Ayse Kutlu - Academia.edu (original) (raw)
Papers by Ayse Kutlu
Archives of Iranian Medicine, 2023
Rhabdomyolysis is a rare serious side effect of antipsychotic medication use. There are cases of ... more Rhabdomyolysis is a rare serious side effect of antipsychotic medication use. There are cases of rhabdomyolysis due to the use of clozapine, risperidone, olanzapine, and haloperidol in the literature. In this report, we describe a rhabdomyolysis case developed on the 13th day of using 2.5 mg /day aripiprazole in a 17-year-old male patient with a diagnosis of somatic symptom disorder. This case is one of the youngest in the literature to develop rhabdomyolysis after the use of aripiprazole. Moreover, this case is distinguished from the others with its low-dose, short-term and single antipsychotic use. In the child and adolescent age group, routine blood tests should be done before starting medication. Symptoms that appear to be nonspecific and that may be overlooked or may be thought to be caused by an existing psychiatric complaint should be carefully and thoroughly considered during follow-up.
Journal of Dr. Behcet Uz Children s Hospital, 2021
Objective: Alopecia areata (AA); is a sudden onset, non-scaring hair loss. Twenty percent of case... more Objective: Alopecia areata (AA); is a sudden onset, non-scaring hair loss. Twenty percent of cases are children.Although it is thought to be related to genetic predisposition, inflammation, immunological processes or psychological triggers, its pathophysiology is still not fully understood. This study was planned to investigate the levels of serum 25-hydroxy vitamin D, vitamin B12, thyroid-stimulating hormone (TSH) and free T4 FT4) in children with AA and compare the results with age-matched healthy individuals. Methods: A retrospective medical record review was carried out in an outpatient dermatology clinic in a tertiary medical center between January 1,2013 and December 31, 2017. The study included 520 patients (ages 0-18 years) who received a clinical diagnosis of AA.106 patients with AA met the inclusion criteria.Patients in the control group (n=106) were selected among children aged 0-18 years without any medical and/or psychiatric diagnosis. Both past medical and family medic...
Journal of Dr Behcet Uz Children s Hospital, 2019
Narcolepsy is a chronic disorder that might cause severe morbidity and functional deterioration w... more Narcolepsy is a chronic disorder that might cause severe morbidity and functional deterioration with a wide range of complicated symptoms and without any clearly identified etiology. The condition is even more difficult to diagnose in children as clinical picture and clusters of symptoms that vary extremely. With this report, we aimed to present, and discuss an 11-year-old case diagnosed with narcolepsy in a child psychiatry unit along with relevant literature. Psychiatric assessment of the case that applied to our child psychiatry unit was carried out by using Diagnostic and Statistical Manual of Mental Disorders 5 th edition (DSM-5) criteria. Detailed clinical examination, neurological tests and imaging modalities as well as polysomnography were performed. The case was diagnosed,and followed up as having narcolepsy after completion of processes of evaluation, and differential diagnosis. She demonstrated clinical improvement with a combined treatment regimen of methylphenydate-OROS and behavioral therapy for sleep pattern and hygiene. She is still being followed up in our unit. Since narcolepsy is a rarely seen condition encountered in child psychiatry settings and symptoms might mimic other neurological and psychiatric conditions, its earlier recognition is a remote possibility. Therefore, we believe that we, as child psychiatrists, need to bear this disorder in our minds for differential diagnosis. Since current treatment options mainly target visible symptoms, developing novel treatment strategies directed towards underlying etiology will carry importance. In that sense, we believe that increasing the number of case studies and clinical researches in this understudied field of child psychiatry shall contribute greatly to more improved understanding of the disorder.
Journal of Contemporary Medicine, 2018
Pediatric practice and research, Dec 25, 2020
Amaç: Düzenli immün süpresif kullanmak zorunda olan renal transplant olguları, Covid-19 salgını d... more Amaç: Düzenli immün süpresif kullanmak zorunda olan renal transplant olguları, Covid-19 salgını döneminde tedavilerini aksatabilir ve bu durum organ reddine neden olabilir. Bu çalışmada, COVİD-19 salgınında renal transplantlı hastaların kaygı düzeylerinin ve psikolojik dayanıklılıklarının sağlıkla ilgili davranışlarına etkisi araştırılmıştır. Gereç ve Yöntem: Kliniğimizde kronik böbrek hastalığı tanısı alıp, böbrek nakline verilen 39 böbrek nakilli olgu çalışmaya alınmıştır. Haziran 2020-Eylül 2020 tarihleri arasında, salgın ile ilgili kaygı düzeylerini ve psikolojik sağlamlılık düzeylerini ölçen ölçekler ve sağlık ile ilgili davranışlarının sorgulandığı sorulardan oluşan online google anket formu hazırlanmıştır. Bulgular: Anksiyete ölçeğine göre anksiyetesi olmayan hiçbir hasta yoktu, 24 hastada (%61) ılımlı kaygı, 8 hastada (%20) orta kaygı ve 7 hastada (%18) ciddi kaygı düzeyi saptandı. Kaygı ve dayanıklılık ölçekleri primer hastalığa, cinsiyete, sosyo-ekonomik veya demografik verilere göre anlamlı farklılık göstermemekteydi. Tek istatistiki farklılık salgın konusunda profesyonellerden bilgi alanların anksiyete ölçek ortalamalarının, salgın konusunda profesyonellerden bilgi almayanlardan daha yüksek olduğu idi (p=0,045). Sonuç: İçinde bulunduğumuz salgın gibi olağanüstü durum ve dönemlerde böbrek nakilli hastalar gibi özellikli ve riskli hasta gruplarına koruyucu, önleyici ve tedavi edici tele-tıp uygulamalarının öncelikli olarak gündeme alınmasıdır.
