Browsing by Author "Tufan, Ali Evren"

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Abdominal epilepsy mimicking conversion disorder: a case report
(TAYLOR \& FRANCIS LTD, 2019-01-01) Ozturk, Yusuf; Gol, Gueler; Savci, Ugur; Cansiz, Mehmet Akif; Tufan, Ali Evren
In children and adolescents, especially younger ones, recurrent abdominal pains may develop as a response to psychosocial stressors. They may be considered as functional and be one of the common reasons for clinical referrals. A rare cause of recurrent, organic abdominal pain is abdominal epilepsy. Abdominal epilepsy may be considered in differential diagnosis of patients that were thought to have functional complaints. In this case, a 16-year-old adolescent girl whose chief complaints included loss of consciousness and recurrent abdominal pains lasting for a year is presented.
Comparison of serum B12, folate and homocysteine concentrations in children with autism spectrum disorder or attention deficit hyperactivity disorder and healthy controls
(DOVE MEDICAL PRESS LTD, 2019-01-01) Yektas, Cigdem; Alpay, Merve; Tufan, Ali Evren
Objective: We aimed to investigate the serum concentrations of vitamin B12, folate and homocysteine in children diagnosed with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) and healthy controls. Materials and methods: Serum vitamin B12, folate and homocysteine concentrations were measured in 118 children (48 children diagnosed with ADHD, 35 children diagnosed with ASD and 35 healthy controls). Symptom severity in the ADHD and ASD groups was evaluated by the Childhood Autism Rating Scale and Turgay-DSM-1V-Based Screening and Assessment Scale for Disruptive Behavior Disorders. Multivariate analysis of covariance was used to evaluate the effects of diagnosis and gender on biochemical parameters. Results: The ADHD and ASD groups and the healthy controls differed significantly regarding vitamin B12 and homocysteine concentrations, but not folate levels. Patients with ASD had the lowest vitamin B12 and the highest homocysteine levels. Vitamin B12 levels correlated negatively with hyperactivity and/orimpulsivity and oppositionality symptoms in children with ADHD. There were no relationships between psychometric evaluations and laboratory measurements in children with ASD. Gender did not affect vitamin concentrations. Conclusion: Previous studies found that vitamin B12 was reduced while homocysteine was elevated among patients with ADHD and ASDs. Our results also support those reported previously. Oppositionality and hyperactivity and/orimpulsivity may be related to vitamin B12 and homocysteine levels in children with ADHD. Further studies are required to define the role of these parameters and effects on the etiology and clinical manifestations of ASD and ADHD.
Imipramine-induced mania in a child diagnosed with attention-deficit/hyperactivity disorder (ADHD): a case report
(TAYLOR \& FRANCIS LTD, 2018-01-01) Yektas, Cigdem; Tufan, Ali Evren
Children and adolescents treated with antidepressants (ADs) are at higher risk for developing hypomania and mania compared with adults. It was suggested that AD-induced mania represent a predisposition to bipolar disorder (BD) so it may accelerate the course of BD in this risky population. According to the literature, susceptibility to manic conversion with the use of ADs is higher in BD patients treated with tricyclic ADs compared with selective serotonin reuptake inhibitors (SSRIs) and placebo. Here, we report a six-year-old girl who was diagnosed with attention-deficit/hyperactivity disorder (ADHD) and primary nocturnal enuresis who developed manic symptoms after imipramine treatment. While using tricyclic antidepressants or SSRIs for different indications in the paediatric population, clinicians should be alert for the manic switch or behavioural activation symptoms, which may show a bipolar predisposition.
Iron and Ferritin Levels of Children and Adolescents with Attention Deficit Hyperactivity Disorder and Attention Deficit Hyperactivity Disorder-Not Otherwise Specified
(GALENOS PUBL HOUSE, 2020-01-01) Ozturk, Yusuf; Topal, Zehra; Demir, Nuran; Tufan, Ali Evren
Aim: The study aimed to compare the levels of iron and ferritin in children with Attention Deficit Hyperactivity Disorder (ADHD) and Attention-Deficit Hyperactivity Disorder-Not Otherwise Specified (ADHD-NOS) and to assess the relationship between ADHD symptom severity and anxiety symptom severity with iron and ferritin levels. Materials and Methods: This study was planned as a cross-sectional, retrospective study. The study was performed by scanning the records of patients who applied to our clinic between January 2012 and January 2013. Accordingly, 205 ADHD and ADHD-NOS case records were evaluated. Patients were diagnosed clinically according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) criteria. ADHD symptom severity was assessed by the Turgay DSM-IV-TR-Based Child and Adolescent Behavior Disorders Screening and Rating scale. Anxiety symptom severity was assessed by The Screen for Anxiety Related Emotional Disorders. Results: Among the whole sample, 99 (48.3\%) patients had ADHD and 106 (51.7\%) had ADHD-NOS. In the ADHD group, the average age of the children was 10.88 +/- 3.02 years, while that of the children in the ADHD-NOS group was 9.93 +/- 2.49 years. Iron and ferritin were measured in 81 of the 205 patients participating in the study. There was no statistically significant difference between the two groups in terms of iron or ferritin levels (p>0.05). Statistically significant negative correlations between ADHD hyperactivity symptom severity and iron levels, and ADHD attention deficit symptom severity and ferritin levels were found. Ferritin levels correlated statistically with the total number of psychiatric diagnoses in the children. Conclusion: Iron and ferritin levels may be differentially affected in children with ADHD. The results we obtained from our study should be supported by studies with larger samples.
