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Amaç: Bu çalışmada kronik tıbbi hastalığı olan psikiyatrik takipteki çocuk ve gençlerin pandemi ile ilgili uyum süreci ve psikiyatrik belirtilerindeki değişikliklerin Teletıp uygulaması ile değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya, Konsültasyon Liyezon Polikliniği’nde takipli, 0-18 yaş arasındaki olgular dahil edilmiştir. Olgular randevularının oldukları gün ve saatlerde, Teletıp yolu ile aranarak ebeveyn ve kendileri ile psikiyatrik görüşme yapılıp son durumları değerlendirilmiştir. Pandemi ile ilgili uyum sürecini araştırmak amacıyla araştırmacılar tarafından hazırlanan anket soruları olgu ve ailelerine sorulmuş, cevapları olgu veri formuna kaydedilmiştir. Olguların pandemi öncesi Klinik Global İzlenim (KGİ) ölçeği puanları dosyalarındaki bilgilere göre, pandemi dönemindeki KGİ puanları da telefonla yapılan görüşme sonucuna göre kaydedilmiştir. Bulgular: Çalışmamıza katılan olguların %49’u (n=25) kız, %51’i (n=26) ise erkektir. En sık görülen kronik tıbbi hastalıklar nörolojik (%21,6, n=11) ve metabolik-genetik (%21,6, n=11) hastalıklar olarak tespit edilmiştir. Olgularımızda pandemi öncesi tespit edilen psikiyatrik tanılarda birinci sırada Dikkat Eksikliği/ Aşırı Hareketlilik Bozukluğu (%35,3), ikinci sırada Depresyon Bozuklukları (%17,6) ve Anlıksal Gelişimsel Bozukluk (Ağır Olmayan) (%17,6) gelmektedir. Olguların pandemi öncesi KGİ puanı 2,62±0,59, pandemi sürecindeki KGİ puanı 2,90±0,80 olarak değerlendirilmiştir. Aradaki fark istatistiksel olarak anlamlıdır (p=0,003). Evde sağlık çalışanı olup olmaması ve yakınlarında hastalıktan etkilenen birey olup olmaması ile KGİ puanı arasında anlamlı bir fark saptanmamıştır (p>0,05). Sonuç: Çalışmamız kronik tıbbi hastalığı olan ve psikiyatrik takipteki olgularda, pandemi sürecinde ruh sağlığının olumsuz etkilendiğini, sinirlilik ve kaygı gibi belirtilerde artma olduğunu ve immatür davranışlar, uyku düzeninde değişiklik gibi yeni ruhsal belirtilerin eklendiğini göstermesi bakımından önemlidir.

