Fakülteler / Faculties
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Item Tibia Stress Fracture Secondary to Obsessive Compulsive Disorder(2016) Guler, Gulen; Kutuk, Meryem; Yildirim, Veli; Celik, Gonca Gul; Toros, Fevziye; Milcan, Abtullah; https://orcid.org/0000-0002-2918-7871; 27284118; AAI-9626-2021Obsessive compulsive disorder (OCD) is a chronic psychiatric disorder characterized by obsessions and compulsions. Early-onset OCD is one of the most common mental illnesses of children and adolescents, with a prevalence of 1% to 3%. It is related to worse lifespan symptoms and prognosis. Therefore, the treatment of OCD in children and adolescent has gained importance. If it is not treated successfully, the compulsive behaviors may cause extreme stress for children and their parents. Although minor complications of OCD are commonly observed, major complications are considerably rare due to the nature of compulsive behaviors. Apparently, loss of vision, autocastration, rectal prolapse are examples of major complications secondary to OCD. As far as we know, it is the first case of tibia stress fracture secondary to OCD. In the present case report, we will discuss tibia stress fracture developing secondary to compulsive behavior due to OCD.Item Burden of Headache Disorders at Attention Deficit Hyperactivity Diagnosed Children and Their Parents(2017) Kucuk, Meryem O.; Guler, Gulen; Tufan, Evren; Yalin, Osman Ozgur; Gozukara, Harika; Ozge, Aynur; Toros, FevziyeItem 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-1671-2019Objective: 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.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 Cytokine expression profiles in Autism spectrum disorder: A multi-center study from Turkey(2020) Kutuk, Meryem Ozlem; Tufan, Evren; Gokcen, Cem; Kilicaslan, Fethiye; Karadag, Mehmet; Mutluer, Tuba; Yektas, Cigdem; Coban, Nurdan; Kandemir, Hasan; Buber, Ahmet; Coskun, Seyma; Acikbas, Ufuk; Guler, Gulen; Topal, Zehra; Celik, Fatma; Altintas, Ebru; Giray, Asli; Aka, Yeliz; Kutuk, Ozgur; 0000-0002-2918-7871; 0000-0001-9854-7220; 0000-0003-2735-4805; 32563959; AAI-9626-2021; AAH-1671-2019; G-8832-2015Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by impairments in communication and social interaction as well as restricted interests and repetitive behaviors. The pathogenesis of ASD is not completely understood, but a growing body of research has demonstrated that the immune response may be a contributing factor in the etiology and/or ontogeny of ASD. The aim of this study was to determine the expression levels of IL-1 beta, IL-1 alpha, IL-4, IL-6, IL-17, TNF-alpha and TGF-beta in peripheral blood mononuclear cells of children with ASD and healthy controls in order to determine the contributions of cytokines to ASD. Within the study timeframe, 195 children with ASDs (80.5% male) and 162 controls (73.6% male) were enrolled. Most children with ASD had a comorbid disorder (n = 114, 58.5%), with the most common diagnoses as Intellectual Developmental Disorder (IDD, n = 64, 32.8%) and ADHD (n = 64, 32.8%). The majority of children with ASD had severe autistic symptoms as evaluated via Childhood Autism Rating Scale (CARS, n = 130, 64.6%). The mean CARS score in the ASD sample was 40.8 (S.D. = 7.6). The patients with ASD were found to have significantly higher levels of IL-6 (p < 0.001) and significantly lower levels of IL-17 (p < 0.05, all Bonferroni corrected). Treatment tended to affect IL-4 levels. Lastly, discriminant function analysis (DFA) revealed that a combination of IL-6, IL-17 and IL-1 alpha correctly classified 56.6% of cases. Despite extensive immunological evidence suggesting immune system aberrations, further research is required to clarify the relationship between immune profiles and ASD symptoms.