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Öğe Child and Adolescent Forensic Psychiatry Experiences During the COVID-19 Pandemic(Galenos Publ House, 2022) Pilan, Birsen Senturk; Kaleli, Ipek Inal; Erermis, Serpil; Kaya, Ahsen; Kose, Sezen; Ozbaran, Burcu; Bildik, TezanObjective: Coronavirus disease-2019 (COVID-19) changed the status-quo in psychiatric interview with the advent of telemental health practices, save for a select group of patients; forensic psychiatric interviews among them. The present study aimed to identify the predictors of completing forensic psychiatric evaluations mandated by the judicial authorities in the hospital setting during the COVID-19 outbreak. Method: Twenty-six patients who had completed an initial forensic psychiatric assessment and were required to complete a child and adolescent forensic psychiatry board interview during the height of the COVID-19 pandemic were recruited. Their records were retrospectively examined, sociodemographic data, Beck Depression Inventory (BDI), the Screen For Child Anxiety Related Disorders (SCARED), and Wecshler Intelligence Scale for Children-revised scores were recorded and analyzed. Results: Statistical analysis revealed an association between conduct disorder and concomitant substance use with missed appointments, and maternal employment and completed interviews. BDI and SCARED total scores showed no difference between the patients who missed or completed their mandatory forensic psychiatry board assessment. BDI individual items of loss of pleasure (item 4), suicidality (item 9), and loss of interest (item 12) were associated with missed appointments. Conclusion: The results of this study support the established relationship between conduct problems and depressive symptoms, and this demographic group may be among the most affected by the limitation of access to mental health services during the COVID-19 pandemic, as they are already less likely to seek help overall.Öğe COVID-19-Related Stigma and Mental Health of Children and Adolescents During Pandemic(Sage Publications Inc, 2022) Ozbaran, Burcu; Turer, Furkan; Yilancioglu, Hazal Y.; Kose, Sezen; Pilan, Birsen Senturk; Guzel, Ozge; Baskol, DilsahThis cross-sectional study aimed to evaluate depression and anxiety symptoms of the children/grandchildren of COVID-19 patients, children/grandchildren of healthcare workers who have not infected COVID-19, and children/grandchildren of the control group. Parent and children's perception about COVID-19-related stigma is also investigated and compared between groups. The perception about COVID-19-related stigma between different age and gender groups among children also investigated and compared. The mental health of the 71 participants aged 6-18 years was evaluated via a telemedicine-based semi-structured interview between March and April 2020. Children's Depression Inventory (CDI), the Screen for Child Anxiety-Related Emotional Disorders (SCARED), and COVID-19-Related Stigma Form were administered to the participants. A significant negative correlation was found between age and separation anxiety disorder (p = .005) and a significant positive correlation was found between age and generalized anxiety disorder (p = .035) in the SCARED-Child report. Generalized anxiety disorder was found to be higher in females compared to males. A significant difference was found between the groups of parents in the COVID-19-Related Stigma Form. Patients infected with COVID-19, healthcare workers, and the control group have different perceptions about COVID-19-related stigma. The age of the children have an impact on stigma perceptions. Anxiety symptoms of children affected by age and gender. Future studies are recommended to determine the other factors associated with perceptions about COVID-19-related stigma among children and parents.Öğe The Effect of The Covid-19 Pandemic On The Adaptation Process and Psychiatric Symptoms of Children Aged 7-12: A Telemedicine Study(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2021) Pilan, Birsen Senturk; Erermis, Serpil; Calisan, Reyhan; Yulug, Begum; Tokmak, Sibel Helin; Kose, Sezen; Ozbaran, BurcuObjective: The aim of the presented study is to evaluate the adaptive process and psychiatric symptoms in the 7-12 age group followed-up with telemedicine interviews during the height of the pandemic. Method: Patients between the ages of 7-12 who were followed up in our outpatient clinic were called by telemedicine service at the appointment date. The questionnaire prepared by the researchers in order to investigate the adaptation process to the pandemic was administered, the answers provided by the patients and their families were recorded in the case data form together with Clinical Global Impression (CGI) Scale score appraised by the interviewing psychiatrist. Medical records pertaining to each patient were also reviewed, their psychiatric diagnoses, according to DSM 5 criteria and CGI scores recorded in their last face-to-face interviews during the pandemic period, were included in the case data form. Results: Fifty patients were included in the study. The mean age of the participants was 9.14 +/- 1.61 years. Attention deficit hyperactivity disorder (60%) was the most common psychiatric diagnosis detected in the participants before the pandemic, followed closely by anxiety and related disorders (20%) and specific learning difficulty (16%). The CGI scores of the cases before, and during the pandemic were 2.72 +/- 0.75, and 2.92 +/- 0.94, respectively. The difference between the mean scores was statistically significant (p=0.024). Conclusion: Our study emphasizes the importance of follow-up by telemental health practices in cases where face-to-face psychiatric interviews are not applicable, i.e., due to the risk of transmission of COVID-19 disease during the current pandemic.Öğe An Evaluation of Quality of Life in Children and Adolescents in an Inpatient Oncology Unit: A 6-month Follow-up Study(Galenos Publ House, 2024) Pilan, Birsen Senturk; Kaleli, Ipek Inal; Erermis, Serpil; Kantar, Mehmet; Ataseven, Eda; Ozbaran, Burcu; Bildik, TezanAim: Childhood cancers are life-threatening diseases which are universally distressing and potentially traumatic for children and their families at the time of diagnosis, during treatment, and beyond. Materials and Metkods: Thirty-nine child patients between the ages of 0-18 years receiving treatment in a pediatric oncology hospital for various pediatric cancers who consented to participate in this study were recruited. The participants were assessed via Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition/KSADS-PL-DSM-5 for ages 6-18 by a trained and certified child and adolescent psychiatrist. The clinical assessments of patients aged 0-5 years were completed by a trained child and adolescent psychiatrist in agreement with the DSM-5 and the standard principles of psychiatric interview for the pediatric population. The previous and current psychiatric diagnoses of the participants were recorded. The Quality-of-Life Scale for Children was administered to the participants and their caregivers at the first interview and at the 6th month of follow-up. Results: While no significant differences were observed in the quality of life of children with a novel pediatric cancer diagnosis and children with cancer recurrence/ongoing treatment per their own reports, the parents reported significant improvement in the quality of life of those children who had a novel cancer diagnosis after six months. Conclusion: The parents' and their children's reports were highly correlated, and this association remained significant in multiple linear regression analyses for both the initial interviews and the follow-ups. The parents' reports on their children's quality of life appear to be reliable in accurately predicting their children's quality of life in the clinical setting.Öğe Evaluation of the Cases who Applied to University Hospital Child and Adolescent Mental Health Committee Because of Sexual Abuse(Galenos Publ House, 2021) Pilan, Birsen Senturk; Erermis, Serpil; Ozcan, Tugce; Calisan, Reyhan; Barankoglu, Ilayda; Kaya, Ahsen; Senol, EnderObjective: The aim of this study was to examine the sociodemographic characteristics, psychiatric diagnoses and factors associated with psychiatric diagnoses of children and adolescents who are victims of sexual abuse. Method: The files of 92 children and adolescents aged between 0-18 who were referred to University Hospital Child and Adolescent Psychiatry Forensic Policlinic between January 2017 and December 2019 due to sexual abuse were evaluated retrospectively. Psychiatric diagnoses of the cases were made according to DSM 5 diagnostic criteria. Intellectual capacity of the cases was evaluated according to the latest verison of Wechsler Intelligence Scale for Children. Results: In our study, 78 (84.8%) cases were female and 14 (15.2%) were male. Mean age of the cases was 14.1 +/- 3.88 years. The most common type of sexual abuse was touching (52.2%, n=48). There was a psychiatric diagnose in 50 (54.3%) of them. The most common psychiatric diagnoses were posttraumatic stress disorder (n=29, 31.5%) and major depressive disorder (n=25, 27.2%). The rate of psychiatric diagnosis was significantly higher in cases exposed to coercion and violence (p=0.032). In 32 cases (34.8%), it was determined that the abuser was within the family. Conclusion: Sexual abuse has an effect on child's development throughout life.In our study, the rate of psychiatric diagnosis was high. It is very important to provide the necessary psychiatric support to the victims of sexual abuse. With the studies to be done in this area, awareness can be increased and necessary precautions can be taken.