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Kategori: Çocuk ve Ergen Psikiyatristi

  • Tek suçlu teknoloji mi??

    Tek suçlu teknoloji mi??

    ​​​Özellikle son yıllarda çocuklarda teknoloji kullanımının artması, buna bağlı olarak çocuğun eğitim ve sosyal hayatının sekteye uğraması ailelerin endişelenmesine neden oluyor.

    Erken çocukluk döneminde çocukların çok hızlı teknolojiye adapte olması aileleri heyecanlandırırken süreçle birlikte bu durum korkuya dönüşüyor. Teknolojinin nimetlerini görmezden gelmek çağa ayak uyduramamakla aynı şey. Bilgiye kolay ulaşabilmemizi sağlayan bu icada kayıtsız kalmamız haksızlık olur.

    Bununla birlikte eğlence kaynağı olması da yadsınamaz bir gerçek. Kabul etmemiz gereken tek gerçek ise teknoloji çocuğumuzun hayat kalitesini olumsuz etkilerken katkı da sağlayabiliyor.

    Teknoloji kullanımını kısıtlayabiliriz ancak tamamen yasaklamak teknolojiye ve en büyük ölçüde çocuğumuza haksızlık olacaktır.

  • 2 nisan otizm farkındalık günü

    ​​​’Dünya Otizm Farkındalık Günü’ ?

    Otizmin tek göstergesinin dönen çamaşır makinesini izlemekten ibaret olduğunu sanacak kadar farkında değiliz.

    Farkında olalım.

    Çocuğumuzun okulunda – sınıfında otizm tanısı olan çocuklar varsa çocuğumuzla arkadaş olmasını sağlayalım, izole etmeyelim, etiketlemeyelim.

    Hayat bu çocuklara ve ailelerine yeterince zor, daha da zorlaştırmayalım

  • Depression and anxiety symptom severity in a group of children with epilepsy and related factors].

    OBJECTIVE:

    The aim of this study was to assess the anxiety and depression symptom severity in a group of epileptic children and compare the results to healthy controls. Additionally, the frequency of psychiatric disorders in epileptic children was also assessed.

    METHOD:

    The study compared 30 children, ranging in age from 8 to 16 years with epileptic disorder who attended a children’s neurology clinic, with healthy controls using the State-Trait Anxiety Inventory and Children’s Depression Inventory scores and suicidal ideation. The MINI was administered to epileptic patients to determine the frequency of psychiatric disorders in this clinical group.

    RESULTS:

    State anxiety scores of the epilepsy group were significantly higher compared to controls. No significant differences were found between patients and controls in terms of trait anxiety and depression scores. In all 3 scales boys scored significantly higher than girls. No significant relationships were found between symptom severity, duration of epilepsy, age of seizure onset and depression and anxiety scores. Psychiatric assessments with the MINI identified psychiatric disorders in 26.7% of epileptic patients. Two epileptic patients reported past suicidal attempts however, only 2 patients were receiving psychiatric treatment.

    CONCLUSION:

    Psychiatric disorders were frequently observed in the group of epileptic patients. Psychiatric disorders occurred more frequently in boys compared to girls in this group. Clinicians should be more aware of accompanying psychiatric symptoms in epileptic patients and take the necessary precautions in the early period of the illness in an effort to prevent future mental health problems.

  • Sociodemographic and clinical factors associated with compliance to methylphenidate treatment in children with attention deficit hyperactivity disorder].

    OBJECTIVE:

    The present study aimed to determine the rate of treatment compliance in children with attention deficit hyperactivity disorder (ADHD) that were newly prescribed methylphenidate, and to evaluate the associated clinical and sociodemographic factors, as well as parental concerns about drug treatment.

