Objective: Although internalizing and externalizing disorders have received considerable attention among young population, the mechanisms that explain the relationships of internalization and externalization symptoms with attention deficit/hyperactivity disorder (ADHD) in children and adolescents are not well understood. Since sluggish cognitive tempo (SCT) symptoms had significant associations with ADHD, and internalization/externalization disorders, we examined whether SCT may mediate between ADHD symptoms and internalizing/externalizing problems during childhood. Methods: We performed a retrospective chart-review of 95 children and adolescents (76 boys and 19 girls, aged 6–16) with ADHD. The severity of ADHD was evaluated by Turgay DSM-IV-Based Disruptive Behavioral Disorders Screening and Rating Scale (T-DSMIV-S) completed by teachers. Measures of SCT, internalisation and externalisation symptoms, social, thought, and attentional problems were based on the Teacher Report Form (TRF) that was completed by subjects’ primary teachers. Results: The withdrawn scores were significantly correlated with SCT scores, social problems, and ADHD-inattention. There was an inverse correlation between withdrawn and ADHD-hyperactivity/impulsivity scores. The mediation test using bootstrapping method showed that the indirect coefficient for SCT was significant, after controlling of ADHD-inattention and social problems covariates, consistent with partial mediation. Conclusion: Our results may demonstrate that while externalization symptoms were associated with hyperactivity/impulsivity symptoms of ADHD, the internalization symptoms were significantly related to SCT in youngs with ADHD. Specifically, although social withdrawal was significantly related to ADHD-inattention, this relationship was mediated by the severity of SCT.

Despite the rising prevalence of methamphetamine use disorder (MUD) among adolescents and its severe consequences, data on hematological inflammatory indices in this population remain limited. This study aimed to evaluate systemic inflammatory markers in adolescents with MUD and their associations with addiction severity. The retrospective case-control study included 44 adolescents with MUD and 44 age- and gender-matched healthy controls. Hematological indices were calculated from complete blood count data, including neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), Basophil-to-lymphocyte ratio (BLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). Group comparisons, receiver operating characteristic (ROC) analyses, and partial correlations were performed. The MUD group included 30 females (68.2%) and 14 males (31.8%); the control group included 25 females (56.8%) and 19 males (43.2%). Adolescents with MUD showed significantly higher neutrophil and platelet counts, NLR, dNLR, PLR, MLR, SII, SIRI, and AISI, alongside reduced lymphocyte counts, compared with controls (all p < .05). ROC analyses revealed good discriminative ability for SII (AUC = 0.79), AISI (AUC = 0.73), and SIRI (AUC = 0.69). Several indices, including NLR, PLR, and SII, correlated negatively with treatment motivation, while PLR and MLR correlated positively with diagnostic severity. Adolescents with MUD demonstrate marked systemic inflammatory alterations detectable through routine hematological indices. These markers may serve as low-cost, clinically accessible biomarkers for identifying high-risk individuals and monitoring disease severity, with implications for early intervention and personalized treatment.

Objective: This study aimed to examine the sociodemographic, clinical, psychosocial, and substance use characteristics of adolescents admitted to an outpatient Child and Adolescent Substance Addiction Treatment Center (ÇEMATEM) in Türkiye. It also compared adolescents who used a single substance with those who used multiple substances (polysubstance users). Materials and Methods: The study retrospectively reviewed the medical records of 66 adolescents over a one-year period. Standardized assessment tools, including the Addiction Profile Index Adolescent Form (API-A) and the Substance Craving Scale (SCS), were used. Results: The mean age of the sample was 15.97 ± 1.51 years. Polysubstance use was observed in 66.7% of the sample. Compared to monosubstance users, polysubstance users were more likely to be female, slightly older, and had significantly higher rates of prior hospitalization and suicide attempts. They also exhibited significantly higher levels of craving and addiction severity across all API-A domains. The most commonly used substances were alcohol, cannabinoids, stimulants, and methamphetamine. Half of the sample reported concurrent use of alcohol, stimulants, and cannabinoids. Conclusions: Polysubstance use among adolescents is associated with greater psychosocial burden and clinical severity. These findings underscore the need for early identification and tailored interventions for this high-risk group.