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Öğe Aripiprazole-induced oculogyric crisis (acute dystonia) in 11 years old girl: a case report(Sivas Cumhuriyet University, 2020) Işık, Cansu Mercan; Demirci, Belde; Sarı, Seda Aybüke; Çiçek, Ayla UzunAbstract Acute dystonic reaction which is described as involuntary muscle spasms and contractions including neck, chin, eye and mouth muscles is an extrapyramidal adverse effect. Acute dystonic reactions are rarely seen with atypical antipsychotics. In this study, we present a case of an aripiprazole-induced oculogyric crisis in an 11 years old girl who diagnosed with mild intellectual disability attention deficit and hyperactivity disorder, and conduct disorder. This case is important as aripiprazole-induced oculogyric crisis caused is not an expected side effect in the child and adolescent population.Öğe Assessment of upper airway obstruction in children with specific learning disorder(2020) Çiçek, Ayla Uzun; Bora, AdemAim: A growing number of findings suggest that there is an important relationship between upper airway obstruction (UAO) andspecific learning disorder (SLD). However, existing evidence is limited to very few studies. We, thus, aimed to explore chronic UAOconditions in children with specific learning disabilities.Materials and Methods: This study involved seventy-seven children aged 7 to 10 years with SLD and eighty-six healthy childrenmatching in age and gender. Psychiatric disorders were diagnosed through the Diagnostic and Statistical Manual of Mental Disorders(DMS-5) Criteria. Porteus Maze Test and Kent-EGY test were used to assess the intelligence of the participants. The diagnoses ofUAO were made by a physical examination, a detailed otorhinolaryngologic examination, the anamnesis and clinical history, anteriorrhinoscopy, and flexible endoscopic nasopharyngoscopy according to the type of UAO.Results: The rates of having at least one pathology causing UAO and secondary sleep difficulties due to UAO were significantlyhigher in children with SLD compared to controls. The severity of SLD was significantly associated with the severity of UAO and thepresence of secondary sleep difficulties, but not the presence of UAO. The verbal and total IQ scores were significantly affected bythe presence and severity of UAO, while the presence of secondary sleep difficulties significantly impacted all IQ scores.Conclusion: Parents, teachers, otorhinolaryngologists, child psychiatrists, and pediatricians should be aware that the associationbetween learning disorders and UAO. It also would be advisable to screen children with learning disorders in terms of UAO, and viceversa.Öğe Çocukluk Çağı Mastürbasyonu Tanılı Olguların Sosyodemografik ve Klinik Özellikleri(2020) Sarı, Seda Aybüke; Çiçek, Ayla UzunAmaç: Çocukluk çağı mastürbasyonu klinik uygulamada giderek yaygınlaşmakla birlikte, bugüne kadar literatürde bu konuda yapılan çalışmalar oldukça sınırlı sayıdadır. Bu nedenle bu çalışmada çocukluk çağı mastürbasyonuyla ilişkili klinik ve sosyodemografik özellikleri ve buna yol açan tetikleyici faktörleri belirleyerek literatüre katkıda bulunmayı amaçladık.Gereç ve Yöntemler: Sivas Cumhuriyet Üniversitesi Tıp Fakültesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Polikliniği’ne 01.01.2019-01.01.2020 tarihleri arasında genital yolla kendi kendini uyarma şikâyeti ile getirilen 0-8 yaş arası 29 olgunun dosyası geriye dönük olarak incelendi. Olguların sosyodemografik ve klinik verileri ile çocukluk çağı mastürbasyonuyla ilgili tetikleyici faktörler SPSS Versiyon 20 istatistik paket programı kullanılarak analiz edildi.Bulgular: Olguların %72.4’ü kız, %27.6’sı erkekti. Ortanca yaş kızlar ve erkekler için sırasıyla 61.0 ay ve 60.0 aydı. Mastürbasyon başlangıcı için ortanca yaş kızlarda 24.0 ay, erkeklerde ise 36.0 aydı. Çalışmadaki çocukların büyük çoğunluğu orta veya yüksek gelirli ailelerden geliyordu. En sık genitoüriner enfeksiyonlar olmak üzere, olguların %72.9’unda mastürbasyona yol açan en az bir tetikleyici faktör saptandı. Sonuç: Çalışmamız sonucunda olguların ebeveynlerinin büyük çoğunluğunun sosyokültürel açıdan iyi düzeyde olmasına rağmen, çocuklarını mastürbasyon davranışının ortaya çıkmasından ortalama 24 ay sonra hekime götürdüklerini sapta-dık. Bu durum mastürbasyonun halen ebeveynler için tabu olarak görüldüğünü destekler nitelikteydi.