Ibrahim Selcuk Esin

The relationship between Vitamin D, autistic spectrum disorders, and cognitive development: do glial cell line-derived neurotrophic factor and nerve growth factor play a role in this relationship?

Objective: In recent years, there has been an increasing interest in the effects of Vitamin D on cognitive development and autism. The aim of this study is to examine the relationship between autism, cognitive developmental delay and behavioral problems. We also aimed to examine the possible mechanisms of interaction between nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF) levels. Methods: Sixty-four toddlers with developmental delay participated in the study. In the initial assessment, the cases were subjected to a psychiatric examination and developmental tests. Vitamin D, GDNF, and NGF levels were observed. Patients who had low vitamin D levels received replacement treatment. Six months later, the same measures were repeated. Results: Significant progress in autistic symptoms and development scores were determined for the group receiving vitamin D replacement. A negative correlation was found between vitamin D levels and NGF levels. Development scores and GDNF levels were found to be positively correlated in patients who were diagnosed with only cognitive development delay. Conclusions: Measuring vitamin D levels and replacing them if they are low may be beneficial in children with developmental delay, particularly those who also have autistic spectrum disorders. NGF may be more related to autism spectrum disorders, while GDNF seems to be more related with global developmental delay.

The effect of ice skating on psychological well-being and sleep quality of children with visual or hearing impairment

Abstract Purpose: Physical exercise and sports have a key role in preventing physical and psychiatric problems in children. However, children with a disability often experience difficulty participating in physical activity due to a lack of suitable opportunities. Participation in an accessible sport is particularly important for these children, but studies examining which sports are beneficial for which disability groups are rare. In this study, we assessed the effects of ice skating on the psychological well-being, self-concept, and sleep quality of children with hearing or visual impairment. Method: Forty students (20 visually impaired and 20 hearing impaired) aged 8–16 were included in a regular ice skating programme for three months. We examined the sleep quality, self-concept, and behavioural and emotional states of the children before and after participating in the programme. Results: There was a significant improvement in self-concept, behavioural and emotional problems, and sleep quality (p < 0.05 for each) of the children with hearing impairment. Although the sleep quality (p = 0.019) and emotional problem scores (p = 0.000) of the visually impaired children improved; self-concept, peer relations and hyperactivity scores of these children worsened (p < 0.05 for each). Conclusion: Ice skating is one of the popular sport alternatives that gives children the opportunity to exercise and have fun together. The results of this study revealed that regular ice skating programmes may have positive effects on the psychological well-being of children with hearing impairment. Despite some positive effects, caution must be use when including visually impaired children in ice skating programmes. Generalization of the studys outcomes is limited as the study group were residential students enrolled in special education institutions for children who are blind or deaf. Implications for Rehabilitation Ice skating is a community-based sport and a popular leisure activity that can also have benefits for people with disabilities. Ice skating and children with hearing impairment: Self-concept, behavioural and emotional problems, and sleep quality of the children with hearing impairment significantly improved after ice skating. Ice skating programmes may be considered as a rehabilitation alternative for children with hearing impairment. Ice skating and children with visual impairment: Caution must be use when including children with visual impairment in ice skating programmes because of possible negative psychological outcomes. Balance exercises before starting the practices on ice should be considered for preventing some possible negative outcomes in children with visual impairment.

Does working with child abuse cases affect professionals' parenting and the psychological well-being of their children?

Work in the field of sexual abuse is extremely stressful and may arouse negative personal reactions. Although these secondary trauma effects are well described on a personal level, there is not enough evidence to understand whether these professionals carry these effects to their homes, families, and offspring. This study aims to identify the effects of working with child abuse cases on the anxiety level and parenting styles of childhood trauma workers and on their children’s well-being. A total of 43 health and legal system workers who worked with abused children in any step of their process and who had children constituted the study group, and 50 control cases, each working in the same institution and having the same occupation as 1 of the participants from the study group and having children but not working directly with children and child abuse cases, were included in the study. Participants were asked to fill out a sociodemographic form, the Parental Attitude Research Instrument, the trait portion of the State-Trait Anxiety Inventory, and an age-appropriate form of the Child Behavior Checklist for each child they had. Professionals in the study working with child abuse cases demonstrated significantly higher democratic parenting attitudes. Law enforcement workers working with child abuse cases demonstrated stricter and more authoritarian parenting strategies, as well as more democratic attitudes, than their colleagues. There was not a statistically significant relationship between child abuse workers’ anxiety level and their children’s well-being among control subjects.

