An Examination of the Relations Between Symptom Distributions in Children Diagnosed with Autism and Caregiver Burden, Anxiety and Depression Levels.

High stress levels and impairment of physical/mental health in parents can delay early and effective intervention in autism. The purpose of this study was to examine relations between the clinical characteristics of children diagnosed with autism spectrum disorder (ASD) and caregiver burden, and anxiety and depression levels. Seventy cases under monitoring at the Namik Kemal University Medical Faculty Child and Adolescent Psychiatric Polyclinic with a diagnosis of ASD, and their principal caregivers, were included in the study. The Autism Behavior Checklist (ABC), Beck Depression Inventory (BDI), Beck Anxiety Inventory, and the Zarit Caregiver Burden Scale were completed. At multiple regression analysis, autism symptom severity and caregiver depressive symptom levels emerged as significant predictors of total caregiver burden scores. Only the ABC language subscale score had a determining effect on caregiver burden (r = 0.51, r2 = 0.26, p = 0.04). ABC body and object use subscale scores were identified as the symptom cluster affecting depression and anxiety scores (r = 0.25, r2 = 0.06, p = 0.03 and r = 0.28, r2 = 0.08, p = 0.01). Our findings show that ASD symptom severity and depressive symptoms in the caregiver are the most important factors giving rise to the caregiver burden, and that the main ASD symptom cluster affecting the caregiver burden was problems associated with language development. Better understanding of variables impacting on the caregiver burden will increase the quality of psychosocial services for caregivers.

Evaluation of psychological characteristics of Turkish children with type 1 diabetes mellitus from two demographically and geographically distinct regions.

Baran RT, Sürer-Adanir A, Karakurt MN, Dündar M, Aydin M, Özbek MN, Demirbilek H. Evaluation of psychological characteristics of Turkish children with type 1 diabetes mellitus from two demographically and geographically distinct regions. Turk J Pediatr 2018; 60: 554-561. Type 1 diabetes mellitus (T1DM), patients have an increased risk of psychiatric morbidity compared to their healthy counterparts. The aim of the present study is to evaluate the demographic and laboratory data and psychological characteristics of children with T1DM from two geographical regions of Turkey. The study included 98 pediatric T1DM patients followed in pediatric endocrinology clinics from Diyarbakir (n=50), an eastern city and Antalya (n=48) a western city, and 43 healthy subjects from Diyarbakir (n=20) and Antalya (n=23). The sociodemographic data, duration of diabetes and the glycated hemoglobin levels (HbA1c) were also noted. For the evaluation of emotional and behavioral problems in children, Turkish version of The Child Behavior Checklist (CBCL) 6-18, and for depression, Child depression inventory (CDI) was used. Patients from the Diyarbakir Diabetes Mellitus (DDM) group had a longer duration of diabetes compared to those of the Antalya Diabetes Mellitus (ADM) group, while HbA1c levels were not statistically different. Children with T1DM from Diyarbakir reported higher problem scores in CBCL in majority of domains and both internalizing and externalizing subscores compared to the controls and in all domains compared to the patients from Antalya. The CDI scores of the DDM group were also significantly higher than those of the ADM group. In conclusion, diabetic children from Diyarbakir had more problems in emotional, social and behavioral domains compared to the healthy peers and patients from Antalya, indicating that T1DM brought more psychosocial burden to these patients independently from the metabolic control. Pediatric specialists working in the eastern region should be more precautious with diabetic patients in terms of comorbid psychiatric conditions and psychiatric referral when needed.

The Effect of Atomoxetin Use in the Treatment of Attention-Deficit/Hyperactivity Disorder on the Symptoms of Restless Legs Syndrome: A Case Report.

Attention-deficit/hyperactivity disorder (ADHD) is frequently accompanied with sleep disorders such as obstructive sleep apnea, periodic limb movement disorder, restless legs syndrome (RLS), and circadian rhythm disorder. We have limited information about the effects of medical therapies used in the treatment of ADHD on RLS. This article discusses the effects of atomoxetine treatment on both disorders in a patient followed by diagnoses of ADHD and RLS.

Neuropsychological and Clinical Profiles of Children and Adolescents Diagnosed with Childhood Obsessive Compulsive Disorder.

