Serhat Nasıroğlu

Posttraumatic stress and depression in Yazidi refugees

Aim The aim of this investigation was to determine the frequency of mental pathologies in children and adolescents of the Yazidi minority group who immigrated to Turkey from Iraq. The refugees were asked about preventive and risk factors that occurred before and after their immigration. Subjects and methods The sample comprised 55 children and adolescents (30 males and 25 females) who were Yazidi refugees and had settled in the Uçkuyular, Oğuz, Onbaşı, and Uğurca villages of Batman, Turkey. The study was conducted 9 months after the refugees had immigrated. The participants were evaluated in their native language through a semistructured interview titled “Reliability and Validity of Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version – Turkish Version”. A sociodemographic form was prepared so that investigators could understand their traumatic experiences before and after the migration and their current social conditions. All the interviews were conducted in the participants’ native language without the help of translators. The investigators filled out the sociodemographic forms. Results Posttraumatic stress disorder (PTSD) was detected in 20 children (36.4%), depression in 18 (32.7%), nocturnal enuresis in six (10.9%), and anxiety in four (7.3%). The following factors were found to be associated with depression: witnessing violence and/or death, being a girl, having older parents, being the elder child, and having multiple siblings (P<0.05). Risk factors for PTSD, depression, and comorbid conditions included witnessing violence and/or death (P<0.05). Four participants were observed to have both PTSD and depression (7.3%). Conclusion Most of the refugee children had experienced serious traumatic events in their home country. PTSD, depression, and comorbid mental problems are frequently seen in refugee children.

Psychometric properties of the Turkish version of the Revised Child Anxiety and Depression Scale – Child Version in a clinical sample

ABSTRACT Objective: The shortage of cross-culturally validated instruments limits the study and treatment of psychopathology in countries other than English-speaking ones. The Revised Child Anxiety and Depression Scale – Child Version (RCADS-CV) is a self-report questionnaire that assesses dimensions of DSM anxiety and depressive disorders in youths. In this present study, we aimed to examine the psychometric properties of the Turkish version of the RCADS-CV in a clinical sample of children in Turkey. Method: The participants were 483 children aged 8–17 years old. Subjects were recruited from the following centers: Bezmialem University Hospital (55.7%), Kütahya Regional Hospital (17.4%), Istanbul Medical Faculty Hospital of the Istanbul University (16.7%), and Sakarya University Hospital (12.2%). A semi-structured diagnostic interview was carried out and the following measures were used: Children’s Depression Inventory, Screen for Child Anxiety-Related Emotional Disorders (SCARED), and Strengths and Difficulties Questionnaire (SDQ). Results: Inter-scale reliability was strong/excellent with a Cronbach’s α of .95 and coefficients for the RCADS-CV subscales ranging from .75 to .86, demonstrating good internal consistency. Convergent and discriminant validity tests against both a semi-structured clinical interview and self-report measures suggested favorable properties. Confirmatory factor analysis supported the original six-factor model. RCADS-CV showed greater correspondence to specific diagnoses in comparative tests with the existing measures of anxiety and depression. Conclusion: Overall, the study provides satisfactory evidence that the Turkish RCADS-CV yields valid scores for clinical purposes among Turkish children.

Determinants of psychiatric disorders in children refugees in Turkey’s Yazidi refugee camp

ABSTRACT Objective: To examine the mental health states of a sample of Yazidi refugee children and adolescents who migrated from war-torn Iraq’s Sinjar region and to determine the risk and protective factors for psychiatric disorders among the refugee children and adolescents. Method: The participants of this research were children and adolescents between ages 6 and 17 who live in a refugee camp in Turkey. Their parents/guardians provided written informed consents for the research. The research was approved by the Ethics Council of Sakarya University. Participants with intellectual disabilities and autism spectrum disorders were excluded from the study. Two child and adolescent psychiatrists speaking their native language interviewed and evaluated each of the participants. Collected data included socio-demographic information about previous and current living situations, Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime – Turkish Version (K-SADS-PL). Results: One hundred and thirty-six children and adolescents (76 boys, 63 girls; mean age = 11.05 ± 3.11 (SD)). At the time of the assessment, 43.4% had posttraumatic stress disorder (PTSD) (n = 59), 27.9% depression (n = 38), 10.3% nocturnal enuresis (n = 14), 9.6% behavioural problems (n = 7), and 5.1% anxiety disorders (n = 13). Conclusions: Many of the refugee children and adolescents had developed psychiatric disorders, or are at risk for PTSD and depression. Also, the ongoing ambiguity regarding their living conditions, interruption of their education, a lack of hope for the future and anxiety regarding the ones they left behind are considered to be risk factors for the development of psychiatric and social problems in the future. Living with family members and not having losses from the immediate family are protective factors.

