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Background The aim of this study was to assess depression, anxiety, and quality of life ( QOL) in a cohort of children and adolescents with end-stage renal disease ( ESRD), to compare these findings with healthy controls, and to evaluate the association between these psychological symptoms, QOL, and clinical variables related to ESRD. Methods Thirty-two children and adolescents 8-18 years of age were enrolled in the study. The sociodemographic data were evaluated. Questionnaires were used to evaluate the psychological status and QOL of the patients and healthy controls. Results There was a significant difference in mean depression score, which was significantly higher for the ESRD patients. Mean state anxiety score was significantly lower for ESRD patients than for controls. Regarding QOL score, there were significant differences between the ESRD patients and control groups for both child-rated and parent-rated QOL scores, which were significantly lower for ESRD patients. Trait anxiety was a negative predictor of all subscales of the Pediatric Quality of Life Inventory 4. Conclusions End-stage renal disease was related to significant morbidity and poorer QOL. The assessment and enhancement of QOL and comorbid psychiatric disorders in ESRD should be a part of disease management. [ABSTRACT FROM AUTHOR]

Objective: It is common to see that child-parent interaction affects psychological problems in adulthood. This interaction process may also be effective in developing emotional schemas and attitudes. The present study aimed to investigate the similarities or differences in emotional schemas between mothers and adolescents in both clinical and control groups. Method: Eighty-two adolescents who applied to the child and adolescent outpatient clinics and their mothers (assigned as the clinical group) and 80 adolescents without any psychiatric problems and their mothers (assigned as the control group) were examined using a Sociodemographic Characteristics Form and Leahy Emotional Schema Scale Turkish Version (LESS-T). A multivariate analysis of variance test was used to determine the intergroup differences in emotional schema levels. Results: LESS-T was applied to all participants. No statistically significant difference was found between mothers and their adolescents on the LESS-T subscales in the control group (p=0.89). Mothers in the clinical group reported higher levels of demand for rationality (p=0.003) and emotional avoidance (p=0.01) than mothers in the control group. In the clinical group, adolescents reported higher levels of uncontrollability (p=0.007), and mothers reported higher levels of comprehensibility (p=0.001), demand for rationality (p=0.001), and emotional avoidance (p=0.007). Conclusion: Mothers' emotional schemas, such as avoidance and demand for rationality, may prevent their children from expressing and experiencing emotions sufficiently. Findings emphasize the importance of healthy mother-child interaction for developing emotional skills. [ABSTRACT FROM AUTHOR]

Objective: Having a child with a chronic illness is a source of stress for the whole family, especially the primary caregiver. The aim of this study was to evaluate the associations between caregiver burden and both the caregiver's and child's psychological symptoms in a cohort of children with systemic lupus erythematosus (SLE). Methods: Thirty-four patients (aged 9–18 years) with childhood-onset SLE and their caregivers participated in this study. The control group was composed of healthy children and their caregivers. Questionnaires were used to evaluate caregiver burden and the psychological status of parents and children and adolescents with and without SLE. Results: No significant difference was found between the study and control groups for caregiver burden, anxiety and depression in parents, and psychological status in children. Caregiver burden was positively correlated with parent's depression, anxiety, and behavioral and peer problems of the children, and it was negatively correlated with the children's prosocial behaviors. According to regression analyses, the parents' depression and children's peer relationship had a positive effect on caregiver burden scores. Conclusion: Physicians should be aware of the presence of psychological symptoms in patients with childhood-onset SLE and their caregivers because it can affect caregiver burden and the caregiver's psychological state. Key points •Caregiver burden was positively correlated with parent's depression and anxiety. •Caregiver burden was positively correlated with children's behavioral and peer problems. •Caregiver burden was negatively correlated with child's prosocial behaviors. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this cross-sectional study were to assess the prevalence of Internet addiction (IA) in a clinical sample of adolescents with attention-deficit hyperactivity disorder (ADHD) and to detect the moderating effects of cooccurring oppositional defiant disorder/conduct disorder (ODD/CD) on the association between ADHD and IA. Methods: The study group comprised 119 adolescent subjects who were consecutively referred to our outpatient clinic with a diagnosis of ADHD. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was completed by parents, and subjects were asked to complete the Internet Addiction Scale (IAS). Results: The IAS results indicated that 63.9% of the participants (n = 76) fell into the IA group. Degree of IA was correlated with hyperactivity/impulsivity symptoms but not with inattention symptoms. As compared to the ADHD-only group (without comorbid ODD/CD), ADHD + ODD/CD subjects returned significantly higher scores on the IAS. Conclusions: As adolescents with ADHD are at high risk of developing IA, early IA detection and intervention is of great importance for this group. In addition, adolescents with ADHD+ ODD/CD may be more vulnerable to IA than those in the ADHD-only group and may need to be more carefully assessed for IA. [ABSTRACT FROM AUTHOR]