    METHOD:

    The sample of this prospective and observational study consisted of 238 children aged 7-18 years with ADHD diagnosed according to DSM-IV criteria. At the end of the first year, the study sample was splitted into 2 groups; compliant and non-compliant. Parental attitudes toward drug therapy, and clinical and sociodemographic characteristics of the 2 groups were compared. A clinician rated parental concerns about drug treatment 4-6 weeks after the interview that was conducted in order to inform them about methylphenidate therapy. Regarding a minimum requirement of 5 days weekly dosage and drug holidays, cases that took more than 70% of the recommended methylphenidate dose at the end of the first year were described as compliant.

    RESULTS:

    At the end of the first year of treatment, the drug compliance rate was 80.3% (n= 191). The non-compliant group consisted of older children. A significant difference was observed between the compliant and non-compliant groups in terms of parental approach toward drug treatment. Children in the non-compliant group had parents that had doubts about pharmacotherapy and these children were less compliant with methylphenidate treatment.

    CONCLUSION:

    Parental concerns about methylphenidate treatment in ADHD may influence treatment compliance. Additionally, it is suggested that developmental psychological characteristics associated with adolescence may also be important.

  • Impaired verbal memory and otherwise spared cognition in remitted bipolar patients on monotherapy with lithium or valproate.

    OBJECTIVES:

    Patients with bipolar disorder have been reported to have neurocognitive deficits; however, it is not known whether the cognitive dysfunctions are state-dependent or a stable trait. Lithium and valproate, 2 of the most widely used mood stabilizers in the treatment of bipolar disorder, have also been associated with cognitive impairment. However, the degree and pattern of neurocognitive impairment in euthymic bipolar patients on either monotherapy with lithium or valproate have not been compared before in depth.

    METHODS:

    We compared 17 euthymic outpatients with bipolar disorder (BD) on lithium monotherapy to 11 euthymic outpatients with BD on valproate monotherapy and 29 comparison subjects using tests measuring immediate verbal memory and executive functions in addition to 3 subtests of the Wechsler Adult Intelligence Scale Revised. The groups were similar in terms of level of education, duration and severity of illness, and gender distribution. Patients on lithium monotherapy were older than patients on valproate and healthy controls. Mood symptoms as assessed by standardized scales were mild to non-existent in both patient groups.

    RESULTS:

    Immediate verbal memory was impaired in both patient groups compared to controls, where the main effect of age was not significant. No significant differences could be found on the other cognitive measures.

    CONCLUSIONS:

    Both lithium and valproate may be associated with immediate verbal memory impairment, sparing other cognitive functions. Presence of a similar verbal memory deficit in the lithium and valproate groups suggests that this deficit might be intrinsic to BD or that the 2 medications influence immediate verbal memory similarly. Larger samples of remitted bipolar patients on monotherapy should be studied for more precise conclusions.

  • Psychiatric symptoms and health-related quality of life in children and adolescents with psoriasis.

    Information about the relationship between psoriasis and psychiatric morbidity and quality of life in children and adolescents is limited. We aimed to examine the symptoms of depression and anxiety and health-related quality of life levels in children and adolescents with psoriasis. Forty-eight outpatients with psoriasis aged 8 to 18 years are included in this study. Child Depression Inventory (CDI), State-Trait Anxiety Inventories for Children (STAI-C) and Pediatric Quality of Life Inventory Parent and Child Versions (PedQL-P and C) were applied to both patient and control groups. Psoriasis symptom severity was measured by the Psoriasis Area Severity Index (PASI). Both study and control groups were divided into two age groups, child (8-12 yrs) and adolescent (13-18 yrs), to exclude the effect of puberty on psychological condition. The mean CDI score was higher, and PedQL-C psychosocial and total scores were lower in the children compared with controls. Duration of psoriasis had an increasing effect on physical-health and total scores of PedQL-C in the child group and all PedQL-C scores in the entire sample. Psoriasis severity showed a negative correlation with psychosocial and total scores of PedQL-P in the adolescent group and PedQL-P physical-health scores in the entire sample. Psoriasis is related to depression and impaired quality of life in children. The depressive symptoms in children with psoriasis should not be overlooked and psychiatric assessment of these children should be provided.