Psychiatry and Clinical Psychopharmacology, 2018
Objective: Smith and Burger developed the Structured Inventory of Malingered Symptomatology (SIMS... more Objective: Smith and Burger developed the Structured Inventory of Malingered Symptomatology (SIMS) in 1997 as a self-report measure for malingering of psychiatric symptoms. The SIMS consists of 75 dichotomous (True-False) items that form into five subscales Psychosis (P), Neurologic Impairment (NI), Affective Disorder (AF), Amnestic Disorders (AM), Low Intelligence (LI), with each subscale containing 15 items. In this study, we aimed to examine the reliability, validity, and factor structure of the SIMS in a Turkish forensic psychiatry sample. Methods: A sample of 103 forensic patients (9 female, 94 male), aged 18-75, undergoing an inpatient forensic evaluations for competency assessment for criminal responsibility were recruited from a large forensic hospital in Turkey. The study protocol was approved by the local ethics committee. Socio-demographic information of the participants was collected and the SIMS, Miller Forensic Assessment of Symptoms Test (M-FAST), the Scales of Psychological Well-being, 36-Item Short Form Survey (SF-36), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered. All statistical analyses were performed by using SPSS version 23.0 for Windows. Results: The Cronbach's alpha coefficients for the Turkish SIMS were ranging from 0.42 to 0.87. The lowest alpha coefficient was observed for the Amnestic Disorders (0.46). For the whole scale, Cronbach's alpha coefficient was found to be 0.93. The test-retest (at after 1 week) correlation coefficients for Psychosis (P), Neurologic Impairment (NI), Affective Disorder (AF), Amnestic Disorders (AM), Low Intelligence (LI), and whole scale were found to be 0.97, 0.97, 0.95, 0.91, and 0.96, respectively. A positive and statistically significant correlation was found between the Turkish SIMS and BDI (r = 0.593, p < .
Psychiatry and Clinical Psychopharmacology, 2018
BACKGROUND: Vitiligo is a chronic skin condition among psychocutaneous diseases that significantl... more BACKGROUND: Vitiligo is a chronic skin condition among psychocutaneous diseases that significantly affect psychiatric well-being of patients, social interactions, and overall quality of life. Only a limited number of studies about psychiatric well-being and quality of life in children with vitiligo and their parents are available. AIMS: With this study, we aimed to assess anxiety, depression, and quality of life in children diagnosed with vitiligo and their parents. METHODS AND MATERIAL: Forty-one vitiligo patients aged 9-16 years 30 healthy controls along with their parents were asked to fill out self-report forms that assessed quality of life (Pediatric Quality of Life Inventory-Child Form; PedsQL-C and Pediatric Quality of Life Inventory-Parent Form; PedsQL-P), anxiety (State-Trait Anxiety Inventory-STAI-C for children and Beck Anxiety Inventory-BAI for parents), and depression (Children's Depression Inventory-CDI and Beck Depression Inventory-BDI for parents). RESULTS: Between groups, significant differences were found in PedsQL-C subscales measuring school functioning, psychosocial health, and overall quality of life. Regarding PedsQL-P scores, there was a significant difference in physical functioning, social functioning, and overall quality of life. No statistical significance was found between groups regarding CDI and STAI-C scores. There was a significant difference in BDI, with higher scores in parents of children with vitiligo. CONCLUSIONS: We believe measuring life quality with standardized instruments and techniques would be important in the assessment of the patient to evaluate the efficacy of treatment, specifically in chronic disorders. Further studies addressing these issues, especially in children, adolescents, and their parents are warranted.
Anatolian Journal of Psychiatry, 2018
Objective: Although autism spectrum disorder (ASD) is one of the most studied neurodevelopmental ... more Objective: Although autism spectrum disorder (ASD) is one of the most studied neurodevelopmental disorders, its etiology has not been fully elucidated. A growing body of evidence suggest the role of neuroinflammation in the etiology of ASD. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are markers of systemic inflammation. In this study, we aimed to evaluate NLR and PLR in children with ASD comparison to healthy controls. Methods: We reviewed the medical files of children with ASD in the ages of 2 to 5. The ASD group were consisted of drug-naïve 64 children who had complete blood count within a month of assessment. Age and sex matched 64 healthy children without any psychiatric disorders were recruited from the healthy child outpatient unit of the hospital. Results: NLRs were significantly higher in ASD. Children with ASD had significantly higher neutrophil counts but lower platelet and lymphocyte counts compared to those of healthy controls. NLR was found to be a predictor of ASD. Conclusions: Increased NLRs support the hypothesis of the involvement of neuroinflammation in the underlying physiopathology of ASD. Even though recent evidence is not enough to suggest that in young children increased NLR levels may be used as screening and early intervention predictor, it should be kept in mind and may inspire new studies. Further longitudinal studies with larger sample size and homogeneous groups regarding the age and subtypes may clarify the inflammatory involvement in ASD.
Psychiatry and Clinical Psychopharmacology, 2017
Melatonin is an indoleamine often used in children and adolescents. Melatonin is considered to be... more Melatonin is an indoleamine often used in children and adolescents. Melatonin is considered to be an effective clinical management for dyssomnias, sleep disorders present in children with attention-deficit hyperactivity, autism spectrum disorders, developmental delays. Quickacting capsules, controlled-release (CR) capsules, sublingual tablets and liquid forms are available. Melatonin is generally very well-tolerated in children and adolescents. The pharmacology, therapeutic applications, and side effects of melatonin are discussed.
Psychiatry and Clinical Psychopharmacology, 2018
Objective: Many individuals with cigarette addiction are known for beginning to smoke cigarettes ... more 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.
