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Kutuk MO, Tufan AE, Kilicaslan F, Vural P, Gokcen C, Alsen Guney S, Kutuk B, Ozyurt G, Inal N, Mutluer T, Acikalin EY, Ozer FH, Pamuk EN, Yesilmese SC, Karadag M, Hangul Z, Bilginer C, Sahin N, Bilac O, Kandemir H, Ercan ES, Eseroglu Soylemez T, Acikel SB, Guler Aksu G, Dag P, Toros F, Mutlu C, Kardas O, Kardas B, Kizildag S, Demirci E, Ozmen S, Sevicin L, Karagoz YS, Isik U, Aktepe E, Altun H, Yektas Ç, Polat Tuysuz B, Buber A, Cansiz MA, Ogutlu H, Eray S, Taner HA, Altintas E, Kutuk O. functional outcome in late adolescence/early adulthood of patients with autism spectrum disorder and its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional study. Heliyon 2023; 9:e20766. [PMID: 37867841 PMCID: PMC10589842 DOI: 10.1016/j.heliyon.2023.e20766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023] Open
Abstract
The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported "good" or "very good" outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education.
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Affiliation(s)
- Meryem Ozlem Kutuk
- Department of Child and Adolescent Psychiatry, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Medical and Research Center, Adana, Turkey
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Fethiye Kilicaslan
- Department of Child and Adolescent Psychiatry, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Pınar Vural
- Department of Child and Adolescent Psychiatry, Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Cem Gokcen
- Department of Child and Adolescent Psychiatry, Gaziantep University, Faculty of Medicine, Gaziantep, Turkey
| | - Sevay Alsen Guney
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Bahtim Kutuk
- Department of Psychology, Ege University, Izmir, Turkey
| | - Gonca Ozyurt
- Department of Child and Adolescent Psychiatry, İzmir Katip Celebi University, Faculty of Medicine, Izmir, Turkey
| | - Neslihan Inal
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Tuba Mutluer
- Department of Child and Adolescent Psychiatry, Koc University Faculty of Medicine, Istanbul, Zip code: 34450, Turkey
| | - Eren Yavuz Acikalin
- Department of Child and Adolescent Psychiatry, Koc University Faculty of Medicine, Istanbul, Zip code: 34450, Turkey
| | - Fadime Hande Ozer
- Department of Psychology, Hasan Kalyoncu University, Gaziantep, Zipcode: 27410, Turkey
| | - Esma Nur Pamuk
- Department of Psychology, Cag University, Mersin, Zip code: 33800, Turkey
| | | | - Mehmet Karadag
- Department of Child and Adolescent Psychiatry, Gaziantep University, Faculty of Medicine, Gaziantep, Zip code: 27310, Turkey
| | - Zehra Hangul
- Department of Child and Adolescent Psychiatry, Gaziantep University, Faculty of Medicine, Gaziantep, Zip code: 27310, Turkey
| | - Cilem Bilginer
- Department of Child and Adolescent Psychiatry, Karadeniz Technical University, Faculty of Medicine, Trabzon, Zip code: 61080, Turkey
| | - Nilfer Sahin
- Department of Child and Adolescent Psychiatry, Mugla Sitki Kocman University, Faculty of Medicine, Mugla, Zip code: 48000, Turkey
| | - Oznur Bilac
- Department of Child and Adolescent Psychiatry, Manisa Celal Bayar University, Faculty of Medicine, Manisa, Zip code: 45030, Turkey
| | - Hasan Kandemir
- Department of Child and Adolescent Psychiatry, Manisa Celal Bayar University, Faculty of Medicine, Manisa, Zip code: 45030, Turkey
| | - Eyup Sabri Ercan
- Department of Child and Adolescent Psychiatry, Ege University, Faculty of Medicine, İzmir, Zip code: 35040, Turkey
| | - Tugba Eseroglu Soylemez
- Department of Child and Adolescent Psychiatry, Baskent University, Faculty of Medicine, Istanbul Medical and Research Center, Istanbul, Zip code: 34662, Turkey
| | - Sadettin Burak Acikel
- Department of Child and Adolescent Psychiatry, Konya City Training and Research Hospital, Konya, Zip code: 42090, Turkey
| | - Gulen Guler Aksu
- Department of Child and Adolescent Psychiatry, Mersin University, Faculty of Medicine, Mersin, Zip code: 33343, Turkey
| | - Pelin Dag
