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Öğe Barkley Child Attention Scale Validity and Reliability Study(2018) Fırat, Sümeyra; Bolat, Gül Ünsel; Gül, Hesna; Baytunca, Muharrem Burak; Kardaş, Burcu; Aysev, Ayla; Ercan, Eyüp SabriObjective: the purpose of this study is to examine the psychometric properties of the Barkley Child Attention Scale (BCAS) for 6- to 12-year-old children. Method: This study was conducted with 291 children (of an age of 6-12 years) with a clinically normal level of intelligence and a diagnosis of attention-deficit/hyperactivity disorder (ADHD). the structure validity of the scale was studied by exploratory and confirmatory factor analyses. in order to evaluate the measure- dependent validity of the scale, Child Behavior Checklist for ages 6-18 and Swanson, Nolan and Pelham Questionnaire (SNAP-IV) parental form were used. Reliability of the scale was measured by Cronbach’s alpha coefficient. Results: As a result of the exploratory factor analysis, the scale consists of two factors called “daydreaming” and “sluggish,” as is the case in its original form. Confirmatory factor analysis indicated that the fit indices of the scale were at an acceptable level. the correlation analysis study for the criterion-related validity study of the scale revealed that Sluggish Cognitive Tempo (SCT) had a positive correlation with ADHD-IN and internalization problems, a negative correlation with attention deficit hyperactivity disorder/hyperactivity- impulsivity (ADHD-HI), and no correlation with externalization problems. Cronbach’s alpha coefficient of the BCAS is 0.86 and the scale is seen to be reliable. Conclusion: It can be said that the BCAS is a valid and reliable scale that can measure sluggish cognitive tempo symptoms of 6- to 12-year-old children.Öğe Barkley Child Attention Scale Validity and Reliability Study(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2018) Firat, Sumeyra; Bolat, Gul Unsel; Gul, Hesna; Baytunca, Muharrem Burak; Kardas, Burcu; Aysev, Ayla; Ercan, Eyup SabriObjective: The purpose of this study is to examine the psychometric properties of the Barkley Child Attention Scale (BCAS) for 6-to 12-year-old children. Method: This study was conducted with 291 children (of an age of 6-12 years) with a clinically normal level of intelligence and a diagnosis of attention-deficit/hyperactivity disorder (ADHD). The structure validity of the scale was studied by exploratory and confirmatory factor analyses. In order to evaluate the measure-dependent validity of the scale, Child Behavior Checklist for ages 6-18 and Swanson, Nolan and Pelham Questionnaire (SNAP-IV) parental form were used. Reliability of the scale was measured by Cronbach's alpha coefficient. Results: As a result of the exploratory factor analysis, the scale consists of two factors called "daydreaming" and "sluggish," as is the case in its original form. Confirmatory factor analysis indicated that the fit indices of the scale were at an acceptable level. The correlation analysis study for the criterion-related validity study of the scale revealed that Sluggish Cognitive Tempo (SCT) had a positive correlation with ADHD-IN and internalization problems, a negative correlation with attention deficit hyperactivity disorder/hyperactivity-impulsivity (ADHD-HI), and no correlation with externalization problems. Cronbach's alpha coefficient of the BCAS is 0.86 and the scale is seen to be reliable. Conclusion: It can be said that the BCAS is a valid and reliable scale that can measure sluggish cognitive tempo symptoms of 6- to 12-year-old children.