Psychometric Properties of the Parent Version of the Revised Child Anxiety and Depression Scale in a Clinical Sample of Turkish Children and Adolescents

The Revised Child Anxiety and Depression Scale-Parent version (RCADS-P) is a self-report questionnaire that assesses dimensions of DSM-based anxiety and depressive disorders in children and adolescents. The present study examined the psychometric properties of the Turkish version in a clinical sample of 483 children and adolescents. The child and parent versions of the RCADS, parent versions of the Screen for Child Anxiety Related Emotional Disorders, the Strengths and Difficulties Questionnaire and Adolescent Symptom Inventory-Depression Scale were administered. Current psychiatric diagnoses were assessed via the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present Version. The RCADS-P demonstrated high internal consistency and test–retest reliability, and good convergent, divergent, and discriminant validity. Confirmatory factor analysis supported the DSM-related six-factor structure. With its demonstrated favorable psychometric properties, the Turkish RCADS-P is currently the only validated parent-report instrument that assesses DSM-based anxiety and depressive disorders in children and adolescents in Turkey.

The number of war-related traumatic events is associated with increased behavioural but not emotional problems among Syrian refugee children years after resettlement

Background: Turkey is the leading refugee-hosting country in the world. However, there are few studies which investigate mental wellbeing of refugee children in Turkey. Objective: The paper aims to examine the prevalence of emotional and behavioural problems and associated risk factors among Syrian refugee minors in Turkey. Methods: The research involved 85 students from 2th to 8th grades. We investigated emotional and behavioural problems with parent-reported Arabic form of Strength and Difficulties Questionnaire (SDQ). Socio-demographical findings and children’s war-related experiences were also examined. Results: The study sample consisted of 49 (63.6%) girls, and 28 (36.4%) boys (total 77) from age 7 to 17. Average time after resettlement was 29.8 ± 11.2 (5 to 50 months) months. 66 (85.7%) children reported to had lost at least one familiar person due to the war. The mean experienced war-related traumatic events were calculated as 2.92 ± 1.86. Total difficulty scores of 30 (39.0%) children were above the cut off values. The rates of children whose SDQ problem scores exceeded the cut-off values were as high as 45.5% (35) for Emotional problems, 64.9% (50) for Peer, 27.3% (21) for conduct and 19.5% (15) for Hyperactivity problems. Discussion: Results indicate high prevalence rates of severe traumatic experiences and possible psychiatric disorders among child survivors of Syrian war which in its seventh year now. Çeri V, Nasirog6lu S / Arch Clin Psychiatry. 2018;45(4):100-5

Three adolescent cases of a very rare disorder: Trichotemnomania

ABSTRACT Trichotemnomania (TT) is characterized as the cutting or shaving of hair, which is an obsessive–compulsive habit. TT takes its name from a fusion of Greek words: thrix (hair), temnein (to cut), and mania (madness). TT is a very rare disease with only five case studies reported in the literature and to the best of our knowledge; no data are available on adolescents. This study focuses on three cases of adolescents with TT. All patients have been evaluated by a dermatologist and two child and adolescent psychiatrists. Dermatological examinations included medical history, physical examination, dermoscopy assessment, and laboratory investigations. Detailed psychiatric assessments consisted of socio-demographic data, clinical history, semi-structured interviews, and psychometric tests. Three cases with TT were both diagnosed with obsessive–compulsive disorder. Two of them diagnosed comorbid social anxiety disorder (in cases 1 and 2), and one case diagnosed with comorbid general anxiety disorder (in case 3) and agoraphobia (in case 3). Cases 1 and 2 were prescribed 50 mg/day of sertraline; however, case 3 refused the treatment. In conclusion, TT may be confused with trichotillomania or other disorders presented with alopecia. Differential diagnoses may be due to histopathological changes or dermoscopic assessment. Dermatologists should consider TT when a supposed alopecia areata looks somewhat unusual and should refer these patients for psychiatric evaluation.

