Oral Research Presentations

10th International Congress on Psychopharmacology & 6th International Symposium on Child and Adolescent Psychopharmacology[Abstract:0110] [Addiction]Cessation of cigarette smoking in adolescents: s...

correlations between SAH and mature defence mechanisms in OUD patients. Beck depression and Beck anxiety scores were higher in the presence of SAH. Conclusions: It was shown that immature defence styles were used more frequently by patients with SMB and SAH. SAH was associated with anxiety and depression scores and SMB has been used as a sort of coping mechanism and has not been associated with anxiety and depression scores in OUD. The application of therapeutic programs for the more effective use of mature defences, as well as specific pharmacotherapies, in patients with OUD can be considered. Considering that the SAH is associated with high anxiety and depression scores, with planned pharmacotherapy, the success rate of treatment can be increased.
[Abstract:0144] [Psychopharmacology] Extrapyramidal and metabolic side effects of haloperidol decanoate: a 12month follow-up study Nazan Aydın, Hasan Mervan Aytaç, Doğan Yılmaz, Pınar Çetinay Aydın, Gökşen Yüksel Yalçın, Cana Canbay, Merve Terzioğlu and Aysel Özer Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey E-mail address: mervan176@hotmail.com ABSTRACT Objective: It is believed that first-generation antipsychotics may cause more extrapyramidal side effects and second-generation antipsychotics also may cause more metabolic syndrome, cardiovascular disease, and type-2 diabetes. However, there are still a lot of controversial studies about this subject in the literature. In particular, recent studies have shown that there is no difference in terms of efficacy and drug tolerability between these two drug groups. The aim of our study is to monitor if extrapyramidal side effects and changes of metabolic parameters were developed in a 12-month follow-up study with Haloperidol Decanoate (HD). Methods: Fifty-four patients who were diagnosed with schizophrenia and hospitalized in Bakırkoy Mental Health and Neurological Diseases Hospital consecutively were included in this naturalistic study. The first examination at the inpatient clinic was named as Assessment 0, the interview after HD applied was named as Assessment 1. The next four Assessments (Assessment 2-5) were conducted as weekly follow-up. In the next month, it was organized as twice a week (Assessment 6-7) and next assessments (8-18) once in a month. The following parameters except the clinical efficacy and plasma levels were evaluated: (1) Assessment of clinical efficacy of haloperidol decanoate and functionality (2) Plasma levels of haloperidol (3) Extrapyramidal symptoms and metabolic side effect (4) The compliance of long-term treatment Results: Fifty-four patients with schizophrenia consisting of 41 women and 13 men were included in the study. There were no severe side effects like neuroleptic malignant syndrome and acute dystonia during our follow-up study. There were only significant correlations between the beginning high dose of haloperidol and EPS scores in the positive direction. There were no statistically significant differences between measurements in the weight variable, but there was a significant difference in waist circumference. The first measurement of waist circumference was significantly higher from both the mid-and final measurements. Among all of these blood measures, only prolactin levels increased significantly over time with the use of haloperidol. There were no statistically significant differences between values of other metabolic parameters (fasting blood glucose, triglyceride, HDL, iron, Hgb, PRL, and HbA1c). In our study, half of the patients still used haloperidol depot at the end of the year and the remaining half of these patients had the following percentages: 14.8% (n = 8) had an atypical antipsychotic, 7.4% (n = 4) were treated with mood stabilizer and another antipsychotic, 7.4% (n = 4) had another depot antipsychotic, and 20.4% (n = 11) had left treatment completely. When the causes of dropout from follow-up study were evaluated, it was learnt that 37.14% of patients had changed their treatment after clinician changing, 37.14% of patients discontinued treatment since lack of social support, and 25.71% of patients left treatment with their own desire or side effects. Conclusions: This study pointed out that the HD was still an effective and tolerable drug for patients with schizophrenia. It is also important to replicate these results in a hospital where severe patients with non-adherence story are treated. As a result, clinicians must choose the best treatment to meet the needs of their patients, leaving the fears and prejudices about the first-generation antipsychotics. Methods: This study was performed in schizophrenia inpatients at the Erenkoy Research and Training Hospital for Psychiatric and Neurological Disorders who attended between April 2015 and February 2016. Twenty-three treatment-resistant schizophrenic patients (18 male, 5 female) were included in this study and these patients were followed up for six months. Participants were evaluated before medication, the first week after start of the drug, the second week, during the first month, and at six months. Electrophysiological investigation was performed in all evaluations. Cognitive functions were evaluated in a week after the start of clozapine and at the end of the six-month follow-up period. Positive and Negative Syndrome Scale (PANSS) and General Functionality Level Scale (GAF) were used for clinical evaluation of patients.
Results: In patients who responded to drug while the significant decrease in PANSS scores were detected in the first month of treatment, an increase in absolute theta wave activity was determined in the first weeks of treatment. When examining the variables related to ERP, there was an increase in the amplitude of P300 in patients who responded to drug. Besides, P300 amplitude changes have been found to be associated with the set shifting test results.
Conclusions: In patients who respond to clozapine, absolute brain theta activity increases in the early stages of treatment and this increase was associated with clinical improvement. İncrease in theta activity could be observed from the first week of treatment prior to clinical response. Therefore, it has been observed that after the start of clozapine treatment, the global increase in theta activity could be a marker that predicts clinical response to clozapine. Moreover, in patients who responded to clozapine, P300 amplitudes were increased in later stages of the treatment. However, changes in P300 amplitudes, due to be determined in late periods, can be a marker to show adequate clinical response rather than predict the clinical response. Our findings should be confirmed with a larger sample size and longer follow-up studies.
[ These two disorders maintain the updated need to identify areas of symptomatological differentiation. In this study, it is aimed to compare the frequency and quality of somatic symptoms between unipolar depression and bipolar depression and address the question to what extent these symptoms contribute to symptomatological differentiation. Methods: Fifty patients diagnosed with unipolar depression (UD) and fifty patients diagnosed with bipolar depression (BD) who presented to the Marmara University School of Medicine's Pendik Training and Research Hospital Psychiatry Outpatient Clinic were enrolled in the study. The subjects in both groups were administered the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to confirm their diagnosis and to determine their psychiatric comorbidities once their informed consents were obtained. The Montgomery Asberg Depression Scale (MADRS) was used to determine the severity of depression, Sociodemographic Data Form was used to determine socio-demographic data and clinical history and the Bradford Somatic Symptom Inventory (BSI) to determine the nature and severity of somatic complaints.
Results: There were no significant differences between the UD and BD groups in terms of BSI total scores and somatic symptoms (p > 0.05). According to evaluation by smoking, BSI total scores were higher in the smokers of the UD group, the smokers of the bipolar-I disorder group, and in all smokers than in non-smokers. There was a significant positive correlation between depression severity (MADRS) and somatic symptom severity (BSI) in all participants and in both groups. In both groups, depression severity was found to predict severity of the somatic symptoms.
Conclusions: There were no statistical differences in terms of somatic symptom levels between UD and BD and it was concluded that the severity of depression was a variable predicting somatic symptoms levels. However, some statistical observations point to the need for larger samplesized studies. Methods: The study group consisted of 89 adolescents with AD; the control group (102 adolescents) comprised of patients from other clinics at hospital. The Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) was used to diagnose in two groups. The Screen for Child Anxiety Related Emotional Disorders (SCARED) and Beck Depression Inventory (BDI) were given in both groups. Adolescents' cognitive properties were assessed using The Cognitive Distortions Scale (CDS). The data of the study were evaluated using the Statistical Package fort the Social Sciences (SPSS). All tests were two-tailed with p-values < 0.05 considered significant.
Result: The average age of the adolescents in the AD was 17.04 ± 0.68 (64 girls and 25 boys) years, and the average age of the adolescents in the control group was 17.07 ± 0.69 (70 girls and 32 boys) years. There were no significant differences between the two groups in terms of socio-demographic data (p > 0.05). When the data of AD and control groups were compared in terms of CDS subscale scores, it was found that the AD group obtained statistically significant high scores in mindreading, all-or-nothing thinking, emotional reasoning, labelling, mental filter, overgeneralization, personalization, should statements, minimizing the positive. There was no statistically significant difference in catastrophizing subscale. Statistically significant differences were found in the CDS interpersonal (IP), personal achievement (PA) domains and total scores when comparing the two groups. It was also found statistically significant difference between the ones with comorbid major depressive disorder (n = 35) and with no comorbidity (n = 54) in terms of CDS IP, PA, and total scores (p = 0.02, p < 0.001, p < 0.001 respectively).
Conclusions: In our study, severity of cognitive distortions in the AD group was higher than healthy controls as in the previous literature. It was also found that adolescents with comorbid major depressive disorder in the AD group have more cognitive distortions than the ones only with AD diagnosis. Our study emphasizes the importance of interventions such as cognitive behavioural therapy for cognitive distortions in the adolescents with AD diagnosis, especially comorbid major depressive disorder. However, further studies with larger sample size may allow us to have more knowledge in this area.

[Abstract:0176][Mood disorders]
Evaluation of uric acid levels in major depression and bipolar disorder patients

Gulcin Elboga and Muhammet Berkay Ozyurek
Gaziantep University School of Medicine Department of Psychiatry E-mail address: berkay_ozyurek@hotmail.com ABSTRACT Objective: The purinergic system plays a role in the regulation of mood, motor activity, cognitive function, sleep, and behaviour. The last product of purine metabolism is uric acid. This study aimed to evaluate whether uric acid levels in patients with unipolar depression and bipolar disorder depressive episodes were different from healthy controls and to determine the clinical parameters that might be related to uric acid level.
Methods: Thirty-one major depressive disorder and 31 bipolar disorder depressive episodes were included in the study and 31 healthy control groups without a known psychiatric disorder story were included in the study between April 2015 and November 2017 at Gaziantep University School of Medicine's Psychiatry Clinic. Patients' diagnoses were determined according to DSM-5 and Hamilton Depression Scale was used in assessing disease severity. Patients with medication (lithium, etc.) and other diseases that may affect uric acid metabolism were not included. Plasma uric acid levels were recorded in all groups by reviewing existing medical records. Descriptive statistics and inferential statistics were performed. SPSS 17.0 was used for analysis. Statistical significance was set at p < 0.05. The ANOVA test was used to compare the variables that fit normal distribution, and the Kruskal-Wallis test was used to compare non-normal distribution variables. Results: Mean serum uric acid level; 4.56 (± 1.53) mg / dL in the major depression group, 5.38 (± 1.42) mg / dL in the bipolar depression group and 4.86 (± 1.26) mg / dL in the control group. In our study, there were no significant differences in serum uric acid levels between the patient and control groups (p = 0.075). However, serum uric acid levels in the bipolar depression group are higher than the major depression and healthy control groups.
Conclusions: Uric acid levels were similar in the major depression and healthy control group and higher in the bipolar depression group. There are studies in the literature that support the change of uric acid levels in depressive patients. In these studies, the dysfunction of the purinergic system accompanying the psychiatric diseases is accused. It is also known that uric acid is an acute phase reactant that increases in response to inflammation in the body. A possible indicator of the inflammatory process, which is also implicated in bipolar and unipolar depression, may be elevation in serum uric acid levels. For this reason, we believe KEYWORDS Bipolar disorder; major depressive disorder; uric acid; purinergic dysfunction; Inflammation that the investigation of uric acid metabolism in patients with major depression and bipolar disorder in larger sample groups may contribute to the understanding of the disease and perhaps open new horizons for treatment.

[Abstract:0177][Schizophrenia and other psychotic disorders]
Altered serum levels of high sensitivity C-reactive protein in first-episode drugnaive and chronic medicated schizophrenia Abdullah Bolu a , Mehmet Sinan Aydın a , Abdullah Akgün a , Ali Coşkun b , Cemil Çelik a , Özcan Uzun a and Taner Öznur a a Gülhane Medical School; Dept. of Psychiatry. Ankara/Turkey; b Gülhane Medical School; Dept. of Pathology. Ankara/Turkey E-mail address: abdullah_bolu@yahoo.com ABSTRACT Objective: Schizophrenia causes significant loss of function and its aetiology still remains unclear. One of the most important hypotheses for explaining pathogenesis is related to immune dysfunction. People with high pro-inflammatory biomarkers in plasma and in serum have a higher risk of developing schizophrenia. Some studies showed higher high-sensitivity C-reactive protein (hsCRP) levels in patients with schizophrenia compared to the control group. However, there are not enough studies comparing the first episode drug-naive psychotic disorder patients with chronic schizophrenia patients.

Methods:
The study was conducted with 39 first-episode drug-naïve psychotic disorder patients and 52 schizophrenia patients. There was no statistically significant difference between the groups in terms of age, marital status, education, and gender. Results: The mean HsCRP levels of first-episode psychotic disorder patients and the mean HsCRP levels of schizophrenia were compared and there was no statistically significant difference between the groups (t = 0.771; p = 0.443). There was a positive correlation between SAPS levels of first-episode psychotic disorder patients and hsCRP (r = 0.424; p = 0.035).
Conclusions: The most important finding in our study was that there was a positive correlation between PANS scores and hsCRP in patients with first episode drug-free psychotic disorder. Past studies showed that the level of hsCRP in patients with schizophrenia was higher than the control group and this elevated level of hsCRP decreased with treatment. While hsCRP was associated with PANSS scores in our study, some of the previous studies report the opposite of our findings. These findings are preliminary results of our study and the final results will be evaluated when the study is completed. 8-F2-isoprostane, Thioredoxin and Thioredoxin Reductase Levels in Children with Obsessive-Compulsive Disorder Conclusions: Results of this study did not suggest the involvement of oxidative stress in the aetiopathogenesis of OCD in children.

Comparison of side effects of different doses of gabapentin in healthy volunteers
Ahmet İnal Erciyes University School of Medicine, Department of Pharmacology, Hakan Çetinsaya Good Clinical Practice and Research Center, Kayseri, Turkey E-mail address: drahmetinal@hotmail.com ABSTRACT Objective: Gabapentin is indicated for the treatment of peripheral neuropathic pain such as painful diabetic neuropathy, post-herpetic neuralgia treatment of partial seizures with and without secondary generalization and anxiety disorders in adults. The objective of the present trials is to examine the safety of both preparations (including 400 mg and 800 mg gabapentin) on the basis of safety clinical examinations (at the beginning and at the end of the trial) and registration of adverse events and/or adverse drug reactions in healthy volunteers. Methods: Four (two trials of 400 mg gabapentin and two trials of 800 mg gabapentin) studies were conducted as a single-centre, open, randomized, single-dose, two-period crossover bioequivalence trials. This trial is conducted with the aim to examine whether differences concerning rate and extent of absorption exist between the test preparation and the reference product. A wash-out period of at least 1 week was observed between two consecutive treatments. A total number of 96 healthy male volunteers, aged 18-54 years, normal weight according to the BMI (18.5-30 kg/m 2 ) completed the four trials (each trial consisted of 24 volunteers). A wash-out period of 7-14 days was planned between the two periods. Each of the volunteers was randomly assigned to one of 2 possible administration sequences. Each volunteer received in random order one single oral dose of 400 mg and 800 mg gabapentin (either 1 capsule of the test preparation or 1 capsule of the reference drug) on two occasions. All volunteers were subjected to a pre-and post-study safety examination (including a laboratory examination). The study subjects were planned as homogeneous as possible; although interaction between galenic formulations and gender of the subject is unlikely, the study subjects were recruited from male subjects only. The dosage of the test and the reference products (400 mg and 800 mg of gabapentin) was chosen as a normal dosage in adults.
Conclusions: This study observed the incidence of neuropsychiatric adverse events associated with gabapentin in healthy volunteers. Even though it is a single dose, some adverse effects were seen at higher rates in healthy volunteers than in patients. This can be caused by the underlying pathology or disease. Results: There were no differences in total and subscale scores of Y-BOCS total and subscale scores between the two groups. OCD patients with lifetime smoking were significantly more likely to attempt suicide (p = 0.011), and had a longer duration of illness (p < 0.0001) than those without smoking. The rate of ritualistic (p = 0.043) and counting compulsions (p = 0.028) were significantly higher in smoker than in non-smoker OCD patients. The physical restraint (mechanical restraint), is usually made by connecting feet and wrists with leather belts to the bed which is fixed to the floor. Two additional leather straps are placed on the patient's legs and body. In our country, the number of inpatient paediatric psychiatry clinics is very limited. As a result, the current literature about the diagnosis and treatment preferences of children and adolescents who are followed-up in the inpatients clinics is very scarce. The aim of this study is to evaluate the characteristics of the patients who have been connected to the bed for the physical restraint and the effect of the physical restraint on the treatment in our inpatient unit. Methods: Medical records of 200 hospitalized and treated patients in 2016 in Manisa Mental Health Hospital have been retrospectively reviewed. Patients who were restrained at least once during the hospitalization period were compared with patients who were not, in terms of diagnosis, psychopharmacological drug use, presence of comorbidity, duration of hospitalization, and the way of discharge.

