Aysegul Yolga Tahiroglu

Internet use among Turkish adolescents.

The aim of this study was to investigate Internet use habits and problematic Internet use (PIU) in Turkish adolescents. Participants were 3,975 undergraduate students, 7.6% of whom used the Internet for more than 12 hours weekly. The Online Cognition Scale (OCS) was used. The most common purpose for using the Internet was playing games, followed by general information search. Female users mostly preferred searching for general information; male users preferred playing games (p < 0.001, gamma = 995.205). The most preferred type of game was violent games. While preference for strategy and fantasy role-play (FRP) games increased with age, preference for other games decreased (p < 0.0001, gamma = 283.767). Participants who used the Internet mostly for general information searches and school-related searches had lower OCS scores (p < 0.0001). The highest OCS scores were related to violent games, followed by FRP, strategy, and sports and motor racing games. Computers and the Internet are useful, important inventions, but like other inventions, if used improperly, they may be harmful. Risk of harm raises concerns about who should use the Internet and computers, and where, when, and why the Internet and computers should be used.

Short-Term Effects of Playing Computer Games on Attention

Objective: The main aim of the present study is to investigate the short-term cognitive effects of computer games in children with different psychiatric disorders and normal controls. Method: One hundred one children are recruited for the study (aged between 9 and 12 years). All participants played a motor-racing game on the computer for 1 hour. The TBAG form of the Stroop task was administered to all participants twice, before playing and immediately after playing the game. Results: Participants with improved posttest scores, compared to their pretest scores, used the computer on average 0.67 ± 1.1 hr/day, while the average administered was measured at 1.6 ± 1.4 hr/day and 1.3 ± 0.9 hr/day computer use for participants with worse or unaltered scores, respectively. According to the regression model, male gender, younger ages, duration of daily computer use, and ADHD inattention type were found to be independent risk factors for worsened posttest scores. Conclusion: Time spent playing computer games can exert a short-term effect on attention as measured by the Stroop test. (J. of Att. Dis. 2010; 13(6) 668-676)

Periodic fever and hyperimmunoglobulin D syndrome in a boy with pediatric autoimmune neuropsychiatric disorders associated with group A β-Hemolytic streptococcus.

The importance of the immune system in pediatric psychiatric disorders has been known since the 1990s. Swedo et al. (1998) have reported that obsessive-compulsive disorder (OCD), tics, and other neuropsychiatric symptoms, such as separation anxiety, irritability, hyperactivity, and attention and concentration deficits, are usually triggered by infections, and have reported a phenomenon known as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). The diagnostic criteria for PANDAS are as follows: 1) Presence of a tic disorder or OCD; 2) onset by puberty (usually at 3–12 years of age); 3) abrupt symptom onset or episodic course of symptom severity; 4) temporal association between symptom exacerbation and streptococcal infections; and 5) presence of neurologic abnormalities during periods of symptom exacerbation (Swedo et al. 1998). To the best of our knowledge, there is no reported case or controlled study describing the psychiatric signs or symptoms accompanying hyperimmunoglobulin D syndrome (HIDS). HIDS is among the periodic fever syndromes that are genetically inherited and share some common features, including recurrent fever, inflammation of serosal membranes, musculoskeletal involvement, skin rashes, and amyloidosis. HIDS was originally described in patients of Dutch ancestry by van der Meer et al. (1984). HIDS is characterized by sustained high fever, lymphadenopathy, abdominal pain, arthritis, and skin rashes; episode duration is from 4 to 8 weeks. HIDS is caused by mutations in the gene that encodes mevalonate kinase (MVK), an enzyme involved in the isoprenoid and cholesterol biosynthesis pathway. The four most prevalent mutations of MVK (V377I, I268T, H20P/N, and P167L) account for 71.5% of the known mutations (van der Hilst et al. 2008; Steichen et al. 2009). The differential diagnosis of HIDS is broad and includes familial mediterranean fever (FMF), tumor necrosis factor receptor associated periodic syndrome (TRAPS), periodic fever adenitis pharyngitis aphthous ulcer (PFAPA), adult-onset Still’s disease, juvenile idiopathic arthritis, rheumatic fever, and Behçet’s disease (Long 2005; Steichen et.al. 2009). Although MVK gene mutations have been suggested to be the genetic defect responsible for the etiopathogenesis of HIDS, they were not observed in a substantial proportion of those with the disease; therefore, the pathophysiology of the disease remains unclear. More than 66% of HIDS patients present to physicians within the first year of life. An earlier study of ours suggested later onset of the HIDS (Tas et al. 2012). Episodic attacks of fever (lasting 3–7 day) are generally accompanied by chills, cervical lymphadenopathy, abdominal pain, and vomiting or diarrhea. Patients may also present with headache, arthralgia or arthritis, aphthous ulceration, rash, and splenomegaly (van Der Hilst et al. 2008). Attacks may be precipitated by vaccination, viral infection, trauma, and stress (Drenth et al.1994). Laboratory test results generally show the presence of characteristic abnormalities such as an Immunoglobulin D (IgD) level >100 kU/L, and some patients also have an elevated immunoglobulin A level. We report a case with concurrent HIDS and OCD comorbid with attention-deficit/hyperactivity disorder (ADHD) combined type, speech disorder (stuttering), and Tourette’s disorder (TD).

