The validity and reliability of preschool age psychiatric assessment (PAPA) in Turkish population

INTRODUCTION

The Preschool Age Psychiatric Assessment (PAPA) was developed in response to the need for a standard and reliable tool for assessing preschool-age psychiatric disorders. The aim of this study was to translate PAPA into the Turkish language and evaluate the validity and reliability.

METHODS

The researchers translated the original PAPA to Turkish, and the Turkish version of PAPA was translated back into its original language by professional translators. After the psychiatric assessment of the 300 patients by child psychiatrist, the PAPA interview was implemented with the parents. The sociodemographic data form and the PAPA short forms were filled out by the clinician conducting the interview. The Child Behavior Checklist for Ages 1.5-5 (CBCL/1½-5) was completed by parents.

RESULTS

The rate of detecting true positives and true negatives in all subscales when comparing PAPA with CBCL in children under 60 months ranged from 65% to 88%. The AUC values were above 50%, ranging from 0.56 to 0.72, indicating that PAPA performed reasonably well in detecting true positives and true negatives compared to CBCL. According to DC: 0-5, it was found that the adjustment was good for total psychopathologies, separation anxiety disorder, social anxiety disorder, and depression (κ = 0.67-0.79), and excellent for GAD and PTSD (κ = 0.81-1.00) CONCLUSION: The validity and reliability obtained from this study are valuable in our country for the objective identification of preschool children showing problematic symptom levels and for distinguishing them from children showing typical characteristics.

Sluggish cognitive tempo symptoms cooccurring with attention deficit hyperactivity disorder

Background

In the current study, the main aim was investigating the sociodemographic features and sluggish cognitive tempo symptoms of children diagnosed with attention deficit hyperactivity disorder and followed at an attention deficit hyperactivity disorder-specific outpatient clinic.

Results

The data of 200 boys and 200 girls who were followed up at the attention deficit hyperactivity disorder outpatient clinic were retrospectively compared. The scores of Turgay’s Scale-Disruptive Behavior Disorders Screening and Rating Scale, the Sluggish Cognitive Tempo subscale of the Children Behavior Checklist, and Conners Rating Scales Revised-Parent and Teacher Forms were analyzed. Among the group with Sluggish Cognitive Tempo scores, the ratio of girls was higher and the mean age at which symptoms of attention deficit hyperactivity disorder were recognized and treatment was offered was significantly older than that of the children with <4 scores. Both internalizing and externalizing symptoms were more frequent among the attention deficit hyperactivity disorder children who had Sluggish Cognitive Tempo scores ≥4.

Conclusions

There is increasing evidence distinguishing sluggish cognitive tempo from attention deficit hyperactivity disorder, and in this study, we would like to highlight the appearance and clinical manifestation of these disorders together. Further research, including Sluggish Cognitive Tempo children from the general population, is warranted to understand the characteristics that accompany and differentiate attention deficit hyperactivity disorder.

Pediatric dysphagia overview: best practice recommendation study by multidisciplinary experts

BACKGROUND

Currently, there is no comprehensive and multidisciplinary recommendation study covering all aspects of pediatric dysphagia (PD). This study aimed to generate PD management recommendations with methods that can be used in clinical practice to fill this gap in our country and in the world, from the perspective of experienced multidisciplinary experts.

METHODS

This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-round modified Delphi survey via e-mail. First, ten open-ended questions were created, and then detailed recommendations including management, diagnosis, treatment, and follow-up were created with the answers from these questions. Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation) and divergent consensus (not recommended).

RESULTS

In the 1st Delphi round, a questionnaire of 414 items was prepared based on the experts' responses to ten open-ended questions. In the 2nd Delphi round, 59.2% of these items were accepted as pre-recommendation. In the 3rd Delphi round, 62.6% of 246 items were accepted for inclusion in the proposals. The final version recommendations consisted of 154 items.

CONCLUSIONS

This study includes comprehensive and detailed answers for every problem that could be posed in clinical practice for the management of PD, and recommendations are for all pediatric patients with both oropharyngeal and esophageal dysphagia.

How does adolescent motherhood affect mother-infant/toddler relationship and emotional availability

BACKGROUND

The present study examined the different aspects of infant-mother relationships in adolescent mothers and compared them in adult mothers.

METHODS

Children aged 18-40 months who were referred to our outpatient Infant Mental Health Department were analysed retrospectively. Sociodemographic data, Parent-Infant Relationship Global Assessment Scale (PIR-GAS) scores, and Emotional Availability (EA) Scales scores were analysed. Twenty-nine adolescent mothers being younger than 20 years at the beginning of pregnancy and thirty mothers who were aged at least 25 years were enrolled the same data as adult mother group.

RESULTS

In the adolescent mothers group, the education years of the mothers, the ratio of mothers having professions were significantly lower (p < 0.001); the spousal age gap was significantly higher than among the adult mothers (p < 0.001). It was also found that an underinvolved relationship pattern was seen more frequently among the mother-infant dyads in the adolescent mothers' group than in the adult mothers group (p = 0.002).

CONCLUSIONS

Although there were not found many problems in terms of the relationship of adolescent mothers with their infants/toddlers in the current study this may have been due to a small sample, we would like to emphasise that the problems should be detected and appropriate interventions should be made for adolescent mothers.Key pointsOur main aim for this study was assesment of the effect of adolescent motherhood in terms of infant\toddler-mother relationshipOur findings showed that lower education level and being unemployed were higher in adolescent mothers group.Higher age gap between spouses was found to be associated with adolescent motherhood. Underinvolved relationship was highly prevalent among adolescent mothersOur findings suggest that early motherhood is a risk factor for mother-infant\toddler-relationship and parenthood.Intervention and education programs during and after pregnancy for adolescent girls may help them to prepare for motherhood more consciously and form established relationships with their infants.

Index depressive episode and antidepressant exposure were associated with illness characteristics of pediatric bipolar disorder

OBJECTIVE

Pediatric bipolar disorder (PBD) is a serious, recurrent disorder leading to severe functional impairment. As a first mood episode, index episode could affect the long-term course of the illness. This study aimed to investigate the clinical characteristics of youth with PBD from our multicenter, nationwide, naturalistic follow-up samples and to identify (i) the effects of index mood episode and (ii) the effect of previous antidepressant treatments on the age at mania onset of PBD.

METHOD

The study sample consisted of 271 youth with BD-I followed by the child and adolescent psychiatry clinics of seven different university hospitals and three research state hospitals, representing six geographic regions across Turkey. All diagnoses were made according to structured interviews, and all data were retrospectively obtained from clinical records by the clinicians.

RESULTS

When patients with index depressive/mixed episodes (IDE, n=129) and patients with index (hypo)manic episodes (IME, n=142) were compared, the total number of mood episodes and rapid cycling feature were significantly higher in the IDE group than in the IME group. The Cox regression analysis adjusted for sociodemographic and illness characteristics revealed female adolescents in the IDE group treated with antidepressants were more likely to have an earlier onset of mania (hazard ratio=2.03, 95% confidence interval=1.31-3.12, p=0.001).

CONCLUSION

This is the first large-scale nationwide follow-up study in Turkey that indicated prior antidepressant treatments were associated with an earlier onset of mania in youth, particularly in adolescent females. Larger prospective studies are needed to identify neurodevelopmental processes underlying PBD and initiate prevention approaches.