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Öğe Abdominal epilepsy mimicking conversion disorder: A case report(Taylor & Francis Ltd, 2019) Öztürk, Yusuf; Göl, Güler; Savcı, Uğur; Cansız, Mehmet Akif; Tufan, Ali EvrenIn children and adolescents, especially younger ones, recurrent abdominal pains may develop as a response to psychosocial stressors. They may be considered as functional and be one of the common reasons for clinical referrals. A rare cause of recurrent, organic abdominal pain is abdominal epilepsy. Abdominal epilepsy may be considered in differential diagnosis of patients that were thought to have functional complaints. In this case, a 16-year-old adolescent girl whose chief complaints included loss of consciousness and recurrent abdominal pains lasting for a year is presented.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 Activation syndrome in a patient with attention-deficit/hyperactivity disorder treated with atomoxetine: A case report(Lippincott Williams & Wilkins, 2021) Karakaya, Sümeyra Elif Kaplan; Yektaş, Çiğdem; Tufan, Ali EvrenActivation syndrome" represents a cluster of symptoms of excessive emotional arousal or behavioral activation, which emerges after the first few weeks of antidepressant treatment or a dose increase and resolves with dose reduction or cessation of treatment. It was reported after treatment with selective serotonin reuptake inhibitor and serotonin-norepinephrine reuptake inhibitor group of agents, but no case of activation syndrome has been reported with the norepinephrine reuptake inhibitor group. Atomoxetine is a norepinephrine reuptake inhibitor and nonstimulant and is used to manage symptoms of attention-deficit/hyperactivity disorder (ADHD). Atomoxetine-related symptoms of mania and hypomania were reported in literature previously. Here, we report a case of activation syndrome arising after atomoxetine (ATX) dose titration in a prepubertal male child with ADHD. Differentiation of activation symptoms from mania/hypomania symptoms after treatment with ATX may be important for the clinicians to manage the adverse effects and understand the risk factors behind activation syndrome with use of ATX in children and adolescents diagnosed with ADHDÖğe Adjustment disorder after botulinum toxin injection in an adolescent palatal myoclonus case: the importance of informed consent in the treatment of neuropsychiatric disorders in children and adolescents(Elsevier Sci Ltd, 2018) Öztürk, Yusuf; Topal, Zehra; Demir, Nuran; Tufan, Ali EvrenInformed consent in clinical practice is a process in which a patient consents to participate or undergo the proposed procedures after being informed of its procedures, risks, and benefits. Ideally, the patient is expected to give his/her consent solely after fully understanding the information about the procedures, benefits, and risks involved in the practice. According to the doctrine, the necessary information should be given by the physician and he/she should also respect the decision of the patient which is based on this information.1 Although the importance of providinginformation about the proposed treatment’s effects and side effects to children and adolescents before treatment is accepted by physicians, this issue is given little importance in research and case presentations.2 In this case, it was aimed to discuss the importance of informed consent and multi-disciplinary approach in treatment by presenting an adolescent patient who was diagnosed with palatal myoclonus and treated with botulinum toxin. Although the neurological treatment was effective, the patient developed adjustment disorder (with depressive mood) due to dysphonia after the procedure.Öğe Agomelatin depresyon tedavisine ne getiriyor? güncel bir gözden geçirme(İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Psikiyatri Anabilim Dalı, 2013) Cerit, Cem; Yaluğ, İrem; Akpınar, Esma; Talas, Anıl; Tufan, Ali Evren; Özten, EylemBu çalışmada melatonin MT-1 ve MT-2 reseptör agonisti ve serotonin 5-HT2C antagonisti bir antidepresan olan agomelatinin depresyon tedavisine ne getirdiği sorusuyla, ilgili literatür gözden geçirilmiştir. Etkinlik açısından farklı sonuçlar olmakla birlikte agomelatinin günümüzde sık kullanılan antidepresanlarla en azından benzer bir etkinliğe sahip olduğu söylenebilir. Bunun yanında uyku üzerine olumlu etkileri ve etkinliğin erken başlaması tedaviye olumlu katkıda bulunabilir. Agomelatinin uyku-uyanıklık döngüsü, endokrin hormon salınımı, vücut ısısının ayarlanması gibi birçok biyolojik sistemi etkileyen sirkadiyen sistem üzerine olumlu etkileri ilgi çekici görünmektedir. Somnolans, agomelatin tedavisinde diğer antidepresanlardan daha fazla görülen bir yan etki olarak not edilmektedir. Bunun yanında kilo alımının ve cinsel yan etkilerin azlığı tedaviye uyumu olumlu yönde etkileyebilir. Agomelatin tedavisi alan hastalarda karaciğer enzimlerinde yükselme görülebilmektedir. Agomelatinin ani bırakılmasının belirgin kesilme belirtilerine yol açmadığı gözlenmiştir.