Aim: In this study, it was aimed to evaluate the changes in the adaptation process and psychiatric symptoms system of children in the preschool age group who are under psychiatric follow-up, related to the COVID-19 pandemic with the Telemedicine system.Materials and Methods: Preschool children who are under psychiatric follow-up were included in this study. On the appointment days, the questionnaire prepared by the researchers in order to evaluate the adaptation process to the pandemic were asked and recorded through the Telemedicine system. Clinical Global Impression-Severity of Illness (CGI-Severity) scale was used to evaluate the severity of illness for the pandemic and pre-pandemic period.Results: In our study, 27.5% of 51 patients were girls and 72.5% were boys. The average age is 4.42±1.15. Most frequently observed psychiatric diagnoses are Autism Spectrum Disorder (52.9%), Attention Deficit and Hyperactivity Disorder (21.6%), and Mild Intellectual Disability (13.7%). As the primary change observed during the pandemic period, 25.5% of the cases reported increased irritability and 19.6% increased anxiety, 54.9% change in sleep pattern and 39.2% change in nutritional routine. CGI-Severity score before the pandemic was evaluated as 3.37 ± 0.87, and as 3.74 ± 0.89 during the pandemic period.Conclusion: The most common complaints in the preschool age group were irritability, anxiety and sleep/ nutritional changes. Our study has been a guide in determining the levels of being affected by the pandemic period and emphasized the necessity of providing children an appropriate information for their age and continuing their treatment and follow-up through telemedicine., Amaç: Bu çalışmada okul öncesi yaş grubunda olup psikiyatrik takibi devam eden çocukların COVID-19 pandemisi ile ilgili uyum süreci ve psikiyatrik belirtilerindeki değişikliklerin Teletıp sistemi ile değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Bu çalışmaya psikiyatrik takibi devam eden okul öncesi yaş grubundaki hastalar alınmıştır. Randevu günlerinde Teletıp sistemi aracılığıyla görüşülerek covıd-19 pandemisi ile ilgili uyum sürecini değerlendirmek amacıyla araştırmacılar tarafından hazırlanan anket soruları sorulmuş ve kaydedilmiştir. Pandemi ve pandemi öncesi dönemdeki hastalık şiddetlerini değerlendirmek için Klinik Global İzlenim-Hastalık Şiddeti (KGİ-Şiddet) ölçeği kullanılmıştırBulgular: Çalışmamıza dahil edilen 51 hastanın %27,5’i kız, %72,5’i erkektir. Yaş ortalaması 4,42±1,15’tir. Psikiyatrik tanılarda birinci sırada Otizm Spektrum Bozukluğu (%52,9), ikinci sırada Dikkat Eksikliği / Hiperaktivite Bozukluğu (%21,6), üçüncü sırada ise Hafif Düzeyde Mental Retardasyon (%13,7) yer almaktadır. Pandemi döneminde gözlenen birincil değişiklik olarak olguların %25,5’i sinirlilikte artış, %19,6’sı kaygıda artış bildirmiştir. Hastaların uyku ve beslenme rutinleri sorgulandığında %54,9’u uyku, %39,2’si beslenme ile ilgili değişiklik bildirmiştir. Hastaların pandemi öncesindeki KGİ-Şiddet puanı 3,37±0,87, pandemi dönemindeki ise 3,74±0,89 olarak değerlendirilmiştir.Sonuç: Okul öncesi yaş grubunda en sık saptanan yakınmalar sinirlilik, kaygı artışı ile uyku ve beslenme düzeni değişiklikleri olmuştur. Çalışmamız pandemi sürecinden etkilenme düzeylerini tespit etmek açısından yol gösterici olmuş ve çocuklara yaş gruplarına uygun bilgilendirmeler yapılmasının, Teletıp yolu ile tedavi ve takiplerinin devam etmesinin gerekliliği vurgulamıştır.

Objectives:This study aims to evaluate the quality of life of children and adolescents diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and to compare the quality of life perceptions of patients and parents.Materials and Methods:Sixty-three ADHD and 32 controls were included in the study. For psychiatric diagnosis, “Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime - Turkish Version” was applied to all patients. “Child Behavior Checklist” and ADHD Scale were applied to parents and Pediatric Quality of Life Inventory (PedsQL) was applied to patients and parents.Results:Physical health summary score, psychosocial health summary score (PHSS), and total scale score (TSS) of the PedsQL filled in both patients and parents were significantly lower in the ADHD group than the control group (p

Prodromal symptoms of bipolar disorder (BD) and early onset schizophrenia spectrum disorder (EOSSD) overlap. To date, there has been no study directly comparing the prodromal stage of both disorders. Thus, the current study is aimed at determining which prodromal symptom clusters differentiate BD and EOSSD. One hundred twenty one adolescents (33 BD-1, 30 EOSSD, 58 healthy controls) were evaluated for the presence of 79 prodromal symptoms, divided into 7 prodromal symptom clusters. Great than 2 subsyndromal manic symptoms and ADHD comorbidity were significantly more specific for BD than schizophrenia; brief limited intermittent psychotic symptoms (BLIPS) were more likely to be part of EOSSD. In contrast, attenuated psychotic symptoms, and negative symptoms were not specifically related to the diagnosis of EOSSD. In conclusion, subsyndromal manic symptoms, BLIPS, and ADHD might be useful for predicting the trajectory of an emerging affective disorder versus schizophrenia and thus valuable for early detection, and intervention strategies.

