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Öğe Association of Suicide Attempts and Non-Suicidal Self-Injury Behaviors With Substance Use and Family Characteristics Among Children and Adolescents Seeking Treatment for Substance Use Disorder(Taylor & Francis Inc, 2017) Doksat, Neslim Güvendeğer; Zahmacıoğlu, Oğuzhan; Demirci, Arzu Çiftçi; Kocaman, Gizem Melissa; Erdoğan, AytenBackground: Numerous studies in youth and adults suggest strong association between substance use disorders and non-suicidal self-injury (NSSI) and suicidal behaviors. There is paucity of studies exploring the association of substance use with history of suicide attempts (HSA) and NSSI in children and adolescents in Turkey. Objective: We aimed to examine the prevalence of NSSI and HSA and their relationship with substance use and family characteristics among youth seeking treatment for substance use in Turkey. Method: Participants were children and adolescents who were admitted to the Bakirkoy Trainee and Research Hospital for Psychiatric and Neurologic Disorders in Istanbul between January 2011 and December 2013. Two thousand five hundred eighteen participants were included. Questionnaires were applied to all patients. The association of NSSI and HSA with substance use, family characteristics, and subject characteristics were analyzed. Results: The prevalence of NSSI and HSA behaviors among substance using youth in our sample were 52% and 21% respectively. Cannabis and cocaine use was found to be a significant risk factor for HSA, and polysubstance use was associated with both NSSI and HSA. Parental separation/divorce, parental mental disorders, alcohol and drug use, and crime were the risk factors for HSA. A positive history of physical and sexual abuse increased the risk of HAS, and a history of neglect increased the risk of NSSI. Conclusions/importance: We suggest that results showing relationship between substance use and associated social features with NSSI and HSA may contribute to elaborating effective and targeted preventive and intervention programs for these high-risk youth groups in Turkey.Öğe Autistic feature and 2D: 4D finger ratio relations children and adolescents with congenital adrenal hyperplasia(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2017) Kocaman, Gizem Melissa; Özmerdivenli, Recep; Yektaş, Çiğdem; Bolu, Semih; Haskılıç, Yunus Emre; Erdoğan, AytenObjective: Because congenital adrenal hiperplazi (CAH) and autism spectrum sisorders (ASD) is rarely seen, it is difficult to assess whether the increased incidence of ASD in girls with CAH. ASD behaviors and 2D: 4D finger ratio changes in patients with androgen overproduction have been reported. The aim of this study is determining the 2D: 4D finger ratios and ASD features in girls with CAH and normal control group. Methods: The study group will consist of thirty female children and adolescents between the ages of 3 and 15 who are diagnosed with classic CAH who were followed at the Pediatric Endocrinology Department of Duzce University Medical Faculty Hospital. For the control group, 30 healthy children and adolescents equalized with CAH patients in terms of age and gender will be taken. Al patients and controls examined for psychiatric disorders. by clinicians Patients and control groups filled Autism Behavior Checlist and semistructured sociodemogrphic form that evaluated the gender, age, pregnancy and birth complications, history of mothers' cigarette and alcohol use. 2D: 4D ratios were measured in both of control and CAH groups. Results: KAH group right and left hand 2D: 4D ratios were statistically lower compared to controls and also lower 2D: 4D ratios had association with high ABC scores. When compared with control group, CAH group ABC scores were significantly higher. In KAH group there was a pozitive correlation between 2D: 4D ratios and ABC scores. Conclusion: In light of present study findings, suggest that high androjen may have effect on low 2D: 4D ratios and high ASD symptoms. Further researchs with a large sample are needed in this field.