Sexual Abuse in a Classroom of Ten Male Students: A Group Victimization

The term “professional perpetrator” is used to describe individuals who commit sexual abuse in the capacity of a position of trust such as a teacher, household member, or employer. There is an increasing body of evidence focusing on educator sexual abuse in the school environment. However, data are limited about this topic. The aim of this paper is to present the rare occurrence of the case of a male teacher in Turkey who sexually abused his students in an elementary school. Although it is unknown which populations are most vulnerable to sexual abuse, in Turkey we think that the indigenous population is at risk. Abuse cases are not logged into the criminal justice system because the majority of abuse allegations are ignored or disbelieved by families.

Vitamin D insufficiency in a boy with obsessive-compulsive disorder

Vitamin D deficiency not only causes low bone mass but also may lead to neuropsychiatric disorders. In the present case, vitamin D supplementation reduced obsessive–compulsive disorder (OCD) symptoms associated with streptococcal infection in a 7‐year‐old boy. Sudden onset of symptoms, including excessive hand washing and fear of touching anything, had occurred 1 month before presentation. Although there are few studies on a possible causal relationship between vitamin D and neuropsychiatric disorders, the present report; together with previous data, suggest an etiological role of vitamin D‐related immune processes.

Aripiprazole Improved Obsessive Compulsive Symptoms in Asperger's Disorder

There are many comorbid disorders associated with autism spectrum disorders in child and adolescent population. Although obsessive compulsive disorder and autism spectrum disorders (ASD) comorbidity has common in clinical practice, there are few reports about psychopharmacological treatment for obsessive compulsive symptoms in children with ASD in the literacy. We report a successful treatment case with aripiprazole in Aspergers Disorder with obsessive compulsive symptoms. The Yale Brown Obsessive Compulsive Scale was performed to assess symptom variety. This case report supports the effectiveness of aripiprazole in treatment of obsessive compulsive symptoms in Aspergers Disorder or ASDs. Aripiprazole may be beneficial to obsessive compulsive disorder comorbid autism spectrum disorders in child and adolescent age group.

Lise öğrencilerinde internet bağımlılığının DEHB ve tütün/alkol kullanma ile ilişkisi

Objective: Our study aims at assessing the association between internet addiction (IA) and attention deficit hyperactivity disorder (ADHD) and tobacco and alcohol use/experimentation in high school students living in the province of Zonguldak. Method: The study included 771 students enrolled in three high schools. They were assessed with a sociodemographic data form prepared by the researchers, the Chen Internet Addiction Scale (CIAS), and the Adult Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD) Diagnostic and Assessment Inventory based on the DSM-IV. Results: In 61 cases (7.9%), IA was established, in 90 cases (11.7%) ADHD. Of the cases with IA, 40 (65.6%) were male, 21 (34.4%) female. Internet access from home (p

Imipramine, methylphenidate and valproic acid-related EPS in a child : a case report

