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

Length of hospitalisation for people with severe mental illness.

Objective: The purpose of this study was to evaluate an innovative, protocol-based, group cognitive behavioral therapy (CBT) program delivered by trained teachers to reduce emotional distress and improve psychological functioning among the war-traumatized Syrian refugee students living in Istanbul. Methods: A total of 32 participants, aged between 10 and 15 years (mean = 12.41, SD = 1.68) and mostly females (m/f = 12/20) were randomly selected from a sample of 113 refugee students based on their trauma-related psychopathology as reflected in the Child Post-Traumatic Stress-Reaction Index (CPTS-RI) total score. The treatment program was implemented by the teachers trained by the study team to deliver a weekly, eight-session, protocol-based intervention in school setting. The degree of the fidelity to the original program was tested via video-recordings and subsequent analyses of the sessions. Effectiveness of the intervention was evaluated by a pre-test/post-test comparison using the CPTS-RI, Spence Children's Anxiety Scale (SCAS), and Strengths and Difficulties Questionnaire (SDQ). Results: All participants were accompanied minors. A significant proportion of them had either witnessed or been personally exposed to traumatic events. Statistically significant reduction in post-intervention evaluation was observed in the SCAS total score (t = 3.73, p = 0.001); CPTS-RI total score (t = 2.72, p = 0.011) and in the intrusive (t = 3.88, p = 0.001) and arousal (t = 2.60, p = 0.015) symptoms of the post-traumatic stress disorder (PTSD). In line with improvement in emotional problems as revealed in the anxiety and PTSD scales, the SDQ subcategory of the emotional problems was the only symptom area that showed a significant improvement (t = 2.85, p = 0.008). No significant change was seen in the SDQ subcategories of conduct (t = 1.01, p = 0.32), hyperactivity (t = 1.30, p = 0.20), peer problems (t = .66, p = 0.51), or in prosocial behavior (t = 2.15, p = 0.039). A significant proportion of the participants did no longer meet the diagnostic threshold for anxiety (p = 0.001) and PTSD (p = 0.021) after completion of the intervention. However, the post-intervention SDQ subcategories and the total SDQ score showed no significant difference as compared with the pre-intervention group. Conclusions: To the best of our knowledge, this is the first interventional study reporting promising results from a school-based, teacher-led and culturally sensitive psychological intervention program for refugee children in Turkey. Such protocol-based interventions need to be examined in controlled designs and larger samples so that a well-established intervention can be created and disseminated to provide the psychosocial support for this vulnerable and traumatized population.

No abstract

More than half of the 2.7 million registered Syrian refugees in Turkey are under 18 years of age. This study investigates prevalence of psychopathology and associated risk factors in refugee children in Turkey. Of a total of 218 children aged 9-15 years, 56.2% lost someone important to them, 55.1% saw dead or wounded people, 70.4% witnessed explosions or gun battles, 42.5% witnessed people being tortured and 25.6% personally experienced cruelty/torture during war. Prevalence of PTSD was 18.3% and that of anxiety-related disorders were as high as 69.0%. Death of an important person (p = .032) and male gender (p = .040) were associated with PTSD; whilst exposure to cruelty or torture (p = .014) and increasing duration of refuge (p = .042) were significantly associated with development of anxiety disorders. Findings of the present study reveals existence of the expected but unspoken mental health needs among the Syrian children in Turkey.

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

Aims Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. Methods A large-scale multicenter online survey was completed by the parents ( n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers—HCW [18.2%] vs. others), geographical (İstanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. Results Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p < .001), a mother (odds ratio 1.67, p < .001), and a younger parent (odds ratio 0.98, p = .012); living with an adult with a chronic physical illness (odds ratio 1.38, p < .001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p = .043), positive psychiatric history (odds ratio 1.29, p < .001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p < .001; vs. odds ratio 2.61, p < .001) were independently associated with significant parental distress. Conclusions Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit.

No abstract