Öğe Childhood sexual abuse and supportive factors(Wiley-Blackwell, 2017) Baytunca, Muharrem Burak; Ata, Emsal; Ozbaran, Burcu; Kaya, Ahsen; Kose, Sezen; Aktas, Ekin Ozgur; Aydin, Rezzan; Guney, Selcen; Yuncu, Zeki; Erermis, Serpil; Bildik, Tezan; Aydin, CahideBackground: Childhood sexual abuse (CSA) can be a devastating life experience and is associated with a higher incidence of mental disorders and suicide attempts. The aim of this study was therefore to identify predictors of mental disorder and suicide attempt in children and adolescents with a history of CSA. Methods: A total of 181 Turkish children and adolescents with a history of CSA were evaluated for age, gender, suicide attempts, family relationships and educational background. Abuse involving the insertion of an organ or foreign object into the individual's body was designated as "qualified sexual abuse" (QSA); other forms of sexual abuse were designated "basic sexual abuse" (BSA). Results: Suicide attempts were significantly higher in adolescent girls in the QSA subgroup; age, gender, family integrity, and school attendance were not associated with risk of mental disorders in this group. Among BSA patients, family integrity was significantly associated with suicide attempts. Suicide attempts were approximately 10-fold higher (OR, 10.154; 95% CI: 2.020-51.051; P = 0.005) in children from broken families. Family integrity and school attendance were also noted as weak protective factors against mental disorders in BSA patients. The incidence of mental disorders was 3.5-fold higher in children who had not been attending school (OR, 3.564; 95% CI: 1.379-9.211; P = 0.009). Conclusion: Family integrity and school attendance were weakly related with psychopathology (e.g. mental disorders or suicide attempts) in BSA survivors but not in QSA survivors. Female gender and puberty also increased the likelihood of suicide attempt in QSA survivors.Öğe Diffusion tensor imaging findings in children with sluggish cognitive tempo comorbid Attention Deficit Hyperactivity Disorder(Taylor & Francis Ltd, 2020) Unsel-Bolat, Gul; Baytunca, Muharrem Burak; Kardas, Burcu; Ipci, Melis; Izmir, Sevim Berrin Inci; Ozyurt, Onur; Ercan, Eyup SabriObjective:The construct of Sluggish Cognitive Tempo (SCT) is characterized by daydreaming, mental confusion, staring blankly and hypoactivity. Our main goal was to explore neuropsychological differences in Attention Deficit Hyperactivity Disorder-Inattentive presentation (ADHD-IA) groups with and without SCT symptoms compared to healthy controls. After detecting specific neuropsychological differences, we examined white matter microstructure using Diffusion Tensor Imaging (DTI) data obtained from 3.0 Tesla MRI scans of the cases with SCT symptoms comparing to Typically Developing (TD) controls. Method:In this study, we included 24 cases in the ADHD-IA group with SCT symptoms, 57 cases in the ADHD-IA group without SCT symptoms and, 24 children in the TD group. We applied tract-based spatial statistics to the DTI measures for obtaining fractional anisotropy (FA), axial, radial and mean diffusivity (AD, RD, MD) to explore white matter differences for the whole brain. Results:Omission error scores and longer reaction time scores were specifically associated with inattention symptoms. Commission error scores were significantly and specifically related to SCT symptoms. Cases with SCT symptoms presented increased FA in the bilateral anterior and posterior limb of the internal capsule, bilateral cerebral peduncle, and the fornix than TD group. Conclusions:Neurobiological differences in ADHD cases are still relatively unexplored. We suggest that including an assessment for SCT in the neuropsychological and neuroimaging studies of ADHD may provide more consistent results.Öğe Dikkat eksikliği ve hiperaktivite bozukluğu ile birlikte ağır bilişsel tempo (sluggish cognitive tempo) olan olguların arterial spin labeling yöntemiyle değerlendirilmesi(Ege Üniversitesi, Tıp Fakültesi, 2016) Baytunca, Muharrem Burak; Ercan, Eyüp SabriAğır Bilişsel Tempo (Sluggish Cognitive Tempo) uykulu görünüm, yavaş hareket etme, yavaş düşünme ve içe yönelim sorunları ile karakterize bir klinik belirti kümesidir. Son 20 yılda SCT alanında farklı araştırmalar ortaya çıkmıştır. SCT hastalarında erken veri işleme ve dikkati devam ettirmenin bozuk olduğu ve posterior beyin bölgelerinin dikkat sorunlarıyla ilişkili olduğu öne sürülmüştür. Böylelikle biz bu araştırmada posterior bölgeler özellikle olacak şekilde bazı beyin bölgelerini araştırmayı hedefledik. SCT komorbiditesi olan DEHB li çocuklarda spesifik beyin bölgelerinde kontrol grubuna kıyasla farklı bir pattern gösterip göstermediğini ölçmeyi amaçladık. SCT grubu 40 olgudan ve kontrol