Early puberty paradox: an investigation of anxiety levels of mothers and children, children's quality of life, and psychiatric diagnoses

Early puberty signs lead to an increase in anxiety levels of parents and children. The aim of this study was to investigate the quality of life and anxiety levels of girls and their mothers who were admitted to a pediatric endocrinology clinic with concerns about early puberty. Girls and their mothers who were admitted to endocrinology outpatient clinic with concerns about early puberty were compared to healthy control group. Screen for Child Anxiety Related Emotional Disorders (SCARED) parent form, Quality of Life for Children Scale (PedsQL) parent form, and Beck Anxiety Inventory (BAI) were administered to the mothers. Children were evaluated with the Schedule for Afective Disorders and Schizophrenia for School-Age Children (Kiddie-SADS Lifetime Version) (K-SADS-PL). The study sample consisted of 92 girls and 62 of them were administered to clinic with concerns about early puberty. There were 30 girls in early puberty group (group 1), 32 girls were in the normal development group (group 2), and 30 were in the healthy control group (group 3). The anxiety level of group 1 and group 2 was signifcantly higher, and their quality of life was signifcantly lower when compared to group 3 (p<0.001). Mother’s anxiety level was found signifcantly higher in group 2 (p<0.001). It has shown that anxiety level and quality of life of children were associated with anxiety level of mothers and the current Tanner stage (r=0.302, p<0.005). Conclusion: Mothers and children who have concerns about early puberty are negatively afected when early puberty is a possibility. For this reason, educating parents will prevent negative impacts of this situation on children. At the same time, it will decrease health burden

Factors Associated with Substance Use in Adolescents Under Legally Required Health Care

Objective:In this study, cases who applied to the polyclinic, where we followed the patients under legally required health care clinic in the last year, were evaluated. It was aimed to compare the socio-demographic and clinical characteristics of patients who use and do not use substances.Methods:Between September 2021 and August 2022, the files of cases aged 14-18 years with health precautions were reviewed retrospectively. Data of 75 cases with complete file information were recorded and analyzed.Results:Seventy-five patients (47 girls, 28 boys) were included in the study. Thirty four patients (21 girls, 13 boys) had substanceuse. The mean age was 15.9±1.2 years and the mean duration of education was 9.5±1.9 years. Legally required counseling was 72% (n=54), education was 29.3% (n=22), institutional care was 22.7% (n=17) Smoking and alcohol use (p=0.001) school absenteeism (p=0.002), criminal behavior (p=0.012), number of negative life events (p=0.025), exposure to emotional abuse (p=0.025) and care measures (p=0.017) were found to be higher in patients with substance use. Academic achievement was lower in patients using substance (p=0.001). Substance use was found to be higher in those residing in the city center than in the districts and rural areas (p=0.002). At least one psychiatric diagnosis (p=0.001), more than one psychiatric diagnosis (p=0.001) and conduct disorder (p=0.016) were detected more frequently in the substance abuser group. Cannabis was the most frequently used substance (79.4%) in the group using drugs.Conclusion:Adolescents who are monitored with in the scope of under legally required health care and who use substances are different from the non-substance use group in terms of some socio-demographic and clinical characteristics. Knowing these features can contribute to the prevention and treatment studies of forensic medicine and child and adolescent mental health clinics working with patients who receive legally required treatment. Therefore, it is recommended to increase cooperation between the clinics

Opioid Kullanım Bozukluğu Olan Ergende Pregabalin Kötüye Kullanımı

Madde kullanım bozukluğu olan gençler genellikle esrar, ekstazi, amfetamin türevleri, eroin, sedative hipnotikler gibi maddelere bağımlılık geliştirmektedirler. Bununla birlikte medikal hastalıklarda ve psikiyatrik bozuklarda kullanılan bazı reçeteli ilaçların kötüye kullanımı da bildirilmiştir. Özellikle modafinil, venlafaksin, ketiapin, tianeptin, gabapentin ve pregabalin son zamanlarda öne çıkmaktadır. Bir antiepileptik olan pregabalin anksiyete bozukluklarında da kullanılmaktadır. Anksiyolitik ve öforizan etkisi bu ilaca bağımlılık gelişmesinde önemli etkenlerdir. Literatürde pregabalin kötüye kullanımı ile ilgili bir çok olgu sunumu mevcut olup ergen olguya rastlanmamıştır. Bu yazıda opiat kullanım bozukluğu tanısı ile izlenen, ilk esrar kullanımı sonrasında panik atak belirtileri yaşayan ve bu belirtilerle baş etmek için kullandığı pregabalinin yatıştırıcı ve öforizan etkileri nedeniyle bu ilaca bağımlılık geliştiren ergen olgunun sunulması amaçlanmıştır.Madde kullanım bozukluğu olan gençler genellikle esrar, ekstazi, amfetamin türevleri, eroin, sedative hipnotikler gibi maddelere bağımlılık geliştirmektedirler.  Bununla birlikte medikal hastalıklarda ve psikiyatrik bozuklarda kullanılan bazı reçeteli ilaçların kötüye kullanımı da bildirilmiştir. Özellikle modafinil, venlafaksin, ketiapin, tianeptin, gabapentin ve pregabalin son zamanlarda öne çıkmaktadır. Bir antiepileptik olan pregabalin anksiyete bozukluklarında da kullanılmaktadır. Anksiyolitik ve öforizan etkisi bu ilaca bağımlılık gelişmesinde önemli etkenlerdir. Literatürde pregabalin kötüye kullanımı ile ilgili bir çok olgu sunumu mevcut olup ergen olguya rastlanmamıştır. Bu yazıda opiat kullanım bozukluğu tanısı ile izlenen, ilk esrar kullanımı sonrasında panik atak belirtileri yaşayan ve bu belirtilerle baş etmek için kullandığı pregabalinin yatıştırıcı ve öforizan etkileri nedeniyle bu ilaca bağımlılık geliştiren  ergen olgunun sunulması amaçlanmıştır.ÖzAmaç:Gereç ve Yöntem:Bulgular:Tartışma