Öğe Comparison of Self-Esteem and Social Anxiety Levels of Adolescents Who Wear Spectacles and Who Do Not(2021) Yeter, Duygu Yalınbaş; Bozali, Erman; Çiçek, Ayla UzunIntroduction: Self-esteem and social anxiety could affect both the social life and school success of adolescents. Wearing spectacles in adolescence may be related to self-esteem and social anxiety. Therefore, in this study, we aimed to compare the level of self-esteem and social anxiety between adolescents who wear spectacles and those who do not. Methods: This comparative descriptive study which was conducted in Sivas Cumhuriyet University Ophthalmology outpatient clinic between March-July 2021, consisted of 108 adolescents who have been wearing spectacles for at least one year, and age and sex-matched, 150 healthy adolescents. Self-esteem was measured by Rosenberg Self-esteem Scale and social anxiety was measured by Social Anxiety Scale for Children-Revised. The socio-demographic characteristics of the participants and clinical data on spectacle were evaluated via a sociodemographic data form. Results: 69 (63.9%) of the study group were girls, and the mean age was 12.92±1.55 years. For the right eyes, the mean spherical equivalent (SE) value was - 1.10±3.23 D and it was -1.15±3.39 D for the left eyes. The mean self-esteem scores of the spectacle wearers were significantly lower (22.53±4.60 vs. 25.50±2.05, p<0.001), and the mean social anxiety scale scores were significantly higher (40.23±10.90 vs. 36.13±7.57, p=0.006) compared the control group. When the patients were evaluated as myopic (n=78) and hyperopic (n=30) regarding the SE, even though there was an increase in the social anxiety score as the degree of myopia increased for both eyes (for right, r=.-280, p=0.01, and for left, r=.-235, p=0.04), there was no significant correlation with self-esteem scores (p>0.05). Conclusion: Wearing spectacles in adolescence seems to be related to self-esteem and social anxiety. An appropriate approach would be to perform a thorough psychological evaluation of adolescents who wear spectacles.Öğe Frequency of headache and related clinical factors in children and adolescents with tic disorders(2020) Çiçek, Ayla Uzun; Ucuz, İlknur; Bolayır, ErtugrulAim: Only a few studies have investigated the comorbid headache in children with tic disorders (TD). In this study, thus, we aimed to examine the frequency and clinical correlates of comorbid headache in TD.Material and Methods: The sample consisted of 98 children and adolescents aged 6–16 years with a diagnosis of any tic disorder and 108 healthy children and adolescents matched for age, gender and sociocultural characteristics. All participants underwent a semi-structured psychiatric interview to establish a psychiatric diagnosis. The diagnosis of headache was made according to thethird edition of the International Classification of Headache Disorders criteria. Also, a specially prepared personal information sheet and Yale Global Tic Severity Scale were applied.Results: Children and adolescents with TD had a significantly higher frequency of headache compared to those in the control group (44.9% vs. 22.2%, p=0.001). The most common type of headache in both groups was migraine. We determined that the rate of diagnosis of chronic tic disorders, percentage of the presence of vocal tics, severity of tics, the proportion of patients takingpharmacotherapy for tics, and the rate of psychiatric comorbidity were significantly higher in patients with a headache than those without headache.Conclusion: The results of our study confirm studies showing suggesting a possible relationship between TD and headache, and supports the proposition that headache is a comorbidity of TD. However, further studies exploring the mechanisms of this relationship are required. It also would be advisable to screen children with TD in terms of headaches.