Öğe Alexithymia is not a good predictor of suicidal ideation in patients with social anxiety disorder(2018) Altıntaş, Ebru; Kütük, Meryem Özlem; Tufan, Ali Evren; Bağ, Harika GözükaraObjective: This study was to determine the relation between alexithymia and suicidal ideation and factors associ- ated with suicidal ideation in patients with social anxiety disorder (SAD). Also we determined whether alexithymia is predictor of suicidal ideation related with SAD. Methods: One hundred and sixty-four SAD (n=57), panic disorder (PD) (n=58), healthy controls (HC) (n=49) subjects (according to DSM-5) were included to study. Alexithymia was measured by Toronto Alexithymia Scale-20(TAS-20), suicidal ideation was measured by Suicidal Ideation Scale (SIS), social anxiety level were evaluated with Liebowitz Social Anxiety Scale and anxiety and depression level evaluated with Beck Depression Inventory and Beck Anxiety Inventory, State and Trait Anxiety Scales. Results: Alexithymia, the rate of was found to be 38.6% in SAD patients and 29.3% in PD patients. In SAD group, significant correlation was found between TAS 20, its factors and SIS. With path analysis, it was found that TAS 20 total scores predicted SIS scores only indirectly and via their effects on trait anxiety and subjective depressive symptoms. Conclusion: In alexithymic SAD patient’s suicidal ideation may occur when comorbid depression is present. Based upon the findings alexithymia may not be a good predictor of suicidal ideation for preventing suicidal attempts in patients with social anxiety disorder. (Anatolian Journal of Psychiatry 2018; 19(6):577-585)Öğe Are Communication Skills, Emotion Regulation and Theory of Mind Skills Impaired in Adolescents with Developmental Dyslexia?(Routledge Journals, Taylor & Francis Ltd, 2024) Ozyurt, Gonca; Ozturk, Yusuf; Turan, Serkan; Ciray, Remzi Ogulcan; Tanigor, Ezgi Karagoez; Ermis, Cagatay; Tufan, Ali EvrenThis study investigates pragmatic language impairment, Theory of Mind (ToM), and emotion regulation in adolescents with Developmental Dyslexia(DD). The Social Responsiveness Scale-2(SRS) and Children's Communication Checklist-2(CCC-2) scores were found to be statistically significantly higher in the DD group than in healthy controls. DD group had lower performance in ToM skills and they have more difficulties in emotion regulation. We also found that CCC-2 and ToM scores were significantly correlated in adolescents with DD. These results may be important in understanding the difficulties experienced in social functioning and interpersonal relationships in adolescents with DD.Öğe Aripiprazole can a viable choice for persistant suppression of symptoms in managing chronic tic disorders and Tourette's disorder through the life span: a case series(Kure Iletisim Grubu A S, 2016) Taşkıran, Sarper; Tufan, Ali Evren; Semerci, BengiTic disorders may cause impairment both by themselves and associated comorbidities. Medications for tic disorders are indicated when tics are moderate/ severe causing severe impairment and in presence of comorbid disorders responsive to medications. Duration of improvement is still not known as the literature lacks prospective studies with a long follow-up period. This case series aims to report management of tic disorders with aripiprazole in patients with different ages. Here, we describe 8 cases with complex motor tic disorder or Tourette's Disorder in which aripiprazole was used. The ages of patients were varied, from 9 to 57 years. Mean follow-up was 19.6 weeks. Mean dose of aripiprazole for pediatric patients was 15.4 mg/ day while it was 12.5 mg/ day for adult patients. All patients benefited from treatment with aripiprazole in the long term. Our results should be supported with controlled studies.