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Obsessive–compulsive disorder (OCD) causes significant psychic distress and affects children's social and academic functioning. Approximately 80% of OCD cases begin in childhood. Earlier onset is associated with more severe OC symptoms, poorer treatment response, and a more unfavorable clinical course. A particular oxidative stress marker, thiol/disulfide homeostasis, using a new, comparatively inexpensive, easily calculated, easily accessible, repeatable, and fully automated method was investigated between pediatric patients diagnosed with OCD and a healthy control group in this study. This study is the first to address this subject in pediatric patients with OCD and aims to contribute to our knowledge of the etiopathogenesis and treatment of pediatric OCD. The study included children with OCD (n = 35, 52.2%) (drug free, comorbidity free) between 11 and 18 years of age and age- and sex-matched healthy controls (n = 32, 47.8%). The total thiol (p = 0.025) and disulfide (p = 0.001) levels and the disulfide/native thiol (p = 0.001) and disulfide/total thiol ratios (p = 0.001) were significantly different between the groups. Also, in the patient group, biochemical analysis revealed that the disulfide level (p = 0.05) and the disulfide/native thiol (p = 0.034) and disulfide/total thiol ratios (p = 0.039) differed significantly according to the presence of a family history of psychiatric disorders. Consequently, the results of our study show that thiol/disulfide homeostasis may affect the etiopathogenesis of pediatric OCD and can be utilized as a new method when evaluating oxidative stress.

AimsA decrease in health-related quality of life (HRQOL) measures among obese (OB) and overweight (OW) children has been shown in several studies, but knowledge about the variables affecting HRQOL impairments is missing. The aim of this study was to evaluate the relationship between HRQOL and sociodemographic characteristics, anthropometric measurements, metabolic parameters, mental symptoms and parental attitudes in a sample of OB/OW children.MethodsEighty-six OB/OW children, aged between 9 and 17 years, participated in the study. We performed sociodemographic questioning, anthropometric examinations and laboratory evaluations of the participants. HRQOL was assessed using the Pediatric Quality-of-Life Inventory (PedsQL), and levels of anxiety and depressive symptoms were measured using the Screen for Child Anxiety-Related Disorders (SCARED) questionnaire and the Children’s Depression Inventory (CDI), respectively. Parental attitudes were assessed with the Parental Attitude Research Instrument (PARI) questionnaire.ResultsA statistically significant relationship was found between total scores of CDI and SCARED answered by children and the total and subscale scores of PedsQL. Scores of total quality of life subscale, physical functionality and emotional functionality subscales were significantly lower in children with a family history of mental illness. No relationship was found between PedsQL subscales, anthropometric and metabolic parameters.ConclusionsEmotional problems and parental psychological distress are important factors in models of HRQOL in the OB/OW pediatric population.

Background: Approximately 80% of obsessive–compulsive disorder (OCD) cases begin in childhood. Various genetic, psychological, sociological factors and biological mechanisms are involved in the etiology of OCD. To the best of our knowledge the relationship between inflammation and OCD is unclear. Chronic inflammation was shown to increase neopterin and decrease tetrahydrobiopterin (BH4) levels by activating the neopterin–BH4 pathway. In addition, studies have shown that it can be an important biomarker in psychiatric disorders. Objective: This study compared serum TGF-1β, TNF-α, IL-1β, IL-2, IL-6, IL-10, IL-17, neopterin, BH4, and nitric oxide (NO) levels between child and adolescent patients diagnosed with OCD and a healthy control group. Methods: The study included 29 patients diagnosed with OCD (comorbidity free, drug free) and 28 healthy children as an aged and sex matched control group. For the measurement of neurobiological markers, venous blood samples were collected, and analyzed by using enzyme-linked immunosorbent assay (ELISA). Results: All cytokine levels were found to be low, but this decrease was statistically significant only for TGF-1β. The neopterin and NO levels were significantly higher and BH4 significantly lower in children with OCD compared to the healthy control group. Conclusion: The results of our study show that the levels of TGF-1β and NO and the activation of the neopterin–BH4 pathway may be implicated in the pathophysiology of OCD. Additionally, anti-oxidant and BH4 adjuvant therapies should be investigated as treatment options for OCD.

Şermin Yalın Sapmaz,1 Bengisu Uzel Tanrıverdi,2 Masum Öztürk,1 Özge Gözaçanlar,1 Gülsüm Yörük Ülker,2 Yekta Özkan1 1Department of Child and Adolescent Psychiatry, 2Department of Psychology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey Purpose: This study assessed early-onset psychiatric disorders and factors related to these disorders in a group of refugee children after immigration due to war.Materials and methods: This study was conducted between January 2016 and June 2016. Clinical interviews were conducted with 89 children and their families, and were performed by native speakers of Arabic and Persian who had been primarily educated in these languages and were living in Turkey. A strengths and difficulties questionnaire (SDQ) that had Arabic and Persian validity and reliability was applied to both children and their families. Independent variables for cases with and without a psychiatric disorder were analyzed using the χ2 test for categorical variables, Student’s t-test for those that were normally distributed, and Mann–Whitney U-test for data that were not normally distributed. Data that showed significant differences between groups who had a psychiatric disorder and on common effects in emerging psychiatric disorders were analyzed through binary logistic regression analysis.Results: A total of 89 children and adolescents were interviewed within the scope of the study. The mean age of cases was 9.96±3.98 years, and 56.2% (n=50) were girls, while 43.8% (n=39) were boys. Among these children, 47 (52.8%) had come from Syria, 27 (30.3%) from Iraq, 14(15.7%) from Afghanistan, and 1 (1.1%) from Iran. A psychiatric disorder was found in 44(49.4%) of the children. A total of 26 children were diagnosed with anxiety disorders, 12 with depressive disorders, 8 with trauma and related disorders, 5 with elimination disorders, 4 with attention deficit/hyperactivity disorder, and 3 with intellectual disabilities. It was determined that seeing a dead or injured person during war/emigration and the father’s unemployment increased the risk of psychopathology. The OR was 7.077 (95% CI1.722–29.087) for having seen a dead or injured individual and 4.51 (95% GA 1.668–12.199) for father’s employment status.Conclusion: Within the context of war and emigration, these children try to cope with the negative circumstances they experience prior to migration, as well as the despair they see their parents experience. Keywords: young refugees, asylum seekers, mental health, risk factors

