Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Self-Harm in Children and Adolescents Who Presented at Emergency Units During the COVID-19 Pandemic: An International Retrospective Cohort Study(2023) Kutuk, Meryem Ozlem; 36806728Objective: To compare psychiatric emergencies and self-harm at emergency departments (EDs) 1 year into the pandemic, to early pandemic and pre pandemic, and to examine the changes in the characteristics of self-harm presentations.Method: This retrospective cohort study expanded on the Pandemic-Related Emergency Psychiatric Presentations (PREP-kids) study. Routine record data in March to April of 2019, 2020, and 2021 from 62 EDs in 25 countries were included. ED presentations made by children and adolescents for any mental health reasons were analyzed.Results: Altogether, 8,174 psychiatric presentations were recorded (63.5% female; mean [SD] age, 14.3 [2.6] years), 3,742 of which were self-harm presentations. Rate of psychiatric ED presentations in March to April 2021 was twice as high as in March to April 2020 (incidence rate ratio [IRR], 1.93; 95% CI, 1.60-2.33), and 50% higher than in March to April 2019 (IRR, 1.51; 95% CI, 1.25-1.81). Rate of self-harm presentations doubled between March to April 2020 and March to April 2021 (IRR, 1.98; 95% CI, 1.68-2.34), and was overall 1.7 times higher than in March to April 2019 (IRR, 1.70; 95% CI, 1.44-2.00). Comparing self-harm characteristics in March to April 2021 with March to April 2019, self-harm contributed to a higher proportion of all psychiatric presentations (odds ratio [OR], 1.30; 95% CI, 1.05-1.62), whereas female representation in self-harm presentations doubled (OR, 1.98; 95% CI, 1.45-2.72) and follow-up appointments were offered 4 times as often (OR, 4.46; 95% CI, 2.32-8.58).Conclusion: Increased pediatric ED visits for both self-harm and psychiatric reasons were observed, suggesting potential deterioration in child mental health. Self-harm in girls possibly increased and needs to be prioritized. Clinical services should continue using follow-up appointments to support discharge from EDs.Diversity & Inclusion Statement: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.Item Functional Outcome in Late Adolescence/Early Adulthood of Patients with Autism Spectrum Disorderresand Its Relationships with Parental Burnout and Depression: A Preliminary Multi-Center, Cross-Sectional Study(2023) Kutuk, Meryem Ozlem; Soylemez, Tugba Eseroglu; Taner, Hande Ayraler; Altintas, Ebru; Kutuk, Ozgur; 37867841The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported "good" or "very good" outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/ hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education.Item Peer Bullying, Anxiety, and Depression Levels Among Turkish Children with Childhood Onset Fluency Disorder (COFD): A single-Center, Case-Control Study(2022) Kilicaslan, Fethiye; Cicek, Ekrem; Gungoren, Sumeyra; Kutuk, Meryem Ozlem; Tufan, Ali EvrenObjective: Childhood Onset Fluency Disorder (COFD) is associated with elevated levels of emotional/ behavioral problems and peer bullying. Studies on Turkish children with COFD are limited. We aimed to evaluate rates of peer bullying and its relationships with stuttering severity and symptoms of depression and anxiety among Turkish children with COFD.Methods: Forty 8-12 years old children with COFD without comorbid neurological/ medical disorders and 36 age - and gender-matched controls were evaluated with self-report scales for depression, trait/ state anxiety and peer bullying. Stuttering severity was evaluated with Stuttering Severity Instrument-4. Multivariate and bivariate analyses were used in comparisons. P was set at 0.05.Results: COFD group had significantly elevated depression and state anxiety scores while trait anxiety was elevated but at trend levels. 52.5 % of children with COFD was bullied while this rate was 27.8 % for controls (Odds Ratio= 2.9). Bullying was not related with gender, self-reported symptoms and stuttering severity.Conclusion: Standardized trainings/practices should be introduced among Turkish speech and language therapists to screen and address peer bullying, depression, and anxiety among children with COFD in collaboration with child and adolescent psychiatrists.Item High Depression Symptoms and Burnout Levels Among Parents of Children with Autism Spectrum Disorders: A Multi-Center, Cross-Sectional, Case-Control Study (Jan, 10.1007/s10803-021-04874-4, 2021)(2021) Kutuk, Meryem Ozlem; Tufan, Ali Evren; Kilicaslan, Fethiye; Guler, Gulen; Celik, Fatma; Altintas, Ebru; Gokcen, Cem; Karadag, Mehmet; Yektas, Cigdem; Mutluer, Tuba; Kandemir, Hasan; Buber, Ahmet; Topal, Zehra; Acikbas, Ufuk; Giray, Asli; Kutuk, Ozgur; 0000-0002-2918-7871; 0000-0001-9854-7220; 33591437; AAI-9626-2021Item Seasonal Variations in Obsessive-Compulsive Disorder: Analysis of Prospective-Clinical Data(2021) Altintas, Ebru; Kutuk, Meryem Ozlem; Tufan, A. Evren; 34526841Introduction: Few studies have investigated potential seasonal changes in anxiety disorders. This study aimed to evaluate whether seasonal changes influence the severity of obsessive and compulsive symptoms in obsessive-compulsive disorder (OCD). The relationship between comorbid anxiety and depression symptoms and the seasons was also investigated. Furthermore, we compared the differences between retrospective data reliant on patients' recall and data obtained by prospective observation. Methods: The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Y-BOCS Symptom Checklist, Beck Anxiety Scale, and Beck Depression Scale were administered to 148 patients with OCD in each of the four seasons over a year. The relationships between the seasons