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Öğe Abused-abuser dilemma in sexual abuse and forensic evaluation: a case report(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2017) Kütük, Meryem Özlem; Güler, Gülen; Tufan, Ali Evren; Sanberk, SatiThe factors such as having family problems, growing up in a disintegrated family, having parents with personality disorders, expressing physical and mental deficiencies, history of alcohol and substance abuse, previous history of sexual abuse, and lack of social support may increase the risk of being exposed to sexual abuse. According to the previous studies about one-third of children who are subjected to abuse may become abusers in the future. In such a condition, a dilemma of abuse-abuser has been experienced. Importantly, additional medical mistakes and lack of experience in such cases make legal evaluation processes more complex. In this case report, we discussed a pediatric patient who was abused by a babysitter with a history of abuse in her adolescence. Early recognition of sexual abuse, treatment of developing psychiatric disorders, and a follow-up program are necessary to minimize the vicious cycle of abused-abuser.Öğe Achalasia as a complication of bulimia nervosa: a case report(Aosis, 2017) Kütük, Meryem Özlem; Güler, Gülen; Tufan, Ali Evren; Toros, Fevziye; Kaytanlı, UmutObjective: Oesophageal achalasia is a medical condition characterised by oesophageal aperistalsis, an increased resting pressure with partial or incomplete relaxation of the lower oesophageal sphincter. Bulimia nervosa (BN) is an eating disorder manifested by binge eating attacks followed by recurrent inappropriate compensatory behaviours, such as self-induced vomiting and excessive exercise. Dysphagia, regurgitation, vomiting, retrosternal pain, heartburn, weight loss, avoidance of eating, consumption of large amount of liquids and aberrant eating behaviours are symptoms of both achalasia and BN. Owing to these common signs and symptoms, oesophageal achalasia can be misdiagnosed as an eating disorder. In addition, oesophageal achalasia can occur as a complication of BN. It is often difficult to distinguish organic and psychological vomiting or comorbidity because of overlapping of the symptoms. Case report: We report the case of a patient who developed oesophageal achalasia following severe, repetitive vomiting as a complication of BN. Conclusion: We want to raise awareness regarding the development of a medical illness in the presence of a psychiatric disorder. Importantly, physicians should have a fundamental knowledge of these two diseases regarding their clinical patterns to differentially diagnose one or both disorders as quickly as possible.Öğe Burden of headache disorders at attention deficit hyperactivity diagnosed children and their parents(Sage Publications Ltd, 2017) Küçük, Meryem Özlem; Güler, Gülen; Tufan, Evren; Yalın, Osman Özgür; Gözükara, Harika[No Abstract Available]Öğe Correction to: High depression symptoms and burnout levels among parents of children with autism spectrum disorders: a multi-center, cross-sectional, case–control study(Springer, 2021) Kütük, Meryem Özlem; Tufan, Ali Evren; Kılıçaslan, Fethiye; Güler, Gülen; Çelik, FatmaThe original version of the article has unfortunately missed the revised affiliations for the following authors. The corrected affiliations are given below: Dr. Ufuk Acikbas - Department of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom Dr. Çiğdem Yektaş - Uskudar University Medical Faculty, Department of Child and Adolescent Psychiatry The original article has been corrected.Öğe Developmental delays and psychiatric diagnoses are elevated in offspring staying in prisons with their mothers(Nature Publishing Group, 2018) Kütük, Meryem Özlem; Altıntaş, Ebru; Tufan, Ali Evren; Güler, Gülen; Aslan, Betül; Aytan, Nurgül; Kütük, ÖzgürThe aim of the study was to describe the sociodemographic and clinical features of the mothers and their offspring staying with them in prison. The study was planned as a cross-sectional, single-center study of mothers residing in Tarsus Closed Women's Prison of Turkish Ministry of Justice along with their 0 to 6 years old offspring. Mothers were evaluated via Structured Clinical Interview for DSM-IV Axis I Disorders. A psychologist blind to maternal evaluations applied the Denver Developmental Screening Test II (DII-DST). Children/mothers were also evaluated by a child and adolescent psychiatrist via K-SADS-PL. Twenty-four mothers with a mean age of 29.3 years were included. Most common diagnoses in mothers were nicotine abuse (n = 17, 70.8%), specific phobia (n = 8, 33.3%), alcohol abuse (n = 7, 29.2%) and substance abuse (n = 5, 20.8%). Twenty-six children (53.9% female) were living with their mothers in prison, and the mean age of those was 26.3 months. Results of the D-II-DST were abnormal in 33.3% of the children. Most common diagnoses in children were adjustment disorder (n = 7, 26.9%) separation anxiety disorder (n = 3, 11.5%) and conduct disorder (n = 2, 7.7%). A multi-center study is necessary to reach that neglected/under-served population and address the inter-generational transmission of abuse, neglect, and psychopathology.