The biological mechanisms underlying obsessive–compulsive disorder (OCD) are not sufficiently elucidated. Chronic inflammation and oxidative stress were shown to increase neopterin and decrease tetrahydrobiopterin (BH4) levels by activating the neopterin–BH4 pathway. This study compared serum TGF-β1, TNF-α, IL-1β, IL-2, IL-6, IL-10, IL-17, neopterin, BH4, and nitric oxide (NO) levels between child and adolescent patients diagnosed with OCD and a healthy control group. The study included 29 patients diagnosed with OCD (comorbidity free, drug free) and 28 healthy children as an aged and sex matched control group. Serum samples were analyzed for TGF-β1, TNF-α, IL-1β, IL-2, IL-6, IL-10, IL-17, neopterin, and BH4 by using enzyme-linked immunosorbent assay method, and NO concentrations were assessed by colorimetric method based on Griess reaction. All cytokine levels were found to be low, but this decrease was statistically significant only for TGF-β1. The neopterin and NO levels were significantly higher and BH4 significantly lower in children with OCD compared to the healthy control group. Also, a statistically significant correlation was found between NO, neopterin, and BH4 levels. The results of our study show that the levels of TGF-β1 and NO and the activation of the neopterin–BH4 pathway may be implicated in the pathophysiology of OCD.

Identification of the structural causes of depression is important for the treatment process, and toxoplasmosis may be related to psychiatric disorders. The aim of this study was to evaluate the relationship between Toxoplasma gondii (T. gondii) seropositivity and depression in children and adolescents. This case-control study included 37 children and adolescents aged 11–18 years diagnosed with depression who were followed by the Manisa Celal Bayar University Child and Adolescent Mental Health Service and 36 children and adolescents aged 11–18 years with no history of depressive episodes or psychiatric disorder treated by the Pediatric Outpatient Department. The T. gondii serology of these two groups was evaluated and compared. There were no statistically significant age or sex differences between the 37 participants with depression and the 36 healthy controls. Eight patients and two controls were seropositive for T. gondii, a statistically significant difference (p = 0.046). Seropositivity was significantly higher in patients with suicidal ideation (p = 0.005) than in those without suicidal ideation. The seropositivity of seven of the nine participants who attempted suicide was significantly higher (p < 0.001) than that of participants who did not. Thus, T. gondii infection may affect the predisposition for and severity of depression. © 2019

Objective The current study aimed to investigate psychiatric consequences of obesity and the relationship between componenets of the metabolic syndrome and psychiatric disorders in children. Our second aim was to elucidate which of the anthropometric parameters or metabolic components were most strongly associated with psychiatric disorders. Methods The study included 88 obese and overweight children with a body mass index (BMI) greater than 85th percentile. The patients were evaluated for psychiatric disorders by a single child and adolescent psychiatrist. Forty patients diagnosed with psychiatric disorders and 48 patients with normal psychiatric evaluation were compared in terms of anthropometric and metabolic parameters. BMI, BMI-standard deviation score and BMI percentile, waist circumference, waist to hip ratio, blood pressure and pubertal stage of all patients were recorded. Fasting serum glucose, insulin, lipid profile and homeostatic model assessments of insulin resistance (HOMA-IR) were measured to evaluate the metabolic parameters. Serum and 24 hour urine cortisol levels were measured. Results HOMA-IR in the group with psychiatric disorders was found to be significantly higher than in the group without psychiatric disorders (6.59±3.36 vs 5.21±2.67; p=0.035). Other anthropometric measurements and metabolic parameters were not significantly different between the two groups. Conclusion An understanding of the relationships between obesity related medical comorbidities and psychiatric pathologies is important to encourage patients and their families to make successful healthy lifestyle changes and for weight management in terms of appropriate treatment.

Toxoplasma Gondii is an obligate intracellular parasite which may infect all nucleated cells. Studies conducted in adult patients show that toxoplasmosis may be related to psychiatric diseases and there is a correlation between Toxoplasma Gondii and schizophrenia, depressive disorder, type 1 bipolar disorder, increased suicide rates, obsessive compulsive disorder, high aggressiveness and impulsivity. Besides psychosocial causes, biological entities such as chronic physical diseases, neuroendocrine disorders and infections that affect immune system are also blamed for depression. The mechanism by which infections affect the immune system and cause an increase in depression and suicidal behaviours has been tried to be explained by the changes in monoamine neurotransmitters such as serotonin, dopamine, epinephrine and norepinephrine. In this case, an adolescent girl with treatment-resistant major depression, was treated of her depression after she was diagnosed and treated for T. Gondii infection. Globally, Toxoplasma Gondii infection is usually asymptomatic with 33% prevalence but its effects on brain are uncertain. Its effects may vary from individual to individual. Immunosuppressed persons may experience many different clinical pictures, and those with good immunity may experience psychiatric symptoms or even treatment-resistant psychiatric disorders. Seropositivity of toxoplasma gondii should also be considered in treatment-related psychiatric disorders.