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The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques. A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD ( = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM). Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e. had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables. Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology and treatment of OCD.

In patients with schizophrenia, a chronic psychiatric disorder, cognitive impairments have a significant impact on functioning as well as symptoms. Cognitive remediation (cognitive remediation) interventions are a treatment approach that aims to improve cognitive functioning in patients with schizophrenia. These interventions can be categorized as \"bottom-up\" approaches that directly target cognitive functions and \"top-down\" approaches that indirectly affect cognitive functions. In this study, the contribution of bottom-up cognitive remediation interventions to functioning in schizophrenia was examined. The study provides evidence that bottom-up cognitive remediation interventions can improve cognitive functioning, social functioning and quality of life in patients with schizophrenia. When the literature is reviewed, it is observed that there is no research or programs about bottom-up cognitive remediation interventions in Türkiye. It is recommended that programs for bottom up cognitive remediation interventions should be developed and utilized in Türkiye and they should be incorporated with the current therapy and rehabilitation approaches. It is important to benefit from technological opportunities, to increase the duration and intensity of interventions, to consider the issue of motivation and to ensure the integration of interventions into daily life, in creation of future bottom-up cognitive remediation intervention programs, in order to increase effectiveness, sustainability and cost-efficiency.

In this study, we aimed to determine the prevelance and severity of mental disorders in institutionalized children between the ages of 3-5 years, investigate the factors associated with the mental disorders and compare these findings with the data of a community sample composed of children who were raised by their own families. Thirty-four children raised in three institutions in Kocaeli were compared with an age- and sex-matched community sample. Children were assessed according to DSM-IV diagnostic criteria. The Socio-demographic information form, and Early Childhood Inventory-4 (ECI-4) parent scale were used for data collection. Children that were reared in institutions had evidence of higher rates of mental disorders. In institution-reared children, symptom severity of attention deficit hyperactivity disorder, reactive attachment disorder, oppositional deficient disorder, and pervasive developmental disorder were higher than the community subjects. Age, time spent with father, duration of institutionalization, number of siblings, number of hospital admissions because of physical symptoms and presence of abuse before institutional care were determined to be predictive factors for psychiatric symptoms. These findings revealed that institutionalized children are at risk for mental disorders and protective measures are as important as instutional care for these children. Our results suggest that essential steps should be taken to protect the mental health of children in institutional care.

Abstract Background: Social anxiety disorder (SAD) occurs in social environment or performance conditions, is characterized by the fear of being negatively evaluated or showing symptoms of anxiety and usually causes avoidance behavior. It is known that that changing negative thoughts and producing alternative thoughts have an important place in the treatment of social anxiety disorder. In Cognitive Behavioral Therapy, the focus is mainly on the person's negative thoughts about himself. Group Based Cognitive Behavioral Therapy (CBGT) is frequently used therapy model in anxiety disorders, including social anxiety. The aim of this study is to examine the effect of CBGT on the social anxiety levels of university students with SAD, as well as on their ruminative thinking and self-compassion. Methods: Liebowitz Social Anxiety Scale was applied to 1200 students. 30 university students who had highest social anxiety levels were selected. The selected students were assigned to the experimental and placebo groups. CBGT was applied to the experimental group, and communication-based group therapy was applied to the placebo group. Results: There is a significant difference between pretest and posttest of the LSF and rumination levels of the experimental group. In addition, LFS and rumination post-test levels were found to differ significantly according to the group. There was no significant difference in self-compassion levels. Conclusion: The social anxiety and ruminative thinking levels of the students with social anxiety disorder who were applied cognitive behavioral group therapy decreased. No change was observed in the self-compassion levels of the individuals.

There has been limited research conducted on the quality of life (QoL) of children with intellectual disabilities (IDs). We investigated the QoL in children aged 5-18 years with ID and compared the results with healthy children of the same age in this study. The results indicated that the scores of students with ID were lower on all scales and also that children with ID should be supported in all QoL dimensions (physical, social, emotional, and school functioning). Associations between QoL and factors such as the educational level of the mothers, income level of the family, age at diagnosis, age group, and level of ID were examined in the ID group. A diagnosis of ID before the age of 2 was found to have a statistically significant positive effect on QoL scores. Our findings highlight that early diagnosis is the most important measure to improve the QoL of people with ID.

