Oppositional defiant disorder/conduct disorder co-occurrence increases the risk of Internet addiction in adolescents with attention-deficit hyperactivity disorder

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 co-occurring 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

The Elements, Lawrence University Flute Ensemble, January 30, 2017

Harper Hal

School Refusal: Clinical Features, Diagnosis and Treatment

Children regularly and voluntarily go to school in order to fulfill the expectations of society from them to continue their education or schooling. School continuation has been made compulsory by laws. Nonetheless, contrary to popular belief, for some children it is distressing to go to school. These children have difficulty continuing school and/or refuse to go to school. Today school refusal is defined as a child’s inability to continue school for reasons, such as anxiety and depression. The prevalence of school refusal has been reported to be approximately 1% in school-age children and 5% in child psychiatry samples. The prevalence of school refusal is similar among boys and girls. School refusal can occur at any time throughout the child’s academic life and at all socio-economic levels. School refusal is considered a symptom rather than a clinical diagnosis and can manifest itself as a sign of many psychiatric disorders, with anxiety disorders predominant. Separation anxiety disorder, generalized anxiety disorder, social phobia, specific phobia, and adjustment disorder with anxiety symptoms are the most common disorders co-occurring with school refusal. While separation anxiety disorder is associated with school refusal in younger children, other anxiety disorders, especially phobias, are associated with school refusal in adolescents. Children who have parents with psychiatric disorders have a higher incidence of school refusal, and psychiatric disorders are more frequently seen in adult relatives of children with school refusal, which supports a significant role of genetic and environmental factors in th etiology of school refusal. School refusal is a emergency state for child mental health. As it leads to detrimental effects in the short term and the long term, it should be regarded as a serious problem. The long-lasting follow-up studies of school refusing children have revealed that these children have a higher incidence of psychiatric disorders or that they are more likely to require psychological assistance. It is for these reasons that the treatment of school refusal is increasingly gaining impor-tance. The major aim of the treatment is to help the child return to school at the shortest time possible. The treatment should be carried out in cooperation with the child’s parents and the school personnel. A widely accepted approach to the treatment of school refusal is one that is concerned with the application of a multi-faceted treatment. Psychosocial and psychopharmacological approaches constitute the crucial parts of the therapeutic process. Today, cognitive behaviour therapy and medication are the most frequently employed approaches in the treatment of school refusal

The clinical features of children and adolescents with school refusal

WOS: 000273170700008Objective: To assess the clinical features of children with school refusal and discuss them in the light of the resources reviewed. Methods: Fifty-five children with school refusal have been included in the study. Firstly, we gave information about study and got informed consent. Detailed clinical interviews were made with child and parents. A sociodemographic information form and a Symptom Check List for Separation Anxiety Disorder were applied to the parents. Definitive statistics were employed in the evaluation of the data. Results: It was found that among children who presented with complaints of school refusal the number of boys was higher; the average age of children was 9.1 +/- 3.0; school refusal was more frequently seen in children who go through important transition periods such as starting primary school (5-7 years) and junior high school (10-11 years); most of the families had either one child or two children; school refusal was more frequently seen in the first child of the family; the most frequently seen psychiatric disorder was separation anxiety disorder; and the most frequently seen accompanying diagnosis in children with separation anxiety disorder was another anxiety disorder. Conclusions: School refusal should be considered as an important problem due to its effects that could be permanent in the social, emotional, and educational life of the affected individual. The early identification and treatment of the cases will inhibit the development of psychiatric disorders. Today there is still ongoing controversy regarding school refusal. Thus, in child and adolescent population, future studies are needed to determine the etiology, epidemiology, subtypes, diagnosis, clinical course, and treatment of school refusal. (Anatolian Journal of Psychiatry 2009; 10: 310-317

The investigation of domestic violence in child psychiatric sample

WOS: 000263263700011Objective: When the studies are reviewed about domestic violence against partner and child, there are a few studies which include psychiatric sample, especially children. The aim of this study is to compare the two methods to domestic violence against child (DVAC) and domestic violence against partner (DVAP) in the pediatric psychiatric sample. Methods: In this study, DVAC and DVAP were investigated with two different methods. The first was self-report questionnaire. The second was to ask similar questions during face to face intervention. Participants were 510 mothers who had 4-12 years old child and who applied child and adolescent psychiatry department. Findings: Both DVAC and DVAP were determined higher rates in the first method. Additionally, correlation between two methods was very little. DVAC rates increased in the children who had DVAP history in their family. Conclusion: This study results werenot similar to literature knowledge that 'DV should be examined as short and close and questions during face to face intervention'; according to our results the rate of this suggested method was effective at a level of only half of the another method. This traditional method might be true, but it couldn't forget that this rate might bring lower results than the reality. When there is a doubt about the possible presence of DV in family, different methods should be use, and each family member should be examined separately. (Anatolian Journal of Psychiatry 2009; 10: 71-76

Forced normalization: an important phenomenon in the relationship between psychiatric disorders and epilepsy

WOS: 000263392500013Although it had long been observed that psychiatric disorders occur in patients with epilepsy, it was only in the 19th century that those were understood and classified. Having been demonstrated in the literature for the last 50 years, forced normalization (alternative psychosis, paradoxical normalization) is a phenomenon that emerges in patients diagnosed with epilepsy. Landolt described it as "a phenomenon characterized by the relative or complete normalization of EEG findings, compared to the previous ones after the occurrence of psychotic states." The psychiatric disorders reported are mostly psychoses, however, "prepsychotic dysphoria" (insomnia, irritability, anxiety), hysteria, and hypochondriasis as well as mood disorders (depression, mania) have also been reported. The pathogenic mechanisms and neurobiological processes that cause this phenomenon have riot yet entirely understood. Moreover, there is lack of information on the incidence of this phenomenon. in this report, the potential pathogenic mechanisms, clinical features, and the diagnosis of forced normalization that is generally assessed by neurologists, yet is also attracting the attention of psychiatrists with the increasing number of cases reported recently, will be reviewed

Chronic (Interictal) Psychosis and Phenomenon of Forced Normalization: Case Report

WOS: 000276284400047Psychosis in epilepsy can be categorized in relation to seizures or the treatment: ictal psychosis, postictal pyschosis, interictal (chronic) psychosis, "forced normalization" or "alternative psychosis", and de novo psychosis following epilepsy surgery. A schizophrenic condition with permanent psychotic symptoms that occurs in between the seizures or that has no direct relation with the seizures is termed as "interictal pychosis". Such definitions as "schizophrenia-like psychosis of epilepsy" or "chronic (interictal) psychosis" are also proposed for interictal psychosis. The concept of "forced normalization" is described as the decrease or complete normalization of electroencephalographic abnormalities present during the seizures in a patient with epilepsy, concurrent with the onset of psychotic signs. This concept, also called as "alternative psychosis" or "paradoxic normalization", has recently attracted more attention. The psychiatric disorders reported are mostly psychoses. Frequently, this phenomenon of psychosis takes the form of a brief psychotic disorder. Chronic psychosis is a rarely seen condition. In this report, a case with chronic (interictal) psychosis and comorbid phenomenon of forced normalization has been presented

Impact of end-stage renal disease on psychological status and quality of life

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

Caregiver burden and related factors in caregivers of patients with childhood-onset systemic lupus erythematosus

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