Burak Dogangun

Psychological effects of repeated general anesthesia in children

Background:  Although methods for reducing preoperative anxiety have been a major interest of pediatric anesthesiologists, there are no reports of the effects of repeated anesthesia on psychological development of children.

The altered promoter methylation of oxytocin receptor gene in autism

Abstract Autism spectrum disorder (ASD) is one of the lifelong existing disorders. Abnormal methylation status of gene promoters of oxytonergic system has been implicated as among the etiologic factors of ASDs. We, therefore, investigated the methylation frequency of oxytocin receptor gene (OXTR) promoter from peripheral blood samples of children with autistic features. Our sample includes 66 children in total (22–94 months); 27 children with ASDs according to the DSM-IV-TR and the Childhood Autism Rating Scale (CARS) and 39 children who do not have any autistic like symptoms as the healthy control group. We investigated the DNA methylation status of OXTR promoter by methylation specific enzymatic digestion of genomic DNA and polymerase chain reaction. A significant relationship has been found between ASDs and healthy controls for the reduction of methylation frequency of the regions MT1 and MT3 of OXTR. We could not find any association in the methylation frequency of MT2 and MT4 regions of OXTR. Although our findings indicate high frequency of OXTR promoter hypomethylation in ASDs, there is need for independent replication of the results for a bigger sample set. We expect that future studies with the inclusion of larger, more homogeneous samples will attempt to disentangle the causes of ASDs.

Emotional effects of hypospadias surgery on Turkish boys

PURPOSE The aim of this study is to investigate in Turkish boys the emotional effects of hypospadias repair before and after the optimal age for repair. MATERIALS AND METHODS Forty hypospadias patients treated in our department were included in this study. Group 1 consisted of 13 patients operated on at less than 30 months of age. Group 2 consisted of 27 patients operated on at over 30 months of age. Age at time of study, severity of hypospadias, age at repair and number of operations were evaluated for both groups retrospectively. Socio-economic and socio-demographic characteristics of these patients including place of residence, educational level of their parents and parental occupations were determined. The Turkish versions of the Childrens Depression Inventory and the State-Trait Anxiety Inventory for Children A-State scale were used to evaluate the emotional effects of hypospadias surgery. For statistical analysis, the Mann-Whitney U test, Students t test and Chi-squared test were used. RESULTS There was a significant difference in the age at repair between Groups 1 and 2. No significant differences existed in severity of hypospadias and number of operations between the two groups. All 40 patients had the same socio-economic and socio-demographic characteristics. Group 1 did not significantly differ from Group 2 in regard to the educational level of their parents and parental occupations. Age at repair, which was the only difference between the two groups, did not affect the level of depression and anxiety-state symptoms. CONCLUSIONS There is a close relationship between emotional effect of hypospadias surgery and age at repair. Possibility of depression and anxiety, which were dominating emotional symptoms among boys operated on for hypospadias, was found not to be high after the recommended age. It is concluded that, as hypospadias surgery creates a circumcised penis, the degree of emotional trauma is lower in Turkish boys than in other nationalities.

Psychological complaints reported by sexually abused children during criminal investigations: Istanbul example

The present study aims at describing the psychological complaints reported, as a part of the criminal investigation process, by the victims of sexual abuse as a part of the criminal investigation process, without attempting at reaching a medical diagnosis; and it discusses the relation of these reports with variables such as victims gender, age and relation to the offender, type and duration of abuse, and parental marital status of the victim. Data is obtained from the statements of childhood sexual abuse (CSA) victims under the age of 15, as taken by Istanbul Juvenile Justice Department between the years 2009 and 2012. The sample consists of 175 cases with a total of 202 victim statements. Through the use of content analysis, the main and sub-categories of themes of the statements were determined. By means of the evaluation of the psychological condition of victims, we evaluated them in two categories: psychological complaints including self-harm and risk taking behaviors and psychological complaints with no self-harm and risk taking behaviors. The statistical analyses yield significant relations between the psychological complaints and childrens parental marital status. Analysis of initial statements of sexual abuse victims is important as it may greatly contribute to professionals diagnosing and treating psychological complaints of these victims. It is essential that victims of sexual abuse should receive immediate psychological support starting with the criminal investigation process.

Mental health problems of second generation children and adolescents with migration background

Abstract Objective: Despite the growing number of young second-generation immigrant (SGI) children and adolescents, studies about their mental health are rare. The objective of this study was to investigate the mental health problems of SGI children and adolescents in Istanbul, Turkey. Methods: In a clinical sample the mental health of 54 SGIs and 50 native children and adolescents were examined using the Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) and Children’s Global Assessment Scale. The assessments were carried out by a blinded rater. Results: SGI children had higher rates of psychiatric disorders such as depression (p = 0.001), post-traumatic stress disorder (PTSD) (p = 0.011) and anxiety disorders (p = 0.013), more comorbid disorders and lower functionality scores compared to their native counterparts (p = 0.001). Conclusions: SGI children seem to have higher rates of psychiatric disorders most probably due to migration-induced burdens. The professionals treating SGI children should have more awareness for these problems to be able to approach them in a culture and language sensitive way.

Do Low Serum UCH-L1 and TDP-43 Levels Indicate Disturbed Ubiquitin- Proteosome System in Autism Spectrum Disorder?

