Data-driven exploratory method investigation on the effect of dyslexia education at brain connectivity in Turkish children: a preliminary study.

Dyslexia is a specific learning disability that is neurobiological in origin and is characterized by reading and/or spelling problems affecting the development of language-related skills. The aim of this study is to reveal functional markers based on dyslexia by examining the functions of brain regions in resting state and reading tasks and to analyze the effects of special education given during the treatment process of dyslexia. A total of 43 children, aged between 7 and 12, whose native language was Turkish, participated in the study in three groups including those diagnosed with dyslexia for the first time, those receiving special education for dyslexia, and healthy children. Independent component analysis method was employed to analyze functional connectivity variations among three groups both at rest and during the continuous reading task. A whole-brain scanning during task fulfillment and resting states revealed that there were significant differences in the regions including lateral visual, default mode, left frontoparietal, ventral attention, orbitofrontal and lateral motor network. Our results revealed the necessity of adding motor coordination exercises to the training of dyslexic participants and showed that training led to functional connectivity in some brain regions similar to the healthy group. Additionally, our findings confirmed that impulsivity is associated with motor coordination and visuality, and that the dyslexic group has weaknesses in brain connectivity related to these conditions. According to our preliminary results, the differences obtained between children with dyslexia, group of dyslexia with special education and healthy children has revealed the effect of education on brain functions as well as enabling a comprehensive examination of dyslexia.

Role of Glutamate Receptor-related Biomarkers in the Etiopathogenesis of ADHD.

Objective: : Pathways associated with glutamate receptors are known to play a role in the pathophysiology of attention-deficit hyperactivity disorder (ADHD). However, cyclin-dependent kinase 5 (CDK5), microtubule-associated protein-2 (MAP2), guanylate kinase-associated protein (GKAP), and postsynaptic density 95 (PSD95), all of which are biomarkers involved in neurodevelopmental processes closely related to glutamatergic pathways, have not previously been studied in patients with ADHD. The main purpose of this study was to evaluate the plasma levels of CDK5, MAP2, GKAP, and PSD95 in children with ADHD and investigate whether these markers have a role in the etiology of ADHD. Methods: : Ninety-six children with ADHD between 6 and 15 years of age and 72 healthy controls were included in the study. Five milliliters of blood samples were taken from all participants. The samples were stored at -80°C until analyzed by the enzyme-linked immunosorbent assay method. Results: : Statistically significantly lower CDK5 levels were observed in children with ADHD than in healthy controls (p = 0.037). The MAP2, GKAP, and PSD95 levels were found to be statistically significantly higher in the ADHD group than in healthy controls (p = 0.012, p = 0.009, and p = 0.024, respectively). According to binary regression analysis, CDK5 and MAP2 levels were found to be predictors of ADHD. Conclusion: : In conclusion, we found that a close relationship existed between ADHD and glutamatergic pathways, and low levels of CDK5 and high levels of MAP2 and GKAP played a role in the etiopathogenesis of ADHD.

functional outcome in late adolescence/early adulthood of patients with autism spectrum disorder and its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional study.

The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported "good" or "very good" outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education.

S100B and Neuron-Specific Enolase Levels as Brain Injury Biomarkers in Internet Addiction: Effect of Sleep.

BACKGROUND: Comorbidity of Internet addiction (IA) with sleep disruptions is common in adolescents. There is evidence that the levels of brain injury markers could be affected by sleep disruptions. In this study, we aimed to evaluate the relationship between sleep quality and these biomarkers within the framework of the relationship between IA and sleep disruptions. METHODS: A total of 65 drug-free adolescents with newly diagnosed IA, aged 12 to 18 years, were included in the study, and they were divided into two groups considering the comorbidities of attention-deficit/hyperactivity disorder (ADHD) and social anxiety. The control group consisted of 30 healthy children. The participants were asked to complete the Young Internet Addiction Scale, Pittsburgh Sleep Quality Index (PSQI), Morningness Eveningness Questionnaire, Beck's Depression Inventory, Beck's Anxiety Inventory, and Barratt Impulsiveness Scale-11. Blood samples were taken between 8 and 9 am to analyze S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE) levels with enzyme-linked immunosorbent assay. RESULTS: Plasma S100B and NSE levels were found to be statistically significantly higher in the IA with ADHD and the IA with anxiety groups than in healthy controls. NSE and S100B levels were found to be correlated with PSQI scores in both the IA groups. Also, there was a positive correlation between these biomarkers and IA severity. CONCLUSIONS: Decreased sleep quality and daily sleep duration in IA might cause brain injury, resulting in an increase in the severity of the addiction. Prospective studies with large samples are needed to better explain the IA-sleep-brain injury relationship.

