Browsing by Author "Aksu, Gulen Guler"

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The close relation of tic disorders with childhood migraine and atopic background of both children and mothers
(2020) Aksu, Gulen Guler; Kutuk, Meryem Ozlem; Tufan, Ali Evren; Toros, Fevziye; Uluduz, Derya; Ozge, Aynur; 0000-0002-2918-7871; AAI-9626-2021
Objective: This study aimed to evaluate primary headache disorders and other causative comorbidities (e.g., epilepsy, atopic disorders, recurrent abdominal pain, motion sickness, and headache) in children with tic disorders (TDs) and their mothers. Materials and Methods: In a multi-center, cross-sectional, familial association study using case-control design, youth (between 7 and 17 years) with TDs (TD, as per Diagnostic and Statistical Manual of Mental Disorders-5 criteria) and age- and sex-matched healthy controls and their mothers were evaluated in the aspect of functional syndromes spectrum including migraine, epilepsy, atopic disorders, motion sickness, and recurrent abdominal pain. Results: Seventy-nine youth with TD and 101 controls were included. Causative comorbidities, other than epilepsy and motion sickness were more common in children with TD with an odds ratio (OR) of 2.1 (atopy) and 3.9 (food allergy). Specifically, recurrent abdominal pain and migraine were found in 36.7% and 31.7% of children (vs. 18.8% and 16.8% of controls, ORs 2.5 and 2.3, respectively). Mothers of youth with TDs also have higher rates of atopy, drug allergy and allergic dermatitis (ORs; 3.8, 3.2 and 2.1; respectively). Conclusion: Results of recent studies suggest a possible link between atopic disorders, migraine, recurrent abdominal pain and TDs. Our results contribute to those studies and suggest that this relationship may extend to the mothers of children as well.
Correlates and predictors of re-incarceration among Turkish adolescent male offenders: A single-center, cross-sectional study
(2022) Aksu, Gulen Guler; Kutuk, Meryem Ozlem; Tufan, Ali Evren; Sanberk, Sati; Guzel, Esra; Dag, Pelin; Tan, Muhammed Emin; Akyol, Betul; Toros, Fevziye; 34924111
Background: Adolescents involved in the legal system are known to be under elevated risk for repeat offending. There may be many reasons for recidivism. Specifically, we aim to investigate the clinical, socio-demographic, and familial factors and psychopathology among adolescents in a penal institution and to determine risk factors for re-incarceration. Methods: This single-center cross-sectional survey was conducted at Tarsus Closed Penal Institution for Children and Youth. This institution is for males only, and all male adolescents detained at the center within the study period were evaluated with semi-structured interviews (K-SADS-PL). The adolescents completed Meaning and Purpose of Life Scale, The EPOCH measure of Adolescent Well-being, Family Sense of Belonging Scale, Children's Alexithymia Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory for themselves. Descriptive and inferential analyses were used. P was set at 0.05. Results: Ninety adolescent offenders with a mean age of 16.6 years (S.D = 0.7) were enrolled. Mean age at first offense was 14.6 years (S.D = 2.1). The most common reason for offenses was reported as as being with peers who were offenders, too (57.8%). Most common diagnoses were substance use (36.7%), attention deficit/hyperactivity disorder (33.3%), and conduct disorder (26.7%). Rates of offending and conviction in first-degree relatives were 62.2% and 60.0%, respectively, and most of the adolescents had at least one peer with a criminal record (n = 71, 78.9%). Re-incarcerated adolescents had lower education, committed more violent crimes, and reported elevated use of substances, suicide attempts, and psychopathology. However, in regression analysis, age of onset was the sole predictor of re-incarceration. Conclusion: Turkish male adolescents in forensic settings may be screened for externalizing disorders and referred for treatment. Re-incarcerated Turkish youth may be more susceptible to peer influence, substance use and externalizing disorders. It may be prudent to systematically screen offending youth for psychiatric disorders regardless of the individual's request for treatment and refer identified cases to treatment. Integration of child and adolescent psychiatrists with penal institutions serving youth may help in this regard.