Öğe Autistic Feature and 2D: 4D Finger Ratio Relations Children and Adolescents with Congenital Adrenal Hyperplasia [conferenceObject](Wiley-Blackwell, 2016) Kocaman, Gizem Melissa; Özmerdivenli, Recep; Yektaş, Çiğdem; Arslanoğlu, İlknur; Özdemir, Esra; Bolu, Semih; Erdoğan, Ayten…Öğe Autistic feature and 2D:4D finger ratio relations children and adolescents with congenital adrenal hyperplasia(Cukurova University, Faculty of Medicine, 2017) Kocaman, Gizem Melissa; Özmerdivenli, Recep; Yektaş, Çiğdem; Bolu, Semih; Haskılıç, Yunus Emre; Erdoğan, AytenObjective: Because congenital adrenal hiperplazi (CAH) and autism spectrum sisorders (ASD) is rarely seen, it is difficult to assess whether the increased incidence of ASD in girls with CAH. ASD behaviors and 2D:4D finger ratio changes in patients with androgen overproduction have been reported. The aim of this study is determining the 2D:4D finger ratios and ASD features in girls with CAH and normal control group. Methods: The study group will consist of thirty female children and adolescents between the ages of 3 and 15 who are diagnosed with classic CAH who were followed at the Pediatric Endocrinology Department of Düzce University Medical Faculty Hospital. For the control group, 30 healthy children and adolescents equalized with CAH patients in terms of age and gender will be taken. Al patients and controls examined for psychiatric disorders. by clinicians Patients and control groups filled Autism Behavior Checlist and semistructured sociodemogrphic form that evaluated the gender, age, pregnancy and birth complications, history of mothers’ cigarette and alcohol use. 2D:4D ratios were measured in both of control and CAH groups. Results: KAH group right and left hand 2D:4D ratios were statistically lower compared to controls and also lower 2D:4D ratios had association with high ABC scores. When compared with control group, CAH group ABC scores were significantly higher. In KAH group there was a pozitive correlation between 2D:4D ratios and ABC scores. Conclusion: In light of present study findings, suggest that high androjen may have effect on low 2D:4D ratios and high ASD symptoms. Further researchs with a large sample are needed in this field. © 2017, Cukurova University, Faculty of Medicine. All rights reserved.Öğe Characteristic features of perpetrators of sexual abuse on children and adolescents in four different regions of Turkey(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2011) Erdoğan, Ayten; Tufan, Evren; Karaman, Mehmet Gökşin; Atabek, Mehmet Süleyman; Koparan, Cem; Özdemir, Esra; Ankaralı, HandanObjective: Referral of sexually abused children and adolescents to the Forensic Medicine Council showed that sexual abuse of children and adolescents is prevalent in Turkey. Unfortunately, very few studies have examined the characteristics of sexual offenders against children and adolescents in Turkey. This study examined the sociocultural features of sexual offenders against children and adolescents from Western Black Sea, Mediterranean, Marmara and East Anatolia regions of Turkey. Methods: The sex offenders against children and adolescents referred for forensic psychiatric examination to the Child and Adolescent Psychiatry outpatient clinics of University of Zonguldak Karaelmas Hospital, Elazig Mental Health Hospital, Adana Ekrem Tok Mental Health Hospital, Bursa Dortcelik Childrens' Hospital were recruited for the study. Data for sex offenders were obtained from the medical and legal documents of children and adolescents. The sex offenders were assessed for demographic and legal characteristics: age, gender, marital status, education level, substance and alcohol use history and use of child pornography/computer. Results: All of the sexual offenders against children and adolescents were male. In most of the cases the child knows the offender (e. g. neighbor, relative, family friend, or local individual with authority). Females were the most commonly abused, with the percentage of abused females increasing with age. In addition, most of the sex offenders was not married and had low level of education, substance and alcohol use history. Conclusion: Most of the sex offenders against children and adolescents were male and not married. They had high rates of substance use history, low level of education. Further research is needed to better identify clinically significant differences among the different types of sex offenders against children and adolescents in Turkey. Anatolian Journal of Psychiatry 2011; 12:55-61)Öğe Çocuk ve gençlerde risperidon tedavisine bağlı serum lipit profili(2011) Karaman, Mehmet Gökşin; Yurteri, Nihal; Özdemir, Esra; Kala, Serhat; Ankaralı, Handan; Elmacı, Figen Karaman; Erdoğan, AytenAmaç: Atipik antipsikotiklerin (AAP), AAP-ilişkili kilo artışı ile sonuçlanabilen metabolik bozukluğa neden olabile-ceği bildirilmiştir. Bu çalışmanın amacı risperidon ile tedavi edilen çocuk ve gençlerde trigliserit, kolesterol ve ağır-lık değişimlerini saptamak ve değerlendirmektir. Yöntem: Herhangi bir psikiyatrik bozukluk nedeniyle risperidon kullanan 80 hasta çalışmaya