Psychiatric Morbidity Among a School Sample of Syrian Refugee Children in Turkey: A Cross-Sectional, Semistructured, Standardized Interview-Based Study

Now in its eighth year, the Syrian civil war has caused displacement of more than half the population before the war and is viewed as the single largest contributing factor to many of the worsening global trends of children living in areas affected by conflict.1.

Recantation of Sexual Abuse Disclosure Among Child Victims: Accommodation Syndrome

ABSTRACT Background: Disclosing the sexual abuse may be related on many individual and/or environmental factors in all age groups. The sociocultural context is the most influential factor of the disclosing process especially for those living in patriarchal cultural values. This study compares the impacts of sexual abuse and other sociodemographic variables between recanting and non-recanting victimized groups in Adana city from Turkey. Methods: The samples attending our department were divided into two groups: group 1 comprised victims who recanted their first abuse disclosure, and group 2 comprised victims who insisted on the veracity of their first report at further evaluations. The characteristics of the child, family, and abuser were compared between recanting victims and non-recanting victims by retrospective data. Results: Each group included 27 children, for a total of 54 subjects. All adverse social reactions after the sexual abuse, including keeping secrets and a repressive family attitude, were higher among group 1 victims than group 2 victims (p < 0.0001). Conclusions: Although they are victimized by protecting family integrity, victims may show a tendency to keep secrets and to not immediately disclose an abuse event.

Mental problems and sociodemographic characteristics in children driven to committing crimes and the preparation of forensic reports

ABSTRACT Objective: In children referred for forensic reports by juvenile courts, particularly as psycho-sexual maturation starts in the initial phases of adolescence, actions defined as criminal by society may be expected to have been committed. These actions, which are frequently the results of unconscious impulses and sometimes affectations, are crimes in the general sense for this reason; great care is required when determining the presence of the ability of children to perceive the legal meaning and consequences of crimes that they commit and their ability to channel their behaviors. The aim of this present study is to examine the mental problems in children driven to committing crimes and the preparation of forensic reports in a Turkish forensic sample. Methods: Children referred by courts to Van Regional Training and Research Hospital Outpatient Clinics of Pediatric Psychiatry between 2013 and 2014 for forensic expert reports evaluating their ability to perceive the legal meaning and consequences of criminal behavior, and their ability to control their behaviors. Seventy-four children were evaluated retrospectively, with interviews of approximately 45 minutes on The Diagnostic and Statistical Manual of Mental Disorders in order to determine psychiatric diagnosis. Results: After evaluations, 26% of children and adolescents were found to possess the ability to perceive the legal meaning and consequences of the crime they had committed and have the ability to control their behaviors, while 27% could perceive the legal meaning and consequences but could not control their behavior, and 47% did not have the ability to perceive the legal meaning and consequences of the crime they had committed and to control their behaviors. Conclusions: The ability to perceive the meaning and consequences of crime and to direct one’s behaviors are affected by pathologies related with the family and the child.

Judicial psychiatric evaluation in adolescents: a case report

It is well known that children exposed to sexual abuse tend to severe mental disorders, are not enough to treat those children. Prisons for children are said to be shut for some reasons, or there are some news that in those prisons some children are exposed to maltreatment or sexual abuse. To provide treatment programs, including families into treatments and acculturation of youth to the society are the focus points to be improved; social support and employment programs will enable improvements in those population. For the sake of population long term treatments and follow up studies are necessary applications. In our case we have discussed how the mental health of these children exposed to sexual abuse can be improved and to provide rehabilitation process. Furthermore the treatment centers used for the children exposed to sexual abuse or pushed to crimes.