Purpose: Individuals with attention deficit/hyperactivity disorder (ADHD) may suffer from emotional dysregulation (ED), although this symptom is not listed among the diagnostic criteria. Methylphenidate (MPH) is useful in reducing emotional symptoms in ADHD. The aim of the present study was to determine both psychosocial risk factors and presence of ED in adolescents with ADHD before and after MPH treatment. Participants and methods: Eighty-two patients aged 12–18 years with ADHD were included as participants. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime, the Difficulties in Emotion Regulation Scale (DERS), sociodemographic form, and the Inventory of Statements About Self-Injury were administered. Results were compared before and after 6 months MPH treatment. Results: A significant improvement was detected on DERS for impulsivity (15.9±6.8 initial vs 14.2±6.5 final test, p<0.01) and total score (88.4±23.3 initial vs 82.4±2.7 final test, p<0.05) across all patients taking MPH regardless of subtype and sex. Despite treatment, a significant difference remained for impulsivity, strategies, and total score in patients with comorbid oppositional defiant disorder (ODD) compared with those without ODD, but no difference was detected for conduct disorder comorbidity. In patients who self-harm, scores for goals, impulsivity, strategies, clarity, and total score were higher before treatment: furthermore, impulsivity and total score remained high after treatment. In maltreated patients, goals, impulsivity, strategies, and total scores were significantly higher before treatment; however, their symptoms were ameliorated after treatment with MPH. Conclusion: Individuals with severe ED may “self-medicate” by smoking and/or self-harming. MPH led to significant improvements in ED possibly owing, in part, to a decrease in impulsivity, so that individuals felt more able to supervise their emotions and engage in goal-directed behaviors. ED should be considered particularly in patients with additional psychosocial factors and ODD comorbidity, and included in the treatment plan.

Purpose: Sleep disturbances are common in patients with celiac disease (CD), but their response to a gluten-free diet (GFD) treatment remains scarce. This study investigated the alteration in sleep disturbances within 6 months of starting a GFD in children with CD. Patients and Methods: A total of 103 children initially diagnosed with CD, with no psychiatric diagnosis and not receiving psychotropic medication, were included in this study. Sociodemographic data were collected, and the Children’s Sleep Habits Questionnaire (CSHQ) was completed both before and after six months of initiating a GFD. Results: Overall, the total average CSHQ score was 46; after starting the GFD, this decreased to 40, which was under the clinically significant cutoff level for sleep disturbance (p < 0.001). A total of 74 patients (71.8%) had a CSHQ score above the clinically significant cutoff before treatment, which decreased to 40 patients (38.8%) six months after GFD (p < 0.001). A significant improvement was detected in all CSHQ subscale scores and in the total CSHQ score after starting the GFD (p < 0.001). Parasomnia and the total CSHQ score were higher in children who were diagnosed incidentally compared to symptomatic children but did not differ after GFD (p < 0.005). In 39 patients (37.8%), the total CSHQ score remained high 6 months after starting the GFD. Maternal and paternal ages were significantly higher in children whose scores remained high (p < 0.05). Conclusion: A significant improvement in sleep scores was detected after starting a GFD, regardless of initial age, sex, and symptom status. With a GFD, children may fall asleep more easily and sleep for longer with less interruptions. GFD may help to reduce sleep disturbances in CD, but future studies should investigate the certain conditions in patients who do not respond to a GFD.