INTRODUCTION: The differential features of childhood-onset obsessive compulsive disorder (OCD) compared to adult-onset OCD are being more of a focus of attention in recent years. The aim of this study was to determine the clinical and neuropsychological profiles of children and adolescents diagnosed with childhood-onset OCD and to investigate the association between the duration, severity, comorbidity, and family history of the disorder and clinical and neuropsychological functional impairments. METHODS: Thirty-five OCD patients (patient group) and 35 healthy control subjects (control group) between 8-15 years of age were included. To investigate the neuropsychological profiles, the Wisconsin Card Sorting Test (WCST), Stroop Test, and Continuous Performance Test (CPT) were applied. To assess the clinical and behavioral profiles, the Children's Depression Inventory (CDI), Conner's Parent Rating Scale (CPRS-48), and the Yale Brown Obsessive Compulsive Scale (YB-OCS) and Yale Global Tic Severity Rating Scale (YGTSRS) were given. RESULTS: Based on the performance in the WCST, Stroop Test, and SPT, the results of the study reveal that childhood-onset OCD patients have statistically significant worse performance compared to healthy controls in terms of executive functions, sustained attention, and motor inhibition tasks. Excluding the comorbid diagnoses, childhood-onset OCD patients did not show a difference in behavioral problems, but they had higher levels of anxiety compared to healthy controls. CONCLUSION: The findings of this study reveal that independent of the duration, severity, comorbid problems, and anxiety levels, the disorder itself is associated with worse performance in executive functions, attention, and motor inhibition processes, and a positive family history of OCD is an important risk factor. Long-term follow-up studies with patients diagnosed with childhood-onset OCD would be a logical next step in order to determine the cause-effect relation between the disorder and cognitive impairments.

[Neuropsychological profiles of adolescents with bipolar disorder and adolescents with a high risk of bipolar disorder]. / Bipolar bozukluk tanisi olan ve bipolar bozukluk için yüksek riskli ergenlerin nöropsikolojik özellikleri.

PURPOSE: In recent years evidence of an association between bipolar disorder (BD), and specific neuropsychological impairment and familial transmission of BD has been mounting. The aim of this study was to identify the clinical and neuropsychological features of BD in adolescents, to assess the clinical and neuropsychological parameters in adolescents with a high risk of familial transmission of BD, and to identify probable early markers of the disorder. MATERIALS AND METHODS: The study included 25 patients aged 12-18 years that were diagnosed as BD (case group), 25 adolescents without a mood disorder that had a parent and/or sibling diagnosed as BD, (risk group), and 25 typically developing adolescents (control group). To determine neuropsychological profiles the participants were administered the Wisconsin Card Sorting Test (WCST), Stroop Color Word Test (SCWT), and Continuous Performance Test (CPT), and to evaluate clinical and behavioral profiles the Children's Depression Inventory (CDI), Parent-Young Mania Rating Scale (P-YMRS), Youth Self-Report (YSR), and Conners' Parent Rating Scale (CPRS-48) were administered. RESULTS: The case group performed significantly lower on the WCST, SCWT, and CPT in terms of executive and attention functions, whereas there wasn't a difference between the risk group and control group. In addition, significantly more of the adolescents in the case and risk groups had clinical and behavioral problems than those in the control group. CONCLUSION: The findings show that behavioral and clinical problems were more common in the risk group than in the control group, and that the frequency of attention and executive function impairment was similar in both of those groups. The findings suggest that BD itself may be associated with attention and executive function impairments, whereas a familial risk of BD may be associated with some behavioral problems. Follow-up and neuroimaging studies conducted with a larger number of participants, and neuropsychological test profiles may provide more detailed information about the neuropsychological profiles of individuals with a genetic risk for BD and may provide descriptive data about where and how the biological and psychometric deterioration initiate.

Post-traumatic stress symptoms in adolescents after two murders in a school: a controlled follow-up study.

OBJECTIVES: Two students were murdered by gunshot by another student. Among the classmates and the students in another school, we aimed to investigate the factors on the fifth day of trauma to be predictive of higher post-traumatic stress symptoms (PTSS) scores five months later. METHODS: The adolescents attending the school (School A: acute phase n:41; second phase n:57; follow-up group n:35) where the event had occurred, and the adolescents attending a school (School B: acute phase n:98; second phase n:57) of similar statue were included. They had completed "Trauma Questionnaire" (TQ), "Childhood Post Traumatic Stress Disorder-Reaction Index" (CPTSD-RI), "Beck Depression Inventory" (BDI), and "State-Trait Anxiety Inventory" (STAI) both 5 days and 5 months after the event. RESULTS: Both 5 days and 5 months after the trauma, students in school A, and the girls in both schools had significantly higher CPTSD-RI scores. Nine students (25.7%) in the follow-up group were found to have CPTSD-RI scores higher than 39, indicating severe PTSD symptoms. The CPTSD-RI scores of this group 5 months after the trauma were significantly correlated with the several scores of the acute term (CPTSD-RI [r: .76,p < .001]; BDI [r: .56, p: .001]; STAI-state [r:. 49, p: .004]). CONCLUSION: Results reveal that a murder of a peer triggers post-traumatic stress symptoms in a vast majority of the 16-year-old adolescents even without directly witnessing the event. The severity of PTSS significantly increases as the adolescent is in closer relationship with the victim. The concomitant depression and/or anxiety with acute stress symptoms 5 days after the trauma, female gender, and worse school performance were found to be significantly related to the development of more severe PTSS 5 months later.