grubu 24 olgudan oluştu. MR çekimlerinde go-nogo testi kullanıldı ve Arterial Spin Labelling kullandığımız yöntemdi. MR verisinin istatiksel analizi go task i sırasında hem hasta hem kontrol grubunda aktivasyon olduğunu gösterdi. Bu aktivasyon en yaygın olarak SCT komorbid DEHB-Dikkat eksikliği baskın alt tipinde görüldü. No go task sırasında tüm hasta grubu ve koNtrol grubunda aktivasyon gözlendi fakat her iki hasta grubu arasında anlamlı istatiksel farklılık yoktu. Lingual gyrus, occipital fusiform gyrus, precuneus, posterior cingulat gyrus’un bazal(dinlenim) ve aktive halleri arasında anlamlı istatiksel farklılık görüldü. Bu dikkat sorunlarının geri döndürülmesi için bir kompansasyon mekanizmasına bağlı olabilir olarak düşünüldü. Sonuç olarak çalışmamızda hipotezimize paralel olarak posterior beyin bölgelerinde bozulma saptadık.Öğe Evaluation of a Neuropsychiatric Disorder: From PANDAS to PANS and CANS(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2016) Baytunca, Muharrem Burak; Donuk, Tugba; Erermis, SerpilPANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) syndrome is a disorder seen before adolescence that possesses an abrupt onset of obsessive compulsive disorder symptoms and/or tics. Swedo and colleagues defined this disorder in 1998 as a syndrome related to Group A streptoccoccus (GAS) infection with neurological issues, such as motor hyperactivation and choreiform movements. The progress of the disorder may be described as wax-and-waning, apart from abrupt onset, and this relapse and remission course is associated with exacerbating infections, according to the creators of PANDAS syndrome Ruling out of Rheumatoid Fever and Sydenham's Chorea was a necessity for making a proper diagnosis. Since the recognition of this syndrome, clinicians encountered many children who could not fulfill all 5 criteria, which must be met for PANDAS diagnosis. In addition, due to literature showing failure and lack of strong evidence of a major role of GAS, the newly-defined categories PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and CANS (Childhood Acute Neuropsychiatric Syndrome) were created to encompass those of "almost met" non-PANDAS cases. PANS and CANS include concurrent significant psychiatric symptoms with abrupt onset of OCD symptoms and/or tics but do not require identification of any infection agent, immune dysfunction, or enviromental precipitants. In this paper, we aimed to discuss PANS/CANS, alterations of PANDAS, and diagnoses in which "almost met" PANDAS patients should be classified on the basis of a case who developed an abrupt onset of anxiety, obsessions, and vocal tics.Öğe Increased cerebral blood flow in the right anterior cingulate cortex and fronto-orbital cortex during go/no-go task in children with ADHD(Taylor & Francis Ltd, 2021) Baytunca, Muharrem Burak; de Frederick, Blaise; Bolat, Gul Unsel; Kardas, Burcu; Inci, Sevim Berrin; Ipci, Melis; Ercan, Eyup SabriObjective Arterial spin labeling (ASL) is a relatively new imaging modality in the field of the cognitive neuroscience. in the present study, we aimed to compare the dynamic regional cerebral blood flow alterations of children with ADHD and healthy controls during a neurocognitive task by using event-related ASL scanning. Methods The study comprised of 17 healthy controls and 20 children with ADHD. The study subjects were scanned on 3 Tesla MRI scanner to obtain ASL imaging data. Subjects performed go/no-go task during the ASL image acquisition. The image analyses were performed by FEAT (fMRI Expert Analysis Tool) Version 6. Results The mean age was 10.88 +/- 1.45 and 11 +/- 1.91 for the control and ADHD group, respectively (p = .112). The go/no-go task was utilized during the ASL scanning. The right anterior cingulate cortex (BA32) extending into the frontopolar and orbitofrontal cortices (BA10 and 11) displayed greater activation in ADHD children relative to the control counterparts (p < .001). With a lenient significance threshold, greater activation was revealed in the right-sided frontoparietal regions during the go session, and in the left precuneus during the no-go session. Conclusion These results indicate that children with ADHD needed to over-activate frontopolar cortex, anterior cingulate as well as the dorsal and ventral attention networks to compensate for the attention demanded in a given cognitive task.