Öğe Grief Accompanied by Suicidal Thoughts After Traumatic Loss in Adolescent: A Case Report(Sivas Cumhuriyet Üniversitesi, 2024) Şireli, Özlem; Yazarlı, İrem Naz; Abanoz, Elif; Çiçek, Ayla Uzun; Işık, Cansu Mercan; Çolak, MehmetGrief is a normal process that occurs following the irreversible loss of a loved one. This process, characterized by painful experiences, varies widely and is influenced by numerous factors, including the identity of the deceased, the circumstances of their death, the individual characteristics of the bereaved, and the availability of support systems. The suddenness and violence of a loss can disrupt the normal grieving process, leading to the manifestation of traumatic symptoms. This phenomenon, referred to as “traumatic grief” in the literature, is associated with an increased risk of various psychiatric disorders, including major depression, anxiety disorders, and post-traumatic stress disorder. The death of a parent represents a profound loss for an adolescent, complicating their coping mechanisms and significantly impacting their psychological well-being. Parental loss alone is a significant risk factor for suicidal behavior in adolescents. When a parent’s death is traumatic, it can further exacerbate this risk, leading to suicidal thoughts and behaviors by disrupting the normal grief process, even in adolescents who were previously mentally healthy. This article presents the diagnosis and treatment of a 17-year-old girl who exhibited active suicidal thoughts and behaviors after her father was killed with a firearm. The objective of this case report is to explore the atypical grief symptoms that can follow traumatic losses during adolescence and to assess the effectiveness of holistic approaches that combine supportive psychotherapy with pharmacotherapy in treating such cases.Öğe Inflammatory and Biochemical Concepts in Children with Specific Learning Disorders: A Comparative Study(Sivas Cumhuriyet Üniversitesi, 2024) Işık, Cansu Mercan; Çiçek, Ayla Uzun; Karaarslan, Melih Uğur; Akkuş, Serdar; Özbek, Dilara ÜlgerThis study aimed to investigate the role of inflammation and biochemical parameters in children with Specific Learning Disorders (SLD) and to evaluate these parameters based on the severity of SLD.The study was planned as a retrospective. 39 children diagnosed with SLD and 32 healthy controls aged 6-16 years, who had hemogram and biochemistry tests performed at their admission, were included in the study. Diagnoses were based on DSM-5 criteria, clinical interviews, family interviews, and assessments of reading, writing, and math skills. The study received ethical approval from the Cumhuriyet University Non-Invasive Clinical Research Ethics Committee.Lymphocyte count and WBC were significantly higher in the SLD group (p = 0.003, p = 0.006, respectively). A significant difference was detected between the groups regarding platelet/lymphocyte ratio (PLR) (p = 0.047). No significant differences were found in blood parameters (erythrocyte, neutrophil, lymphocyte, WBC, platelet, T4, TSH, folic acid, vitamin B12, PLR, neutrophil/lymphocyte ratio (NLR)) when evaluated according to the severity of SLD.The results of our study suggest that inflammation may play a role in SLD, but further research with larger sample sizes, longitudinal designs, and comprehensive assessments of inflammatory markers is needed to better understand these associations.Öğe Parental temperament characteristics of juvenile delinquents(2023) Yılmaz, Yavuz; Çiçek, Ayla UzunCriminal behavior in children emerges as a result of a complex process. If the criminal behavior is repetitive and preventive interventions are not applied, it can also lead to the emergence of criminal behavior in adulthood. In our study, we aimed to compare the parental temperament characteristics of juvenile delinquents with those of non-offending children of similar age and gender. The study group included parents of 69 juvenile delinquents aged between 12 and 15, while the control group consisted of parents of 73 non-offending children of the same age range. Data was collected using a demographic information form prepared by researchers and the TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire) Temperament Scale. The study group included 37 fathers and 32 mothers, while the control group included 40 fathers and 33 mothers. Parents in the study group had less