Objective: The aim of this retrospective study is to examine the clinical outcomes and safety of clozapine in children and adolescents with schizophrenia or other psychotic disorders/autism spectrum disorder (ASD) or affective disorders.Methods: The inpatient and outpatient files of all children and adolescents treated with clozapine over a period of 34 months (from October 2011 to July 2014) were reviewed. Demographic and clinical data were examined to describe clinical and metabolic findings, dosing, and tolerability of clozapine treatment in youth with schizophrenia, other psychotic disorders, ASD, or bipolar disorder.Results: The 37 pediatric patients included 26 patients with schizophrenia or other psychotic disorders, 7 patients with ASD complicated by schizophrenia or other psychotic disorders or affective disorders, and 4 patients with ASD only. In all groups (n = 37) there was a significant reduction (p < 0.001) in Brief Psychiatric Rating Scale (BPRS) points after clozapine treatment during the inpatient period (38.78 ± 27.75 days). In patients with schizophrenia or other psychotic disorders co-occurring with ASD or not (n = 31), there was a significant improvement in psychotic symptoms according to Positive and Negative Syndrome Scale (PANSS) total scores and subscores (p < 0.001). Of the 26 patients with schizophrenia or other psychotic disorders, 8 (30.8%) showed a positive response (>30% symptom reduction on BPRS). In patients with ASD complicated by schizophrenia or other psychotic disorders or bipolar disorders (n = 7), there was a significant reduction (p = 0.017) in BPRS scores after clozapine treatment. The discontinuation rate for clozapine was 10.8%, and the most frequently observed side effect was hypersalivation (54.1%). Neutropenia associated with clozapine was observed in only one patient (2.7%).Conclusions: Clozapine seems to be effective and safe in children and adolescents with schizophrenia or other psychotic disorders co-occuring with ASD or not. There is a need for further studies for determining the efficacy of clozapine in children and adolescents with bipolar affective disorder or ASD. [ABSTRACT FROM AUTHOR]

Objectives: Second-generation antipsychotics (SGA) are commonly used in several psychopathologies. Paliperidone, a new SGA, offers a potential new treatment option for adolescents, with several advantages including single dosage per day and availability in hepatic problems. In this report, it was aimed to investigate the efficacy and tolerability of paliperidone in a small sample of adolescent inpatients. Methods: Demographic and clinical variables of eleven adolescents (6 male, 5 female) were evaluated. Of paliperidone, efficacy was assessed with clinical global impression scale-severity (CGI-S) for all cases, Young Mania Rating Scale (YMRS) for those with bipolar disorders, and positive and negative syndrome scale (PANNS) for those with psychosis. Tolerability was assessed with Simpson-Angus Extrapyramidal Side Effects Scale (SAS). Data was analyzed in descriptive statistics (frequency, mean and standard deviation). Results: The mean age was 16.1 years and mean duration of paliperidone use was 20.1 days. Diagnoses of patients were psychotic disorder (n=5), bipolar disorder (n=3, 2 cases with psychotic symptoms), conduct disorder (n=1), and conduct disorder with comorbid bipolar disorder not otherwise specified (n=2). Mean paliperidone dose was 9.8 mg/day. Mean improvements were 1.2 in CGI-S scores (n=11), 20.3 in PANNS total score (n=7) and 17.8 in YMRS score (n=5). Seven patients had a score higher than 0.3 on SAS (63.6%). Conclusion: Results showed clinically meaningful improvements in symptom measurements of different disorders. However, side effects should be evaluated regularly in adolescents. Future prospective studies with large samples are needed for definite conclusions. [ABSTRACT FROM AUTHOR]

