Şahika Gülen Şişmanlar

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.

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.

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.

Kocaeli Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Daltna Başvuran Çocuklara Yönelik Cinsel İstismar Olguları 1998-2006

Child sexual abuse is the abuse of the child, who has not yet completed his/her sexual development, by an adult for sexual arousal. Misdiagnosed sexual abuse is the cause of either suspect’s being punished or harming of unguilt as well as preventing children’s protection. In this study, it was aimed to evaluate child sexual abuse cases with their characteristics and examination periods which are informed to Kocaeli University School of Medicine, Department of Forensic Medicine. Between 1998-2006, the reports and files of cases at the registers of Kocaeli University School of Medicine, Department of Forensic Medicine, examined retrospectively. Fifty cases (3,1%)under the heading of sexual abuse are included in the study. It is determined that 62% of cases are females, 38% of them are males and 60 % of the cases are under the age of 12. It is also determined that suspects are mostly the cases’ acquaintances (70%) and all of suspects are males. In the 36% (n= 18) of the cases, the questions are asked towards physical diagnosis, in 50% (n = 25) of the cases, the questions were oriented towards mental health, while 14% (n=7) of the cases are examined through both physical and mental evaluations. Impairment of mental health which can be considered as the result of sexual abuse are determined in the 60,5% (n=23) of 38 mental-oriented cases. After recent legal arrangement, a significant increase in sexual abuses is observed and recorded in Department of Forensic Medicine. The organisation and functioning of the units connected to the Ministry of Health and Ministry of Justice are considered unsuitable for the evaluation of sexual abuse. Foundation of Center of Sexual Abuse Evaluation would provide early treatment of present or probable pathologies as well as precise diagnosis.Key words: Child, sexual abuse, mental evaluation, child psychiatry