ÖZET Amaç: Bu çalışmada DSM-5 tanı ölçütlerine göre yeniden düzenlenen Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi (6-18 Yaş) -Şimdi ve Yaşam Boyu Şekli-DSM-5 Kasım 2016-Türkçe Uyarlaması'nın (ÇDŞG-ŞY-DSM-5-T) geçerlik ve güvenirliğinin değerlendirilmesi amaçlanmıştır. Yöntem: Yaşları 6-17 arasındaki, 150 çocuk ve ergene ÇDŞG-ŞY-DSM-5-T uygulanmıştır. ÇDŞG-ŞY-DSM-5-T ile konulan tanıların geçerliği, klinik değerlendirme ile konulan DSM-5 tanıları (uyum geçerliği) ve o tanıyı değerlendiren ölçek puanları (eş zaman geçerliği) dikkate alınarak değerlendirilmiştir. Değerlendiriciler arası güvenirlik seçkisiz yöntemle belirlenen 20 katılımcıda incelenmiştir. Ayrıca aynı yöntemle seçilen 20 farklı katılımcıyla yapılan ilk değerlendirmeden üç hafta sonra ÇDŞG-ŞY-DSM-5-T uygulanarak test-tekrar test güvenirliği araştırılmıştır.Bulgular: ÇDŞG-ŞY-DSM-5-T ile yapılan görüşme ile konulan tanıların uyumunun yeme bozuklukları, seçici konuşmazlık ve otizm spektrumu bozuklukları açısından çok iyi (κ=0,92-1,0), dışa atım bozuklukları, obsesif kompulsif bozukluk, karşıt olma/karşı gelme bozukluğu, yaygın anksiyete bozukluğu, sosyal anksiyete bozukluğu, depresif bozukluklar, yıkıcı duygudurum düzensizliği bozukluğu ve dikkat eksikliği hiperaktivite bozukluğu açısından iyi (κ=0,67-0,80) düzeyde olduğu gözlenmiştir. Değerlendiriciler arası güvenirliğin seçici konuşmazlık için çok iyi (κ=1,0), karşıt olma/karşı gelme bozukluğu, yıkıcı duygudurum düzensizliği bozukluğu, dikkat eksikliği hiperaktivite bozukluğu ve depresif bozukluklar için iyi derecede (κ=0,63-0,73) olduğu; test-tekrar test güvenirliğinin de otizm spektrumu bozuklukları için çok iyi derecede (κ=0,82), dikkat eksikliği hiperaktivite bozukluğu, karşıt olma/karşı gelme bozukluğu, depresif bozukluklar ve yaygın anksiyete bozukluğu ve için iyi derecede (κ=0,62-0,78) olduğu görülmüştür.Sonuç: Bu çalışmanın sonuçları ÇDŞG-ŞY-DSM-5-T'nin görüşme çizelgesine yeni eklenen seçici konuşmazlık, yıkıcı duygudurum düzensizliği bozukluğu ve otizm spektrumu bozuklukları dâhil birçok tanı grubu için geçerli ve güvenilir veri sağladığını düşündürmüştür. Method:A total of 150 children and adolescents between 6 and 17 years of age were assessed with K-SADS-PL-DSM-5-T. The degree of agreement between the DSM-5 criteria diagnoses and the K-SADS-PL-DSM-5-T diagnoses were considered as the measure of consensus validity. In addition, concurrent validity was examined by analyzing the correlation between the diagnoses on K-SADS-PL-DSM-5-T and relevant scales. Interrater reliabilities were assessed on randomly selected 20 participants. Likewise, randomly selected 20 other participants were interviewed with K-SADS-PL-DSM-5-T three weeks after the first interview to evaluate test-retest reliability. Results:The consistency of diagnoses was almost perfect for eating disorders, selective mutism and autism spectrum disorder (κ=0.92-1.0), substantial for elimination disorders, obsessive-compulsive disorder, oppositional defiant disorder, generalized anxiety disorder, s...