Nerve growth factor and angiotensin converting enzyme 2 levels in children with neurodevelopmental disorders.

OBJECTIVE: Neurodevelopmental disorders (NDDs) are the most common psychiatric disorders in childhood, and there are many factors in their etiology. In recent years, many biomarkers have been studied to elucidate the etiology of these disorders. In this study, it was aimed to investigate the levels of nerve growth factor (NGF) and angiotensin converting enzyme 2 (ACE2) in attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID). METHODS: The study included 74 children with NDDs (the number of patients in ADHD, ASD and ID groups were 24, 25 and 25 respectively) and 30 healthy controls (HCs). Serum NGF and ACE2 levels were studied with ELISA kits, also complete blood count (CBC), levels of fasting glucose and serum lipids were assessed. RESULTS: ACE2 levels were found to be lower in NDD group than HCs in girls. In boys with ASD, triglyceride levels were significantly higher than other groups. Also a positive correlation was found between ACE2 and NGF levels when all sample assessed together. CONCLUSIONS: This study is a premise for investigating ACE2 and NGF in NDDs. The role of these markers in ADHD, ASD, ID and other NDDs and their associations with gender should be assessed by studies in which both larger sample groups and more disorders.

The Role of BDNF and NPY Levels, Effects of Behavioral Systems and Emotion Regulation on Internet Addiction in Adolescents.

Internet addiction (IA), one of the behavioral addictions, is also related to impulsivity. Although studies on its etiology and risks continue, the number of studies is limited. In this study, we aimed to assess the roles of behavioral systems, emotional regulation (ER), and impulsivity in the development of IA in adolescents and also to assess the relationship between all these clinical parameters and brain-derived neurotrophic factor (BDNF) and neuropeptide Y (NPY). Forty-two adolescents with IA and 30 healthy controls (ages 12 -17) were included in the study. Self-reported measures included the Internet Addiction Scale. (IAS), Behavioral Activation and Behavioral Inhibition Scale (BAS/BIS), Barratt. Impulsiveness Scale-11 (BIS-11), and Difficulties in Emotion Regulation Scale-16 (DERS-16) were used for the assessment of the participants. The levels of plasma brain BDNF and NPY were evaluated with the ELISA method. BAS/BIS subscale scores, BIS-11, and DERS-16 scale total scores were found to be statistically significantly higher, while BDNF and NPY levels were found to be lower in adolescents with IA compared to the healthy controls. IA severity was not found to correlate with both BDNF and NPY. IA was found to be more related to BIS than to BAS. There is a need for further studies evaluating developmental features and possible diagnostic biomarkers that may be associated with IA in adolescents.

Decreased levels of alpha synuclein in families with autism spectrum disorder and relationship between the disease severity.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorders that begin in early childhood. Mutations in α-synuclein (SNCA) gene have been shown to result in the accumulation of α-synuclein, which occurs in many neurodegenerative diseases. Our aim was to determine the changes in the expression profile and protein level of this gene by comparing the autistic children with their healthy siblings, their mothers and healthy controls in order to elucidate the possible contribution of the SNCA gene to the etiology of ASD. 50 autistic patients, their mothers, siblings and 25 healthy controls and their mothers were enrolled to determine SNCA gene expression and serum α-synuclein levels. It was determined that α-synuclein serum levels decreased in the autistic patients. Similarly, it was found that SNCA gene expression and serum α-synuclein levels were significantly decreased in the mothers of the patients. Significant negative correlation was observed between the SNCA gene and protein expression amounts in the 6-8 age of the patients. This family-based study is the first in the literature, with both gene expression and serum levels of α-synuclein. The relationship between ASD severity and α-synuclein level needs to be confirmed in larger-scale studies.