KEYWORDS
Results: When we compared the groups that were restrained and not restrained, it was found that much more drugs were used in the restrained group. The use of antipsychotic and anxiolytic (lorazepam, alprazolam, diazepam, etc.) drugs was found to be significantly higher in the restrained group (p < 0.05). The use of haloperidol-biperidine injection was significantly higher in the restrained group (p < 0.05). The rate of multiple psychiatric diagnoses was significantly higher in the patients who had been restrained (p < 0.05). Major depression, conduct disorder, and bipolar disorder were found to be more frequent in the restrained group (p < 0.05). Self-injurious behaviours were also significantly higher in this group (p < 0.05). The hospitalization period was similar in both groups, but those who were discharged with the request of their family or caregivers before the end of treatment was more frequent in the restrained group (p < 0.05). Clinical global improvement scores were lower in the restrained group (p < 0.05). When the causes of physical restraint were examined, it was determined that the most frequent cause was the attempt of harming the other patients in the unit and the second one was self-harm attempts. Other causes were identified as disrupting the treatment environment, inflicting damage to property, threatening violence, physical attacks on the treatment team, and attempting to escape from the service. Conclusions: Physical restraint practice causes psychological distress both to the patient and to the treatment team. It also results in the lack of patient's confidence to the treatment. In our study, it was also found that the reliability of the treatment was decreased and the clinical KEYWORDS Physical restraint; child and adolescent psychiatry; hospitalization; inpatients global recovery improvement scores were lower in the families whose children were physically restrained. In conclusion, prior to the application of physical restraint, the other methods must be tried and physical restraint must be the last resort. In this presentation, the reasons for the physical restraint and the study results will be discussed in the context of current literature.  [2][3][4]. Although the PKU is seen every 10,000 to 30,000 newborns in America and many European countries, the frequency in our country is 1/6094. PKU is the most common genetic metabolic disease with a well-defined association with autism spectrum disorders (ASD) in single case reports and case series, although the exact prevalence rate of autism in PKU is unknown. In this study, we aimed to examine the frequency of ASD in patients with PKU. Methods: We reviewed retrospectively the file summaries and medical reports of 397 patients with PKU diagnosis between the ages of 0 and 18 years registered between 2014 and 2018 in our clinic. Psychiatric interviews based on DSM-5 for ASD were evaluated during the health report procedures of patients with PKU, and each case was filled with an autism behaviour checklist.

KEYWORDS
Phenylketonuria; autism spectrum disorder; prevalence; comorbidity; intellectual disability Results: The average age of the group was found to be 47.8 ± 43 months. Of the cases, 201 (50.6%) were female and 196 (49.4%) were male. ASD was detected 2% (n = 8) of the PKU cases and 8.6% (n = 34) of intellectual disabilities were detected. Conclusions: In our study, the prevalence of ASD was found to be quite high in patients with PKU. Our work was found to be consistent with the results of the few studies conducted in this area. In a study of adult patients with PKU, ASD was found to be significantly higher than control group. Reiss et al. have suggested that up to 20% of the ASD frequency is seen in PKU cases. In different studies, autism was associated only with uncontrolled and late diagnosed PKU cases. Several reports suggested that ASD might represent the end result of a dysfunction caused by a metabolic block in the brain. Among the potential pathophysiological mechanisms implicated in ASD is the excitation/inhibition (E/I) imbalance which might result from alterations in excitatory/inhibitory synapse development, synaptic transmission and plasticity, downstream signalling pathways, and intrinsic neuronal excitability. This cohort report is important because of its potential to give a new direction to studies that aim at the management of ASD, which has come to the occasion like this.
[ Objective: It has been reported that attention deficit, hyperactivity, and impulsivity in attention-deficit/hyperactivity disorder (ADHD) may lead to more frequent suicidal ideation and/or attempts. However, research on cases of ADHD with suicidal ideation and/or attempts is limited in children. We aimed to examine the relationship between the executive function deficits and emotional regulation difficulties of ADHD and suicidal ideation in children.
Methods: This study was performed between January and June of 2017 with patients between the ages of 8 and 12 years with diagnoses of ADHD presented to the outpatient clinics of the Child and Adolescent Psychiatry Department at the Turgut Özal Medical Center at Inonu University. All participants met DSM-5 diagnostic criteria for ADHD according to clinical psychiatric and psychometric examinations. The K-SADS-PL questionnaire was used to determine suicidal ideation. Parents were assessed using behavioural-rating inventory of executive function (BRIEF) scale and emotion regulation checklist (ERC), while children were evaluated using the children depression inventory (CDI) and screen for child anxiety and related emotional disorders (SCARED) scale. Thirtyeight cases (ADHD + SI) describing suicidal ideation and 41 cases (ADHD) with no suicidal ideation were included in the study. Thirty-three healthy individuals were selected for the control group at similar ages. IBM SPSS Statistics 22.0 was used for statistical analysis of the data. Results: Significant differences were found between the ADHD + SI, ADHD and the control group in terms of maternal and paternal psychiatric disorder, maternal suicidal behaviour, paternal drug use, and home violence. According to the DSM-5 ADHD severity rating, moderate and severe ADHD scores were significantly higher in the ADHD + SI group. Additionally, comorbid depressive disorder and conduct disorder were significantly more frequent in the ADHD + SI group. Significantly higher scores were also obtained in the ADHD + SI group in the subscale inhibit, emotion control, monitor, behavioural regulation index, and total scores, and the ERC lability\negativity subscale scores. Finally, significantly higher scores were obtained in the CDI and SCARED general anxiety, separation anxiety, and total test scores in the ADHD + SI group. Conclusions: Executive function deficits associated with ADHD and difficulties in regulating emotions may lead to suicidal ideation. It is possible for suicidal thinking to proceed to suicide attempts and/or completed suicide. Recognition and treatment of executive functioning problems and difficulties in emotional management in children with ADHD may prevent the development of possible suicidal behaviour. Our results suggest the need for further and larger scale research to be conducted to better understand the relationship between ADHD and suicidal ideation. Results: In our study, the percentage of those who diagnosed NES among the MDD diagnosed patients was 13.4%, whereas in the control group, this was 2.3%. In the comparison of MDD patients with NES and without NES, the proportion of smokers and suicide attempt narratives was higher in the group with NES. BDI score was significantly higher in the NES group. Furthermore, the proportion of those with severe depression in the NES group was higher than non-NES group. Similarly, BAI score was significantly higher in the NES group. Also the proportion of those with severe anxiety levels in the NES group was higher than non-NES group. Comparisons between NES and non-NES patients also revealed significant differences in PSQI subscale scores for subjective sleep quality, sleep latency, sleep duration, and sleep disturbance, daytime dysfunction, insomnia severity and quality of life. The percentage of patients with moderate and severe clinical insomnia was significantly higher in the NES group. Among the NES patients, the percentage of those with other eating disorders, especially those with Binge Eating Disorder (BED), was found significantly higher than the non-NES group. In our sample, the predictors of NES were BDI and the presence of any other eating disorders.

Attention
Conclusions: Based on the data of this study, it was found that NES is very common in patients with MDD. Objective: Adolescent pregnancy is a phenomenon seen in all societies, because of child marriages, adolescent sexuality, child sexual abuse, and so on. According to Turkish Statistical Institute 2013 data, the rate of adolescent fertility is 29.4 per thousand in Turkey. As pregnancy is a risky period even in young adults; teens are more vulnerable in case of psychiatric disorders, and many other medical and psychosocial problems. Especially if the psychiatric disorders during this period are not recognized and treated in a timely manner, they may result in significant impairment in general health and functionality in the postpartum period and may negatively affect mother-infant attachment and neonatal health. Unfortunately, there has been limited research on such a topic about public health. In this study, it was aimed to evaluate the post-traumatic stress disorder (PTSD) in this risky group. Methods: All pregnant adolescents who had presented to clinics of obstetrics and gynaecology at Antalya Training and Research Hospital between September 2016 and September 2017 were asked to participate in the study. Adolescents with a chronic disease and mental developmental delay were excluded before. Two of them declined participation, and the study group consisted of 47. A total of 45 adolescents, age-matched with the patient group, without any medical illness and/or mental retardation, were randomly chosen from the schools of the hospital environment by pre-interview and they constituted the control group. Socio-demographic characteristics of the study participants, including age, education, and characteristics of the baby's father were recorded during the interview. PTSD was rated using the Child Post-Traumatic Stress Disorder-Reaction Index (CPTSD-RI). All children were interviewed by a child psychiatrist, and a total stress score was obtained. PTSD symptoms were also classified as "Mild," "Moderate," "Severe," or "Extremely Severe." In the study group, pregnancy, and in controls, the most important traumatic event (traffic accident, fire, earthquake etc.) reported by them during the interview were taken into account in the evaluations.
Results: About the study group, thirty-five (%74.5) adolescents defined themselves as "married." Five (%10.6) had a previous pregnancy. Twenty-five (%53.2) of pregnancies were not planned. Years of education and parents' education were significantly lower, whereas teen pregnancy family history was significantly higher in the study group. When 2 groups were compared in terms of PTSD scores, it was significantly high in pregnant. Nearly in twothirds of the study group, various severities of PTSD were observed. Twelve (25.5%) of these adolescents manifested mild and 42.6% clinically significant (n = 20; moderate 21.3% and severe & extremely severe 21.3%) degrees of PTSD symptoms. However, clinically significant PTSD manifestations were 23.3% in healthy controls (n = 10).
Conclusions: In this study, PTSD was more frequently seen in adolescents with pregnancy, compared to their healthy age-matched peers. Although PTSD in adolescent pregnancy was reported to be high in the limited research in this area, to date, to our knowledge, there is no study evaluating gestation as a trauma in teens. Educating the adolescents about birth control methods and preventing marriages under the age of 18 will be protective from this point of view. Recent evidence from both experimental and postmortem studies has shown that ER stress is one of the processes involved in the pathogenesis of autism spectrum disorder (ASD). However, no circulating markers of ER stress have been reported so far in these patients. Glucose-regulated protein 78 (GRP78), an ER-resident chaperone, regulates the ER stress response and is accepted as the main indicator for ER stress both in tissue and in blood. In the present study, the circulating GRP78 levels were examined in ASD patients as a potential marker for ER stress.

KEYWORDS
Autism; autism spectrum disorders; endoplasmic reticulum stress; GRP78; pathogenesis Methods: Plasma samples from healthy control subjects (n = 29) and ASD patients (n = 33) were used to evaluate circulating GRP78 levels. Plasma GRP78 concentrations were measured by ELISA. Data are presented as mean ± standard deviation. Results: Plasma GRP78 concentration was 11.61 ± 4.03 ng/ml in the healthy control group and did not change significantly in the ASD group (11.56 ± 5.73 ng/ml) (p = 0.9688).
Conclusions: Although ER stress has been implicated in ASD, our results showed that plasma levels of GRP78 did not change in ASD patients. It is suggested that GRP78 is not an appropriate circulating marker to evaluate ER stress in ASD patients. Clinical interview based on DSM-IV was performed. Socio-demographic data form, Wender Utah Rating Scale, Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale, Adult ADHD Self-Report Scale (ASRS) and Personal and Social Performance Scale (PSP) were filled out. The detailed laboratory parameters were evaluated during the study.
Results: Ninety-one cases were included in the study. The mean age of the patients was 28.5 ± 10.4. A total of 50 patients were female (54.9%) and mean duration of education was 13,05 ± 2,19. Mean duration of ADHD treatment was 22.8 ± 24.46 months. ADHD was diagnosed in 7.7% of the cases before 12 years, 14,3% between 12 and 18 years and 71% after 18 years of age. When the ADHD subtypes were evaluated, 51.6% (n = 47) showed combined type, 42.9% (n = 39) showed attention deficit, and 5.5% (n = 5) showed hyperactive/ impulsive subtype. The rate of family history of ADHD was 50.5% (n = 46). The compliance rate of treatment in the first year was 85.7%; 20.9% (n = 19) of cases attempted suicide. The rate of medical illness was 28.6% (n = 26); 17.6% (n = 16) of the cases had drug side effects. The most frequent side effects were insomnia with 4.4% and anorexia with 2.2%. D vitamin level was low (mean = 19.42 ± 9.25%). In 44.8% of cases, the level of ferritin was low (mean: = 39.55 ± 41.2). Hyperlipidaemia was present in 32.6% of the sample. The first mean ASRS score was 49.08 ± 9.53, while the last mean ASRS score was 21.32 ± 8.38. The first mean PSP score was 60.6 ± 9.59, the last mean PSP score was 83.53 ± 6.92. 81.3% (n = 74) of the cases had comorbid diagnosis. Depression was the most common comorbidity with rate of 33% (n = 30). The most commonly used psychostimulant was methylphenidate, with an average dose of 26.18 ± 6.03 mg / day; 15.4% of the cases were using dual psychostimulants. When treatment response were evaluated, there was a significant difference between ADHD subtypes (p = 0.045). When the group with psychiatric comorbidity was compared with those who did not have comorbidity, severity of illness was higher and level of functioning was lower (p = 0.041).
Conclusions: ADHD is a neurodevelopmental disorder that can persist throughout life. ADHD is a risk factor for other psychiatric comorbidities if it continues in adulthood. In our study, the treatment response of the combined subtype emerged later, indicating that the use of psychotropic drug was higher in this group. ADHD comorbidity alters the appearance of other clinical conditions, increasing the negative effects of both diseases on severity and functioning. Systematic evaluation of cases and comorbidities in clinical practice will help to understand and manage the prognostic determinants of adult ADHD. and total motor skills scores on BOT-2. WISC-IV working memory subscale score was significantly correlated with fine motor skills (p < 0.01). The ASD group had higher scores on SCQ and SRS as expected; SCQ score was inversely correlated with balance (p < 0.05), running speed and agility (p < 0.01),upper limb coordination (p < 0.01), strength (p < 0.05) subtests, also with gross motor subscale (p < 0.01), both gross and fine motor scale (p < 0.01) and total score of BOT-2 (p < 0.05); SRS total score was inversely correlated with balance (p < 0.01), running speed and agility (p < 0.01), upper KEYWORDS Autism spectrum disorder; cognitive features; motor skills; social skills; WISC-IV limb coordination (p < 0.01), strength (p < 0.01) subtests, also with gross motor subscale (p < 0.01), both gross and fine motor scale (p < 0.01) and total score of BOT-2 (p < 0.01).

