Ayşe Rodopman Arman

Antibodies against neural, nuclear, cytoskeletal, and streptococcal epitopes in children and adults with Tourette’s syndrome, Sydenham’s chorea, and autoimmune disorders

BACKGROUND Some cases of Tourettes syndrome (TS) are hypothesized to be caused by autoantibodies that develop in response to a preceding group A beta hemolytic streptococcal infection. METHODS To test this hypothesis, we looked for the presence ot total and IgG antibodies against neural, nuclear, cytoskeletal and streptococcal epitopes using indirect immunofluorescent assays and Western blot techniques in three patient groups: TS (n = 81), SC (n = 27), and a group of autoimmune disorders (n = 52) and in normal controls (n = 67). Subjects were ranked after titrations of autoantibodies from 0 to 227 according to their level of immunoreactivity. RESULTS TS patients had a significantly higher mean rank for total antineural and antinuclear antibodies, as well as antistreptolysin O titers. However, among children and adolescents, only the total antinuclear antibodies were increased in TS patients compared to age matched controls. Compared to SC patients, TS patients had a significantly lower mean rank for total and IgG class antineural antibodies, significantly lower IgG class anticytoskeletal antibodies, and a significantly higher rank for total antinuclear antibodies. Compared to a mixed group of autoimmune disorders, the TS patients had a significantly lower mean rank for total and IgG class antineural antibodies, total and IgG class antinuclear antibodies, IgG class anticytoskeletal antibodies, and a significantly higher rank for antistreptococcal antibodies. CONCLUSIONS TS patients had significantly higher levels of total antineural and antinuclear antibodies than did controls. Their relation to IgG class antineural and antinuclear antibodies, markers for prior streptococcal infection, and other clinical characteristics, especially chronological age, was equivocal.

EEG abnormalities and epilepsy in autistic spectrum disorders: Clinical and familial correlates

Our aim was to examine the characteristics of EEG findings and epilepsy in autistic spectrum disorders (ASD) and the associated clinical and familial risk factors. Fifty-seven children (86% male) with ASD, mean age 82+/-36.2 months, were included in the study. Thirty-nine (68.4%) children had the diagnosis of autism, 15 (26.3%) had Pervasive Developmental Disorder Not Otherwise Specified, and 3 (5.3%) had high-functioning autism. One hour of sleep and/or awake EEG recordings was obtained for each child. All patients were evaluated with respect to clinical and familial characteristics and with the Childhood Autism Rating Scale, the Autism Behavior Checklist, and the Aberrant Behavior Checklist. The frequency of interictal epileptiform EEG abnormalities (IIEAs) was 24.6% (n=14), and the frequency of epilepsy was 14.2% (n=8). IIEAs were associated with a diagnosis of epilepsy (P=0.0001), Childhood Autism Rating Scale Activity scores (P=0.047), and a history of asthma and allergy (P=0.044). Epilepsy was associated with a family history of epilepsy (P=0.049) and psychiatric problems in the mother during pregnancy (P=0.0026). Future studies with larger samples will help to clarify the possible associations of epilepsy/IIEAs with asthma/allergy, hyperactivity, and familial factors in ASD.

The Prevalence of Headache and Its Association With Socioeconomic Status Among Schoolchildren in Istanbul, Turkey

Objective.— The etiology and pathogenesis of migraine and other types of headache are still under discussion. An interaction of organic, psychological, and psychosocial factors is operative. In this study, we aimed to determine the prevalence of headache and its association with socioeconomic status among schoolchildren.

Association of sleep duration with socio‐economic status and behavioural problems among schoolchildren

Aim:  In this population‐based study, we aimed to determine the total sleep duration (TSD), its association with socio‐economic status (SES) and behavioural symptoms among schoolchildren.

The phenomenology of autistic regression: subtypes and associated factors

This study aimed to investigate the association of autistic regression (AR) and subtypes of AR with medical, developmental and psychiatric factors. Fifty-seven children with autistic spectrum disorders (ASD) were included in the study. Two types of AR are defined as regression after a normal social/language development (type 1) and regression as the worsening of previously reported autistic features (type 2). The frequency of history of AR was 56.1%. Male gender and sleep problems were found to be associated with a positive history of AR. The frequency of gastrointestinal complaints/diseases was higher in children with regression type 2 when compared to the children with regression type 1. Future studies with larger sample size and prospective design will contribute to clarifying the phenomenology and the associated factors of AR.

