Nusret Soylu

Psychiatric disorders and characteristics of abuse in sexually abused children and adolescents with and without intellectual disabilities

The purpose of this study was to compare sexually abused children and adolescents, with and without intellectual disabilities (ID), in terms of post-abuse psychiatric disorders, features of the sexual abuse, and sociodemographic characteristics. The study included sexually abused children aged 6-16 years, who were sent to three different child mental health units for forensic evaluation; there were 102 cases (69 girls and 33 boys) with ID and 154 cases (126 girls and 28 boys) without ID. Researchers retrospectively examined the files, social examination reports, and the judicial reports of the cases. It was determined that in the group with ID, sexual abuse types including penetration and contact had higher rates, they were exposed to more frequent repeated abuses, the abuses were revealed with their own reports at a later period and lower rates, and post-abuse pregnancies were more frequent. It was also determined that the abuser was a familiar person and a family member at lower rates and more than one abuser was encountered more frequently, compared to the group without ID. While no difference was determined between the two groups in terms of the frequency of post-abuse post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), conduct disorder (CD) was observed more frequently in the group with ID. This study emphasizes that sexual abuse, which is an important problem in individuals with ID, has different features and effects.

Disordered eating attitudes, alexithymia and suicide probability among Turkish high school girls

We aimed to examine association between disordered eating attitudes (DEAs), alexithymia and suicide probability among adolescent females and to explore potential link between alexithymia and suicide probability in subjects with DEAs. 381 female students completed Eating Attitude Test (EAT-26), Toronto Alexithymia Scale (TAS-20) and Suicide Probability Scale (SPS). It was found that 13.2% (n=52) of the subjects have DEAs. Results indicated that total TAS-20 score and scores of Difficulty in Identifying Feelings (DIF) and Difficulty in Describing Feelings (DDF) subscales were significantly higher in DEAs group than in those non DEAs group (p<0.05). Additionally, total SPS score (p<0.001), Hopelessness (p=0.001), Suicide Ideation (p<0.001) and Hostility (p=0.003) subscales scores of SPS were significantly higher in the alexithymic DEAs than the non-alexithymic DEAs group. In order to control potential effect of depression, SPS subscales were used as covariate factors in ANCOVA. Negative Self-Evaluation subscale yielded a statistically significant difference between groups, other subscales did not. Results point out these; DEAs are relatively frequent phenomenon among female students in Turkey and presence of alexithymia was associated with an increased suicide probability in adolescents with DEAs. The results should be evaluated taking into account that depressive symptomatology was not assessed using a depression scale.

Effects of attention-deficit/hyperactivity disorder on child abuse and neglect

It is known that children with mental and developmental problems are at risk of abuse and neglect. Attention-deficit/hyperactivity disorder is one of the most frequent neurodevelopmental disorders in children and adolescents. The purpose of this study is to examine whether children diagnosed with ADHD are under more risk in terms of child abuse and neglect compared to controls. In this case-control study, 104 children, who applied to Child and Adolescent Psychiatry Unit of Bursa Yuksek Ihtisas Training and Research Hospital between January and June 2015, were diagnosed with ADHD, and had no other psychiatric comorbidity except for disruptive behavior disorders, and 104 healthy children were compared. Abuse Assessment Questionnaire was applied to children after approval of the families was received. It was determined that the children diagnosed with ADHD were exposed to more physical (96.2%) and emotional abuse (87.5%) in a statistically significant way compared to controls (46.2%; 34.6%), they were exposed to physical and emotional neglect (5.8%) at a lower rate compared to healthy children (24.0%), and there was no difference between them and healthy children in terms of witnessing family violence (56.7%; 47.1%) and being exposed to sexual abuse (5.8%; 1.9%). The children diagnosed with ADHD were exposed to physical and emotional abuse at a higher rate; further studies should emphasize the role of parents in this topic and how parental education and treatment programs change the results.

Gender Differences in Sexually Abused Children and Adolescents: A Multicenter Study in Turkey

ABSTRACT The purpose of this study was to examine gender-based differences in abuse-related characteristics and post-abuse psychiatric disorders among sexually abused children and adolescents. The researchers retrospectively examined files, judicial reports, and social examination reports of 1,250 sexually abused youth cases. Results showed that boys were more often victimized by penetration, force, and physical violence. Incidence of sexual abuse by family members, familiar persons, and multiple persons was higher among girls. In addition, a higher rate of major depressive disorder as well as alcohol consumption and cigarette smoking were found in sexually abused girls. No difference was observed between boys and girls in terms of post-traumatic stress disorder, conduct disorder, and other mental disorders. Intellectual disability was more frequent in boys.

Problematic Internet use was more common in Turkish adolescents with major depressive disorders than controls.

This study compared problematic Internet use (PIU) rates in 12‐ to 18‐year‐olds with major depressive disorder (MDD) and healthy controls and explored potential links between PIU and suicide among patients with MDD.