INTRODUCTION The mechanism of ubiquitination-related abnormalities causing neural development problems is still unclear. We examined the association between autism and serum transactive response DNA-binding protein-43 (TDP-43) and ubiquitin c-terminal hydrolase-L1 (UCH-L1) levels, both of which are members of the ubiquitin-proteosome system. METHODS We measured serum levels of TDP-43 and UCH-L1 in 24 children with autism and 24 healthy children. Childhood Autism Rating Scale (CARS) was used to assess symptom severity at admission. RESULTS The mean serum TDP-43 and UCH-L1 levels in children with autism spectrum disorder (ASD) were found to decrease compared to healthy controls (p<0.001, 506.21±780.97 ng/L and 1245.80±996.76 ng/L, respectively; 3.08±5.44 ng/mL and 8.64±6.67 ng/mL, respectively). A positive correlation between serum TDP-43 levels and UCH-L1 levels was found in the ASD group (r=0.947, n=24, p<0.001). The CARS score of children with ASD was 48.91 points (standard deviation [SD]: 5.82). CONCLUSION Low serum levels of UCH-L1 and TDP-43 may reflect disturbed ubiquitination in autism.

Emotional and behavioral influence of headache in Pediatric rheumatic diseases

• Headache can be the expression of psychological difficulties, such as anxiety and depression.

How should Child Psychiatrists Get Dressed? Children's Perspective

Abstract Objectives. The aim of the present study was to investigate the patients’ preference regarding psychiatrists’ attire and whether attire styles were important for patients in child and adolescent mental health services. It was additionally sought to examine the influence of doctors’ attire on patients’ confidence in their psychiatrists. Methods. Sixty-four participants between the ages of six and eighteen were recruited from a child and adolescent mental health service within Turkey. Participants were asked to report their preferences for five types of doctor attires (white coat, formal, semi-formal, casual wear and relaxed attire) in both male and female psychiatrists. Participants were additionally asked whether they considered psychiatrist dress important and whether their psychiatrists’ attire influenced their confidence. Results. A large proportion of our sample (N=49) reported doctors’ attire as important. For both male and female psychiatrists, white coat was determined to be the most preferred style of attire, whereas relaxed attire was the least preferred attire in children’s psychiatrists. Around 67% of our respondents reported that doctors’ attire has an influence on the confidence and trustwortiness they will hold for their psychiatrists. Conclusions. The present study confirms that psychiatrists’ attire is considered as important by the children and adolescent patients, and white coat is the most preffered type of attire by children and adolescents. Psychiatrists’ attires can additionally be suggested as influencial on children and young people’s confidence in their doctors.

Otizmde Yüz ve Duyguların Yüz İfadelerini Tanıma

OZET Otizm, sosyal etkilesim, iletisim ve duygusal karsiliklilik gibi kisilerarasi iliski- leri iceren bircok alanda ciddi ve suregen bozukluklarin goruldugu, genetik temelli norogelisimsel bir bozukluktur. Otistik bireylerde yuz tanima, goz goze iliski kurma, yuzdeki duygulari okuma ve kisilerarasi iliskilerde kusurlar mevcuttur. Yuz tanima islemi sirasinda yalnizca yuz tanima islevi yerine geti- rilmez, ayrica yuzdeki duygusal ifadeyi tanima da gerceklestirilir. Otizmde fusiform girus, amigdala, ust temporal sulkus ve diger beyin bolgelerindeki yapisal ve islevsel sorunlarin yuz tanima ve yuzlerden duygulari tanima gibi becerilerde bozukluklara yol acarak sosyal etkilesim ve duygusal kusurlara neden oldugu belirtilmektedir. Calismalarda otistik bireylerin gozlere bakmak- tan cok agiz bolgesine baktiklari, yuz ifadelerini tanimakta zorlandiklari bildi- rilmistir. Ayrica otistiklerin muglâk ifadeleri daha cok olumsuz duygu olarak yorumladiklari gosterilmistir. Otizmde yuz islemenin bircok asamasinda (bakis yonunu algilama, yuz kimligini ve duygusal ifadeleri tanima) kusurlar bulunmaktadir. Otistik spektrum bozukluklarinda gorulen sosyal iletisim sorunlari bebeklik, cocukluk ve ergenlik doneminde yuz isleme islevindeki kusurlardan kaynaklanabilir. Otizmde yuz tanima ve duygulari yuz ifadelerin- den tanima becerileri hem dogustan itibaren var olabilecek (yuze otomatik yonelim) hem de gelisim donemlerinde ogrenme sureclerinde (kimlik ve duygu isleme) meydana gelen sorunlardan etkilendigi dusunulmektedir. Bu gozden gecirme yazisinda normal gelisim ve otizmde yuz tanima ve duygularin yuz ifadelerini tanima becerileri ve norobiyolojik temelleri incelenecektir. Anahtar Sozcukler: Otizm, yuz tanima, duygu yuz ifadeleri, yuz isleme ABSTRACT Autism is a genetically transferred neurodevelopmental disorder characterized by severe and permanent deficits in many interpersonal relation areas like

A case imitating Panayiotopoulos syndrome

Panayiotopoulos syndrome is one of the most common childhood-specific epileptic disorders. It is characterized by autonomic symptoms; the most common being emesis. However, the presence of emetic symptoms may cause misdiagnosis, for example with some organic disorders which have similar autonomic features. On the other hand, since this syndrome has been recently well documented, the tendency for early recognition may lead to overdiagnosis. Here, we present a case which could be mistaken for Panayiotopoulos syndrome based on anamnesis, however, with the aid of ictal video-EEG monitoring, the patientwas shown to present with a non-epileptic psychogenic seizure. This report is an example of careful evaluation in order to avoid over- or underdiagnosis of this benign disorder.