Işık Karakaya

Social anxiety level in Turkish adolescents.

Social phobia is a mental disorder characterized by extreme and consistent fear of meeting new people, scrutiny in a variety of performance and/or interactional situations. The aim of this study was to investigate the level of self-reported social anxiety in a community sample of Turkish adolescents and the relationship between social anxiety and some sociodemographic parameters. This study was a school-based cross-sectional study. Students in grades 6–8 (aged 10–16) from 12 schools in Kocaeli/Turkey were screened by the Social Anxiety Scale for Adolescents (SAS-A). The correlations of sociodemographic parameters with the SAS-A scores were examined. Data from a sample of 1,713 students (865 boys 50.4% and 848 girls 49.5%) were analyzed. A significant gender difference in the SAS-A points was found. Boys reported higher SAS-A total and subscale scores (except social avoidance and distress-general subscale score) than did girls. A significant negative correlation was found between socioeconomic status and social anxiety level. SAS-A scores were higher in those with a low socioeconomic level, and who were going to rural schools. The result of this study showed that social phobic symptoms among Turkish adolescents were more severe in boys. Some factors such as low socioeconomic level, and going to a rural school had impact on the SAS-A scores. As the impairment in the school-domain was reported to be quite high, professionals and teachers need to recognize social anxiety in adolescents, so that help can be offered to overcome the difficulties social phobia causes.

Selective mutism. A school-based cross-sectional study from Turkey.

ObjectiveThe aim of this study is to examine the prevalence of selective mutism (SM) in Kocaeli, Turkey.MethodKindergarten, first, second and third grade students of all public/private schools within the city were included in the study. “SM screening forms” prepared on basis of DSM-IV were submitted to classroom teachers in all these schools asking whether they had any students meeting such symptoms.ResultsAbout 84.51% of the schools returned forms covering 64,103 children. Five hundred and twenty six of these children were thought to have symptoms of SM by their teachers. After their DSM-IV based clinical evaluation by a child and adolescent psychiatrist, only 21 children were diagnosed as SM. Among the SM group, three were in the kindergarten, 15 were in the first grade and three were in the second grade. Twelve of the children were male and nine were female (male: female ratio is 1.3:1). In this cross-sectional study, 0.83% of children were reported to have SM symptoms by their teachers. After the clinical evaluation of these children, the prevalence rate of SM was found to be 0.033%.

Posttraumatic stress symptoms in children diagnosed with type 1 diabetes

BackgroundStudies consistently found remarkable rates of posttraumatic stress symptoms (PTSS) in children with chronic diseases. But, only one study had searched PTSS in children with diabetes, until now. So, the present study aimed to examine incidence rate and predictors of PTSS in children with type 1 diabetes.MethodPTSS were evaluated by Child Posttraumatic Stress Reaction Index in fifty four children with diabetes (aged between 8–18 years). This assessment was based on hypoglycaemia as the potential traumatic event. Children were also introduced a brief questionnaire about demographic and disease related information. Some other information was obtained from families, medical stuff and records. Among 54 children, forty two had complete information. Hence, to evaluate possible predictive factors related with PTSS, multiple regression analysis was conducted for 42 children.Results18.5% of children were reported PTSS at severe or very severe level, and 51.9% were reported PTSS at moderate level or above. Multiple regression analyses were shown that child PTSS were not significantly related with possible predictive factors other than number of hypoglycaemic attacks for the last month.ConclusionThe study results support that posttraumatic stress symptoms are not rarely seen in paediatric patients with diabetes, and even if not severe, hypoglycaemic attacks may be perceived as traumatic by the children with diabetes. But, because of some limitations, the results should be carefully interpreted.

Anksiyete Bozukluğu Olan Çocuk ve Ergenlerde Sertralin Tedavisinin Yaşam Kalitesi Üzerine Etkisi

INTRODUCTION In this study, we aimed to determine the changes in quality of life of children/adolescents with anxiety disorders during six months of sertraline treatment, to investigate parent-child/adolescent concordance in perception of quality of life and to examine the effect of treatment on children/adolescents. METHODS In this study, 30 patients with anxiety disorders according to criteria specified in Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition (DSM-IV) were assigned to sertraline treatment. The patients were evaluated using the Pediatric Quality of Life Inventory (PedsQL), State-Trait Anxiety Inventory for Children, Clinical Global Impression Scale (CGI) and the Childrens Global Assessment Scale (CGAS) at 0th, 2nd and 6th months. RESULTS PedsQL total scores increased significantly with the treatment in children and adolescents (p<.001), however, no differences were observed in parent proxy report (p=.326). The mean CGAS score was 59.85±7.73 at the beginning of treatment and 73.70±7.01 at the end of treatment (p<.001). The average CGI score decreased from 4.68±.96 to 2.27±.84. CONCLUSION It was observed that perception of quality of life in children and adolescents with anxiety disorders increased with the treatment.