- Department of Child and Adolescent Psychiatry, Mersin City Training and Research Hospital, Mersin, Zip code: 33240, Turkey
| | - Fevziye Toros
- Department of Child and Adolescent Psychiatry, Mersin University, Faculty of Medicine, Mersin, Zip code: 33343, Turkey
| | - Caner Mutlu
- Department of Child and Adolescent Psychiatry, Uludag University Faculty of Medicine, Bursa, Zip code: 34494, Turkey
| | - Omer Kardas
- Department of Child and Adolescent Psychiatry, Dicle University, Faculty of Medicine, Diyarbakır, Zip code: 21280, Turkey
| | - Burcu Kardas
- Department of Child and Adolescent Psychiatry, Gazi Yasargil Education and Research Hospital, Diyarbakir, Zip code: 21010, Turkey
| | - Suleyman Kizildag
- Department of Child and Adolescent Psychiatry, Dicle University, Faculty of Medicine, Diyarbakır, Zip code: 21280, Turkey
| | - Esra Demirci
- Department of Child and Adolescent Psychiatry, Erciyes University, Faculty of Medicine, Kayseri, Zip code: 38039, Turkey
| | - Sevgi Ozmen
- Department of Child and Adolescent Psychiatry, Erciyes University, Faculty of Medicine, Kayseri, Zip code: 38039, Turkey
| | - Leyla Sevicin
- Department of Child and Adolescent Psychiatry, Erciyes University, Faculty of Medicine, Kayseri, Zip code: 38039, Turkey
| | - Yuksel Sumeyra Karagoz
- Department of Child and Adolescent Psychiatry, Training and Research Hospital, Erzurum, Zip code: 25240, Turkey
| | - Umit Isik
- Department of Child and Adolescent Psychiatry, Suleyman Demirel University, Faculty of Medicine, Isparta, Zip code: 71100, Turkey
| | - Evrim Aktepe
- Department of Child and Adolescent Psychiatry, Suleyman Demirel University, Faculty of Medicine, Isparta, Zip code: 71100, Turkey
| | - Hatice Altun
- Department of Child and Adolescent Psychiatry, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Zip code: 46000, Turkey
| | - Çigdem Yektas
- Department of Child and Adolescent Psychiatry, Uskudar University, Istanbul, Zip code: 34662, Turkey
| | - Berna Polat Tuysuz
- Department of Child and Adolescent Psychiatry, Sanliurfa Education and Research Hospital, Sanliurfa, Zip code: 63250, Turkey
| | - Ahmet Buber
- Department of Child and Adolescent Psychiatry, Pamukkale University, Faculty of Medicine, Denizli, Zip code: 20070, Turkey
| | - Mehmet Akif Cansiz
- Department of Child and Adolescent Psychiatry, Yozgat Bozok University, Faculty of Medicine, Yozgat, Zip code: 66100, Turkey
| | - Hakan Ogutlu
- Department of Child and Adolescent Psychiatry, Ankara City Hospital, Ankara, Zip code: 06800, Turkey
| | - Safak Eray
- Department of Child and Adolescent Psychiatry, Uludag University Faculty of Medicine, Bursa, Zip code: 16059, Turkey
| | - Hande Ayraler Taner
- Department of Child and Adolescent Psychiatry, Baskent University, Medical Faculty, Ankara, Zip code: 06490, Turkey
| | - Ebru Altintas
- Department of Psychiatry, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Medical and Research Center, Adana, Zip code: 01110, Turkey
| | - Ozgur Kutuk
- Department of Immunology, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Medical and Research Center, Adana, Zip code: 01110, Turkey
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Tuncturk M, Ermis C, Buyuktaskin D, Turan S, Saglam Y, Alarslan S, Guler D, Sut E, Unutmaz G, Guzel AB, Atay Canbek O, Inal N, Karacetin G, Hazell P. Electroconvulsive therapy or clozapine for adolescents with treatment-resistant schizophrenia: an explorative analysis on symptom dimensions. Int J Psychiatry Clin Pract 2023; 27:257-263. [PMID: 36576216 DOI: 10.1080/13651501.2022.2160764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/16/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study sought to compare pre-intervention patient characteristics and post-intervention outcomes in a naturalistic sample of adolescent inpatients with treatment-resistant psychotic symptoms who received either electroconvulsive therapy (ECT) or clozapine. METHODS Data of adolescents with schizophrenia/schizoaffective disorder receiving ECT or clozapine were retrospectively collected from