Öğe Evaluating clonidine response in children and adolescents with attention-deficit/hyperactivity disorder(Amer Inst Mathematical Sciences-Aims, 2018) Kütük, Meryem Özlem; Güler, Gülen; Tufan, Ali Evren; Sungur, Mehmet Ali; Topal, Zehra; Kütük, ÖzgürAttention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood, which is generally treated with stimulant and non-stimulant medications. However, 10-30% of patients in clinical setting do not present with adequate response to initial stimulant treatment. Thereby, clonidine may be considered for those patients who have failed to respond to psychostimulant/atomoxetine monotherapy or as an augmentation for inadequate response/comorbidity. This observational study evaluated its effectiveness as a single drug in ADHD cases unresponsive to previous treatment trials. Seventeen ADHD cases that were non-responders to stimulant, non-stimulant and combination therapy for the primary symptoms of ADHD were included in the study. Four cases dropped out before follow up, leaving thirteen cases who were administered immediate release clonidine treatment alone with a mean dose of 0.2 +/- 0.05 mg/day at baseline. The trial lasted for 12 weeks, and treatment outcomes were evaluated by the Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S) and the Clinical Global Impressions-Severity (CGI-S) and Improvement (CGI-I) scales. Mean age of the sample was 12.5 years (SD = 3.0) and eleven of the subjects had another comorbid psychopathology. Only two cases were evaluated as "very much improved", while another patient was judged to be "minimally improved" after 12 weeks of clonidine treatment. Attrition during follow-up was associated with higher median scores on the hyperactivity and impulsivity subscales (Mann-Whitney U test, p = 0.02). According to the T-DSM-IV-S, CGI-S, and CGI-I scales, clonidine treatment by itself had minimal benefits in this sample of treatment of refractory cases with ADHD evaluated at the study center. Clonidine is not available in Turkey pharmaceutical marketing system and patients' access to drug is limited. Our results provide first data regarding the use of clonidine in Turkish ADHD patients.Öğe Hiccup due to aripiprazole plus methylphenidate treatment in an adolescent with attention deficit and hyperactivity disorder and conduct disorder: a case report(Korean Coll Neuropsychopharmacology, 2017) Kütük, Meryem Özlem; Güler, Gülen; Tufan, Ali Evren; Kütük, ÖzgürOur case had hiccups arising in an adolescent with the attention deficit and hyperactivity disorder (ADHD) and conduct disorder (CD) after adding aripiprazole treatment to extended-release methylphenidate. Actually, antipsychotics are also used in the treatment of hiccups, but studies suggest that they can cause hiccups as well. Within 12 hours of taking 2.5 mg aripiprazole added to extended-release methylphenidate at a dose of 54 mg/day, 16-year-old boy began having hiccups in the morning, which lasted after 3-4 hours. As a result, aripiprazole was discontinued and methylphenidate was continued alone because we could not convince the patient to use another additional drug due to this side effect. Subsequently, when his behavior got worsened day by day, his mother administered aripiprazole alone again at the dose of 2.5 mg/day at the weekend and continued treatment because hiccup did not occur again. But when it was administered with methylphenidate on Monday, hiccup started again next morning and lasted one hour at this time. In conclusion, we concluded that concurrent use of methylphenidate and aripiprazole in this adolescent led to hiccups.Öğe High depression symptoms and burnout levels among parents of children with autism spectrum disorders: A multi-center, cross-sectional, case–control study(SPRINGER/PLENUM PUBLISHERS, 2021) Kütük, Meryem Özlem; Tufan, Ali Evren; Kılıçaslan, Fethiye; Güler, Gülen; Çelik, Fatma; Altıntaş, EbruThe diagnosis of autism spectrum disorder (ASD) in a child afects family processes, increases parenting stress and marital conficts, and may lead to parental psychopathology. It may also afect the prognosis for their children. The aim of this study is to determine depression and burnout levels as well as their predictors among parents of children with ASD compared with those of healthy children. We also sought to evaluate rate of complementary and alternative medicine (CAM) interventions among parents and explore the associations of this phenomenon in an exploratory fashion. 