education than those in the control group, and psychopathology was more common. The study group's parents experienced more legal issues on average. In comparison to the control group, fathers in the study group scored higher for cyclothymic temperament, hyperthymic temperament, and irritable temperament. Compared to the control group, mothers in the study group scored higher on all temperamental variables. The fathers' assessments of their depressive and anxious temperaments did not differ significantly. Fathers in the study group scored higher on the cyclothymic, hyperthymic, and irritable temperament scales. There was a considerable difference in the prevailing temperament type between the groups. Moms in the research group had significantly higher temperament scores than those in the control group.Öğe Pharmacists' Knowledge, Attitudes And Beliefs About Attention Deficit And Hyperactivity Disorder And Medical Treatment(2024) Işık, Cansu Mercan; Çiçek, Ayla UzunAim: Attention deficit hyperactivity disorder (ADHD) is a common and devastating disorder that poses a significant burden on families and society.ADHD treatment is multifaceted and requires long-term care and support. As pharmacists are directly involved in the distribution of medication, they are well positioned to collaborate with patients, support their treatment, highlight the importance of adherence to medication, and explain the medicine. This survey study aimed to identify pharmacists' knowledge gaps, attitudes and beliefs about ADHD and its medical treatment, and their experience in ADHD management. Method: In our study, a questionnaire was prepared for pharmacists in Sivas Center, covering descriptive questions such as the pharmacist's age and professional year, what pharmacists do when they encounter children and adolescents with attention problems and/or mobility, and their thoughts on the diagnosis and treatment of ADHD, and applied face-to-face. Results: The study involved 113 pharmacists. Respondents were asked to assess their level of knowledge regarding ADHD. It was observed that 29.2% of the participants had limited knowledge about ADHD and 14.2% had good knowledge. Nearly half (48.7%) of the respondents acknowledged their lack of knowledge on psychostimulants. It was revealed that 41.6% of the pharmacists consider ADHD treatment medication to be potentially addictive. When comparing survey responses on ADHD among participants based on their professional experience, it was discovered that there is a statistically significant relationship (p<0.023) between pharmacists with limited professional experience and their beliefs about ADHD as a condition that can lead to lifelong issues. Conclusion: Our study is the first to measure the awareness of pharmacists about ADHD in our country. Pharmacists have sufficient knowledge to counsel patients and to answer the most frequently asked questions about the drug's safety profile and onset of action is of great importance in the management of ADHD. So it would be useful to organize trainings on ADHD for pharmacists.Öğe Psychiatric Comorbidity and Psychosocial Impairments in Children with Dermatologic Disorders(2020) Çiçek, Ayla Uzun; Sarı, Seda Aybüke; Güner, Rukiye Yasak; Akyol, Melih; Hayta, Berksoy Sibel; Çam, SelimObjective: Few studies have explored the psychiatric comorbidity, psychological and social factors in the field of pediatric psycho-dermatology, thus the literature about children and adolescents is limited. In this study, we aimed to find out the prevalence and pattern of psychiatric comorbidity and to investigate the impacts of dermatological problems on psychological well-being, school performance, self-esteem in children suffering from dermatologic disorders. Method:In total, 247 consecutive outpatients with different dermatologic disorders aged 4–17 years (143 (52.9%) females, mean age 11.81±3.40 years) were included in this study. A semi-constructed diagnosis interview and The Diagnostic and Statistical Manual of Mental Disorders (DMS-5) criteria were performed to establish a psychiatric diagnosis according to the age range of the child and adolescent. A specially prepared personal information sheet, Rosenberg Self-Esteem