two tertiary-care psychiatry-teaching university hospitals. Subscale scores of the Positive and Negative Symptom Scale (PANSS) factors were calculated according to the five-factor solution. Baseline demographics, illness characteristics, and post-intervention outcomes were compared. RESULTS There was no significant difference between patients receiving ECT (n = 13) and clozapine (n = 66) in terms of age, sex, and the duration of hospital stay. The ECT group more commonly had higher overall illness and aggression severity. Smoking was less frequent in the clozapine group. Baseline resistance/excitement symptom severity was significantly higher in the ECT group, while positive, negative, affect, disorganisation, and total symptom scores were not. Both interventions provided a significant reduction in PANSS scores with large effect sizes. CONCLUSION Both ECT and clozapine yielded high effectiveness rates in adolescents with treatment-resistant schizophrenia/schizoaffective disorder. Youth receiving ECT were generally more activated than those who received clozapine.
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Affiliation(s)
- Mustafa Tuncturk
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | | | | | - Serkan Turan
- Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, Bursa, Turkey
| | - Yesim Saglam
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Sezen Alarslan
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Duru Guler
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ekin Sut
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Guldal Unutmaz
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ayse Beste Guzel
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Ozge Atay Canbek
- Department of Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Neslihan Inal
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Gul Karacetin
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Philip Hazell
- Specialty of Psychiatry, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Ozturk Y, Ozyurt G, Gormez V, Aslankaya ZD, Baykara B, Ekinci O, Kaya I, Adak I, Esin IS, Turan S, Sari M, Ozcan GG, Ermis C, Ekinci N, Dogan OI, Tiryaki I, Kitapcioglu S, Tufan AE, Inal N, Akay AP. Parent rated bedtime resistance and comorbidity may predict levels of attention among Turkish children diagnosed with ADHD in on-line education classes during the COVID-19 outbreak. North Clin Istanb 2023; 10:197-204. [PMID: 37181063 PMCID: PMC10170383 DOI: 10.14744/nci.2022.77674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 08/15/2022] [Accepted: 09/17/2022] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVE This study aimed to compare the attention levels, of Turkish children and adolescents with Attention Deficit/ Hyperactivity Disorder (ADHD) in on-line education classes with healthy controls. METHODS This study is a cross-sectional, internet-based, case-control study that recruited 6-18 years old patients diagnosed with ADHD and receving treatment and healthy controls from eight centers. The measurements used in the study were prepared in the google survey and delivered to the participants via Whatsapp application. RESULTS Within the study period, 510 children with ADHD and 893 controls were enrolled. Parent- rated attention decreased significantly in both groups during on-line education classes due to COVID-19 outbreak (p<0.001; for each). Children and adolescents with ADHD had significantly elevated bedtime resistance, problems in family functioning difficulties than control children according to parental reports (p=0.003; p<0.001; p<0.001, respectively). Furthermore, bedtime resistance and comorbidity significantly predicted attention levels in on-line education. CONCLUSION Our findings may underline the need to augment student engagement in on-line education both for children without attention problems and those with ADHD. Interventions shown to be effective in the management of sleep difficulties in children as well as parent management interventions should continue during on-line education.