Öğe Assaultiveness in psychiatric patients and approach to assaultive patients(2013) Bilici, Rabia; Sercan, Mustafa; Tufan, Ali EvrenPsikiyatrik hasta saldırıları ruh sağlığı alanında çalışanların mesleki uygulamada karşılaştıkları önemli olaylardandır. Bu saldırılar yaralanma, geçici veya kalıcı sakatlıklar, travma sonrası stres bozukluğu dahil ciddi sorunlar meydana getirmekte ve hatta bazen ölümle sonuçlanabilmekte, ayrıca klinik ve ekonomik yüke neden olmaktadır. Konu, önemine oranla az ilgi görmektedir çünkü saldırılar, mağdur personel tarafından, görevinin bir parçası olarak kabul görmekte, dile getirilmemekte ve yasal işleme başvurulmamaktadır. Psikiyatristlerin %5-48’inin hasta ve/veya hasta yakınları tarafından şiddet gördüğü, 4 yıllık asistanlık eğitimi boyunca asistanların %40-50’sinin fiziksel saldırıya uğradığı gösterilmiştir. Yardımcı sağlık personeli de hastalar, hasta yakınları ve ziyaretçiler tarafından sıklıkla duygusal, sözel ve fiziksel şiddete maruz kalmaktadır. Saldırıya maruz kalma riski yüksek olan personelin güvenliğinin sağlanması önemlidir ve çalışanlara bu konularda devamlı eğitim verilmelidir. Bu yazıda hasta saldırılarının nedenleri ve saldırgan hastaya yaklaşım (farmakolojik tedavi ve diğer önlemler) gözden geçirilmiştir.Öğe Association of reactive-proactive aggression and anxiety sensitivity with internalizing and externalizing symptoms in children with attention-deficit/hyperactivity disorder(Springer, 2017) Bilgiç, Ayhan; Tufan, Ali Evren; Yılmaz, Savaş; Özcan, Özlem; Özmen, Sevgi; Cansız, Mehmet Akif; Savcı, UğurThis study evaluates the associations among the symptoms of anxiety, depression, and disruptive behavioral disorders (DBD) in the context of their relationships with reactive-proactive aggression and anxiety sensitivity in children with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 342 treatment-naive children with ADHD. The severity of ADHD and DBD symptoms were assessed via parent-and teacher-rated inventories. Anxiety sensitivity, reactive-proactive aggression and severity of anxiety and depression symp-toms of children were evaluated by self-report inventories. According to structural equation modeling, depression and anxiety scores had a relation with the DBD scores through reactive-proactive aggression. Results also showed a negative relation of the total scores of anxiety sensitivity on DBD scores, while conduct disorder scores had a positive relation with anxiety scores. This study suggests that examining the relations of reactive-proactive aggression and anxiety sensitivity with internalizing and externalizing disorders could be useful for understanding the link among these disorders in ADHD.Öğe Association of theory of mind and empathy abilities in adolescents with social anxiety disorder(Springer, 2020) Öztürk, Yusuf; Özyurt, Gonca; Turan, Serkan; Mutlu, Caner; Tufan, Ali Evren; Akay, Aynur PekcanlarStudies have shown that elevated empathic abilities and impaired theory of mind (ToM) tasks may be associated with social anxiety disorder (SAD). Adolescence is a critical period for the onset of SAD which may cause impairment in various domains of functioning. We aimed to investigate the association of ToM and empathy characteristics in adolescents diagnosed as having SAD. Forty-one drug-naive adolescents (between 12 and 18 years), who were diagnosed as having SAD without comorbidities were enrolled in the patient group. Forty adolescents in the same age range without any psychiatric disorders were matched as the healthy control group. The sample was evaluated via the Kiddie and Young Adult Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version. The severity of the SAD symptoms was evaluated using the Social Anxiety Scale for Adolescents. ToM was evaluated with the Reading the Mind in the Eyes Test and emotion recognition was assessed by Faces Test. The KA-SI Empathic Tendency Scale was used to assess empathic abilities. The average age was 14.36 +/- 1.41 years in the SAD group and 14.30 +/- 1.04 years in the control group. Twenty-eight adolescents were female in the SAD and control groups. SAD and healthy controls did not differ in terms of sociodemographic data. There were higher scores in the KA-SI cognitive and affective empathic subscales (p < .001 in all scales) in the SAD group compared with the healthy controls. Adolescents with SAD have more difficulties both in Reading the Mind in the Eyes Test and Faces Test. The results of this study may indicate that although adolescents with SAD may be impaired in decoding aspects of ToM they may evaluate themselves as more empathic in self-report tests. The discrepancy between objective tests of ToM decoding and subjective reports of empathy may play an important role in the etiology and treatment of SAD in adolescents.