KEYWORDS
Conclusions: The ASD group exhibited poorer motor skills than the control group. Social skills were concluded to be linear with motor skills. This study is one of the earlier studies in autism research to examine the relationship between motor skills and cognitive and social features. To understand the nature of motor symptoms and their social and cognitive correlates in ASD; more studies including motor tasks and correlation analysis are needed. Larger sample use, narrow age range, well-stated comorbidity, and medication use are important to find more specific and generalizable results in this field.
[ Participants were also assessed using the Tissue Doppler Echocardiography (also called Tissue Doppler Imaging-TDI), a useful echocardiographic technique for assessing global and regional myocardial systolic and diastolic function. The obtained data were compared statistically.
Results: There was a statistically significant difference in the distribution of iso-volumetric contraction time (IVCT) between the case and control groups (p: 0.049). IVCT values of all patients using MPH were found to be statistically significantly shorter than those who did not use it. It was observed that the IVCT changed depending on the type of MPH used. Participants using IR / ER: 22/78 had IVCT: 54.4 + 8.9 and IRC / ER: 50/50 participants had IVCT: 48.9 + 10.1. In addition, there was a statistically significant positive correlation between the IVCT scores and the symptoms of Stares a lot or daydreams (r = 0.398, p = 0.004) and uninterested in others (r = 0.321, p = 0.021) (Spearman's rho p < 0.05).
Conclusions: MPH is the most commonly used psychostimulant drug in the treatment of ADHD in children and adolescents. It is a potent central nervous system stimulant that exerts its effects by increasing pre-synaptic levels of dopamine and norepinephrine. Previous studies have shown that extended release MPH increases heart rate, systolic blood pressure, diastolic blood pressure, and corrected QT (QTc) interval. Methamphetamine has been found to increase cardiomyopathy probability by 3.7 fold. The exact mechanism through which methamphetamine or methylphenidate exerts myocardial pathology remains unclear. But it is thought to be due to mainly direct catecholamine effects on cardiac myocytes. Increased catecholamine levels are thought to be due to myocardial overexpression of adrenoceptors, which may lead to pathological changes in cellular hypertrophy, apoptosis, and contractile function. In our study, MPH users were also found to have shorter IVCT. As the IR release rate increased, this shortening in IVCT was found to be increased. We think that monitoring of cardiac pathology of MPH users is important. We consider that there is a need for more comprehensive and longitudinal studies on the potential cardiovascular effects of MPH. Objective: Autism Spectrum Disorders (ASD) is a heterogeneous group of neurodevelopmental disorders occurring with a prevalence ranging from 0.7% to 2.64% in early childhood. Although there is still a lack of full understanding of the etiology of ASD, various clues suggest possible association with altered immune responses and ASD. In this study, it was aimed to evaluate the neutrophil / lymphocyte ratio (NLR) in children with ASD.

Methylphenidate
Methods: This retrospective study included 66 children with drug-naive ASD diagnosed by DSM-5 criteria and 44 age-and gender-matched healthy controls. NLR was measured according to the complete blood count. The severity of ASD was evaluated with the Childhood Autism Rating Scale (CARS) total score. Results: NLR values of the autism group were 1.19 ± 0.69 and those of the control group were 1.56 ± 0.72. The difference between the two groups was statistically significant (p = 0.008). There was no correlation between CARS scores and NLR in the autism group (p > 0.05).
Conclusions: To the best of our knowledge, this is the first study to evaluate the NLR ratio in children with ASD. This study has shown that children with autism have lower NLR ratio than healthy controls. However, there were no correlations between the NLR and autism severity. Decreased NLR levels may reflect altered immune response in autistic patients, and this immune response may play a role in the complex pathophysiology of ASD.

KEYWORDS
Autism spectrum disorder; aetiology; inflammation; neutrophil; lymphocyte; neutrophil-lymphocyte ratio The influential presence of internet has affected children and adolescents more than adults. The aim of this study was to define internet addiction prevalence and its relation with income level among the eighth-grader students in Çanakkale.
Methods: This was a cross-sectional, descriptive study. The study group was selected from the eighth-grader students. The Internet Addiction Scale was used for determining the internet addiction level.
Results: A total of 257 students were enrolled in the study, 47% (n = 100) of the participants were girls, and 53% (n = 157) of participants were boys. Mean score of test was 26.5 ± 17.0 in girls and 29.3 ± 20.0 in boys, and there was no statistically significant difference (p > 0.05). Prevalence of internet addiction was 0.8% (n = 2) and they were from the schools with children from high-income level families. Boys were more likely to have risks for internet addiction than girls but there was no statistically significant difference between boys and girls (p > 0.05). Schools with children from high-income level families had significantly higher number of internet addict students than the low-income level schools (p = 0.018).
Conclusions: The internet addiction among adolescent students from the eighth-grader students was rather low in this study. Male gender and high socio-economic level may be important determinants for internet addiction in adolescents according to this study. Objective: Depression is a devastating mood disorder in which many factors are involved in its formation. Hypothalamic-hypophyseal-thyroid (HPT) axis and hypothalamic-hypophysisadrenal (HPA) axis abnormalities are seen in patients with depression. When studies conducted in recent years have been examined, it is seen that studies on HPT axis have been made less frequently. Childhood trauma and biological effects of the trauma have been the subject of research and still remain important. Severe and prolonged traumatic stress can expose physiological loads to both neurotransmitters and neuroendocrine interactions from the body and brain stress response systems, and may cause permanent changes. It has been reported that stress may create a new adaptive physiological or behavioural state through epigenetic mechanisms. We aimed to examine the differences in the HPA and HPT axes of childhood trauma and depression in this study and the reason why depression did not occur in healthy siblings who were exposed to the same trauma.
Methods: The patients who were diagnosed with major depressive disorder (MDD) according to DSM-5 diagnostic criteria after clinical interview from outpatients who presented to the Düzce University School of Medicine Department of Psychiatry were included the study. Patients were divided into three groups: patients who according to DSM-5 MDD has been diagnosed (GROUP 1: n = 47), the siblings who were healthy and close to the age of patients we selected for the first group (GROUP 2: n = 47) and healthy control group (GROUP 3: n = 85). The Sociodemographic Form, Beck Depression Scale (BDI), the Childhood Mental Trauma Scale (CTQ-28), and the Eysenck Personality Inventory were administered to the participants in all three groups. Participants in each group were given 1 mg of dexamethasone tablet to take oral route at 11:00 pm. Venous blood was collected at 8:00 am on the next day to evaluate the cortisol, TSH, free T3, free T4 values. Results: Childhood trauma was positively correlated with depression. Furthermore, in the CTQ-28 subscale, there was a statistically significant association between physical abuse and KEYWORDS Childhood trauma; depression; HPA; HPT; suicide dexamethasone hypersuppression. The Serum T4 value of patients and brothers who were physically neglected were found to be significantly lower than controls. There was a significant positive correlation between CTQ-28 subscale scores and suicide attempts among all three groups. In addition, participants who attempted suicide had a higher rate of Serum T3 (ST3)/ Serum T4 (ST4) than those who did not attempt suicide. We thought that depression and childhood trauma affected the HPA and HPT counterpart by creating different effects in some areas.
Conclusions: In this study, we found significant differences between the MDD group and their siblings, and healthy controls in terms of HPA and HPT. To the best of our knowledge, this is the first study in which both axes are examined and the siblings of the patients are also examined. It has been suggested that the rate of ST3/ST4 or basal hormone levels in depressed patients may be supported by new studies and may be used as new markers for suicide, antidepressant response, long traumatic experiences, poor or good course of illness. [Abstract:0275][OCD] Evaluation of the hemogram parameters in drug-naive, comorbidity-free adolescents with obsessive-compulsive disorder Objective: Obsessive-Compulsive Disorder (OCD) is a psychiatric disorder which has different etiopathogenic mechanisms. One of these mechanisms is immunologic factors. Studies on immunologic factors, various cytokines, and cellular elements were examined. In order to evaluate the immunological factors in psychiatric disorders, a simple and inexpensive method, hemogram parameters have been examined. We aimed to evaluate hemogram parameters in adolescents with OCD compared with controls.
Methods: A total of 31 patients diagnosed with OCD, who received no medical treatment within the past one month, were included in the study. The control group consisted of 47 healthy subjects with no organic and psychiatric disorders. Conclusions: The findings of the study reveal that lymphocytes and RDW tend to be lower in adolescents with OCD. The findings of our study are consistent with those of previous studies, indicating decreased hemogram parameters associated with inflammation in adolescents with OCD. Our study supported the notion of the need for larger sample studies on the routine use of blood parameters in adolescent OCD. Maternal psychological distress and coping strategies in mothers of children with myelomeningocele aged 0-6 years Methods: The study included 40 mothers with a child aged 1-72 months with MMC and a control group of 40 mothers of age-and gender-matched healthy children. All mothers were asked to complete the socio-demographic form, the Symptom Check List-90-Revised (SCL-90-R), and the Coping Strategies with Stress Inventory (COPE) forms.

Obsessive
Results: The SCL-90-R somatization, depression, anxiety, hostility, phobic anxiety, psychotic, additional items subscales points and Global Severity Index (GSI) were determined to be significantly higher for the mothers of the MMC children compared to the control group mothers (p < 0.05). All of the MMC patients had at least one urological, neurosurgical or orthopaedic problems and difficulties experienced. The denial and behavioural disengagement subscale points of the COPE were determined to be statistically significantly higher and the points of active coping, planning and focus on and venting of emotions were lower in the mothers of the MMC children compared with the control group (p < 0.05). There were negative correlations between the maternal age and the somatization, obsessivecompulsive, anxiety, and paranoid thought subscales and GSI of the SCL-90-R.There were positive correlations between all the SCL-90-R subscales and GSI and the behavioural disengagement subscale points of the COPE.

Conclusions:
The results of this study showed that mothers of children diagnosed with MMC had a higher level of maternal distress, more dysfunctional coping strategies, and less problemfocused coping strategies. It was also determined that the mothers experienced several difficulties in areas related to the biopsychosocial functionality of the disease. In the treatment process of children with MMC, screening the parents for psychiatric problems, providing the family with psychosocial support and developing appropriate coping skills in the mother could provide a positive contribution to the quality of life of both the child and the family. There is a need for further studies including parents of all age groups to be able to develop the area of providing social support for the mothers and other family members of these children. Objective: In terms of morphology and innervation, bladder is a very complex organ. Impairment or change in the contractility of the bladder smooth muscle affects the voiding functions. The bladder normally shows no contractility or activity during the filling phase. When it is filled to capacity, desire to urinate and strong bladder contractions occur and this event continues until the bladder is empty. In overactive bladder, spontaneous contractions and detrusor instability are seen in the filling phase and detrusor hyperreflexia occurs. When these reflexes cannot be inhibited due to detrusor and sphincter instability, urinary incontinence occurs. Haloperidol and olanzapine are most frequently used for treatment of patients with schizophrenia. The aim of this study was to demonstrate the effects of firstgeneration antipsychotic haloperidol and second-generation antipsychotic olanzapine in mice isolated bladder using the organ bath system. Methods: Thirty-five male inbred mice were used in this study. They were randomly divided into five experimental groups (n = 7) as follows: saline; haloperidol 0.125 mg/kg, haloperidol 0.25 mg/kg, olanzapine 1 mg/kg, and olanzapine 2 mg/kg. Mice were treated by intraperitoneal (IP) injection of drugs during 21 days. Mice receiving only the vehicle (0.9% saline, IP) during 21 days served as control group. Then, the effects of drugs were examined on isoproterenol-induced relaxation responses of carbachol-induced contractions in isolated detrusor strips. First the detrusor strips were stimulated with 80 mM potassium chloride (KCl), then tissues were washed for a further 30 min, and precontracted with a submaximal concentration of carbachol (3×10-6 M). After the contraction reached plateau, cumulative concentration-response curves to isoproterenol (10-8 to 10-4 M) were obtained. At the end 10-4 M, papaverin was obtained. The significance of differences was tested by one-way ANOVA with a post-hoc Tukey-Kramer test.
Results: We showed carbachol-induced contractions relaxed by isoproterenol and papaverin in mice detrusor strips obtained from atypical neuroleptic drug olanzapine-treated group. However, neither haloperidol nor olanzapine treatment had no effect on KCl responses of mice bladder. There were no significant differences in KCl-induced contractile responses among the groups.

