Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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    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; 36806728
    Objective: 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.
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    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; 37867841
    The 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.
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    An Exploratory, Single-Center Study of Factors Associated with Child Marriage Among Syrian Female Adolescents Residing in Turkey
    (2022) Kutuk, Meryem Ozlem; Kilicaslan, Fethiye; Tufan, Ali Evren; Celik, Fatma; Gokcen, Cem; Bag, Harika Gozukara; Servi, Gulay; Karali, Mehtap; Bahsi, Gamze; Servi, Ceyhun; Alatli, Resat; Kandemir, Betul; Aytekin, Neslihan; Kutuk, Ozgur; https://orcid.org/0000-0001-9854-7220; AAH-1671-2019
    This exploratory study aimed to evaluate factors related with child marriage compared to unmarried status in female adolescent residents in a refugee camp in Turkey. The rate of child marriage and developmental status of offspring from those marriages were reported. A research team evaluated married female youth and their offspring for psychopathologies according to DSM-5 criteria and ascertained lifetime traumatic events among mothers. We compared the traumatic experiences and psychopathologies of married females and controls. Post-traumatic stress disorder (PTSD) was the most common diagnosis in both groups and child brides reported greater cumulative traumatic experiences and elevated rates of PTSD. More than one-tenth (i.e., 15.1%) of offspring of child brides displayed developmental delays and 12.1% were diagnosed with global developmental delay.
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    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.
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    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.
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    Migraine and Associated Comorbidities are Three Times More Frequent in Children With ADHD and Their Mothers
    (2018) Kutuk, Meryem Ozlem; Tufan, Ali Evren; Guler, Gulen; Yalin, Osman Ozgur; Altintas, Ebru; Bag, Harika Gozukara; Uluduz, Derya; Toros, Fevziye; Aytan, Nurgul; Kutuk, Ozgur; Ozge, Aynur; https://orcid.org/0000-0002-2918-7871; https://orcid.org/0000-0001-5207-6240; https://orcid.org/0000-0003-2735-4805; https://orcid.org/0000-0001-9854-7220; 29921473; AAI-9626-2021; C-5074-2015; G-8832-2015; AAH-1671-2019
    Objective: Attention deficit and hyperactivity disorder (ADHD) is a neuro-developmental disorder related to internalizing and externalizing disorders as well as somatic complaints and disorders. This study was conducted to evaluate the prevalence of headache subtypes, epilepsy, atopic disorders, motion sickness and recurrent abdominal pain among children and adolescents with ADHD and their parents. Methods: In a multi-center, cross-sectional, familial association study using case-control design, treatment na ve children and adolescents between 6 and 18 years of age diagnosed with ADHD according to the DSM-5 criteria as well as age- and gender matched healthy controls and their parents were evaluated by a neurologist and analyzed accordingly. Results: 117 children and adolescents with ADHD and 111 controls were included. Headache disorder diagnosis was common for both patients and healthy controls (59.0% vs. 37.8%), with a significantly elevated rate in the ADHD group (p = 0.002). Migraine was found in 26.0% of ADHD patients and 9.9% of healthy controls. Tension headache was found in 32.4% of ADHD patients and 27.9% of healthy controls. Headache diagnosis was also found to be significantly more common in mothers of children with ADHD than control group mothers (90.5% vs. 36.6%, p < 0.001). Conclusion: Headache diagnoses and specifically migraines were significantly more common among children with ADHD and their mothers, while recurrent abdominal pain was elevated in both parents and ADHD patients. Migraine is an important part of ADHD comorbidity, not only for children but also for mothers. Motion sickness may be reduced among families of ADHD probands. (C) 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
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    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.
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    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 Evren
    Objective: 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.
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    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-9626-2021
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    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.