Browsing by Author "Sapmaz, SY"

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    Cognitive functioning of adolescents using Methamphetamine: The impact of inflammatory and oxidative processes
    Cakir, B; Cakir, ADU; Sapmaz, SY; Bilac, O; Taneli, F; Kandemir, H
    BackgroundMethamphetamine is a substance that causes neurotoxicity and its use is increasing in recent years. Literature highlights cognitive impairment resulting from Methamphetamine use. The aim of the present study is to evaluate the relationship between cognitive impairment and inflammatory processes in adolescents with Methamphetamine use disorder.MethodsThe study included 69 adolescents aged 15-19 years, comprising 37 participants with Methamphetamine Use Disorder and 32 healthy controls. Central Nervous System Vital Signs was used to detect cognitive impairment. Childhood Trauma Questionnaire-33 and The Children's Depression Inventory scales were used. In addition, venous blood was collected from the volunteers. Biochemical parameters (IL-1beta, IL-6, TNF-a, BDNF, FAM19A5, TAS, TOS) were analyzed.ResultsOur study showed that (I) IL-6 and TNF-a levels of Methamphetamine users were lower than the healthy group; (II) BDNF levels of Methamphetamine users were higher than the healthy group; (III) mean Neurocognitive Index in cognitive tests of Methamphetamine using adolescents was negatively correlated with duration of Methamphetamine use and BDNF levels.ConclusionsOur study suggests that Methamphetamine use may have a negative effect on cognitive functions.
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    Mental health of both child and parents plays a larger role in the health-related quality of life of obese and overweight children
    Kizilay, DÖ; Sapmaz, SY; Sen, S; Özkan, Y; Özyurt, BC; Ersoy, B
    Aims: A decrease in health-related quality of life (HRQOL) measures among obese (OB) and overweight (OW) children has been shown in several studies, but knowledge about the variables affecting HRQOL impairments is missing. The aim of this study was to evaluate the relationship between HRQOL and sociodemographic characteristics, anthropometric measurements, metabolic parameters, mental symptoms and parental attitudes in a sample of OB/OW children. Methods: Eighty-six OB/OW children, aged between 9 and 17 years, participated in the study. We performed sociodemographic questioning, anthropometric examinations and laboratory evaluations of the participants. HRQOL was assessed using the Pediatric Quality-of-Life Inventory (PedsQL), and levels of anxiety and depressive symptoms were measured using the Screen for Child Anxiety-Related Disorders (SCARED) questionnaire and the Children's Depression Inventory (CDI), respectively. Parental attitudes were assessed with the Parental Attitude Research Instrument (PARI) questionnaire. Results: A statistically significant relationship was found between total scores of CDI and SCARED answered by children and the total and subscale scores of PedsQL. Scores of total quality of life subscale, physical functionality and emotional functionality subscales were significantly lower in children with a family history of mental illness. No relationship was found between PedsQL subscales, anthropometric and metabolic parameters. Conclusions: Emotional problems and parental psychological distress are important factors in models of HRQOL in the OB/OW pediatric population.
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    Do We Learn to Internalize Stigma from Our Parents? Comparison of Internalized Stigmatization in Adolescents Diagnosed with ADHD and Their Parents
    Dikeç, G; Bilaç, Ö; Kardelen, C; Sapmaz, SY
    This study compared internalized stigmatization levels of adolescents diagnosed with attention deficit and hyperactivity disorder (ADHD) with those of their parents. The study's data were collected from 107 adolescents diagnosed with ADHD and their parents between July 2020 and March 2021. The adolescents were followed up in the child and adolescent psychiatry outpatient clinic of a university hospital in western Turkey. The information forms for adolescents and parents, the Internalized Stigma of Mental Illness Scale-Adolescent Form (ISMI-AF) and the Parental Internalized Stigma of Mental Illness Scale (PISMI), were used to collect the data. There was no statistically significant difference between the total scores of internalized stigma and subscale mean scores of the adolescents and their parents (p > 0.05); only the subscale scores for stereotype endorsement were found to be significantly different (p < 0.05). PISMI scores affected ISMI-AF scores, which can be interpreted as parents' perspectives and attitudes toward stigmatization affecting adolescents. For ADHD, whose frequency is increasing daily, intervention studies should be conducted to reduce adolescents' and parents' internalized stigma and to enhance the educational outcomes of adolescents.
