Browsing by Author "Tufan, AE"
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Item The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T)Ercan, ES; Polanczyk, G; Ardic, UA; Yuce, D; Karacetin, G; Tufan, AE; Tural, U; Aksu, H; Aktepei, E; Arman, AR; Basgülk, S; Bilac, O; CosKunm, M; Celik, GG; Demirkaya, SK; Dursun, BO; Durukan, I; Fidan, T; Fis, NP; Gençoglan, S; Gökçen, C; Görker, I; Görmez, V; Gündogdu, OY; Gurkan, CK; Hergüner, S; Hesapçioglu, ST; Kandemir, H; Kiliç, BG; Kilinçaslan, A; Mutluer, T; Nasiroglu, S; Özcan, ÖÖ; Öztürk, M; Öztop, D; Sapmad, SY; Süren, S; Sahin, N; Tahiroglu, AY; Toros, F; Ünal, F; Vural, P; Yazici, IP; Yazici, KU; Yildirim, V; Yulaf, Y; Yüce, M; Yüksel, T; Akdemir, D; Altun, H; Ayik, B; Bilgic, A; Bozkurt, ÖH; Çakir, ED; Çeri, V; Demir, NÜ; Dinç, G; Irmak, MY; Karaman, D; Kinik, MF; Mazlum, B; Memik, NÇ; Özdemir, DF; Sinir, H; Tasdelen, BI; Taskin, B; Ugur, Ç; Uran, P; Uysal, T; Üneri, Ö; Yilmaz, S; Yilmaz, SS; Açikel, B; Aktas, H; Alaca, R; Aliç, BG; Almaidan, M; Ari, FP; Aslan, C; Atabay, E; Ay, MG; Aydemir, H; Ayranci, G; Babadagi, Z; Bayar, H; Bayhan, PÇ; Bayram, Ö; Bektas, ND; Berberoglu, KK; Bostan, R; Canli, MA; Cansiz, MA; Ceylan, C; Coskun, N; Coskun, S; Çakan, Y; Demir, I; Demir, N; Demirdögen, EY; Dogan, B; Dönmez, YE; Dönder, F; Efe, A; Eray, S; Erbilgin, S; Erden, S; Ersoy, EG; Eseroglu, T; Firat, SK; Gök, EE; Güler, G; Güles, Z; Günes, S; Günes, A; Günay, G; Özgür, BG; Güven, G; Goksoy, SC; Horozcu, H; Irmak, A; Isik, U; Kahraman, Ö; Kalayci, BM; Karaaslan, U; Karadag, M; Kilic, HT; Kiliçaslan, F; Kinay, D; Kocael, O; Koç, EB; Mutlu, RK; Lushi-San, Z; Nalbant, K; Okumus, N; Özbek, F; Özdemir, FA; Özdemir, H; Özkan, S; Özyurt, EY; Polat, B; Polat, H; Sekmen, E; Sertçelik, M; Sevgen, FH; Sevince, O; Süleyman, F; Shamkhalova, Ü; Simsek, NE; Tanir, Y; Tekden, M; Temtek, S; Topal, M; Topal, Z; Türk, T; Uçar, HN; Uçar, F; Uygun, D; Uzun, N; Vatansever, Z; Yazgili, NG; Yildiz, DM; Yildiz, NAim: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. Method: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. Results: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. Conclusion: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.Item Prevalence of Childhood Affective disorders in Turkey: An epidemiological studyKaracetin, G; Arman, AR; Fis, NP; Demirci, E; Ozmen, S; Hesapcioglu, ST; Oztop, D; Tufan, AE; Tural, U; Aktepe, E; Aksu, H; Ardic, UA; Basgul, S; Bilac, O; Coskun, M; Celik, GG; Demirkaya, SK; Dursun, OB; Durukan, I; Fidan, T; Gencoglan, S; Gokcen, C; Gokten, ES; Gorker, I; Gormez, V; Gundogdu, OY; Gurkan, CK; Herguner, S; Kandemir, H; Kilic, BG; Kilincaslan, A; Mutluer, T; Nasiroglu, S; Ozcan, OO; Ozturk, M; Sapmaz, SY; Suren, S; Sahin, N; Tahiroglu, AY; Toros, F; Unal, F; Vural, P; Yazici, IP; Yazici, KU; Yildirim, V; Yulaf, Y; Yuce, M; Yuksel, T; Akdemir, D; Altun, H; Ayik, B; Bilgic, A; Bozkurt, OH; Cakir, ED; Ceri, V; Demir, NU; Dinc, G; Irmak, MY; Karaman, D; Kinik, MF; Mazlum, B; Memik, NC; Ozdemir, DF; Sinir, H; Tasdelen, BI; Taskin, B; Ugur, C; Uran, P; Uysal, T; Uneri, OS; Yilmaz, S; Yilmaz, SS; Acikel, B; Aktas, H; Alaca