KEYWORDS
Haloperidol; olanzapine; overactive bladder; mice; antipsychotic Conclusions: The over active bladder causes increase in the frequency and severity in contractions of detrusor smooth muscle. This causes urination frequently and allows the bladder to drain out without adequate filling of the bladder. Olanzapine increased the isoproterenol-induced relaxations of the detrusor smooth muscle that increased the bladder capacity. We showed that olanzapine may offer a potential drug for patients with over active bladder. Olanzapine might be clinically useful for the treatment of overactive bladder in patients that should use antipsychotic drugs. These findings open a new perspective to develop drugs in the treatment of overactive bladder in the future. [Abstract:0283][OCD] Assessment of socio-demographic characteristics and obsessive-compulsive symptoms according to gender in adolescents with obsessive-compulsive disorder Results: There were 38 girls (56.7%) and 29 boys (43.3%) in the study; mean age was 13.50 ± 1.87 years in girls and 14.10 ± 2.30 years in boys. When stratified according to age groups, there was a significant difference between genders. Of 40 patients aged 11-14 years, 27 were girls and 13 were boys (p < 0.05). There were no significant differences between genders regarding other socio-demographic characteristics (birth order, number of siblings, household income level, and psychopathology in parents) and MOCS and Y-BOCS total scores (p > 0.05). There were significant differences between genders in terms of MOCI subscales. Mean MOCS subscale scores were highest in cleaning item, followed by doubting, rumination, checking, and slowness items in girls, whereas it has highest in rumination item; followed by cleaning, checking, doubting, and slowness items in boys.
Conclusions: In our study, the finding that there were no significant differences in household income level, psychopathology in parents, being first child, and total scores were all consistent with the current literature. On the other hand, it was found that age at diagnosis was lower in girls and that rumination was most common symptom in boys. We concluded that understanding of most common obsessive-compulsive symptoms according to gender and socio-demographic data in children and adolescents would help in identifying individuals at risk for OCD and early diagnosis and timely treatment of childhood-onset OCD. Objective: Major depressive disorder (MDD) is the most common mood disorder which has high rates of recurrence, accompanying cognitive, motor and somatic symptoms, associated with loss of physical and psychosocial abilities. So far, the neurobiological alterations related to pathophysiological mechanism of MDD are not still well recognized [1]. MR spectroscopy (MRS) studies on patients with MDD provide various findings regarding dysfunction of dorsolateral prefrontal cortex (DLPFC). In this study, possible effects of major depression on brain biochemistry were aimed to be examined using the method of MRS.
Methods: This preliminary study was carried out with 9 healthy individuals and 9 previously untreated major depressive disorder patients who were admitted to Inonu University School of Medicine's Department of Psychiatry and diagnosed with moderate-to-severe MDD based on DSM-5 diagnostic criteria and Hamilton Depression Rating Scale (HDRS) scores. Patients and healthy controls underwent brain MRS examination for left DLPFC on 3.0 T magnetic resonance device (Avanto, Siemens) and obtained data were compared in terms of metabolite ratios between the two groups. Jere, we are presenting our preliminary results while the study is still ongoing.
Results: No statistically significant differences were found between patient and healthy control group in terms of age and gender (p = 1.00; p = 0.969, respectively). The mean age was 40.44 ± 7.17 in the patient group and 40.33 ± 4.30 in the healthy control group. The HDRS average score of the patient group was calculated as 23.39 ± 4.95. Neurochemical metabolite ratios of left DLPFC in the patient and control group are shown in Table 1. Comparison of neurochemical metabolite ratios in left DLPFC between patient and control group revealed statistically significant differences in terms of Glu/Cr, Glu/NAA, and Glu/mIns ratios (p = 0.042; p = 0.038; p = 0.007, respectively). Glu/Cr, Glu/NAA, and Glu/mIns ratios in the patient group were lower than those in the controls. No statistically significant differences were found between two groups in terms of other parameters.
Conclusions: DLPFC is known to be responsible for executive functions and pertain to regulation of mood as a part of prefrontal cortex which is thought to play a vital role in the pathophysiology of MDD [2]. In our study, Glu/Cr and Glu/mIns ratios obtained from left DLPFC of moderate and severe MDD patients differ from those of healthy controls. Glutamate is the primary excitatory neurotransmitter of central nervous system. Since it is discovered that glutamate might cause neuronal cell death due to overstimulation of NMDA receptors and that this overstimulation may be induced by stress, glutamate is associated with the aetiopathogenesis of depression [3]. Our preliminary results suggest that glutamatergic system plays a role in the neurobiology of depression with moderate and severe features. The response categories for the items are 0 = very false or often false; 1 = sometimes or somewhat false; 2 = sometimes or somewhat true; 3 = very true or often true. The SCID-II-PQ is a self-report measure comprised of 121 items rated dichotomously, which typically is administered prior to the SCID-II interview to shorten the interview period, that map onto criteria of DSM-IV personality disorder. Questionnaires were considered incomplete if more than 5% of the items were not answered in the test.
Results: The mean age of the healthy controls was 27.36; 53.9% of healthy controls were female (n = 745), and more than half of the healthy controls were graduated from university (n = 828). The mean age was 31.75 for patients; 53.4% of patients were female (n:330), and 28.5% of whole patients completed university education (n = 176); 48.5% of patients were diagnosed with depression (n = 300) and 19.4% of them had anxiety disorders (n = 120). PID-5 ′ s facets of the personality trait and SCID-II-PQ personality disorders subscales were correlated positively. Cronbach's alpha values were >0.50 (between 0.5-0.92) for each of the facets of the personality trait in PID-5. Conclusions: These findings supported the reliability and validity of the Personality Inventory for DSM-5 in Turkish sample. During the year, totally 152 implants were administered to 120 patients (5 female, 115 male). Results: Twenty-five patients did not come to follow-up exams during the three months after the application and totally in 6 patients developed an infection and antibiotic treatment was started. In 1 of the 6 patients, the implant came out by itself. Allergy developed in 2 of 120 patients and the implant was removed in 1 of them due to a bullous allergic reaction. In 120 patients, 25% were found positive for Hepatitis C virus and 17.5% were found positive for Hepatitis B virus.
Conclusions: To the best of our knowledge, such an extensive implant application has not been performed and no study examined the socio-demographic characteristics of patients who were treated with the implant in Turkey. Studies have shown that naltrexone implant is more effective than oral naltrexone or placebo in patients with opioid or alcohol-use disorders.
[ Objective: Recent studies emphasized that bipolar disorders (BD) are often unrecognized and the correct diagnosis and treatment may be delayed by 8-10 years. Prolonged duration between the initial onset of symptoms and appropriate treatment is associated with poorer social functioning, more annual hospitalizations, more lifetime suicide attempts. It is widely accepted that there are several biological, structural and functional changes in the brain of patients with BD. Even though our knowledge about BD and its prognosis has been growing, the initial effects of the illness have not been clear enough yet. The aim of this study was to include undiagnosed and drug-naive patients who meet BD-I or BD-II diagnostic criteria according to the DSM-IV and evaluate the neurocognitive, neurobiological, and neurodevelopmental changes by comparing with chronic patients and healthy controls. The second goal of the study was to obtain data for recent staging researches. Methods: In order to determine the high-risk group for bipolar disorders, Hypomania Check List-32 Revised (HCL-32R) was administered to the 2757 first grade students of Celal Bayar University (CBU). A total of 1688 participants who got score of ≥14 on HCL-32R were called by a psychiatrist and interviewed over the phone with the Mood Disorders Module of SCID-I. Afterwards, participants who had been suspected for the diagnosis of bipolar disorder were invited to Psychiatry Department of the Celal Bayar University Hospital for an interview of the whole SCID-I and a clinical evaluation by a psychiatrist. In the end, never diagnosed before and unmedicated patients who met BD-I or BD-II criteria according to DSM-IV (who experienced an undefined hypo/manic episode in the past but never medicated) were included in the study as drug-naïve patients (DNP) group (n = 27). Healthy control (HC) group (n = 27) and chronic patients (CP) group (n = 26) were included to compare with the DNP group. All the participants completed a neurocognitive test battery which evaluates the executive functioning, attention, working memory and verbal learning. Beside this, brain magnetic resonance images (MRI) of all the participants were scanned and oxidative stress marker levels were measured for neurobiological analysis. In statistical analysis of neurocognitive data and oxidative stress marker levels, one-way ANOVA was performed to determine the group differences. Also statistical group analysis of the MRI data were performed by using QDEC tool of the FreeSurfer software package version v5.3.0.
Results: Verbal learning, attention, working memory, and executive functions were significantly worse in the two bipolar disorder patient groups than the HC group and the worst performance was belonging to the CP group. Levels of catalase enzyme were significantly higher in the two bipolar disorder patient groups than the HC group (p < 0.05) and levels of SOD enzyme were significantly higher in the CP than the newly diagnosed bipolar disorder patients (p < 0.0001).

KEYWORDS
Bipolar disorder; early stage; neurocognition; neuroimaging; oxidative stress rate of psychiatric comorbidity in these patients, little is known about childhood and current ADHD symptoms and their effects on pain in these patients. This study aimed to determine whether childhood and current ADHD symptoms were higher than control group and whether these symptoms predicted pain in patients with fibromyalgia. Methods: Sixty-four patients who were followed up with fibromyalgia diagnosis in a physical therapy and rehabilitation and a specific pain outpatient clinic and 58 healthy individuals who have similar socio-demographic features were included in the study. A sociodemographic and clinical data form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Adult ADHD Self-Report Scale (ASRS), Wender Utah Rating Scale (WURS), Fibromyalgia Impact Questionnaire (FIQ) were administered to participants. Results: BDI, BAI, ASRS, and WURS scores were found to be significantly higher in the fibromyalgia group than the control group. WURS scores were found to be a significant predictor of pain in patients with fibromyalgia. Our results also showed that both BDI and BAI scores significantly mediated the association between childhood ADHD symptoms and pain.
Conclusions: Childhood and current ADHD symptoms are found to be higher in patients with fibromyalgia than the control group. Childhood ADHD symptoms may contribute to development and exacerbation of pain in fibromyalgia. Taking the ADHD symptoms into account has an important role in the treatment of patients with fibromyalgia who have frequent cognitive symptoms. Our findings also suggested that the strong relationship between childhood ADHD symptoms and pain can be explained by the presence of depression and anxiety symptoms in these patients.  In recent years, longitudinal studies with large sample have been conducted to describe the "risk group" and predictors of BD. These studies showed that baseline anxiety/depression, baseline and proximal affective lability and proximal subsyndromal manic symptoms were the most important predictors of BD. The aim of this study was to reveal the differences of the structural brain changes and neurocognitive features of the UHR group by comparing with high-risk (HR) and healthy control (HC) groups. The second goal of the study was to identify predictive and biologic feature candidates of the disease. Methods: In order to determine the high-risk groups for BD, the children of BD patients, who are aged 15-30 have been administered the Bipolar Prodromal Symptom Scale-Retrospective (BPSS-R) and structured clinical interviews. As a result of these, in the study, offsprings with subsyndromal manic symptoms or offsprings who had recurrent depressive disorder (DD) with high affective lability score( > 3) on BPSS-R were included as UHR (n = 21) group and offsprings who did not have any psychiatric disorders or offsprings with a psychiatric diagnosis other than alcohol/substance abuse in the last six months, BD (1, 2, NOS-not otherwise specified), recurrent DD, all schizophrenia spectrum disorders, and autism spectrum disorders were included as the HR (n = 54) group. The HC (n = 50) group were included to compare with the UHR, HR groups. All the participants completed stop signal task (SST), Barratt Impulsiveness Scale (BIS-11), neurocognitive test battery which evaluates the executive functioning, working memory, verbal, visual learning, speed processing, and fluency. Beside this structure brain magnetic resonance imaging (brain MRI) and diffusion tensor imaging (DTI) were obtained. DTI data were analysed using FSL and the fractional anisotropy (FA) values were obtained by using ROI-based measurements. In statistical analysis of neurocognitive data, BIS-11 and SST scores, and the FA values; one-way ANOVA was performed to determine the group differences. Also statistical group analyses of the MRI data were performed by using QDEC tool of the FreeSurfer software package version v5.3.0.
Results: In our study, executive functions, verbal, visual learning impairments were determined KEYWORDS Bipolar disorders; cognition; impulsivity; ultra-high risk; neuroimaging; DTI in both risk groups. Fluency and working memory impairments increased in UHR group compared to HR (p < 0.05) and HC (p = 0.000) groups. Furthermore, increased behavioural impulsivity (lack of response inhibition and interference) was not found in the UHR group, while the cognitive impulsivity (lack of planning and attention) increased according to the HR and HC groups in all the tests. In addition, there were changes in the grey matter volumes of the fronto-limbic regions and FA of the corpus callosum (CC) body (p < 0.002), fornix (p < 0.005) of the white matter.
Conclusions: Neurocognitive impairments and structural changes of the brain regions occur in the UHR individuals and some of these impairments are candidate for biological trait markers of the disorder and stage-specific changes could predispose them to developing the disorder.
[ There is growing evidence about the role of inflammation in the underlying pathology of major psychoses. In this study, we aimed to compare inflammatory markers between hospitalized patients with the first-episode psychosis and bipolar mania.
Methods: Patients hospitalized with the diagnosis of first episode psychosis (n = 44) or bipolar mania (n = 44) were recruited for the study. Patients with comorbid medical conditions were excluded from the study. White blood cell (WBC), neutrophil, lymphocyte, platelet and monocyte counts, Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) were evaluated.
Results: There were no significant differences between diagnostic groups in terms of age (p = 0.2, x2 = 1. Conclusions: Even though inflammation markers were higher in psychotic disorders than bipolar disorder, we could not find any significant differences between the first episode psychosis patients and bipolar mania patients. It might be speculated that the fact that no differences were found between the first episode psychotic disorders and mood disorders, the difference might be related to the chronicity and duration of the disorder. However, it is difficult to make conclusive comments due to the lack of a healthy control group comparison and relatively small sample size in our study. Objective: The bladder normally shows no contractility or activity during the filling phase. When it is filled to capacity, desire to urinate and strong bladder contractions occur and this event continues until the bladder is empty. In overactive bladder, spontaneous contractions and detrusor instability are seen in the filling phase and detrusor hyperreflexia occurs. When KEYWORDS Quetiapine; paliperidone; over active bladder; mice; antipsychotic these reflexes cannot be inhibited, due to detrusor and sphincter instability, urinary incontinence occurs. Quetiapine and paliperidone, second-generation antipsychotic medications, are most commonly used for treatment of patients with schizophrenia, atypical antipsychotic agents are favoured over traditional antipsychotic medication as haloperidol because of their lower incidence of extrapyramidal side effects, their greater efficacy in improving negative symptoms of schizophrenia, and their effectiveness in treating schizophrenic patients not responding to conventional neuroleptics. The aim of the current study was to identify the effects of atypical antipsychotic drugs quetiapine and paliperidone in mice isolated bladder using the organ bath system. Methods: Thirty-five male inbred mice were used in this study. They were randomly divided into five experimental groups (n = 7) as follows: saline, quetiapine 5 mg/kg, quetiapine 10 mg/kg, paliperidone 0,25 mg/kg, and paliperidone 0,50 mg/kg. Mice were treated by ip injection of drugs for 21 days. Mice receiving only the vehicle (0.9% saline, IP) for 21 days served as the control group. Then, the effects of drugs were examined on isoproterenolinduced relaxation responses of carbachol-induced contractions in isolated detrusor strips. First, the detrusor strips were stimulated with 80 mM KCl, then tissues were washed for a further 30 min and precontracted with a submaximal concentration of carbachol (3×10-6 M).

KEYWORDS
After the contraction reached plateau, cumulative concentration-response curves to isoproterenol (10-8 to 10-4 M) were obtained. The significance of differences was tested by one-way ANOVA with a post-hoc Tukey-Kramer test.
Results: We showed that carbachol-induced contractions were dose-dependently relaxed by isoproterenol in mice detrusor strips obtained from atypical antipsychotic drugs quetiapine and paliperidone treated group. However, neither quetiapine nor paliperidone treatment had no effect on potassium chloride (KCl) responses of mice bladder. There were no significant differences in KCl-induced contractile responses among the groups.

Conclusions:
The overactive bladder causes increase in frequency and severity in contractions of detrusor smooth muscle. This causes urination frequently and allows the bladder to drain out without adequate filling of the bladder. Quetiapine and paliperidone increased the isoproterenol-induced relaxations of the detrusor smooth muscle that these two antipsychotics increased the bladder capacity. We demonstrated that quetiapine and paliperidone may have represented a potential drug for patients with overactive bladder. These two drugs might be clinically useful for the treatment of overactive bladder in patients who should use antipsychotic drugs. These findings open a new approach to develop drugs for overactive bladder in the future. Social cognitive deficits can contribute to depression and to psychosocial impairment during depression. We conducted a prospective case-control study to compare theory of mind (ToM) abilities, a cognitively more demanding aspect of social cognition of adolescents with first episode untreated MDD and healthy controls. Methods: This study included 35 adolescents with first episode untreated MDD and 37 healthy controls with similar socio-demographic features aged 13-18 years. We use a ToM tasks named Reading the Mind in the Eyes Task (RMET) as social cognition measure and Beck Depression Scale and Clinic Global Impression Scale-Severity (CGI-S) to diagnose and measure severity of depression. Results: There were no statistically significant differences in Reading the Mind in the Eyes Task that assess theory of mind (ToM) abilities as an aspect of social cognitive skills. Score of RMET in depressive group was 20.89 (± 3.2) and in healthy controls, it was 21.27 (± 2.6). (p = 0.580) Conclusions: Contrary to our prediction, a social cognitive skill ToM was roughly equivalent between the two groups and there was no significant link between symptom severity and social cognitive ability.