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    Exploring the Association between Depression, Suicidality, and Serum Brain-Derived Neurotrophic Factor, FAM19A5, Total Antioxidant Status, Total Oxidant Status, Oxidative Stress Index, and Cytokine Levels: A Case-Control Study of Drug-Naive Adolescents with First-Episode Major Depressive Disorder
    Çakir, ADU; Çakir, B; Sapmaz, SY; Bilaç, O; Taneli, F; Kandemir, H
    Introduction: Considering the importance of neuroinflammation and neurodegeneration in the pathophysiology of major depressive disorder (MDD), peripheral blood biomarkers are promising for the prediction of diagnosis and treatment outcomes. We aimed to elucidate the neuroinflammatory pathophysiology of depression by evaluating serum levels of FAM19A5 as a new biomarker of inflammatory activation, proinflammatory cytokines, brain-derived neurotrophic factor (BDNF), and oxidative stress parameters. Methods: Adolescents diagnosed with first-episode drug-naive MDD (n = 35) were compared neurobiologically healthy control group (n = 33). Serum FAM19A5 levels, cytokine levels, BDNF and oxidative stress parameters were evaluated using the enzyme-linked immunoassay method. All participants were assessed with the Level-2 Depression Severity Scale, Sleep Disturbance Scale, Somatic Symptom Scale. Results: BDNF levels were significantly higher in the patient group compared to the control group. While BDNF showed a positive correlation with all scale scores; BDNF was significantly higher in the suicide risk groups than the control group. IL-1 beta levels displayed a negative correlation with the severity of sleep disturbances. Conclusions: In adolescents with MDD, inflammatory and oxidative stress markers were not raised in peripheral blood, unlike in adults. However, BDNF levels, which typically decrease in neurodegenerative conditions, were higher in those with MDD.
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    Clinical findings, child and mother psychosocial status in functional constipation
    Appak, YÇ; Sapmaz, SY; Dogan, G; Herdem, A; Özyurt, BC; Kasirga, E
    Background/Aims: Functional constipation (FC) is a common problem in childhood. In this study, we aimed to analyze the clinical and sociodemographic findings of patients with FC, parenting behaviors, and psychosocial states of children and parents. Materials and Methods: According to the Roma III diagnosis criteria, 32 patients with FC and 31 healthy controls were included. Patients' clinical and sociodemographic data set associated with constipation was determined. Strengths and Difficulties Questionnaire was used to screen the emotional and behavioral problems in children. To evaluate the parents and family, Beck Depression Inventory, State-Trait Anxiety Inventory, Parental Attitude Research Instrument were used. Results: Emotional and peer problems subscale scores, parental concerns as well as over-parenting attitude were found higher in patients. Significant difference was also observed between the groups in terms of mean score of authoritarian attitude dimensions. Attitude of hostility and rejection and marital discordance was found to be significantly high in patient families. Our study revealed a decrease in the constipation rate with the increasing education level of parents, higher rate of constipation in families with less income than expenses, and lower rate of working mothers in patients with constipation. Parents' depressive symptoms and anxiety level were determined to be considerably higher. Conclusion: A mother's low education level, low socioeconomic level, presence of psychological symptoms, and problems of parental attitude-primarily the authoritarian attitude-increase the risk of FC occurrence. Therefore, FC patients and their families should definitely undergo a psychosocial assessment.
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    Does Working with Child Abuse Cases Affect Professionals' Parenting and the Psychological Well-Being of Their Children?
    Dursun, OB; Sener, MT; Esin, IS; Ançi, Y; Sapmaz, SY
    Work in the field of sexual abuse is extremely stressful and may arouse negative personal reactions. Although these secondary trauma effects are well described on a personal level, there is not enough evidence to understand whether these professionals carry these effects to their homes, families, and offspring. This study aims to identify the effects of working with child abuse cases on the anxiety level and parenting styles of childhood trauma workers and on their children's well-being. A total of 43 health and legal system workers who worked with abused children in any step of their process and who had children constituted the study group, and 50 control cases, each working in the same institution and having the same occupation as 1 of the participants from the study group and having children but not working directly with children and child abuse cases, were included in the study. Participants were asked to fill out a sociodemographic form, the Parental Attitude Research Instrument, the trait portion of the State-Trait Anxiety Inventory, and an age-appropriate form of the Child Behavior Checklist for each child they had. Professionals in the study working with child abuse cases demonstrated significantly higher democratic parenting attitudes. Law enforcement workers working with child abuse cases demonstrated stricter and more authoritarian parenting strategies, as well as more democratic attitudes, than their colleagues. There was not a statistically significant relationship between child abuse workers' anxiety level and their children's well-being among control subjects.