Journal of Dr Behcet Uz Children s Hospital, 2016
Alopesi areata (AA) tanılı çocuk ve ergenlerde aile işlevselliği, psikopatoloji ve yaşam kalitesi... more Alopesi areata (AA) tanılı çocuk ve ergenlerde aile işlevselliği, psikopatoloji ve yaşam kalitesini belirlemek sosyodemografik ve hastalık ile ilgili değişkenlerle ilişkisini araştırmaktır. Yöntem: İki-18 yaş arasındaki 45 hasta retrospektif olarak incelendi. Aile Değerlendirme Ölçeği (ADÖ), Çocuklar ve Gençler İçin Yaşam Kalitesi Ölçeği (ÇYKÖ), Çocuklar için Depresyon Ölçeği (ÇDÖ) ile Sosyodemografik veri formu kullanılmıştır. İstatistiksel analizde SPSS 18.0 programı kullanılmıştır. Bulgular: Çalışma grubunun yaş ortalaması 9.22±3.79 yıldır ve %55.6'sı kadındır. Tüm olgu grubunda ADÖ gereken ilgiyi gösterme ve davranış kontrolü alt ölçeklerinde sorun olduğu belirlenmiştir (>2). Olguların %42.2'si en az bir psikiyatrik tanı almıştır. Psikiyatrik komorbidite varlığı; depresyon, ADÖ genel işlevler, Ebeveyn yaşam kalitesi psikososyal sağlık, çocuk yaşam kalitesinde de tüm alanlarda bozulmaya neden olmuştur. Olguların %51.1'inde psikososyal tetikleyici olay tespit edilmiştir. Ama tetikleyici olay saptanmayan olgularda ÇDÖ ve ÇYKÖ tüm alanlarda anlamlı düzeyde bozulmuştur (p<0.05). Lezyon yaygınlığı yalnızca, atak sayısı ve hastalık süresi ile pozitif yönde ilişkili bulunmuştur. Sonuç: AA hastalarında aile işlevselliği gereken ilgiyi gösterme ve davranış kontrolü alanlarında bozuktur. Psikososyal tetikleyici olaylar AA'da sık olmasına rağmen psikopatoloji, yaşam kalitesi ve aile işlevselliği ile ilişkili olmayabilir. Psikiyatrik komorbidite yaşam kalitesini en fazla bozan faktör olmuştur.
Journal of Dr Behcet Uz Children s Hospital, 2017
Amaç: 1 Ocak-31 Aralık 2016 tarihleri arasında okul öncesi dönem çocuklarda Dikkat Eksikliği Hipe... more Amaç: 1 Ocak-31 Aralık 2016 tarihleri arasında okul öncesi dönem çocuklarda Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) prevalansı ve ilaç kullanım sıklığını araştırmak. Yöntem: Çocuk ve Ergen Ruh Sağlığı ve hastalıkları polikliniklerine başvuran ve ICD-10 tanı kriterlerine göre DEHB tanısı konan 36-60 ay yaş aralığındaki çocukları dosyaları taranmıştır. Mental retardasyon, duygudurum bozuklukları, anksiyete bozuklukları, otizm spektrum bozuklukları, kronik tıbbi hastalık ve dosyalarda eksik veri olan çocuklar çalışma dışında bırakılmıştır. Bulgular: 218 DEHB tanılı okul öncesi çocuk çalışma grubunu oluşturmuştur. DEHB prevalansı okul öncesi çocuklarda %7,8'dir. Hastaların 61'inde (%28) bir komorbid hastalık vardır ve %32,1 oranında en sık eştanı yıkıcı davranış bozuklukları (karşıt olma, karşı gelme bozukluğu+davranım bozukluğu) olmuştur. Psikososyal tedavi olguların 116 (%53,2) iken, 102 (%46,8) çocuğa psikofarmakolojik tedavi başlanmıştır İlaç tedavisi olarak en sık önerilen psikofarmakolojik ajan risperidon olmuştur. Otuz altı-kırk sekiz ay yaş grubuna göre 49-60 ay yaş grubunda daha fazla komorbidite saptanmış ve ilaç tedavisinin kullanıldığı belirlenmiştir. Eştanı sayısının fazlalığı ilaç tedavisi seçeneğini tercih etmede belirleyici olduğu saptanmıştır (p<0,05). Sonuç: Psikosoyal tedavi ilk sırada tedavi seçeneği olsa da ilaç tedavisi de gerekli gibi görünmektedir. İlk sırada tercih edilen psikofarmakolojik ajan Risperidon olmuştur. İlaç tedavisini tercih edilmesinde daha büyük yaş ve eştanı sayısının fazlalığı belirleyici gibi görünmektedir.
Rivista di psichiatria, 2019
OBJECTIVE The primary objective of this study was to compare the adult-onset and adolescent obses... more OBJECTIVE The primary objective of this study was to compare the adult-onset and adolescent obsessive-compulsive disorder (OCD) patients in terms of the subthreshold autistic traits. METHODS 29 adolescent, and 45 adult-onset OCD patients were assessed by Autism-spectrum Quotient (AQ). RESULTS The ratio of males to females, the frequency of ritualistic compulsions, and the mean number of lifetime compulsions were significantly higher in adolescents with OCD compared to adult-onset patients. Adult-onset OCD patients had significantly higher scores on total, social skills, attention shifting, and imagination subscales of AQ than adolescent OCD patients. The mean number of compulsions, attention shifting scores of AQ, and female gender significantly predicted the distinction between adolescent and adult-onset OCD patients. In adult-onset patients, there were significant correlations between the mean number of lifetime obsessions and total, social skills, attention switching, communicati...
Turkish Archives of Pediatrics
Klinik Psikofarmakoloji Bulteni- Bulletin of Clinical Psychopharmacology has been publishing peer... more Klinik Psikofarmakoloji Bulteni- Bulletin of Clinical Psychopharmacology has been publishing peer-reviewed articles in English and Turkish in four issues per year since 1990. The articles reflecting contemporary interests of clinical, experimental and basic scientists and authors in the following and related fields are published: Psychopharmacology, psychiatry (pediatric and adulthood), and behavioral sciences. Bulletin of Clinical Psychopharmacology is a scientific publication aiming free access by medical institutions and professionals from all over the world. Target audience of The Bulletin of Clinical Psychopharmacology includes specialistsand students in psychiatry, psychology, neurology, pharmacology, molecular biology, genetics, physiology, neurochemistry and related sciences.