KEYWORDS
Adolescent; first episode; major depressive disorder; social cognition; theory of mind Though the literature on social cognition and depression reports that social cognitive skills are impaired in depressive adults, in our study which is conducted in adolescent population, we found no significant difference between depressive group and healthy control group in the RMET administered to evaluate the theory of mind. Although this is one of the first studies conducted in this age group to the best of our knowledge, further studies about this issue will be helpful for better understanding and interpretation. Methods: Sixty Type I DM-diagnosed children and adolescents aged between 8 and 16 years were enrolled in this study. The diagnostic assessments of psychiatric disorders in all of the subjects were made according to the DSM-IV criteria, the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and the Lifetime (K-SADS PL). Type 1 DM patients with psychiatric disorder or another physical disorder were excluded from the study. To analyse the socio-demographic backgrounds of the participants, a semi-structured questionnaire designed by the researcher was administered to all subjects. HbA1c levels of Type I DM cases were obtained from patients' data in paediatric endocrinology department. Pearson's correlation tests were used in order compare HBA1c level and the problems in Child Behaviour Check List (CBCL) in Type I DM-diagnosed children and adolescents. Results: Pearson's correlation tests revealed that there was a significant positive correlation (r = 0.31, p = 0.02) between the HBA1c level and CBCL-Somatic Complaints Subscale and a significant negative correlation between HBA1c level and CBCL-Social Problems Subscale (r = −0.33, p = 0.01). Both correlations were found to be at moderate level. Conclusions: It is assumed that high levels of HbA1c mean uncontrolled Diabetes Mellitus and therefore directly related to somatic complaints. In addition, high levels of HbA1c also induce more visits to hospital. That might be the reason why parents take care of their child better. Furthermore, meeting the children with the same problems and also meeting doctors trying to understand the child might make the child feel better as well. Consequently, those advantageous situations might be the reasons of the decline in social problems. The aim of this study was to compare serum nitric oxide (NO) and adrenomedullin (ADM) levels in children with attention-deficit/ hyperactivity disorder, anxiety disorder, and healthy controls, especially due to their effect mechanisms as they may predict anxiety symptom, and to examine the relationship between serum nitric oxide and adrenomedullin KEYWORDS Attention-deficit/ hyperactivity disorder; anxiety disorder; nitric oxide; adrenomedullin; child levels anxiety symptoms in children with attention-deficit/ hyperactivity disorder, anxiety disorder, and healthy control. Methods: Clinically normal intelligence, 6-12 years of age, without any medical and psychiatric comorbidities, 27 children with attention-deficit/ hyperactivity disorder, 27 children with anxiety disorder, and 23 children with no psychiatric disorders were included in the study. The study participants were interviewed by using the Semi-Structured Clinical Interview for DSM-IV Scale for Affective Disorders and Schizophrenia Interview for School Children -Now and for the Life Long Version (K-SADS-PL). State-Trait Anxiety Inventory (STAI) was completed by all the children participating in the study. Parents and teachers of children Atilla Turgay Screening and Assessment Scale Based on DSM-IV for Behavioural Disorders in Children and Adolescents (ATS), Conners Parent Rating Scale Revised Long Form (CPRS-LF) and Conners' Teacher Rating Scale Revised Long Form (CTRS-LF) were filled. Results: There were no statistically significant differences in terms of serum nitric oxide and adrenomedullin levels between attention-deficit hyperactivity disorder, anxiety disorder, and control groups. There were no statistically significant differences in terms of serum nitric oxide and adrenomedullin levels of the children included in the sampling group according to age and gender. There was no statistically significant relationship between serum nitric oxide and adrenomedullin levels and attention-deficit hyperactivity disorder, anxiety disorder, and state-trait anxiety scores of control group children (Table 1). Conclusions: In our study, there was no difference in serum nitric oxide and adrenomedullin levels between attention-deficit hyperactivity disorder, anxiety disorder, and control groups. There have been several studies in the field of psychiatric disorders. Changes in serum nitric oxide and adrenomedullin levels have been reported to decrease or increase when compared to healthy controls. These changes are explained by the oxidative stress in the field and the dysfunction of the hypothalamus-pituitary-adrenal axis. The serum nitric oxide and adrenomedullin levels in our study did not differ significantly from the literature. This can be explained by the low number of samples, the fact that the adult age group is not included in the study, the oxidative stress and other parameters affecting the dysfunction of the hypothalamus-pituitary-adrenal axis. Attention-deficit hyperactivity disorder, anxiety disorder and serum nitric oxide and adrenomedullin levels were not significantly correlated with anxiety symptom in the context of state-continuity anxiety scale. There are no studies that relate serum nitric oxide and adrenomedullin levels to symptoms in the field. In the future, there is a need for longitudinal studies to assess causal relationship with the number of larger samples to be made.  Results: Epilepsy patients and control group were similar in terms of age, gender, education level, and presence of psychiatric family history. There were significant differences between groups in marital status, presence of children, and smoking. The number of marriages was higher in the control group but the number of grade repetitions, disciplinary punishments, physical traumas, job changes, forensic events, traffic accidents, and traffic fines were similar. The paranoid ideation subscale scores of SCL-90-R were not statistically different besides somatization, anxiety, obsessive-compulsiveness, depression, interpersonal sensitivity, psychoticism, hostility, phobic anxiety subscales, and total scores were significantly higher in epilepsy patients (p < 0.05). There were significant differences between the plan subscale scores of the BIQ-11 (p < 0.05), while motor, attention, and total scores were similar (p > 0.05). According to adult ADD attention subscale, scores were statistically higher in epilepsy patients (p < 0.05) but hyperactivity and impulsivity-related features were similar (p > 0.05). We did not find any significant differences in life quality between the groups. Conclusions: Our findings indicated that inattentiveness symptoms in epilepsy patients significantly higher than controls. Most of the previous studies have shown similar to our findings indicating the predominance of inattentiveness subtype in epilepsy patients comorbid with ADHD. The high occurrence of ADHD inattentiveness subtype in epilepsy provides insight into pathogenesis by revealing shared neurobiological mechanisms underlying multiple disorders. It has been suggested that specific neuropsychological impairments both in epilepsy and in ADHD like attention and working memory deficits can be responsible for the increased prevalence of inattentiveness symptoms. Alternatively, ADHD, like epilepsy, is a manifestation of underlying neurodevelopmental vulnerability or it may be the presence of ADHD that predisposes to a seizure disorder. Finally, treatment options for neuro-behavioural comorbidities remain to be developed. Treating physicians should be vigilant to the possibility of these comorbidities in epilepsy patients and future research should examine the impact of comorbidities on treatment outcomes in epilepsy. In some studies, it is reported that bruxism prevalence is higher in children with ADHD than healthy controls but the prevalence and effects of bruxism is mostly studied on medicated children with ADHD. With regard to the clinical evidence of ADHD and sleep problems association, it is aimed to present the preliminary results of prevalence of bruxism and discuss the related factors in non-medicated children with ADHD with this study. Methods: Thirty-four cases of newly diagnosed ADHD without medical treatment and chronic medical disease were obtained as the study group. The Schedule for Affective Disorders and Schizophrenia for School Age Children was used to diagnose ADHD and comorbidities. The Children's Sleep Habits Questionnaire was used to detect sleep bruxism and provide information of sleep habits. Parents were asked for signs and symptoms related to bruxism in their children using a questionnaire. Results: Prevalence of sleep bruxism was found in 23.5% (n = 8) in the study group; 50% of children with sleep bruxism (n = 4) also had awake bruxism and 62.5% (n = 5) described symptoms related to bruxism (tooth wear, jaw clicking, facial pain). ADHD combined type was found as the most common type (62.5%, n = 5) and ODD as the most common comorbidity (62.5%, n = 5) in children with sleep bruxism.

Sleep bruxism; prevalence; ADHD; early diagnosis; child psychiatry
Conclusions: Although the number of cases is limited, our prevalence rate is similar with the previous studies. We may suggest that bruxism and related symptoms can be found frequently in non-medicated children with ADHD. Further studies especially focused on non-medicated children with ADHD may contribute to the clarification of the relationship between bruxism and ADHD. Objective: In this study, the abuse awareness of mothers with children aged 4-6 years and from low socio-economic groups was examined. The aim of this research was to understand the relationship between socio-demographic conditions and mothers' abuse awareness. Methods: A total of 100 mothers residing in the same neighbourhood with low-income families were enrolled in this study. The sample includes mothers from different ages and with different occupations whose children included in the study were aged 4-6 years. The Sociodemographic Form and Abuse Awareness Scale-Parent Form were administered to all mothers in the sample.
Results: It was revealed that there was statistically significant difference between male and female children groups in terms of mother's abuse awareness. Furthermore, there was a significant correlation between mother's abuse awareness and marital status.
Conclusions: The research revealed that the level of abuse awareness was higher among mothers with a daughter compared to those with a son. It was assumed that mothers' abuse awareness sensitivity increases after giving a birth to a girl because of the fact that sexual abuse to girls were reported to be more frequent than boys. Moreover, the results of this study suggested that there was a relationship between the level of abuse awareness and mother's marital status. It was found that married mothers had higher awareness compared to divorced or widowed mothers. This might be related to the fact that single mothers have restricted time for their children compared to married mothers due to economical requirements. Methods: The 5-year (2011-2016) data of the CMHC, which serve at Hitit University Çorum Erol Olçok Research and Training Hospital, was retrospectively analysed; 139 patients who were diagnosed with psychotic disorder and getting TRSM services for at least 2 years were included in the study. The number of medications and hospitalizations were compared before and after the CMHC service.

KEYWORDS
Results: The mean age of the cases was 43.74 ± 11.90; 64.0% was male. It was found that number of drugs and hospitalizations in the time period before CMHC enrolment was statistically significantly higher than the ones after CMHC enrolment (p < 0.05). Conclusions: We found that CMHC reduced the recurrence of illness by increasing compliance with treatment and social adaptation as the number of medications and hospitalization decreased during the follow-up period of CMHC. This finding was consistent with the studies which claim that psychosocial support therapy administered in CMHC would decrease the rates of disease exacerbation and inpatient treatments (4). We believe that further research about the impact of CMHC on disease course and treatment compliance would be useful for the more effective use of these centres. Results: Children with DD and NF-1 exhibited significant deficits in all neurocognitive measures when compared to the healthy control group. Findings showed that children with NF typ-1 + DD performed similarly to children with DD-only on phonological awareness, rapid naming, and single word reading and attention measures; however, children with NF-1 + DD displayed pronounced visual spatial deficits as compared to DDonly and Control groups.

References
Conclusions: İn the current study, we focused on further understanding the NF-1 cognitive profile by examining the reading, attention, and visuospatial skills of groups of children with NF-1 who were subdivided by whether they did or did not meet criteria for DD. Overall, findings suggest that a more refined classification of children with NF-1 might be helpful for tailoring specialized behavioural therapy interventions. Objective: Regardless of gender, process of getting married under the age of 18 is described as early-age marriage. According to Turkish Civil Code, an individual is legally permitted to get married if he/she is older than 17 years old. However, courts are also authorized to grant permission for individuals to get married if aged 16 years or above, in the face of extraordinary circumstances and other significant and valid reasons addressed to the court. With this study, we have aimed to evaluate socio-demographic characteristics, sense of self and family environment of children who were referred to our unit by legal authorities to assess and prepare a report "whether the cases would be fit for marriage regarding their physical and psychiatric development at the time of referral." Methods: Medical file records of cases that were referred to our child and adolescent psychiatry unit by legal authorities between the dates of February 2017 and August 2017, with a formal request pending to evaluate these individuals whether they were psychologically fit for getting married or not. Healthy children matched by gender and age who had presented to the paediatrics department of the same hospital between given dates, due to acute and transient health problems such as upper respiratory infection or for routine check-up, were assigned to the control group, upon obtaining their consent, followed by a diagnostic evaluation carried out by a senior child and adolescent psychiatrist. All participants were asked to fill out Sociodemographic Data Form, Rosenberg Self-Esteem Scale and Family Environment Scale.
Results: Mean age of girls in the process of early-age marriage was 16.02 ± 0.22. Statistically significant difference was found between case and controls regarding family structure and number of siblings. It was found that 73.9% of girls in the case group did not resume their education after secondary school, their parents had lower education levels, mean age gap between cases and their partners was found to be 6.6 ± 2.23 and 47.8% had a religious marital ceremony. Case group also scored lower on Rosenberg Self-esteem Scale, indicating lower levels of self-esteem within the case group. As measured by Family Environment Scale, case group scored lower on cohesion-coherence subscale, though higher scores were obtained on control subscale.

