Background: This article presents the results of a comprehensive national model developed for managing maladaptive behaviors (MBs) in children with mental special needs (CMSNs) during the coronavirus disease 2019 (COVID-19) pandemic that combines telehealth-based Applied Behavioral Analyses, psychiatric interventions, and support from local psychosocial teams. This study aims to determine the effectiveness of a system that combined telehealth applications with local psychosocial support teams, allowing services from video calls to emergency interventions. Materials and Methods: The system combines the telehealth applications with the services from local psychosocial intervention teams. In addition to system records covering socio-demographic variables and initial complaints, a telephone survey questioning the effectiveness and satisfaction of the system was used as the main outcome. Results: In total, 347 individuals used the system with mothers constituting the majority of applicants (88.7%, n = 332). The overall satisfaction of the system was 8.8/10. In terms of effectiveness, 63.3% (n = 237) of caregivers reported an improvement in the reason of application. Counselors decided on a need for follow-up visits for 36.6% (n = 137) of applications. A referral to a psychiatrist was asked for 40 patients (10.6%). Discussion: To our best knowledge, this is the first study presenting a model for managing MBs of CMSNs during the COVID-19 outbreak. In general, therefore, it seems that there is a need for unique systems to handle behavioral problems of CMSNs. Conclusions: The findings of this study suggest that it is possible to establish an integrative multistep multidisciplinary telehealth-based approach in a short while.

Evidence-based parenting programmes are beneficial for children's behavioural and emotional problems as well as parenting practices. Along with effectiveness, attendance affects the programme outcome and identification of risks associated with dropout may aid in development of special policy to increase engagement. In this study, we aimed to compare sociodemographics, parental attitudes, child behavioural and emotional problems of programme-completing and dropout parents from Level-4 Triple-P parenting programme applied at Child and Adolescent Mental Health Services (CAMHS). We also aimed to determine the attrition rate. In addition, we inquired whether there was a change in parenting styles and child behaviour and emotional problems before and after Level-4 Triple-P for the programme-completing parents at CAMHS. Results displayed that 52% ( n = 58) of the parents who were significantly less educated, used hostile rejecting attitudes, and reported more hyperactive/inattentive behaviour in their children compared to the parents who competed the programme ( p = 0.022, p = 0.016, p = 0.027, respectively) discontinued the programme. Parents who were able to complete the programme ( n = 54) reported a reduction in over-parenting and improvements in children's conduct problems along with overall stress levels before and after Triple-P ( p = 0.009, p = 0.040, p = 0.023). Parents at risk of discontinuing parenting programmes may require special policy to be engaged since these programmes may offer significant benefits for parenting practices and, in turn, children's well-being.

Objective: Many individuals with cigarette addiction are known for beginning to smoke cigarettes during adolescence years. In this study, we aimed to present the clinical outcomes of smoking cessation project conducted in an Anatolian school in Kartal district of Istanbul, Turkey. Methods: Social and motivational studies were carried out on adolescent smokers after scanning in terms of smoking in an Anatolian school and 44 of these adolescents who are clinical requirements were evaluated and followed by Chest disease and child and adolescent mental health for six months. Carbonmonoxide (CO) measurements in the expiratory air and carboximeter (piCO smokerlyzer, Bedfont Scientific Ltd, England) were made at the first visit and follow-up. Simultaneously, K-SADS PL (Schedule for Schizophrenia and Affective disorders for School Age Children) was administered diagnostically in mental health evaluation. Results: A total of 44 adolescents, 13 girl (29.5%) and 31 boy (70.5%), with a mean age of 17.31 were followed up. The mean age of initiation of cigarette smoking was 14.2 ± 1 and 32 (82.7%) adolescent were found to have at least one smoker in their home. While 22.7% of adolescents did not try smoking cessation, 77.3% of them did. Six of these adolescents indicated that they did not smoke during the six months; 55.5% of these adolescents have at least one mental illness; the most common diagnoses were 25.0% (n = 11) of ADHD (Attention Deficit Hyperactivity Disorder) and 20% (10) of MD (Major Depression). While depression was significantly frequent in girls (p = 0.043), the frequency of ADHD was not significant in terms of gender. Depression presence was associated with early onset of cigarette smoking in males (p = 0.019), but not with females (p = 0.394). There was a statistically significant correlation between smoking cessation effort and age in the follow-up period (p = 0.022), and earlier adolescents stated that they wanted to quit smoking more. While there is no significant association between smoking cessation effort and mental disease, there was a statistically close relation with parent and sibling smoking (p = 0.07) and significant correlation with motivation and smoking cessation effort (p = 0.016). Conclusions: Smoking cessation work in adolescents is much more difficult than in adults. Biological and social factors and peer impact influence interventions. In our study, very few adolescents stated to quit smoking for 6 months, and the rate of psychiatric illnesses among adolescents and the presence of individuals smoking at home were found to be quite high. It has been the result of these factors also affecting the success of adolescents to start smoking and to quit smoking.

Bu çalışmada, trikotillomani tanısı alan çocukların aile özellikleri, ebeveyn tutumları ve aile uyumlarının sağlıklı kontrollerle karşılaştırılarak incelenmesi amaçlanmıştır. Yöntem: Çalışmaya saç koparma nedeniyle başvuran 4-12 yaş aralığında 24 çocuk ile aynı hastanelerin farklı polikliniklerine başvuran ve çalışmaya katılmayı kabul eden; yaş ve cinsiyet olarak benzer 54 sağlıklı çocuk ile aileleri katılmıştır. Olgu grubunun hastalık şiddeti Klinik Global İzlenim Ölçeği hastalık şiddeti indeksi (CGI-SI) ile belirlenmiştir. Ailelerin ebeveyn tutumları ve anne baba çocuk uyumları çocuk uyumu ve anne baba yeterlik ölçeği (CAPES-TR) ve anne babalık ve aile uyum ölçeği (PAFAS) ile araştırılmıştır. Bulgular: Trikotillomani olgularının CGI-SI puanı ortalaması 4.00±1.02'dir. Olgu grubunun ebeveynlerinin aile yapısı ve eş ilişkisi kontrol grubundan istatistiksel açıdan anlamlı düzeyde farklıdır (sırasıyla p=0.025, p=0.018). Olgu grubu ebeveynleri PAFAS alt ölçeklerinden zorlayıcı anne babalık, anne baba çocuk ilişkisi, anne baba duygusal uyum ve takım çalışması alanlarında kontrol grubuna göre anlamlı olarak farklıdır (sırasıyla p=0.001, p=0.000, p=0.000, p=0.009). Benzer şeklide CAPES-TR alt ölçeklerinden duygusal ve davranışsal uyum ve ebeveyn öz yeterliliği trikotillomani grubunda kontrol grubuna göre anlamlı düzeyde daha bozuktur (sırasıyla p=0.001, p=0.000, p=0.000). CGI-SI puanları ile PAFAS alt ölçeklerinden zorlayıcı anne babalık, anne baba çocuk ilişkisi, anne baba duygusal uyumu ve takım çalışması ilişkiliyken (sırasıyla p=0.003, p=0.000, p=0.000, p=0.008); CGI-SI ile CAPES-TR alt ölçeklerinden davranışsal ve duygusal uyum ve ebeveyn öz yeterliliği puanları ilişkilidir (sırasıyla p=0.000, p=0.001, p=0.000). Sonuç: Trikotillomani tanısı alan çocuklar ile sağlıklı çocukların aile özellikleri, ebeveyn tutumları ve aile uyumlarının ele alınması, olguların tedavisinde kullanılan ilişkisel ve davranışsal müdahalelere katkı sunabilir.