Diabulimia, a Type I diabetes mellitus-specific eating disorder

Type I diabetes mellitus is the most common endocrinologic disorder affecting pediatric patients. Diet regimen adaptations in patients with diabetes may result in focusing on only diet and weight control, which causes eating disorders more often in these patients. Diabulimia is an eating disorder specific to patients with diabetes characterized by limiting and/or skipping insulin dosing. It is well observed that diet management and insulin treatment are withheld for body appearence and social acceptance issues, especially in patients whose disease is diagnosed during adolescence. We hereby present a patient who was diagnosed as having diabetes at the age of 12 years and skipped insulin doses in order to control weight and was subsequently diagnosed as having diabulimia.

Addiction of Oxybutynin: An Adolescent Case Report

Oxybutynin is an antimuscarinic substance used frequently for the treatment of overactive bladder and nocturnal enuresis. During the use of such anticholinergic substances, such effects as the decrease in depressive symptoms, euphoria effect, relaxation and the alleviation of the side-effects of neuroleptic medications could be seen. In this case report, an adolescent who was referred to our clinic because of oxybutynin abuse and a suicide attempt has presented. According to the criteria of the DSM-V, other (or unknown) substance use disorder was diagnosed. Oxybutynin is among the non-controlled drugs and can be obtained easily without prescription in Turkey. In the literature this is the first case of Oxybutynin abuse in an adolescent. This case has been presented for the purpose of drawing attention to the oxybutynin abuse which is a growing problem among adolescents.

The Factors Affect Traumatic Stress in Child and Adolescent: A Case Series -

Traumas are the experiences which can not be tolerated and can lead to serious emotional, psychological, cognitive and behavioral problems for child and adolescent. Posttraumatic stress disorder is defined in DSM-5; the observation of re-experiencing of traumatic event, avoidance and trauma-related hyperarousal symptoms after of faced with directly or indirectly, real or intimidating manner to death, severe injuries or sexual assault. Traumatic events are the insistent events like natural disasters such as earthquake, floods, childhood neglect and abuse, forced abduction, traffic accidents, the diagnosis of a life-threatening illness. Epidemiological data reveals that posttraumatic stress disorder is the the most frequently seen psychiatric disorder after developing trauma. The community-based studies which investigating the incidence of posttraumatic stress disorder in child and adolescents are less. The lifetime prevalence of disorder in the general population is reported between 1% to 14%. There are many factors that influence the development of posttraumatic stress disorder. Response to trauma, coping and defense mechanisms of each patient may be different. In this case series it has been discussed the affecting factors for traumatic stress of 7 cases who approximately in one year follow-up outpatient clinic. The cases who did not have stress symptoms or shortly seen symptoms after experienced traumatic events.

The Assessment of the Relationship Between ADHD and Posttraumatic Stress Disorder in Child and Adolescent Patients.

Objective: This study examined ADHD comorbidity in child and adolescent patients who diagnosed with posttraumatic stress disorder (PTSD) or obsessive compulsive disorder (OCD). Method: Sixty-eight child and adolescent patients with PTSD and 42 child and adolescent patients with OCD were evaluated for ADHD. The sample included 110 patients who were administered structured clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Results: Results showed that 22.05% patients with PTSD and 59.52% patients with OCD met criteria for ADHD. Conclusion: The results of our study indicate that no meaningful differences were detected in comparisons between PTSD and OCD groups, in having ADHD as comorbidity.

Tic disorders in the differential diagnosis of chronic cough in children in relation to four cases.

Chronic cough is a frequent reason for medical referrals in childhood. In patients who do not have signs or symptoms of an underlying respiratory system disease and who do not respond to experimental treatment, psychogenic cough should be considered. In this paper, four patients who were referred to our department with a prediagnosis of psychogenic cough, found to have tic disorder as a result of the assessments performed and improved with antipsychotic medication are presented. The differantial diagnosis of chronic cough in children should include tic disorders as well as psychogenic cough. Tic disorders can be diagnosed easily with detailed history and their response to medical treatment is rather satisfactory. Recognition of these disorders by pediatricians will minimize erroneous diagnoses and inappropriate therapies in children with a complaint of chronic cough.

Trauma-focused cognitive-behavior therapy among children and adolescents -

Trauma focus cognitive behavioral therapy (TF-CBT) had been thoroughly investigated as a treatment modality in traumatized children which is widely used nowadays, but there is no one studies that uses this treatment model in Turkish literature. Initially developed for sexually abused children; TF-CBT was adopted for the treatment of other traumatic events. This model is a structured short term treatment approach with the core components of: psychoeducation, behavioral parenting skills, affective regulation skills, cognitive coping skills, construction of a trauma narrative, cognitive processing of the traumatic events, in vivo exposure to trauma reminders, conjoint child-parent sessions, and enhancing personal safety. The purpose of the present study is to analyze the previous studies of TF-CBT treatment in traumatized children with respect to their effectiveness.