The aims of the present study were to evaluate 1-year retention in program and buprenorphine/naloxone (BUP/NAL) treatment, and abstinence of heroin-dependent adolescents. The present study included the follow-up information of 112 heroin dependent adolescents who took BUP/NAL treatment for the first time in a specific inpatient unit. Retention and abstinence were assessed by self-report and urine drug screen at each visit. Mean age was 16.9 years, with 101 (90.2%) male. Program retention was 81.3% at day 30, and 24.1% at 1 year, while retention in BUP/NAL treatment was 69.6% at day 30 and 16.1% at 1 year. Rates of abstinence were 69.0% at day 30 and 10.3% at 1 year. There was a significant positive correlation between duration of inpatient treatment and program retention, treatment retention, abstinence (p < 0.05 for all), and between the dose and treatment retention, abstinence (p < 0.05 for both). Patients with comorbid psychiatric disease were more likely to be retained in treatment for 3 months, and in program for 6 months (p < 0.05, for all). Patients who completed inpatient treatment were more likely to be retained in treatment for 1 year, and in program for 9 months, and to be abstinent for 1 year (p < 0.05, for all). Findings suggested that starting BUP/NAL treatment in an inpatient unit might result in better outcomes compared to literature. Duration of inpatient treatment, the completion of inpatient treatment, BUP/NAL dose, and having a comorbid psychiatric disease seemed to be important factors for heroin-dependent adolescents in retention and abstinence within 1-year period. [ABSTRACT FROM AUTHOR]

Objective: The aim was to investigate predictors of hospitalization of adolescents with conduct disorder (CD) seen in emergency service of a mental health hospital. Method: Patients were evaluated retrospectively by age, gender, school status, family structure, presenting symptoms and their duration, comorbid psychiatric diagnoses, prior emergency service or outpatient clinic use, prior psychiatric hospitalization and family history of any mental disorder, according to first presentation during a 6-month period. Results: Mean age was 15.69±1.26 (12-17) years. Of the total of 144 patients, 61.8% (n=89) were female and 50 (34.7%) were hospitalized. Adolescents admitted to the inpatient unit presented significantly more often with suicidal ideation, had longer symptom duration, and were more likely to have a comorbid psychiatric disorder and a family history of a psychiatric disorder compared to those not admitted. In multivariate logistic regression analysis, suicidal ideation, having a comorbid psychiatric disorder, and having family history of a mental disorder predicted admission to the psychiatric inpatient unit. Conclusion: Clinicians in emergency settings should be aware of the prediction of hospitalization in adolescents with CD who have suicidal ideation, a comorbid psychiatric disorder and family history of a mental disorder. Suicide attempt seems to have an indirect effect, rather than a direct effect, on the prediction of hospitalization in youths with CD. [ABSTRACT FROM AUTHOR]