alınmıştır. Açlık total düşük dansiteli lipoprotein kolesterol (LDL-K), yüksek dansiteli lipoprotein kolesterol (HDL-K), total kolesterol (TK) ve trigliserit (TG) düzeyleri başlangıçta ve 12 aylık tedavi sonrası ölçülmüştür. Sonuçlar: Başlangıçtaki ortalama TG, TK, HDL-K ve LDL-K düzeyleri ile on iki aylık ortalama TG, TK, HDL-K ve LDL-K düzeyleri arasında anlamlı fark bulunmamıştır (sırasıyla p0.341, p0.135, p0.414, p0.411, p0.707). Başlangıç ve 12. ay verileri yaş gruplarına göre karşılaştırıldığında yaş, cinsiyet, risperidon dozu ve serum TG, TK, LDL-K veya HDL-K düzeylerindeki değişimler açısından anlamlı bir ilişki saptanmamıştır. Tartışma: Bu çalışmada çocuk ve ergenlerde dislipidemi ve bir yıllık risperidon tedavisi arasında anlamlı bir ilişki saptanmamıştır. Literatürde gençlerde ve çocuklarda atipik antipsikotik tedavi sonrası lipid profili değişiklikleri ile ilgili çalışmalar sınırlı olduğundan, daha büyük örneklemlerde kontrollü çalışmalar yürütülerek varsa dislipidemi sıklığı ve risk etkenleri ortaya konulmalıdır.Öğe Evaluation of Gender Role Perceptions in Adolescents According to Sociodemographic Factors(Duzce Univ, 2018) Kantoglu, Aycan; Çetin, Nihal Yurteri; Erdogan, Ayten; Kantoğlu, Aycan; Çetin, Nihal Yurteri; Erdoğan, AytenObjective: The main focus of the study is to evaluate the relationship between the development of gender role perception during the adolescence and the social demographic backgrounds such as sex; age; educational level, financial situation and working status of the parents. Methods: One hundred individuals aged between 12 and 17 were chosen as a study group. To analyze the sociodemographic backgrounds of the participants, a semi-structured questionnaire designed by the researcher was applied to all subjects. To describe the sexual role and gender role perceptions of each individual, two existing measures are used: "BEM sex role inventory" (BSRI) and "gender roles attitude scale" (GRAS). Results: The subcategories of "gender roles attitude scale" (GRAS) (egalitarian gender roles, female gender roles, marriage gender roles, traditional gender roles and male gender roles) were significantly different according to different age and gender groups. Similar results were obtained for the subgroups of "BEM sex role inventory" (femininity, masculinity, and neutral) as well. Furthermore, the novel finding of this study was the significant relationship between the educational and financial situation of the parents and the gender role perception in their children. While children of the families with low education and low income were more prone to have traditional view; the children with highly educated parents, working mother and high income tended to have more egalitarian view. Conclusion: Results of the present study clearly suggest that certain sociodemographic backgrounds of adolescents are significantly associated with certain aspects of their gender role perceptions.Öğe First episode psychosis: The relation between symptoms, initial treatment, and clinical response(Turkish Association of Nervous and Mental Health, 2015) Yıldızhan, Eren; Türkcan, Ahmet; İnan, Serhat; Erenkuş, Zehra; Yalçın, Özhan; Erdoğan, AytenObjective: It was aimed to explore the relationship of clinical psychopathology and treatment response with "duration of untreated psychosis" (DUP) and "duration of untreated illness"(DUI) in 15-20 years old (mean age: 17,34 ± 1.69) inpatients in Turkey. Method: Mood disorders with psyhotic features were grouped as affective psychoses (18 patients, mean age: 17,28 ± 1,75); schizophrenia, schizophreniform disorder and other psychotic disorders were grouped as non-affective psychoses (25 patients, mean age: 17,38 ± 1,68). 43 patiens (11 females, 32 males) were evaluated for acute treatment response with Positive and Negative Sydrome Scale - PANSS and Clinical Global Impressions Scale -CGI. Results: Mean DUP was determined as 6,5 ± 12,4 weeks, mean DUI was determined as 37,8 ± 49,8 weeks. For the affective psychosis (AP) group; mean DUP was 1,9 ± 1,2 weeks, mean DUI was 24,6 ± 37,1 weeks, for the non-affective psychosis (NAP) group; mean DUP was 9,8 ± 15,5 weeks, mean DUI was 47,3 ± 55,9 weeks. Treatment response was better for the non-affective psychosis group and for the patients who had earlier access to treatment. Shorter DUP and DUI was related with better PANSS negative symptom severity at the time of the discharge. Conclusion: Better treatment response related with shorter DUP and DUI reveals the significance of early treatment for the disease prognosis.