Using electrooculography with visual stimulus tracking test in diagnosing of ADHD: findings from machine learning algorithms.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD), one of the most common neurodevelopmental disorders in childhood, is diagnosed clinically by assessing the symptoms of inattention, hyperactivity, and impulsivity. Also, there are limited objective assessment tools to support the diagnosis. Thus, in this study, a new electrooculography (EOG) based on visual stimulus tracking to support the diagnosis of ADHD was proposed. METHODS: Reference stimulus one-to-one tracking numbers (RSOT) and colour game detection (CGD) were applied to 53 medication-free children with ADHD and 36 healthy controls (HCs). Also, the test was applied six months after the treatment to children with ADHD. Parameters obtained during the visual stimulus tracking test were analyzed and Higuchi fractal dimension (HFD) and Hjorth parameters were calculated for all EOG records. RESULTS: The average test success rate was higher in HCs than in children with ADHD. Based on machine learning algorithms, the proposed system can distinguish drug-free ADHD patients from HCs with an 89.13% classification performance and also distinguish drug-free children from treated children with an 80.47% classification performance. DISCUSSION: The findings showed that the proposed system could be helpful to support the diagnosis of ADHD and the follow-up of the treatment.

A novel approach for detection of dyslexia using convolutional neural network with EOG signals.

Dyslexia is a learning disability in acquiring reading skills, even though the individual has the appropriate learning opportunity, adequate education, and appropriate sociocultural environment. Dyslexia negatively affects children's educational development; hence, early detection is highly important. Electrooculogram (EOG) signals are one of the most frequently used physiological signals in human-computer interfaces applications. EOG is a method based on the examination of the electrical potential of eye movements. The advantages of EOG-based systems are non-invasive, affordable, easy to record, and can be processed in real time. In this paper, a novel 1D CNN approach using EOG signals is proposed for the diagnosis of dyslexia. The proposed approach aims to diagnose dyslexia using EOG signals that are recorded simultaneously during reading texts, which are prepared in different typefaces and fonts. EOG signals were recorded from both horizontal and vertical channels, thus comparing the success of vertical and horizontal EOG signals in detecting dyslexia. The proposed approach provided an effective classification without requiring any hand-crafted feature extraction techniques. The proposed method achieved classifier accuracy of 98.70% and 80.94% for horizontal and vertical channel EOG signals, respectively. The results show that the EOG signals-based approach gives successful results for the diagnosis of dyslexia.

A view of response and resistance to atomoxetine treatment in children with ADHD: effects of CYP2C19 polymorphisms and BDNF levels.

OBJECTIVE: Although several genes have previously been studied about the treatment of Attention Deficit Hyperactivity Disorder (ADHD), the number of studies investigating the effects of genes on atomoxetine (ATX) treatment is very limited. In this study, we aimed to investigate the effect of CYP2C19 polymorphisms, which have a role in ATX biotransformation, on the treatment response and also to assess whether there is a relationship between BDNF and treatment response in children and adolescents with ADHD. METHODS: One hundred children with ADHD and 100 healthy controls (HCs) were included in this study. The treatment response was assessed 2 months after the start of the ATX treatment. DNA samples from peripheral venous blood were replicated using PCR and analyzed using the ILLUMINA next-generation sequencing method. The resulting fastqs were analyzed using Basespace's Variant Interpreter Program. Plasma BDNF levels were evaluated with ELISA kits. RESULTS: Treatment response was found to be lower in both heterozygous and homozygous carriers of the c.681G > A (CYP2C19*2) polymorphism. When the BDNF level was compared, it was found to be significantly higher in the ADHD group compared to HCs. Also, BDNF has a stronger predictive value for assessing resistance to ATX treatment. CONCLUSIONS: To our knowledge, this is the first study to assess the effects of CYP2C19 polymorphisms and BDNF levels together on ATX treatment in children. Further studies with an extensive population are needed to better understand the effects of CYP2C19 polymorphisms on treatment and side effects, as well as the effects of BDNF levels.