Hiccups in an Adult Case with Schizophrenia due to Aripiprazole: A Case Report
(2021) Kutuk, Meryem Ozlem; Berdzenishvili, Ekaterina; Aksu, Gulen Guler; 33795958
Neurotransmitters and neuroreceptors involved in the pathophysiology of hiccups are not well defined. However, dopamine and serotonin are reported to have roles in activating hiccups, and recent case reports suggest that some psychopharmacologic medications -such as antipsychotics- may trigger hiccups in many cases. Our case describes the activation of hiccups in a young male with schizophrenia while being treated with aripiprazole. The patient was switched from risperidone to aripiprazole due to excessive sedation, hiccups started within 48 hours of initiation of treatment with aripiprazole at a dosage of 15 mg/day, and no change in the hiccups was observed despite a dose reduction. Discontinuation of aripiprazole treatment resulted in complete relief from hiccups. This case report shows that antipsychotics may trigger hiccups.
Novel inflammatory targets for immunotherapies in pediatric patients with trichotillomania
(2020) Kutuk, Meryem Ozlem; Tufan, Ali Evren; Kilicaslan, Fethiye; Mutluer, Tuba; Gokcen, Cem; Karadag, Mehmet; Yektas, Cigdem; Kandemir, Hasan; Buber, Ahmet; Aksu, Gulen Guler; Topal, Zehra; Giray, Asli; Celik, Fatma; Acikbas, Ufuk; Kutuk, Ozgur; 0000-0002-2918-7871; 32113788; AAI-9626-2021
Immune dysregulation may be important in the etiology of obsessive-compulsive and related disordersandbody-focusedrepetitivebehaviors, such as Trichotillomania (TTM). The role of inflammation and inflammatory markers in TTM has received relatively little attention. This study was aimed to determine the expression levels of inflammatory markers (i.e. IL-1 beta, IL-1 alpha, IL-4, IL-6, IL-17, TNF-alpha and TGF-5) in peripheral blood mononuclear cells of children with TTM and healthy controls and to evaluate their association with clinical variables. Seventy-seven patients with TTM and 107 healthy controls were enrolled in the study. Peripheral blood was collected in standardized conditions. The mean age of patients and controls did not differ significantly (10.8 +/- 4.4 and 12.0 +/- 3.2 years; respectively). The majority of patients with TTM and controls were females (n = 55, 71.4 % and n = 55, 51.4 %; respectively); with a greater preponderance of females among TTM. Patients with TTM had significantly elevated expression levels of TNF-alpha, IL-6 and IL-17 compared to controls. However, the expression level of IL-4 was significantly reduced in TTM patients compared to controls. Accordingly, we found a proinflammatory state in TTM and those findings may suggest novel treatment options for TTM and further, crossdisciplinary studies focusing on neuro- inflammation in TTM conducted on larger samples are needed.
Oromandibular Dystonia Related to Sertraline Treatment in a Child
(2019) Kutuk, Meryem Ozlem; Aksu, Gulen Guler; Tufan, Ali Evren; Celik, Tamer; https://orcid.org/0000-0002-2918-7871; 30575411; AAI-9626-2021
In children, similar to adults, the agents that cause movement disorders are most commonly dopaminergic and antidopaminergic drugs. However, it is also known that selective serotonin reuptake inhibitors (SSRIs), which are frequently prescribed in child psychiatry practice, may rarely lead to tremor, akathisia, dystonia, dyskinesia, and parkinsonism. In this study, we report a rare side effect of SSRIs, namely oromandibular dystonia related to sertraline, in a pediatric patient who was diagnosed with posttraumatic stress disorder.
