Tezan Bildik

Broader autistic phenotype in parents of children with autism: Autism Spectrum Quotient-Turkish version

The Autism Spectrum Quotient (AQ) is a self‐assessment screening instrument for measuring the degree to which an individual of normal intelligence shows autistic traits. Genetic factors could be responsible for the relatives of individuals with autism exhibiting higher than normal rates of autism‐related impairments, referred to as the ‘broader autism phenotype’ (BAP). The aim of this study was to test whether there is a difference between the parents of autistic and those of typically developing children (TDC) on AQ scores in a Turkish sample.

Social and Emotional Outcomes of Child Sexual Abuse: A Clinical Sample in Turkey

Childhood sexual abuse is a traumatic life event that may cause psychiatric disorders such as posttraumatic stress disorder and depression. During 2003-2004, 20 sexually abused children were referred to the Child and Adolescent Psychiatry Clinic of Ege University in Izmir, Turkey. Two years later, the psychological adjustment of these children (M age = 9.4 years, SD = 3.63 years, range = 5 to 16 years) is evaluated. Semistructured interviews, a form for the sociodemographic characteristics, are used for evaluations by a child psychiatrist who is blind to the first evaluation. It is determined that sexually abused children have more psychiatric disorders within the first year than 2 years later. However, some behavior problems occur at both short-term and long-term follow-ups.

Zuclopenthixol-induced neuroleptic malignant syndrome in an adolescent girl

We present the case of a 14-year-old female who had many characteristics of neuroleptic malignant syndrome (NMS) without pyrexia following a single depot injection of 200 mg of zuclopenthixol. The patient presented with a change in mental status that had progressed over the preceding 48 hours. Subsequently, she became increasingly agitated and confused, and developed diffuse muscular rigidity, mutism, tremor, tachycardia, diaphoresis, sialorrhea, and incontinence. Results of laboratory tests showed elevated CPK levels, leukocytosis, and a low serum iron level. Bromocriptine and diazepam were used as initial treatment of a probable NMS and provided significant improvement. During the next seven days, she clinically improved but continued to exhibit emotional lability, logorrhea, elevated mood, and increased psychomotor activity. Therefore, bromocriptine and diazepam were discontinued and lorazepam and lithium were administered as treatment of a bipolar disorder. Four weeks later, she was discharged in stable condition. The presentation of this case report suggests that the primary psychiatric diagnosis is important in antipsychotic usage in the pediatric population, and that young patients receiving neuroleptic treatment should be monitored for the early signs of NMS. Using the diagnostic criteria of a neuroleptic toxicity spectrum may result in greater clinical awareness and earlier recognition of NMS.

Hypohidrotic ectodermal dysplasia: a multidisciplinary approach.

Hypohidrotic ectodermal dysplasia (HED; Christ-Siemens-Touraine syndrome) is a genetic disorder characterized by sparse hair, oligodontia with peg-shaped teeth, reduced sweating, and defects in a number of other ectodermal organs. A partial or complete absence of eccrine glands can lead to recurrent severe overheating that may cause seizures and neurological deficits. This clinical report presents a 14-year-old male patient with hypohidrotic ectodermal dysplasia, including the clinical and radiographic findings, and multidisciplinary treatment. The Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) was administered to patient along with mother to assess for any psychiatric disorders. The screening and rating scales completed by mother and two teachers to evaluate the severity of attention deficit hyperactivity disorder (ADHD) symptoms, and other behavioral problems. Patients academic performance, adaptive functioning, and problem behavior was evaluated using The Teacher Report Form. Mental capacity was assessed with the Wechsler Intelligence Scale for Children (WISC-R). Illness Perception Questionnaire Revised was used to systematically assess illness representation attributes and emotional representations of illness. On the psychiatric diagnosis assessment using K-SADS-PL sub-threshold attention deficits and anxiety symptoms were determined. In this case we established a multidisciplinary approach in his treatment with pediatric, dermatological, and dental examinations, beside his psychiatric evaluation. The prosthetic rehabilitation included restoring upper teeth with copings and fabrication of upper and lower complete dentures. Metal framework was not incorporated in the partial denture design allowing modifications as the oral and maxillofacial development continued. Removable complete or partial dentures without metal framework is a treatment of choice until the completion of facial growth at which definitive treatment is considered.