Öğe The impacts of COVID-19 pandemic on children with neurodevelopmental disorder(Klinik Psikiyatri Dergisi, 2021) Kose, Sezen; Yuksel, Gamze; Pilan, Birsen Senturk; Tortop, Elif; Anilir, Gokce; Calisan, Reyhan; Yulug, BegumObjective: In this study, we aimed to evaluate the impact of Covid-19 pandemic on children with neurodevelopmental disorders through Tele-Medicine system. Method: Children aged between 7-18 years old with neurodevelopmental disorders were evaluated. On the routine control visit day, they and their parents were called by phone via the Tele-Medicine system and a questionnaire prepared by the researchers was applied to evaluate the compliance process to the pandemic. The disease severity of the cases was evaluated by the Clinical Global Impression Scale. Results: In our study, 17.6% of the cases were girls and 82.4% were boys. The average age is 11.66 +/- 3.46 years. In this study 51% of the cases were diagnosed with Autism Spectrum Disorder; 47.1% with Intellectual Disability and 17.6% with Special Learning Disorder. The comorbidity of Attention Deficit and Hyperactivity Disorder was found to be 49%. Increased anxiety is reported by 25.5% of the cases, appetite and nutritional problems by %37.3 and sleep pattern changes by 62.7%. Pre-pandemic score of Clinical Global Impression Scale was evaluated as 3.82 +/- 0.81, and the score during the pandemic as 4.09 +/- 0.87. Discussion: It was found that, in the early period of the Covid-19 pandemic, the most common problems of the cases with neurodevelopmental disorder were the sleep pattern changes, appetite and nutritional problems and increased anxiety. It is thought that our findings will guide psychosocial support interventions for children and adolescents with developmental problems during the pandemic.Öğe Parental alienation syndrome: A case alienated from the mother(Klinik Psikiyatri Dergisi, 2022) Pilan, Birsen Senturk; Akkas, Oyku; Er, Gokul; Bayturan, Ali Fuat; Akdas, Gizem; Bildik, TezanParental alienation syndrome is a clinical condition in which the child is consciously and programmatically alienated from one parent by the other parent, constantly subjected to an unfair defamation campaign against the target parent. Despite the definition of clinical features, there is serious debate about the validity and reliability of this syndrome. Therefore, it is not included in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5) and International Classification of Diseases 11 (ICD 11). With the increase in divorce and custody cases, this syndrome is encountered more and more, but it is not sufficiently recognized and often overlooked by mental health professionals, forensic experts, judges and prosecutors. In this case report, an 8-year-old girl who was alienated from her mother by her father is presented and parental alienation syndrome is discussed.Öğe The prevalence and risk factors for overweight/obesity among Turkish children with neurodevelopmental disorders(Pergamon-Elsevier Science Ltd, 2021) Kose, Sezen; Kafali, Helin Yilmaz; Idris, Zeynep Gokce Erkan; Pilan, Birsen Senturk; Ozbaran, Burcu; Erermis, SerpilObjective: To compare the prevalence and correlates of overweight (OW) and obesity (OB) between autism spectrum disorder (ASD), intellectual disability (ID), and attention deficithyperactivity disorder (ADHD) and to investigate which variables significantly contribute to OW/OB in each group. Methods: Of 267 cases (96 with ASD, 80 with ID, and 91 with ADHD) aged 2-18 years, body mass index (BMI) percentiles, birth weight, food reward usage, weekly screen and physical activity time, and psychotropics used were recorded. Results: OB (OB + OW) prevalence was 22.9 % (36.4 %) in ASD; 22.5 % (40 %) in ID; and 17.6 % (27.5 %) in ADHD. Although the ADHD group had the highest rate of stimulant usage (chi 2 = 69.605, p < 0.001), physical activity attendance (chi 2 = 49.751, p < 0.001), and the lowest anti-psychotic (chi 2 = 69.142, p < 0.001), and anti-depressant usage (chi 2 = 7.219, p < 0.001) than ID/DD or ASD, BMI percentile of the participants did not differ between the groups (H(2) = 1.652, p = 0.43). In hierarchical logistic regression analysis, in ASD, food reward (OR = 4.65, 95 %Cl = 1.25-17.19) and the number of psychotropics used (OR = 2.168, 95 %Cl = 1.07-4.36) were significantly related to the risk of OW/OB. In ADHD, each drugs administered and a 1-kilogram elevation in birth weight was associated with a 4.09 and 2.82 increased risk for OW/OB. Conclusion: OW/OB is prevalent in children with neurodevelopmental disorders regardless of their diagnosis. Our findings showed that food rewards put a higher risk for OW/OB in ASD than administering a psychotropic. It could be better to use other positive reinforcements other than edible ones to prevent OW/OB in these children.