Öğe Konjenital adrenal hiperplazisi olan çocuk ve ergenlerde otistik özellikler ve 2D:4D parmak oranlarının ilişkisi(2017) Kocaman, Gizem Melissa; Özmerdivenli, Recep; Yektaş, Çiğdem; Bolu, Semih; Haskılıç, Yunus Emre; Erdoğan, AytenAmaç: Hem konjenital adrenal hiperplazi (KAH), hem de otizm spektrum bozukluğu (OSB) çok nadir olarak görüldüğünden, KAH olan çocuk ve ergenlerde OSB görülme oranının artmış olup olmadığını saptamak güçtür. KAH ile OSB'nin düşük 2D:4D parmak oranları arasında ilişki olabileceği bildirilmiştir. Bu çalışmada KAH olan çocuk ve ergenlerde ve normal kontrol grubu çocuklarda OSB ve 2D:4D parmak oranları arasındaki ilişkinin belirlenmesi amaçlandı. Yöntem: Çalışmaya, 3-18 yaşları arasında, Düzce Üniversitesi ve Erciyes Üniversitesi Tıp Fakültesi Hastanesi Çocuk Endokrinolojisi bölümünde izlenen klasik KAH tanısı konmuş otuz çocuk ve ergen alındı. Kontrol grubuna yaş ve cinsiyet açısından hasta grubuyla bire bir eşleştirilmiş 30 sağlıklı çocuk ve ergen alınmıştır. Araştırma kapsamındaki çocuk ve ergenlerin anne-babalarının Otizm Davranış Kontrol Listesi (Autism Behavior Checklist-ABC) ve sosyodemografik veri formunu doldurmaları sağlandı. Sosyodemografik veri formunda olgunun yaş, cinsiyet, annenin gebeliği sırasında yaşadığı psikiyatrik ve fiziksel sorunlar, sigara, alkol kullanım öyküleri, aldığı ilaç ve tedaviler, gebelik komplikasyonları, erken ve zor doğum öyküsü sorgulandı. Çalışmaya alınan tüm olgularla psikiyatrik eş tanıları dışlamak amacıyla klinik görüşme yapıldı. Bulgular: KAH ve kontrol grubunun sağ ve sol el 2D:4D oranları karşılaştırıldığında, KAH'lı grupta sağ el 2D:4D oranı istatistiksel olarak anlamlı düzeyde düşük saptandı. KAH grubu, kontrol grubu ile karşılaştırıldığında, KAH grubu ABC ölçeği puanları istatistiksel olarak anlamlı düzeyde yüksek bulundu. KAH'li grupta ABC ölçeği puanları ile sağ el 2D:4D oranları arasında pozitif korelasyon saptandı. Sonuç: Çalışmamızda elde edilen sonuçlara göre, düşük sağ el 2D:4D oranı ile OSB'nin etiyolojisinde testosteron hormonunun rolünün olabileceği şeklinde yorumlanabilir. Gelecekte sadece her iki cinsiyetteki çocuk ve ergenlerin alt tip dağılımındaki sayıları artırılarak yapılacak çalışmaların bu ilişkilerin daha iyi tanımlanabilmesi açısından önemli olabileceğini düşünmekteyiz.Öğe Liver enzyme levels in adolescent patients treated with buprenorphine and additional psychotropic agents(Taylor & Francis Inc, 2015) Demirci, Arzu Çiftçi; Güneş, Hatice; Adaletli, Hilal; Bulanık, Esra; Erdoğan, AytenBackground: There are limited efficacy and safety data for buprenorphine/naloxone treatment in adolescents, and little is known about the incidence and prevalence of liver function abnormalities in young patients using buprenorphine/naloxone. Objectives: To assess the changes in liver enzyme levels associated with buprenorphine/naloxone treatment and co-medication with psychotropic agents among opioid dependent subjects aged 15-18 years. Methods: Liver enzyme levels (ALT and AST) were evaluated among 59 adolescent subjects before and following eight weeks of buprenorphine/naloxone treatment. Results: The frequency of additional psychotropic use was 60%. The patients' mean liver enzyme levels at weeks 2 and 4 were significantly higher than the baseline (ALT: p<0.0001 and p = 0.003, and AST: p<0.0001 and p = 0.016, respectively). However, there was no statistically significant difference in AST and ALT levels between the baseline and week 8. The majority of the abnormalities seen were clinically nonsignificant elevations (less than two times the upper limit of normal). It is plausible that the abnormalities in liver enzymes could have been mediated by the use of psychotropic medications. Conclusions: Buprenorphine/naloxone was well tolerated in most adolescent patients, besides clinically nonsignificant liver enzyme elevations. Psychotropic medications may have been associated with the liver enzyme changes early in the course of treatment. Nevertheless, given the relatively small number of adolescents studied to date with buprenorphine/naloxone, additional studies evaluating liver enzymes in young patients receiving buprenorphine/naloxone (and no other psychotropics) are needed.Öğe LIVER FUNCTION TESTS AND ONE YEAR RISPERIDONE TREATMENT IN CHILDREN AND ADOLESCENTS(Elsevier France-Editions Scientifiques Medicales Elsevier, 2011) Erdoğan, Ayten; Yurteri, Nihal; Tufan, A. Evren; Ankaralı, Handan; Demirci, E.