Nursu Çakın Memik

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.

Turkish validity and reliability study of the Weiss Functional Impairment Rating Scale-Parent Report

Abstract Attention deficit hyperactivity disorder (ADHD) is seen frequently in childhood and leads to marked impairment in functioning. There is no scale in Turkey with documented validity and reliability that assesses ADHD-specific functional impairment (FI). This study aimed at adapting the Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P), which assesses ADHD-related FI, for use in Turkey, and examining psychometric aspects of the scale. The study included 250 children diagnosed with ADHD and 250 healthy children and their parents. Internal consistency and test–retest methods were used to test the reliability of the scale. Validity was tested with exploratory and confirmatory factor analyses and convergent and discriminant validity analyses. Since all six questions of the WFIRS-P were scored 0, analyses were conducted for the original scale questionnaire consisting of 50 items and the questionnaire consisting of 44 items where the six questions scored 0 were not included. The Cronbach’s alpha coefficient was 0.93 for the whole scale. The Spearman’s correlation coefficient was 0.93 for test–retest reliability. The exploratory factor analysis run on the 44-item questionnaire showed that the scale items were best represented in a 7-factor structure, but some items were placed in different subdomains than those of the original scale. In the confirmatory factor analysis, the root mean square error of approximation was 0.061, and the comparative fit index was 0.95 for the whole model. Therefore, the Turkish WFIRS-P is valid and reliable in testing functional impairment in children with ADHD.

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%.

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.

Anxiety Disorders Comorbidity in Children and Adolescents with Attention Deficit Hyperactivity Disorder

INTRODUCTION Our aim is to investigate the prevalence of comorbidity of anxiety disorders (AD) among patients newly diagnosed with attention deficit hyperactivity disorder (ADHD) and to compare symptom severity of ADHD and sociodemographic parameters between patients with and without AD. METHODS Among 1683 children and adolescents admitted to Kocaeli University Medical Faculty, Child and Adolescent Mental Health Outpatient Clinic, 447 children and adolescents, who were preliminarily diagnosed as ADHD by clinical interview based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), were invited to participate in the second phase of the study. Kiddie Schedule for Affective Disorder and Schizophrenia, Present and Lifetime-Turkish Version were applied to children and adolescents with ADHD and one of their parents to support the diagnoses of both ADHD and AD. Mothers, fathers, and teachers of the children were asked to complete DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale. RESULTS Our study group comprised 170 children and adolescents diagnosed with ADHD of whom 19.4% were girls and 80.6% were boys; 27.6% of patients diagnosed with ADHD showed AD comorbidity. Age of the parents at birth of the patients with AD was significantly lower than that of patients without AD. CONCLUSION In line with the previous studies, the comorbidity rate of AD was found to be higher among patients with ADHD than general population and clinical sample without ADHD. The possibility of comorbidity of AD in patients with ADHD should be considered because higher rates of AD are observed in ADHD and comorbidities of AD.

An obsessive compulsive disorder case mixed with the very early onset schizophrenia

Obsessive-compulsive disorder (OCD) is a psychiatric disorder which seen with recurrent obsessions and/or compulsions, chronic, demonstrate periodic course and affects social and daily functions of the individual considerably. Studies shown that about half of the adult patients with a diagnosis of OCD; the onset of disease in childhood or adolescence. Early onset is associated with more severe symptoms, more comorbidities and bad course of disease. In cases with early-onset OCD may also occur psychotic symptoms; difficulties being experienced for the diagnosis, treatment and follow-up process of these cases. In this case report it has been studied the differential diagnosis of an OCD case mixed with early onset schizophrenia.

Very Early Onset Obsessive-Compulsive Disorder: A Case Report

In this case report we present a case of obsessive-compulsive disorder in a 3-year-2-month old girl. It is aimed to describe a very early onset case of obsessive-compulsive disorder, which was treated with fluoxetine and had benefited from treatment. The case had massive crying, yelling and tantrum attacks in the foreground. She had her first compulsions at 2 years of age, and after that, her compulsions were increased day by day. These symptoms were just like not bathing and not changing other clothes or dirty diapers. The case was obsessive-compulsive disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnostic criteria. It has been started selective serotonin reuptake inhibitors. Her compulsions have been decreased during the first month of therapy. This case highlights the issue that obsessive-compulsive disorder should may start very early in the lifetime and if severe, early onset OCD can seriously affect the quality of life of the patient and her family.

Poor insight in obsessive compulsive disorder: a case report -

Obsessions are repetitive and continuous thoughts, impulses, or images which experienced as forcibly, coming unintentionally, and are causing significant anxiety or distress in most people. Compulsions are defined as repetitive behaviors or mental acts that occurs in response to peoples obsession or felt strictly forced according to the rules that must be followed. Until recent studies, researchers believed that obsessive-compulsive disorder (OCD) is rare in childhood, but new studies show that it’s not rare as believed. Insight in OCD is defined as acceptance of obsessions and compulsions unreasonable and excessive. Insight of some children and young people with OCD can be poor. Poor insight in OCD is the determinant of poor response to treatment. In literature, there is not enough information about poor insight in children. So, a lot of questions still remain unanswered and there is a need to work on insight in children. In this case report, it is aimed to discuss the process of diagnose and treatment of a patient who is fifteen years old and diagnosed as OCD with poor insight.