The aim of this study was to investigate health-related quality of life (HRQoL) in children with neurofibromatosis type 1 (NF1) and to determine the factors affecting HRQoL in these children, with particular emphasis on NF1-specific findings and complications. The patient group included 60 NF1 patients aged 3-18 years that were evaluated at our pediatric neurology outpatient clinic between January 2001 and January 2011. The control group included 96 age-matched patients without chronic disease and whose mothers had similar levels of education as the mothers of those in the patient group. All the mothers completed the Pediatric Quality of Life Inventory PedsQoL-Parent Form and the PedsQoL scores in the 2 groups were statistically compared. In addition, the effects of sociodemographic variables, as well as NF1-specific findings and complications (skin findings, neurofibromas, Lisch nodules, arterial hypertension and/or cardiac pathology, short stature, macrocephaly, orthopedic problems, hyperintense lesions on cranial MRI, epileptic seizures, psychiatric disease, and cognitive involvement) were statistically analyzed. All PedsQoL domain scores were lower in the patient group than in the control group (P = 0.0001). HRQoL decreased, and the number of NF1-specific findings and complications increased as age increased in the patient group (P = 0.013). Short stature, neurofibromas and/or plexiform neurofibromas, bone lesions, and psychiatric problems were factors specifically related to low-level HRQoL in the NF1 patients. NF1 negatively affected HRQoL in the patient group. We think that multidisciplinary evaluation and, in particular, psychiatric management of NF1 patients are necessary to improve patient HRQoL.

Behavioral and emotional problems experienced in early childhood may have a major impact on the development and functioning of a child, leading to a number of psychiatric problems at a later age. The purpose of this study was to determine the incidence of psychiatric disorders in 3-5-year-old children presenting to the Outpatients Department and in the general population, and the relationship between psychiatric disorders and the sociodemographic characteristics of the children. This was a cross-sectional study carried out in Kocaeli, Turkey. Data were collected from two different groups, one representing the general population and the other based on children presenting to the Pediatric Psychiatry Outpatients Department at Kocaeli University Faculty of Medicine. Of the 309 children in the study, 187 (60.5%) were boys and 122 (39.5%) were girls. Children aged 3-5 years (n = 81) were assessed by clinical examination. The mean age of the children was 3.94 +/- 0.81 years. No significant difference was observed between the groups in terms of parents' age groups, presence of consanguineous marriage, family structure, and siblings. The mothers were assessed in terms of regular visits to their physicians, major medical conditions, medication use, alcohol or tobacco consumption, and stress factors during their pregnancies. No significant difference was found between the study samples. The presence of a medical problem after birth was significantly more common in the clinical sample. Of the children in the clinical sample, 79% had at least one psychiatric problem, while the ratio for the general population sample was 41.7%.

Ailenin özellikleri, çocuǧun yetersizliǧi veya biyolojik risk faktörleri aile içi örüntüleri etkilemekte, bu özellikler birleşerek çocuǧun gelişiminde belirleyici olmaktadır (Özmen & Çetinkaya, 2012). Engelli bir bebeǧin doǧacaǧını öǧrenme ailede karmaşıklık yaratmakta olup bu durum aile üyelerinin beklentilerini deǧiştirmektedir (Yıldırım-Doǧru & Arslan, 2016). İçinde bulunulan bu olumsuz durumun en asgari düzeye indirilmesi, çocuǧun saǧlıklı gelişiminin ve ailenin ihtiyaçlarının en yüksek düzeyde desteklenmesi aile gereksinimlerinin belirlenmesinin temel amacı olarak ifade edilmektedir (Durualp, Kocabas, Arslan & Özaydın, 2011; Kaytes vd., 2015). Bunun sonucunda aileler kendilerini tehdit altında hissetmekte ve bu durum kendilik algılarını etkilemektedir (Arı vd., 2012; Yıldırım-Doǧru & Arslan, 2016). Ebeveynlerin yaşadıkları bu durum karşısında gereksinimlerinin belirlenmesi ebeveynlerin endişelerini azaltmakta ve çocuklarının gelişimlerine katkı saǧlamaktadır (Dinnebeil, 1999). Annelerin olumsuz olayları eleyerek, yaşantılar arasında baş etmekte güçlük çektiǧi olumsuz olaylarla nasıl baş edebileceǧi konusunda bireylerin durumlar karşısında daha iyi yönde gelişmesine katkıda bulunmak, dayanma gücünü artırmak ve çevredeki dışsal faktörlere karşı önleyici olarak bireylerin olumlu duygulara yönlendirilmesinde sosyal desteǧin teşvik edici olduǧu görülmektedir (House, 1981). Normal gelişim gösteren çocuǧun doǧumu ile birlikte annenin sorumluluklarında ve iş yükünde artış olduǧu bilinmekte, engelli bir çocuǧun doǧumuyla birlikte ise bu sorumluluk ve iş yükü daha da artmaktadır ve bu durum da annenin yaşamını güçleştirmektedir (Atagün, Devrim-Balaban, Atagün, Elagöz & Yılmaz-Özpolat, 2011; Gören, 2015). Bu baǧlamda, çocuǧun içinde yaşadıǧı aile ortamının güçlenmesi ve ailenin çocuǧun yaşamında daha etkin rol almasını saǧlayan aile çalışmaları ve işbirliǧi önemli görülmektedir. Yöntem Araştırma Deseni Nitel araştırma desenlerinden biri olan durum çalışması bu çalışmanın desenini oluşturmaktadır. Durum çalışması; bir veya birden çok durumu ortam, zaman, birey, olay, süreç gibi faktörlerle kendi sınırları içinde bütüncül olarak analiz eder.