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Öğe Altered serum levels of vascular endothelial growth factor and glial-derived neurotrophic factor but not fibroblast growth factor-2 in treatment-naive children with attention deficit/hyperactivity disorder(Taylor & Francis Ltd, 2019) Yurteri, Nihal; Şahin, İbrahim Ethem; Tufan, Ali EvrenBackground and aim: Recent evidence suggests that growth factors might be involved in the pathophysiology of attention deficit hyperactivity disorder (ADHD). The aim of this study was to determine whether serum levels of brain-derived neurotrophic factor (BDNF), glial-derived neurotrophic factor (GDNF), neurotrophin-3 (NT-3), nerve growth factor (NGF), fibroblast growth factor-2 (FGF-2) and vascular endothelial growth factor (VEGF) were altered in children with ADHD.Methods: Serum levels of BDNF, GDNF, NT-3, NGF, VEGF and FGF-2 were analyzed in 49 treatment- naive children with ADHD and age, gender matched 36 healthy controls using enzyme-linked immunosorbent assay. ADHD symptoms were scored by Du Paul ADHD Rating Scale and Strengths and Difficulties Questionnaire.Results: We found that serum VEGF levels were significantly lower (p<0.001) and GDNF levels were significantly higher in ADHD group compared to control group (p=0.003). However, we found no correlations between ADHD symptoms and serum VEGF or GDNF levels. Furthermore, we observed no significant alterations in serum BDNF, NT-3, NGF, FGF-2 levels in children with ADHD.Conclusion: To our knowledge, the present study is the first to examine serum VEGF and FGF-2 levels in children with ADHD. Our results indicate that VEGF and GDNF might be involved in the etiology of ADHD. Further studies are required to determine the role of growth factors in the etiology and consequently in the treatment of ADHD.Öğe Assessment of health-related quality of life in children with ADHD by comparison with type 1 diabetes and healthy control groups(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2019) Yurteri, Nihal; Pekcanlar Akay, Aynur; Ellidokuz, HülyaObjective: The purpose of this study is to compare health related quality of life of children and adolescents with attention deficit hyperactivity disorder (ADHD) both with health related quality of life of type 1 diabetes mellitus (T1DM) and healthy control groups. Methods: Sixty ADHD newly diagnosed cases with no treatment, age and gender matched two control groups; 60 T1DM and 60 healthy control groups aged between 8 and 16 years were enrolled in this study. The diagnostic assessments and exclusion criteria of psychiatric disorders of all subjects were made according to the DSM-IV criteria and the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and the Lifetime (K-SADS PL). Sociodemographic Form, Pediatric Quality of Life Scale for Children (PedsQL 4.0 TM) were applied to all of participants and their parents. DSM-IV based Turgay ADHD and Distruptive Behavior Disorders Screening Scale, ADHD Rating Scale-IV and Clinical Global Impression Scale were additionally administered to ADHD group. HbA1c levels were used in terms of T1DM disease severity. Results: Children and adolescents diagnosed ADHD reported lower self-concept in emotional functioning and psychosocial health summary scores than children and adolescents with T1DM. Compared with healthy controls, children and adolescents diagnosed ADHD reported lower self-concept in all subscales and total scores of PedsQL except physical health summary. Parent of ADHD children reported lower concept in all scores of quality of life than parents of healthy controls. Conclusions: Life quality in terms of psychosocial health were found to be impaired in newly diagnosed ADHD subjects more than T1DM and healthy controls. Evaluation of quality of life during diagnosis and treatment stages of ADHD may help to identify and manage the overall impact of the disorder.