Role of the norepinephrine transporter polymorphisms in atomoxetine treatment: From response to side effects in children with ADHD.

OBJECTIVE: Atomoxetine (ATX), one of the most commonly used drugs after stimulants in attention deficit hyperactivity disorder (ADHD) treatment, is an inhibitor of the norepinephrine transporter (NET/SLC6A2), which is also associated with the etiology of ADHD. In this study, we aimed to investigate the effect of NET gene polymorphisms on response to ATX treatment and to find the answers to the questions about whether there is a relationship between the severity of the disorder and the observed side effects in children with ADHD. METHOD: About 100 children with ADHD and 80 healthy controls (HCs) were included in this study. The dose of ATX was started at 0.5 mg/kg/day and titrated at 1.2 mg/kg/day. Response to treatment of 78 patients was evaluated 2 months after the beginning of the treatment. After whole blood samples were obtained, DNAs were isolated, and samples were stored at -80°C. Two single-nucleotide polymorphisms (SNPs) (rs12708954 and rs3785143) were analyzed by real-time quantitative PCR (qRT-PCR). RESULTS: The patients with both rs12708954 and rs3785143 heterozygous genotype had better treatment response and more side effects than patients with wild type. There was not found any association between any of the investigated NET polymorphisms and ADHD severity. CONCLUSION: It was, however, found that the NET rs12708954 and rs3785143 genotypes affect the treatment response to ATX in our study; thus, further studies with a large population are needed to understand the effects of NET polymorphisms on treatment, side effects, and also the severity of ADHD.

The study of Tau and phospho Tau protein levels in attention deficit and hyperactivity disorder

Background/aim: Attention deficit and hyperactivity disorder (ADHD) is a widespread neurodevelopmental disorder that begins in childhood and has negative consequences throughout adult life. The etiology and pathogenesis of ADHD are still unclear. Tau protein is a soluble microtubule-related protein expressed by neurons and localized in the cytoplasm as well as axons. Tau protein provides stability of microtubule in two ways: phosphorylation and isoforms. The excessive phosphorylation of Tau separates the protein from the microtubule, thus making it unstable. In this study, we aimed to investigate whether there is a relationship between serum Tau protein and phospho Tau (p-Tau181) levels and ADHD occurrence. Materials and methods: This study included 26 male children aged 7­12 years with newly diagnosed ADHD, who had previously not used any medication for ADHD, and 26 male healthy children. Serum Tau and p-Tau181 concentrations were performed by enzyme- linked immunosorbent assay (ELISA). Results: In patients, the Tau levels were not significantly different from those of the controls; the p-Tau181 levels were significantly higher than those of the controls. Conclusion: We concluded that high p-Tau181 might be associated with the progression of ADHD and cognitive changes in ADHD.

A Different View on the Etiopathogenesis of Attention-deficit Hyperactivity Disorder from an Inflammation Perspective.

OBJECTIVE: Attention-deficit hyperactivity disorder (ADHD) has a complex etiology and genetic, environmental and biological factors are considered to play a role in the etiology of ADHD by mutually interacting. Recent studies have emphasized that inflammation may be present in the etiology of ADHD. This study aims to investigate the possible role of visfatin, IL-6, IL-1b and TNF-α molecules in the etiology of ADHD. METHODS: The study included 60 patients and 20 healthy controls between the ages of 6-18. Serum visfatin, IL-6, IL-1b and TNF-α levels were evaluated with enzyme-linked immunosorbent assay (ELISA) kits at a biochemistry laboratory. RESULTS: The study showed no statistically significant difference between children with ADHD and healthy controls in terms of visfatin, IL-6, IL-1b and TNF-α levels. When ADHD subgroups (combined and predominantly inattentive types) and the control group were compared in terms of visfatin, IL-6, IL-1b and TNF-α levels, no statistically significant difference was recorded. CONCLUSION: Data on the relationship between ADHD and IL-6, IL-1b and TNF-α in this study are in compliance with the literature. However, no study was found on visfatin in ADHD. This study is the first one evaluating the ADHD-Visfatin relationship.

Diagnosis of attention-deficit hyperactivity disorder using EOG signals: a new approach.