Cinsel istismara uğrayan çocuk ve ergenlerde klinik özellikler ve intihar girişimi ile ilişkili risk etmenleri

Amac: Calismamizda klinigimize adli rapor istemi ile yonlendirilen cinsel istismara ugramis cocuk ve ergenlerin sosyodemografik ozellikleri, zeka duzeyleri, istismar sonrasi gelisen ruhsal bozukluklarin, intihar girisimi varliginin ve iliskili risk etmenlerinin degerlendirilmesi amaclanmistir. Yontem: Adli makamlarca Temmuz 2011-Haziran 2012 tarihleri arasinda cinsel istismara ugramis ve adli rapor duzenlenmesi istemi ile cocuk ve ergen psikiyatrisi poliklinigine yonlendirilen 3-17 yaslari arasindaki 157 olgunun dosya bilgileri geriye donuk olarak incelenmistir. Bulgular: Cinsel istismara ugramis 157 cocuk ve ergenin %83,4’i kiz, %16.6’si erkektir. Olgularin basvuru sirasinda yapilan degerlendirilmelerinde % 87.9 oraninda ruhsal bozukluk belirlenmistir. En sik gorulen ruhsal bozukluk travma sonrasi stres bozuklugudur (TSSB) (%36.9). Toplam 22 (% 14) olguda istismar sonrasi intihar girisimi saptanmistir. Zorlama ile vajinal-anal-oral penetrasyon seklinde cinsel istismara ugrama, depresif bozukluk ve TSSB tanilarinin varliginin intihar girisimi riskini anlamli oranda artirdigi belirlenmistir (sirasiyla OR: 3.24, 4.05, 6.78 p= 0.045, 0.03, 0.004). Sonuc: Olgularin buyuk bir kisminda bir ruhsal bozukluk gelistigi gorulmustur. En sik gorulen ruhsal bozukluk TSSB’dir. Cinsel istismar magduru cocuk ve ergenlerin ruhsal degerlendirmesinde intihar riskinin sorgulanip mudahale yaklasimlarinin buna gore belirlenmesi gerekmektedir.

Cognitive and psychosocial development in children with familial hypomagnesaemia

AIM Familial hypomagnesaemia (FH) is a rare genetic condition. Neuromuscular and cardiovascular manifestations are well described, whereas cognitive and psychosocial development of children with FH is generally overlooked. METHODS Nine patients with FH were evaluated with psychiatric examination and psychometric tests for cognitive and psychosocial outcome. RESULTS Nine children (median age 10.1 yrs, range 3-16.3 yrs, 5 boys and 4 girls) with FH participated. Psychiatric symptoms were hyperactivity, irritability, sleep and speech problems and finger sucking. Common psychiatric diagnoses were Attention Deficit Hyperactivity Disorder, borderline intelligence, mild mental retardation and speech disorders. Parent-rated Child Behavior Checklist and Child Health Questionnaire mean scores were between 0.32-0.79, and 0.4-2.12, respectively; indicating the worsened psychosocial well-being besides considerable psychiatric diagnoses. CONCLUSIONS Cognitive and psychosocial outcome in FH may influence morbidity, quality of life and social performance. Neuropsychiatric evaluation should be a routine part of management of children with FH.

Psychiatric evaluation of juvenile delinquents under probation in the context of recidivism