Öğe Psychiatric view for disorders of sex development a 12-year experience of a multidisciplinary team in a university hospital(Walter De Gruyter Gmbh, 2020) Pilan, Birsen Senturk; Ozbaran, Burcu; Celik, Didem; Ozcan, Tugce; Ozen, Samim; Goksen, Damla; Ulman, IbrahimBackground: Psychiatric consultation is important in the follow-up of disorders of sex development (DSD) patients. in this study, we aimed to present the 12-year psychiatric follow-up data of the patients who were referred by Ege University Medical Faculty DSD Multidisciplinary Team and followed up in Child and Adolescent Psychiatry. Methods: Psychiatric data of 118 patients, who were followed by the DSD multidisciplinary team between 2007 and 2019, were reviewed retrospectively. the psychiatric diagnoses of the patients were evaluated according to semi-structured interview form Schedule for Affective Disorders and Schizophrenia for School-Age Children/ Present and Lifetime Turkish Version. Results: the mean age of the 118 cases was 13.21 years (+/- 7.18). Endocrine diagnoses of the cases were 46 XX DSD in 35 (29.6%), 46 XY DSD in 81 (68.7%), and chromosome disorders in 2 (1.7%). There was at least psychiatric diagnosis in 36 (30.5%) cases. the most common psychiatric diagnosis was attention deficit and hyperactivity disorder (ADHD) (n=18, 15.3%). ADHD was most common in congenital adrenal hyperplasia (n =4, 22.4%) and androgen synthesis defects (ASD) (n= 4, 22.4%); depression was most common in complete gonadal dysgenesis and ASD n=3, 23.1%); and mental retardation was most common in ASD (n = 3, 37.5%). Conclusions: in order to provide a healthy perspective for cases with DSD, it is important to make a psychiatric evaluation and to share observations and clinical findings in regular team meetings.Öğe The psychosocial outcomes of advanced hybrid closed-loop system in children and adolescents with type 1 diabetes(Springer, 2024) Jalilova, Arzu; Pilan, Birsen Senturk; Demir, Gunay; Ozbaran, Burcu; Balki, Hanife Gul; Arslan, Emrullah; Kose, Sezen GokcenThe study was carried out to determine the psychosocial outcomes of advanced hybrid closed-loop (AHCL) systems in children and adolescents with type 1 diabetes (T1D). Single-center and cohort study with a duration 6 months consisted of 60 children and adolescents with T1D. Standard clinical procedures, including both glycemic indicators, e.g., sensor-measured time within the 70-180 mg/dL range and glycated hemoglobin (HbA1c) levels, and psychosocial metrics were used for data collection. The psychosocial metrics included the Pediatric Quality of Life Inventory (PedsQL) 3.0 Diabetes Module for both children (8-12 years) and parents; the Quality of Life for Youth scale for adolescents (13-18 years); the Strengths and Difficulties Questionnaire (SDQ); the Hypoglycemia Fear Survey for Children (HFS-C); the Revised Child Anxiety and Depression Scale (R-CADS); and AHCLS-specific DTSEQ satisfaction and expectation survey. These metrics were evaluated at the baseline and after 6 months of AHCL use. Of the 60 children and adolescents with T1D for whom the AHCL system was utilized, 41 of them, 23 female and 18 male, completed the surveys. The mean age of the 41 children and adolescents was 12.5 +/- 3.2 (min. 6.7, max. 18) years. The time spent within the target glycemic range, i.e., time-in-range (TIR), improved from 76.9 +/- 9% at the baseline to 80.4 +/- 5% after 6 months of AHCL system use (p = 0.03). Additionally, HbA1c levels reduced from 7.1% +/- 0.7% at the baseline to 6.8% +/- 0.8% after 6 months of AHCL system use (p = 0.03). The most notable decline in HbA1c was observed in participants with higher baseline HbA1c levels. All patients' HFS-C and AHCL system-specific DTSEQ satisfaction and expectation survey scores were within the normal range at the baseline and remained unchanged during the follow-up period. No significant difference was found in the R-CADS scores of children and adolescents between baseline and after 6 months of AHCL system use. However, there was a significant decrease in the R-CADS scores of the parents. Patients' PedsQL scores were high both at the baseline and after 6 months. The SDQ scores were high at baseline, and there was no significant improvement at the end of 6 months. Conclusion: This is the first study to investigate in detail the psychosocial outcomes of AHCL system use in T1D patients and their parents. Although state-of-the-art technologies such as AHCL provide