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BACKGROUND: The increasing incidence of autism spectrum disorder (ASD) is a common finding of many studies. Early diagnosis and appropriate treatment approaches for ASD can provide favourable clinical outcomes. This study aimed to determine the factors affecting the age at diagnosis, in children with ASD. METHODS: Two hundred and two cases diagnosed with ASD were included in the study, according to the DSM-5 diagnostic criteria, at the Mersin City Training and Research Hospital Child and Adolescent Psychiatry outpatient clinics, between April 2021 and August 2022. Clinical features and sociodemographic data that may be related to early diagnosis were investigated. RESULTS: The mean age at diagnosis was 36.76 ± 15.30 months. In 71.3% of cases parents were the first to suspect that children were developmentally different. In 38.1% of the cases, at least one of the parents denied the symptoms and evaluated their child`s development as age-appropriate. It was found that 32.7% of the cases evaluated by pediatricians and 32.5% of cases evaluated by family physicians, were referred to child psychiatry examination. The present study revealed that higher educational level of the father and the middlehigh socioeconomic status, were associated with early diagnosis. There was also a positive correlation between paternal age and age at diagnosis. CONCLUSIONS: The age at diagnosis is below the target level for early diagnosis. Studies should focus on increasing awareness of health professionals and parents about ASD.

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OBJECTIVE: Tic disorder (TD) is one of the neurodevelopmental disorders and its etiology has not been fully elucidated. Complete blood count (CBC) values have been used as indicators of a systemic inflammatory response. In our study, we aimed to assess hemogram parameters in drug-naive, comorbidity-free children with TD compared with controls. METHODS: This retrospective study included 62 drug-naive children with TD who had undergone CBC within one month prior to the study. A control group of 48 healthy children, matched for age and gender, without any organic or psychiatric disorders, was included. Statistical analysis was performed by using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp., Armonk, New York, United States).  Results: Hematocrit (p = 0.044), mean corpuscular volume (p = 0.002), platelet count (p = 0.011), and plateletcrit (p = 0.031) values were significantly higher in the TD group, whereas mean corpuscular hemoglobin concentration (p = 0.00) was significantly lower in the TD group. Additionally, a significant negative correlation was observed between the duration of illness and platelet (p = 0.05, r=-0.282), plateletcrit (p = 0.038, r = -0.295), and neutrophil count (p = 0.006, r = -0.391), while a positive correlation was found between the duration of illness and eosinophil count (p = 0.018, r = 0.336). CONCLUSION: The results revealed several significant differences in hemogram parameters between TD patients and the control group. These may suggest the role of inflammation and/or other underlying mechanisms in TD and may inspire new studies. Future studies with larger and more homogeneous samples, including comprehensive inflammatory markers, may contribute to a deeper understanding of the relationship between inflammation and TD.

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OBJECTIVE: Oxidative metabolism is impaired in several medical conditions including psychiatric disorders, and this imbalance may be involved in the etiology of these diseases. The present study evaluated oxidative balance in pediatric and adolescent patients with attention deficit hyperactivity disorder (ADHD). METHODS: The study included 48 children and adolescents (34 male, 14 female) with ADHD who had no neurological, systemic, or comorbid psychiatric disorders, with the exception of oppositional defiant disorder (ODD), and 24 sex- and age-matched healthy controls (17 male and seven female). RESULTS: TAS was significantly lower, and TOS and OSI were significantly higher in patients with ADHD than in healthy controls. Total antioxidant levels were lower in patients with comorbid ODD than in those with no comorbidity. No difference was found in TOS or OSI among the ADHD subtypes; however, TAS was higher in the attention-deficient subtype. CONCLUSION: Our findings demonstrated that oxidative balance is impaired and oxidative stress is increased in children and adolescents with ADHD. This results are consistent with those of previous studies.

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This study aimed to compare the quality of life of children and adolescents in various stages of their chronic kidney disease (CKD) who were managed with different treatment modalities to that of children and adolescents without any chronic disease. The study included 18 renal transplant and 21 dialysis patients (8 on hemodialysis, 13 on peritoneal dialysis) and 16 patients who did not yet require renal replacement therapy. The control group consisted of 37 children without any chronic disease. Psychosocial Health Summary scores, Physical Health Summary scores, and Total Scale scores of Pediatric Quality of Life Inventory scores were estimated for the groups. CKD patients had lower scores in all scales of Pediatric Quality of Life Inventory than the control group. There were no differences in self-reported scores on the Pediatric Quality of Life scale scores between treatment groups; however, parents of the transplant patients had reported higher (more favorable) Physical Health Summary scores than those of the dialysis patients. Reports of parents and their children differed only in Physical Health Summary scores in the dialysis group; self-reports of the children were more favorable. These findings show that children and adolescents with CKD experience impaired quality of life on the physical and psychosocial functioning domains in comparison with healthy controls. The study findings implicate the need for further studies to investigate the quality of life in CKD patients at different stages as well as the perceptional differences between pediatric and adolescent CKD patients and caregiver proxy-reports about their quality of life.

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