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Background: This article presents the results of a comprehensive national model developed for managing maladaptive behaviors (MBs) in children with mental special needs (CMSNs) during the coronavirus disease 2019 (COVID-19) pandemic that combines telehealth-based Applied Behavioral Analyses, psychiatric interventions, and support from local psychosocial teams. This study aims to determine the effectiveness of a system that combined telehealth applications with local psychosocial support teams, allowing services from video calls to emergency interventions. Materials and Methods: The system combines the telehealth applications with the services from local psychosocial intervention teams. In addition to system records covering sociodemographic variables and initial complaints, a telephone survey questioning the effectiveness and satisfaction of the system was used as the main outcome. Results: In total, 347 individuals used the system with mothers constituting the majority of applicants (88.7%, n = 332). The overall satisfaction of the system was 8.8/10. In terms of effectiveness, 63.3% (n = 237) of caregivers reported an improvement in the reason of application. Counselors decided on a need for follow-up visits for 36.6% (n = 137) of applications. A referral to a psychiatrist was asked for 40 patients (10.6%). Discussion: To our best knowledge, this is the first study presenting a model for managing MBs of CMSNs during the COVID-19 outbreak. In general, therefore, it seems that there is a need for unique systems to handle behavioral problems of CMSNs. Conclusions: The findings of this study suggest that it is possible to establish an integrative multistep multidisciplinary telehealth-based approach in a short while.

Risperidone is an effective drug used for the treatment of irritability in children with autism spectrum disorder (ASD). Atomoxetine (ATX) is a well-tolerated drug used in first-line therapy in children with attention-deficit/hyperactivity disorder (ADHD). However, uncommon adverse effects of risperidone and ATX are a concern among mental health professionals. To our knowledge, this is the first case report of priapism after addition of ATX upon existing treatment with risperidone.Written informed consent for publication was obtained from the patient and his parents, and their identities were concealed for ethical reasons.Here, we report a case of priapism as an adverse effect of ATX and risperidone treatment in a 7-year-old boy with ASD and comorbid ADHD. In this case, priapism was not observed with risperidone until ATX was added.Priapism is a condition viewed as a medical emergency. Although risperidone-induced priapism is a rare phenomenon, it is advised for clinicians to consider the drug interactions in treatment of ASD and ADHD in terms of early diagnosis and intervention.

Working memory (WM) is assumed as the limited cognitive skill that enables the preference of proper actions for coding stimuli from the environment, stores them for a limited periods and helps us use them purposefully in daily life. WM assists human thinking continuum by supplying an interface among sensation, long-term memory and behavior. The current WM includes a a central executive and three storage systems: the phonological loop, the episodic buffer and the visuospatial sketchpad. The literature has inclined to show that WM is a robust predictor of fundamental academic skills such as language, reading and writing, and mathematics. From this point of view, the active role of WM deficits in the etiopathogenesis of neurodevelopmental disorders such as attention deficit hyperactivity disorder, autism spectrum disorder, specific learning disabilities, and communication disorder is understood. In this paper, researches about WM and neurodevelopmental disorders were scanned from online search engines such as PubMed, Turkish Psychiatry Index, Google Schoolar and the data obtained were combined with the information in the basic books. Each subgroup of neurodevelopmental disorders was mentioned in a separate subtitle and it was aimed to review the role of WM in etiopathogenesis.

Aripiprazole is an atypical antipsychotic commonly used in the treatment of psychiatric disorders, such as schizophrenia, bipolar disorder, and irritability associated with autism spectrum disorder. Common adverse effects associated with aripiprazole usage in children and adolescents are nausea, vomiting, extrapyramidal adverse effects, akathisia, sedation, tremor, and increased appetite. Enuresis is one of the least expected adverse effects during aripiprazole use. The pathophysiology of aripiprazole-induced enuresis has not been fully clarified. To our knowledge, our report presents enuresis related to aripiprazole use at the lowest dose in the literature. In this report, we present the case of a 9-year-old boy who developed nocturnal enuresis after the beginning of low-dose aripiprazole treatment.

Highlights • Children with OCD was clinically worsened during COVID-19 pandemic • Contamination obsessions and cleaning compulsions was specifically increased • Limited exposure to news about pandemic may prevent symptom deterioration., Objective To investigate the effects of COVID-19 pandemic and related home confinement on symptom profile, symptom severity and exacerbation of obsessive compulsive disorder (OCD) symptoms and related factors among young subjects with OCD. Method Young subjects who have been followed up with a primary diagnosis of OCD in a university hospital were reached by telephone or online programs to assess symptom profile, symptom severity and exacerbation during pandemic. Children's Yale-Brown Obsessive Compulsive (CY-BOCS) and Clinical Global Impression- Severity (CGI-S) Scales were used to rate symptom profile and severity before pandemic and during pandemic periods. Results There was a significant increase in the frequency of contamination obsessions (p=0.008) and cleaning/washing compulsions (p=0.039) during pandemic period. CY-BOCS obsessions (p

Fluoxetine, a selective serotonin reuptake inhibitor, is an efficacious medication in social anxiety disorder with a generally well-tolerated adverse effect profile. However, infrequent side effects may occur during treatment. Here, we report a case of systemic hypertension in a 12-year-old female patient with social anxiety disorder receiving fluoxetine treatment. To the best of our knowledge, this is the first report of fluoxetine-induced systemic hypertension in children and adolescences.

Aims Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. Methods A large-scale multicenter online survey was completed by the parents ( n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers—HCW [18.2%] vs. others), geographical (İstanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. Results Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p Conclusions Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit.

EgeUn###, Aim: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. Method: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. Results: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. Conclusion: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.

GOKCEN, CEM/0000-0003-3824-5890; Topal, Zehra/0000-0001-8397-5636; Tural, Umit/0000-0002-1593-2180; Unal, Fatih/0000-0001-8386-9884; Acikel, Burak/0000-0002-8964-9513; Erden, Semih/0000-0002-7723-9584; Kilic, Birim Gunay/0000-0002-4566-2564; Ucar, Halit Necmi/0000-0002-2706-7454; CELIK, GONCA/0000-0001-6101-0796; Gunes, Serkan/0000-0002-8247-2145; Isik, Umit/0000-0001-6006-3247; Coskun, Murat/0000-0002-4808-5870; Tufan, ALI EVREN/0000-0001-5207-6240; Donmez, Yunus Emre/0000-0002-7785-2805; Ceri, Veysi/0000-0001-6152-0227; Uzun, Necati/0000-0003-3381-2331; Hesapcioglu, Selma Tural/0000-0002-4816-0228; Kandemir, Hasan/0000-0002-1138-4973; Gormez, Vahdet/0000-0002-2704-9520 WOS: 000439557000070 PubMed: 29936389 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.

Atomoxetine, a selective norepinephrine (noradrenaline) reuptake inhibitor, is an effective and safe medication in the treatment of attention-deficit hyperactivity disorder (ADHD) with or without autism spectrum disorder (ASD) in children. However, unusual side effects may occur during the course of the treatment. In this case study, we present a 6-year-old child diagnosed with ASD comorbid with ADHD who developed atomoxetine induced mania during his treatment for ADHD.