[No Abstract Available]

Objective: The aim of this study was to examine the sociodemographic characteristics, psychiatric diagnoses and factors associated with psychiatric diagnoses of children and adolescents who are victims of sexual abuse. Method: The files of 92 children and adolescents aged between 0-18 who were referred to University Hospital Child and Adolescent Psychiatry Forensic Policlinic between January 2017 and December 2019 due to sexual abuse were evaluated retrospectively. Psychiatric diagnoses of the cases were made according to DSM 5 diagnostic criteria. Intellectual capacity of the cases was evaluated according to the latest verison of Wechsler Intelligence Scale for Children. Results: In our study, 78 (84.8%) cases were female and 14 (15.2%) were male. Mean age of the cases was 14.1±3.88 years. The most common type of sexual abuse was touching (52.2%, n=48). There was a psychiatric diagnose in 50 (54.3%) of them. The most common psychiatric diagnoses were posttraumatic stress disorder (n=29, 31.5%) and major depressive disorder (n=25, 27.2%). The rate of psychiatric diagnosis was significantly higher in cases exposed to coercion and violence (p=0.032). In 32 cases (34.8%), it was determined that the abuser was within the family. Conclusion: Sexual abuse has an effect on child’s development throughout life.In our study, the rate of psychiatric diagnosis was high. It is very important to provide the necessary psychiatric support to the victims of sexual abuse. With the studies to be done in this area, awareness can be increased and necessary precautions can be taken.

Objective: The aim of the presented study is to evaluate the adaptive process and psychiatric symptoms in the 7-12 age group followed-up with telemedicine interviews during the height of the pandemic. Method: Patients between the ages of 7-12 who were followed up in our outpatient clinic were called by telemedicine service at the appointment date. The questionnaire prepared by the researchers in order to investigate the adaptation process to the pandemic was administered, the answers provided by the patients and their families were recorded in the case data form together with Clinical Global Impression (CGI) Scale score appraised by the interviewing psychiatrist. Medical records pertaining to each patient were also reviewed, their psychiatric diagnoses, according to DSM 5 criteria and CGI scores recorded in their last face-to-face interviews during the pandemic period, were included in the case data form. Results: Fifty patients were included in the study. The mean age of the participants was 9.14±1.61 years. Attention deficit hyperactivity disorder (60%) was the most common psychiatric diagnosis detected in the participants before the pandemic, followed closely by anxiety and related disorders (20%) and specific learning difficulty (16%). The CGI scores of the cases before, and during the pandemic were 2.72±0.75, and 2.92±0.94, respectively. The difference between the mean scores was statistically significant (p=0.024). Conclusion: Our study emphasizes the importance of follow-up by telemental health practices in cases where face-to-face psychiatric interviews are not applicable, i.e., due to the risk of transmission of COVID-19 disease during the current pandemic

10th International Congress on Psychopharmacology & 6th International Symposium on Child and Adolescent Psychopharmacology[Abstract:0103][Mood disorders]A forgotten diagnosis: funeral maniaABSTRACT...

Adolescence is an important developmental period for the first onset of non-suicidal self-injury (NSSI), a behavior known to be associated with elevated suicide risk. Little is currently known, however, about NSSI among adolescents. The primary objectives of this research were to establish the prevalence of non-suicidal self-injury (NSSI) in a representative sample of Turkish high school students and to identify and describe distinct subgroups of self-injurers. A total of 1656 of 1676 eligible students (98.8 % participation rate) from 18 schools were surveyed during the 2010–2011 academic year. Questionnaires were administered that assessed prior engagement in a variety of self-injurious behaviors, current psychiatric symptoms, suicide-related risk factors, and participation in health-risk behaviors. Latent class analysis (LCA) methods were used to identify distinct groups of self-injurers. Almost one-third of the sample (N = 519) endorsed some previous engagement in NSSI behaviors. In LCA analyses restricted to youth with prior histories of NSSI, four distinct classes were identified characterized by: (1) low rates of NSSI behaviors (29 %); (2) high rates of self-battery (32 %); (3) high rates of self-cutting (19 %); and (4) high rates of multiple NSSI behaviors (19 %). These classes were further distinguished by current psychiatric symptoms, suicide risk factors, and other health-risk behaviors. Findings from the present study indicate that NSSI is a common form of behavior among adolescent youth. There is, however, considerable heterogeneity among those with NSSI histories, with about 40 % at particularly high risk for ongoing distress, future acts of intentional self-harm, and suicidal behavior.

