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Öğe Are adolescents with social anxiety disorder in danger of peer bullying?(2024) Sireli, Ozlem; Ucuz, Ilknur; Cicek, Ayla Uzun; Abanoz, Elif; Arslan, Semiha ComertogluAim: This study aimed to assess the rates of peer bullying and stress-coping strategies in adolescents with SAD and to investigate the relationship between SAD and different types of peer bullying. Materials and Methods: This cross-sectional study included ninety-two adolescents aged 14 to 17 years with SAD and one hundred-five typically developing adolescents. A semi-structured psychiatric interview, the Social Anxiety Scale for Adolescents (SAS-A), the Peer Bullying Scale-Adolescent Form (PBS-AF), and the Coping Scale for Adolescents (CSA) were applied to all participants. Peer bullying was classified into six types (physical, verbal, exclusion, spreading rumors, attacks against property, and sexual) and two roles (bullying and victimization). