The Validity of the Turkish Translation of Mania Rating Scale, and the Depression Rating Scale for Children and Adolescents

INTRODUCTION: The aim of this study is to analyze the validity and reliability of the Turkish translation of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children - Mania Rating Scale (K-SADSC-MRS), and the Depression Rating Scale (K-SADSC -DRS). METHODS: 151 children and adolescents (6 - 18 years old) and 30 healthy controls (6 - 18 years old) who applied to the Child and Adolescent Psychiatry clinic between September 2020 and May 2022 were included in the study. All participants were given K-SADSC-MRS, K-SADSC-DRS, Children's Depression Rating Scale - Revised Form (CDRS), Young Mania Rating Scale (YMRS), Children's General Assessment Scale (CCI) and Clinical Global Impression Scale (CGI) ) scales were applied. RESULTS: Cronbach's alpha coefficient of K-SADSC-MRS was found to be 0.899 and similarly, Cronbach's alpha coefficient of K-SADSC-DRS was found to be 0.899. A high correlation was found between YMRS and K-SADSC-MRS (r=0.932, p&lt; 0.001), and between CDRS and K-SADSC-DRS (r=0.911, p&lt; 0.001). There was a negative correlation between the scales showing opposite polarity. In ROC analyses, the area under the curve was found to be 0.927 for K-SADSC-MRS and 0.920 for K-SADSC-DRS. Intra-class correlation coefficients between the interviewers were için 0,996 (%95 confidence interval= 0,992 – 0,998) for K-SADSC-MRS and 0,980 (%95 confidence interval= 0,956 – 0,991) for K-SADSC-DRS. DISCUSSION AND CONCLUSION: The Turkish forms of K-SADSC-MRS and K-SADSC-DRS are valid and reliable scales and are suitable for use in children and adolescents in our country.</p

Effort allocation for rewards in first-episode psychosis and first-episode mania

Background: Effort-based decision-making has been shown to be impaired inpatients with schizophrenia. Motivational deficits can also be seen in bipolardisorder given the growing evidence of phenomenological, biological, and genetic overlaps between schizophrenia spectrum disorders and bipolar disorder.This study aimed to evaluate the effort for reward in subjects who had the firstepisode of psychosis (FEP), the variation of this effort according to the size andprobability of reward; and to compare the changes in the effort for the rewards inpatients with the first episode of mania (FEM), and healthy control groups. Wealso aimed to assess whether these deficits in the willingness to expend effort forrewards are related to negative symptoms, positive symptoms, thought disorder,global cognition, and medication.Methods: In this study, effort-based decision-making was compared in patientswith the FEP (n¼53), the FEM (n¼45), and the healthy controls (n¼37). Effortbased decision-making has been evaluated using Effort-Expenditure for RewardsTask( EEfRT). This test evaluates individuals' efforts based on reward magnitudeand probability. Global cognition scores were calculated by a factor analysisbased on a comprehensive neurocognitive battery. Negative symptoms wereassessed with the Brief Negative Symptom Scale (BNSS). Positive symptoms wereevaluated with the Scale for the Assessment of Positive Symptoms (SAPS).Chlorpromazine equivalent doses were calculated for people having medicaltreatment.For EEfRT, the data were analyzed using a mixed model repeated measuresANOVA with the group as a between-subject factor and both probability andreward level (low, medium, high) as within-subjects factors.Results: The main effect for interaction between probability, reward, and thegroup was significant in EEfRT (F¼4,546 p&lt;0,001). Post hoc tests for therepeated measures ANOVA showed significant differences between patients withFEP and healthy controls, and between patients with FEM and healthy controls.In terms of the likelihood of hard task choices, conditions that differed betweengroups were medium probability-low reward (F¼6,02, p¼0,003), mediumprobability- high reward (F¼11,52, P&lt;0,001), high probability-medium reward(F¼15,01, p&lt;0,001), and high probability-high reward (F¼46,78, P&lt;0,001).Global cognition was associated with reduced effort only in high rewardmagnitude and high probability status in patients with FEP. The likelihood ofchoosing the hard task wasn’t correlated with medication, positive symptoms,negative symptoms, or thought disorder in patients with FEP and FEM. Inaddition, a significant difference was found between patients with FEP and FEMin uncorrected analysis in the high reward-high probability condition (p¼0,009).Conclusions: Deficits in the willingness to expend effort for rewards wereevident in FEP and FEM. Demonstration of motivational deficits in the sameprobability and reward situations in both groups may indicate a common pathophysiological mechanism in some subgroups of these disorders. The currentstudy reported cross-sectional evidence for decision-making abnormalities inschizophrenia and bipolar disorder. Further comparative research investigatinglongitudinal changes in effort-based decision-making in the early phases of bipolar and psychotic disorders is needed.</p

Electroconvulsive therapy or clozapine for adolescents with treatment-resistant schizophrenia: an explorative analysis on symptom dimensions

ObjectiveThis study sought to compare pre-intervention patient characteristics and post-intervention outcomes in a naturalistic sample of adolescent inpatients with treatment-resistant psychotic symptoms who received either electroconvulsive therapy (ECT) or clozapine.MethodsData of adolescents with schizophrenia/schizoaffective disorder receiving ECT or clozapine were retrospectively collected from two tertiary-care psychiatry-teaching university hospitals. Subscale scores of the Positive and Negative Symptom Scale (PANSS) factors were calculated according to the five-factor solution. Baseline demographics, illness characteristics, and post-intervention outcomes were compared.ResultsThere was no significant difference between patients receiving ECT (n = 13) and clozapine (n = 66) in terms of age, sex, and the duration of hospital stay. The ECT group more commonly had higher overall illness and aggression severity. Smoking was less frequent in the clozapine group. Baseline resistance/excitement symptom severity was significantly higher in the ECT group, while positive, negative, affect, disorganisation, and total symptom scores were not. Both interventions provided a significant reduction in PANSS scores with large effect sizes.ConclusionBoth ECT and clozapine yielded high effectiveness rates in adolescents with treatment-resistant schizophrenia/schizoaffective disorder. Youth receiving ECT were generally more activated than those who received clozapine