, R; Alic, BG; Almbaidheen, M; Ari, FP; Aslan, C; Atabay, E; Ay, MG; Aydemir, H; Ayranci, G; Babadagi, Z; Bayar, H; Bayhan, PC; Bayram, O; Bektas, ND; Berberoglu, KK; Bostan, R; Cakan, Y; Canli, MA; Cansiz, MA; Ceylan, C; Coskun, N; Coskun, S; Demir, I; Demir, N; Demirdogen, EY; Dogan, B; Donmez, YE; Donder, F; Efe, A; Eray, S; Erbilgin, S; Erden, S; Ersoy, EG; Eseroglu, T; Firat, SK; Gok, EE; Goksoy, SC; Guler, G; Gules, Z; Gunay, G; Gunes, S; Gunes, A; Guven, G; Horozcu, H; Irmak, A; Isik, U; Kahraman, O; Kalayci, BM; Karaaslan, U; Karadag, M; Kilic, HT; Kilicaslan, F; Kinay, D; Koc, EB; Kocael, O; Mutlu, RK; San, Z; Nalbant, K; Okumus, N; Ozbek, F; Ozdemir, FA; Ozdemir, H; Ozgur, BG; Ozkan, S; Ozyurt, EY; Polat, B; Polat, H; Sekmen, E; Sertcelik, M; Sevgen, FH; Sevince, O; Shamkhalova, U; Suleyman, F; Simsek, NE; Tanir, Y; Tekden, M; Temtek, S; Topal, M; Topal, Z; Turk, T; Ucar, HN; Ucar, F; Uygun, D; Uzun, N; Vatansever, Z; Yazgili, NG; Yildiz, DM; Yildiz, N; Ercan, ESAim: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. Methods: This study was conducted as a part of the The Epidemiology of Childhood Psychopathology in Turkey (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. Results: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. Conclusion: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.Item Self-Harm in Children and Adolescents Who Presented at Emergency Units During the COVID-19 Pandemic: An International Retrospective Cohort StudyWong, BHC; Cross, S; Zavaleta-Ramirez, P; Bauda, I; Hoffman, P; Ibeziako, P; Nussbaum, L; Berger, GE; Hassanian-Moghaddam, H; Kapornai, K; Mehdi, T; Tolmac, J; Barrett, E; Romaniuk, L; Davico, C; Moghraby, OS; Ostrauskaite, G; Chakrabarti, S; Carucci, S; Sofi, G; Hussain, H; Lloyd, ASK; Mcnicholas, F; Meadowcroft, B; Rao, MN; Csabi, G; Gatica-Bahamonde, G; Ogutlu, H; Skouta, E; Elvins, R; Boege, I; Dahanayake, DMA; Anderluh, M; Chandradasa, M; Girela-Serrano, BM; Uccella, S; Stevanovic, D; Lamberti, M; Piercey, A; Nagy, P; Mehta, VS; Rohanachandra, Y; Li, J; Tufan, AE; Mirza, H; Rozali, F; Baig, BJ; Noor, IM; Fujita, S; Gholami, N; Hangul, Z; Vasileva, A; Salucci, K; Bilac, O; Yektas, C; Cansiz, MA; Aksu, GG; Babatunde, S; Youssef, F; Al-Huseini, S; Kilicaslan, F; Kutuk, MO; Pilecka, I; Bakolis, I; Ougrin, DObjective: 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.Item Cytokine expression profiles in children and adolescents with tic disordersKutuk, MO; Tufan, AE; Kilicaslan, F; Gokcen, C; Aksu, GG; 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, OThe 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-1 beta, TNF-alpha, 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.Item High Depression Symptoms and Burnout Levels Among Parents of Children with Autism Spectrum Disorders: A Multi-Center, Cross-Sectional, Case-Control Study (Jan, 10.1007/s10803-021-04874-4, 2021)Kütük, MÖ; Tufan, AE; Kiliçaslan, F; Güler, G; Çelik, F; Altintas, E; Gökçen, C; Karadag, M; Yektas, Ç; Mutluer, T; Kandemir, H; Büber, A; Topal, Z; Acikbas, U; Giray, A; Kütük, ÖThe original version of the article has unfortunately missed the revised