…Öğe Liver function tests in children and adolescents receiving risperidone treatment for a year: A longitudinal, observational study from Turkey(Informa Healthcare, 2011) Karaman, Mehmet Gökşin; Erdoğan, Ayten; Tufan, Evren; Yurteri, Nihal; Özdemir, Esra; Ankaralı, HandanObjective. To determine the changes in liver function tests after long-term risperidone treatment in a child and adolescent population. Methods. Weight, alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transpeptidase, alkaline phosphatase and serum bilirubin of the patients were assessed in pre-treatment period, and at the sixth and 12th months of treatment. One hundred children and adolescents (aged between 3 and 18 years) were enrolled to the study. Results. Liver enzyme and bilirubin levels are higher than normal in 21.0% of the patients without clinical symptoms. No cases of hepatic failure or jaundice were seen. Only in an 8-year-old boy were there ALT level increases up to three-fold and AST level increases up to two-fold. After discontinuation of the risperidone treatment, enzyme levels were normalized in this patient. Alkaline phosphatase, alanine and aspartate aminotransferases were the most frequently increased enzymes. Conclusion. In this study, after long-term risperidone treatment of children and adolescents there was no evidence of clinically significant increases of liver enzymes and bilirubin levels. These results indicate that risperidone treatment may rarely cause serious liver enzyme increases, and may commonly cause clinically insignificant changes in liver function tests.Öğe The prescribing pattern of paliperidone in a pediatric population(Taylor & Francis Ltd, 2018) Yektaş, Çiğdem; Paşabeyoğlu, Başak; Mutlu, Caner; Erdoğan, AytenOBJECTIVES: Paliperidone is a relatively new atypical antipsychotic, offers a potential new treatment option for adolescents, with several advantages including single dosage per day and availability in hepatic problems. However, there is a lack of efficacy and safety data for the use of this medication in various psychiatric disorders among children and adolescents. In this study, we retrospectively investigated the use of paliperidone in various psychiatric disorders among a youth population. METHODS: The children and adolescents treated with paliperidone for any psychiatric problem at the outpatient and inpatient Child and Adolescent Psychiatry clinics of Duzce University Medical Faculty Hospital and Bakirkoy Mental Health Hospital were evaluated for the study. Data were collected retrospectively from the patient records. Patients' charts were reviewed to retrieve additional data on indications of the medications, adverse drug reactions (ADRs) and changes in the clinical condition. The clinical status of individual patients was assessed using the Clinical Global Index (CGI) score for severity and improvement. RESULTS: The mean age of patients was 15.8 +/- 1.3 years, and 59.6% (n = 31) of the group was male and 40.4% (n = 21) was female. Paliperidone was prescribed for median 150 days (quartiles 60 and 487 days). The median average daily dose was 7.6 mg/day (range 3-12 mg/day). The main indications for paliperidone prescription were psychotic disorders and bipolar disorders (BPDs) (17 patients, 32.6%; 16 patients, 30.7%, respectively). The other most common diagnostic group was disruptive behavior disorders (DBDs) associated with attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, intellectual disability, conduct disorders, or oppositional defiant disorders (15 patients; 28.8%) tic/neurological disorder (4 patients; 7.9%). Thirty-five patients (67.4%) did not have a diagnosis of schizophrenia and were considered to have received these drugs off-label. Dosing was notably lower in the group of DBDs patients than for patients with BPD or psychotic disorders. Of the 52 patients receiving paliperidone, 53.9% of patients were concurrently treated at some point with one or more than one of a psychostimulant/ADHD medication, an other antipsychotics, an antidepressant, a mood stabilizer, and any other class of psychotropic drug (such as a sleep medication). Totally, ADRs were recorded in 26 (50%) patients: weight gain (n = 24); extra pyramidal symptoms (n = 8); gastrointestinal system symptoms (n = 4); insomnia (n = 2); hyperprolactinemia (n = 4); sedation (n = 2); and skin affection (n = 1). CONCLUSIONS: In this study group, paliperidone has been commonly used for schizophrenia, but it has also been used for mood disorders, DBDs, and Tourette's disorder in children and adolescents. Results showed clinically meaningful improvements in symptom measurements of different disorders. The drug is generally well tolerated and the most frequent adverse events include rigidity, akathisia, sedation, and increased appetite. Future prospective studies with large samples are needed for definite conclusions.