Araştırma Çıktıları
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Item 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.Item 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, AynurIntroduction: 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.Item 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, AynurObjective: 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 (ORsItem 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, BengiObjectivesThe 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\%Item 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 EvrenChildren 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.Item 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 EvrenObjective: 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.Item 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 EvrenIn 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.Item Psychiatric comorbidities in cases with Duchenne muscular dystrophy: a case series(YERKURE TANITIM \& YAYINCILIK HIZMETLERI A S, 2019-01-01) Ozer, Urun; Tufan, Ali EvrenDuchenne 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.