Mind Conduct disorders in children with poor oral hygiene habits and attention deficit hyperactivity disorder in children with excessive tooth decay

Introduction Dental caries and poor oral hygiene are among the major childhood public health problems. Although dental research frequently refers to the link between these conditions and behavioural issues, little attention has been paid to understanding the reason for oral health problems from a psychiatric point of view. The aim of this study was to examine the relationship between poor oral health and hygiene and parental attitudes towards child rearing, parents’ and children’s oral hygiene behaviours, and childhood psychiatric disorders. Material and methods This study included 323 children aged 3–15 years. Decayed, missing, filled and decayed, extracted, filled indices, the Simplified Oral Hygiene Index, the Strengths and Difficulties Questionnaire, and the Parent Attitude Research Instrument were used in the study. Results We found that the subjects’ hyperactivity/inattention scores were positively correlated with poor oral health (p = 0.001) and heavy cariogenic food consumption (p = 0.040). Tooth brushing frequency was found to be significantly lower in children who have a risk for conduct/oppositional disorders than in their non-problematic peers (p = 0.001). Conclusions Dental health and oral hygiene behaviours have close links with psychiatric disorders and psychosocial issues. Improving cooperation between child psychiatrists and dentists seems to be important in the prevention of paediatric dental problems.

Turkish Validation and Adaptation of Children’s Chronotype Questionnaire (CCTQ)

OBJECTIVE Chronotype refers to the time of the day that a persons physical and cognitive functions are active. Simply this is a circadian phase preference of a person. While some of the people are morning active (so called larks) others are more active at nights (The owls). The study of circadian rhythms, known as chronobiology, is all about the metabolic and psychiatric differences between people who have different chronotypes. A few tests are used to determine chronotypes. The CCTQ (Childrens Chronotype Questionnaire) is a parent-report, 27-item mixed format questionnaire measuring chronotype of children in multiple domains : the midsleep point on free days (MSF), a morningness/eveningness scale(M/E) score, and a five-point chronotype (CT) score. The aim of this study is adapting Childrens Chronotype Questionnaire (CCTQ) into Turkish language and validating the instrument in Turkish population. MATERIALS AND METHODS 101 children aged nine through eighteen constitude the sample of the study. The sample was composed of clinical (n=51) and community groups (n=50). CCTQ and Morningness Eveningness Scale for Children (MESC) questionnaires were applied to children and parents, then the CCTQ and MESC scores were compared to examine the validity of CCTQ. RESULTS The internal consistency and external validity of the Turkish CCTQ was sufficient to compare MESC-Turkish. As a result of this research carried out in accordance with methodological research principles, correlation between the M/E scores of CCTQ and MESC was significant. CONCLUSION The Turkish version of CCTQ has been found to be valid and reliable in Turkish children.

Unintentional injuries in preschool age children: is there a correlation with parenting style and parental attention deficit and hyperactivity symptoms

AbstractUnintentional injuries are the leading cause of death among children. Previous research has shown that most of the injuries occur in and around the home. Therefore, parents have a key role in the occurrence and prevention of injuries. In this study, we examined the relationship among home injuries to children and parental attention deficit hyperactivity disorder (ADHD) symptoms, parental attitudes, and childrens behavioral problems.Forty children who were admitted to the emergency department because of home injuries constitute the study group. The control group also consisted of 40 children, who were admitted for mild throat infections. The parents filled out questionnaires assessing parental ADHD, child behavioral problems, and parenting attitudes.Scores were significantly higher for both internalizing disorders and externalizing disorders in study groups. We also found that ADHD symptoms were significantly higher among fathers of injured children compared with fathers of control groups. Democratic parenting was also found to correlate with higher numbers of injuries.Parenting style, as well as the psychopathology of both the parents and children, is important factors in childrens injuries. A child psychiatrist visit following an emergency procedure may help to prevent further unintentional injuries to the child.

A Possible Cause of Trauma for Children in Justice System of Turkey: Attitudes of Prosecutors and Judges

A possible cause of secondary traumas for children in justice system of Turkey: attitudes of prosecutors and judges Objective: Inappropriate procedures or settings may cause secondary traumas in children and adolescents who are involved in justice systems. For improving the quality of assessments and preventing court-induced traumas, it is necessary to determine the existing problems. The aim of this study was to examine the problems with forensic assessments of children and adolescents, their causes, and possible solutions from the prosecutors’ and judges’ points of view. We also aimed to determine the collaboration problems from the legal authorities’ perspective. Method: The present study was conducted in the City of Erzurum, which is one of the metropolitan cities of Turkey. Thirty-five prosecutors and 14 judges filled out a questionnaire assessing their problems in child assessments. Results: The results indicate that 87.8% of the prosecutors and judges had difficulties at child assessments but none of the participants had an education on child evaluation in law school while only 18.4% participated a post-graduate education program. 61.2% of the respondents indicated that there were problems in the application of the current law. Conclusion: Court induced trauma is a challenging issue for child and adolescent psychiatry. The skills of legal authorities on child evaluations and their cooperation with mental health professionals may directly influence the quality of legal processes. Vocational training programs, creation of direct channels to reach the mental health specialists, and reorganizing the faculty of law education programs may be useful in terms of prevention.