Öğe Isoniazid-Induced Psychosis with Obsessive-Compulsive Symptoms (Schizo-Obsessive Disorder) in a Female Child(Mary Ann Liebert, Inc, 2015) Baytunca, Muharrem Burak; Erermis, Serpil; Bildik, Tezan; Kayahan, BulentÖğe Landau-Kleffner Sendromu: Olgu Sunumu(Galenos Yayincilik, 2015) Baytunca, Muharrem Burak; Percinel, Ipek; Tekin, Hande Gazeteci; Serdaroglu, Gul; Gokben, SarenurLandau-Kleffner syndrome (LKS) is acquired aphasia circumstance with loss of gained language ability and epilepti form electroencephalography or clinical seizure described first in 1957 by Landau and Kleffner. Expressive aphasia starts commonly among children of 3 to 8 age group and verbal auditor agnosia are other clinical features of LKS. Patients have difficulty in understanding what they are being told and respond to visual as well as auditory arousals. Seizure is seen in 70% of the cases. Patients with LKS usually develop normally, but it has been reported that about 13% of the cases had speech ability problem previously. Due to resemblance of symptomatology, causals such as audition loss, deafness, psychiatric disorders, progressive encephalopathy, "Childhood Rolandic Epilepsy" should be considered as differential diagnoses of LKS. We have briefly discussed the clinical progress of an 8-year-old male child who was followed with prediagnosis of major depression by child psychiatry department because of agression, relationship problems with his friends and regression in his speech. His behavior problems and absence of seizures had delayed obtaining an EEG in the early period. Seizures started two years after the behavior problems and loss of speech. Thus, we suggest that if a child with normal language development starts to regress, Landau-Kleffner syndrome must be considered in the differential diagnosis even in the absence of epileptic seizures.Öğe The neurocognitive nature of children with ADHD comorbid sluggish cognitive tempo: Might SCT be a disorder of vigilance?(Elsevier Ireland Ltd, 2018) Baytunca, Muharrem Burak; Inci, Sevim Berrin; Ipci, Melis; Kardas, Burcu; Bolat, Gul Unsel; Ercan, Eyup SabriSluggish Cognitive Tempo (SCT) refers to a clinical construct including several symptoms such as sluggishness, absentmindedness, low energy. In the present study, we compared neurocognitive laboratory outcomes of ADHD children with or without SCT. Method: The CNS Vital Signs Battery was utilized to measure neurocognitive measure of the participants. The SCT + ADHD group comprised of 42 subjects, ADHD group was 41 subjects and control group was 24 subjects. Results: The cognitive flexibility score was found to be more severely impaired in ADHD children with SCT in comparison to the ADHD-only. Additionally, greater deficits in the Shifting Attention Test (p = 0.014) and the Continuous Performance Test (reaction time score, p < 0.01) were found in the SCT + ADHD group relative to ADHD group. Processing speed, visual/auditory memory, psychomotor speed and reaction time were not found to more impaired in those comorbid with SCT. Conclusion: Impairments in the cognitive flexibility and more specifically shifting attention and continuous performance may be indicative of vigilance and orientation problems rather than executive functions for the SCT construct.Öğe Nöropsikiyatrik Bir Hastalığın Evrimi: PANDAS'tan PANS ve CANS'a(2016) Donuk, Tuğba; Erermiş, Hatice Serpil; Baytunca, Muharrem BurakPANDAS (Streptokok enfeksiyonu ile ilişkili pediatrik otoimmün nöropsikiyatrik hastalıklar) sendromu ergenlik dönemi öncesinde görülen ani başlangıçlı obsesif kompulsif bozukluk belirtileri ve/veya tikler ile ortaya çıkan bir hastalıktır. Bu hastalık Grup A Streptokok (GAS) enfeksiyonuyla birlikte, motor hiperaktivite ve koreiform hareketler gibi nörolojik bulgularla ilişkilidir. Hastalığın gidişatı ani başlangıç haricinde alevlenip sönmelerle gidebilmektedir ve PANDAS sendromu tanımlayıcılarına göre bu nüks ve iyileşmelerle giden gidişat, tetikleyici