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Affiliation(s)
- Yusuf Ozturk
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkiye
- Correspondence: Yusuf OZTURK, MD. Abant Izzet Baysal Universitesi Tip Fakultesi, Cocuk ve Ergen Psikiyatrisi Anabilim Dali, Bolu, Turkiye. Tel: +90 374 275 25 25 e-mail:
| | - Gonca Ozyurt
- Department of Child and Adolescent Psychiatry, Katip Celebi University Faculty of Medicine, Izmir, Turkiye
| | - Vahdet Gormez
- Department of Child and Adolescent Psychiatry, Medeniyet University, Istanbul, Turkiye
| | | | - Burak Baykara
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkiye
| | - Ozalp Ekinci
- Department of Child and Adolescent Psychiatry, University of Health Sciences Faculty of Medicine, Erenkoy Health Practice and Research Center, Istanbul, Turkiye
| | - Ilyas Kaya
- Department of Child and Adolescent Psychiatry, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkiye
| | - Ibrahim Adak
- Department of Child and Adolescent Psychiatry, University of Health Sciences Faculty of Medicine, Erenkoy Health Practice and Research Center, Istanbul, Turkiye
| | - Ibrahim Selcuk Esin
- Department of Child and Adolescent Psychiatry, Ataturk University Faculty of Medicine, Erzurum, Turkiye
| | - Serkan Turan
- Department of Child and Adolescent Psychiatry, Tekirdag State Hospital, Izmir, Turkiye
| | - Mesut Sari
- Department of Child and Adolescent Psychiatry, Istanbul Cam and Sakura City Hospital, Istanbul, Turkiye
| | - Guler Gol Ozcan
- Department of Child and Adolescent Psychiatry, Bilecik State Hospital, Bilecik, Turkiye
| | - Cagatay Ermis
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkiye
| | - Nazan Ekinci
- Department of Child and Adolescent Psychiatry, University of Health Sciences Faculty of Medicine, Erenkoy Health Practice and Research Center, Istanbul, Turkiye
| | - Ozge Ipek Dogan
- Department of Child and Adolescent Psychiatry, University of Health Sciences Faculty of Medicine, Erenkoy Health Practice and Research Center, Istanbul, Turkiye
| | - Ibrahim Tiryaki
- Department of Child and Adolescent Psychiatry, Ataturk University Faculty of Medicine, Erzurum, Turkiye
| | | | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkiye
| | - Neslihan Inal
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkiye
| | - Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkiye
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Koc D, Ince E, San T, Akan P, Paketci A, Bober E, Tecirli ND, Inal N, Akay AP. Association between thyroid autoimmunity and antidepressant treatment-emergent mania in pediatric mood disorders. Psychiatry Res 2022; 314:114676. [PMID: 35709636 DOI: 10.1016/j.psychres.2022.114676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 10/18/2022]
Abstract
Risk factors associated with antidepressant treatment-emergent mania(ATEM) are poorly characterized in child and adolescent populations. To identify better biomarkers, we aimed to explore whether thyroid autoimmunity is associated with ATEM in pediatric mood disorders. We enrolled two groups of pediatric mood disorders, those with ATEM+ (n = 29) and those with ATEM- controls (n = 31). All diagnoses were made according to structured interviews by the clinicians. Autoimmune thyroiditis (anti-thyroid peroxidase antibodies [TPO-abs] and thyroid function (thyroid-stimulating hormone [TSH] and free thyroxin [FT4]) were assessed. Logistic regression was used to explore the relationship between TPO-abs seroprevalence and ATEM+ while controlling for covariates. Group comparisons showed that the patient with ATEM+ had significantly higher seroprevalence and titer of TPO-abs compared to ATEM- controls. In logistic regression analysis adjusting for age, gender, Tanner stage, body mass index, antipsychotic treatments, smoking status and family history of thyroid disorder, the seroprevalence of TPO-abs (>60 U/mL) was significantly associated with ATEM+ (OR = 3.67, 95% confidence interval [CI] = 1.2-11.1, p = 0.022). Our findings demonstrated that seroprevalence and titer of TPO-abs in pediatric mood disorders are associated with ATEM+ status. TPO-abs could potentially serve as a biomarker when assessing the risk of ATEM in the child and adolescent population.
