Ilyas Kaya

Psychometric properties of the Turkish version of the Revised Child Anxiety and Depression Scale – Child Version in a clinical sample

ABSTRACT Objective: The shortage of cross-culturally validated instruments limits the study and treatment of psychopathology in countries other than English-speaking ones. The Revised Child Anxiety and Depression Scale – Child Version (RCADS-CV) is a self-report questionnaire that assesses dimensions of DSM anxiety and depressive disorders in youths. In this present study, we aimed to examine the psychometric properties of the Turkish version of the RCADS-CV in a clinical sample of children in Turkey. Method: The participants were 483 children aged 8–17 years old. Subjects were recruited from the following centers: Bezmialem University Hospital (55.7%), Kütahya Regional Hospital (17.4%), Istanbul Medical Faculty Hospital of the Istanbul University (16.7%), and Sakarya University Hospital (12.2%). A semi-structured diagnostic interview was carried out and the following measures were used: Children’s Depression Inventory, Screen for Child Anxiety-Related Emotional Disorders (SCARED), and Strengths and Difficulties Questionnaire (SDQ). Results: Inter-scale reliability was strong/excellent with a Cronbach’s α of .95 and coefficients for the RCADS-CV subscales ranging from .75 to .86, demonstrating good internal consistency. Convergent and discriminant validity tests against both a semi-structured clinical interview and self-report measures suggested favorable properties. Confirmatory factor analysis supported the original six-factor model. RCADS-CV showed greater correspondence to specific diagnoses in comparative tests with the existing measures of anxiety and depression. Conclusion: Overall, the study provides satisfactory evidence that the Turkish RCADS-CV yields valid scores for clinical purposes among Turkish children.

Diffuse Maculopapular Rash With Increasing Dosage of Methylphenidate.

FIGURE 1. Diffuse maculopapuler rash after increasing dosage of OROS-methylphenidate. CASE E is an 11-year-old boy who has been followed up with diagnosis of social and generalized anxiety and attention deficit disorders for the last 2 years. His developmental history and intellectual capacity were within normal limits. He had no significant medical or neurological history but had several episodes of itching and mild and local skin eruptions on his arms and

Psychogenic Purpura Successfully Treated with Antidepressant Therapy.

Psychogenic purpura (PP) or Gardner-Diamond syndrome is a very rare condition characterized by spontaneous, recurrent, and painful edematous skin lesions progressing to ecchymoses [1]. Bleeding from the nose, gastrointestinal organs, kidneys, and uterus has also been reported [2]. PP is commonly regarded as an autoimmune vasculopathy with sensitization to phosphatidylserine, a component of erythrocyte membranes [3]. Development of the lesions generally follows minor physical trauma and/or emotional distress, and they are often accompanied by certain psychiatric conditions [4]. However, it is still unclear how stress influences the physiological processes and changes the immune reactivity so that organisms react with the formation of erythrocyte autoantibodies [1]. Here we present a case associated with depression and sexual abuse.

Self-Injury and Suicide Attempt in Relation with Trauma and Dissociation among Adolescents with Dissociative and Non-Dissociative Disorders

Objective To explore the role of trauma and dissociation over self-injurious behaviors (SIB) and suicide attempts (SA) in adolescents. Methods A total of 207 adolescents participated in the study. After conducting diagnostic interview, participants were divided into five groups as subjects with dissociative disorders (DD), attention deficit hyperactivity disorder (ADHD), major depressive disorder (MDD) and anxiety disorders (AD), and a control group (CG) without any psychiatric disorder. ADHD, MDD and AD groups were considered as non-dissociative disorders (non-DD group) in the present study. Results There is no significant difference between groups in terms of number and age of the subjects (p>0.05). Among all participants SIB was reported in 32.2% of females (n=37) and 25% of males (n=23) while SA was reported in 29.6% of females (n=34) and 4.4% of males (n=4). Adolescents with DD were found to experience higher rates of SIB and SA than the other groups. Dissociation was the most important variable contributing to SIB and female gender was the most efficient variable for SA. Total trauma scores were also found to be significantly higher in DD group followed by non-DD and CG respectively. Conclusion SIB and SA are complex behavioral problems which may be associated with many psychiatric factors. However higher level dissociation seems as an important mediating factor, even regardless of psychiatric diagnosis, in the development of SIB and SA. More research is needed to further explore the factors effective over SIB and SA in adolescents.