Is Functional Improvement Always Correlated with Symptomatic Improvement in Children with Attention-Deficit/Hyperactivity Disorder Managed with Oros Methylphenidate? A Prospective Open-Label Naturalistic Follow-Up Study
(AVES, 2020-01-01) Tarakcioglu, Mahmut Cem; Caliskan, Yasin; Kadak, Muhammed Tayyib; Aliyev, Nilufer Okumus; Aksoy, Umut Mert; Tufan, Ali Evren; Gundogdu, Ozlem Yildiz; Memik, Nursu Cakin; Weiss, Margaret D.
Background: To investigate the relationship between symptomatic improvement and functional improvement in children with attention deficit hyperactivity disorder (ADHD) who were being treated with OROS methylphenidate. Methods: Parents evaluated the severity of ADHD symptoms on the Turgay-DSM-IV ADHD/Disruptive Behavior Disorders Scale (T-DSM-IV). They assessed functioning on the Weiss Functional Impairment Rating Scale - Parent Form (WFIRS-P), and the Pediatric Quality of Life Inventory (PedsQL) was used to assess quality of life. Clinicians rated global outcome on the Clinical Global Impressions Scale (CGI). Response was measured in terms of the following criteria: a 20\% change in symptoms, a CGI-I score that was much improved (2) or very much improved (1), or an improvement of 0.25 (the minimally important difference) on the WFIRS. Improvement in quality of life was defined as >= 20\% change in PedsQL score. Results: Sixty-three children completed the study. After 12 weeks, 77.7\% of patients met the a priori criteria for treatment response rate. Among patients who exhibited improvement in symptoms, 42.9\% also showed improved functioning. Among those who showed improved functioning, 95.5\% showed improvement in symptoms. Of patients who showed improvement in symptoms, 34.6\% percent also showed improvement in quality of life. Of those who showed improvement in quality of life, 94.4\% also showed improvement in symptoms. Conclusions: Evaluation of changes in functional improvement, quality of life improvement, and symptom improvement during ADHD treatment enables clinicians to identify individuals whose functional impairment/quality of life persists despite symptom improvement. On that basis, additional treatment interventions can be organized for those individuals.
Psychiatric comorbidities in cases with Duchenne muscular dystrophy: a case series
(YERKURE TANITIM \& YAYINCILIK HIZMETLERI A S, 2019-01-01) Ozer, Urun; Tufan, Ali Evren
Duchenne muscular dystrophy is a hereditary multisystem disease caused by mutations in the dystrophin gene, characterized by proximal muscle weakness in early childhood, generally resulting in death before the age of 20 years. Cognitive and neurobehavioral changes are prevalent in Duchenne muscular dystrophy. Furthermore, psychiatric disorders have been reported. Here we present 12 cases with Duchenne muscular dystrophy, aiming to address psychiatric comorbidities and to examine anxiety and depression levels as well as the quality of life in these cases. Twelve inpatients with Duchenne muscular dystrophy were followed, according to their ages, by an adult psychiatrist or a child and adolescent psychiatrist. Psychiatric examination and detailed psychiatric and medical history-taking were performed. The Hospital Anxiety and Depression Scale (HADS) and the KINDL Questionnaire were administered and family interviews conducted. In 5 cases, comorbid psychiatric diagnoses were present, including depression, obsessive compulsive disorder, and generalized anxiety disorder. Anxiety levels according to the HADS were higher than threshold level in two cases. Alongside cognitive and neurobehavioral changes, psychiatric comorbidities such as depression, obsessive compulsive disorder, or generalized anxiety disorder might be seen in Duchenne muscular dystrophy, as was the case with our patients. At the same time, due to the chronic illness process and disability involved, psychosocial support is needed both for the patient and the family. Therefore, it is important that psychiatry should be part of a holistic treatment approach and that psychiatric support should be provided right from the first years in these cases.