Association between premenstrual syndrome and alexithymia among Turkish University students

Abstract Premenstrual syndrome (PMS) is a heterogeneous disorder, which includes physical, cognitive, affective and behavioral symptoms. The aim of this study was to determine the factors affecting PMS and the relationship between PMS and alexithymia. The research was performed with 308 students. Data were collected using a demographic questionnaire, the Toronto alexithymia scale (TAS-20) and a premenstrual assessment form (PAF). The prevalence of PMS in our sample was 66.6%. The contributing factors to PMS were having a history of psychiatric treatment and having a smoking habit (p < 0.05). The PMS group showed higher scores than the non-PMS group on all the items of the TAS-20 which includes the three factors: difficulty in identifying feelings, difficulty in describing feelings and externally oriented thinking (p < 0.05). The alexithymic students showed higher scores on all PAF subscales (p ≤ 0.001). Further studies are needed to determine the probable role of alexithymia in the pathogenesis of PMS.

Fine motor skills in children with rolandic epilepsy.

This study aimed to evaluate fine motor skills in children with rolandic epilepsy (RE). The research included 44 children diagnosed with typical RE and 44 controls matched in terms of age, gender, and level of education. Fine motor skills were evaluated with the Purdue Pegboard Test, and intelligence was measured with the Wechsler Intelligence Scale for Children. After controlling for the effect of intelligence on fine motor skills, the results showed that the children with RE did not perform as well as the controls in the PPT dominant hand, both hands, and assembly subtests. Epileptic focus, treatment status, type of antiepileptic treatment, age at the time of the first seizure, time since the last seizure, and total number of seizures did not affect motor skills. Rolandic epilepsy negatively affected fine motor skills regardless of the childrens level of intelligence.

Factors related with unintentional injuries in children with newly diagnosed attention-deficit/hyperactivity disorder

The aim of the present study was to investigate the factors associated with unintentional injury in children newly diagnosed with attention-deficit/hyperactivity disorder (ADHD). One thousand four hundred and thirty children between the ages of 6 and 18 who were diagnosed with ADHD for the first time in child psychiatry outpatient clinics were included in the present study. The socio-demographic information of the children, their developmental histories, chronic physical health conditions, comorbid psychiatric disorders, and information obtained via the Turgay DSM-IV-based Child and Adolescent Disorders Screening and Rating Scale were examined retrospectively. It was determined that 12.8% of the children (n = 183) experienced unintentional injury. It was established that age, male gender, disruptive behavioural problems, and low education levels among mothers were predictive of unintentional injuries. The results of the present study suggest that behavioural problems accompanying ADHD and comorbid psychiatric disorders are important in terms of unintentional injuries.

Psychiatric disorders and symptoms severity in pre-school children with cow's milk allergy.

BACKGROUND Psychiatric disorders are seen frequently in atopic diseases. The present study aims to evaluate the frequency of psychiatric disorders and the severity of psychiatric symptoms in pre-school children with cows milk allergy. METHODS The parents of the pre-school children with cows milk allergy were interviewed in person and asked to fill out the Early Childhood Inventory-4 form. RESULTS The cows milk allergy group included 40 children (27 male, 13 female) with mean age, 44.5±14.7 months, and the control group included 41 children (25 male, 16 female) with mean age, 47.6±15.2 months. It was established that 65% of the group with cows milk allergy received at least one psychiatric diagnosis, while 36.6% of the control group received at least one psychiatric diagnosis, with a statistically significant difference (p=0.02). Within the psychiatric disorders, attention deficit hyperactivity disorders (odds ratio: 4.9, 95% CI: 1.472-16.856, p=0.006), oppositional defiant disorder (odds ratio: 5.6, 95% CI: 1.139-28.128, p=0.026), and attachment disorder (odds ratio: 4.8, 95% CI: 1.747-13.506, p=0.004) were found significantly higher compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores, calculated by using the Early Childhood Inventory-4 form, attention deficit hyperactivity disorders severity (p=0.006) and oppositional defiant disorder severity (p=0.037) were found to be higher in the cows milk allergy group. CONCLUSION Psychiatric disorders are frequent and severe in pre-school children with cows milk allergy.

Medication Persistence in Turkish Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

OBJECTIVE The aim of this study was to investigate medication persistence in Turkish children and adolescents with attention-deficit/hyperactivity disorder (ADHD). The effects of sociodemographic characteristics, symptom severity of ADHD, comorbidity, and treatment-related factors influencing medication persistence in children diagnosed with ADHD were studied. METHODS Medication persistence over a continuous 12 month period was evaluated for 877 children and adolescents between 6 and 18 years of age, who were diagnosed with ADHD for the first time and started to receive medication. Medication persistence was determined according to whether or not taking the prescribed medication continued for 12 months after the initiation of treatment. Whereas the symptom severity of ADHD was assessed by using the Turgay Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV)-based Child and Adolescent Behaviour Disorders Screening and Rating Scale-Parents Form (T-DSM-IV-S), perceived medication efficacy after the first treatment was evaluated by the Clinical Global Impressions-Improvement Scale (CGI-I). RESULTS In this study, medication persistence over a continuous 12 month period occurred at a rate of 30.2% (n=265) in the subjects studied. The hierarchical regression analysis conducted in this research revealed that younger age, higher hyperactivity/impulsivity symptom severity, use of long-acting methylphenidate, addition of another ADHD medication, addition of other psychotropic medications, absence of side effects, and perceived medication efficacy were associated with successful medication persistence over a continuous 12 month period. CONCLUSIONS Understanding the factors that affect medication persistence in ADHD may improve treatment efficacy and symptom control, while minimizing future risks.