpetuating factors in anorexia nervosa (AN). Mindfulness can be protective and therapeutic. We aimed to understand the relationship between these factors and mindfulness in AN. METHODS: 20 adolescent girls in the acute phase of the AN, 16 in remission, and 40 in the control group were evaluated. RESULTS: Mindfulness was lowest in the acute AN group. The difference in the acute AN group regarding body dissatisfaction, emotion dysregulation, perfectionism, and mindfulness disappeared after controlling for the effects of depression and anxiety. The predictors of disordered eating in the entire study population were body dissatisfaction and depressive symptoms. Emotion regulation and perfectionism were the predictors of mindfulness in the acute AN group and the entire study population. When mindfulness decreased, concerns about body shape increased in both acute AN and remission groups, while dietary restriction and disordered eating behaviors increased only in the remission group. DISCUSSION: Emotion regulation difficulties in acute AN could be related to depression and anxiety. Mindfulness interventions for emotion regulation could be used for depression during the acute phase while for perfectionism in remission. Early intervention for depression and body dissatisfaction seems protective, and mindfulness could be an appropriate intervention.

Investigation of adolescents and their mothers in terms of nomophobia.

BACKGROUND: Nomophobia (NoMP) is the fear of being unable to interact with others via mobile phones and is a current topic in adolescents` mental health. The purpose of this study was to investigate the association between NoMP in adolescents and their mothers` level of NoMP. METHODS: The levels of depression, anxiety, attention deficit/hyperactivity-impulsivity symptoms, NoMP, and perceived parental emotional availability were examined. RESULTS: One hundred fifty-five adolescents (60% girls) were included in the study with their mothers. Ninetythree (60%) adolescents (67.7% girls) and 64 (41.3%) mothers were classified as nomophobic. There was a positive correlation between the NoMP levels of adolescents and their mothers. Nomophobic girls perceived less paternal support. All psychopathologic symptoms were higher in the nomophobic mothers. There was no difference between nomophobic and non-nomophobic adolescents in terms of maternal psychopathologies. CONCLUSIONS: We suggest that parental effects should be investigated during the assessment of NoMP, especially in adolescent girls. The phone usage habits of mothers and their relationship with their adolescent children were closely associated with adolescent NoMP.

Suicidal and Homicidal Thoughts as Psychotic Symptoms in an Adolescent: A Case Report. / Ergende Psikotik Belirti Olarak Suisidal ve Homisidal Düsünceler: Olgu Sunumu.

The first episode of psychotic disorders often occurs in adolescence. Depressive symptoms are the most common symptoms in the prodromal period and the symptoms in this period are not specific to psychosis. Adolescence is a risky period in terms of suicidal behaviors. The risk of self-harm is further increased in the prodromal period and in the psychotic episode. Homicides in psychosis constitute a small part of all homicidal cases and homicidal thoughts have been associated with command hallucinations and delusions. In this article, an adolescent girl with psychosis who had intense homicidal and suicidal thoughts and self-harming behaviors will be presented, and homicidal thoughts in psychosis will be discussed. The symptoms of the case decreased with risperidone, and she started to socialize with the support of her teacher, who visited her house for lectures. The medical, legal, and social aspects of suicides and homicides in psychosis are discussed. Keywords: Adolescent, psychosis, homicidal, suicidal.

Pregabalin abuse in adolescence: a case series.

BACKGROUND: Pregabalin is an inhibitor of gamma-aminobutyric acid (GABA) and can be abused, especially by polydrug abuser adults. Drug abuse is one of the many risky behaviors that can be seen during adolescence. Here, three adolescents with pregabalin abuse were described. CASE: These adolescents abused pregabalin to cope with their depressive and anxiety symptoms, become tranquilized, boost other drug effects, and reduce withdrawal symptoms. Therefore, the risk factors should be assessed while pregabalin is prescribed to adolescents. CONCLUSIONS: The cases were reported in order to increase awareness concerning the abuse risk of pregabalin among adolescents.