Relationships Between Theory of Mind (ToM) and Attachment Properties in Adolescent with Social Axiety Disorder
(TURKISH NEUROPSYCHIATRY ASSOC-TURK NOROPSIKIYATRI DERNEGI, 2020-01-01) Ozturk, Yusuf; Ozyurt, Gonca; Turan, Serkan; Mutlu, Caner; Tufan, Ali Evren; Pekcanlar Akay, Aynur
Introduction: Studies have suggested that attachment styles are associated with social anxiety disorder (SAD). Recent studies found that individuals with a diagnosis of SAD were significantly impaired relative to healthy controls on tasks of theory of mind (ToM). We aimed to investigate the association of ToM and attachment styles in adolescents diagnosed with SAD in this study. Methods: Drug-naive 42 adolescents diagnosed with SAD and aged between 12 to 18, without psychiatric comorbidity were enrolled in the patient group. Forty-two adolescents in the same age range without any psychiatric disorders were matched as the healthy control group. The diagnosis was made by experienced clinicians using the Kiddie and Young Adult Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version and diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. The severity of SAD symptoms was evaluated with the Social Anxiety Scale for Adolescents. ToM was evaluated with Reading the Mind in the Eyes task and faces test. Parent and Peer Attachment Inventory was used for assessing attachment properties. Results: Adolescents with SAD compared to healthy control groups have more difficulties both in Reading the Mind in the Eyes task and faces test. We found a statistically significant decrease in peer and parent attachment scores when compared with SAD and healthy controls (p<0.05). A negative correlation between the severity of SAD and both ToM tasks and attachment has been found. Conclusions: The results of this study indicate that ToM deficits arid insecure attachment style may play an important role in the etiology and treatment of SAD in adolescents.
Relationships between Vitamin B12, Folate Levels and Clinical Features in Attention Deficit Hyperactivity Disorder and Attention Deficit Hyperactivity Disorder-Not Otherwise Specified
(GALENOS PUBL HOUSE, 2020-01-01) Ozturk, Yusuf; Topal, Zehra; Demir, Nuran; Tufan, Ali Evren
Aim: In this study, we aimed to compare the levels of vitamin 812 and folate in children with Attention Deficit and Hyperactivity Disorder (ADHD) and Attention Deficit and Hyperactivity Disorder-Not Otherwise Specified (ADHD-NOS). Materials and Methods: This study was planned as a cross-sectional, retrospective study. Patients were recruited between January 2012 and January 2013 and 205 case records were evaluated. The ADHD and ADHA-NOS groups were compared according to vitamin B12 and folate levels. Symptom severity was evaluated by the Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating scale. Anxiety symptom severity was assessed by The Screen for Anxiety Related Emotional Disorders. Results: The average age of the children in the ADHD group was 10.88 +/- 3.02 (n=99) years, and the average age of the children in the ADHD-NOS group was 9.93 +/- 2.49 (n=106) years. There was no statistically significant difference between two groups in terms of Vitamin B12 level and folate level (p>0.05). A statistically significant negative correlation between the total number of diagnoses of a child and vitamin 812 levels was found. Folate levels correlated significantly with anxiety total scores generalized anxiety subscale. Conclusion: Vitamin B12 levels may be affected in children with impairing ADHD symptoms and increased comorbidities. The results of the study should be supported by future studies.
Retrospective Analysis of Demographic, Epidemiologic, and Clinical Characteristics of Poisoning in Pediatric Intensive Care Unit
(BEZMIALEM VAKIF UNIV, 2020-01-01) Sik, Guntulu; Demirbuga, Asuman; Annayev, Agageldi; Deliceo, Elif; Tufan, Ali Evren; Citak, Agop
Objective: Poisonings are significant causes of preventable morbidities and mortalities in pediatric patients hospitalized in pediatric intensive care units. In this study, we aimed to evaluate demographic and epidemiologic features, interventions, treatments, clinical course, and prognosis of patients hospitalized in pediatric intensive care unit for poisoning retrospectively. Methods: The recordings of 172 patients admitted to the pediatric intensive care unit with acute poisoning between 2015 and 2019 were evaluated retrospectively. Results: A total of 172 patients were admitted to our pediatric intensive care unit with the diagnosis of poisoning. Eighty-eight of them (51.2\%) were girl. The average age was 5.8 +/- 5.6 years, and mean length of stay was 2.9 days. It was noted that 72.1\% of patients with poisoning were accidental, whereas 27.9\% of them were suicidal. Majority of suicidal patients were girls (89.5\%), and the mean age was 13.1 +/- 4.9 years. However, only 36.2\% of patients with accidental poisoning were girls and the mean age was 3.1 +/- 2.6 years. Patients with poisoning were most commonly seen during spring. The most common cause of poisoning was drugs (76.7\%). Poisoning with multiple drugs were seen in 36 patients (20.9\%). Central nervous system drugs were the most common cause (32.7\%). Nausea-vomiting (17.4\%), altered mental status (12.7\%), and abdominal pain (7.5\%) were the most common symptoms. Thirteen patients required invasive mechanical ventilation. Five patients were treated with hemodialysis and eight patients treated with plasma exchange. Conclusion: Poisonings are important part of pediatric intensive care unit hospitalization. Accidental poisoning is common especially in children under five years of age. Taking preventive measures, educating parents about home accidents, storing medications in safe and locked places and keeping them out of reach of children can reduce the rate of accidental poisoning.