Öğe A Retrospective Investigation of Clozapine Treatment in Autistic and Nonautistic Children and Adolescents in an Inpatient Clinic in Turkey(Mary Ann Liebert, Inc, 2016) Yalçın, Özhan; Kaymak, Gizem; Erdoğan, Ayten; Tanıdır, Canan; Karaçetin, Gül; Kılıçoğlu, Ali Güven; Üneri, Özden ŞükranObjective: The aim of this retrospective study is to examine the clinical outcomes and safety of clozapine in children and adolescents with schizophrenia or other psychotic disorders/autism spectrum disorder (ASD) or affective disorders. Methods: The inpatient and outpatient files of all children and adolescents treated with clozapine over a period of 34 months (from October 2011 to July 2014) were reviewed. Demographic and clinical data were examined to describe clinical and metabolic findings, dosing, and tolerability of clozapine treatment in youth with schizophrenia, other psychotic disorders, ASD, or bipolar disorder. Results: The 37 pediatric patients included 26 patients with schizophrenia or other psychotic disorders, 7 patients with ASD complicated by schizophrenia or other psychotic disorders or affective disorders, and 4 patients with ASD only. In all groups (n = 37) there was a significant reduction (p < 0.001) in Brief Psychiatric Rating Scale (BPRS) points after clozapine treatment during the inpatient period (38.78 +/- 27.75 days). In patients with schizophrenia or other psychotic disorders co-occurring with ASD or not (n = 31), there was a significant improvement in psychotic symptoms according to Positive and Negative Syndrome Scale (PANSS) total scores and subscores (p < 0.001). Of the 26 patients with schizophrenia or other psychotic disorders, 8 (30.8%) showed a positive response (>30% symptom reduction on BPRS). In patients with ASD complicated by schizophrenia or other psychotic disorders or bipolar disorders (n = 7), there was a significant reduction (p = 0.017) in BPRS scores after clozapine treatment. The discontinuation rate for clozapine was 10.8%, and the most frequently observed side effect was hypersalivation (54.1%). Neutropenia associated with clozapine was observed in only one patient (2.7%). Conclusions: Clozapine seems to be effective and safe in children and adolescents with schizophrenia or other psychotic disorders co-occuring with ASD or not. There is a need for further studies for determining the efficacy of clozapine in children and adolescents with bipolar affective disorder or ASD.Öğe Risperidone use in preschool children with aggressive and destructive behavioral symptoms(2015) Mutlu, Caner; Şükran, Özden Üneri; Tanıdır, Canan; Güneş, Hatice; Çöpür, Mazlum; Kılıçoğlu, Ali Güven; Erdoğan, AytenAmaç: Temel olarak agresif ve yıkıcı davranışsal belirtiler ile başvuran okul öncesi çağdaki çocuklarda risperidon kullanım yaygınlığı ve özelliklerini araştırmayı amaçladık. Yöntem: Bu geriye dönük dosya tarama çalışmasında, hastaların tıbbi kayıtları yaş, cinsiyet, birincil ve eş tanılar, risperidon dozu ve tedavi süresi açısından gözden geçirildi. Risperidon dozu ve tedavi süresi birincil tanılar arasında karşılaştırıldı. Bulgular: Risperidonun 2790 çocukta kullanım yaygınlığı %18.5ti (s516). Ortalama yaş 4.861.12 yıl idi. Bu hastaların %74.4ünde bir yıkıcı davranış bozukluğu (YDB) birincil tanısı vardı. Risperidon ortalama başlangıç dozu 0.35 mg/gün ve ortalama idame dozu 0.52 mg/gün idi. Tedavinin ortalama süresi 4.9 ay idi. Zeka geriliği (ZG) olan hastalarda, YDB olan hastalara göre, başlangıç ve sürdürme dozları anlamlı olarak daha yüksek ve tedavi süresi anlamlı olarak daha uzundu. Tartışma: Okul öncesi çocuklarda, risperidon MR olan hastalarda daha yüksek dozlarla ve daha uzun süreli tedavi ile azaltılabilen agresif ve yıkıcı davranışsal belirtilerini kontrol etmek için sıklıkla kullanılır Agresif ve yıkıcı davranışları olan çocuklar için kanıta dayalı tedavi yöntemlerinin geliştirilmesi kontrollü çalışmalara ve onların klinik pratiğe uygunluğunun onayını gerektirir.