Myasthenia Gravis Attack after Oral Risperidone Treatment: A Case Report

Myasthenia gravis (MG) is an autoimmune disease, which can be triggered by anticholinergic agents. The 6-year-old female patient was admitted to the outpatient clinic. She was had been previously diagnosed with comorbid attention deficit hyperactivity disorder and conduct disorder and was receiving short-acting methylphenidate and risperidone, as recommended by a child psychiatrist. However, after using the drugs, she stated that she was overly tired during the day and that her eyelids drooped. Hence, the current treatment was stopped. She was hospitalized with a prediagnosis of ocular type MG and pyridostigmine (90 mg/day) treatment was started. The patient recovered and subsequently the treatment was stopped. Since psychiatric symptoms of the patient resurfaced, long-acting methylphenidate treatment was initiated. During this treatment, the symptoms of MG did not return. The Naranjos scale of adverse drug reaction probability was completed. Consequently, there may be an association between risperidone and MG.

The Role of Nerve Growth Factor (NGF) and Glial Cell Line‑Derived Neurotrophic Factor (GDNF) in Tic Disorders

Objectives: Tic disorders are associated with neurodevelopmental origin, changes in dopaminergic neurons, and the formation of immunoreactivity, it is thought that neurotrophic factors may be crucial in the emergence of tic disorders. In this study, we targeted to explore role of neurotrophic factors in tic disorders. The aim of this study was to investigate serum Glial Cell Line-Derived Neurotrophic Factor (GDNF) and Nerve Growth Factor (NGF) levels in patients with tic disorder and healthy controls. Methods: Thirty-four children, constituted the case group, were diagnosed with tic disorder. The control group included 34 healthy children. Development and Well-Being Assessment (DAWBA) (structured interview) and Yale Global Tic Severity Rating Scale (YGTSRS) was applied to the patients. NGF and GDNF levels were measured with ELISA kit. Results: In case group, serum NGF and GDNF levels were found to be significantly higher in females than males (p = 0.042, p = 0.031). It was determined that serum NGF and GDNF levels were correlated with each other (r = 0.803, p <0.001) and there were no correlations between other parameters. There was no significant difference in NGF and GDNF in patients with tic disorder, compared to healthy controls. Conclusions: The absence of this relationship does not exclude the hypothesis that neurotrophic factors may play a role in the etiopathogenesis of tic disorders.

Sexual abuse and exploitation of an adolescent girl with gender dysphoria and congenital adrenal hyperplasia

Sexual abuse and exploitation of an adolescent girl with gender dysphoria and congenital adrenal hyperplasia Gender dysphoria is a psychosexual disorder characterized by powerful cross-gender identification and a continuous dissatisfaction with one’s biological gender role. Congenital Adrenal Hyperplasia (CAH) is a sexual developmental disorder resulting from congenital deficiency and functional impairment of enzymes enabling cortisol synthesis. Gender dysphoria may be developed in 5.2% of CAH patients. In our case, sexual abuse and exploitation of an adolescent girl with gender dysphoria and CAH will be discussed. The 17-year-old girl was admitted to our clinic with complaints of increasing sexual desire for girls, dissatisfaction with being a girl, desire to be male, self-harming, and overstepping personal borders. She sexually touched girls against their will, tried to kiss them, desired to have sex with them, and when they rejected sexual intercourse, she threatened them with a knife when her demands were not met; she attacked the officials at the institution and cut her own arm. In her medical history, a diagnosis of 46XX simple virilizing CAH had been made on the basis of labioscrotal fusion and the presence of a single urogenital opening at 1 month. At the age of 1.5 years, the patient was operated to be raised as a girl and surgical reconstruction was completed. As a result of inadequate parental care, she had been taken into institutional care at the age of 4. We learned that the patient who was in the institution until the age of 17 was frequently running away from the institution and once had been exposed to sexual abuse. We also learned that she had threatened a girl in her last institution and sexually abused her for 3 months. Gender dysphoria and personality disorder traits were detected in the patient. Genetic and environmental causes may lead to gender dysphoria. As in our case, interest in same-sex partners and forced sexual contact are problems that may occur in gender dysphoria. It should be emphasized that in individuals with genetic or environmental risk factors of gender dysphoria, the risk of developing gender dysphoria and the risk of sexual abuse need to be considered.