Öğe Atomoxetine Induced Tics in ADHD Treatment: A Case Report(Galenos Publishing House, 2022) Sarı, Mesut; Özcan, Güler Göl; İmrek, Yasemin Akkuş; Öztürk, Yusuf; Tufan, Ali EvrenAttention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children and adolescents and its main symptoms are attention deficit, hyperactivity and impulsivity. Atomoxetine is a selective noradrenaline reuptake inhibitor with proven efficacy in the treatment of ADHD. Although it is known that it has side effects such as gastrointestinal problems, sleep problems, irritability and fatigue, atomoxetine is frequently preferred in children and adolescents with ADHD who also have tic disorder. However, a small number of patients whose tics started or worsened during atomoxetine treatment have been reported. In this case report, we discussed the mechanism of this adverse effect in a 7-year-old child who used atomoxetine for ADHD treatment who had treatment related triggering of tics. © Telif Hakkı 2022 Türkiye Çocuk ve Genç Psikiyatrisi Derneği/Çocuk ve Gençlik Ruh Sağlığı Dergisi, Galenos Yayınevi tarafından yayınlanmıştır.Öğe Attention deficit hyperactivity disorder comorbidity in an adolescent diagnosed with l-2 hydroxyglutaric aciduria and response to atomoxetine treatment: A case report(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2016) Yektaş, Çiğdem; Tufan, Ali EvrenL-2-hydroxyglutaric aciduria (L-2 HGA) is a rare, neurodegenerative, slowly progressing and autosomal recessively inherited metabolic disorder. The disease progresses with mental retardation, behavioral disorder, ataxia, extrapyramidal signs and epileptic seizures. Diagnosis is made by detection of increased levels of L-2-hydroxyglutaric acid in urine, plasma or cerebrospinal fluid. In this report, we presented a 13 year old male patient diagnosed with L-2 HGA and had seizures, intellectual disability, attention deficit hyperactivity disorder (ADHD) symptoms and failure in school performance. Here we discussed this rare disease with ADHD symptoms and the response to atomoxetine treatment.Öğe Attitudes of psychiatrists towards the diagnosis and treatment of attention deficit and hyperactivity disorder in adults : a survey from Turkey(Nobel İlaç, 2015) Aksoy, Umut Mert; Baysal, Özge Doğanavşargil; Aksoy, Şennur Günay; Tufan, Ali Evren; Maner, FulyaObjective: The aim of this descriptive study was to explore the attitudes of adult psychiatrists toward the diagnosis of adult attention deficit hyperactivity disorder (ADHD). Material and Method: A questionnaire was mailed to all participants. The percentage of adults diagnosed with ADHD in the largest and oldest psychiatry hospital in Turkey within a year was calculated from hospital records. Results: Half of the participants displayed negative attitudes toward psychostimulants: 40% of participants reported that prescribing stimulants was a chore, 40% reported a fear of abuse, and 40% reported prescribing a non-stimulant agent. A majority of participants were unclear on the prevalence of ADHD. Records from the general psychiatry outpatient setting revealed only four patients (0.02%) diagnosed with adult ADHD. Conclusion: The results reflect an urgent need for education of psychiatrists about adult ADHD diagnosis and treatment.Öğe Autism spectrum disorder: Comorbidity and demographics in a clinical sample(TAYLOR & FRANCIS LTD, 2022) Kılıçaslan, Fethiye; Tufan, Ali EvrenObjective: To determine the demographic and clinical characteristics of children followed up with the diagnosis of autism spectrum disorder (ASD) at a tertiary center in Southeeast Turkey. Methods: Children followed up with the diagnosis of ASD at a university hospital child psychiatry clinic between June 2016 and June 2021 were evaluated retrospectively for comorbidities, intellectual functioning and age at diagnosis. Results: In the preschool group, females displayed significantly more frequent cognitive developmental delay. Median age at diagnosis was 36 months (IQR= 22) regardless of gender. Approximately three-fourth (73.7%) of the cases had at least one psychiatric comorbid disorder while 22.8% had at least one medical diagnosis. Psychiatric comorbidity was found to be associated with later diagnosis. Conclusion: Although the age at first diagnosis in this study is relatively earlier than the studies in the literature, most of the children with ASD are still diagnosed very late. Psychiatric comorbidities may lead to later diagnosis due to overshadowing. Training of educational and primary healthcare workers on symptoms of ASD may enable earlier diagnosis.