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    TGF-β1, neopterin, tetrahydrobiopterin, and nitric oxide levels in pediatric obsessive-compulsive disorder
    Özkan, Y; Kandemir, H; Sapmaz, SY; Taneli, F
    The biological mechanisms underlying obsessive-compulsive disorder (OCD) are not sufficiently elucidated. Chronic inflammation and oxidative stress were shown to increase neopterin and decrease tetrahydrobiopterin (BH4) levels by activating the neopterin-BH4 pathway. This study compared serum TGF-beta 1, TNF-alpha, IL-1 beta, IL-2, IL-6, IL-10, IL-17, neopterin, BH4, and nitric oxide (NO) levels between child and adolescent patients diagnosed with OCD and a healthy control group. The study included 29 patients diagnosed with OCD (comorbidity free, drug free) and 28 healthy children as an aged and sex matched control group. Serum samples were analyzed for TGF-beta 1, TNF-alpha, IL-1 beta, IL-2, IL-6, IL-10, IL-17, neopterin, and BH4 by using enzyme-linked immunosorbent assay method, and NO concentrations were assessed by colorimetric method based on Griess reaction. All cytokine levels were found to be low, but this decrease was statistically significant only for TGF-beta 1. The neopterin and NO levels were significantly higher and BH4 significantly lower in children with OCD compared to the healthy control group. Also, a statistically significant correlation was found between NO, neopterin, and BH4 levels. The results of our study show that the levels of TGF-beta 1 and NO and the activation of the neopterin-BH4 pathway may be implicated in the pathophysiology of OCD.
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    Which factors affect internalized stigmatization in adolescents with mental disorders?
    Dikeç, G; Bilaç, Ö; Kardelen, C; Sapmaz, SY; Kandemir, H
    Purpose: The aim of this descriptive study was to determine the factors affecting internalized stigmatization of adolescents with mental disorders. Method: The study data were collected in a university hospital between August 1, 2020 and July 30, 2021 (n = 123), using a Personal information form and the Internalized Stigmatization of Mental Illness-Adolescent Form (ISMI-AF). Results: Gender and the number of hospitalizations were determined to be independent variables with explanatory power in the ISMI-AF, and in the model created with these variables, it was determined that these variables explained 18% of the change in the total points of the ISMI-AF. Conclusions: It could be recommended that psychosocial programs are developed with the aim of decreasing internalized stigmatization and increasing the psychological resilience of adolescents.
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    Reliability and Validity of the Turkish Version of Impact of Weight on Quality of Life for Kids
    Kizilay, DÖ; Sapmaz, SY; Tepe, D; Ersoy, B
    Objective: The Impact of Weight on Quality of Life-Kids is a self-reported weight-related quality of life measure that has been validated for children and adolescents aged between 11 and 19. Impact of Weight on Quality of Life-Kids does not have a Turkish version. The aim of this study was to explore the reliability and validity of the Impact of Weight on Quality of Life-Kids in Turkish. Materials and Methods: The Impact of Weight on Quality of Life-Kids was translated into Turkish using Mapi Research Institute's suggested international translation technique. The psychometric evaluation included test-retest reliability, internal consistency, discriminant validity, concurrent validity, exploratory factor analysis, and confirmatory factor analysis. Results: For the total score, the internal consistency of the scale (Cronbach's alpha coefficient) was 0.93. The item-total score correlation coefficients ranged from 0.178 to 0.785. The testretest coefficients were found to be 0.94 for the total score and the subscales ranged from 0.66 to 0.89 after 2 weeks. Discriminant validity analysis demonstrated that the instrument differentiated well between the obese and non-obese samples. Five variables were discovered via factor analysis that explained 66.9% of the total variation. The chi-square/degree of freedom ratio value was 3.535, the comparative fit index value was 0.834, and the value of root mean square error of approximation was 0.10, as determined by confirmatory factor analysis. Conclusion: Our results demonstrated the adequate reliability and validity of the Impact of Weight on Quality of Life-Kids, suggesting that this scale is a useful tool for screening Turkish children and adolescents for weight-related quality of life.
