Gul Karacetin

Epidemiology of depression in an urban population of Turkish children and adolescents

BACKGROUND In Turkey, studies of childhood depression have been limited to those using only scales. METHODS This is a two-stage cross-sectional epidemiological study. Three schools in Fatih, Istanbul, Turkey were selected by cluster sampling. The study included 1482 students between the fourth and eighth grades. The Child Depression Inventory (CDI) was used for screening in the first stage. According to test results, 320 children were interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Depressive disorders were diagnosed in 62 students, constituting the case group. The control group was matched to the case group on school, grade, age, gender, and socioeconomic status (SES). RESULTS The prevalence rate was 4.2% for some form of depressive disorder, 1.55% for major depressive disorder, 1.75% for dysthymic disorder, 0.26% for double depression, and 0.60% for depressive disorder-not otherwise specified. According to the logistic regression analysis, increasing age, having a working mother and low maternal education were all positively associated with CDI score. Low SES, perception of paternal health and relations with father as negatively, low popularity and behavior subscales of the Piers-Harris self-concept scale, and high trait anxiety were associated with the presence of a depressive disorder. LIMITATIONS Parents were not included in the diagnostic interviews. CONCLUSIONS Dysthymic disorder was the most common depressive disorder. Low maternal education, low SES, dysfunctional interaction with the father, anxiety, and low self-esteem, which were all associated with depression, may be the target of interventions for prevention and treatment of depression.

Psychiatric assessment of children with nonsyndromic cleft lip and palate

OBJECTIVE The aim of the study was to determine whether children with nonsyndromic cleft lip and palate (NSCLP) are more likely to be diagnosed with psychiatric disorders and whether cleft-related factors are related to psychopathology. METHOD Twenty children from 6 to 16 years of age with NSCLP, attending the Plastic, Reconstructive and Aesthetic Surgery Department of Cerrahpasa Medical Faculty between January and October 2010, were included as the case group. Forty healthy children who were matched on age and sex with the case group served as controls. Children were assessed by psychiatric interviews and scales. RESULTS Social anxiety disorder (SAD) (P=.003) and major depressive disorder (MDD) (P=.010) were more prevalent in children with NSCLP. The severity of dentofacial (P=.035) and cleft lip nose deformities (P=.002), appearance and competence of the lip (P=.008), dental alignment (P=.002), feeding (P=.044) and articulation problems (P<.001) were associated with clinical global functioning. CONCLUSIONS Children with NSCLP are at risk of developing psychopathology, especially SAD and MDD. The above cleft-related factors and articulation problems may be the target of interventions to prevent and treat psychiatric disorders in these children.

Maternal psychopathology and psychomotor development of children with GERD.

Objectives: The relation between gastroesophageal reflux disease (GERD) and maternal psychopathology as well as the role of impairments in mother–child interactions in the perpetuation of feeding problems in children with GERD was previously implicated but not confirmed. The present study aimed to study the relation between maternal psychopathology and feeding problems in children with GERD and the effects of GERD on the psychomotor development of children. Subjects and Methods: The case group included 39 children with GERD and their mothers and the comparison group included 39 healthy children and their mothers. The groups were matched for age, gestational age, socioeconomic status, and sex. Scales used for the psychiatric assessment of mothers were the Beck Anxiety Inventory, Hamilton Rating Scale for Depression, Eating Attitudes Test, and Experiences in Close Relationships-Revised. The childrens developmental levels were assessed by the Brunet-Lezine Revised test. Results: Maternal Beck Anxiety Inventory, Hamilton Rating Scale for Depression, Eating Attitudes Test, and Experiences in Close Relationships-Revised scores were significantly higher in the case group. Forced feeding and maternal thoughts of the childs feeding as insufficient were associated with a high level of maternal attachment-related anxiety and avoidance. Children with GERD had significantly lower Brunet-Lezine-Revised scores. Conclusions: Maternal psychopathology, especially insecure attachment, may play a role in the feeding problems in children with GERD. Children with GERD should be examined for maternal psychopathology and feeding problems so that maladaptive feeding behaviors can receive appropriate intervention before the development of negative reinforcement to feeding. The psychomotor development of children should be kept in mind.

Prevalence and some psychosocial characteristics of social anxiety disorder in an urban population of Turkish children and adolescents.

PURPOSE To define the prevalence and some of the psychosocial characteristics of social anxiety disorder (SAD) in an urban population of Turkish children and adolescents. SUBJECTS AND METHODS This was a two-stage cross-sectional urban-based study conducted in Fatih, Istanbul, Turkey. The initial sample included 1,482 students between the 4th and 8th grades. The first stage involved screening using the Social Anxiety Scale for Children-Revised (SASC-R) and the Capa Social Phobia Scale for Children and Adolescents (CSPSCA). According to the test results, 324 children were interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) in the second stage. RESULTS The SAD prevalence rate was 3.9%. According to the multiple regression analysis, low paternal education and trait anxiety were associated with SASC-R scores, whereas female gender and trait anxiety were associated with CSPSCA scores. According to logistic regression analysis, the anxiety subscale of the self-concept scale and trait anxiety were associated with SAD. CONCLUSION SAD is a relatively common disorder that is associated with lower self-concept in children and adolescents. Low paternal education, trait anxiety, and low self-concept may be the intervention targets for SAD prevention and treatment.

