Osman Abali

Venlafaxine in children and adolescents with attention deficit hyperactivity disorder

Abstract  The primary purpose of this study was to describe tolerability and efficacy of venlafaxine in the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD). A 6‐week open trial of venlafaxine was conducted in 13 children and adolescents (mean age 9.9 ± 2.5 years) with ADHD, and without comorbid depression. Venlafaxine was initiated at a dose of 18.75 mg/day and flexibly titrated to 56.25 mg/day. The Conners parent scale and Clinical Global Improvement (CGI) severity item were performed at baseline and at the end of the 6‐week trial. All subjects completed the trial. Mean final dose of venlafaxine was 40.3 ± 7.0. Venlafaxine was significantly effective in reducing the total score of the Conners parent scale from baseline to endpoint (P < 0.002, Z =−3.113) and the CGI severity item (P < 0.05). Transient side‐effects such as somnolence (n = 2), stomachache (n = 2), and headache (n = 1) disappeared after second week of treatment. Also three subjects complained of sedation after raising the dose to 56.5 mg/day, therefore the dose was reduced to the previous level. These preliminary data suggest that venlafaxine may be an effective medication in the treatment of some children and adolescents with ADHD. Future double‐blind controlled trials should be undertaken.

Citalopram treatment of children and adolescents with obsessive–compulsive disorder: A preliminary report

Abstract The purpose of the present study was to assess the efficacy and tolerability of citalopram in the acute treatment of children and adolescents with obsessive compulsive disorder (OCD) during an 8‐week, open‐label study. Fifteen patients (six female, nine male) with a mean age of 12.1 ± 3.3 years (range: 6–17 years) were treated with citalopram (range of dose: 20–30 mg/day, mean dose: 24 ± 5.5 mg/day). The childrens version of the Yale–Brown Obsessive–Compulsive scale (CY‐BOCS) was rated at the baseline, at the 4th week and at the 8th week of treatment. Fourteen patients had a decrease in total score of CY‐BOCS from baseline to the 4th week of treatment (P < 0.01) and the 8th week of treatment (P < 0.01). Sedation (n = 1) and insomnia (n = 1) were reported in the first weeks of treatment. The primary data suggest the efficacy and tolerability of citalopram in young patients with OCD.

The Psychological Effects of Forced Emigration on Muslim Albanian Children and Adolescents

Objectives: The object of this study was to investigate the psychological effects of forced emigration on Muslim Albanian children and adolescents who were forced to emigrate due to the war in Kosova. Method: The sample of the study consisted of 150 children between the ages 9–12 and 100 adolescents between the ages 15–19 living in the Gaziosmanpaşa Refugee Shelter in Turkey, and as a control group, 66 children and 52 adolescents; making a total of 368 subjects were included in the study. We applied State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Childrens Depression Inventory (CDI) as well as a semi-structured open-ended questionnaire investigating the socio-demographic characteristics and psychiatric symptoms of the study and control groups. Results: Trait anxiety (TAI) levels of the children in the study group are higher than these in the control group. The analysis of the average Depressive Symptom scores of study group children (M = 15.70) and control group children (M = 7.37) was conducted with the application of t-test. The highly significant values of t = 7.73 p < 0.0001 indicate depressive symptoms among study group. Trait anxiety (TAİ) scores of study group adolescents were higher than these in the control group (M = 43.56) and (M = 35.59), respectively and the values of t = 5.95, p < 0.0001 show that this is a highly significant difference. The comparison of the average depressive (BDI) symptom scores of study group and control group adolescents (M = 17.57 and M = 4.59 respectively) revealed the very significant values of t = 7.88, p < 0.0001. The evaluation of the semi-structured questionnaires also revealed that depressive symptoms, somatic symptoms and other psychiatric symptoms were also higher in the study group. Conclusion: Our findings support the common opinion that war and terror incidents severely hurt children.

Short-Term Efficacy and Safety of Risperidone in Young Children with Autistic Disorder (AD)

Summary Recently, atypical antipsychotic treatments have been used in children with autistic disorder (AD). However, data on safety and efficacy of atypical antipsychotic agents in autistic children are limited. In this open, prospective trial, subjects were treated with risperidone for six weeks. Nineteen children (12 male, 7 female) aged 4 to 8 years were started on 0.5 mg daily with individual titration to a maximum of 1.5 mg daily. Behavioural assessments were completed by Conners parent 10-item index, AD symptom checklist and CGI-Global improvement. Statistically significant improvement was observed in mean total scores of Conners parent 10-item index from baseline to the end of study (p > 0.001). On the basis of the CGI-Global improvement item, 15 children were considered responders. Statistically significant improvement was also found in some aspects of social contact, impulsive-aggression and repetitive, ritualistic behaviour based on assessment with the AD-symptom checklist. Weight gain and increase in night-time sleep were the most frequent side effects.