patients with more flexibility in their daily lives and information about glucose fluctuations, the AHCL resulted in a TIR above the recommended target range without a change in QOL, HFS-C, SDQ, and R-CADS scores. The scores obtained from the R-CADS conducted by the parents of the children indicated that the use of pumps caused a psychological improvement in the long term, with a significant decrease in the R-CADS scores of the children and adolescents with T1D. What is Known: center dot Previous studies focused on clinical outcomes of AHCL systems in pediatric T1D patients, showing glycemic control improvements. center dot Limited attention given to psychosocial outcomes of AHCL systems in children and adolescents with T1D. center dot Crucial psychosocial factors like quality of life, emotional well-being, and fear of hypoglycemia underexplored in AHCL system context. What is New: center dot First study to comprehensively examine psychosocial outcomes of AHCL systems in pediatric T1D patients. center dot Study's robust methodology sets new standard for diabetes technology research and its impact on qualiy of life.Öğe Quality of Life and Psychological Well-being in Children and Adolescents with Disorders of Sex Development(Galenos Yayincilik, 2021) Pilan, Birsen Senturk; Ozbaran, Burcu; Celik, Didem; Ozcan, Tugce; Ozen, Samim; Goksen, Damla; Cogulu, OzgurObjective: The aim of this study was to assess the quality of life (QoL) and psychological well-being in child and adolescent with disorders of sex development (DSD). Methods: Sixty-two cases, aged 2-18 years, who were followed by a multidisciplinary DSD team were included. All participants and their parents were requested the complete the Pediatric Quality of Life Inventory (PedsQL) and the Strengths and Difficulties Questionnaire. The psychiatric diagnoses of the patients were evaluated according to Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Turkish Version. Results: There was no significant difference between the 46,XX DSD and 46,XY DSD groups for both child and parent in Total PedsQL score. in the subscale scores, the PedsQL Physical Functionality Score reported by children was significantly lower for the 46,XX DSD group than for the 46,XY DSD group (p=0.01). There was a psychiatric diagnosis in 25.8% of cases. The PedsQL School Functionality Score reported by children in the group with psychiatric diagnosis was significantly lower than the group without psychiatric diagnosis (p=0.018). in the group with psychiatric diagnosis, the PedsQL Total Score and the subscale scores (Emotional Functionality Score, Social Functionality Score, School Functionality) reported by parents were significantly lower than in parents of the group without psychiatric diagnosis. Conclusion: This study emphasized that psychiatric disorders in DSD patients negatively affect the QoL. Psychiatric support and counseling from a multidisciplinary team are very important for families affected by DSD.Öğe Telemental Health Assessment of Adolescents During the COVID-19 Pandemic: A Follow-up Study(Galenos Publ House, 2023) Pilan, Birsen Senturk; Kaleli, Ipek Inal; Cek, Didem; Ozcan, Tugce; Azizov, Faig; Huseynova, Samira; Cengiz, GizemAim: This study aimed to understand how the pandemic has affected the mental health of adolescents with a previous psychiatric diagnosis.Materials and Methods: Fifty-nine patients aged 12-18 years who had been previously followed up in the adolescent mental health unit were included in this study. The participants were interviewed via telephone between June-July, 2020 and December, 2020-January 2021. Their socio-demographic data, psychiatric diagnoses and the previous Clinical Global Impression (CGI) scores were obtained from the patient files. The clinical global follow-up scale was scored by the interviewing physician.Results: Past CGI scores before the pandemic were significantly greater for those participants with more than one psychiatric condition (p=0.024). For those participants with more than one psychiatric condition, the difference between the CGI scores prior to the pandemic and during the early stages of the pandemic were significant (p=0.004). The total satisfaction scores for telepsychiatry services assessed via the telemedicine evaluation form were statistically higher for those participants with a single psychiatric disorder (p=0.023). The past and early pandemic CGI scores were found to be inversely correlated with the telemedicine evaluation form with r=-0.338, p=0.019, r=-0.353 p=0.014, respectively. Conclusion: The present study offers a perspective for adolescent mental health during the pandemic, underlining the importance and caveats of healthcare delivery to the youth with mental health problems during lockdown.