scale and Strengths and Difficulties Questionnaire were applied. Results:The prevalence of psychopathology was found to be 58.7% in our study population. The most common psychiatric comorbidities were anxiety disorders, mood disorders, attention deficit hyperactivitydisorder and disruptive behavior disorders. Dermatologic diagnoses were dividedinto 8 groups. The riskiest dermatologic diagnostic groups in terms of psychopathology, self-esteem, body appreciation anxiety, academic performance, social isolation, stigmatization, significant association with psychosocial stressors at onset and/or exacerbation were psoriasis, primary psychiatric disorders, pigmentation disorders and hair disorders. Conclusions:Psychiatric comorbidity is quite common (58.7%) in the pediatric population with dermatologic disorders. The impacts upon the psychosocial functioning of dermatologic conditions are also enormous. Both dermatologists and child and adolescent psychiatrists should be well aware of psychiatric disturbance or psychosocial impairment, and patients should be meticulously assessed for psychiatric support.Öğe Sivas İlinde Suça Sürüklenen Çocuk Olguların Sosyodemografik ve Klinik Özellikleri(2019) Sarı, Seda Aybüke; Çiçek, Ayla Uzun; Bütün, Celal; Yıldırım, AliAmaç: Bu çalışmada suça sürüklenen çocukların sosyodemografik özelliklerinin,işledikleri suç tiplerinin ve zeka düzeylerinin belirlenmesi ve bu çocukları suça itennedenlerin saptanması amaçlandı.Gereç ve Yöntem: Adli makamlarca 01.01.2017-01.06.2018 tarihleri arasındaadli rapor düzenlenmesi için Cumhuriyet Üniversitesi çocuk ve ergen ruh sağlığı vehastalıkları polikliniğine yönlendirilen 86 olgunun dosyası geriye yönelik olarak incelendi. Olguların yaş, cinsiyet, sosyoekonomik düzeyi, eğitim durumu, zekâ seviyesive DSM-5’e göre ruhsal tanıları; işlenen suça ait özellikler ve adli rapor sonuçlarıdeğerlendirildi.Bulgular: Olguların %90.6’sı erkekti. Suç tarihindeki yaş ortalamaları 13.76±0.89idi. Büyük çoğunluğu sosyoekonomik düzeyi düşük ve orta düzeydeki ailelerinçocuklarıydı. %72’sinde herhangi bir ruhsal hastalık saptanmadı. Davranım Bozukluğu(DB) en sık saptanan ruhsal bozukluktu. Büyük çoğunluğunun (%82.5) zekası normaldi. En sık işlenen suç “hırsızlık” (%50) suçuydu. Olguların %30,2‘sinin tekrarlayan suç öyküsü vardı. Bu olgulardan sadece %25.5’i işlediği fiilin hukuki anlam vesonuçlarını algılayabilme ve fille ilgili davranışlarını yönlendirme yeteneğine sahipti.Sonuç: Çocuk suçluluğu ülkemizde her geçen gün artmakta olan bir sorundur.Bu nedenle çocukları suç işlemeye iten risk faktörlerinin belirlenmesi ve bu husustagerekli önlemlerin alınması önem arz etmektedir.Öğe The association between loss of appetite and sense of olfaction in children with iron deficiency anemia(Galenos Publishing House, 2020) Aygüneş, Utku; Çiçek, Ayla UzunINTRODUCTION: IDA (iron deficiency anemia) is the most common type of anemia in pediatric patients and very little is known about the effect of IDA on the sense of smell and about the effects of smell on appetite. This study shows the effect of IDA on the sense of smell and about the effects of smell on appetite. MATERIALS and METHODS: The study enrolled 57 IDA patients and 57 healthy subjects. Olfactory function was evaluated using the Sniffin’ Sticks olfactory test. The evaluation was performed by using a semi-structured psychiatric interview using Sociodemographic Data Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version and The Child Eating Behaviour Questionnaire. RESULTS: Patients with IDA had a significantly lower threshold, discrimination, and identification value, and a lower threshold compared with the control group. Correlation analysis showed a significant correlation between an increase in the total olfactory test score and the total score for appetite indicators. CONCLUSIONS: In this study, it was observed that decreased appetite in children with IDA was accompanied by impaired odor functions. It suggests that odor dysfunction may be a significiant factor for decreased appetite. © 2020, Galenos Yayincilik,. All rights reserved.