ABSTRACT OBJECTIVE: High rates of psychiatric disorders and comorbidities have been reported in the juvenile justice system, and both phenomena are thought to contribute to repetitive offending. Although extensive research on the prevalence of psychiatric disorders in juvenile offenders has been conducted in European countries and the USA, epidemiological research concerning this issue is limited in Turkish population. The aim of the present study is to examine psychiatric diagnoses, comorbidity patterns, psychometric properties, and the factors related to recidivism defined as reconvictions, in juveniles under probation in Turkey. METHODS: We conducted face-to-face interviews with volunteers. This study sample consisted of 55 individuals (Female/Male = 4/51) who were in the Istanbul Anatolian Probation Department. The participants’ age ranged from 14 to 18 years (mean age = 17.22 ± 0.62). Diagnoses were established based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. A detailed sociodemographic form, Wechsler Intelligence Scale, Child Depression Inventory, and Beck Anxiety Inventory were used for assessment. The subjects were divided into two groups based on the number of conviction: Group 1 consisted of 65% of the sample (n = 36) with one conviction and Group 2 consisted of 35% of the sample (n = 19) with more than one conviction. We examined the psychometric properties that might predict recidivism through the logistic regression analysis. RESULTS: We ascertained that 67.3% of the juveniles had at least one psychiatric disorder, and 45.5% had two or more comorbid psychiatric disorders. The most common diagnosis was attention deficit hyperactivity disorder (ADHD) (43.6%), and followed by depressive mood disorders (34.5%). Juveniles in Group 2 were less educated, had low levels of verbal, performance and total intelligence quotient (IQ) score, had more numbers of psychiatric diagnoses, particularly depressive mood disorders and history of substance use disorders (p < .05). Having a higher number of psychiatric diagnoses and having comorbidity of both externalizing (i.e. ADHD, conduct disorder) and internalizing disorders (i.e. depressive mood disorders, anxiety disorders) were significantly higher in Group 2 (p < .05). Total duration of education (OR = 0.470, 95% CI = 0.257–0.861, p < .05) and having at least one psychiatric disorder (OR = 10.64, 95% CI = 1.642–68.954, p < .05) were found to predict multiple convictions. CONCLUSION: Juveniles in the justice system are faced with multiple psychiatric disorders, along with social/environmental adversities. There is a need of a holistic approach addressing multiple areas to prevent repetitive offending behaviour. Accordingly, in addition to legal sanctions, evaluation and interventions regarding mental health will contribute to improve for both psychosocial well-being of delinquent juveniles and prevention strategies for recidivism.

The Interaction Between Attention Deficit Hyperactivity Disorder and Anxiety Symptoms

The interaction between attention deficit hyperactivity disorder and anxiety symptoms Objective: Attention deficit hyperactivity disorder (ADHD) and anxiety disorders are commonly seen in the field of child psychiatry. Childhood ADHD and anxiety disorders are comorbid with an estimated rate of 13% to 50%. In this study, it was aimed to research anxiety symptoms and its relation with ADHD symptoms in children with ADHD. Method: Fifty children with ADHD and 49 healthy controls (aged 8-15 years) who do not have any psychiatric diagnosis were included in study. We used socio-demographic information form, Conners’ Teacher Rating Scale (CTRS), Child Behavior Checklist for 4-18 years (CBCL), The Screen for Child Anxiety Related Emotional Disorders (SCARED) both parent and child report for assessing these children. The diagnosis were made with Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL). Results: The anxiety disorders comorbidity rate was 24% in ADHD group. The total scores of SCARED parent and children reports were higher in ADHD group. SCARED children report scores were higher than SCARED parent report scores in both groups. Discussion: Our results agree with the previously reported common anxiety comorbidity with ADHD and the association between attention deficit symptoms and anxiety symptoms. In our study, parents reported fewer anxiety symptoms in their children than children’s self reports. Clinicians should evaluate anxiety symptoms carefully in children with ADHD that could be unnoticed by their parents. The treatment should be determined according to the comorbidities.

Dikkat Eksikliği Hiperaktivite Bozukluğu olan Çocukların Ebeveynleri ve Kardeşlerinde Psikopatoloji / Psychopathology İn Parents And Siblings Of Children With Attention Deficit Hyperactivity Disorder

Objective: In this article, developmental and psychosocial adjustment problems observed in parents and siblings of children with Attention Deficit Hyperactivity Disorder (ADHD) are aimed to review. Method: For this purpose we searched Medline, and examined books related with the subject and previous studies related with these families. Results: ADHD, other psychiatric disorders and social emotional adjustment problems were more frequently seen in parents and siblings of children with ADHD. Discussion: Because of the genetic and psychosocial effects on the family, the risk of psychopathology is increased in parents and siblings of children with ADHD. In order to decrease the risk and have early diagnosis and interventions, families should be informed and involved in the treatment process.