ÖZET Amaç: Bu çalışmanın amacı, yıkıcı davranış bozukluğu tanısı alan çocuklarda kombine tedavi s... more ÖZET Amaç: Bu çalışmanın amacı, yıkıcı davranış bozukluğu tanısı alan çocuklarda kombine tedavi seçenek-lerinin etkilerini araştırmaktır. Yöntem: Ege Üniversitesi Tıp Fakültesi Çocuk Psikiyatrisi kliniğine baş-vuruda bulunan 6-13 yaşları arasındaki çocuklardan Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) ve Karşıt Olma Karşı Gelme Bozukluğu (KOB) tanısı konan 67 çocuk (%55,8) ile DEHB ve Davranım Bozukluğu (DB) tanısı konan 53 çocuk (%44,2) iki görüşmeci tarafından belirlenerek çalışma kapsamına alınmıştır. Çalışmaya alınan olgulardan 6-11 yaş arasındakilere 5mg/gün, 11-13 yaş arasındakilere ise 10mg/gün metilfenidat tedavisi başlanmış ve doz çalışma boyunca düzenlenmiştir. Çalışmadaki 83 olgunun ailesi ebeveyn gruplarına katılırken 37 olgunun ailesi katılmamıştır. Araştırmanın 1.,6.,12.,18. aylarında her iki tedavi grubu Dikkat Eksikliği ve Yıkıcı Davranış Bozuklukları için DSM-IV'e dayalı Tarama ve Değerlendirme Ölçeği, Conners Ebeveyn Derecelendirme Ölçeği, Conners Öğretme...
Asian journal of psychiatry, Jan 9, 2018
This paper is aimed at enumeration of some of the Quranic principles to suggest an account of 'Is... more This paper is aimed at enumeration of some of the Quranic principles to suggest an account of 'Islamic pluralism'. The Quran accepts plurality as a natural phenomenon. Allah SWT states in the Quran:-O Humankind! Verily we have created you of a male and female; and we have distributed you in nations and tribes that you might know one another and recognise that, in the sight of God the most honourable of you is the most pious. Verily God is wise and all knowing‖ (49:13). The aim of Islam is to integrate such diversity into unity through the sacred principles of the Quran; it explains the reason and purpose for such racial and religious multiplicity. After arriving in Medina, the Holy Prophet SAW introduced a new structure and value system which was connected through religion and citizenship instead of tribal links. He formed the constitution of Medina which stated the terms of relationships with Jews of Medina. The Prophet SAW extended the act of citizenship and cooperation to the Christians of Najran. The paper glances through Islamic history in order to identify a common official attitude of Muslim authority towards non-Muslim subjects.
Psychopharmacology bulletin, Jan 26, 2017
Long QT syndrome (LQTS) is described as the development of sudden syncope attacks or death as a r... more Long QT syndrome (LQTS) is described as the development of sudden syncope attacks or death as a result of ventricular tachycardia (VT) episodes that might be observed as elongated QT interval in electrocardiography (ECG). Implantable Cardioverter Defibrillator (ICD) is recommended as first-line treatment for the condition in guidelines. We aimed to present an adolescent recently diagnosed with Bipolar Disorder (BD) who had LQTS that was treated with ICD, discussing her follow up and treatment along with relevant literature. Psychiatric assessment of the case that applied to our child psychiatry unit due to manic symptoms were carried out by using Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) criteria. Symptom severity was monitored via Young Mania Rating Scale scores (YMRSS). The case met criteria for Bipolar Disorder Type I (BD-I). She had improvement in her mood symptoms with treatment regimen as risperidone 3 mg/day, valproate 1000 mg/day and lorazepam...
Journal of clinical psychopharmacology, 2017
Emotional dysregulation (ED) is a frequent feature of attention-deficit/hyperactivity disorder (A... more Emotional dysregulation (ED) is a frequent feature of attention-deficit/hyperactivity disorder (ADHD). It can be observed as a dysregulation profile or a deficient emotional self-regulation (DESR) profile. Oppositional defiant disorder/conduct disorder (ODD/CD) comorbidity is prevalent in ADHD and known to be related with ED. The first-line treatment of ADHD includes psychostimulants, but their effects on ED are not well studied. This study aimed to evaluate the outcomes of methylphenidate (MPH) treatment on ED in ADHD + ODD/CD cases. A total of 118 ADHD + ODD/CD patients with a mean age of 9.0 ± 1.9 years were treated with MPH for 1 year. Also, parents of cases were recruited for a parent-training program, which initiated after first month of MPH treatment. Symptom severity was assessed at baseline and 12th month by Turgay Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Based Child and Adolescent Behavior Disorders Screening and Rating Scale-Parent Form, Child...
Anatolian Journal of Psychiatry, 2016
Objective: Three preschool mania cases were presented discussing clinical phenomenology and treat... more Objective: Three preschool mania cases were presented discussing clinical phenomenology and treatment with relevant literature. Methods: Psychiatric assessments were done based on Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) criteria. Symptom severity was measured using Young Mania Rating Scale. Results: All met criteria for bipolar disorder type I and attention deficit hyperactivity disorder (ADHD). Familial depression, anxiety and stressful life events increased symptom severity and treatment resistance. Premature dropouts and referrals due to repetitive manic episodes were frequent. While no clinical improvement was observed in a case where valproate was single agent, new generation antipsychotics (risperidone, olanzapine, aripiprazole, paliperidone) were well-tolerated. Discussion: We believe nature, clinical course and treatment of bipolar disorder in preschoolers needs to be further enlightened with larger sample groups and longitudinal follow- up studies, as this rare condition is an important cause of morbidity and functional loss mainly for this age group where lower rates of treatment response and follow-up and comorbidity with other psychiatric disorders, especially ADHD is common.
Archives of Iranian Medicine, 2023
Rhabdomyolysis is a rare serious side effect of antipsychotic medication use. There are cases of ... more Rhabdomyolysis is a rare serious side effect of antipsychotic medication use. There are cases of rhabdomyolysis due to the use of clozapine, risperidone, olanzapine, and haloperidol in the literature. In this report, we describe a rhabdomyolysis case developed on the 13th day of using 2.5 mg /day aripiprazole in a 17-year-old male patient with a diagnosis of somatic symptom disorder. This case is one of the youngest in the literature to develop rhabdomyolysis after the use of aripiprazole. Moreover, this case is distinguished from the others with its low-dose, short-term and single antipsychotic use. In the child and adolescent age group, routine blood tests should be done before starting medication. Symptoms that appear to be nonspecific and that may be overlooked or may be thought to be caused by an existing psychiatric complaint should be carefully and thoroughly considered during follow-up.
Journal of Dr. Behcet Uz Children s Hospital, 2021
Objective: Alopecia areata (AA); is a sudden onset, non-scaring hair loss. Twenty percent of case... more Objective: Alopecia areata (AA); is a sudden onset, non-scaring hair loss. Twenty percent of cases are children.Although it is thought to be related to genetic predisposition, inflammation, immunological processes or psychological triggers, its pathophysiology is still not fully understood. This study was planned to investigate the levels of serum 25-hydroxy vitamin D, vitamin B12, thyroid-stimulating hormone (TSH) and free T4 FT4) in children with AA and compare the results with age-matched healthy individuals. Methods: A retrospective medical record review was carried out in an outpatient dermatology clinic in a tertiary medical center between January 1,2013 and December 31, 2017. The study included 520 patients (ages 0-18 years) who received a clinical diagnosis of AA.106 patients with AA met the inclusion criteria.Patients in the control group (n=106) were selected among children aged 0-18 years without any medical and/or psychiatric diagnosis. Both past medical and family medic...
Journal of Dr Behcet Uz Children s Hospital, 2019
Narcolepsy is a chronic disorder that might cause severe morbidity and functional deterioration w... more Narcolepsy is a chronic disorder that might cause severe morbidity and functional deterioration with a wide range of complicated symptoms and without any clearly identified etiology. The condition is even more difficult to diagnose in children as clinical picture and clusters of symptoms that vary extremely. With this report, we aimed to present, and discuss an 11-year-old case diagnosed with narcolepsy in a child psychiatry unit along with relevant literature. Psychiatric assessment of the case that applied to our child psychiatry unit was carried out by using Diagnostic and Statistical Manual of Mental Disorders 5 th edition (DSM-5) criteria. Detailed clinical examination, neurological tests and imaging modalities as well as polysomnography were performed. The case was diagnosed,and followed up as having narcolepsy after completion of processes of evaluation, and differential diagnosis. She demonstrated clinical improvement with a combined treatment regimen of methylphenydate-OROS and behavioral therapy for sleep pattern and hygiene. She is still being followed up in our unit. Since narcolepsy is a rarely seen condition encountered in child psychiatry settings and symptoms might mimic other neurological and psychiatric conditions, its earlier recognition is a remote possibility. Therefore, we believe that we, as child psychiatrists, need to bear this disorder in our minds for differential diagnosis. Since current treatment options mainly target visible symptoms, developing novel treatment strategies directed towards underlying etiology will carry importance. In that sense, we believe that increasing the number of case studies and clinical researches in this understudied field of child psychiatry shall contribute greatly to more improved understanding of the disorder.
Journal of Contemporary Medicine, 2018
Pediatric practice and research, Dec 25, 2020
Amaç: Düzenli immün süpresif kullanmak zorunda olan renal transplant olguları, Covid-19 salgını d... more Amaç: Düzenli immün süpresif kullanmak zorunda olan renal transplant olguları, Covid-19 salgını döneminde tedavilerini aksatabilir ve bu durum organ reddine neden olabilir. Bu çalışmada, COVİD-19 salgınında renal transplantlı hastaların kaygı düzeylerinin ve psikolojik dayanıklılıklarının sağlıkla ilgili davranışlarına etkisi araştırılmıştır. Gereç ve Yöntem: Kliniğimizde kronik böbrek hastalığı tanısı alıp, böbrek nakline verilen 39 böbrek nakilli olgu çalışmaya alınmıştır. Haziran 2020-Eylül 2020 tarihleri arasında, salgın ile ilgili kaygı düzeylerini ve psikolojik sağlamlılık düzeylerini ölçen ölçekler ve sağlık ile ilgili davranışlarının sorgulandığı sorulardan oluşan online google anket formu hazırlanmıştır. Bulgular: Anksiyete ölçeğine göre anksiyetesi olmayan hiçbir hasta yoktu, 24 hastada (%61) ılımlı kaygı, 8 hastada (%20) orta kaygı ve 7 hastada (%18) ciddi kaygı düzeyi saptandı. Kaygı ve dayanıklılık ölçekleri primer hastalığa, cinsiyete, sosyo-ekonomik veya demografik verilere göre anlamlı farklılık göstermemekteydi. Tek istatistiki farklılık salgın konusunda profesyonellerden bilgi alanların anksiyete ölçek ortalamalarının, salgın konusunda profesyonellerden bilgi almayanlardan daha yüksek olduğu idi (p=0,045). Sonuç: İçinde bulunduğumuz salgın gibi olağanüstü durum ve dönemlerde böbrek nakilli hastalar gibi özellikli ve riskli hasta gruplarına koruyucu, önleyici ve tedavi edici tele-tıp uygulamalarının öncelikli olarak gündeme alınmasıdır.