We aimed to investigate the Health Related Quality of Life and related clinical variables (HRQoL) of children with Autism Spectrum Disorders (ASD). We included 102 children with ASD (46 with autism, 38 with pervasive developmental disorder not otherwise specified (PDD-NOS) and 18 with Asperger's syndrome (AS)) and 39 typically developing children as a control (TDC), between 3 and 18 years of age. The mothers scored the Pediatric Quality of Life Inventory 4.0 (PedsQLTM 4.0). The physical health, psychosocial health and total summary score of ASD group were significantly lower than TDC. Within ASD group, psychosocial ( p p p

Aims 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. Method The AQ total and subscale scores of the 100 parents (47 fathers, 53 mothers) of children with autistic disorder (AD) were compared with the 100 parents (48 fathers, 52 mothers) of TDC. Results The parents of AD children scored significantly higher than the TDC parents on total AQ score, and two of five subscale scores; social skills, and communication. The other three subscales (attention to detail, attention switching, imagination) did not differentiate groups. There was no significant difference between mothers and fathers on any AQ scores, neither in the AD nor TDC group. The group × gender interaction was not significant on the total or the five subscale scores of AQ. Conclusion Social skill and communication subscales differentiate AD parents more successfully, and are more sensitive, as reported in other studies. The present findings confirm that social skill and communication impairments in parents of children with autism spectrum disorders are indicators of BAP.

3 OZET: Cocuk ve genclerde aripiprazol kullan›m›: Olgu serisi Cocuk ve genclerde atipik antipsikotikler sald›rganl›k, duy- gudurumda deiflkenlik ve psikoz tedavisinde yayg›n ola- rak kullan›lmaktad›r. Aripiprazolun flizofreni, yayg›n geli- flimsel bozukluk ve bipolar bozukluu olan cocuk ve genc- lerde kullan›m›na iliflkin ilgi artmaktad›r. Farkl› psikiyatrik bozukluu olan 11-17 yafl aras›ndaki befli erkek 7 cocuk ve genc aripiprazol ile tedavi edilmifltir. Hastalar›n tumune da- ha once farkl› psikiyatrik ilaclar ile tedavi uygulanm›flt›r. Ari- piprazol gunluk 2.5 ya da 5 mg dozda bafllanm›flt›r ve opti- mal doz gunde 5 ile 10 mg aras›nda deiflmektedir. Yedi hastan›n alt›s›n›n aripiprazol tedavisinden yararland›¤› go- rulmufltur. Ekstrapiramidal yan etki ya da ajitasyon gozlen- memifltir. Aripiprazol hastalar›m›zda iyi tolere edilmifltir ve cocuk ve genclerde guvenilir ve etkin bir secenek gibi go- runmektedir. Ancak randomize kontrollu ileriye donuk kli- nik cal›flmalar›n yap›lmas› gerekmektedir. Klinik Psikofarmakoloji Bulteni 2010;20:84-93 ABSTRACT: Aripiprazole use in children and adolescents: a case series In children and adolescents, atypical antipsychotics have been largely used to treat aggression, mood instability, and psychosis. There is a growing interest in the use of aripiprazole in children and adolescents with schizophrenia, pervasive developmental disorders, and bipolar disorders. A series of 7 children and adolescents (ages 11-17 years, 5 males) were treated with aripiprazole for different psychiatric disorders. All patients had been treated previously with several psychotropic drugs. Aripiprazole was initiated at a starting dose of 2.5 or 5 mg daily and optimal dosages ranged from 5 to 10 mg daily. Six of the 7 patients appeared to benefit from aripiprazole. Neither extrapyramidal side effects nor agitation was observed in any case. Aripiprazole was well tolerated and effective in our cases and appears to be a safe and efficacious alternative in the child and adolescents. However, prospective clinical trials with a randomized placebo controlled design are needed.

BACKGROUND: Childhood sexual abuse (CSA) can be a devastating life experience that produces higher incidences of mental disorders and suicide attempts. However, there are factors that may be found with a greater ratio in the vulnerable victims. METHOD: We evaluated 181 Turkish children and adolescents with a history of CSA regarding their age, gender, suicide attempts, family relations and educational background. Abuse involving the insertion of an organ or foreign object into the individual's body was designated as a "Qualified Sexual Abuse" (QSA); other forms of sexual abuse were designated "Basic Sexual Abuse" (BSA). RESULTS: Suicide attempts were significantly higher in adolescent girls in the QSA subgroup; age, gender, family integrity, and school attendance did not associate with the risk of mental disorders in this group. Among BSA patients, family integrity statistically influenced suicide attempts. Suicide attempts were approximately 10 times higher (P = 0.005, 95%CI: 2.020-51.051, OR, 10.154) in the participants of children living in broken families. Family integrity and school attendance were also noted as weak protective factors against mental disorders in BSA patients. The incidence of mental disorders was 3.5 times higher in children who had not been attending school (P = 0.009, 95%CI: 1.379-9.211, OR, 3.564). CONCLUSION: We found that family integrity and school attendance weakly related with psychopathology (e.g., mental disorders or suicide attempts) for BSA survivors but not for QSA survivors. Female gender and puberty also increased the likelihood of a suicide attempt for QSA survivors. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved. Language: en