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.

Mindful Eating, Body Weight, and Psychological Well-Being in Adolescence.

Background: This study investigated the relationships among psychological well-being, mindful eating, and weight in adolescents. Methods: Data of this cross-sectional study were collected from students of three high schools. Various questionnaires regarding mindful eating, eating behavior, emotion regulation, self-esteem, coping, body attitude, depression, and anxiety were given. BMI percentile was calculated and four groups were detemined. Hacettepe University Non-Inventional Clinical Researches Review Board approved the study (GO 18/1116). Results: Among 401 participants (59.1% girls), 16 adolescents (4.0%) were underweight, 295 (73.6%) were normal, 62 (15.5%) were overweight, and 28 (7.0%) were obese. Emotional and external eating were more common in girls. Restrictive eating was distinguishing between all adolescents, except ones with obesity and overweight. Adolescents with obesity perceived themselves as the least self-confident, attractive, and healthy, while the opposites were true for adolescents with normal weight. The groups that differed mostly from each other were normal weight and overweight. Conclusions: The psychological well-being of being overweight should not be underestimated. Emotional and external eating were correlated with low mindful eating, and gender differences were found in different aspects of mindful eating types. Calorie information and healthy eating interventions may be beneficial in boys, while interventions targeting to understand physical and emotional states may be beneficial in girls during the treatment of disordered eating behaviors.

Comparision of Radiochemotherapy Applications that Committing with Two Different Chemotherapies Route in Locally Advanced Lung Cancer.

OBJECTIVE: This study investigated pre- and post-treatment tumor and lymph node dimension response rates and differences between side-effect profiles in patients with locally advanced inoperable nonsmall-cell lung cancer (NSCLC) receiving radiotherapy (RT) and concurrent chemotherapy (CT). MATERIALS AND METHODS: A total of 30 inoperable patients who had not previously received RT and having a mean age of 58.73±8.65 years with sufficient hematological reserves and normal hepatic and renal functions were included in the study. Those with pleural effusion, supraventricular lymph node metastasis, and N3 lymph node involvement were excluded. Group I (n=15) received a 21-day 75 mg/m2 cisplatin (D1) and 15 mg/m2 vinorelbine (D1, D8), whereas Group II (n=15) received 45 mg/m2 paclitaxel and AUC2 carboplatin weekly. RT was administered using a linear accelerator device with the 3D conformal RT technique at 6-18 MV energy with a 1.8-2 Gy fraction for 6-7 weeks. RESULTS: Patients were randomized into Group I receiving RT and concurrent cisplatin-vinorelbine and Group II receiving weekly paclitaxel-carboplatin CT. Pre- and post-treatment tumor and lymph node dimensions significantly differed in both groups (p<0.001 and p<0.01, respectively). No significant change was observed in post-RT tumor and lymph node dimensions in terms of applied CT regimens (p>0.05). CONCLUSION: The significant response achieved with concurrent RT and CT in groups I and II in the local advanced stage of NSCLC is important for local tumor control. Responses to treatment in the group of two arms did not differ.

[The Role of Gut Microbiota in Autism Spectrum Disorder]. / Otizm Spektrum Bozuklugunda Bagirsak Mikrobiyotasinin Rolü.