Psychiatry and Clinical Psychopharmacology, 2018
Objective: Smith and Burger developed the Structured Inventory of Malingered Symptomatology (SIMS... more Objective: Smith and Burger developed the Structured Inventory of Malingered Symptomatology (SIMS) in 1997 as a self-report measure for malingering of psychiatric symptoms. The SIMS consists of 75 dichotomous (True-False) items that form into five subscales Psychosis (P), Neurologic Impairment (NI), Affective Disorder (AF), Amnestic Disorders (AM), Low Intelligence (LI), with each subscale containing 15 items. In this study, we aimed to examine the reliability, validity, and factor structure of the SIMS in a Turkish forensic psychiatry sample. Methods: A sample of 103 forensic patients (9 female, 94 male), aged 18-75, undergoing an inpatient forensic evaluations for competency assessment for criminal responsibility were recruited from a large forensic hospital in Turkey. The study protocol was approved by the local ethics committee. Socio-demographic information of the participants was collected and the SIMS, Miller Forensic Assessment of Symptoms Test (M-FAST), the Scales of Psychological Well-being, 36-Item Short Form Survey (SF-36), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered. All statistical analyses were performed by using SPSS version 23.0 for Windows. Results: The Cronbach's alpha coefficients for the Turkish SIMS were ranging from 0.42 to 0.87. The lowest alpha coefficient was observed for the Amnestic Disorders (0.46). For the whole scale, Cronbach's alpha coefficient was found to be 0.93. The test-retest (at after 1 week) correlation coefficients for Psychosis (P), Neurologic Impairment (NI), Affective Disorder (AF), Amnestic Disorders (AM), Low Intelligence (LI), and whole scale were found to be 0.97, 0.97, 0.95, 0.91, and 0.96, respectively. A positive and statistically significant correlation was found between the Turkish SIMS and BDI (r = 0.593, p < .
Psychiatry and Clinical Psychopharmacology, 2018
BACKGROUND: Vitiligo is a chronic skin condition among psychocutaneous diseases that significantl... more BACKGROUND: Vitiligo is a chronic skin condition among psychocutaneous diseases that significantly affect psychiatric well-being of patients, social interactions, and overall quality of life. Only a limited number of studies about psychiatric well-being and quality of life in children with vitiligo and their parents are available. AIMS: With this study, we aimed to assess anxiety, depression, and quality of life in children diagnosed with vitiligo and their parents. METHODS AND MATERIAL: Forty-one vitiligo patients aged 9-16 years 30 healthy controls along with their parents were asked to fill out self-report forms that assessed quality of life (Pediatric Quality of Life Inventory-Child Form; PedsQL-C and Pediatric Quality of Life Inventory-Parent Form; PedsQL-P), anxiety (State-Trait Anxiety Inventory-STAI-C for children and Beck Anxiety Inventory-BAI for parents), and depression (Children's Depression Inventory-CDI and Beck Depression Inventory-BDI for parents). RESULTS: Between groups, significant differences were found in PedsQL-C subscales measuring school functioning, psychosocial health, and overall quality of life. Regarding PedsQL-P scores, there was a significant difference in physical functioning, social functioning, and overall quality of life. No statistical significance was found between groups regarding CDI and STAI-C scores. There was a significant difference in BDI, with higher scores in parents of children with vitiligo. CONCLUSIONS: We believe measuring life quality with standardized instruments and techniques would be important in the assessment of the patient to evaluate the efficacy of treatment, specifically in chronic disorders. Further studies addressing these issues, especially in children, adolescents, and their parents are warranted.
Anatolian Journal of Psychiatry, 2018
Objective: Although autism spectrum disorder (ASD) is one of the most studied neurodevelopmental ... more Objective: Although autism spectrum disorder (ASD) is one of the most studied neurodevelopmental disorders, its etiology has not been fully elucidated. A growing body of evidence suggest the role of neuroinflammation in the etiology of ASD. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are markers of systemic inflammation. In this study, we aimed to evaluate NLR and PLR in children with ASD comparison to healthy controls. Methods: We reviewed the medical files of children with ASD in the ages of 2 to 5. The ASD group were consisted of drug-naïve 64 children who had complete blood count within a month of assessment. Age and sex matched 64 healthy children without any psychiatric disorders were recruited from the healthy child outpatient unit of the hospital. Results: NLRs were significantly higher in ASD. Children with ASD had significantly higher neutrophil counts but lower platelet and lymphocyte counts compared to those of healthy controls. NLR was found to be a predictor of ASD. Conclusions: Increased NLRs support the hypothesis of the involvement of neuroinflammation in the underlying physiopathology of ASD. Even though recent evidence is not enough to suggest that in young children increased NLR levels may be used as screening and early intervention predictor, it should be kept in mind and may inspire new studies. Further longitudinal studies with larger sample size and homogeneous groups regarding the age and subtypes may clarify the inflammatory involvement in ASD.
Psychiatry and Clinical Psychopharmacology, 2017
Melatonin is an indoleamine often used in children and adolescents. Melatonin is considered to be... more Melatonin is an indoleamine often used in children and adolescents. Melatonin is considered to be an effective clinical management for dyssomnias, sleep disorders present in children with attention-deficit hyperactivity, autism spectrum disorders, developmental delays. Quickacting capsules, controlled-release (CR) capsules, sublingual tablets and liquid forms are available. Melatonin is generally very well-tolerated in children and adolescents. The pharmacology, therapeutic applications, and side effects of melatonin are discussed.
Psychiatry and Clinical Psychopharmacology, 2018
Objective: Many individuals with cigarette addiction are known for beginning to smoke cigarettes ... more 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.