Abstract Effects of Problem Solving Therapy in Substance Use Disorder in Adolescents

Objective: In this study, it was aimed to examine the effects of problem solving therapy, which is a cognitive behavioral method, on adolescents diagnosed with alcohol and substance use disorder. Method: A semi-structured interview and intelligence test were administered to adolescents with diagnosis of substance use disorder to identify comorbidities. 46 adolescents who met the inclusion criteria were divided into two groups. Problem solving therapy was applied to the first group for 5 weeks, once a week, while the other group continued their routine controls in the center. Beck Depression Inventory, Screen for Child Anxiety Disorders, Revised Social Problem Solving Inventory, Addiction Profile Index and Treatment Motivation Questionnaire were administered to the groups at the beginning of the study and at the end of the 5th week and the results were analyzed. Results: Sociodemographic and substance use characteristics, comorbid psychopathologies and scale mean scores of the groups in the first evaluation were found to be similar to each other. Although the depression and anxiety scores decreased significantly in both groups, no significant difference was found between the groups. Problem -solving skills and treatment motivation increased in the therapy group and decreased in the control group. The difference between groups was found to be significant (p=0.045, 0.037 for problem solving and treatment motivation respectively). While the severity of addiction decreased in therapy group, it increased in control group, but the difference was not significant. Conclusion: This study is important in that it shows that psychosocial interventions strengthen the treatment of substance use disorder in adolescents. In our country, no other study was evaluating the effects of the intervention methods in addicted adolescents was found. Future studies with larger sample sizes and where the long-term results of substance use disorder are evaluated are needed

Investigation of the effect of comorbid psychopathologies on glycemic control in children and adolescents with type 1 diabetes mellitus

Objective: The presence of comorbid psychiatric conditions in chronic diseases makes the management of the disease difficult. Our study, we aimed to examine the relationship between psychiatric comorbid conditions and glycemic control in children and adolescents with Type 1 Diabetes. Method: In our study, depending on the number of patients, good and moderate controls were evaluated as a single group, and HbA1c levels of 8.5 and below were included in this group. Children for Depression Inventory (CDI), Screen for Child Anxiety-Related Emotional Disorders (SCARED), Turgay Child and Adolescent Behavioral Disorders Based on DSM-IV Screening and Evaluation Scale were applied. The case and parents were evaluated with K-SADS-PL.Among 778 diabetic patients who were followed up in the pediatric endocrinology clinic, 73 cases between the ages of 8 and 17 who were followed up regularly, who did not have any comorbidities and who accepted to participate in the study were evaluated psychiatrically. Results: Of the 73 cases included in the study, 29 were accepted as the patients with good glycemic control (HbA1c 8.5mg / dl). In cases with poor glycemic control, parents' education level and income level were significantly lower, while the rate of attention deficit and hyperactivity disorder, major depressive disorder, social anxiety disorder and psychopathology was significantly higher. Discussion: The findings of this study revealed that there are many factors affecting glycemic control and there is a strong relationship between glycemic control and psychopathologies

A Case of Sluggish Cognitive Tempo Followed Up with a Diagnosis of Childhood Depression

Even though children with a sluggish cognitive tempo (SCT) may exhibit symptoms similar to the attention deficit hyperactivity disorder-inattentive type, they are categorized separately because of their excessive daydreaming, mental confusion, and lethargy. Although there is a developing literature on SCT in recent years, studies and case reports on clinical manifestations are limited. This case report provides information about the clinical appearance of SCT, and to discuss its qualitative distinction with other disorders