enfeksiyonlarla ilişkilidir. PANDAS tanısını koymak için Romatizmal Ateş (RA) ve Sydenham Koresi'nin dışlanması gerekmektedir. Sendromun tanımlanmasından sonra klinisyenler PANDAS sınıflaması için gerekli 5 ölçütün tamamını karşılayamayan hastalarla karşılaşmışlardır. GAS enfeksiyonun önemli rolü olduğuna dair kanıt eksikliğini ve yokluğunu gösteren yazın bulguları üzerine, "arada kalmış" PANDAS hastalarını karşılamak için yeni tanımlanmış PANS (Pediatrik Akut başlangıçlı Nöropsikiyatrik Sendrom) ve CANS (Çocukluk çağı Akut Nöropsikiyatrik Sendrom) sınıflandırmaları oluşturulmuştur. PANS ve CANS ani başlangıçlı OKB ve/veya tik bulgularıyla ilişkili psikiyatrik bulguları içermekte fakat herhangi bir enfeksiyon etkeninin, immün disfonksiyonun ya da çevresel tetikleyicilerin tanımlanmasına ihtiyaç duymamaktadırlar. Biz bu yazıda enfeksiyon sonrası ani başlangıçlı kaygı, obsesyon, vokal tik geliştiren bir olgu üzerinden PANS/CANS tanısını tartışmayı amaçladık. PANDAS sınıflama kriterlerinin gelişimini ve "arada kalmış" PANDAS hastalarının hangi tanı başlığında sınıflandırılabileceğini tartıştık.Öğe The Psychometric Properties of Turkish Version of Autism Spectrum Screening Questionnaire in Children aged 6-18 years(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2017) Kose, Sezen; Ozbaran, Burcu; Yazgan, Yanki; Baytunca, Muharrem Burak; Bildik, Tezan; Erermis, Serpil; Aydin, CahideObjective: The objective of this study is to determine the psychometric properties of the Turkish version of the Autism Spectrum Screening Questionnaire (ASSQ-TR) and to find the best cutoff score for Pervasive Developmental Disorder (PDD) cases. Method: Children between 6 to 18 years old with diagnoses of PDD, Obsessive Compulsive Disorder (OCD), and Attention Deficit Hyperactivity Disorder (ADHD) were included. The healthy control (HC) group was recruited from children who did not have any psychiatric complaints or history. Furthermore, parents of 268 children filled the ASSQ-TR. Of the children, 51 were PDD, 67 were ADHD, 50 were OCD, and 100 were HC. In order to show the reliability of the ASSQ-TR, Cronbach's alpha values and test-retest were evaluated. ROC analyses was carried out to show concurrent validity and to determine the cutoff score. Results: The Cronbach's alpha of ASSQ-TR is 0,86, while the test retest reliability is r: 0,98. Total ASSQ-TR scores of children with PDD (27,96 +/- 9,5) were significantly higher than other groups (p<0,001). ROC analysis of ASSQ-TR showed the area under curve to be 0,97 with a cutoff of 16, having the maximum sensitivity (94,1%), specificity (89,0%), and 90,7% diagnostic accuracy of PDD versus HC scores. Conclusions: Our pilot data showed that ASSQ-TR is a reliable instrument that successfully differentiates clinically diagnosed PDD from HC. This instrument might therefore be useful for the screening of PDD in school-aged children in Turkish populations.Öğe Reply to comments on "A pilot study assessing retinal pathology in psychosis using optical coherence tomography: Choroidal and macular thickness" Reply(Elsevier Ireland Ltd, 2019) Baytunca, Muharrem Burak; Inci, Sevim Berrin; Ercan, Eyup SabriÖğe Risperidone, quetiapine and chlorpromazine may have induced priapism in an adolescent(Wiley-Blackwell, 2016) Baytunca, Muharrem Burak; Kose, Sezen; Ozbaran, Burcu; Erermis, SerpilPriapism is the prolonged, painful erection of penile tissue not accompanied by sexual arousal. Priapism has been established as a rare adverse drug reaction to drugs such as antipsychotics, psychostimulants, antidepressants, and mood stabilizers. Immediate intervention is needed to prevent destructive and irreversible complications, such as erectile dysfunction, disfigurement, inability of the penis to stay erect, and related social/emotional problems. Antipsychotic-induced priapism may result from the alpha receptor occupancy property of those drugs. We report the case of a 13-year-old suffering from attention deficit-hyperactivity disorder plus conduct disorder with priapism related to antipsychotics. Episodes occurred with risperidone plus methylphenidate, quetiapine plus methylphenidate, and chlorpromazine alone.
