Sevcan Karakoç Demirkaya

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.

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.

The probable role of adrenomedullin and nitric oxide in childhood attention deficit hyperactivity disorder

Abstract Background: The role of adrenomedullin hormone, which has been shown to be associated with many psychiatric disorders, in the etiology of ADHD and its relation to disease is not yet known. Aim: In this study, it was aimed to compare plasma adrenomedullin and nitric oxide (NO) levels of newly diagnosed, treatment-naive patients with ADHD with healthy children. Methods: A total of 45 children with ADHD and 45 healthy children were included. The Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS), a semi-structured interview, was applied to all cases by child and adolescent psychiatrist. Age and gender matched participants who admitted to the hospital for any other reasons without any psychiatric diagnosis according to K-SADS were selected as a control group. Sociodemographic data form and The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale-parental form were applied to the all groups. NO and adrenomedullin levels were analysed by ELISA method with specific commercial kits. Results: There was no statistically significant difference in NO and adrenomedullin levels, neither between the groups nor ADHD subtypes. A positive correlation between adrenomedullin and NO levels was found in both the case (r = 0.659) and the control groups (r = 0.494). Conclusions: Besides being the first study to evaluate adrenomedullin levels to elucidate the etiology of childhood ADHD as well as NO, significant differences was not found between the case and the control groups in terms of NO and adrenomedullin levels.

A Retrospective Study of Long Acting Risperidone Use to Support Treatment Adherence in Youth with Conduct Disorder

Objective Risperidone has been widely used to control aggression and conduct disorder (CD) in youth; however, treatment compliance is a major problem in CD. Our aim is to evaluate the effectiveness and tolerability of long-acting risperidone (LAR) in treating nonadherent cases. Methods The medical records of children and adolescents who had CD and were nonadherent to conventional drugs and psychosocial interventions (and therefore taking LAR) were reviewed. Informed consent on offlabel use of LAR was obtained from the parents. Clinical Global Impression (CGI) Severity (CGI-S) and CGI-Improvement scales were used and baseline and end points were compared. Results The study comprised 14 children and adolescents (5 girls, 9 boys). All had comorbid disorders: substance use disorder (n=8), attention deficit hyperactivity disorder (n=6), and major depression (n=2). Mean duration of LAR use was 3.1 months (1.5–8 months). We observed significant improvements in the baseline and endpoint CGI-S scores for CD in all but one patient (Z=−3.198; p<0.001). Only mild adverse effects were observed: weight gain (n=2), sedation (n=1), leg cramps (n=1), and increased appetite with no weight gain (n=1). Conclusion LAR is effective and tolerable for patients with CD who can’t be medicated with oral preparations due to non-adherence to treatment. Even short-term LAR use is effective to get compliance. As CD predicts numerous problems in adulthood, appropriate treatment is crucial. To our knowledge, this is the first study on LAR use in youth with CD. The use of LAR deserves careful consideration and further controlled studies are needed to confirm our findings.

NÖROGELİŞİMSEL PSİKİYATRİK BOZUKLUKLARIN DOĞUM MEVSİMİ İLE İLİŞKİSİNİN İNCELENMESİ

Amac: Norogelisimsel psikiyatrik hastaliklarin etiyolojik nedenleri arasinda dogum mevsiminin yer alabilecegi ve D vitamini eksikligi ve enfeksiyonlarin patogenezde rol oynadigi ileri surulmektedir. Mevcut verilerde tutarsizliklar olmasina ragmen, ulkemizde dogum mevsimi iliskisini inceleyen calismalar kisitlidir. Bu calismada, dikkat eksikligi hiperaktivite bozuklugu (DEHB), tik bozuklugu, obsesif kompulsif bozukluk (OKB) ve otizm spektrum bozuklugunu (OSB) iceren cocukluk cagi norogelisimsel bozukluklar ile dogum mevsimi arasindaki iliskinin arastirilmasi amaclanmistir. Gerec ve yontem: Universite hastanesi cocuk ve ergen psikiyatrisi poliklinigine 01 Ocak 2014- 1 Ocak 2015 tarihleri arasinda ilk kez basvuran olgularin dosyalari degerlendirildi. Dogum mevsimleri, aldiklari psikiyatrik tanilar, dogum sekli ve zamani geriye donuk olarak incelendi. Norogelisimsel psikiyatrik bozukluk grubuna OKB, OSB, tik bozuklugu tanisi alan olgular dahil edildi. Kontrol grubuna norogelisimsel bozukluk sayilmayan anksiyete bozukluklari, depresyon, enurezis, enkoprezis ve uyum bozuklugu tanisi olan olgular alindi. Dogum mevsimi acisindan gruplar karsilastirildi. Bulgular: Toplam 616 olgunun %29,2’si (n=180) kiz, %70,8’i erkekti. Tum olgularin %89,1’inin zamaninda dogdugu belirlendi. DEHB tanisi alan olgularin en fazla yazin (%30,3), OSB tanisi alanlarin kisin (%32,9), tik bozuklugu olanlarin ilkbahar (%29) ve OKB olgularinin kis (%36,8) mevsiminde dogmus olduklari belirlendi. Ancak tanilar ve mevsimler arasinda istatistiksel olarak anlamli fark yoktu (p>0.05). Norogelisimsel bozukluklar ile kontrol grubu arasinda da dogum mevsimleri arasinda anlamli bir iliski bulunamadi (p>0.05). Sonuc: Calismamizda norogelisimsel psikiyatrik hastalik tanilari ile dogum mevsimi arasinda iliskisi saptanmamistir. Dogum mevsimselligini kiyaslamak icin daha buyuk hasta gruplarini iceren ve etkili olabilecek prenatal ve perinatal riskler, D vitamini seviyesi, anne beslenme durumu gibi diger karistirici faktorlerin incelendigi daha kapsamli arastirmalara ihtiyac vardir.

Evaluation of child and adolescent forensic cases within one year in Aydın city, in Turkey -

Objective: The aim of this study was to investigate the features related with the referral reasons, sociodemographic features, diagnoses of mental disorders, treatment processes and criminal profiles of all the child and adolescent forensic cases who were referred to forensic medicine and child and adolescent psychiatry (CAP) clinics by judicial authorities to get forensic report in Aydin city as well as was to inference the general profile of this city for this age bracket. Methods: All the data from child and adolescent forensic cases referred to forensic medicine and CAP clinics throughout the year in order to be examined for a forensic report have been retrospectively analyzed. Results: One hundred and fifty of total 272 cases were female (42.3%) and 157 were male (57.7%) and the average age was determined as 13.46±2.3. All the cases were analyzed according to the crime types or referral reasons; 147 of them due to drifting into crime while 85 cases were referred due to sexual abuse. In the cases referred to CAP clinics, sexual abuse was the most populated reason with the number of 85 (31.6%). The most common referral reasons of the cases drifting into crime were theft and malicious injury with the numbers of 77 (52.4%) and 26 (17.7%) respectively among 147 cases. The most common mental disorder was the post-traumatic stress disorder among sexual abuse cases. Fifty percent point six of those cases have been initiated treatment however only 37.2% of the cases were detected as maintaining the treatment. Conclusion: The first step in the fight against child and adolescent forensic cases being sexually abused and drifted into crime is consciousness of the individual and familial characteristics of those children and the differences of these among other regions. New efforts which will be carried out in collaboration with health care institutions and other related departments are required in order to maintain psychiatric treatment and follow-up during the process of bringing those children to healthy individuals in society.