Safe and Effective Use of Venlafaxine, Mirtazapine, and Aripiprazole in an Adolescent with Treatment-Resistant Obsessive Compulsive Disorder
(2020) Aksu, Gulen Guler; Dogdu, Pinar Akdere; Dag, Pelin; Kutuk, Meryem Ozlem; Toros, Fevziye; 0000-0002-2918-7871; AAI-9626-2021
Managing treatment-resistant obsessive-compulsive disorder (TR-OCD) is often a challenge for clinicians, especially when adolescents and children are the patients. Approximately one-quarter to one-third of children with OCD do not respond to first-line treatments. Studies on the combination of venlafaxine and mirtazapine in children and adolescents are promising, but there is insufficient information about the use of this combination in TR-OCD. As far as we know, this is the first report of an adolescent patient with TR-OCD who responded favorably to a combination of a serotonin-norepinephrine reuptake inhibitor (venlafaxine), an alpha-2 adrenergic receptor antagonist (mirtazapine), and an atypical antipsychotic (aripiprazole). This case provides an example of the effective and safe use of the venlafaxine, mirtazapine, and aripiprazole given in combination in an adolescent with TR-OCD.
Screening results of psychomotor development of children at inpatient unit of a training hospital in Turkey
(2019) Kutuk, Meryem Ozlem; Gokcen, Cem; Aksu, Gulen Guler; Akin, Fatih; Kardas, Aysenur; Sarp, Ayse Sevde; Tufan, Ali Evren
Purpose: This study aimed to assess the psychomotor development of inpatient children in the pediatrics clinic and referring the children who have problems. Materials and Methods: Four hundred twenty children between 4-72 months at inpatient unit of the department of Pediatrics at Konya State Research hospital were included in the present study. A child development specialist who was unaware of the history and neurological examination of the cases administered Denver developmental screening test (DDST) II to all children once. Children who were found to be abnormal or questionable were further evaluated by the child and adolescent psychiatrist. Results: Three hundred forty five (82%) were found to be 'normal', 12 (2.8%) were found to be 'questionable' and 64 (15.2%) cases were found to be 'abnormal' with regard to DDST II. Post evaluation of questionable and abnormal cases by the child and adolescent psychiatrist, 26 cases were referred to special education institutions with the diagnosis of global developmental delay and 2 cases with the diagnosis of pervasive developmental disorder. Conclusion: It is important to apply screening tests for developmental evaluation to each child at inpatient pediatric clinics in order to diagnose developmental delays earlier.
Sociodemographic and Clinical Features of Obsessive Compulsive Disorder in a Large Sample of Children and Adolescents from Turkey
(2018) Kutuk, Meryem Ozlem; Tufan, Ali Evren; Erden, Sema; Aksu, Gulen Guler; Kilicaslan, Fethiye; Sogut, Figen; Kutuk, Ozgur; Toros, Fevziye; https://orcid.org/0000-0001-9854-7220; AAH-1671-2019
Objective: Obsessive compulsive disorder (OCD) is a time-consuming and chronic disorder characterized by obsessions and compulsions that can start before age of eighteen and can be associated with significant impairments in academic, social and family functioning. In this study, our aim was to evaluate sociodemographic characteristics, clinical pictures and comorbid diagnoses of a large sample of children and adolescents who were diagnosed with OCD according to diagnostic criteria of DSM-IV-TR in a child and adolescent psychiatry outpatient clinic of a University Hospital. Methods: Patients who were first diagnosed at the study center with OCD according to DSM-IV-TR criteria were included. For inclusion, the primary diagnosis should be OCD as per DSM-IV-TR criteria and there must be concordance between at least 2 clinicians (one resident and the head of department) for diagnosis. Results: 440 cases were included in our study and the most common obsessions in our sample were contamination with dirt (48.8%), and exactness (23.8%) and most common compulsions were ordering/checking (42.4%) and washing/cleaning (32.0%). Most of the patients in our sample (78.0%) had a comorbid diagnosis and most common comorbidities were Attention-Deficit/ Hyperactivity Disorder (26.6%) and Generalized Anxiety Disorder (20.5%). Discussion: Accordingly, our results in terms of comorbidity, obsessions and compulsions are consistent with the literature. In conclusion, this is the largest study on a clinical sample of pediatric OCD from Turkey that we are aware of in terms of sample size, time frame and statistical power.