Journal of Dr Behcet Uz Children s Hospital, 2016
Alopesi areata (AA) tanılı çocuk ve ergenlerde aile işlevselliği, psikopatoloji ve yaşam kalitesi... more Alopesi areata (AA) tanılı çocuk ve ergenlerde aile işlevselliği, psikopatoloji ve yaşam kalitesini belirlemek sosyodemografik ve hastalık ile ilgili değişkenlerle ilişkisini araştırmaktır. Yöntem: İki-18 yaş arasındaki 45 hasta retrospektif olarak incelendi. Aile Değerlendirme Ölçeği (ADÖ), Çocuklar ve Gençler İçin Yaşam Kalitesi Ölçeği (ÇYKÖ), Çocuklar için Depresyon Ölçeği (ÇDÖ) ile Sosyodemografik veri formu kullanılmıştır. İstatistiksel analizde SPSS 18.0 programı kullanılmıştır. Bulgular: Çalışma grubunun yaş ortalaması 9.22±3.79 yıldır ve %55.6'sı kadındır. Tüm olgu grubunda ADÖ gereken ilgiyi gösterme ve davranış kontrolü alt ölçeklerinde sorun olduğu belirlenmiştir (>2). Olguların %42.2'si en az bir psikiyatrik tanı almıştır. Psikiyatrik komorbidite varlığı; depresyon, ADÖ genel işlevler, Ebeveyn yaşam kalitesi psikososyal sağlık, çocuk yaşam kalitesinde de tüm alanlarda bozulmaya neden olmuştur. Olguların %51.1'inde psikososyal tetikleyici olay tespit edilmiştir. Ama tetikleyici olay saptanmayan olgularda ÇDÖ ve ÇYKÖ tüm alanlarda anlamlı düzeyde bozulmuştur (p<0.05). Lezyon yaygınlığı yalnızca, atak sayısı ve hastalık süresi ile pozitif yönde ilişkili bulunmuştur. Sonuç: AA hastalarında aile işlevselliği gereken ilgiyi gösterme ve davranış kontrolü alanlarında bozuktur. Psikososyal tetikleyici olaylar AA'da sık olmasına rağmen psikopatoloji, yaşam kalitesi ve aile işlevselliği ile ilişkili olmayabilir. Psikiyatrik komorbidite yaşam kalitesini en fazla bozan faktör olmuştur.
Journal of Dr Behcet Uz Children s Hospital, 2017
Amaç: 1 Ocak-31 Aralık 2016 tarihleri arasında okul öncesi dönem çocuklarda Dikkat Eksikliği Hipe... more Amaç: 1 Ocak-31 Aralık 2016 tarihleri arasında okul öncesi dönem çocuklarda Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) prevalansı ve ilaç kullanım sıklığını araştırmak. Yöntem: Çocuk ve Ergen Ruh Sağlığı ve hastalıkları polikliniklerine başvuran ve ICD-10 tanı kriterlerine göre DEHB tanısı konan 36-60 ay yaş aralığındaki çocukları dosyaları taranmıştır. Mental retardasyon, duygudurum bozuklukları, anksiyete bozuklukları, otizm spektrum bozuklukları, kronik tıbbi hastalık ve dosyalarda eksik veri olan çocuklar çalışma dışında bırakılmıştır. Bulgular: 218 DEHB tanılı okul öncesi çocuk çalışma grubunu oluşturmuştur. DEHB prevalansı okul öncesi çocuklarda %7,8'dir. Hastaların 61'inde (%28) bir komorbid hastalık vardır ve %32,1 oranında en sık eştanı yıkıcı davranış bozuklukları (karşıt olma, karşı gelme bozukluğu+davranım bozukluğu) olmuştur. Psikososyal tedavi olguların 116 (%53,2) iken, 102 (%46,8) çocuğa psikofarmakolojik tedavi başlanmıştır İlaç tedavisi olarak en sık önerilen psikofarmakolojik ajan risperidon olmuştur. Otuz altı-kırk sekiz ay yaş grubuna göre 49-60 ay yaş grubunda daha fazla komorbidite saptanmış ve ilaç tedavisinin kullanıldığı belirlenmiştir. Eştanı sayısının fazlalığı ilaç tedavisi seçeneğini tercih etmede belirleyici olduğu saptanmıştır (p<0,05). Sonuç: Psikosoyal tedavi ilk sırada tedavi seçeneği olsa da ilaç tedavisi de gerekli gibi görünmektedir. İlk sırada tercih edilen psikofarmakolojik ajan Risperidon olmuştur. İlaç tedavisini tercih edilmesinde daha büyük yaş ve eştanı sayısının fazlalığı belirleyici gibi görünmektedir.
Rivista di psichiatria, 2019
OBJECTIVE The primary objective of this study was to compare the adult-onset and adolescent obses... more OBJECTIVE The primary objective of this study was to compare the adult-onset and adolescent obsessive-compulsive disorder (OCD) patients in terms of the subthreshold autistic traits. METHODS 29 adolescent, and 45 adult-onset OCD patients were assessed by Autism-spectrum Quotient (AQ). RESULTS The ratio of males to females, the frequency of ritualistic compulsions, and the mean number of lifetime compulsions were significantly higher in adolescents with OCD compared to adult-onset patients. Adult-onset OCD patients had significantly higher scores on total, social skills, attention shifting, and imagination subscales of AQ than adolescent OCD patients. The mean number of compulsions, attention shifting scores of AQ, and female gender significantly predicted the distinction between adolescent and adult-onset OCD patients. In adult-onset patients, there were significant correlations between the mean number of lifetime obsessions and total, social skills, attention switching, communicati...
Turkish Archives of Pediatrics
Klinik Psikofarmakoloji Bulteni- Bulletin of Clinical Psychopharmacology has been publishing peer... more Klinik Psikofarmakoloji Bulteni- Bulletin of Clinical Psychopharmacology has been publishing peer-reviewed articles in English and Turkish in four issues per year since 1990. The articles reflecting contemporary interests of clinical, experimental and basic scientists and authors in the following and related fields are published: Psychopharmacology, psychiatry (pediatric and adulthood), and behavioral sciences. Bulletin of Clinical Psychopharmacology is a scientific publication aiming free access by medical institutions and professionals from all over the world. Target audience of The Bulletin of Clinical Psychopharmacology includes specialistsand students in psychiatry, psychology, neurology, pharmacology, molecular biology, genetics, physiology, neurochemistry and related sciences.