WOS: 000426019000007, PubMed ID: 29730864, 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, Cronbach's alpha values and test-retest were evaluated. ROC analyses was carried out to show concurrent validity and to determine the cutoff score. Results: The Cronbach's 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

WOS: 000406928300006, Aim: We aimed to reassess the psychosocial difficulties, psychiatric diagnosis and follow-up period from childhood through adolescence of Asperger disorder cases. Materials and Methods: We reevaluated the files of five cases (four boys, one girl) between 13-17 years of age who had been up for theree to seven years. The psychiatric diagnosis and psychosocial adjustment levels during the last six months were re-evaluated by psychiatric interview. The severity of illness was evaluated with Clinical Global Impression Scale/Violence, and the improvement level with Clinical Global Impression Scale/Recovery. Results: We found that in adolescence, social adjustment problems, affective symptoms and impulse control problems were dominant in the cases. The psychiatric diagnosis were major depressive disorder (n=2), attention deficit hyperactivity disorder (n=1), obsessive compulsive disorder (n=1), bipolar disorder (n=1); psychotropic medications were antidepressants (n=3), antipsychotics (n=3), methyphenidate (n=1), and mood stabilizator (n=1). The cases benefited from psychopharmacological medication and psychological arrangements. Conclusion: Psychiatric comorbidity is among the factors that affect psychological adjustment in Asperger disorder. Social adjustment problems were found to have increased and additional psychiatric disorders occurred or the existing disorders became more severe in all 5 cases. Affective disorders, disruptive behavior disorders and anxiety disorder have often been seen in our cases as compatible with the literature.

Observations made with lamotrigine add-on therapy with venlafaxine in this case give clues for some aspects of its use in adolescent-onset bipolar II disorder. An 18-year-old adolescent boy with a 3-year history of bipolar II disorder had experienced 2 episodes of hypomania and 4 episodes of major depression. He had been depressed for the last 3 months and had taken olanzapine 5 mg daily for over 6 weeks as mood stabilizer but was still depressed at referral. Other aspects of the patient history included anhedonia, psychomotor retardation, poor concentration, a feeling of hopelessness, hypersomnia, overeating, weight gain, low energy and a refusal to attend school. Parents reported that his symptoms had recently become more severe. His medicine was replaced by venlafaxine, which has a more rapid onset of action and is often used in bipolar depression, especially in patients with atypical depression. Since the clinical response at 6 weeks was only partial, lamotrigine was added to this regimen. The patient responded to lamotrigine after 3 weeks of treatment while on a dose of 50 mg/ day. After 6 weeks of treatment, whilst on a dose of 75 mg/day, his symptoms remitted completely with no evidence of any adverse effects. At the time of publication of this article, the patient had remained euthymic for a total of 8 months. The present report shows that lamotrigine add-on therapy with venlafaxine facilitated clinical remission and that this combination is well tolerated.

The aim of the study was to evaluate the distribution of psychological symptoms in young workers, and the relationship with regard to sociodemographic characteristics using the Brief Symptom Inventory (BSI; Derogatis, 1992), in İzmir Apprenticeship Training Center, Turkey, with 203 randomly selected apprentices aged 15–21, 31 (15.3%) females and 172 (84.7%) males. The mean age was 17.48± 1.24 years. The apprentices were from four different occupational groups: Metalwork (21.7%), Auto repair (29.6%), Electric repair (20.7%) and Hairdressing (28.1%). Results showed that apprentices who are female, who come from single-parent families, who reported low socioeconomic status, who had lost one of their parents or siblings, whose fathers had no stable job, and who work in hairdressing are at risk for psychological problems. In conclusion, those “at risk” apprentices should receive psychosocial support and counseling for coping with problems.