Study Design. Cross-sectional case-control study. Objective. Compare psychosocial profile of magnetically-controlled growing rod (MCGR) patients to traditional-growing rod (TGR) with an array of psychiatric tools, expecting improvement in MCGR due to decreased number of surgical procedures. Summary of Background Data. TGR treatment has had positive clinical and radiographic results; however, upward of 10 surgical sessions and high complication rates have called into question the quality of life of these children. Improvement with the introduction of the MCGR is expected. Methods. GR patients with minimum of 2-years follow-up were recruited. None had neurological conditions. All underwent testing with the Wechsler Intelligence Scale for Children-Revised, and only those in the normal range were included. Patients filled out questionnaires with mental health professionals to measure psychosocial status. MCGR patients’ results were compared to TGR patients. Results. Twenty-seven patients met criteria (10 MCGR, 17 TGR): average age at enrollment 11.8 years (range 5.9–17). MCGR group was significantly younger (9.1 vs. 13.3 yr) and had significantly shorter follow-up (45.6 vs. 82.8 mo) (P < 0.05). TGR patients underwent an average of 16 surgical procedures, MCGR an average of 1.5 (including complications, P < 0.05). Age at index surgery (6 yr), preoperative and postoperative major curve magnitudes (60°, 40° respectively) were statistically similar. There was no difference in current psychiatric diagnoses between the groups. MCGR patients scored worse than TGR patients in general functionality domains. TGR patients showed increased functionality and prosocial scores with increased number of procedures. This effect was not observed in MCGR. Conclusions. The expected improvement in psychosocial status with the MCGR was not observed at a 31.6-month-follow-up. It appears that provided the patient spends enough time in the treatment process to notice benefit and does not experience major complications, noninvasiveness of lengthening procedures does not show up as an advantage with the psychosocial tools utilized in this study. Level of Evidence: 3
Objective: Many individuals with cigarette addiction are known for beginning to smoke cigarettes during adolescence years. In this study, we aimed to present the clinical outcomes of smoking cessation project conducted in an Anatolian school in Kartal district of Istanbul, Turkey. Methods: Social and motivational studies were carried out on adolescent smokers after scanning in terms of smoking in an Anatolian school and 44 of these adolescents who are clinical requirements were evaluated and followed by Chest disease and child and adolescent mental health for six months. Carbonmonoxide (CO) measurements in the expiratory air and carboximeter (piCO smokerlyzer, Bedfont Scientific Ltd, England) were made at the first visit and follow-up. Simultaneously, K-SADS PL (Schedule for Schizophrenia and Affective disorders for School Age Children) was administered diagnostically in mental health evaluation. Results: A total of 44 adolescents, 13 girl (29.5%) and 31 boy (70.5%), with a mean age of 17.31 were followed up. The mean age of initiation of cigarette smoking was 14.2 ± 1 and 32 (82.7%) adolescent were found to have at least one smoker in their home. While 22.7% of adolescents did not try smoking cessation, 77.3% of them did. Six of these adolescents indicated that they did not smoke during the six months; 55.5% of these adolescents have at least one mental illness; the most common diagnoses were 25.0% (n = 11) of ADHD (Attention Deficit Hyperactivity Disorder) and 20% (10) of MD (Major Depression). While depression was significantly frequent in girls (p = 0.043), the frequency of ADHD was not significant in terms of gender. Depression presence was associated with early onset of cigarette smoking in males (p = 0.019), but not with females (p = 0.394). There was a statistically significant correlation between smoking cessation effort and age in the follow-up period (p = 0.022), and earlier adolescents stated that they wanted to quit smoking more. While there is no significant association between smoking cessation effort and mental disease, there was a statistically close relation with parent and sibling smoking (p = 0.07) and significant correlation with motivation and smoking cessation effort (p = 0.016). Conclusions: Smoking cessation work in adolescents is much more difficult than in adults. Biological and social factors and peer impact influence interventions. In our study, very few adolescents stated to quit smoking for 6 months, and the rate of psychiatric illnesses among adolescents and the presence of individuals smoking at home were found to be quite high. It has been the result of these factors also affecting the success of adolescents to start smoking and to quit smoking.
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