ÖZET Amaç: Bu çalışmanın amacı, yıkıcı davranış bozukluğu tanısı alan çocuklarda kombine tedavi s... more ÖZET Amaç: Bu çalışmanın amacı, yıkıcı davranış bozukluğu tanısı alan çocuklarda kombine tedavi seçenek-lerinin etkilerini araştırmaktır. Yöntem: Ege Üniversitesi Tıp Fakültesi Çocuk Psikiyatrisi kliniğine baş-vuruda bulunan 6-13 yaşları arasındaki çocuklardan Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) ve Karşıt Olma Karşı Gelme Bozukluğu (KOB) tanısı konan 67 çocuk (%55,8) ile DEHB ve Davranım Bozukluğu (DB) tanısı konan 53 çocuk (%44,2) iki görüşmeci tarafından belirlenerek çalışma kapsamına alınmıştır. Çalışmaya alınan olgulardan 6-11 yaş arasındakilere 5mg/gün, 11-13 yaş arasındakilere ise 10mg/gün metilfenidat tedavisi başlanmış ve doz çalışma boyunca düzenlenmiştir. Çalışmadaki 83 olgunun ailesi ebeveyn gruplarına katılırken 37 olgunun ailesi katılmamıştır. Araştırmanın 1.,6.,12.,18. aylarında her iki tedavi grubu Dikkat Eksikliği ve Yıkıcı Davranış Bozuklukları için DSM-IV'e dayalı Tarama ve Değerlendirme Ölçeği, Conners Ebeveyn Derecelendirme Ölçeği, Conners Öğretme...
Asian journal of psychiatry, Jan 9, 2018
This paper is aimed at enumeration of some of the Quranic principles to suggest an account of 'Is... more This paper is aimed at enumeration of some of the Quranic principles to suggest an account of 'Islamic pluralism'. The Quran accepts plurality as a natural phenomenon. Allah SWT states in the Quran:-O Humankind! Verily we have created you of a male and female; and we have distributed you in nations and tribes that you might know one another and recognise that, in the sight of God the most honourable of you is the most pious. Verily God is wise and all knowing‖ (49:13). The aim of Islam is to integrate such diversity into unity through the sacred principles of the Quran; it explains the reason and purpose for such racial and religious multiplicity. After arriving in Medina, the Holy Prophet SAW introduced a new structure and value system which was connected through religion and citizenship instead of tribal links. He formed the constitution of Medina which stated the terms of relationships with Jews of Medina. The Prophet SAW extended the act of citizenship and cooperation to the Christians of Najran. The paper glances through Islamic history in order to identify a common official attitude of Muslim authority towards non-Muslim subjects.
Psychopharmacology bulletin, Jan 26, 2017
Long QT syndrome (LQTS) is described as the development of sudden syncope attacks or death as a r... more Long QT syndrome (LQTS) is described as the development of sudden syncope attacks or death as a result of ventricular tachycardia (VT) episodes that might be observed as elongated QT interval in electrocardiography (ECG). Implantable Cardioverter Defibrillator (ICD) is recommended as first-line treatment for the condition in guidelines. We aimed to present an adolescent recently diagnosed with Bipolar Disorder (BD) who had LQTS that was treated with ICD, discussing her follow up and treatment along with relevant literature. Psychiatric assessment of the case that applied to our child psychiatry unit due to manic symptoms were carried out by using Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) criteria. Symptom severity was monitored via Young Mania Rating Scale scores (YMRSS). The case met criteria for Bipolar Disorder Type I (BD-I). She had improvement in her mood symptoms with treatment regimen as risperidone 3 mg/day, valproate 1000 mg/day and lorazepam...
Journal of clinical psychopharmacology, 2017
Emotional dysregulation (ED) is a frequent feature of attention-deficit/hyperactivity disorder (A... more Emotional dysregulation (ED) is a frequent feature of attention-deficit/hyperactivity disorder (ADHD). It can be observed as a dysregulation profile or a deficient emotional self-regulation (DESR) profile. Oppositional defiant disorder/conduct disorder (ODD/CD) comorbidity is prevalent in ADHD and known to be related with ED. The first-line treatment of ADHD includes psychostimulants, but their effects on ED are not well studied. This study aimed to evaluate the outcomes of methylphenidate (MPH) treatment on ED in ADHD + ODD/CD cases. A total of 118 ADHD + ODD/CD patients with a mean age of 9.0 ± 1.9 years were treated with MPH for 1 year. Also, parents of cases were recruited for a parent-training program, which initiated after first month of MPH treatment. Symptom severity was assessed at baseline and 12th month by Turgay Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Based Child and Adolescent Behavior Disorders Screening and Rating Scale-Parent Form, Child...
Anatolian Journal of Psychiatry, 2016
Objective: Three preschool mania cases were presented discussing clinical phenomenology and treat... more Objective: Three preschool mania cases were presented discussing clinical phenomenology and treatment with relevant literature. Methods: Psychiatric assessments were done based on Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) criteria. Symptom severity was measured using Young Mania Rating Scale. Results: All met criteria for bipolar disorder type I and attention deficit hyperactivity disorder (ADHD). Familial depression, anxiety and stressful life events increased symptom severity and treatment resistance. Premature dropouts and referrals due to repetitive manic episodes were frequent. While no clinical improvement was observed in a case where valproate was single agent, new generation antipsychotics (risperidone, olanzapine, aripiprazole, paliperidone) were well-tolerated. Discussion: We believe nature, clinical course and treatment of bipolar disorder in preschoolers needs to be further enlightened with larger sample groups and longitudinal follow- up studies, as this rare condition is an important cause of morbidity and functional loss mainly for this age group where lower rates of treatment response and follow-up and comorbidity with other psychiatric disorders, especially ADHD is common.