Öğe The Rapunzel Syndrome in a Four-year-old Girl(Galenos Publishing House, 2022) Sarı, Seda Aybüke; Cankorkmaz, Levent; Çiçek, Ayla UzunTrichobezoar is a rare pathology in which swallowed hair accumulates in the stomach. An unusual form of bezoar extending from the stomach to the small intestine or beyond is described as Rapunzel syndrome (RS). Trichobezoars typically cause abdominal pain and nausea, but can also present as an asymptomatic abdominal mass, progressing to abdominal obstruction and perforation. Trichobezoar with RS is an uncommon diagnosis. It is predominantly found in emotionally disturbed or mentally retarded young people. The diagnosis may be suspected in young females with abdominal pain, epigastric mass, and malnutrition, who have a history of trichophagia. We present a case of successful laparotomy removal of a gastro-duodenal trichobezoar in a 4-year-old girl with a history of trichotillophagia. The psychodynamic aspects, clinical manifestations, diagnoses, and therapeutic strategies are discussed. © 2022 by the Turkish Association for child and Adolescent Psychiatry / Turkish Journal of Child and Adolescent Mental Health. published by Galenos Publishing House.Öğe Therapeutic approaches to children with enuresis: A retrospective study(2021) Ucuz, İlknur; Çiçek, Ayla UzunEnuresis is a common pediatric condition and there are different treatment options. This study aimed to evaluate treatment options for enuresis in a sample of the childand adolescent psychiatry clinic. The data and treatment results of 98 patients (mean age: 10.38±2.15 years, range=6-16 years) diagnosed with enuresis between 1 May2015 and 1 October 2020 were retrospectively reviewed. We found that 57 of the patients had previously applied to the hospital for enuresis, and 14 of them have appliedto child and adolescent psychiatry, 10 of them to pediatric surgery, 20 of them to other branches of pediatrics, and 13 of them to the urology clinic. In previous hospitalapplications, behavioral treatment only had been applied to 40.4% of the patients, and pharmacotherapy had been applied in 59.6% of the patients. On the other hand,in the child and ado-lescent psychiatry clinic, 26.5% of the patients received behavioral treatment only, and 73.5% used drugs along with behavioral treatment, and themost frequently preferred drugs were imipramine (oftenest) and desmopressin. Also, the rates of psychiatric comorbidity in those who received medical treatment weresignificantly higher than those who treated behavioral treatment only. In conclusion, this study revealed that different clinical branches apply different treatment approachesto enuresis. In child and adolescent psychiatry, imipramine was the most commonly used agent in medical treatment, and this has been attributed to the high rate ofpsychiatric comorbidityÖğe Treatment Complexity in a Twin Adolescent Pair with Selective Mutism: A Case Report(Sivas Cumhuriyet Üniversitesi, 2024) Şireli, Özlem; Pakoz, Seyda Muberra; Soyhan, Merve; Işık, Cansu Mercan; Abanoz, Elif; Çiçek, Ayla UzunSelective Mutism (SM) is a disorder characterized by the individual's persistent inability to speak in specific social situations (e.g., school) where speech is expected, even though the individual is able to speak in other situations. It is a rare anxiety disorder and is often seen in children between the ages of 4-8. The presence of SM in family members is important in terms of both etiology and clinical course. While family burden is a factor that increases the incidence of SM, according to some research results, the clinical symptoms of twin cases diagnosed with SM are more severe than those of non-twins. A positive family history negatively affects the prognosis of SM and increases resistance to treatment. In this article, the diagnosis and treatment process of 14-year-old monozygotic twin adolescents who have been followed up with the diagnosis of SM for a long time will be discussed. The main treatment methods for SM are medication and psychotherapy. It is known that psychotherapeutic interventions in particular vary depending on individual differences. The most important purpose of this article is to draw attention to the differences in treatment interventions of twin SM cases and to evaluate the clinical features of the cases in the light of the literature.