A system based on objective data was developed in the diagnosis and follow-up of attention-deficit hyperactivity disorder (ADHD) in this study. First of all, an electronic circuit, with a two-channel instrumentation amplifier designed to detect eye movements in the horizontal and vertical directions via surface electrodes, was developed to obtain the electrooculogram (EOG) signals. In order to provide a controlled analysis of eye movements during the reception of the signal, an attention test with visual stimulus software was developed. Eight patients with ADHD and eight healthy subjects were asked to monitor the stimulus images on the screen in the reference directions of the test system while recording EOG signals. According to the results of the t-test, no significant difference was found (p=0.11) between the healthy group and the reference movement information, whereas a significant difference was found between patients and the reference motion information (p=0.049). According to these results, it was seen that the number of eye movements of healthy individuals was statistically significant. In addition, they were inconsistent with the reference movement information. The level of significance was found to be low in patients. In this study, a new method is presented to test and diagnose individuals who were attention deficit.

Ghrelin and leptin levels in children with anxiety disorders.

Background Anxiety disorders are common psychiatric disorders in childhood and an important health problem that is associated with the risk of serious mental, educational and economical problems. Researchers have mentioned many different mechanisms in the etiopathology of anxiety disorders. This study aimed to investigate ghrelin and leptin levels in children with anxiety disorders and thus to contribute to the clarification of anxiety in children. Methods Forty-three children aged 6-12 years with a diagnosis of the Anxiety Disorder according to DSM 5 and 21 healthy children age- and gender-matched to the study group were included. All the subjects were assessed with Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL) and State-Trait Anxiety Inventory for Children (STAI-C) scale. Blood samples were obtained in the morning and serum ghrelin and leptin levels were measured with enzyme-linked immunosorbent assay (ELISA) kits. Results In the anxiety group the ghrelin levels were higher than the control group (p = 0.037) but there was no significant difference between the leptin levels (p = 0.430). Also, when the girls in the anxiety group and the girls in the control group were compared, ghrelin levels were higher in the anxiety group (p < 0.01). Conclusions These findings suggest that ghrelin may play a significant role in the etiologic mechanisms of anxiety disorders. However, more detailed studies are needed to explain the linkage between anxiety disorders and neuropeptides.

Levels of Salivary Sialic Acid in Children with Autism Spectrum Disorder; Could It Be Related to Stereotypes and Hyperactivity?

OBJECTIVE: Sialic acid (Sia) is an essential nutrient for brain development, learning, memory and cognition and plays a role in neurodevelopment of infants. The aim of this study was to determine whether Sia levels are significantly associated with the autism spectrum disorder (ASD). METHODS: Forty-six ASD children and 30 typically developing children aged 3 to 10 years were included in the study. Behavioral symptoms in ASD children was assessed by the Autism Behavior Checklist (AuBC), the Childhood Autism Rating Scale, and the Aberrant Behavior Checklist (ABC). After the collection of saliva samples, the supernatant was separated. All the samples kept at -80°C until Sia analysis was done. RESULTS: Sia level was found to be significantly lower in the ASD group when compared to healthy controls ( p = 0.013). There was no correlation between severity of ASD and salivary Sia levels. We found a negative correlation between AuBC scores and Sia levels and a negative correlation in both ABC Stereotypic Behavior and Hyperactivity/Noncompliance subscales with Sia levels in ASD group. CONCLUSION: The obtained data indicate that Sia levels could have an effect on autism-like behaviors, particularly on stereotypes and hyperactivity.

Effects of Methylphenidate on Reaction Time in Children with Attention Deficit / Hyperactivity Disorder.

INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is associated with a broad range of neuropsychological impairments that are attenuated with methylphenidate (MPH) treatment. The aim of this study was to determine how MPH effects attentional functioning in terms of reaction time (RT) in ADHD. METHODS: Eighteen pre-medicated ADHD children (7 to 12 years old) and eighteen gender matched normal controls (7 to 12 years old) were included in the study. Participants performed an auditory attention task and the RT of participants to each target response was calculated automatically. The same test was repeated 3 months after OROS-MPH administration for ADHD group. RT, RT standard deviation (RTSD), and response errors (omission and commission errors) were compared between control and pre-MPH ADHD groups, and between Pre-MPH and post-MPH ADHD groups. RESULTS: Relative to control subjects, significantly longer RTs, higher RTSD and more errors of omission were observed in unmedicated ADHD children during auditory attention task. Analyses revealed significant effects of medication across all measures except commission errors. After treatment RTs were faster, RTSD values were lower, and errors of omission were attenuated compared to pre-medication condition in ADHD group. There were no significant differences in terms of commission errors between groups. CONCLUSION: In this study it was observed that MPH reduced RTs to stimuli, attenuated omission errors during the task in ADHD group and after 3 months of treatment ADHD children showed similar patterns in RT as compared to controls. Results suggest that when treating ADHD, it might help clinicians to evaluate objective and non-invasive cognitive outcomes such as RT, RTSD and response errors to evaluate the effects of treatment.

Evaluation of Two Types of Drug Treatment with QEEG in Children with ADHD.

AIMS: The aim of this study is to evalute the effects of methylphenidate and atomoxetine treatments on electroencephalography (EEG) signals in volunteer children diagnosed with Attention Deficit and Hyperactivity Disorder(ADHD). METHODS: The study contained 40 children all of whom were between the ages of 7 and 17. The participants were classified into two groups as ADHD (n=20), which was in itself divided into two groups as ADHD-MPH (ADHD- Metylphenidate treatment) (n=10) and as ADHD-ATX (ADHD-Atomoxetin treatment) (n=10), and one control group (n=20). Following the first EEG recordings of the ADHD group, long-acting methylphenidate dose was applied to one ADHD group and atomoxetine dose was applied to the other ADHD group. The effect of optimal dosage is about for 4-6 weeks in general. Therefore, the response or lack of response to the treatment was evaluated three months after the beginning of the treatment.After methylphenidate and atomoxetine drug treatment, in order to obtain mean and maximum power values for delta, theta, alpha and beta band, the EEG data were analyzed. RESULTS: The EEG power spectrum densities in all the bands yielded similar findings in both methylphenidate and atomoxetine. Although statistically significant frequency values of the electrodes were amplitude and maximally varied, in general, they appeared mostly at both frontal and temporal regions for methylphenidate and atomoxetine. CONCLUSION: Especially, after atomoxetine treatment, Quantitative Electroencephalography (QEEG) rates at frontal area electrodes were found statistically more significant than methylphenidate QEEG rates. What has been researched in this study is not only whether QEEG is likely to support the diagnosis, but whether changes on QEEG by treatment may be related to the severity of ADHD as well.

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.

Internet addiction and attention-deficit-hyperactivity disorder: Effects of anxiety, depression and self-esteem.

BACKGROUND: Attention-deficit-hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood. Behavioral disinhibition, poor neurocognitive skills and immediate reward preference in children with ADHD have been suggested as risk factors for Internet addiction (IA). The aim of the present study was therefore to investigate the relationship between IA and depression, anxiety, and self-esteem in adolescents with ADHD, and to identify the features of Internet use that predict IA. METHODS: We studied 111 patients with ADHD aged 12-18 years, and 108 healthy controls. The ADHD patients and controls were asked to complete a sociodemographic data form, the Internet Addiction Scale (IAS), Children's Depression Inventory, Childhood Screening Scale for Anxiety in Children, and the Rosenberg Self-Esteem Scale. RESULTS: IAS total score in the adolescents with ADHD was significantly higher than in the control group. Compared with the control group, the ADHD group depression scale score was significantly higher, and self-esteem score significantly lower (P < 0.05 for both). There was no difference between the groups in anxiety score. IAS score had a positive correlation with depression and anxiety scores, and a negative correlation with self-esteem score. CONCLUSION: The relationship between IA scale score and depression, anxiety and self-esteem scale scores were similar in the ADHD and the control group. In addition, IAS subscale and total scores were significantly higher in the ADHD group than the control group, even after controlling for the effects of self-esteem, depression and anxiety scores. Thus, ADHD is thought to be an independent risk factor for depression, anxiety and self-esteem, and, hence, for IA.