Browsing by Author "Aksu G.G."

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    Self-Harm in Children and Adolescents Who Presented at Emergency Units During the COVID-19 Pandemic: An International Retrospective Cohort Study
    (Elsevier Inc., 2023) Wong B.H.-C.; Cross S.; Zavaleta-Ramírez P.; Bauda I.; Hoffman P.; Ibeziako P.; Nussbaum L.; Berger G.E.; Hassanian-Moghaddam H.; Kapornai K.; Mehdi T.; Tolmac J.; Barrett E.; Romaniuk L.; Davico C.; Moghraby O.S.; Ostrauskaite G.; Chakrabarti S.; Carucci S.; Sofi G.; Hussain H.; Lloyd A.S.K.; McNicholas F.; Meadowcroft B.; Rao M.; Csábi G.; Gatica-Bahamonde G.; Öğütlü H.; Skouta E.; Elvins R.; Boege I.; Dahanayake D.M.A.; Anderluh M.; Chandradasa M.; Girela-Serrano B.M.; Uccella S.; Stevanovic D.; Lamberti M.; Piercey A.; Nagy P.; Mehta V.S.; Rohanachandra Y.; Li J.; Tufan A.E.; Mirza H.; Rozali F.; Baig B.J.; Noor I.M.; Fujita S.; Gholami N.; Hangül Z.; Vasileva A.; Salucci K.; Bilaç Ö.; Yektaş Ç.; Cansız M.A.; Aksu G.G.; Babatunde S.; Youssef F.; Al-Huseini S.; Kılıçaslan F.; Kutuk M.O.; Pilecka I.; Bakolis I.; Ougrin D.
    Objective: To compare psychiatric emergencies and self-harm at emergency departments (EDs) 1 year into the pandemic, to early pandemic and pre-pandemic, and to examine the changes in the characteristics of self-harm presentations. Method: This retrospective cohort study expanded on the Pandemic-Related Emergency Psychiatric Presentations (PREP-kids) study. Routine record data in March to April of 2019, 2020, and 2021 from 62 EDs in 25 countries were included. ED presentations made by children and adolescents for any mental health reasons were analyzed. Results: Altogether, 8,174 psychiatric presentations were recorded (63.5% female; mean [SD] age, 14.3 [2.6] years), 3,742 of which were self-harm presentations. Rate of psychiatric ED presentations in March to April 2021 was twice as high as in March to April 2020 (incidence rate ratio [IRR], 1.93; 95% CI, 1.60-2.33), and 50% higher than in March to April 2019 (IRR, 1.51; 95% CI, 1.25-1.81). Rate of self-harm presentations doubled between March to April 2020 and March to April 2021 (IRR, 1.98; 95% CI, 1.68-2.34), and was overall 1.7 times higher than in March to April 2019 (IRR, 1.70; 95% CI, 1.44-2.00). Comparing self-harm characteristics in March to April 2021 with March to April 2019, self-harm contributed to a higher proportion of all psychiatric presentations (odds ratio [OR], 1.30; 95% CI, 1.05-1.62), whereas female representation in self-harm presentations doubled (OR, 1.98; 95% CI, 1.45-2.72) and follow-up appointments were offered 4 times as often (OR, 4.46; 95% CI, 2.32-8.58). Conclusion: Increased pediatric ED visits for both self-harm and psychiatric reasons were observed, suggesting potential deterioration in child mental health. Self-harm in girls possibly increased and needs to be prioritized. Clinical services should continue using follow-up appointments to support discharge from EDs. Diversity & Inclusion Statement: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. © 2023 American Academy of Child and Adolescent Psychiatry
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    Cytokine expression profiles in children and adolescents with tic disorders
    (Nature Research, 2024) Kutuk M.O.; Tufan A.E.; Kilicaslan F.; Gokcen C.; Aksu G.G.; Yektas C.; Kandemir H.; Celik F.; Mutluer T.; Buber A.; Karadag M.; Coban N.; Coskun S.; Hangul Z.; Altintas E.; Acikbas U.; Giray A.; Aka Y.; Basturk B.; Kutuk O.
    The etiology of tic disorders (TDs) is not precisely known, although several lines of evidence suggest involvement of the immune system in pathogenesis. Here, we aimed to determine the expression levels of pro-inflammatory and anti-inflammatory cytokines in children with TD and compare them with those of healthy controls. Furthermore, we also evaluated their association with clinical variables in the TD group. Within the study period, 88 children with tic disorders and 111 healthy control children were enrolled. Most children with tic disorders were diagnosed with Tourette’s disorder (n = 47, 53.4%) or persistent motor tic disorder (n = 39, 44.3%), while the remainder (n = 2, 2.3%) were diagnosed with persistent vocal tic disorder. We found that children with tic disorders had significantly elevated levels of IL-1β, TNF-α, IL-6 and IL-4 expression, while we detected lower expression levels of IL-17 in children with tic disorders. Our findings provide a molecular landscape of cytokine expression in children with TD, which may suggest a proinflammatory state not affected by the presence of comorbidity and symptom severity. Delineating the contribution of alterations in the immune system to the pathogenesis of tic disorders may pave the way for better therapeutic interventions. © The Author(s) 2024.