Group A beta hemolytic streptococcal infections and obsessive‐compulsive symptoms in a Turkish pediatric population

Abstract  The purpose of the present study was to evaluate obsessive‐compulsive disease (OCD) in Turkish Children who had group A beta hemolytic streptococcal (GABHS) infections and those who had not. Thirty‐one children and adolescents (the study group) were compared with 28 children and adolescents. The Childrens Yale‐Brown Obsessive‐Compulsive Scale (CY‐BOCS) scores were rated between study group and control group. The mean score, obsession and compulsion scores of CY‐BOCS in the study group were significantly higher than they were in the control group (P < 0.05). The GABHS infections should be assessed in the etiology of OCD in children. Considering GABHS infections may help the treatment of OCD.

Elevated plasma concentrations of S100 calcium-binding protein B and tumor necrosis factor alpha in children with autism spectrum disorders

Objective: To investigate plasma concentrations of S100B (a calcium-binding protein derived primarily from the glia) and inflammatory cytokines in children with autism and the relationship between S100B and cytokine concentrations. Methods: Plasma levels of S100B, tumor necrosis factor alpha (TNF-α), interferon gamma, interleukin (IL)-1β, IL-4, IL-6, IL-10, and IL-17A were measured in 40 unmedicated children with autism and 35 normally developing healthy children. The severity of autism was assessed using the Childhood Autism Rating Scale (CARS). Results: Concentrations of both S100B and TNF-α were higher in children with autism before and after adjusting for a priori-selected confounders (age, sex, and body mass index). S100B concentrations were higher in children with severe autism compared to children with mild-moderate autism. However, this association remained as a trend after adjusting for confounders. S100B concentrations correlated positively with TNF-α concentrations. Conclusion: Our findings showing an increase in peripheral concentrations of S100B and TNF-α provide limited support to the hypothesis about the roles of altered immune function and S100B in autism spectrum disorder (ASD). Studies of larger numbers of well-characterized individuals with ASD are needed to clarify the potential role of the immune system in the pathophysiology of this disorder.

Clinical, psychological and maternal characteristics in early functional constipation

This cross‐sectional study investigated the clinical features of functional constipation (FC) at preschool age, as well as emotional and behavioral characteristics of the children, psychological symptom level and parental attitudes of the mothers, and compared these with that of non‐referred typically developing controls with normal intestinal habits.

Acute Psychological Reactions of Children and Adolescents after the Marmara Earthquake: A Brief Preliminary Report

An earthquake took place in August 1999 in the Marmara region of Turkey. A psychiatry team from Istanbul arrived two weeks later. Children and adolescents under 19 years of age were evaluated by a child and adolescent psychiatrist. A semi-structured clinical interview was administered to every patient presented. In addition, a non-structured, clinical interview was administered. One hundred and two children and adolescents were interviewed. The most frequent complaint was a ‘fear of being alone’ (96%), and the most common diagnosis given to these patients was acute stress disorder (74.5%). A considerable number of children started experiencing severe psychological symptoms immediately after the earthquake. Psychological support and treatment should be started as soon as possible, in such circumstances.

Assessment of sleep problems and related risk factors observed in Turkish children with Autism spectrum disorders

Sleep problems are common and difficult to manage in children with autism spectrum disorders (ASD). Another major adverse impact of sleep problems is that they exacerbate behavioral problems. To assess sleep problems and possible behavioral risk factors in detail, we aimed to compare sleep habits of children with ASD, with healthy children. The relationship between sleep difficulties and concomitant behavioral problems such as repetitive behaviors, hyperactivity, and social withdrawal were also examined. Hundred and seventeen children and adolescents including 64 with the diagnosis of ASD and 53 healthy subjects were enrolled in the study. Diagnostic Interview for ASD was performed according to DSM‐IV‐TR. Socio‐demographical data form and childhood autism rating scale were filled by researchers. Aberrant behavior checklist (ABC), child behavior checklist and pediatric sleep questionnaire (PSQ) were completed by the parents of the children. Children with ASD had higher frequency of sleep problems, snoring, breathing problems, behavioral problems compared with healthy children (for all parameters; P < 0.001). A positive correlation was identified between the total score of PSQ and the total score of ABC (P < 0.05, Spearman correlation coefficient: 0.347). Sleep latency was prolonged in children with ASD compared with healthy subjects (P < 0.001). In accordance with the current literature, children with ASD were subject to sleep problems significantly more than the control group. Identified risk factors for sleep problems in ASD children were behavioral factors such as stereotypies, self‐mutilation, hyperactivity, and social withdrawal. Autism Res 2016, 9: 536–542.

Immune system changes after sexual abuse in adolescents.

The immunological changes in diseases such as rheumatoid arthritis and multiple sclerosis have been found to be similar to the immunological changes in adults with post‐traumatic stress disorder (PTSD). The biological consequences of and immunological disruptions associated with psychological trauma in sexually abused adolescents were investigated in this study.