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    Neutrophil-to-lymphocyte ratio and platelet distribution width: A potential new peripheral biomarker in adolescent depression
    Ozturk, M; Ozkan, Y; Sapmaz, SY; Kandemir, H
    Objective: The aim of this study is to evaluate the role of inflammation in the underlying pathophysiology of ado-lescent depression by evaluating neutrophile-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and hemogram parameters and also to determine whether there is a relationship between depression severity and inflammatory parameters. Method: This retrospective study was carried out on 93 major depressive disorder (MDD) patients and 65 healthy control. Clinical features such as diagnosis date, diagnosis during admission to hospital using DSM-5 diagnostic criteria, comorbid phys-ical and psychiatric illness, drug use, previous psychiatric diagnosis, history of suicide attempt were determined. In addition, hemogram parameters of the participant included in the study in the hospital data system were used. Results: NLR and platelet distribution width (PDW) were found to be statistically significantly higher in the patient group than in the control group (p<0.05). A weakly significant positive correlation (p =0.039, r=0.165) was found between NLR and depression seve-rity scale; a positive correlation was found between PDW and depression scale scores and depression severity scale total scores (p<0.001, r=0.317; p<0.001, r=0.320, respectively). Discussion: NLR and PDW were found to be significantly higher in patients with MDD than in healthy controls, and it supports the possible role of low-grade inflammation in the pathophysiology of MDD. In the next years, prospective studies in which hemogram parameters are evaluated together with proinflammato-ry cytokines will more clearly illuminate the role of inflammation and platelet activation in the etiology of MDD in adolescents.
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    Validity and Reliability of the Turkish Version of the DSM-5 Posttraumatic Stress Symptom Severity Scale-Child Form
    Sapmaz, SY; Ergin, D; Özek Erkuran, H; Sen Celasin, N; Öztürk, M; Karaarslan, D; Köroglu, E; Aydemir, Ö
    Introduction: This study assessed the validity and reliability of the Turkish version of the DSM-5 Posttraumatic Stress Symptom Severity Scale-Child Form for use among the Turkish population. Methods: The study group consisted of 30 patients that had been treated in a child psychiatry unit and diagnosed with posttraumatic stress disorder and 83 healthy volunteers that were attending middle or high school during the study period. For reliability analyses, the internal consistency coefficient and the test-retest correlation coefficient were measured. For validity analyses, the exploratory factor analysis and correlation analysis with the Child Posttraumatic Stress Reaction Index for concurrent validity were measured. Results: The Cronbach's alpha (the internal consistency coefficient) of the scale was 0.909, and the test-retest correlation coefficient was 0.663. One factor that could explain 58.5% of the variance was obtained and was congruent with the original construct of the scale. As for concurrent validity, the scale showed high correlation with the Child Posttraumatic Stress Reaction Index. Conclusion: It was concluded that the Turkish version of the DSM-5 Posttraumatic Stress Symptom Severity Scale-Child Form can be used as a valid and reliable tool.
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    Behavioral characteristics of children with type-1 diabetes and the effect of family attitudes on dietary adherence problems
    Onen, O; Nalbantoglu, O; Erkuran, HO; Sapmaz, SY; Erbas, M; Arslan, G; Ozkan, B
    Objective: Assessing the behavioral characteristics and family attitudes of children and adolescents in diabetes is linked to determining the reasons for difficulties in dietary adherence. Our aim was to assess the relationship between behavioral characteristics, family attitudes in children diagnosed with type 1 diabetes mellitus (T1DM), and the dietary adherence and glycemic control. Method: Fifty-four patients T1DM patients and 47 controls aged 7-18 years were included in the study together with their parents. Among the patients diagnosed with T1DM followed in the Pediatric Endocrinology Outpatient Clinic, those with high HbA1c levels (with poor dietary compliance) and those with a HbA1c level below 7.5 (with good dietary compliance) were included in the study as the patient and control group, respectively. A psychiatric assessment interview was conducted with both groups. Sociodemographic data and information on diabetes-related variables, Strengths and Difficulties Questionnaire and Parental Attitude Scale scores were recorded. Results: We have found higher standard diet application rates in patients compared to regular carbohydrate count. The patient group had higher odds of neglecting blood glucose measurement, insulin doses, and a history of stress before decompensation. The rate of psychiatric diagnosis was 26.2%, similar to the general literature, and combined diagnoses were less frequent. Hospital admissions and hypoglycemic episodes were observed at a higher rate in the group that had problems in dietary adherence. Compared to those with good dietary compliance, patients in the dietary non-adherence group had a higher level of parental control and poorer parental perception of their children's peer relationships. Conclusion: To reduce the risk of acute complications of the disease and to prevent long-term chronic sequelae, it is important to identify positive and some negative behavioral characteristics of child and parental attitudes. Parental role is among the key factors in supporting the autonomy of the child in ensuring dietary compliance.