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Affiliation(s)
- Dogukan Koc
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Ecem Ince
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - Tugba San
- Department of Neuroscience, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Pınar Akan
- Department of Biochemistry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ahu Paketci
- Department of Pediatric Endocrinology, Dokuz Eylul University, Izmir, Turkey
| | - Ece Bober
- Department of Pediatric Endocrinology, Dokuz Eylul University, Izmir, Turkey
| | - Nese Direk Tecirli
- Department of Psychiatry, Istanbul University Faculty of Medicine, Izmir, Turkey
| | - Neslihan Inal
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
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Inal N, Ermis C, Koc D, Aksoy S, Karacetin G, Tuncturk M, Eray S, Karabina B, Faruk Akca O, Ozgul D, Gunay Kilic B, Cikili Uytun M, Besenek M, Kavurma C, Bilac O, Gokcen C, Topal Z, Percinel Yazıcı I, Sapmaz SY, Ozyurt G, Diler RS. Index depressive episode and antidepressant exposure were associated with illness characteristics of pediatric bipolar disorder. Acta Psychiatr Scand 2022; 145:200-208. [PMID: 34076890 DOI: 10.1111/acps.13333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/28/2021] [Accepted: 05/31/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Pediatric bipolar disorder (PBD) is a serious, recurrent disorder leading to severe functional impairment. As a first mood episode, index episode could affect the long-term course of the illness. This study aimed to investigate the clinical characteristics of youth with PBD from our multicenter, nationwide, naturalistic follow-up samples and to identify (i) the effects of index mood episode and (ii) the effect of previous antidepressant treatments on the age at mania onset of PBD. METHOD The study sample consisted of 271 youth with BD-I followed by the child and adolescent psychiatry clinics of seven different university hospitals and three research state hospitals, representing six geographic regions across Turkey. All diagnoses were made according to structured interviews, and all data were retrospectively obtained from clinical records by the clinicians. RESULTS When patients with index depressive/mixed episodes (IDE, n=129) and patients with index (hypo)manic episodes (IME, n=142) were compared, the total number of mood episodes and rapid cycling feature were significantly higher in the IDE group than in the IME group. The Cox regression analysis adjusted for sociodemographic and illness characteristics revealed female adolescents in the IDE group treated with antidepressants were more likely to have an earlier onset of mania (hazard ratio=2.03, 95% confidence interval=1.31-3.12, p=0.001). CONCLUSION This is the first large-scale nationwide follow-up study in Turkey that indicated prior antidepressant treatments were associated with an earlier onset of mania in youth, particularly in adolescent females. Larger prospective studies are needed to identify neurodevelopmental processes underlying PBD and initiate prevention approaches.
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Affiliation(s)
- Neslihan Inal
- Department of Child and Adolescent Psychiatry, Medical Faculty, Dokuz Eylul University, Izmir, Turkey
| | - Cagatay Ermis
- Department of Child and Adolescent Psychiatry, Medical Faculty, Dokuz Eylul University, Izmir, Turkey
| | - Dogukan Koc
- Department of Child and Adolescent Psychiatry, Medical Faculty, Dokuz Eylul University, Izmir, Turkey
| | - Sena Aksoy
- Department of Child and Adolescent Psychiatry, Kastamonu Training and Research Hospital, Kastamonu, Turkey
| | - Gul Karacetin
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Mustafa Tuncturk
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Safak Eray
- Department of Child and Adolescent Psychiatry, Medical Faculty, Bursa Uludag University, Bursa, Turkey
| | - Berna Karabina
- Department of Child and Adolescent Psychiatry, Medical Faculty, Bursa Uludag University, Bursa, Turkey
| | - Omer Faruk Akca
- Department of Child and Adolescent Psychiatry, Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Dilek Ozgul
- Department of Child and Adolescent Psychiatry, Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Birim Gunay Kilic
- Department of Child and Adolescent Psychiatry, Medical Faculty, Ankara University, Ankara, Turkey
| | - Merve Cikili Uytun
