Enes Sarıgedik

Background/Objectives: Early identification of post-traumatic stress disorder (PTSD) after childhood sexual abuse may support timely assessment, but triage requires evaluation of calibration, missed cases, and referral workload. This study assessed whether routinely recorded information could support prioritization for PTSD-focused assessment. Methods: This retrospective single-center study evaluated classification of post-event diagnostic outcomes documented by a specialist child and adolescent psychiatrist in 311 forensic referral records. DSM-5 diagnoses were grouped as PTSD versus no recorded post-event psychiatric diagnosis (n = 218; PTSD = 106) and PTSD versus other non-PTSD clinical outcomes (n = 199; PTSD = 106). Five models were compared. Within each evaluation design, preprocessing, model selection, sigmoid calibration, and threshold derivation were confined to the development partition; each pipeline was applied unchanged to held-out or chronologically later records. Results: Histogram-based gradient boosting yielded a held-out ROC-AUC of 0.6190 (95% CI, 0.4472–0.7853) and PR-AUC of 0.6578 in the primary formulation. Its threshold flagged 36 of 44 records and captured 18 of 21 PTSD cases (sensitivity, 0.8571; specificity, 0.2174). LightGBM yielded a ROC-AUC of 0.6441 (95% CI, 0.4475–0.8125) and PR-AUC of 0.6805 in the secondary formulation. Its threshold flagged 30 of 40 records and captured 18 of 21 PTSD cases (sensitivity, 0.8571; specificity, 0.3684). Calibration reduced Brier scores to 0.2537 and 0.2401, but the calibrated primary model remained slightly worse than the prevalence-only reference (Brier skill score, −0.0165; calibration slope, 0.4276). Temporal ROC-AUC values were 0.6358 and 0.6767, with high workloads. Conclusions: Routinely recorded information provided modest discrimination, and high case capture required assessment of most records. External validation, prospective workflow evaluation, and local recalibration are required before clinical use.

Background: Childhood sexual abuse (CSA) is a major risk factor for post-traumatic stress disorder (PTSD), but biological factors associated with differing clinical outcomes following CSA remain poorly understood. We compared serum neuropeptide Y (NPY) and ghrelin concentrations in female adolescents with CSA-related PTSD, CSA without PTSD, and healthy controls. Methods: The study included 111 postmenarcheal female adolescents aged 12–18 years: 37 with CSA + PTSD, 37 with CSA without PTSD, and 37 healthy controls. PTSD and other psychiatric disorders were assessed using the K-SADS-PL-DSM-5-T. Fasting morning serum NPY and ghrelin concentrations were measured by ELISA. Group comparisons were performed, and exploratory ROC analyses assessed within-sample discrimination between CSA-exposed adolescents with and without PTSD. Results: Serum NPY differed significantly across groups (F(2,108) = 43.63, p < 0.001, η² = 0.447), with lower concentrations in the CSA + PTSD group than in both comparison groups; the CSA without PTSD and healthy control groups did not differ significantly. Ghrelin also differed significantly across groups (H(2) = 85.95, p < 0.001, ε² = 0.777), showing a graded pattern with the highest concentrations in the CSA + PTSD group, intermediate concentrations in the CSA without PTSD group, and the lowest concentrations in healthy controls. Exploratory ROC analyses yielded AUCs of 0.896 for NPY and 0.881 for ghrelin within the CSA-exposed sample. Conclusion: Serum NPY and ghrelin showed distinct cross-sectional group patterns in female adolescents with and without CSA-related PTSD. These findings should not be interpreted as PTSD-specific or clinically validated diagnostic effects. Longitudinal studies in independent, more representative samples are needed to clarify their temporal and clinical significance.