Öğe Body-focused repetitive behaviors in children and adolescents, clinical characteristics, and the effects of treatment choices on symptoms: A single-center retrospective cohort study(Dermatovenerological Soc Slovenia, 2022) Hangül, Zehra Topal; Tuman, Taha Can; Tuman, Bengü Altunay; Saygılı, Gizem Yılmaz; Tufan, Ali EvrenIntroduction: This study determines clinical features of body-focused repetitive behaviors (BFRBs) among a sample of Turkish children and adolescents, evaluates the naturalistic treatments selected in this sample, and determines the effects of those treatments during a 3-month follow-up. Methods: The study included a cohort of 67 patients 9 to 17 years old attending a tertiary center between March and June 2013 with complaints of nail biting, skin picking, and/or hair pulling. The patients completed psychometric scales and were evaluated for symptom severity, improvement, and adverse effects after an initial interview and at control visits during the 4th and 8th weeks. Results: The most common BFRB was nail biting. In nail-biting behavior, subjective awareness was higher, and urges prior to the behavior and release after the behavior were found to be higher. Although there was no significant difference between the choice of treatment and the course of psychiatric measures, significant improvement was found in functionality after treatment. Conclusions: Despite its limitations, the small number of studies on BFRBs increases the importance of studies in this area.Öğe A case of cerebellar mutism initially diagnosed as adjustment disorder with anxiety(Cukurova Univ, Fac Medicine, 2024) Comak, Gulsah; Macit, Seyma Selcen; Tufan, Ali Evren; Ozturk, YusufÖğe A case of emetophobia responding to mirtazapine and propranolol treatment(Korean Society of Neurogastroenterlogy and Motility, 2022) Köksal, Merve; Koçak, Gökçe; Öztürk, Yusuf; Tufan, Ali EvrenEmetophobia (“phobia of vomiting and nausea” or “Specific Phobia- Other [Vomiting]” in Diagnostic and statistical manual of mental disorders-Fifth Edition [DSM-5]) is characterized by impairing, chronic phobic avoidance of nausea/vomiting as well as inordinate cognitive and autonomic responses when avoidance is not possible.1,2 Patients may have elevated disgust sensitivity, a tendency to display gastrointestinal symptoms of anxiety as well as misinterpretation of those symptoms as catastrophic.2 Data on pharmacological management of emetophobia among adolescents is limited with only 2 cases benefiting from selective serotonin reuptake inhibitors (fluoxetine and sertraline) while adults may also benefit from benzodiazepines. 3-5 Patients may apply to various medical specialty clinics for treatment and this may delay diagnosis and management. Here; we aim to present an adolescent with emetophobia and its management by mirtazapine and propranolol.Öğe Chronotype and Childhood Psychiatric Disorders(Galenos Publishing House, 2021) Balta, Büşra; Özcan, Güler Göl; Sari, Mesut; İmrek, Yasemin; Taşkan, Merve; Öztürk, Yusuf; Tufan, Ali EvrenThe chronotype, which reflects differences among individuals in daily activity patterns and sleep-wake cycles, is actually linked to being healthy. The most important factor that determines the chronotype is the environmental light-dark cycle. Chronotype is the study of classification as morning or evening types according to the physiological and genetic characteristics of the human. There are many factors that determine chronotypes. Although the evidence shows a negative picture for evening types, it should be emphasized that only eveningness cannot cause depression or other psychiatric disorders alone and additional effects may play a role. Conducting studies on mechanisms underlying the chronotype-psychopathology connection is important for interventions that can help reduce the incidence of psychiatric disorders in evening types; these interventions may include sleep training, dietary advice, and cognitive-behavioral techniques. The purpose of this review is to provide an overview of psychiatric disorders in children and adolescents and their relationship with the morning and evening types. © Telif Hakkı 2021 Türkiye Çocuk ve Genç Psikiyatrisi Derneği/Çocuk ve Gençlik Ruh Sağlığı Dergisi, Galenos Yayınevi tarafından yayınlanmıştır.