Genetic polymorphism of angiotensin I-converting enzyme (ACE), but not angiotensin II type I receptor (ATr1), has a gender-specific role in panic disorder

Aims:  Angiotensins were shown to have some role in the development of panic disorder (PD). In this study, we aimed to determine the frequency of polymorphisms in two angiotensin‐related genes, angiotensin I‐converting enzyme (ACE) and angiotensin II type I receptor (ATr1), in a sample of Turkish patients with PD and to evaluate their association with PD development.

Serotonin-2a receptor and catechol-O-methyltransferase polymorphisms in panic disorder

Catechol-O-methyltransferase (COMT) and serotonin receptor 2A (5HTR2A) polymorphisms have been investigated for their possible role in panic disorder (PD). The aim of this study was to investigate the genotype distribution of the COMT val158met and 5HTR2A 102T/C polymorphisms in PD. COMT val158met is a polymorphism at codon 158 that results in variations in COMT enzymatic activity with high- (H) and low-activity (L) alleles. The 5HTR2A 102T/C polymorphism comprises a T-to-C mutation at position 102. The effects of symptom severity, gender, and age of onset were also investigated. The participants were 105 outpatients with PD and 130 controls. The severity of the symptoms of PD was assessed by the Panic and Agoraphobia Scale (PAS). Polymorphisms of the 5HTR2A and COMT genes were identified using polymerase chain reaction and restriction fragment length polymorphism analysis. A significant relationship was found between the COMT Val158Met polymorphism and PD. No significant differences were found in genotype distributions or allele frequencies of the 5HTR2A polymorphisms between the PD and control groups. There were no significant relationships between the COMT and 5HTR2A polymorphisms and age of onset, gender, presence of agoraphobia, or PAS scores in the PD group (p>0.05).

Doğuştan Görme Engeli Olan Çocuk ve Ergenlerde Bağlanma Özellikleri ve Davranışsal Sorunlar

INTRODUCTION This study aimed to assess the behavioral problems and the attachment characteristics of children and adolescents with congenital blindness (CB). METHOD Forty children and adolescents aged 11-14 years with CB were included as the case group. Forty healthy children and adolescents who were matched for age, gender, and socioeconomic status with the case group served as the comparison group. Behavioral problems were assessed by the Child Behavior Checklist for ages 4-18 (CBCL 4/18). Attachment characteristics were assessed via the Short Form of Inventory of Parent and Peer Attachment (s-IPPA). RESULTS The case group had lower CBCL total problems scores as well as anxiety/depression, withdrawal/depression, and attention problems subscales scores with respect to the comparison group. There were no significant differences between the two groups in s-IPPA scores. CONCLUSION Children and adolescents with CB did not differ from the comparison group in terms of attachment, whereas, they had lower scores on behavioral problems than the comparison group. Although previous studies indicate that children and adolescents with CB may be at the risk of insecure attachment, our study suggested that adaptive mechanisms of their families together with professional help from specialized teachers and services provided by schools for children and adolescents with CB may play compensatory roles.

A Review of the Etiology Delirium

Delirium, also called as organic brain syndrome, acute brain syndrome, acute brain failure, acute confusional episode and reversible or masked dementia, as a concept, stretches back to the age of Hypocrates (Burns et al., 2004). Delirium is described as a condition characterized by a disturbance of consciousness with reduced ability to focus, sustain, or shift attention according to the Diagnostic and Statistical Classification of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria (American Psychiatric Association, 2000). Also, delirium involves a change in cognition (such as memory deficit, disorientation, language disturbance) or the development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia (American Psychiatric Association, 2000). In addition to these, impairment in the brain’s ability to integrate perceptions correctly, coupled with memory deficits and confusion may result in psychotic symptoms in delirium. Hallucinations (especially visual and tactile), delusions, paranoia, illusions, and bizarre behavior are the commonly encountered psychotic symptoms in delirium (Leigh, 2008).

Successful Treatment of Benzodiazepine-Resistant Malignant Catatonia With Electroconvulsive Therapy

mm 3 , and CPK levels decreased to 2,230 U/liter. Olanzapine was initiated at a dose of 10 mg/day. The patient was reevaluated by the consulting neurologist, who recommended cranial MRI and thyroid function tests (TFT), to exclude Hashimoto thyroiditis. Both the MRI and TFT were within normal limits. The WBC count and CPK levels decreased over the ensuing days, but the clinical signs and symptoms of catatonia did not change. Olanzapine treatment was ceased at the 5th day of treatment, and diazepam dose was increased gradually to a dose of 20 mg/day on the 7th day of treatment. At this point, as his general-medical condition was stabilized, ECT was initiated. The motor behaviors and