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.Item Persistent hiccups due to aripiprazole in an adolescent with obsessive compulsive disorder responding to dose reduction and rechallenge(2016) Kutuk, Meryem Ozlem; Tufan, Ali Evren; Guler, Gulen; Yildirim, Veli; Toros, Fevziye; 27099770Our case involves persistent hiccup arising in an adolescent with obsessive compulsive disorder (OCD) who was using aripiprazole as an augmentation to fluoxetine and whose hiccups remitted with dose reduction and rechallenge. Treatment suggested that aripiprazole might lead to hiccups. Antipsychotics are also used for the treatment of hiccups, but recent case reports suggest that they cause hiccups as well. Within 12 h of taking 5mg aripiprazole, the 13-year-old girl began having continuous hiccups, which lasted for 3-4 h. The hiccups resolved when the dose of aripiprazole was reduced to 2.5 mg. To achieve augmentation, aripiprazole was replaced with risperidone 0.5 mg/day for 1 month, but excess sedation was observed. As a result, aripiprazole was restarted at a dose of 2.5 mg/ day, and 1 week later, it was increased to 5 mg/every other day. No hiccups were observed.Item Determination of Beliefs, Attitudes of Consulting Teachers towards Mental Diseases, and Referral Reasons of Their Students to a Child and Adolescent Psychiatrist(2016) Kutuk, Meryem Ozlem; Durmus, Emine; Gokcen, Cem; Toros, Fevziye; Guler, Gulen; Evegu, Erkan; 0000-0002-2918-7871; AAI-9626-2021Objective: In the present study, the aim was to evaluate the beliefs and attitudes of school counselors about mental illnesses, and reasons why counselors referred students to psychiatrists. Method: The study was carried out with 118 school counselors. Data were collected with sociodemographic information form and Beliefs toward Mental Illness Scale (BMIS). Results: According to study results, 15.3% of school counselors stated that they referred to a psychiatrist for their own psychological problems at some time, and 32% of subjects referred their own children to a child and adolescent psychiatrist. The proportion of teachers who referred their students to a child and adolescent psychiatrist was 89.8%. Scores of school counselors were 80.41 +/- 9.32 in overall BMIS, 28.82 +/- 5.35 in dangerousness, 43.83 +/- 4.93 in poor social and interpersonal skills, and 7.76 +/- 1.81 points in incurability subscales. No statistically significant relationship was determined between mean scores of participants and gender, age, marital status, institution where they work, working duration, and graduate program they attended. The four most frequent student referral causes were conduct disorder (31.10%), attention deficit (16.10%), depressive mood (14.72%) and hyperactivity (12.20%). Conclusion: It is noticed that school counselors have negative beliefs about mental disorders, feel shame because of them, and they regard these patients dangerous. On the other hand, participants believe that these disorders lead to despair in individuals and impair interpersonal communication. According to the literature search, this study is the first investigating beliefs and attitudes of school counselors about mental illnesses, and reasons why they refer students to psychiatrists.Item Achalasia as a complication of bulimia nervosa: A case report(2017) Kutuk, Meryem Ozlem; Guler, Gulen; Tufan, Ali Evren; Toros, Fevziye; Kaytanli, Umut; 0000-0002-2918-7871; 30263180; AAI-9626-2021Objective: Oesophageal achalasia is a medical condition characterised by oesophageal aperistalsis, an increased resting pressure with partial or incomplete relaxation of the lower oesophageal sphincter. Bulimia nervosa (BN) is an eating disorder manifested by binge eating attacks followed by recurrent inappropriate compensatory behaviours, such as self-induced vomiting and excessive exercise. Dysphagia, regurgitation, vomiting, retrosternal pain, heartburn, weight loss, avoidance of eating, consumption of large amount of liquids and aberrant eating behaviours are symptoms of both achalasia and BN. Owing to these common signs and symptoms, oesophageal achalasia can be misdiagnosed as an eating disorder. In addition, oesophageal achalasia can occur as a complication of BN. It is often difficult to distinguish organic and psychological vomiting or comorbidity because of overlapping of the symptoms. Case report: We report the case of a patient who developed oesophageal achalasia following severe, repetitive vomiting as a complication of BN. Conclusion: We want to raise awareness regarding the development of a medical illness in the presence of a psychiatric disorder. Importantly, physicians should have a fundamental knowledge of these two diseases regarding their clinical patterns to differentially diagnose one or both disorders as quickly as possible.