Screening results of psychomotor development of children at inpatient unit of a training hospital in Turkey
(CUKUROVA UNIV, FAC MEDICINE, 2019-01-01) Kutuk, Meryem Ozlem; Gokcen, Cem; Aksu, Gulen Guler; Akin, Fatih; Kardas, Aysenur; Sarp, Ayse Sevde; Tufan, Ali Evren
Purpose: This study aimed to assess the psychomotor development of inpatient children in the pediatrics clinic and referring the children who have problems. Materials and Methods: Four hundred twenty children between 4-72 months at inpatient unit of the department of Pediatrics at Konya State Research hospital were included in the present study. A child development specialist who was unaware of the history and neurological examination of the cases administered Denver developmental screening test (DDST) II to all children once. Children who were found to be abnormal or questionable were further evaluated by the child and adolescent psychiatrist. Results: Three hundred forty five (82\%) were found to be `normal', 12 (2.8\%) were found to be `questionable' and 64 (15.2\%) cases were found to be `abnormal' with regard to DDST II. Post evaluation of questionable and abnormal cases by the child and adolescent psychiatrist, 26 cases were referred to special education institutions with the diagnosis of global developmental delay and 2 cases with the diagnosis of pervasive developmental disorder. Conclusion: It is important to apply screening tests for developmental evaluation to each child at inpatient pediatric clinics in order to diagnose developmental delays earlier.
Syrian Civil War?s effects on Turkish school children: prevalence and predictors of psychopathology
(AVES, 2019-01-01) Tabur, Sinem; Tufan, Ali Evren; Ceri, Veysi; Semerci, Bengi
ObjectivesThe Syrian Civil War forced millions into asylum in neighbouring countries. Refugees/asylum seekers have elevated risk for psychopathology with the most important being post-traumatic stress disorder (PTSD). Subjective experiences and symptoms of the hosting populations which have also experienced similar traumas have received relatively little attention up to now. We aimed to evaluate the effects of Syrian Civil War in terms of psychopathology, traumatic experiences and PTSD on Turkish primary school students living in Suru? which is on the border with Syria and hosts a large population of asylum seekers.MethodsTwo randomly selected schools operating in the district were included in the study. Sociodemographic Data forms, Child Behaviour Checklist (CBCL), Children?s Post-traumatic Reaction Index (CPRI) were used for evaluations. Data were analysed with SPSS 23.0. P was set at 0.05 (two-tailed).ResultsMost common traumatic experiences via parental report were witnessing explosions (26.9\%), witnessing injuries of extended family/relatives (21.8\%) and witnessing deaths of acquaintances (17.9\%). Lifetime traumatic events and lifetime self-injurious behaviour in children via parental report were 26.9\% and 19.9\%
The close relation of tic disorders with childhood migraine and atopic background of both children and mothers
(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2020-01-01) Aksu, Gulen Guler; Kutuk, Meryem Ozlem; Tufan, Ali Evren; Toros, Fevziye; Uluduz, Derya; Ozge, Aynur
Objective: This study aimed to evaluate primary headache disorders and other causative comorbidities (e.g., epilepsy, atopic disorders, recurrent abdominal pain, motion sickness, and headache) in children with tic disorders (TDs) and their mothers. Materials and Methods: In a multi-center, cross-sectional, familial association study using case-control design, youth (between 7 and 17 years) with TDs (TD, as per Diagnostic and Statistical Manual of Mental Disorders-5 criteria) and age- and sex-matched healthy controls and their mothers were evaluated in the aspect of functional syndromes spectrum including migraine, epilepsy, atopic disorders, motion sickness, and recurrent abdominal pain. Results: Seventy-nine youth with TD and 101 controls were included. Causative comorbidities, other than epilepsy and motion sickness were more common in children with TD with an odds ratio (OR) of 2.1 (atopy) and 3.9 (food allergy). Specifically, recurrent abdominal pain and migraine were found in 36.7\% and 31.7\% of children (vs. 18.8\% and 16.8\% of controls, ORs 2.5 and 2.3, respectively). Mothers of youth with TDs also have higher rates of atopy, drug allergy and allergic dermatitis (ORs