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    The role of the kynurenine pathway and quinolinic acid in adolescent major depressive disorder
    Öztürk, M; Sapmaz, SY; Kandemir, H; Taneli, F; Aydemir, Ö
    Background The biological mechanisms underlying major depressive disorder (MDD) are not yet sufficiently understood. The kynurenine pathway has been proposed to play a key role between peripheral inflammation and alterations in the central nervous system. This is because of reduced usability of tryptophan (TRP) and production of oxygen radicals and highly potent neurotoxic agents in this pathway. Objective In this study, we aimed to compare the metabolites of the serum kynurenine pathway (tryptophan, kynurenine, quinolinic acid and kynurenic acid) and IFN-gamma, IL-6, IL-1 beta and high-sensitivity C-reactive protein (hsCRP) levels in patients with major depressive disorder and in healthy controls and to evaluate the relationship between cytokine levels and the functioning of the kynurenine pathway. Methods Clinical and biochemical data from the patients were obtained and assessed in a cross-sectional design. Serum samples were analysed for IL-6, IL-1 beta, interferon (IFN)-gamma, tryptophan (TRP), quinolinic acid (QUIN), kynurenic acid (KYNA) and kynurenine (Kyn) levels by the enzyme-linked immunosorbent assay. hsCRP test was analysed by the immunoturbidimetric method. Results In total, 48 adolescent patients with major depressive disorder (no drug use) and 31 healthy controls were included in the study. TRP levels were observed to be significantly lower in patients with MDD than in healthy controls (P = .046); the Kyn/TRP ratio was significantly higher in patients with MDD than in healthy controls (P = .032); the levels of QUIN were significantly higher in patients with MDD than in healthy controls (P = .003). No significant difference was found between the groups in terms of other kynurenine metabolites and cytokines levels. Conclusion These results suggest that the Kyn and related molecular pathways may play a role in the pathophysiology of MDD. The most important finding was the increased level of QUIN, which has a neurotoxic effect, in the kynurenine pathway.
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    Quickly diagnosed and treated prepubertal Type 1 narcolepsy case
    Çökmüs, FP; Aydin, O; Dikici, DS; Sapmaz, SY
    Excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucination are the classic tetrad of narcolepsy. It has been shown that narcolepsy, a chronic and disabling disease, starts in childhood and adolescence rather than adulthood. The International Classification of Sleep Disorder (ICSD-3) classifies narcolepsy into Type 1 (narcolepsy with cataplexy) and Type 2 (narcolepsy without cataplexy). There is low awareness and knowledge of narcolepsy among the general public, primary care physicians, and sleep specialists. It has been shown that the lack of recognition of disease symptoms delayed the diagnosis of narcolepsy from 8.7 to 22.1 years. In this case report, we will discuss the case of Type 1 narcolepsy, which started in the prepubertal period and was diagnosed and treated in a short period of time.
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    Thiol/Disulfide Homeostasis: A Potential New Peripheral Biomarker in Adolescent Depression
    Öztürk, M; Özkan, Y; Sapmaz, SY; Erdal, S; Taneli, F; Kandemir, H
    Background: Thiol-disulfide homeostasis (TDH), one of the most important antioxidants, is involved in the non -enzymatic removal of reactive oxygen molecules in the body and is one of the many methods to measure the level of oxidative stress (OS). In the present study, TDH is investigated in adolescent depression, and its relationship to clinical variables is examined. Methods: Thirty-two (50.0%) patients diagnosed with major depressive disorder (MDD) and without psychotropic drug use and 32 (50.0%) healthy controls were included in the present study. The subjects MDD and control groups were between 13 and 18 years old. Participants completed the DSM-5 Level -2 scales for depression and irritability. A colorimetric method proposed by Erel and Neselioglu was used to analyze the TDH parameters of serum samples. Results: Biochemical analyses of samples from the MDD and control groups showed significant differences between the groups in native thiol (SH) levels ( P = .002), disulfide (SS) levels ( P = .021), disulfide/total thiol (SS/ToSH) ( P = .009), and disulfide/native thiol (SS/SH) ( P = .003) levels. Analysis of receiver operating characteristic showed that the area under the curve values with acceptable discrimination potential for the TDH parameters were significantly able to discriminate individuals with MDD from healthy controls. Conclusion: Thiol-disulfide homeostasis, one of the OS parameters, was found to be impaired in adolescents with depression. Our results suggest that TDH may contribute to the etiopathogenesis of adolescent MDD and that TDH may be a novel approach to assess OS in adolescent depression.