KEYWORDS
Child marriage; early-age marriage; child abuse; selfesteem; family environment Conclusions: Early-age marriages could as well be regarded as another aspect of child sexual abuse. Through letting and actively coordinating early-age marital processes of these children, many rights of these children, most prominently their rights to have an age-appropriate education are violated, in turn, increasing the possibility of these children encountering many adversities identified from the perspective of psychosocial welfare. In order to prevent early-age marriage, causes of this problem need to be addressed in a complementary fashion.  Methods: The study sample consisted of 42 patients with ADHD and 46 healthy individuals between the ages of 18 and 60. A questionnaire form that evaluated physical activity, sleep and feeding behaviour, Adult ADD/ ADHD Diagnostic and Assessment Inventory based on DSM-IV (Turgay), Adults Attention-Deficit/ Hyperactivity Disorder Self-Report Scale (ASRS) were administered after detailed clinical evaluation of all participants. In addition, serum HMWA, ADM, ghrelin, and OXA were measured. Results: As a result of the study among 42 adults diagnosed with ADHD, 19 (45.2%) had attention-deficiency predominant type; 23 (54.8%) were diagnosed with combined type and none was diagnosed with hyperactivity-impulsivity predominant type ADHD. Serum ADM and HMWA levels were significantly higher (p = 0.0001) in patients with ADHD than in controls. Serum OXA and ghrelin levels were also higher in patients with ADHD but that was not significant. A significant negative correlation (r = 0.356, p = 0.021) was found between serum OXA and attention-deficit scores in the Turgay Scale in ADHD patients. OXA levels were significantly lower (p = 0.005) in the group with combined type ADHD than the other groups and significantly higher (p = 0.013) in ADHD patients with attention deficit than in the combined type group. Compared to controls, ADHD group has reported significantly higher rates of irregular sleep (p = 0.000), being more sleepy and/or drowsy during daytime (p = 0.001), much more energy drink consumption (p = 0.006).
Conclusions: Due to well-known protective action of serum ADM and adiponectin against oxidative stress and neuroprotective characteristics, we have hypothesized that significantly higher levels of ADM and HMWA measured in our ADHD group compared to controls, could indicate protective mechanisms against oxidative stress might be working among these individuals. Consistent with the findings of the study that suggested hypoactive orexin neurons located within perifornical and dorsomedial hypothalamic regions that are well known to have an important role in control of vigilance and being awake, as well as with the relevant literature that states attention deficits in the face of decreased orexin levels, in predominantly attention-deficit type of ADHD, we have found much more irregularity among sleep cycles of individuals with ADHD, with more sleepiness during daytime and/or drowsiness, significant increase in the consumption of energy drinks, presence of a negative correlation between serum OXA levels and Turgay ADHD scale attention deficiency scores, as well as though statistically insignificant when compared to other groups, higher levels of OXA measured in attention-deficiency predominant type ADHD might indicate possible compensatory reaction towards these findings in our study. Consistent with the literature finding that postulated possible causal relation between increased motor activity in ADHD and hyperactivation of orexin system located within the lateral hypothalamus, lower levels of serum OXA in combined type ADHD cases when compared to other groups might have been due to above-mentioned compensatory systems. Future studies that would preferably be carried out with larger samples and treatment responses would provide important findings.
Results: There were no significant differences in terms of CARS, ADST, AuBC, and ABC scores between the patients and controls. Early developmental milestones (i.e. language skills, potty training, walking etc.) were attained earlier in regressive group. Anti-GAD antibodies were detected in the serum of 5 (20.8%) ASD patients with regression vs. none of the controls (p < 0.05). There was no seropositivity of neuronal surface autoantibodies in any participant. A significant direct relationship was found between the levels of language skills attained before the regression and regained after the regression (p < 0.05). Gradual onset pattern of regression was shown to be associated with disruption in most of the behavioural domains, especially social and self-help skills.
Conclusions: This study provided novel findings related to the phenomenology of regression and we postulated that autoimmunity might have had a specific contribution to the aetiology of ASD.
[  1,2). Mean WSCT score was 7.63 ± 3.05 in the OCD group and 6.30 ± 2.09 in the control group; the scores in the OCD group were significantly higher than those in the control group (t (68) = 2.167; p < 0.05). WSCT scores established a strong inverse correlation with the severity of OCD. Similarly, WSCT scores established moderate-to-strong correlations with OBQ-44, MCQ, and TAFS scores. The evaluation of implicit memory performance via WSCT indicated that WSCT performance was higher in the OCD patients compared to healthy controls. It was also revealed that WSCT performance decreased as the parameters indicating the severity of the disease (Y-BOCS and DY-BOCS) and the parameters used for evaluating cognitive performance (OBQ-44, TAFS, MCQ) increased and TAFS had the highest effect on WSCT among all the parameters evaluated in the study.
Conclusions: In this present study, although age margins were not wide, the age-related effect on KKTT was found to be statistically insignificant when evaluated in terms of both control and healthy subjects in accordance with the literature information (2).The results also indicated that the WSCT scores were higher in the OCD patients compared to the healthy controls. Multiple regression analysis revealed that the WSCT scores in the OCD group decreased as the Y-BOCS and DY-BOCS scores increased, suggesting that there is an inverse correlation between the impact on the memory functions and the severity of the disease. This correlation could be explained by the fact that since OCD is characterized by impaired cognitive flexibility in attention and perception, it is likely to have adverse effects on implicit memory performance. Literature shows that the studies reporting on the relationship between OCD and implicit memory performance have reported contradictory findings. This contradiction could be related to the variation in the drugs used by the patients evaluated in each study (3). In our study, no significant effect was observed among our patients in terms of drug use since the patient group was heterogeneous with regard to drug use. The results also indicated that implicit memory function was preserved up to a certain degree of the severity of OCD. This finding could be attributed to the heterogeneity of the patient group with regard to drug use and/or to the compensatory mechanisms attempting to reduce explicit memory deficits.
medication should include either a mood stabilizer or an antipsychotic drug; 150 patients who were followed-up as outpatient or hospitalized were evaluated cross-sectionally and included in the study and grouped as euthymic patients and patients in period attack; 59 of the patients (39.4%) had good response to the treatment and 91 (60.6%) had insufficient response. Totally 4 groups were constructed; Results: It is found that psychotic symptoms compatible with mood status were more common in patients with good response to the treatment. History of starting to treatment lately, many medication trial, no adaptation to medication, and leaving medication were more common in patients with insufficient response to treatment, and there was a significant difference. Evaluating drug using status, in patients with insufficient response to treatment, especially in patients with acute mania period, antipsychotic drug usage was more common. In patients with insufficient response to treatment, especially in patients with acute depression period, antidepressant, benzodiazepine usage and ECT treatment ratio were higher and there was a statistically significant difference. Among groups 2, 3 and 4, in patients with insufficient response to treatment, there was more additional diagnosis. According to DSM-5 criteria as additional diagnosis, generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder and alcohol-and drug-use disorder were found and additional diagnoses were more common in patients with insufficient response to treatment. Among all patient groups, YMRS scores, HDRS scores, HAS total scores, HAS psychic and somatic anxiety scores, CGI-S scores, SDS work-social-family scores were significantly higher in patients with insufficient response to treatment; and WHOQOL-BREF total scores, WHOQOL-BREF general-physical-spiritual-social-environmental area scores were less; and in national environment area, scores were higher. Conclusions: In our study, history of alcohol-drug usage, insufficient family support, existence of additional diagnosis, episode type of first mood disorder, more total number of mood disorder episode, mismatch of psychotic features with mood status, seasonality, lack of insight, being long time between symptoms and diagnosis, drug incompatibility, and leaving medication were found to be the predictors of unresponsiveness.  The RNFL, IPL, choroid thickness, and GCL volumes were measured and recorded automatically by a spectral OCT device.
Results: No differences in socio-demographics were found between groups except for occupation and education. There was no difference in the RNFL layers between the CD group and the control group (p > 0.05). The left and right choroid layer thickness acquired from three regions of choroid layer was higher in patients compared with controls (p < 0.05). The GCL and IPL volumes were also significantly lower in the patient group (p < 0.05).
Conclusions: Somas of the ganglion cells form GCL, dendrites of ganglion cells form IPL, and their axons form RNFL. GCL and IPL findings of our study suggest that neurodegeneration occurs during the course of CD, especially in subtype-involved motor component. Axonal degeneration can be responsible for decreases in the grey matter volume and also the thinning of the RNFL. The second remarkable finding of our study is differences between subtypes of CD in terms of GCL and IPL. Neuronal degeneration in M-CD and SM-CD patients was found to be significantly higher than the control group, but no neuronal loss in SS-CD was found. This finding suggests that a more destructive aetiopathogenesis is responsible for neuronal damage in the motor component dominant CD. The third important finding of our study is changes in choroid thickness in CD patients. The choroid may be used to determine active stage of the disease and to monitor inflammatory process like other inflammation markers used in systemic inflammatory diseases. Major limitation of this study is its cross-sectional design. Another limitation of our study is lack of control measurements to increase validity and reliability of OCT to detect inflammation and degeneration. Comparison of optic coherence tomography results of patients with obsessivecompulsive disorder with controls: findings in favour of neurodegeneration 0.030). The native and total thiol levels of the patients with ADHD were significantly higher than the control group (p < 0.001). The Hg levels of the patients were significantly higher than the control group (p = 0.002). Pb levels were not different between ADHD and control groups while Cd levels were significantly higher in the control group (p < 0.001).
Conclusions: Maternal smoking during pregnancy and increase in blood Hg levels might be risk factors for ADHD. In ADHD patients in response to oxidation, antioxidant levels might increase. We could not find any relationship between thiol/disulphide levels and heavy metal levels in patients with ADHD.
[ Results: There were no statistically significant differences between the two groups in terms of age and gender (p > 0.05). The rates of Maras powder use in the patient group were higher than those in the control group. The rates of cigarette use in the patient group were also higher than those in the control group; 16 years and above males were found to use Maras powder at a higher rate in both groups. It was determined that compared to healthy controls, the emotional symptoms, conduct problem, hyperactivity scale, peer problem, and total difficulties scores were statistically significantly higher and prosocial scale scores were lower in children and adolescents with ADHD (p < 0.05). Also the conduct problem and hyperactivity subscale scores of SDQ were statistically significantly higher and prosocial scale scores were lower in Maras powder use group.
Results: The results of this study showed that Maras powder use in ADHD group was higher than those in the controls and that the children and adolescents with the use of Maras powder had higher level of the conduct problem and hyperactivity subscale scores of SDQ and less prosocial subscale scores. Unfortunately, the sale of Maraş powder in our region is not supervised. Easy access to Maraş powder is a risk for all adolescents, especially those with ADHD, in terms of substance use. Especially children with ADHD and their families should be informed about the use of Maraş powder and its risks and damages. Further investigations are needed with a large sample size on Maras powder usage in ADHD. Methods: A total of 100 IBD outpatients (39 in active period and 61 in remission) attending to gastroenterology outpatient clinic in Istanbul Medeniyet University Goztepe Research and Training Hospital, and 100 healthy controls who have no bowel disease or any acute psychiatric disorders were included in the study. Hospital Anxiety and Depression Scale, Turkish version of Ruminative Thinking Scale, and Penn State Worry Questionnaire were filled by all subjects and socio-demographic form was completed by researchers.

KEYWORDS
Results: In our study, we found significantly higher scores of rumination and worry in patient group compared to the controls (p < 0.001 and p = 0.007 respectively). Also patients in active period of IBD had higher scores of rumination (p = 0.004) and worry (p < 0.001) compared to the controls. There were statistically significant differences in rumination scores (p = 0.026) but not in worry scores (p = 0.153) in patients in remission period compared to the controls. Additionally, in the patient group, there were statistically significant correlations between rumination and worry, and Anxiety, Depression and Total scores of Hospital Anxiety and Depression Scale.
Conclusions: These findings suggest that ruminative thinking levels are higher in patients with IBD in acute period and this might be related to higher scores of HAD. Interventions for the levels of ruminative thinking in IBD patients may contribute to a decrease in the symptoms of anxiety and depression and psychiatric comorbidity in these patients. As in all ages of life, headache is a common condition among children and adolescent, which adversely affects daily living. In a study on school-aged children, it was reported that 15-20% of children suffer headache. In addition, its incidence is progressively increasing among adolescents. In children, migraine and tension-type headache (TTH) comprises majority of primary headaches. Depression, anxiety disorders, and somatization disorder are commonly seen among children and adolescents with headache. In this study, it was aimed to review psychiatric diagnoses retrospectively in children and adolescents who were consulted for migraine and TTH by paediatric neurology outpatient clinic. Methods: We retrospectively reviewed records of 5,187 patients who presented to the Harran University School of Medicine's Child and Adolescent Psychiatry Department between the dates of January 1, 2017 and December 29, 2017. The data of 35 patients who were referred with migraine and TTH by paediatric neurology outpatient clinic were assessed regarding psychiatric disorders in retrospective manner. Results: Of the patients, 27 (77.14%) were girls while 8 (22.85) were boys. Mean age was 13.02 (range 8-16) years. Of the patients, 5 (14.28%) were elementary school, 12 (34.28%) were middle school, and 11 (31.42%) were high school students. Seven subjects (20%) were not attending to school. There was migraine in 14 patients (11 girls and 3 boys) (40%) and TTH in 21 patients (16 girls and 5 boys) (60%). Of the patients with migraine, a psychiatric diagnosis according to DSM-5 criteria was made in 8 patients (57.14%) including major depressive disorder (MDD) in 3 (21.42%), attention-deficit/ hyperactivity disorder (ADHD) in 3 (21.42%), nocturnal enuresis in one (7.14%), and anxiety disorder (AD) in one patient (7.14%). Of 8 patients with psychiatric comorbidity, 6 (75%) were girls while 2 (25%) were boys. There was MDD in 3 (27.27%) and AD in 1 (9.09%) of girls, while ADHD in 2 boys (66.66%). Of the patients with TTH, a psychiatric diagnosis according to DSM-5 criteria was made in 15 patients (71.42%) including MDD in 6 (40.0%), ADHD in 4 (26.66%), AD in 3 patients (20.0%), and ODD in 1 patient (6.66%). Of 15 patients with psychiatric comorbidity, 10 (66.66%) were girls while 5 (33.33%) were boys. There was MDD in 6 (37.5%) and AD in 3 (18.75%) of girls while there was ADHD in 4 (80.00%) and ODD in 1 (20.00%) of boys.
Conclusions: Psychiatric comorbidities generally make it difficult to treat headache and indicate poorer prognosis for headache. In the literature, it has been reported that both the depression and anxiety incidences are higher in children with migraine or TTH when compared to controls. Our study showed that depression and anxiety frequencies were higher in children with migraine or TTH in agreement with literature. In addition, it was seen that internalization disorder (MDD, AD) was more common among girls, whereas externalization disorders (ADHD, ODD) among boys. The headache affects physical, KEYWORDS Children adolescent, headache; migraine; psychiatric comorbidity; tension-type headache emotional, social life, academic success, thus, quality of life in children. It is important to reveal psychiatric comorbidity via a multi-disciplinary approach enabling timely intervention.
[Abstract:0520] [Other] Social cognition in children with attention-deficit/ hyperactivity disorder, specific learning disorder, or autism spectrum disorder: relationship between clinical signs Results: It was found that in all the tests in which we evaluated the Theory of Mind (ToM) skills, the SLD, ADHD, and ASD groups showed low performance compared to the control group, and that the performance of all three patient groups did not differ significantly. Intelligence and language development showed a positive correlation with ToM performance and after these two covariates were controlled, there was a significant effect on RMET performance. There was a significant negative correlation between scale scores evaluating problems in social reciprocity, problem behaviour, attention and learning areas, and ToM skills. There was a relationship between disease severity and simple ToM skills in ASD subjects, but no correlations between advanced ToM skills were found. ODD comorbidities were found higher in ADHD patients. The presence of ODD comorbidity has an impact on the basic ToM skills but not on the advanced ToM skills. SLD subjects who have no ADHD comorbidity were found to be similar to the control group in terms of simple ToM skills but showed poor performance in advanced ToM skills.

Conclusions:
The results of this study showed that the social cognition skills of the ASD, ADHD, and SLD were poorer than those of typically developed children. The children in the patient group have more social and academic problems and that there is a relationship between these problems and the ToM skills. There are many parameters that affect ToM skills. However, it is important to determine the social cognitive characteristics of the patients, to identify areas of difficulty, and to apply patient-tailored treatment approaches. Objective: Today, substance-use disorders constitute an important problem concerning both personal and societal health. Substance-use disorders are increasingly more prevalent in our country and throughout the world. It is observed that diseases transmitted by blood are prevalent in those with intravenous (IV) opiate substance use. It was determined that approximately half of those who engage in IV substance use reused another person's needle and a very large portion either used wrong methods to clean the needles or did not clean at all. IV drug users are a significant risk group for hepatitis C virus (HCV) infection due to the use of contaminated needles and injection equipment. The rate of HCV positivity rises up to 50-90% in IV substance users. A study carried out in England determined that, for 428 IV drug users under the age of 30, 4% encountered HIV and 44% encountered hepatitis C. The most common HCV subtype was determined in a study in Thailand as HCV-3a (50-60%) as a result of sequence analysis of amplified fragments of HCV genome, as 1a and 3a when HCV sequence data of 108 IV drug users from 7 European countries was analysed, and as 3b and 6a for 125 participants in China. In a study done in Turkey, genotype 1 was observed in 120 of 238 (50.4%) chronic HCV-infected IV substance users.  (2,3). Second-generation antipsychotic drugs especially olanzapine and clozapine are known for their elevated risk of causing MetS. Clozapine is preferred, especially in patients with treatment-resistant schizophrenia. For this reason, changes in antipsychotic drug therapy may not be possible despite metabolic disturbances. At this point, changes in lifestyle can be considered. One of the main objectives of our study is to examine MetS parameters in patients with schizophrenia and to determine the incidence of MetS and its reversal, secondly to detect the predictive factors to describe the incident and reversed cases. Methods: The sample group of the study comprised patients who were followed up and monitored at the Psychotic Disorders Outpatient Clinic of Bakirkoy Training and Research Hospital as outpatients between January 1, 2014 and January 1, 2017 and were admitted with schizophrenia diagnosis per the DSM-IV-TR. We present a retrospective analysis of longitudinal data addressing socio-demographic characteristics, metabolic parameters, and favourable lifestyle features in these patients. MetS was defined by fulfilling three or more of the five criteria defined by ATP-III A.
Results: Three hundred and fifty patients with a mean age of 42.6 were included in the study. The metabolic syndrome prevalence was 20% in the first assessment, while 25.4% in the last assessment. The increase in MetS prevalence at first and last evaluation was not significant (p = 0.052). We found two-year incidence of 13% and a rate of 33% for reversal of MetS within two years. The logistic regression analysis revealed that the increase in age and less favourable life style had a significant effect on incident cases and the only significant variable that predicted the reversal was the favourable lifestyle.
Conclusions: Our study showed that favourable lifestyle may have an impact on reversal of MetS in patients with schizophrenia. Healthy food intake and more physical activity may represent an important therapeutic target to control metabolic abnormalities in these patients. Objective: Schizophrenia is a chronic and young-onset psychiatric disorder, having 0.5-1% prevalence and characterized by positive, negative, and cognitive symptoms. While current treatments improve most of the positive symptoms, they are not successful enough to prevent negative and cognitive symptoms. Additionally, they may cause serious side effects such as tardive dyskinesia and metabolic syndrome. Therefore, new drug development became an important target for schizophrenia treatment. Glutamatergic hypoactivity has been shown to play a fundamental role in the pathophysiology of schizophrenia and Nmethyl-D-aspartate receptor (NMDAR) antagonists such as MK-801 and Phencyclidine are widely used for modelling schizophrenia in rats [1]. Deficits in glutamic acid decarboxylase (GAD) 67 and parvalbumin expressions are well-known molecular findings of schizophrenia [2]. Recent studies have shown that alpha-7 nicotinic acetylcholine receptors (nAChR) play an important role in the neurobiology of the disease. Besides, agonists and positive allosteric modulators (PAMs) of nAChR might be valuable candidates for schizophrenia treatment [3].