affiliations for the following authors.Item Novel inflammatory targets for immunotherapies in pediatric patients with trichotillomaniaKutuk, MO; Tufan, AE; Kilicaslan, F; Mutluer, T; Gokcen, C; Karadag, M; Yektas, C; Kandemir, H; Buber, A; Aksu, GG; Topal, Z; Giray, A; Celik, F; Acikbas, U; Kutuk, OImmune dysregulation may be important in the etiology of obsessive-compulsive and related disordersandbody-focusedrepetitivebehaviors, such as Trichotillomania (TTM). The role of inflammation and inflammatory markers in TTM has received relatively little attention. This study was aimed to determine the expression levels of inflammatory markers (i.e. IL-1 beta, IL-1 alpha, IL-4, IL-6, IL-17, TNF-alpha and TGF-5) in peripheral blood mononuclear cells of children with TTM and healthy controls and to evaluate their association with clinical variables. Seventy-seven patients with TTM and 107 healthy controls were enrolled in the study. Peripheral blood was collected in standardized conditions. The mean age of patients and controls did not differ significantly (10.8 +/- 4.4 and 12.0 +/- 3.2 years; respectively). The majority of patients with TTM and controls were females (n = 55, 71.4 % and n = 55, 51.4 %; respectively); with a greater preponderance of females among TTM. Patients with TTM had significantly elevated expression levels of TNF-alpha, IL-6 and IL-17 compared to controls. However, the expression level of IL-4 was significantly reduced in TTM patients compared to controls. Accordingly, we found a proinflammatory state in TTM and those findings may suggest novel treatment options for TTM and further, crossdisciplinary studies focusing on neuro- inflammation in TTM conducted on larger samples are needed.Item High Depression Symptoms and Burnout Levels Among Parents of Children with Autism Spectrum Disorders: A Multi-Center, Cross-Sectional, Case-Control StudyKütük, MÖ; Tufan, AE; Kiliçaslan, F; Güler, G; Çelik, F; Altintas, E; Gökçen, C; Karadag, M; Yektas, Ç; Mutluer, T; Kandemir, H; Büber, A; Topal, Z; Acikbas, U; Giray, A; Kütük, ÖThe diagnosis of autism spectrum disorder (ASD) in a child affects family processes, increases parenting stress and marital conflicts, and may lead to parental psychopathology. It may also affect 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 Inventory were used to evaluate parents' depression symptoms and burnout levels. Symptoms of children with ASDs were evaluated 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 significantly elevated compared to controls. Burnout levels of mothers were significantly elevated compared to fathers while depression scores of fathers were significantly elevated compared to mothers. Maternal burnout was significantly predicted by presence of functional speech in child while paternal burnout was significantly 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 depression. More than half the parents sought CAM interventions. Education level did not affect 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 beneficial for the family unit as a whole.Item Effect of Impairment on the Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder in a National Survey: Nation-Wide Prevalence and Comorbidities of ADHDErcan, ES; Unsel-Bolat, G; Tufan, AE; Demirkaya, SK; Bilac, O; Celik, G; Kiliç, BG; Ardic, UA; Sapmaz, SY; Aksu, H; Tahiroglu, AY; Karacetin, G; Tural, U; Aktepe, E; Arman, AR; Basgül, S; Coskun, M; Dursun, OB; Durukan, I; Fis, NP; Gençoglan, S; Gökçen, C; Gokten, ES; Görker, I; Görmez, V; Gündogdu, ÖY; Hesapçioglu, ST; Kandemir, H; Mutluer, T; Nasiroglu, S; Özcan, Ö; Sahin, N; Toros, F; Yazici, IP; Yazici, KU; Yulaf, Y; Yüksel, T; Bilgic, A; Altun, H; Akdemir, D; Mazlum, B; Memik, NÇ; Özdemir, DF; Üneri, Ö; Ünal, FObjective: This study aimed to determine the prevalence and comorbidities of attention-deficit hyperactivity disorder (ADHD) by evaluating a large-scale nation-wide sample of children. Method: The inclusion criterion was being enrolled as a 2nd, 3rd, or 4th-grade student. A semi-structured diagnostic interview (K-SADS-PL), DSM-IV-Based Screening Scale for Disruptive Behavior Disorders, and assessment of impairment (by both parents and teachers) were applied to 5,842 participants. Results: The prevalence of ADHD was 19.5% without impairment and 12.4% with impairment. Both ADHD with and without impairment groups had similar psychiatric comorbidity rates except for oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses. Impairment in the ADHD group resulted in significantly higher ODD and CD diagnoses. Conclusion: Even when impairment is not described, other psychiatric disorders accompany the diagnosis of ADHD and may cause impairment in the future. Impairment in the diagnosis of ADHD significantly increases the likelihood of ODD and CD.Item Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological studyMutluer, T; Gorker, I; Akdemir, D; Ozdemir, DF; Ozel, OO; Vural, P; Tufan, AE; Karacetin, G; Arman, AR; Fis, NP; Demirci, E; Ozmen, S; Hesapcioglu, ST; Oztop, D; Tural, U; Aktepe, E; Aksu, H; Ardic, UA; Basgul, S; Bilac, O; Coskun, M; Celik, GG; Demirkaya, SK; Dursun, OB; Durukan, I; Fidan, T; Gokcen, C; Gormez, V; Gundogdu, OY; Herguner, S; Kandemir, H; Kilic, BG; Kilincaslan, A; Nasiroglu, S; Sapmaz, SY; Sahin, N; Tahiroglu, AY; Toros, F; Unal, F; Yazici, IP; Yazici, KU; Isik, U; Ercan, ESPurpose The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. Methods This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years. Results The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. Conclusion Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment.Item Functional outcome in late adolescence/early adulthood of patients with autism spectrum disorderresand its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional studyKutuk, MO; Tufan, AE; Kilicaslan, F; Vural, P; Gokcen, C; Guney, SA; Kutuk, B; Ozyurt, G; Inal, N; Multer, T; Acikalin, EY; Ozer, FH; Pamuk, EN; Yesilmese, SC; Karadag, M; Hangul, Z; Bilginer, C; Sahin, N; Bilac, O; Kandemir, H; Ercan, ES; Soylemez, TE; Acikel, SB; Aksu, GG; 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; Tuysuz, BP; Buber, A; Cansiz, MA; Ogutlu, H; Eray, S; Taner, HA; Altintas, E; Kutuk, OThe 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.