Objective: Although it is widely accepted that inpatient psychiatric treatment of children and adolescents is effective, it is also essential to evaluate its effectiveness by assessing the treatment compliance following discharge and the persistence of treatment effects in the long run. The aim of this study is to assess the effectiveness of inpatient treatment provided in one of the rare units in our country via evaluation of the achievement of treatment goals, changes in risk assessment scores, treatment compliance following discharge, and psychological functioning as reflected in the current relationships with the family, peers and school. Methods: This study was conducted in patients who had received at least 2 weeks of inpatient treatment in Dokuz Eylul University Hospital, the Child and Adolescent Mental Health Inpatient Unit between February 2008 and January 2009. Achievement of treatment goals, changes in risk assessment scores, treatment compliance following discharge, and the level of general functioning were assessed 1 year after the discharge. Socio-demographic variables, psychiatric diagnosis, and duration of hospital stay were recorded for each patient. Treatment goals questionnaire, risk assessment procedure, assessment of treatment compliance following discharge, relations with peers, family and school, and general functioning were assessed with the The Children's Global Assessment Scale (CGAS). Results: Forty-six patients with a mean (Standard Deviation, SD) age of 16.2 (1.6) years were included in the study. It was observed that 84.7% of patients had good compliance with the outpatient treatment plans. The mean (SD) CGAS scores calculated at admission, discharge and 1 year following the inpatient treatment were 40.6 (8.8), 60.7 (9.0) and 65.1 (1.7), respectively. The change in CGAS scores was found to be statistically significant (p=0.000). Additionally, the risk assessment scores were significantly lower 1 year following the discharge (p=0.000). Conclusion: Data obtained from the study display that the inpatient treatment of children and adolescents showed marked improvements in their psychiatric morbidities, peer, family and school functioning and outpatient treatment compliance. These findings could indicate the necessity of establishing and improving child and adolescent inpatient units in our country. (Archives of Neuropsychiatry 2010; 47: 319-23)

ÖZET Amaç:Bebek kayb› ile oluflan komplike yas, hem anne hem de sonraki kuflaklar için olumsuz sonuçlar› olan, ruhsal hastal›klar aç›s›ndan incinebilirli¤i artt›ran bir durumdur Bu çal›flma, yavru kay›plar›n›n difli s›çanlara etkilerini ve bir sonraki jenerasyon için do¤urabilece¤i sonuçlar› araflt›rmay› amaçlayan bir hayvan modeli çal›flmas›d›r. Yöntemler: Primipar Sprague-Dawley s›çanlar› ayr›lma-birleflme grubu, tam ayr›l›k grubu ve ayr›l›k yaflamayan kontrol grubu olarak gruplanm›flt›r. Ayr›lmay›, birleflmeyi ve bir sonraki yavrular›n do¤umunu izleyen süreçlerde annelik davran›fllar› gözlenmifl, kan kortikosteron düzeyleri ölçülmüfltür. Gruplar›n ikinci kuflak yavrular›n ö¤renmeleri, aktivite düzeyleri, anksiyete durumlar› ve psikojenik stresöre maruziyetin ard›ndan kan kortikosteron düzeyleri incelenmifltir. Bulgular: Yavrular›ndan ayr›l›p, tekrar birleflen s›çanlar›n birleflmeyi takiben yuvada anlaml› olarak daha fazla zaman geçirdikleri ve ikinci kuflak yavrular›n› an-laml› düzeyde daha fazla yalad›klar› görülmüfltür. Bu grubun kontrol grubunda gözlenen ikinci kuflak yavrular› emzirme süresindeki anlaml› art›fl› göstermedi¤i saptanm›flt›r. Anne s›çanlar›n kan kortikosteron düzeyleri yavrulardan ayr›lma ve birleflme sonras› anlaml› olarak etkilenmifltir. Erken yavru kayb› yaflayan annelerin sonraki kuflak yavrular›nda kontrol grubuyla karfl›laflt›r›ld›¤›nda anlaml› düzeyde daha fazla biliflsel bozulma saptanm›flt›r. Sonuç: Hayvan modellerinde kay›p süreçlerinin çal›fl›lmaya devam edilmesinin yas sürecindeki anneler ve bebekleri için klinik de¤eri olabilir. (Nöropsikiyatri Arflivi 2011; 48: 44-52) Anahtar kelimeler: Komplike yas, yavru kayb›, annelik davran›fl›, kan kortikosteron düzeyi, ö¤renme ABSTRACT Objective: Loss of a baby accompanied by complicated grief increases vulnerability to mental disease with adverse consequences both for the mother and the long-term well-being of the subsequent generations. This study presents an animal model and aims to study the reactions of female rats to the loss of their litters and the consequences for the next litter. Methods: Primiparious Sprague-Dawley rats were recruited into three groups: of separation-reunion, complete separation and no-separation. Maternal behaviors following separation, reunion and the birth of the subsequent litter were observed. The blood corticosterone levels of the dams in response to separation and reunion were measured. Learning, activity, anxiety and blood corticosterone response to stress of the second litters were evaluated. Results: Dams in the separation group spent significantly more time at the nest following reunion, displayed increased pup licking in their second litters compared to their first litters and did not achieve the increased duration of nursing in their second generation litters as observed for the control group. Dams' blood corticosterone levels were significantly influenced by separation and reunion. Pups born to mothers that have experienced an early loss of their previous litters had significantly impaired cogni...