Alpha
In this study, we examined the effects of alpha-7 nAChR partial agonist  Objective: Severe disability is a definition for patients who are determined to be unable to fulfil their daily living activities without the help of others and who are found to have 50% or more of the disability rate. In this study, it was aimed to share the data about the socio-demographic and clinical characteristics of the patients who presented to the disabled health committee and secondly to determine the possible parameters that distinguish the cases reported as severely disabled from other cases. Methods: Data were collected retrospectively from Selçuk University School of Medicine Child and Adolescent Psychiatry Clinic files which were directed to receive a health committee report between January 2016 and December 2017. In the process of evaluating each case for the committee, a standard psychiatric examination was carried out by the research assistant and the consultant faculty member according to DSM-5 criteria. Each case was discussed with the family, and the stories and statements taken from the cases were confirmed. Ankara Developmental Screening Inventory (ADSI) and Wechsler Children's Intelligence Test (WISC-R) were administered to each case to support clinical diagnosis when necessary. Standard socio-demographic information of the cases was obtained with the standard data form created for this purpose. Results: A total of 195 cases were evaluated. 59.5% of the cases were male and the mean age was 83.3 ± 64.6 (4-216, min-max) months. Of the cases, 53.3% had applied to pay for maintenance and other social support, 46.7% had applied to various official institutions to declare the case. No psychopathology was found in 40.5% of the cases. The remaining of the cases were mental retardation (43.6%), autistic spectrum disorder (8.7%), specific learning disability (2.6%), adjustment disorder (1.5%), traumatic brain injury (1.5%) had attentiondeficit/ hyperactivity disorder (1%), and post-traumatic stress disorder (0.5%); 54.9% of the cases had a comorbid neurological or other systemic diagnosis. The prevalence of neurological comorbidities was 49.1% in mild MR patients and the difference was significant (p < 0.001), while 90.0% of patients were with severe mental retardation (MR); 47.7% of the patients were "severely disabled" as had been reported. Severe disability was 87.1% in moderate and severe MR cases, and 26.4% in mild MR cases, and the difference was KEYWORDS Children; disability health committee; psychopathology; severe disability significant (p < 0.001). However, 70.1% of patients with systemic comorbid diagnosis and only 20.4% of patients without comorbid diagnosis were evaluated in severe disability category, the difference was significant (p < 0.001).
Conclusions: This study has once again shown that the prevalence of neurological / systemic comorbidity increases as the severity of psychopathology increases. In addition, it has been determined that the presence of advanced psychopathology in terms of neurological / systemic comorbidity and moderate-to-severe MR may be predictive of reporting as severe disability. Considering the necessity of decision-making by a single child-adolescent psychiatrist in a very short period of time, it is necessary to clarify the issues which will be reported as severe disability with broader sample and more distinct parameters. . No significant differences were found between OCD and control groups in terms of nonacceptance of negative emotions, emotional clarity, ability to engage in goal-directed behaviour, and impulse control. In all sample, the DERS-Total score was positively correlated with CGI (r = 0.457, p < 0.001). Multiple linear regression analysis showed that the severity of illness (CGI) was a significant predictor of ER skills (DERS-Total) (β = 5.067, p < 0.05). Conclusions: Our findings showed that OCD sample has difficulties to control their behaviours while experiencing negative emotions. Consistent with expectations, OCD severity was significantly related to poor understanding and regulating of the patients own emotions. Ribosomal DNA transcription in buccal epithelial cells of children diagnosed with attention-deficit/ hyperactivity disorder (ADHD): a preliminary study Study Design: Buccal epithelial samples were collected from twelve male patients, diagnosed with ADHD-combined type. Ten age-and gender-matched patients without any psychiatric or chronic disease were included as control group. The captured images were transferred to image processing software and one hundred nuclei have been evaluated for each, and mean Total AgNOR number/Total nuclear number (TAN/TNN), and Total AgNOR area/Total nuclear area (TAA/TNA) ratios were calculated. Results: TAA/TNA and TAN/TNN and of ADHD patients was significantly lower than healthy controls (p < 0.05). In polynomial regression analysis, there was a statistically negative relation between inattention subscale scores and TAA/TNA in ADHD patients (R2: 0.72; p = 0.014). There was also statistically negative relation between hyperactivity-impulsivity scores and TAA/TNA in ADHD children (R2: 0.59; p = 0.05).
Conclusions: There is no diagnostic or follow-up parameter for ADHD. AgNOR staining method from buccal epithelial cells is a conventional, karyometric, and non-invasive method which would be helpful to enhance the diagnostic accuracy of ADHD. Additional studies should be conducted to obtain more certain knowledge about this topic.
[Abstract:0584][Impulse control disorders] The influence of volleyball on impulsivity and problematic behaviours of adolescents Objective: It has been reported that individuals who do sports activities have lower aggressive behaviour and impulsivity levels, and especially in adolescents with attention-deficit/ hyperactivity disorder (ADHD), regular and planned sports activities fit for purpose have been reported to have positive influences on the functions of cognitive and behavioural preventive control, planning, and organization. Therefore, the objective of this study is to analyse the influences of volleyball sport activity on adolescents' impulsivity and behavioural problems, specifically, to find out the association between regular and continuing sports activity on impulsivity and behaviour patterns and to show whether impulsivity and problematic behaviour patterns change through volleyball. Methods: Forty-seven adolescents between the ages of 12 and 18 who had been playing volleyball and 47 healthy adolescent controls who had not been doing any sport activities were included in the study. Volleyball training was conducted between December 2015 and March 2016, six hours a week for 12 weeks in total. Before starting the volleyball activity, the study participants were assessed synchronously by a child and adolescent psychiatry specialist for possible psychiatric disorders through clinical psychiatric interview, DSM-5 diagnostic criteria, and Schedule for Affective Disorders Schizophrenia for School Aged Children, Present and Lifetime Version (in Turkish). Socio-demographic Data Form, Child Behaviour Checklist (CBCL) and Screening and Assessment Scale based on DSM-IV for Behavioural Disorders in Children and Adolescents given to the ADHD group before volleyball activity, and on the first and third months of post-activity and to the control group at the same time were completed by the parents, while Barratt Impulsiveness Scale (BIS) and Youth Self Report Scale (YSRS) were filled in by participant adolescents self-reportedly. Results: Post-activity CBCL, YSRS, and BIS impulsivity and problematic behaviour scores at the first and third month were found to decrease significantly in the ADHD group compared to the controls. This decrease was found to be more evident when activity time increased. While significant decrease was found in all impulsivity and problematic behaviours scores of the ADHD group in post-activity first and third month, adolescents who had ADHD and/or Oppositional Defiant Disorder (ODD) when compared to those who did not, no significant decrease was found in the scores in all post-activity at the first and third month assessments. Conclusions: In this study, volleyball sport activity was found to cause significant recovery in impulsivity and problematic behaviours, and this recovery was found to be associated with regular, planned, and continuous activity, and activity time. On the other hand, it was found that impulsivity and problematic behaviour patterns of the cases with ADHD and/or ODD did not recover significantly and that they may need medical management. The first purpose of this study was to compare executive functions in children and adolescents with and without ADHD using performance-based measures. The second aim was to demonstrate how daily functions of the children and adolescents with ADHD are impaired using the developed questionnaire about Homework and Work Habits (HWH). Finally, we aimed to examine the relationship between HWH ratings and performance-based measures of executive functions. Methods: A group of children between the age of 7 and 17 who met the DSM-IV criteria for the first time for ADHD (n = 60) as the patient group and 7-17 aged children and adolescents (n = 60) as the healthy control group were included in this study sample. Parents and teachers of the participants were asked to complete a form of Conner's Parent and Teacher Ratings and HWH ratings to evaluate performance-based executive functions. Participants completed the Wisconsin Card Sorting, Stroop Color and Word and Trail Making (B) tasks. In addition, HWH questionnaire was given to the children and adolescents and their intelligence level was evaluated by using the Wechsler Intelligence Scale for Children-Revised (WISC-R). Results: ADHD group participants displayed lower performance on all of the performancebased executive functions measures and lower HWH scores compared to the controls. The HWH questionnaire was found to be significantly related with performance based executive function tests negatively. Conclusions: HWH questionnaire may be a more feasible and cost-effective method to evaluate executive functions compared to performance-based measures in children and adolescents. It can also be used to monitor levels of executive functions before and after medical management in children and adolescent with ADHD. The primary aim of the present study was to examine whether adult-onset (AO) OCD patients would differ from subjects with juvenile OCD in terms of autistic and schizotypal traits, socio-demographic variables, and clinical characteristics. Our hypothesis was that juvenile OCD differs from adult onset OCD with respect to autistic and schizotypal traits, and therefore, juvenile and adult onset OCD are different subtypes of disorder. Methods: Adolescent OCD patients (current age 12-17 years; n = 29) who consecutively admitted to Child and Adolescent Psychiatry Department of Behcet Uz Child Diseases and Neurosurgery Research and Training Hospital were interviewed with the Kiddie Schedule for Affective Disorders and Schizophrenia-Present state and Lifetime version (KSADS-PL). Adult patients who were 18-65 years who had the diagnosis of OCD according to Diagnostic and Statistical Manual of Mental Disorders, 4thedition DSM-IV criteria were recruited from consecutive subjects who were admitted to the psychiatry department of the Adnan KEYWORDS Adolescents; adults; autistic traits; schizotypal traits; subtypes Menderes University (onset age and current age ≥ 18 years; n = 60). The severity and content of obsessive-compulsive symptoms were determined through Childhood Yale-Brown obsessivecompulsive scale (CYBOCS) and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Autism symptoms were assessed by using the Turkish version of Autism-Spectrum Quotient (AQ). Schizotypal traits were assessed using Turkish version of 22-item Schizotypal Personality Questionnaire (SPQ-B). Results: The course of OCD in AO patients was chronic, whereas adolescent patients had a more episodic course. The rates of lifetime aggressive, religious, and somatic obsessions were significantly higher in adolescent patients compared to AO patients. Adolescent patients had also more lifetime checking, ritualistic, and miscellaneous compulsions than AO patients. The mean number of lifetime obsessions, and compulsions were significantly higher in adolescents than in AO subjects. We have found that total, attention switching, and imagination scores of AQ in AO patients were higher than in adolescent patients. In contrast, adolescent patients had higher scores of total, cognitive-perceptual, interpersonal, and disorganized scores of SPQ-B compared to AO patients. The correlation analysis in adolescent group revealed that total scores of AQ, and SPQ-B were significantly correlated with the mean number of lifetime obsession, and compulsions. There were also significant correlations between total AQ scores and total, cognitive-perceptual, interpersonal, and disorganized scores of SPQ-B. In the AO group, total scores of AQ and SPQ-B were not correlated with the mean number of lifetime obsessions and compulsions. There were significant correlations between total AQ scores and total, cognitive-perceptual, interpersonal, and disorganized scores of SPQ-B. Conclusions: Our findings suggested that autistic traits might have been related to development of OCD in adulthood, indicating a subgroup of patients in adults. Clinical profile of OCD adolescent patients seemed to be influenced by autistic and schizotypal traits, indicating an autistic and schizotypal subtype of OCD in this age group. We also suggest that the differences between adolescent and AO patients represent developmentally variable manifestation of OCD across juvenile and adult periods. OCD in adolescents seemed to be related to an autistic and schizotypy subtype of the disorder. In this study, we aimed to examine the anxiety sensitivities, sleep characteristics of adolescents diagnosed with obsessive-compulsive disorder (OCD). Methods: Participants were 27 adolescents diagnosed with OCD. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) interview was administered to all cases included. Severity and clinical features of OCD were assessed by the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and Clinical Global Impression Severity Index (CGI-SI). Anxiety sensitivity of participants was examined by the Childhood Anxiety Sensitivity Index (CASI) and sleep habits and possible sleep problems were assessed by Children's Sleep Habits Questionnaire (CSHQ). The State-Trait Anxiety Inventory (STAI) was used to measure of anxiety levels. Results: The mean CASI (Childhood Anxiety Sensitivity Index) total sum was 33.18 (S.D.6.96) with scores ranging from 22 to 48. CASI cognitive factor scores were significantly positively correlated with CY-BOCS obsession, compulsion, and total scores (p = 0.006, p = 0.000, p = 0.001, respectively). Additionally, CASI cognitive factor scores were significantly positively correlated with CSHQ sleep duration and sleep disordered breathing scores (p = 0.012, p = 0.049, respectively). While CSHQ sleep duration scores were significantly positively correlated with CY-BOCS obsession scores (p = 0.048), CY-BOCS compulsion and total scores did not correlate with CSHQ scores. CY-BOCS compulsion and total scores tended to decrease when STAI-I and STAI-II scores increased. Conclusions: The present study examined the relationship between anxiety sensitivity and obsessive-compulsive symptoms using dimensional measures of these constructs. Our correlational analyses suggested that these phenomena were associated with one another.  Objective: Tuberous sclerosis complex (TSC) is an autosomal dominant condition, caused by mutations in either the TSC1 or TSC2 gene. It has widespread systemic manifestations and is associated with significant neurological morbidity. The most frequent neurologic symptoms are seizures, which occur in up to 90% of patients and are often intractable, followed by autism spectrum disorders (ASD), intellectual disability (ID), attention-deficit/ hyperactivity disorder (ADHD), and sleep problems. ADHD is frequently present in patients with TSC, with a rate of 50%, comparable to the prevalence of ASD in TSC. In this study, we aimed to examine the frequency of neuropsychiatric comorbidities like ASD, ADHD, and OCD in patients with TS. Methods: We reviewed retrospectively the patient charts and medical reports of 67 patients with TS diagnosis between the ages of 2 and 16 years registered between 2014 and 2018 in our clinic. Psychiatric interviews based on DSM-5 for neuropsychiatric diseases were evaluated during the health report procedures of patients with TS, and each case was filled with an autism behaviour checklist and Conners' Parent and Teacher Rating Scales. Results: The average age of the group was found to be 113.7 ± 56.7 months. Of the cases, 32 (47.8%) were female and 35 (52.2%) were male. ASD was detected 19.4% (n = 13) of the TS cases, 49.3% (n = 33) of intellectual disabilities, 28.4% (n = 19) of ADHD, 6.0% (n = 4) of OCD, and 7.5% (n = 5) of specific learning disorder were detected. Conclusions: Neuropsychiatric disorders are present in up to 90% of patients with TSC and represent an important issue for families. In our study, the prevalence of neuropsychiatric disorders was found to be quite high in patients with TS. Our work was found to be consistent with the results of the few studies conducted in this area. TSC is one of the most frequently identified monogenic causes of autism and a promising model to study its pathogenetic mechanism. However, the neurobiological pathway remains unclear and severity seems to have a notable variability in TSC patients. This cohort report is important because of its potential to give a new direction to studies that aim at the importance of early ASD screening and intervention for infants with TSC. Early recognition of patients developing neuropsychiatric disorders such as ASD symptomatology can bring them to early behavioural intervention focused on specific signs, and can address the need of global care requested by the families. The suicide is a significant health problem. It is among the leading causes of death. Female gender, young age, and lower socio-economic status are some of the risk factors. The risk level of suicide is higher for people having a psychiatric disorder than others. D-type personality has been described as the tendency to experience a high joint occurrence of negative affectivity and social inhibition. Personality disorder rates of people attempting or committing suicide may go up to 80%. The effects of the D-type personality are not known in cases of suicide. Methods: We formed an experimental group with 43 patients who attempted suicide previously and a control group with 44 people. We requested all participants to fill out the  (2). Likewise, childhood traumas have a critical role in temperament and personality (3). Our aim was to examine the relationship between common temperament patterns and traits in epilepsy patients, and their relationship with childhood traumas. The first hypothesis in our study was that we have worse disease outcomes in patients with high childhood trauma scores in juvenile myoclonic epilepsy patients and that temperament traits common in these patients were also associated with childhood trauma. Another hypothesis was that juvenile myoclonic epilepsy was frequently associated with depressive symptoms, as well as the interaction of the anxiety symptoms with the course of the disease and the presence of childhood trauma. Methods: The study was conducted with 38 volunteer patients who presented to the Haydarpaşa Numune Hospital Neurology Clinic Epilepsy Outpatient Clinic. They are diagnosed as epilepsy and placed in the follow-up list and they accepted to participate in the follow-up list. All participants were administered the Structured Clinical Interview for DSM-IV (SCID-I), the TEMPS-A scale, Childhood Trauma Questionnaire, the Beck Depression Scale (BDI), the Beck Anxiety Scale (BAI), and Sociodemographic Data Form. Results: There was a significant relationship between depression and anxiety values in Juvenile Myoclonic Epilepsy (JME). When the subscale and subscale scores of the JME patients were compared with the subscale scores of the TEMPS-A scale, it was determined that the two groups (divided by points) differed in terms of depressive temperament and irritable temperament scores. A meaningful relationship between emotional neglect subscale and BDI was abolished. There was also a significant difference in BDI scores between the two groups at the same time. In the treatment of childhood diseases, there was a significant positive correlation between BDI and BAI. With BDI, a moderately significant relationship was found between irritable temperament, depressive temperament, cyclothymic temperament, and anxious temperament. A moderately significant relationship was found between IBS and irritable temperament, depressive temperament, cyclothymic temperament, and anxious temperament. Conclusions: Time in patients with juvenile myoclonic epilepsy: the longer ones are more depressed. Temperament traits in juvenile myoclonic epilepsy patients are associated with childhood trauma in these patients. The prescribing pattern of duloxetine in child and adolescent psychiatric disorders