Öğe Atomoxetine Induced Skin Picking: A Case Report(NLM (Medline), 2020) Kasar, Nurdan; Yurteri, Nihal"Skin picking disorder," also known as "dermatillomania" or "psychogenic excoriation," is classified in the "Obsessive Compulsive and Related Disorders" category in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and characterized by repetitive skin picking behaviors resulting in skin lesions. Atomoxetine (ATX) is a selective norepinephrine (noradrenaline) reuptake inhibitor commonly used in the management of attention-deficit/hyperactivity disorder. Atomoxetine is considered to increase levels of noradrenaline and dopamine by inhibiting norepinephrine transporters. In this case report, we present an 8-year-old male attention-deficit/hyperactivity disorder patient with skin picking behavior due to ATX treatment. We discussed possible explanations of skin picking behavior with ATX in the light of the current literature. To our knowledge, this is the first report of skin picking due to ATX in literature, and further studies are needed to investigate the frequency and mechanisms of skin picking with ATX.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 Sleep Quality and Quality of Life in Female Adolescents with Post-Traumatic Stress Disorder Related to Sexual Abuse(Aves, 2021) Sarigedik, Enes; Yurteri, NihalObjective: This study aims to evaluate the sleep quality of adolescents with PTSD related to sexual abuse and to investigate the relationship between sleep quality, PTSD symptoms, and quality of life. Our study was designed as a cross-sectional study. Materials and Method: Forty adolescents who were diagnosed with PTSD related to sexual abuse and 40 healthy adolescents as a control group were included in the study. Structured interview scale Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) were applied to children by the clinician. All participants also filled out the Pediatric Quality of Life Inventory (PedsQL), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI). Results: The analyses of the data revealed that the quality of life scores of the case group was significantly associated with worse results. Sleeplessness index (ISI) and morning sleepiness scores (ESS) were higher in the case group than the control group (P <.001; P <.001) and perceived quality of sleep (PSQI) was determined to be lower (P <.001). A statistically significant relationship between PTSD total score and PSQI (P <.001; r = 0.550), ESS (P <.05; r = 0.369), ISI (P <.001; r = 0.613), and PedsQL (P <.001; r = -0.473) were identified. PSQI, ESS, and ISI were also found to be correlated with each other (PSQI, ESS r = 488; PSQI, ISI r = 0.755; ESS and ISI r = 0.514). Moreover, PSQI scores explain the deterioration in quality of life more significantly than CAPS-CA-TOTAL scores (PSQI P = .008; CAPS P = .572). Conclusion: In cases with PTSD related to sexual abuse, we found that sleep affects the quality of life more than the symptoms of PTSD. Sleep-based approaches in PTSD may affect both quality of life and functionality positively, and PSQI may be used in clinical practice to assess both sleep and quality of life in the follow up of patients with PTSD related to sexual abuse.Öğe Factors affecting disclosure time of sexual abuse in children and adolescents(Wiley, 2022) Yurteri, Nihal; Erdogan, Ayten; Büken, Bora; Yektaş, Çiğdem; Çelik, Mehmet SakiBackground The aim of this study is to determine the factors affecting early and delayed disclosure time of child sexual abuse (CSA). Early disclosure of CSA is considered to be crucial for child protection. Methods A total of 125 sexually abused children and adolescents, who had been evaluated by child adolescent psychiatry and forensic medicine specialists, were enrolled in this study. Files of medical and criminal data were analyzed retrospectively and synchronously by child adolescent psychiatrist and forensic medicine specialist authors who had evaluated victims using the standard procedures of Duzce University Faculty of Medicine Child Abuse Assessment Council. Univariate and multivariate logistic regression analyses were conducted to evaluate predictors. Results Delayed disclosers were found to be younger than early disclosers. Among the delayed disclosers, there were also more victims of intrafamilial CSA, fewer victims of penetration, and fewer voluntary disclosures. Multivariate logistic regression revealed that