Methylphenidate is a stimulant agent that has been used in attention deficit hyperactivity disorder (ADHD); valproic acid is an anticonvulsant and an effective mood stabilizer (Scahill and Martin, 2003) and imipramine is a tricyclic antidepressant (TCA). Some studies have reported a positive effect of imipramine on ADHD symptoms, while others reported it to be ineffective (Gundersen and Keller, 2003; Winsberg et al., 1980). Methylphenidate (CYP2D6), valproic acid (CYP2C9) and imipramine (CYP2C19, CYP2D6, CYP3A) are metabolized by several CYP enzymes. Psychotropic drug interactions are not rare in combination therapy. One drug can interact with other drugs and substances at a variety of points during distribution and metabolism. Most interactions occur at the CYP isoenzyme complex in the liver (Oesterheld and Flockhart, 2003). Extrapyramidal symptoms (EPS) (dystonic reaction, rigidity and akathisia) occur as a result of D2 receptor blockade (Findling et al., 2003). EPS are more common with high-potency neuroleptics (Scahill and Martin, 2003). However, it is not unusual for EPS to manifest during other psychotropic drug therapy (Ozalp et al., 2006). Moreover, younger patients appear to be at high risk of developing EPS. EPS can be controlled with a reduced dose of medication or be treated with intramuscular or oral diphenhydramine, benztropine or trihexyphenidyl administration (Findling et al., 2003). EPS are rare adverse drug reactions to antidepressant agents. Selective serotonin reuptake inhibitors (SSRIs) have been reported to induce extrapyramidal signs and symptoms but TCAs have been less frequently reported (Lambert et al., 1998; Leo, 1996; Mamo et al., 2000; Schillevoort et al., 2002). A literature review on children and adolescents revealed only three case reports where SSRIs induced EPS (Diler et al., 2002; Horrigan and Barnhill, 1994; Sokolski et al., 2004), while only one EPS-related SSRI+TCA combination has been reported (Figueroa et al., 1998) and no EPS-related TCA alone has been reported. This may be a consequence of serotonergically mediated inhibition of the dopaminergic system, monoamine oxidase inhibitor discontinuation, comorbid Parkinson’s disease and possibly deficient cytochrome P450 (CYP) isoenzyme status (Lane, 1998). Hedenmalm et al. (2006) reported that the risk of EPS with SSRIs seems to increase with advanced age and the presence of the A1 allele of the DRD2 TaqIA polymorphism. EPS are very rare side-effect in valproic acid administration, particularly in children. It has been suggested that EPS may occur because of a disturbance in the GABAergic pathways inducing reversible dopamine inhibition (Ricard et al., 2005). One child (Alvarez-Gomez et al., 1993) and eight adults with epilepsy reported that they developed EPS during sodium-valproate therapy (Masmoudi et al., 2000; Ricard et al., 2005; Sasso et al., 1994). There are no EPS reports relating to stimulant usage. In this paper, we present a case under multiple pharmacological treatment who developed EPS (oculogyric crisis) shortly after the adjunct of imipramine to a combination of methylphenidate and valproic acid, which had been administered for 1 yr.

Recantation of Sexual Abuse Disclosure Among Child Victims: Accommodation Syndrome

ABSTRACT Background: Disclosing the sexual abuse may be related on many individual and/or environmental factors in all age groups. The sociocultural context is the most influential factor of the disclosing process especially for those living in patriarchal cultural values. This study compares the impacts of sexual abuse and other sociodemographic variables between recanting and non-recanting victimized groups in Adana city from Turkey. Methods: The samples attending our department were divided into two groups: group 1 comprised victims who recanted their first abuse disclosure, and group 2 comprised victims who insisted on the veracity of their first report at further evaluations. The characteristics of the child, family, and abuser were compared between recanting victims and non-recanting victims by retrospective data. Results: Each group included 27 children, for a total of 54 subjects. All adverse social reactions after the sexual abuse, including keeping secrets and a repressive family attitude, were higher among group 1 victims than group 2 victims (p < 0.0001). Conclusions: Although they are victimized by protecting family integrity, victims may show a tendency to keep secrets and to not immediately disclose an abuse event.

Effects of methylphenidate treatment on quality of life in adolescents

Effects of methylphenidate treatment on quality of life in adolescents Objective: Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood mental disorders. Improvement in quality of life is observed with the treatment of ADHD which is a chronic disorder that disrupts the quality of life. In this study, it was aimed to investigate the changes in symptoms of anxiety and depression associated with ADHD and quality of life of adolescents after methylphenidate treatment. Method: Fifty patients between 13-18 years old, who admitted to Mersin University Medical Faculty Hospital Pediatric and Adolescent Psychiatry Outpatient Clinics; were diagnosed with ADHD; received methylphenidate treatment for the first time; and continued with the treatment for three months; were included in the study. Pretreatment and 3rd month results of Children’s Depression Inventory (CDI), StateTrait Anxiety Inventory for Children (STAI-CH), and adolescent and parent forms of Pediatric Quality of Life InventoryTM 4.0 (PedsQLTM 4.0) were assessed by retrospectively screening of patient charts. Results: After methylphenidate treatment, quality of life scores were improved, except for physical functioning. Quality of life scores were higher in adolescent reports, compared to parents. Male adolescents scored their quality of life more positively than girls before and after the treatment. In addition, anxiety symptoms improved after methylphenidate treatment. Conclusion: It is important to determine the changes in quality of life with the treatment of ADHD in terms of emphasizing the importance of ADHD treatment, evaluating treatment outcomes, and establishing effective and sophisticated treatment plans.