  • Use of complementary and alternative medicine in children with autism spectrum disorders: a multicenter study.

    INTRODUCTION:

    This study examined the prevalence of the use of different complementary and alternative medicine (CAM) strategies, families’ attitudes and belief systems about the use of these strategies, and the economic burden of these strategies placed on family income in families of children with autism spectrum disorders (ASD).

    METHOD:

    A questionnaire survey concerning the use of CAM in children with ASD was administered to parents in the five different geographic locations in Turkey.

    RESULT:

    Of the 172 respondents, 56% had used at least one CAM therapy. The most frequently used CAM intervention was spiritual healing. Among the most reported reasons for seeking CAM were dissatisfaction with conventional interventions and a search for ways to enhance the effectiveness of conventional treatments. The most frequently reported source of recommendation for CAM was advice from family members. The mean economic burden of the CAM methods was a total of 4,005 Turkish lira ($2,670) in the sample using CAM. The CAM usage rate was lower in parents who suspected genetic/congenital factors for the development of ASD.

    CONCLUSION:

    This study observed the importance of socioeconomic and cultural factors as well as parents’ beliefs about the etiology of ASD in treatment decisions about CAM.

  • The relationship between psychological symptoms, lung function and quality of life in children and adolescents with non-cystic fibrosis bronchiectasis.

    OBJECTIVES:

    The aim of this study was to evaluate the relationship between psychological symptoms and quality of life (QOL) and clinical variables in a cohort of children and adolescents with non-cystic fibrosis (non-CF) bronchiectasis.

    METHODS:

    Seventy-six patients (aged 8-17years) participated in this study. Questionnaires were used to evaluate the psychological status and QOL of the patients and healthy controls. The patient and control groups were divided into child and adolescent groups to exclude the effect of puberty on psychological status.

    RESULTS:

    No significant difference was found between patient and control groups for mean depression and trait anxiety scores. Only the child-rated physical health QOL scores were significantly lower for patients than the controls. Also, excepting physical health scores in adolescent group, all of the parent-rated QOL scores were significantly lower in both group and total subjects. Regarding determinants of QOL, age of children and FEV1/FVC percent predicted had positive effects, while dyspnea severity and trait anxiety had negative effects, for the sample as a whole.

    CONCLUSIONS:

    Non-CF bronchiectasis is associated with poorer QOL in childhood. The impact of the disease on QOL occurs through both clinical and psychological variables.

  • Possible atomoxetine-induced vitiligo: a case report.

    Vitiligo is a chronic skin disease characterized by the appearance of white depigmented lesion due to a loss of melanocytes. The etiopathogenesis of vitiligo is not clear, but according to the neural theory of vitiligo, the direct and indirect effects of monoamine neurotransmitters cause melanocyte destruction and various studies have supported this theory. Many drugs have been related to the development of vitiligo, and the melanocytotoxic effects of the some of these drugs are thought to be related due to their effects on the monoaminergic system. Furthermore, a recent article reported the development of a localized loss of pigmentation after the application of a methylphenidate patch in a patient with attention-deficit/hyperactivity disorder (ADHD). Atomoxetine is an inhibitor of norepinephrine reuptake sites and is a drug that has been used for the treatment of ADHD. Here, we present a school-aged child with ADHD who displayed a vitiligo lesion following the initiation of atomoxetine. We further discuss the possible impact of the ADHD drugs on the development of vitiligo.

  • Methylphenidate-induced awake bruxism: a case report.

    Methylphenidate (MPH) is a stimulant that is commonly used in the treatment of attention-deficit/hyperactivity disorder in children and adults. Several reports are available regarding the relationship of MPH use and sleep bruxism. We report the case of a 9-year-old boy who presented with severe awake bruxism after his second dose of sustained release form of MPH treatment, which was confirmed on rechallenge. This is the first report of its kind showing such relationship in the literature.