and the scales based on retrospective observations of the patients, and between the seasons and scales based on prospective data collected over the year were analyzed. Scores from clinical assessments were compared between the different seasons. Results: The severity of obsessive and compulsive symptoms, did not show seasonal changes. Multi-level growth models suggested that the change in Y-BOCS Total scores across seasons could be explained by subjective symptoms of depression and anxiety and their interactions. Importantly, results obtained using prospective observations from structured clinical assessment differed from those obtained using retrospective observations of patients. Conclusions: Our study does not support the existence of seasonal variations in symptoms of OCD. Future studies are needed to delineate seasonal variations in OCD symptoms.Item 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-9626-2021Objective: 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.Item 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 EvrenPurpose: 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.Item Antineuronal antibodies and 8-OHdG an indicator of cerebellar dysfunction in autism spectrum disorder: a case?control study(2019) Kilicaslan, Fethiye; Ayaydin, Hamza; Celik, Hakim; Kutuk, Meryem Ozlem; Kandemir, Hasan; Koyuncu, Ismail; Kirnit, AdnanObjectives: Autism spectrum disorder (ASD) is a neurodevelopmental disorder, that starts in early childhood and presents with deficiencies in social-communicational domains along with restricted and repetitive behaviours/interests. While genetic factors are dominant in its pathogenesis, many factors, including neurological, environmental and immunological have been identified. Furtheremore, although cerebellar dysfunction in the etiology of autism has been shown in different studies, the possible causes of the dysfunction and the role of neuroinflammation among these causes have not been clarified yet. Anti-Yo, anti-Hu, anti-Ri and anti-Amphiphysin antibodies have been found to be associated with cerebellar degeneration. The aim of the present study was to compare anti-Yo, anti-Hu, anti-Ri and anti- Amphiphysin antibodies and 8-OHdG values in blood using the ELISA method between ASD patients and healthy children to demonstrate the role of neuroinflammation as a potential cause of cerebellar dysfunction and DNA damage and evaluate the relationship between Childhood Autism Rating Scale (CARS) scores in children diagnosed with ASD and these parameters. Methods: Thirty-five consecutive children between the ages of 3 and 12 referred to the Child and Adolescent Psychiatry Outpatient Clinic of Harran University Hospital and diagnosed with ASD according to the DSM-5 diagnostic criteria were included in the study. The children did not have any chronic physical disorders and were treatment naive. Thirty-three healthy children between the ages of 3 and 12 without any physical or psychiatric disorders were included as the healthy control group. For psychiatric evaluation, a sociodemographic form and to measure the severity of autism, CARS was used. In the study, anti-Yo, anti-Hu, anti-Ri and anti-Amphiphysin antibodies and 8-OHdG values in blood were investigated using the ELISA method. Results: Thirty-five cases with autism (62.9% males) and thirty-three healthy controls (72.7% males) were included in the present study (p?=?0.385). The median age was 6.0 in the ASD group and 7.0 in the control group (p?=?0.146). Among ASD patients, anti-Ri antibody positivity was detected, while no anti-Ri antibody positivity was found in the control group (p?=?0.002). In the ASD group, the anti-Hu and 8-OHdG values were found to be significantly higher than those of the controls (p?Item Dystonia in an Adolescent on Risperidone Following the Discontinuation of Methylphenidate: A Case Report(2015) Guler, Gulen; Yildirim, Veli; Kutuk, Meryem Ozlem; Toros, Fevziye; 25912546Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with common comorbidities that include oppositional defiant disorder, conduct disorder, anxiety disorder, and affective disorders. Because of these comorbidities, drug combination treatments and drug drug interactions are becoming increasingly more frequent. The present case report describes an acute dystonic reaction following the abrupt discontinuation of methylphenidate from a drug regimen with risperidone. The patient experienced acute dystonic reactions on three separate occasions when he forgot to take his methylphenidate medication. The present report informs clinicians about the possible side effects, such as dystonia, when psychostimulant and antipsychotic drug combinations are altered and suggests that the abrupt cessation of stimulants may lead to the development of movement disorders, Therefore, appropriate care is necessary when changing the dose of a drug or abruptly discontinuing a drug from a combination of psychostimulants and antipsychotics.Item Cutaneous allergic reaction due to alprazolam in a child(2016) Kutuk, Meryem Ozlem; Guler, Gulen; Guvenc, Ulas; Toros, Fevziye; Kaya, Tamer IrfanCutaneous allergic reactions due to drug intake may be triggered by many types of drugs such as atropine, anticonvulsants and benzodiazepines. But allergic reactions due to benzodiazepines are extremely rare. Alprazolam is a benzodiazepine which may be useful for refractory idiopathic urticaria due to antihistaminergic effect. Although antihistaminergic effect of alprazolam, a cold urticaria case and an angioedema case induced by alprazolam are known in the literature. In the case, we present a child suffering from cutaneous allergic reaction due to alprazolam at the first dose taken.