Kemal Utku Yazici and Ipek Percinel Yazici
Firat University School of Medicine, Department of Child and Adolescent Psychiatry, Elazig, Turkey E-mail address: dr.kemal.utku@outlook.com ABSTRACT Objective: Duloxetine is a serotonin-noradrenaline reuptake inhibitor (SNRI). As the frequency of use increases in age groups for childhood and adolescence, the efficacy and side effects are still unclear. In this study, we aimed to discuss the efficacy and side effects of duloxetine used in our outpatient clinic due to various psychiatric disorders. Methods: The files of patients who were diagnosed at the Firat University School of Medicine Child and Adolescent Psychiatry Outpatient Clinic, and who were treated with duloxetine treatment were evaluated retrospectively. Clinical Global Impression -Severity scale (CGI-S), Clinical Global Impression-Improvement scale (CGI-I) were used in the evaluation. Results: A total of 28 cases using duloxetine treatment were detected. The mean age of the cases was 15.46 (SD = 1.37). Diagnosis distribution was observed as: 32.21% (n = 9) generalized anxiety disorder, 10.7% (n = 3) major depressive disorder, 10.7% (n = 3) obsessive-compulsive disorder, 10.7% (n = 3) attention deficit hyperactivity disorder, 14.3% (n = 4) generalized anxiety disorder and major depressive disorder, 7.1% (n = 2) major depressive disorder and attention deficit hyperactivity disorder, 7.1% (n = 2) major depressive disorder and obsessive-compulsive disorder, 3.6% (n = 1) attention-deficit/ hyperactivity disorder and generalized anxiety disorder, and 3.6% (n = 1) major depressive disorder and body dysmorphic disorder. The average duloxetine dose used was 73.92 (SD = 25.14) mg/day. The mean duration of use of duloxetine was 36.96 (SD = 21.84) weeks; 64.3% of the cases (n = 18) were treated with monotherapy; 21.4% (n = 6) of the patients used atypical antipsychotic, 10.7% (n = 3) psychostimulant, 3.6% (n = 1) atomoxetine, in addition to duloxetine at one stage of duloxetine treatment. No side effects were detected during treatment in 53.6% of the cases (n = 15). The most common side effects observed in other cases were at a level not requiring drug discontinuation, 14.3% (n = 4) dizziness, 14.3% (n = 4) fatigue, 10.7% (n = 3) appetite change, 10.7% (n = 3) nausea/abdominal pain, and 7.1% (n = 2) headache. Treatment was stopped because of visual hallucinations in only one patient (3.6%, n = 1). In this patient with generalized anxiety disorder, duloxetine was discontinued, and then the hallucinations disappeared. At the beginning of duloxetine treatment, 60.7% (n = 17) of the cases were classified as markedly ill, 25.0% (n = 7) as severely ill, and 14.3% (n = 4) as moderately ill according to CGI-S scores. Improvement scores according to CGI-I evaluation of cases; 50.0% (n = 14) "much improved," 14.3% (n = 4) "very much improved," 14.3% (n = 4) "minimally improved," 14.3% (n = 4) "no change from baseline," 3.6% (n = 1) "minimally worse," and 3.6% (n = 1) "not assessed." Conclusions: It can be said that duloxetine can be safely used and well tolerated in various psychiatric disorders in children and adolescents. Future prospective studies with large samples are needed to draw definitive conclusions. Objective: Aripiprazole is an antipsychotic used not only for schizophrenia, bipolar disorder but also in some depression and anxiety disorders. Aripiprazole has dopamine D2 partial agonism characteristics, serotonin 5-HT1A partial agonism, and 5-HT2A antagonism characteristics.

KEYWORDS
Antipsychotics; aripiprazole; chromosomes; clastogenic effect; mutagenic Insomnia, tremor, akathisia, nausea, and vomiting are the most frequently observed side effects of them. The only partial dopamine agonist in the treatment of aripiprazole schizophrenia is suggested as an option to be considered in patients who cannot tolerate long-term antipsychotics due to weight gain, sedation, and extrapyramidal symptoms. As far as we know, cell killer, mutagenic, and destructive effects on chromosome structure and cell division mechanisms of Aripiprazole on human are unknown. Methods: We have prepared human peripheral blood lymphocytes cultures to evaluate the cytotoxic and the genotoxic effects. We administered distilled water as a negative control, mitomycin c, and aripiprazole at doses of 0.4, 0.8, 1.2, 1.6, and 2 μg / ml as a positive control for 24 hours for each of the prepared cultures. In human lymphocytes chromosomes, in addition to the aberration proportions, mitotic activity rates, micronucleus frequency and the nuclear division index and the nuclear cytotoxic division index, we also defined apoptotic and necrotic cells. Results: When the dose of Aripiprazole (0.4, 0.8, 1.2, 1.6, and 2 μg/ml) increases the rate of fracture and other chromosome aberrations are also increasing. However, the mitotic index reduces (r = 0.98) depending on the dose. Aripiprazole increases the MN frequency, reduces the division index and also causes apoptosis and necrosis. There is a positive correlation between the dosage of Aripiprazole and the number of necrotic cells (r = 0.96) together with apoptotic cell count (r = 0.41). Conclusions: Aripiprazole warned the formation of chromosome aberrations. However, this increase is not as much as in the MMC which is the positive control. The results of the study show that aripiprazole (0.4, 0.8, 1.2, 1.6, 2 μg / ml) has in vitro clastogenic potential in human lymphocyte chromosomes. There is a certain relation between the MN frequency the apoptotic cell. Here, it can be inferred that aripiprazole causes the necrotic cell death more than the apoptosis does. Aripiprazole may have mutagenic and destructive effects on chromosome structures and cell division mechanisms of humans. The development of in vivo studies to examine these issues may be useful.

[Abstract:0610][Autism]
The patterns of psychotropic drug use in cases diagnosed with autism spectrum disorder Ipek Percınel Yazici and Kemal Utku Yazici Firat University School of Medicine, Department of Child and Adolescent Psychiatry, Elazig, Turkey E-mail address: ipek.pr@hotmail.com ABSTRACT Objective: In this study, we aimed to evaluate the drug-use characteristics of children diagnosed with autism spectrum disorder (ASD) followed up at the Firat University School of Medicine's Child and Adolescent Psychiatry Outpatient Clinic. Methods: The files of the patients who presented to our outpatient clinic between January 2016 and September 2017 and diagnosed with ASD were examined retrospectively. The data were analysed using the SPSS 22 for Windows. Results: A total of 311 cases diagnosed with ASD were detected. Gender distribution was observed as: 32.5% (n = 101) girls and 67.50% (n = 210) boys. The mean age of the cases was 7.54 ± 4.31 (7.54 ± 4.52 of the girls, 7.53 ± 4.22 of the boys). The proportion of the cases younger than 6 years of age was 53.37% (n = 166), and the mean age 4.19 ± 1.30. In all of the cases, the proportion of the cases received special education was 91.6% (n = 285). A total of 199 cases (64.0%) had a comorbid psychiatric disorder. Attention-deficit hyperactivity disorder, intellectual disability, depression, anxiety disorder, and obsessive-compulsive disorder were found in 25.41% (n = 79), 46.90% (n = 146), 10.30% (n = 32), 7.70% (n = 24), and 3.90% (n = 12) of the cases with ASD, respectively. The rate of the medication use in all cases was 68.8% (n = 214). Irritability was the most common target symptom requiring drug. The most commonly prescribed drug group was atypical antipsychotics (n = 120), and the most commonly prescribed antipsychotics were risperidone and aripiprazole. Other drugs used were typical antipsychotics (n = 7), psychostimulants (n = 47), atomoxetine (n = 26), selective serotonin reuptake inhibitors (n = 56), mirtazapine (n = 5), clomipramine (n = 3), mood stabilizer (n = 7), melatonin (n = 7), and omega-3 (n = 6); 43.90% (n = 94) of cases that used medication reported side effects. The most common side effects observed in the cases were sedation, appetite change, weight gain, and irritability. The most common side effect that required drug discontinuation was sedation (n = 8). The rate of the medication used in the cases younger than 6 years was 57.2% (n = 95), the most commonly prescribed group of drug was atypical antipsychotics (n = 65) and the most frequent target symptom that required drug use was irritability. In this group, the rate of KEYWORDS Aripiprazole; autism spectrum disorder; children; psychopharmacology; risperidone the side effect was 48.4% (n = 46), and the most common side effect required treatment discontinuation was sedation (n = 7). Conclusions: Recognition of the drug-use pattern of ASD cases followed by child and adolescent mental health outpatient clinics is considered to be important in terms of clinical practice of physicians. It is known that pharmacological treatment in addition to special education used in the presence of target symptoms and comorbid conditions affects positively the level of social adaptation and efficacy of special education for the patients. It is thought that the knowledge of the drug patterns of cases with ASD, especially those younger than 6 years is important in terms of to start on time and not to delay the drug treatment when necessary. Objective: This study aims to explore parental alexithymia of paediatric trichotillomania in comparison with healthy controls. Methods: Participants were 31 cases of trichotillomania and 32 healthy controls aged between 4-17 years. Severity of trichotillomania was assessed by the Clinical Global Impression -Severity Scale (CGI-S). Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia scores of parents. TAS-20 has subscales such as difficulty describing feelings (TAS-1), difficulty identifying feeling (TAS-2), and externally oriented thinking (TAS-3). Results: TAS-20 total scores, TAS-1 scores (difficulty describing feelings), and TAS-2 scores (difficulty identifying feeling of parents) were significantly higher in the case group than in the control group (p = 0.002; p = 0.001; p = 0.003, respectively). Additionally CGI-SI scores were positively correlated with total scores of TAS-20 (p = 0.000) and CGI-SI scores also correlated with scores of all subscales of TAS-20 (p = 0.000; p = 0.004; p = 0.0084, respectively). Ordinal logistic regression analysis revealed that parental alexithymia level significantly predicted severity of trichotillomania disease measured by CGI-SI (p = 0.003). Conclusions: As we know, there has been no study about the association between trichotillomania and parental alexithymia. Parental emotional experience should be considered carefully in cases of trichotillomania. Association between severity of suicidal intent/behaviour and psychopathology in adolescent suicide attempters sedimentation. There were also relationships between the WBC, RBC, Hgb, MCV, MCH, MCHC, RDW, Neu, Lym, Bas, Eus, PCT, MPV, PDW, and Plt. Conclusions: This study shows that there can be a relationship between sleep latency, sleep efficiency, and some of the hemogram parameters. But it is not possible to infer causality from this study. We think that it is appropriate to make controlled prospective studies on this topic. We think that our results contribute to both clinicians working on sleep disorders and first-and second-level clinicians of healthcare system. The patients with chronic kidney disease (CKD) have to cope with various characteristics of the disease, and experience psychiatric problems in this process. Identifying the coping strategies that they use in adapting themselves to the disease and their level of hope may provide valuable information to improve treatment plan and the response to treatment. This study aimed to evaluate the CKD patients in terms of their hope levels, coping strategies, depression and anxiety levels, and perceived social support levels, to make a comparison with healthy controls, and also to identify these parameters' relationship to the socio-demographic data and to each other. Methods: A total of 98 grade 3 or 4 CKD patients and 85 healthy controls were included in the study. The participants were administered a socio-demographic data form, the Herth's Hope Scale, the COPE Inventory, Multidimensional Perceived Social Support Scale (MSPSS) and Hospital Anxiety Depression Scale (HADS). Results: Whereas no statistically significant difference was found between the CKD patients and healthy controls in terms of using problem-focused, emotion-focused and non-functional coping strategies, the CKD group was found to use religious coping strategies more often than the healthy ones. It was seen that the anxiety and depression level had a negative and the perceived social support had a positive and significant effect on the level of hope in CKD patients; however, the levels of hope do not vary according to age, sex, occupation, level of education, and grade of the disease. Conclusions: CKD increases the frequency of depressive symptoms in people whereby it affects the hope levels and the strategies used to cope with problems. Psychiatric evaluation of the patients with CKD play an important role in increasing the compliance of treatment to existing disease and planning the treatment methods such as dialysis, renal transplantation to be encountered in the later period. The clinician may help the patients more effectively to cope with chronic illnesses by identifying the patient's coping strategies and the associated sources of personal and social support. to be done in this regard, it can be said that the thiol/disulphide balance parameters may be candidates to be biomarkers which can be diagnosed in depression.

[Abstract:0779][Dementia syndromes]
Characteristics of bone density loss among subjects with dementia in comparison with non-demented subjects Bahadir Bilgin Basgoz a , Semra Ince b , Umut Safer a and İlker Tasci a a Health Sciences University Gulhane School of Medicine, Department of Internal Medicine, Ankara, Turkey; b Health Sciences University Gulhane School of Medicine, Department of Nuclear Medicine, Ankara, Turkey E-mail address: bbbasgoz@gmail.com ABSTRACT Objective: Dementias and osteoporosis are both common at the same ages. There is some evidence, albeit weak, that women with osteoporosis are under increased risk of developing dementia. In the present case-control study, we examined whether older adults having dementia had different bone density measures and osteoporosis prevalence compared to non-demented individuals. Methods: Non-institutionalized participants aged 65 years or older with and without dementia were enrolled prospectively. Dementia work-up included both the neuropsychological testing and clinical assessment. Dementia types included were Alzheimer's disease, vascular dementia, or the mixt type. Bone density was determined by DEXA at spine, femur total, or femoral neck region. Results: In a sample of 363 participants, 93 subjects had the diagnosis of dementia and 270 were non-demented (Mean age: 78.7 ± 6.0 vs. 78.3 ± 5.1, p > 0.05; female: 62.4% vs. 62.4%, p > 0.05). Controlled for age and gender, demented patients had similar bone density at spine with that of non-demented individuals [F(1,358) = 0.83, p = 363]; but, femur total bone density [F(1,359) = 10.26, p = 0.001] and femur neck bone density [F(1,359) = 15.21, p < 0.001] were lower. Based on a T score ≤−2.5 at either site, prevalence of osteoporosis in demented group was higher, but the difference was not significant (40.9% vs. 31.1%, p = 0.086). However, when only a femoral neck T score ≤−2.5 was taken as diagnostic, prevalence of osteoporosis in the demented group was significantly higher (25.8% vs. 15.9%, p = 0.034). Low bone mass (LBM) (T score ≤−1.0 at either region) was found significantly more frequent in the demented group (95.7% vs. 84.8%, p = 0.006). The strongest difference in LBM was observed between T-scores obtained at femur neck. The distribution of T-scores across normal, osteopenia, and osteoporosis stages was significantly different between demented and non-demented subjects (4.3% vs. 15.2%, 54.8% vs. 53.7%, and 40.9% vs. 31.1%, p = 0.014). Conclusion: The present study showed evidence of lower bone mass in patients with dementia which was prominent in the femur region. According to T-score based definitions, demented individuals had true diagnosis of osteoporosis only at femur neck. The results suggest that patients with osteoporosis may be under increased risk of developing hip fractures due to worse femur bone density.