[Author Affiliation]Muharrem Burak Baytunca. Child and Adolescent Psychiatry Department, School of Medicine, Ege University, Izmir, Turkey.Serpil Erermis. Child and Adolescent Psychiatry Department, School of Medicine, Ege University, Izmir, Turkey.Tezan Bildik. Child and Adolescent Psychiatry Department, School of Medicine, Ege University, Izmir, Turkey.Bulent Kayahan. Child and Adolescent Psychiatry Department, School of Medicine, Ege University, Izmir, Turkey.Address correspondence to: Muharrem Burak Baytunca, MD, Child and Adolescent Psychiatry Department, School of Medicine, Ege University, Bornova 35040, Izmir, Turkey, E-mail, : baytunca@yahoo.comTo The Editor:Tuberculosis (Tbc) has been a common worldwide health problem for many years, leading to morbidity and mortality. Drugs that are being used widely in the treatment of tuberculosis may cause psychiatric conditions. Isoniazid (INH), which can be used as a prophylactic agent in initial treatment of Tbc, has associated with psychotic conditions, which has been reported in the literature. One of the putative theories about this effect of INH is monoamine oxidase inhibition, and the other is decreasing N-Methyl-d-aspartate receptors (NMDA) caused by the oxidative stress side effect of INH. Although INH has been associated with psychosis in many reports in the literature, there are rare case reports about psychotic disorders with obsessive compulsive features and INH administration. In this article, we aimed to present a patient who developed psychotic disorder with obsessive compulsive features after administration of INH.Case ReportAn 11-year-old girl who had been previously mentally and physically healthy, was prediagnosed with tuberculosis after investigation of coughing, and was given 300 mg/day INH prophylaxis because of her purified protein derivative (PPD) positivity (18 mm). In the 2nd week of INH augmentation, she developed bizarre delusions and behaviors (wrapping her feces into a piece of paper in order to preserve it, holding her breath when she was coming out of a room and coming in to another room, making associations between the color of food and death, such as tha tgreen means coffin, white means shroud, and black means death, and, therefore, not eating anything), paranoid delusions, visual hallucinations, agressive obsessions, and touching/hoarding compulsions. She had also anxiety, social withdrawal, concentration difficulties, academic problems, and weight loss. She was admitted to the psychiatric inpatient unit. Her neurological and pediatric consultations were normal. Her routine laboratory tests were performed, including complete blood count, basic metabolic profile, and organic acid tests, which were within normal limits. Her cranial magnetic resonance imaging and electroencephalography were also normal. Her mental and motor milestones had been normal. There was no history of trauma, surgery, or any other physical disorder. Her mother had been diagnosed with schizoaffective disorder previously, and had been given risperidone depot treatment. After the first examination, Yale Brown Obsessive Compulsive Scale (Y-BOCS) was administered (Goodman et al. 1989). Y-BOCS score was 30. Both risperidone 1 mg/day and fluoxetine 10 mg/day were started. Risperidone dose titrated up to 2 mg/day, and fluoxetine was titrated up to 20 mg/day within a week. The patient had acute dystonia, and risperidone was discontinued, with the patient switched to aripiprazole starting at 2.5mg/day, then titrated to 5 mg/day gradually. The patient's psychotic symptoms totally disappeared in 2 months (INH treatment was in the 3rd month) and aripiprazole was discontinued after 1 year. Because of the schizoaffective disorder in the patient's family, her clinical symptoms were not necessarily thought to be related to INH prophylaxis, and INH was not discontinued immediately, but the patient was followed for short periods. …

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. Patient's 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.

Objective: In our study, it’s aimed to evaluate the emotion recognition and regulation skills of adolescents with attention deficit and hyperactivity disorder (ADHD) and to compare the results to healthy control cases. Methods: To our study, 63 ADHD diagnosed and 32 control cases with similar sociodemographic characteristics to patient group aged 11-18 years were included. ‘Schedule for Affective Disorders and Schizophrenia for School Age Children- Present and Lifetime Version' was applied to all cases in order to psychiatric evaluation. In all cases Child Behavior Checklist, Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale, Difficulties in Emotion Regulation Scale and to evaluate social cognitive properties Faces Test, Reading the Mind in the Eyes Test, The Unexpected Outcomes Test and Comprehension Test are applied. Results: The scores of tests evaluating emotion recognition and regulation abilities in adolescents with ADHD were lower than control group. Conclusion: The better understanding of the problems in emotion recognition and regulation abilities of the adolescents with ADHD may be helpful in determining the required interventions (social skill training etc.) in this respect.

