Yüksel Sümeyra Naralan, Merve Yazıcı, Uğur Tekeoğlu
New Trends in Medicine Sciences - 2025;6(3):77-87
To profile the psychiatric burden, sociodemographic risk factors, supplementary protective interventions, and outpatient follow-up compliance of children and adolescents placed under court-mandated protective health measures in a tertiary child and adolescent psychiatry clinic. This retrospective review covered 138 youths (89 girls, 49 boys) assessed between January 2022 and July 2024 at Recep Tayyip Erdoğan University Training and Research Hospital. Sociodemographic data, reasons for the protective order, prior service use, and follow-up attendance were extracted from medical and social-service records. Psychiatric diagnoses were established through Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) interviews conducted at the index visit. Group differences were analysed with Pearson chi-square or Fisher exact tests; significance was set at p < 0.05. The mean age was 14.4 +/- 4.2 years, and the mean age at first psychiatric evaluation under the health measure was 12.9 +/- 4.0 years. At least one DSM-5 diagnosis was documented in 82.6 % of participants; the most frequent were attention-deficit/hyperactivity disorder (42.0 %), conduct disorders (34.8 %), and mood disorders (26.8 %). Psychotropic medication was prescribed in 73.9 %, predominantly antipsychotics (50.7 %) and antidepressants (42.0 %). Girls had significantly higher rates of sexual abuse, self-harm, suicide attempts, substance use, prior psychiatric contact, current diagnosis, and medication use (p <= 0.043). Provision of in-kind or financial aid was more common in boys (p = 0.017). Regular appointment adherence reached only 62.3 % and was compromised by parental loss or separation, school non-attendance, and psychiatric comorbidity (p <= 0.033). Diagnostic prevalence and medication use rose steadily with age (p <= 0.006). Children and adolescents under protective health measures exhibit an exceptionally high and complex psychiatric load, with service engagement further undermined by gender-specific vulnerabilities, family instability, and educational disruption. Early, gender-sensitive, and integrative care models-augmented by telepsychiatry and "service cascade" approaches-are essential to sustain treatment continuity and mitigate long-term mental-health risks in this vulnerable population.