younger age and intrafamilial CSA were independent predictors of delayed disclosure of CSA. Conclusions The results of our study contribute to an understanding of the factors related to delayed disclosure and underline the need for age-appropriate education and prevention programs targeted to increase the awareness of sexual abuse, particularly intrafamilial abuse, and to promote voluntary disclosure in children and adolescents, especially for younger age groups. The education of potential recipients of CSA and further education of professionals is extremely important in order to support children and adolescents' voluntary disclosure of CSA.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 Otizm spektrum bozukluğu olan çocuklarda müzik terapinin otizm belirtileri ve yaşam kalitesine etkisi(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2019) Yurteri, Nihal; Akdemir, MüslümAmaç: Bu çalışmanın amacı, müzik terapinin otizm spektrum bozukluğu (OSB) olan çocuklarda otizm belirtileri ve yaşam kalitesi üzerine etkisinin araştırılmasıdır. Yöntem: Çalışmada OSB’li iki grup 24 olgu, aylık rutin çocuk psikiyatri kontrolleri ve özel eğitim ve dışında herhangi bir eğitim veya tedavi almayan bir grup ile bunlara ek olarak müzik terapi alan diğer grup, müzik terapi öncesi ve sonrasına ilişkin otizm belirtileri ve yaşam kalitesi açısından karşılaştırılmıştır. Olguların hiçbiri psikiyatrik ilaç kullanmamıştır. Müzik terapi grubundaki çocuklara müzik terapisti tarafından sekiz hafta süreyle, haftada iki kez 40 dakikalık improvizasyonel müzik terapi uygulanmıştır. Otizm belirtileri Otizm Davranış Kontrol Listesi (ODKL), yaşam kalitesi Çocuklar için Yaşam Kalitesi Ölçeği (ÇİYKÖ) ile belirlenmiştir. Bulgular: Müzik terapi öncesi için iki grup arasında ODKL ve ÇİYKÖ alt ölçeklerinde istatistiksel olarak anlamlı bir fark saptanmamış olup, müzik terapi sonrası için iki grup arasında ODKL ilişki kurma, dil becerileri, toplam ölçek puanında (p=0.012, p=0.04, p=0.032) ve ÇİYKÖ duygusal yaşam kalitesi puanlarında (p<0.001) istatistiksel olarak anlamlı farklılıklar bulunmuştur. Ayrıca, müzik terapi grubundaki OSB’li çocukların müzik terapi sonrası öncesine göre ODKL ilişki kurma, beden-nesne kullanımı, dil becerileri, toplumsal-öz bakım, ölçek toplam puanlarında istatistiksel olarak anlamlı düzeyde düşük puanlar aldıkları (sırasıyla, p<0.001, p=0.017, p=0.009, p=0.027, p<0.001) ve ÇİYKÖ duygusal, toplumsal, okul, ruhsal-toplumsal ve ölçek toplam puanlarında ise istatistiksel olarak anlamlı düzeyde yüksek puanlar aldıkları saptanmıştır (sırasıyla, p=0.002, p<0.001, p=0.009, p<0.001, p<0.001). Tartışma: Çalışmamızda müzik terapinin OSB’li çocuklarda hem otizm spektrum belirtileri, hem de yaşam kalitesi açısından ek olumlu gelişmeler sağladığı saptanmıştır. Çalışmamızda elde edilen bu sonuçlar literatürle uyumlu olup müzik terapinin OSB’li çocuklarda rutin tedaviye ek olarak tamamlayıcı bir yöntem olarak kullanılabileceğini düşündürmektedir. (Anadolu Psikiyatri Derg 2019; 20(4):436-441)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 Skin Picking Successfully Treated With Atomoxetine in Comorbid Skin Picking and Attention-Deficit/Hyperactivity Disorder: A Case Report(Lippincott Williams & Wilkins, 2020) Yurteri, Nihal; Sarigedik, EnesSkin picking disorder (SPD: also known as neurotic excoriation, psychogenic excoriation, or dermatillomania) is classified in the obsessive-compulsive and related disorders category in theDiagnostic and Statistical Manual of Mental Disorders,Fifth Edition, and characterized by unintentional, repetitive skin picking behaviors. Atomoxetine is a selective noradrenaline reuptake inhibitor used in the treatment of attention-deficit/hyperactivity disorder (ADHD). In this case report, we present a 9-year-old girl with the comorbid diagnosis of ADHD and SPD treated successfully with atomoxetine. To our knowledge, this is the first report of skin picking treated with atomoxetine in a patient with ADHD. We discussed possible explanations of mechanisms. Further studies are required on the effectiveness of atomoxetine for the treatment of SPD in the presence and absence of comorbid ADHD.