- Department of Child and Adolescent Psychiatry, Medical Faculty, Ankara University, Ankara, Turkey
| | - Mert Besenek
- Department of Child and Adolescent Psychiatry, Recep Tayyip Erdogan University, Rize Training and Research Hospital, Rize, Turkey
| | - Canem Kavurma
- Department of Child and Adolescent Psychiatry, Manisa Mental Health Hospital, Manisa, Turkey
| | - Oznur Bilac
- Department of Child and Adolescent Psychiatry, Manisa Mental Health Hospital, Manisa, Turkey
| | - Cem Gokcen
- Department of Child and Adolescent Psychiatry, Medical Faculty, Gaziantep University, Gaziantep, Turkey
| | - Zehra Topal
- Department of Child and Adolescent Psychiatry, Medical Faculty, Gaziantep University, Gaziantep, Turkey
| | - Ipek Percinel Yazıcı
- Department of Child and Adolescent Psychiatry, Medical Faculty, Firat University, Elazig, Turkey
| | - Sermin Yalin Sapmaz
- Department of Child and Adolescent Psychiatry, Medical Faculty, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Gonca Ozyurt
- Department of Child and Adolescent Psychiatry, Medical Faculty, Izmir Katip Celebi University, İzmir, Turkey
| | - Rasim Somer Diler
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Bora E, Can G, Zorlu N, Ulas G, Inal N, Ozerdem A. Structural dysconnectivity in offspring of individuals with bipolar disorder: The effect of co-existing clinical-high-risk for bipolar disorder. J Affect Disord 2021; 281:109-116. [PMID: 33310660 DOI: 10.1016/j.jad.2020.11.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/22/2020] [Accepted: 11/26/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Bipolar disorder (BD) might be associated in disturbances in brain networks. However, little is known about the abnormalities in structural brain connectivity which might be related to vulnerability to BD and predictive of the emergence of manic symptoms. No previous study has investigated the effect of subthreshold syndromes on structural dysconnectivity in offspring of parents with BD (BDoff). METHODS We investigated diffusion weighted images of 70 BDoff and 48 healthy controls (HC). Nineteen of the 70 BDoff had presented with subthreshold syndromes indicating a clinical high-risk (BDoff-CHR) and other 51 BDoff had no such history (BDoff-non-CHR). Global and regional network properties, rich club organization and inter-regional connectivity in BDoff and healthy controls were investigated using graph analytical methods and network-based-statistics (NBS). RESULTS Global properties of WM networks appeared to be intact in BDoff-CHR and BDoff-non-CHR. However, decreased regional connectivity in right occipito-parietal areas and cerebellum was a common feature of both BDoff groups. Importantly, decreased interregional connectivity between nodes in right and left prefrontal regions, nodes in right prefrontal lobe and right temporal lobe and nodes in left occipital area and left cerebellum were evident in BDoff-CHR but not BDoff-non-CHR. LIMITATIONS The cross-sectional nature of the study was the main consideration. CONCLUSION Decreased regional connectivity in right posterior brain regions might be related to vulnerability to BD. On the other hand, interregional dysconnectivity in anterior frontal and limbic regions and left posterior brain regions might be evident in individuals genetically at risk for developing BD who had experienced subthreshold mood symptoms.
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Affiliation(s)
- Emre Bora
- Dokuz Eylul University, Faculty of Medicine, Department of Psychiatry, Izmir, Turkey; Dokuz Eylul University, Institute of Neuroscience, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne.
| | - Gunes Can
- Izmir Biomedicine and Genome Center, Dokuz Eylul University Health Campus, Izmir, Turkey
| | - Nabi Zorlu
- Department of Psychiatry, Faculty of Medicine, Ataturk Training and Research Hospital, Izmir Katip Celebi University, İzmir, Turkey
| | - Gozde Ulas
- Department of Child and Adolescent Psychiatry, Tepecik Research and Training Hospital, İzmir, Turkey
| | - Neslihan Inal
- Dokuz Eylul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Izmir, Turkey
| | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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François M, Inal N, Nassar E, Benrahho A, Moujawaz B. The “epiphysa” fibular nail - 45 Cases during 30 months. Eur J Orthop Surg Traumatol 1998. [DOI: 10.1007/bf01682047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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