Background: The study investigated whether manic/hypomanic symptoms mediate the link between impulsivity dimensions and ADHD severity. Methods: Initially, 175 adolescents aged 12–18 years were recruited; following three exclusions due to incomplete records, the final sample comprised 62 adolescents with ADHD and 110 controls. Participants and parents completed the Barratt Impulsivity Scale–Short Form (BIS), Conners-Wells Adolescent Self-Report Scale–Short Form (CASS-S), Mood Disorder Questionnaire–Parent Form (MDQ), and DSM-IV-Based Disruptive Behavior Disorders Rating Scale–Parent Form. Mediation analyses were estimated via generalized linear modeling (identity link) with bias-corrected bootstrap confidence intervals (5000 resamples) to evaluate parent-reported mood symptoms (MDQ) as a mediator between self-reported BIS dimensions and CASS-S ADHD Index scores. Results: The ADHD group scored significantly higher across all impulsivity, mood, and ADHD dimensions than controls ( p ≤ .05). Additionally, MDQ scores significantly mediated the relationships between nonplanning, motor, attentional, and total impulsivity scores and ADHD severity across all models ( p ≤ .01). Direct paths remained robust, indicating partial mediation. Conclusions: Manic/hypomanic symptoms partially mediate the relationship between trait impulsivity and ADHD severity dimensionally. Clinically, screening for subthreshold affective symptoms is clinically vital to limit diagnostic overshadowing and differentiate core neurodevelopmental deficits from emerging bipolar spectrum features.

The aim of this study is to compare the levels of alexithymia and childhood trauma experiences of mothers of sexually abused children with those of mothers in the control group, and to examine the relationships between alexithymia and trauma experiences. The research was conducted with a case-control design. The case group consisted of 41 mothers of sexually abused children. The control group consisted of 41 mothers whose children had no history of sexual abuse. Data were collected using a personal information form, the Childhood Trauma Questionnaire (CTQ-28), and the Toronto Alexithymia Scale (TAS-20). In the case group, sexual abuse and emotional neglect scores were significantly higher compared to the control group (p=0.041; p=0.004, respectively), while minimization scores were significantly lower. No significant differences were observed between the groups on the TAS subscales and total scores. In the case group, negative correlations were observed between age and Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), and the TAS total score; positive correlations were observed between emotional neglect and DIF, DDF, EOT (Externally Oriented Thinking), and the TAS total score. The findings indicated that past traumatic experiences had marked effects on the mothers of sexually abused children and that these experiences were associated with alexithymia. The results highlight the importance of supporting the mental health of mothers for both parental well-being and the psychosocial development of the child.

The documents a unique instance of guanfacine-induced secondary nocturnal enuresis in an 8-year-old boy diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). In this case, an 8-year-old boy with ADHD and a history of Ventricular Septal Defect surgery was treated with guanfacine XR 1 mg/day. Within three days, the boy experienced intermittent nocturnal enuresis. Despite partial ADHD symptom improvement with a dose increase to 2 mg/day, nocturnal enuresis worsened (up to four times a week). Subsequent dose reductions and additions of desmopressin partially alleviated enuresis symptoms. Notably, ADHD symptoms remitted with a dose escalation to 3 mg/day but were accompanied by increased enuresis frequency. Significant improvement was achieved through dose adjustments and the introduction of desmopressin, highlighting a potential management strategy for this side effect.

Amaç: Çalışmada bir hastanenin çocuk izlem merkezinde değerlendirilen çocuk ve ergenlerin demografik özelliklerini, istismara ilişkin bilgilerini ve adli muayene bulgularını gözden geçirmeyi amaçladık. Yöntem: 2022-2023 yılları arasında cinsel istismar şüphesiyle adli muayenesi yapılmış olguların kayıtları geriye dönük tarandı. Olguların demografik bilgileri, bildirim şekilleri, şüphelinin yakınlık derecesi, şüphelinin yaşı, istismar tipi, mağdurun gebelik durumu ve adli muayene bulguları çalışma dosyasına kaydedildi. Bulgular: Çalışmaya toplam 121 olgu dahil edildi. Olguların %89,3’ü kız ve %10,7’si erkekti. Mağdurların yaş ortalaması 13,67 ± 3,186’idi. Şüphelilerin çoğunluğunu aile dışı bireyler oluşturdu (%70,2). Ergenlerde tekrarlı istismar (n=23, %92, p

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.