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    Awareness and intervention approaches related to smoking addiction among child and adolescent psychiatrists
    Erten, T; Sapmaz, SY; Güleç, AG; Hesapçioglu, ST; Kandemir, H; Yilmaz, Ö; Yüksel, H
    Aim: To determine the attitudes of child and adolescent psychiatrists working in different institutions throughout Turkey towards smoking addiction and intervention steps. Material and Methods: An information form assessing physicians' 5As approach was established considering the studies included in the literature, and this form was applied to physicians working in the area of child psychiatry by way of e-mail and phone. Results: Although most physicians (52.5%) asked about smoking status, which is included in the first step in the 5As approach used in smoking cessation, it was observed that they implemented further steps of the 5As with gradually decreasing rates in our study. Only 15% of the physicians performed follow-up in smoking cessation treatment. Conclusion: Physicians who work with pediatric and adolescent patients in Turkey have low levels of awareness about smoking addiction and they do not feel competent. Considering that tobacco and related addictions are gradually increasing in children and adolescents, physicians must receive training in the area of smoking cessation methods and start practicing these methods. It was thought that organizing smoking cessation training for physicians would contribute positively to the treatment of patients.
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    Is There a Significant Deterioration in Blood Lipid Levels of Children and Adolescents Diagnosed with Conduct Disorder?
    Bilaç, Ö; Akyol, CK; Tahillioglu, A; Sapmaz, SY; Kandemir, H; Ercan, ES
    Conduct disorder (CD) is diagnosed in childhood or adolescence and presents itself through a persistent pattern of behavior in which the basic rights of others or major age-appropriate norms are violated. It affects not only the individual and family but also the society negatively. Attention-deficit/hyperactivity disorder (ADHD) can be defined as a precursor of CD. Some studies indicate that there is a relationship between serum cholesterol and ADHD. The associations between serum lipid levels and antisocial personality disorder (APD), which often develops after CD, have also been demonstrated. To our knowledge this study is the first to examine the relationship between cholesterol levels and conduct disorder as a diagnosis. For this study the files of the patients who were examined between December 2017 and December 2019 were scrutinized to determine patients with CD. Results revealed that there were 45 patients with CD without a comorbid disease, according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Fasting serum total cholesterol (T-Chol), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels in blood tests of these 45 patients and age- and gender-matched 45 healthy children and adolescents, were compared. As a result of these, serum total cholesterol and LDL-C levels were found to be lower in children and adolescents with a diagnosis of CD (p = <.001). The results of our study indicates that serum lipid levels may play a role in the etiopathogenesis of CD. More studies examining biochemical markers are necessary to develop more appropriate treatments for CD. As far as we are concerned, our study will shed light on new researches regarding the etiology of CD, which is an important childhood and adolescence psychiatric disorder.
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    Insulin Resistance as Related to Psychiatric Disorders in Obese Children
    Kizilay, DÖ; Sapmaz, SY; Sen, S; Özkan, Y; Ersoy, B
    Objective: The current study aimed to investigate psychiatric consequences of obesity and the relationship between componenets of the metabolic syndrome and psychiatric disorders in children. Our second aim was to elucidate which of the anthropometric parameters or metabolic components were most strongly associated with psychiatric disorders. Methods: The study included 88 obese and overweight children with a body mass index (BMI) greater than 85th percentile. The patients were evaluated for psychiatric disorders by a single child and adolescent psychiatrist. Forty patients diagnosed with psychiatric disorders and 48 patients with normal psychiatric evaluation were compared in terms of anthropometric and metabolic parameters. BMI, BMI-standard deviation score and BMI percentile, waist circumference, waist to hip ratio, blood pressure and pubertal stage of all patients were recorded. Fasting serum glucose, insulin, lipid profile and homeostatic model assessments of insulin resistance (HOMA-IR) were measured to evaluate the metabolic parameters. Serum and 24 hour urine cortisol levels were measured. Results: HOMA-IR in the group with psychiatric disorders was found to be significantly higher than in the group without psychiatric disorders (6.59 +/- 3.36 vs 5.21 +/- 2.67; p = 0.035). Other anthropometric measurements and metabolic parameters were not significantly different between the two groups. Conclusion: An understanding of the relationships between obesity related medical comorbidities and psychiatric pathologies is important to encourage patients and their families to make successful healthy lifestyle changes and for weight management in terms of appropriate treatment.