Amaç: Bu çalışmada, madde kullanımı veya temini nedeniyle denetimli serbestlik (DS) yükümlüsü olan ergenlerde, sosyal dışlanma, toplumsal aidiyet ve gelecek beklentisinin sağlıklı kontrollerle karşılaştırılması amaçlanmıştır.Yöntem: Çalışmaya, İstanbul’daki bir Çocuk ve Ergen Arındırma Merkezi (ÇEMATEM) Kliniği’ne uyuşturucu madde kullanımı veya temini gerekçesiyle DS yükümlüsü olarak başvuran 70 ergen ve psikiyatrik tanısı olmayan, yaş, cinsiyet ve sosyoekonomik düzeyi eşleştirilmiş 70 sağlıklı kontrol alınmıştır. Olgulara, sosyodemografik veri formu, Ergenler için Sosyal Dışlanma (Ostrasizm) Ölçeği, Ergenlerde Topluluk Hissi Ölçeği ve Ergen Gelecek Beklentileri Ölçeği uygulanmıştır. Bulgular: DS yükümlüsü ergenlerin, %85,7 (n=60)’si erkek ve yaş ortalaması 17.17 ± 0.85 olarak saptandı. Bu ergenlerin, %74,3'ünde (n=52) en az bir psikiyatrik hastalık mevcuttu. En sık saptanan ruhsal bozukluğun ise %80.2 oranla dikkat eksikliği hiperaktivite bozukluğu (DEHB) olduğu bulundu. Bu grupta, okulu bırakma ve ailede adli öykü oranı anlamlı düzeyde yüksekti. Yükümlü ergenlerin sosyal dışlanma ölçek puanları anlamlı düzeyde yüksek , toplumsal aidiyet ve gelecek beklentileri ölçek puanları ise anlamlı düzeyde düşüktü.Sonuç: Ergenlerde madde kullanımı; sosyal dışlanma, topluma aidiyet ve gelecek beklentilerini etkileyebilmektedir. DS yükümlüsü ergenlerde, psikososyal faktörler ve DEHB başta olmak üzere diğer psikopatolojilerin de irdelenmesi ve riskli grupların belirlenmesi önemlidir.

Background: Depression is a significant health issue among adolescents, often associated with decreased academic performance, self‐harm and increased suicide attempts. Suicidal and self‐harm behaviours are particularly concerning and are influenced by multiple factors beyond depression. This study aims to examine the factors contributing to suicidal behaviour and nonsuicidal self‐harm in adolescents diagnosed with major depressive disorder (MDD). Materials and Methods: This prospective study included adolescent patients aged 12–18 years diagnosed with MDD according to DSM‐5 criteria, referred to our Child and Adolescent Psychiatry Clinic between 1 February 2023 and 1 August 2023. Participants with intellectual disability, autism spectrum disorder, schizophrenia or other psychotic disorders were excluded. Data collection tools included the Sociodemographic Data Form, Inventory of Statements About Self‐Injury, Child Depression Inventory, Borderline Personality Inventory (BPI), Toronto Alexithymia Scale and Child and Youth Resilience Measure‐12 (CYRM‐12). Data were analysed using SPSS25.0. Results: Out of the 185 participants initially screened, 153 completed the study and were evenly divided into three groups: those who had never engaged in self‐harm or attempted suicide ( n = 51), those who had engaged in self‐harm at least once but had not attempted suicide ( n = 51) and those who had both engaged in self‐harm and attempted suicide ( n = 51). There were no significant differences in sociodemographic variables among the groups. Cutting was identified as the most common method of self‐harm (84.3%), followed by scratching (72.5%). In terms of resilience, measured by the CYRM‐12, the group with no history of self‐harm or suicide attempts had significantly higher scores (M = 36.55) than the self‐harm only group (M = 32.83) and the self‐harm plus suicide attempt group (M = 31.03) ( p < 0.001). For the BPI, the highest scores were observed in the group that had both engaged in self‐harm and attempted suicide (M = 29.28), followed by the self‐harm only group (M = 24.91) and the no self‐harm or suicide group (M = 19.26) ( p < 0.001). Conclusion: Adolescents with MDD who exhibit suicidal or self‐harm behaviours have higher borderline personality traits and alexithymia levels, and lower resilience compared to their counterparts without such behaviours. These findings suggest the importance of early identification and intervention targeting these factors to mitigate the risk of self‐harm and suicidal behaviour in depressed adolescents.