Psychometric Properties of the Parent Version of the Revised Child Anxiety and Depression Scale in a Clinical Sample of Turkish Children and Adolescents

The Revised Child Anxiety and Depression Scale-Parent version (RCADS-P) is a self-report questionnaire that assesses dimensions of DSM-based anxiety and depressive disorders in children and adolescents. The present study examined the psychometric properties of the Turkish version in a clinical sample of 483 children and adolescents. The child and parent versions of the RCADS, parent versions of the Screen for Child Anxiety Related Emotional Disorders, the Strengths and Difficulties Questionnaire and Adolescent Symptom Inventory-Depression Scale were administered. Current psychiatric diagnoses were assessed via the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present Version. The RCADS-P demonstrated high internal consistency and test–retest reliability, and good convergent, divergent, and discriminant validity. Confirmatory factor analysis supported the DSM-related six-factor structure. With its demonstrated favorable psychometric properties, the Turkish RCADS-P is currently the only validated parent-report instrument that assesses DSM-based anxiety and depressive disorders in children and adolescents in Turkey.

Painful Muscle Cramps Possibly Associated with Withdrawal from Methylphenidate

As far as we know, there is no reported case of painful muscle cramps associated with withdrawal from immediate release (IR) or osmotic controlled release oral delivery system (OROS) methylphenidate (MPH) in children with attention-deficit/ hyperactivity disorder (ADHD). Here, we present a female subject with ADHD who developed painful muscle cramps in her legs associated with withdrawal from IR MPH.

An Investigation of SDF1/CXCR4 Gene Polymorphisms in Autism Spectrum Disorder: A Family-Based Study

Objective Autism spectrum disorders (ASD) have a complex pathophysiology including genetic, inflammatory and neurodevelopmental components. We aim to investigate the relationship between ASD and gene polymorphisms of stromal cell-derived factor-1 (SDF-1) and its receptor CXC chemokine receptor-4 (CXCR4), which may affect inflammatory and neurodevelopmental processes. Methods 101 children diagnosed with ASD aged 2–18 and their biological parents were included in the study. All participants were assessed using an information form and the Children were assessed using Childhood Autism Rating Scale (CARS). SDF-1 G801→A and CXCR4 C13→T polymorphisms were detected by genetic techniques. The results were evaluated using the transmission disequilibrium test (TDT) and haplotype relative risk (HRR). Results Following TDT evaluation for CXCR4, the assumption of equality was not rejected (χ2=1.385, p=0.239). HRR for the C allele was 1.037 [HRR (95%CI)=0.937 (0.450–2.387), χ2=0.007, p=0.933] and HRR for the T allele was 0.965 [HRR (95%CI)=0.965 (0.419– 2.221), χ2=1.219, p=0.270], but the findings were statistically insignificant. Based on TDT evaluation for SDF1, the assumption of equality cannot be rejected (χ2=0, p=0.999). HRR for the A allele was 0.701 [HRR (95%CI)=0.701 (0.372–1.319), χ2=1.219, p=0.270] and HRR for the G allele was 1.427 [HRR (95%CI)=1.427 (0.758–2.686), χ2=1.219, p=0.270], but the findings were statistically insignificant. Conclusion The genetic screening of blood samples from mother, father and child trios could not show a significant association between SDF1/CXCR4 genes and ASD on the basis of TDT and HRR tests. More extensive genetic studies are now needed to investigate the relationship between SDF1/CXCR4 gene polymorphisms and ASD.

High Rates of Psychiatric Disorders and Below Normal Mental Capacity Associated With Spastic Peroneal Flatfoot: A New Relationship

ABSTRACT Spastic peroneal flatfoot (SPFF) is a rare hindfoot pathology usually seen in the adolescent age group that is characterized by painful spasms in the peroneal muscles. We have clinically observed that patients with SPFF also have some behavioral and emotional difficulties and problems in their academic achievements. Because of these observations, we investigated the prevalence and patterns of psychiatric disorders and intellectual disability among young subjects with SPFF. Our cohort consisted of 16 patients with SPFF. Their mean age at presentation was 21 (range 13 to 31) years. Only 6 patients had a tarsal coalition as an underlying condition. The psychometric evaluation was conducted using validated instruments (Wechsler Intelligence Scale for Children–revised form, Stanford Binet intelligence quotient [IQ] test, and Cattell IQ test). Psychiatric disorders were assessed using a semistructured diagnostic instrument (Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version). The testers and psychiatrists were unaware of the orthopedic condition and the preliminary psychiatric diagnoses. The ethical committee approved the study protocol. The mean follow‐up period was 41 (range 12 to 97) months. The mean IQ score of the patients was 75.1 ± 17.9 (range 52 to 107). Compared with the general population, the rate of intellectual disability was significantly greater (p = .0001) and the rate of normal intelligence significantly lower (p = .0015) in our patient group. Furthermore, according to the community schooling ratio, our cohort also had lower junior high and secondary education rates compared with the general population. The rate of most psychiatric disorders diagnosed in the SPFF patients was greater than that in the normal population. The most commonly identified psychiatric disorders were social phobia and attention deficit and hyperactivity disorder (75%). Timely interventions of the psychosocial and academic problems of patients with SPFF might increase their compliance with orthopedic treatment and help with their psychological well‐being and academic achievement. In addition, this relationship might be a clue for uncovering the etiology of this disease, which has not yet been clarified. Level of Clinical Evidence: 4