Background: Obsessive-compulsive disorder (OCD) is a heterogeneous disorder; therefore, there is a need for identifying more homogeneous subtypes. This study aimed to examine the clinical characteristics and comorbidity pattern of a large sample of pediatric OCD subjects, and to examine the impact of gender, age at onset, and lifetime tic disorders on the clinical presentation and comorbidity pattern.Methods: A total of 110 children and adolescents diagnosed with OCD were assessed using the Kiddle Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL) for psychiatric comorbidity, and a clinical data form was filled out. The cutoff for differentiating prepubertal from adolescent onset was 11 years of age.Results: A total of 83.6% of the subjects had at least one comorbid psychiatric disorder. Oppositional defiant disorder and contamination/somatic obsessions were significantly higher in males (p=0.036 and p=0.03, respectively) than in females. Depressive disorders and religious obsessions were significantly higher in the adolescent-onset group (p=0.02, p=0.05, respectively) whereas disruptive behavior disorders were higher in the prepubertal-onset group (p=0.037). Disruptive behavior disorders were significantly more frequent in the tic (+) group than in tic (-) group (p=0.021).Conclusions: There were differences in the comorbidity pattern and clinical expression between genders and between prepubertal and adolescent-onset cases. Findings of this study supported the introduction of tic-related OCD as a specifier in Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5), and the necessity of a detailed assessment of other psychiatric disorders in youth with OCD. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the relationship between psychological symptoms and quality of life (QOL) and clinical variables in a cohort of children and adolescents with non-cystic fibrosis (non-CF) bronchiectasis. Methods Seventy-six patients (aged 8-17years) participated in this study. Questionnaires were used to evaluate the psychological status and QOL of the patients and healthy controls. The patient and control groups were divided into child and adolescent groups to exclude the effect of puberty on psychological status. Results No significant difference was found between patient and control groups for mean depression and trait anxiety scores. Only the child-rated physical health QOL scores were significantly lower for patients than the controls. Also, excepting physical health scores in adolescent group, all of the parent-rated QOL scores were significantly lower in both group and total subjects. Regarding determinants of QOL, age of children and FEV1/FVC percent predicted had positive effects, while dyspnea severity and trait anxiety had negative effects, for the sample as a whole. Conclusions Non-CF bronchiectasis is associated with poorer QOL in childhood. The impact of the disease on QOL occurs through both clinical and psychological variables. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 17-year old girl who was referred to an adult psychiatry clinic by her family due to paranoid delusions. It mentions that she was started with Olanzapine after diagnosis of acute psychosis in a psychiatry unit. It states that the patient was transferred to our child and adolescent inpatient unit because of treatment resistance. It informs that her mental state and autonomic symptoms improved after fifth bilateral electroconvulsive therapy (ECT).

Objective: The aim of the present study was to evaluate the characteristics of patients accessing child and adolescent inpatient unit in a mental health hospital. Method: Data were obtained from child and adolescent inpatient unit files. Files of patients under 18 years of age were evaluated over a 10-months period retrospectively. Subjects were evaluated by number of admissions to inpatient unit within a year, age, gender, school status, family structure, reasons for admission, source of referral, length of stay on the unit, DSM-IV psychiatric diagnosis and the rate of multiple diagnosis, previous admission of psychiatric inpatient unit, history of substance use and sexual abuse, and family history of mental illness. Data reflected only the first psychiatric admission for each youth within the year. Results: Completed data were available for 599 admissions in 472 patients (11-18 years old); 255 (54.0%) were female and 385 (81.6%) patients admitted only once in a year. Mean age was 15.73 years (SD=1.43). Of patients, 40.7 percent (n=187) were still at school and 67.5 percent (n=311) had the nuclear or extended family. While the most common reason for admission was risk of suicidality (43.9%; n=206), 52.3 percent of patients (n=247) were referred from psychiatric emergency department. The mean length of stay of admissions on the unit was 9.58 days (SD=11.97). One hundred thirty six patients (29.5%) had two and more diagnoses. Seventy seven patients (16.3%) were previously admitted to an inpatient unit. Of patients, 26.7 percent had a history of substance use (n=126), and 17.4 percent had a history of sexual abuse (n=82). In this study, 67.1 percent (n=281) had family history of mental illness. Conclusion: It was found that of patients, most had one diagnosis, admitted only once in a year and had no previous admission to an inpatient unit, and half were referred from psychiatric emergency department. Also, the mean length of stay in patients on the unit were shorter than of those in the literature. These findings indicate that child and adolescent inpatient unit in mental health hospital might have an important role in crisis intervention in Turkey. [ABSTRACT FROM AUTHOR]