Human microbiota are colonies of microorganisms located in different parts of the human body with diverse functions. Healthy gut microbiota comprises differing ratios of microoganisms wholly contributing to metabolic and other molecular reactions in a healthy, functioning body. After the demonstration of the bidirectional interaction between the central nervous system and gut microbiota through neuroendocrine, neuroimmune, and autonomic nervous mechanisms, investigations have been started on the microbiota-gut-brain axis in psychiatric disorders. Autism spectrum disorder (ASD), which is a neurodevelopmental disorder of early childhood, is one of these disorders. Most of such studies were cross-sectional and mainly investigated the bacterial species. Changes in gut microbiota composition and the leaky gut syndrome are some of the hypotheses proposed to explain the core symptoms and gastrointestinal (GI) symptoms of ASD. Probiotics, prebiotics, fecal microbiota transplantation, diet have been proposed as treatment options. However, the role of microbiota in diagnosis, followup, and treatment is not yet clear. The bidirectional interaction between central nervous system and intestinal microbiota makes it difficult to establish the cause-effect relationship. The current data on microbiota may be useful to plan patient-specific treatment in autistic children with GI symptoms. This article aims to review the results of the studies on microbiota in animal models and children and discuss the emerging clinical relationship of ASD and gut microbiota.

The impact of nanoparticles on aerobic degradation of municipal solid waste.

The amount of nanoparticles released from industrial and consumer products has increased rapidly in the last decade. These products may enter landfills directly or indirectly after the end of their useful life. In order to determine the impact of TiO2 and Ag nanoparticles on aerobic landfilling processes, municipal solid waste was loaded to three pilot-scale aerobic landfill bioreactors (80 cm diameter and 350 cm height) and exposed to TiO2 (AT) and Ag (AA) nanoparticles at total concentrations of 100 mg kg-1 of solid waste. Aerobic landfill bioreactors were operated under the conditions about 0.03 L min-1 kg-1 aeration rate for 250 days, during which the leachate, solid waste, and gas characteristics were measured. The results indicate that there was no significant difference in the leachate characteristics, gas constituents, solid quality parameters, and temperature variations, which are the most important indicators of landfill operations, and overall aerobic degradation performance between the reactors containing TiO2 and Ag nanoparticles, and control (AC) reactor. The data also indicate that the pH levels, ionic strength, and the complex formation capacity of nanoparticles with Cl- ions can reduce the toxicity effects of nanoparticles on aerobic degradation processes. The results suggest that TiO2 and Ag nanoparticles at concentrations of 100 mg kg-1 of solid waste do not have significant impacts on aerobic biological processes and waste management systems.

Initial Ophthalmic Findings in Turkish Children with Autism Spectrum Disorder.

Children with autism spectrum disorders (ASD) frequently have ophthalmologic disorders. Due to poor cooperation with ophthalmological examination, ocular abnormalities in such children may be overlooked. We retrospectively studied the records of 324 patients diagnosed as ASD that underwent ophthalmological examination between January 2011 and November 2014 at Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey. Ophthalmic pathology was noted in 26.9% of patients with ASD, of which 22% had significant refractive errors and 8.6% had strabismus. Comprehensive eye examination by a pediatric ophthalmologist is recommended for all children diagnosed as ASD.

Change in metabolic parameters and weight in response to risperidone monotherapy in young children with nonpsychotic disorders: a prospective open-label study.

BACKGROUND: This study investigates changes in metabolic parameters in prepubertal children after 14-16 weeks of treatment with low-dose risperidone. METHOD: Thirty-one children (mean age 5.46 ± 1.98 years) were treated with risperidone (0.25-1 mg/day; 0.01-0.07 mg/kg/day). Patients were excluded if they were using any medication other than risperidone or were diagnosed with any medical problem in addition to a non-psychotic disorder. RESULTS: Weight (Δ: 2.51 ± 1.94 kg), height (Δ: 0.03 ± 0.04 cm), BMI (Δ: 0.82 ± 1.4), BMI percentile (Δ: 9.72 ± 16.40), BMI z-score (Δ: 0.33 ± 1.03), triglyceride (Δ: 1.50 ± 23.97 mg/dl), very low density lipoprotein (Δ: 2.99 ± 4.76 mg/dl), insulin (Δ: 3.07 ± 3.38 mIU/ml), and leptin (Δ: 3.02 ± 4.69 ng/ml) were significantly increased (p < .05). CONCLUSION: The metabolic side effects of risperidone must be carefully monitored in prepubertal children.