Öğe Risperidone use in preschool children with aggressive and destructive behavioral symptoms(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2015) Mutlu, Caner; Üneri, Özden Şükran; Tanıdır, Canan; Güneş, Hatice; Çöpür, Mazlum; Kılıçoğlu, Ali Güven; Erdoğan, AytenObjective: We aimed to investigate the prevalence and mode of risperidone use in preschool aged children admitted with a chief complaint of aggressive and destructive behavioral symptoms. Methods: In this retrospective chart review study, medical records of the patients were reviewed for age, gender, primary and comorbid diagnoses, dosage and duration of risperidone treatment. Dosage and duration of risperidone treatment were compared among primary diagnoses. Results: In 2790 children prevalence of risperidone use was 18.5% (n=516). Mean age was 4.86 +/- 1.12 years. Of these patients, %74.4 had primary diagnosis of a disruptive behavior disorder (DBD). Mean starting dosage of risperidone was 0.35 mg/day and mean maintenance dosage was 0.52 mg/day. The mean length of treatment was 4.9 months. Starting and maintenance doses were significantly higher and treatment duration was longer in patients with mental retardation (MR) than in those with DBDs. Conclusion: In preschoolers, risperidone is frequently used to control aggressive and destructive behavioral symptoms which may improve with higher doses and longer treatment in those with MR. The development of evidence-based treatment modalities for children with aggressive and destructive behaviors necessitates controlled studies and confirmation of their pertinence to clinical practice.Öğe Serum lipid profile due to risperidone treatment in child and youth patients(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2011) Karaman, Mehmet Gökşin; Yurteri, Nihal; Özdemir, Esra; Kala, Serhat; Ankaralı, Handan; Elmacı, Figen Karaman; Erdoğan, AytenObjective: Atypical antipsychotics (AAPs) have been reported to cause metabolic dysregulation that may result in AAPs-related weight gain. The purpose of this study was to assess triglyceride, cholesterol and weight changes among risperidone-treated child and youths. Methods: Eighty subjects treated with risperidone for any psychiatric disturbances were included in the study. Fasting total low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, (HDL-C), total cholesterol (TC), and triglyceride (TG) levels were measured at baseline and at 12 months of treatment. Results: There was no significant difference between baseline mean levels of TG, TC, HDL-C and LDL-C and twelfth months mean levels of TG, TC, HDL-C and LDL-C (respectively p=0.341, p=0.135, p=0.414, p=0.411, p=0.707). Comparison of baseline and 12 months data with respect to the age groups were presented in table 2. There was no significant association with age, gender, risperidone dose and changes of serum TG, TC, LDL-C or HDL-C levels. Conclusion: In conclusion, this study did not identify significant associations between dyslipidemia and one year risperidone treatment in children and adolescents. Because little long-term lipid profile follow-up is available with atypical antipsychotics treatment in youths, controlled studies in larger samples should be carried out to reveal the frequency and the risk factors of dyslipidemia. (Anatolian Journal of Psychiatry 2011; 12:295-300)Öğe Sociodemographic characteristics and drug abuse patterns of adolescents admitted for substance use disorder treatment in Istanbul(Taylor & Francis Inc, 2015) Demirci, Arzu Çiftçi; Erdoğan, Ayten; Yalçın, Özhan; Yıldızhan, Eren; Koyuncu, Zehra; Eseroğlu, Tuğba; Evren, CüneytBackground: Adolescent substance use is an increasing major health problem in developing countries. Objectives: To evaluate the sociodemographic characteristics and drug abuse patterns of children and youth seeking treatment in Turkey. Methods: This retrospective study reviewed the demographic and clinical data of substance users who visited the substance addiction treatment clinic for children and youth in Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery in Istanbul, between January 2011 and December 2012. Results: The sample comprised of 1969 children and youth aged between 11 and 20 (346 female and 1623 male). Cannabis (60.1%), followed by solvents/inhalants (38.3%) and ecstasy (33.4%), were the most prevalent substances used. The use of solvents/inhalants was more common among males, whereas ecstasy and cocaine use were more common among females. The mean age for the onset of substance use was 13 years. The proportion of polysubstance use was 60.2%. There was a mean duration of 2.28 +/- 1.91 years between the first substance use and seeking treatment. The risk factors for most of the drug usage were onset of substance use at a young age, gender, treatment admission at older ages, higher parental criminal history, and having substance using parents or relatives. Conclusion: Findings of the very early onset of substance and polysubstance use indicated easy accessibility of legal and illicit substances by children and youth in Istanbul. These findings on Turkish children and youth who seek substance use treatment can be useful in developing preventive early interventions and treatment facilities.