WOS: 000311598000004, Effectiveness and tolerability of aripiprazole in a real-world outpatient population of youth Objectives: To identify the pattern of initiation for off-label use of aripiprazole among adolescent outpatients; determine whether or not aripiprazole is effective and tolerable for the treatment of adolescents with a wide range of psychiatric symptoms and disorders or not. Methods: Medical charts were retrospectively reviewed for the effectiveness and tolerability of aripiprazole. The Clinical Global Impression Scale (CGI), the Brief Symptom Inventory (BSI), and the Extrapyramidal Symptom Rating Scale were used. Results: The data were available on 31 patients. The sample consisted of mostly females (87.1%). The mean age was 16.38 +/- 1.14 years, and the ages range was 15-19 years. Twenty-one patients (67.8%) had at least one comorbid disorder. The most common comorbid disorder was major depressive disorder. The mean initial dosage of aripiprazole was 4.83 +/- 3.59 mg (2.50 mg - 20.00 mg), and the mean endpoint dosage was 8.62 +/- 3.46 mg (2.50 mg - 15.00 mg). The mean duration of aripiprazole medication was 19.56 +/- 1.23 months (range: 4-48 months). Endpoint CGI-S scores were significantly lower compared with baseline CGI-S score (p

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.

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.

Objective: To identify a range of risk and protective factors associated with depressive symptoms in adolescents. Methods: Fifty-two adolescents who were diagnosed with semi-structured interviews for major depressive disorder (MDD) were included in the study. Fifty-eight healthy controls of the same age, gender and socioeconomic status were included in the study. Participants were asked to fill the Beck Depression Inventory, Kiddo-Kindl Quality of Life-Questionnaire, Scale of Socioeconomic Status and “Sociodemographic Form. Moreover, depression symptom levels of parents who are involved in clinical and control group were compared. Results: Study and control groups differentiated in terms of employment status of mothers, the presence of mental illness in the family, the existence of domestic violence, marital problems between parents, school performance. It was found that adolescents in the study group, adolescent mothers and fathers’ symptom levels of depression are higher than adolescents in the control group, adolescent mothers and fathers, respectively. In the depression group, quality of life levels are significantly lower than control group. In multivariate logistic regression analysis in final model; it is found that employment status of mother, the presence of mental illness in the family, mother-father depression scores the lead to an increase in the levels of depression. But self-esteem is a protective role in depression. Conclusion: Employment statuses of mothers, the presence of mental illness in the family, mother-father level of depression appear as risk factors in the way of depression. But self-esteem is a protective role in depression.

Objective Non-suicidal self-injury (NSSI) is defined as the repetitive deliberate destruction of one's body tissue without suicidal intent and is frequently repetitive. The aim of this study was to examine the psychometric properties of the Inventory of Statements About Self-injury (ISAS), a measure designed to comprehensively assess non-suicidal self-injury (NSSI). The ISAS assesses 13 functions of NSSI, as well as the frequency of 12 NSSI behaviors. Method The ISAS was administered to 529 high school students who had performed at least one NSSI behavior. The internal consistency and test-retest reliability of the scale were examined; for construct validity, the relationship between the Turkish form of the ISAS and various criteria scales was examined, and confirmatory factor analysis (CFA) was conducted. Results Consistent with previous research, factor analysis of the functions scale confirmed the good-fit of the original's 2-dimension model (c²=243; s.d. = 59; NCI (c²/sd) = 4; RMSEA = 0.08 (.07-.09); CFI=0.97; NFI=0.97). In order to test the scale for construct validity, the Brief Symptom Inventory and Suicide Probability Scale were administered to participants, in addition to the ISAS, and the correlations with clinical constructs (e.g., suicidality, depression, anxiety) were in the expected direction. Also the reliability analysis revealed that the ISAS subscales demonstrated high internal consistency. Conclusion In the light of the findings, it was concluded that the Turkish version of ISAS could be used as a reliable and valid tool in assessing non-suicidal self-injury in research and treatment contexts.