145 children with ASD and 127 control children were enrolled along with their mothers and fathers. Beck Depression Inventory and Maslach Burnout Inven tory were used to evaluate parents’ depression symptoms and burnout levels. Symptoms of children with ASDs were evalu ated according to the Childhood Autism Rating Scale by the clinicians. Family, child and CAM variables were screened by means of a sociodemographic data form. Descriptive, bivariate and correlation analyses were used in statistical evaluations. Predictors of burnout were evaluated with multiple regression analysis. Burnout and depression levels among parents of children with ASD were signifcantly elevated compared to controls. Burnout levels of mothers were signifcantly elevated compared to fathers while depression scores of fathers were signifcantly elevated compared to mothers. Maternal burnout was signifcantly predicted by presence of functional speech in child while paternal burnout was signifcantly predicted by paternal vocation. Maternal depression was associated with paternal depression, lack of speech in child and attendance of child to special education services. Paternal depression was associated with autistic symptom severity and maternal depres sion. More than half the parents sought CAM interventions. Education level did not afect search for CAM interventions while both maternal and paternal psychopathology and presence of epilepsy among children increased use of CAM methods. Psychological support should be provided to both mothers and fathers of a child receiving a diagnosis of ASD. Addressing parents’ burnout and stress levels and facilitating their negotiation of knowledge on etiology and treatments for ASD may be benefcial for the family unit as a whole.Öğe Migraine and associated comorbidities are three times more frequent in children with ADHD and their mothers(Elsevier, 2018) Kütük, Meryem Özlem; Tufan, Ali Evren; Güler, Gülen; Yalın, Osman Özgür; Altıntaş, EbruObjective: Attention deficit and hyperactivity disorder (ADHD) is a neuro-developmental disorder related to internalizing and externalizing disorders as well as somatic complaints and disorders. This study was conducted to evaluate the prevalence of headache subtypes, epilepsy, atopic disorders, motion sickness and recurrent abdominal pain among children and adolescents with ADHD and their parents. Methods: In a multi-center, cross-sectional, familial association study using case-control design, treatment na ve children and adolescents between 6 and 18 years of age diagnosed with ADHD according to the DSM-5 criteria as well as age- and gender matched healthy controls and their parents were evaluated by a neurologist and analyzed accordingly. Results: 117 children and adolescents with ADHD and 111 controls were included. Headache disorder diagnosis was common for both patients and healthy controls (59.0% vs. 37.8%), with a significantly elevated rate in the ADHD group (p = 0.002). Migraine was found in 26.0% of ADHD patients and 9.9% of healthy controls. Tension headache was found in 32.4% of ADHD patients and 27.9% of healthy controls. Headache diagnosis was also found to be significantly more common in mothers of children with ADHD than control group mothers (90.5% vs. 36.6%, p < 0.001). Conclusion: Headache diagnoses and specifically migraines were significantly more common among children with ADHD and their mothers, while recurrent abdominal pain was elevated in both parents and ADHD patients. Migraine is an important part of ADHD comorbidity, not only for children but also for mothers. Motion sickness may be reduced among families of ADHD probands. (C) 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.Öğe Persistent hiccups due to aripiprazole in an adolescent with obsessive compulsive disorder responding to dose reduction and rechallenge(Oxford Univ Press, 2016) Kütük, Meryem Özlem; Tufan, Ali Evren; Güler, Gülen; Yıldırım, Veli; Toros, FevziyeOur case involves persistent hiccup arising in an adolescent with obsessive compulsive disorder (OCD) who was using aripiprazole as an augmentation to fluoxetine and whose hiccups remitted with dose reduction and rechallenge. Treatment suggested that aripiprazole might lead to hiccups. Antipsychotics are also used for the treatment of hiccups, but recent case reports suggest that they cause hiccups as well. Within 12 h of taking 5mg aripiprazole, the 13-year-old girl began having continuous hiccups, which lasted for 3-4 h. The hiccups resolved when the dose of aripiprazole was reduced to 2.5 mg. To achieve augmentation, aripiprazole was replaced with risperidone 0.5 mg/day for 1 month, but excess sedation was observed. As a result, aripiprazole was restarted at a dose of 2.5 mg/ day, and 1 week later, it was increased to 5 mg/every other day. No hiccups were observed.