Childhood sexual abuse and supportive factors

Childhood sexual abuse (CSA) can be a devastating life experience and is associated with a higher incidence of mental disorders and suicide attempts. The aim of this study was therefore to identify predictors of mental disorder and suicide attempt in children and adolescents with a history of CSA.

The Psychometric Properties of Turkish Version of Autism Spectrum Screening Questionnaire in Children aged 6-18 years

OBJECTIVE The objective of this study is to determine the psychometric properties of the Turkish version of the Autism Spectrum Screening Questionnaire (ASSQ-TR) and to find the best cutoff score for Pervasive Developmental Disorder (PDD) cases. METHOD Children between 6 to 18 years old with diagnoses of PDD, Obsessive Compulsive Disorder (OCD), and Attention Deficit Hyperactivity Disorder (ADHD) were included. The healthy control (HC) group was recruited from children who did not have any psychiatric complaints or history. Furthermore, parents of 268 children filled the ASSQ-TR. Of the children, 51 were PDD, 67 were ADHD, 50 were OCD, and 100 were HC. In order to show the reliability of the ASSQ-TR, Cronbachs alpha values and test-retest were evaluated. ROC analyses was carried out to show concurrent validity and to determine the cutoff score. RESULTS The Cronbachs alpha of ASSQ-TR is 0,86, while the test-retest reliability is r: 0,98. Total ASSQ-TR scores of children with PDD (27,96±9,5) were significantly higher than other groups (p<0,001). ROC analysis of ASSQ-TR showed the area under curve to be 0,97 with a cutoff of 16, having the maximum sensitivity (94,1%), specificity (89,0%), and 90,7% diagnostic accuracy of PDD versus HC scores. CONCLUSIONS Our pilot data showed that ASSQ-TR is a reliable instrument that successfully differentiates clinically diagnosed PDD from HC. This instrument might therefore be useful for the screening of PDD in school-aged children in Turkish populations.

486 PSYCHIATRIC DIAGNOSIS OF CHILDREN AND ADOLESCENTS WHO WERE REFERRED TO CHILD AND ADOLESCENT PSYCHIATRY DEPARTMENT WITH PAIN COMPLAINTS

Background and Aims: On DSM-IV (Diagnostic and Statistical Manual of Mental Disorders 4th edition) and ICD-10 there are many mental disorders including the term “pain”, likewise somatoform, anxiety, delusional disorders, somatic type etc. It is also common by depressive disorders that patients can suffer from pain. Children and adolescents often use somatization due to developmental features, headache, abdominal and chest pain are common seen symptoms by children’s depressive disorders. Methods: The study was made by Ege University Child Psychiatry – Consultation-Liasion Department on January 2005–April 2006. Children and adolescents who were referred to our department with application complaint pain were evaluated. Children with physical diseases were excluded. Children and adolescents were interviewed with using the DSMIV diagnostic criteria’s and their psychopharmacological treatment was ordered. Results: 13 cases were evaluated by this study. The mean age was 10.85 (sd = 3.58). 61.5% (n = 8) of cases were girls; 38.5% boys. 62.5% of the patients were going to primary school. Headache was the common symptom of all patients (61.5%). 38.5% of cases had depressive symptomatology; 15.4% diagnosed as depressive and 15.4% as anxiety disorders. 7.7% of cases did not met to any criteria of psychiatric disorders. 46.2% of cases treated with antidepressant and anxiolytic combined medication. Conclusions: It is noticeable by children’s and adolescents’ psychiatric evaluations that they use the somatization very frequently. Pain can be a depression or anxiety sign by this age group. Some psychological and psychopharmacological interventions can be helpful by curing these symptoms and underlying syndromes and disorders.