Öğe Trends and gender differences in alcohol and substance use among children and adolescents admitted to an addiction treatment center in Turkey: comparison of 2014 with 2011(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2016) Doksat, Neslim Güvendeğer; Çiftçi, Arzu Demirci; Zahmacıoğlu, Oğuzhan; Tekden, Mehmet; Özbek, Fatih; Günay, Gülay; Erdoğan, AytenObjective: The aim of this study was to evaluate the trends and gender differences in alcohol and substance use behaviors in youth admitted to an addiction treatment center in Istanbul. Methods: Participants were 2755 substance using children and adolescents who were treated at the Bakirkoy Mental Health and Neurologic Disorders Hospital between 2011 and 2014. The World Health Organization student drug use questionnaire' was completed by trained clinicians. Results: There was an increase in the total number of youths admitted for substance use treatment (31.4% in 2011, 68.6% in 2014). A significant increase found in polysubstance use and in the number of females seeking treatment for substance use from 2011 to 2014. Alcohol, ecstasy, synthetics cannabinoids and heroin usage showed increase whereas inhalants, cannabis, prescribed medicines usage showed decrease in 2014. In 2014 while girls mostly consumed ecstasy, prescribed medicines and cocaine boys mostly used cannabis and synthetics. Conclusions: As new popular illicit drugs emerge in the market in the recent years, it is essential to reexamine the new trends in substance use and to reconsider prevention policies and treatment strategies.Öğe Trends and Gender Differences in Substance Use Among Children and Adolescents Admitted to an Addiction Treatment Center in Turkey: Years 2011-2013(Kure Iletisim Grubu A S, 2015) Tanıdır, Canan; Çiftçi, Arzu Demirci; Doksat, Neslim Güvendeğer; Güneş, Hatice; Toz, Hamiyet İpek; Erdoğan, AytenObjective: In this study we aimed to examine the trends and gender differences in substance use behaviors and treatment seeking patterns of children and adolescents who were admitted to an addiction treatment center in Turkey. Method: Participants were 2718 children and adolescents who had been consecutively admitted to the 'Children and Adolescent Alcohol and Drug Dependency Treatment Center' in Istanbul between January 2011 and December 2013. A detailed drug use questionnaire was completed by all participants, and substance use characteristics were analyzed in terms of gender and substance types. The data regarding age of first use, age at referral, referral pattern, and type of the substances used were compared between three years (2011, 2012, and 2013) and between genders. Results: There was a statistically significant increase in the number of females (p<0.001) and in the total number of children and adolescents (p<0.001) seeking treatment for substance use through these years. The mean age of first use was 13.8 years (SD: 2.1) and the mean age at referral for treatment was 16.1 years (SD: 1.5) in the whole group. The mean age at referral for treatment was significantly lower in the female group (p<0.001). There was a statistically significant increase in the proportion of subjects admitted to the addiction treatment center alone or with their family (p<0.001) and in the number of subjects brought in by social services (p<0.001), while there was a statistically significant decrease in the number of non-voluntary referrals from forensic services through the years (p<0.001). There was a statistically significant increase in the rate of ecstasy, heroin, synthetic cannabinoid use and polysubstance use and a statistically significant decrease in the age of first use (p<0.0001) and inhalant/solvent use through the years. Use of solvents/ inhalants was more common among men (p<0.001), whereas ecstasy and cocaine use was more common among women (for each, p<0.001). Polysubstance use was present in 60.2% of the subjects, and there was a statistically significant increase in the mean number of substance types used in the last two years (p<0.001). Conclusion: As different and new illicit drugs rise and fall in popularity, it is important to re-examine the patterns of substance use and to re-organize the prevention policies and treatment strategies. Considering the decrease in the age of first use and the increase in the number of youth using multiple drugs and/or hard drugs, new and more effective preventive strategies should be developed targeting children and adolescents in Turkey.
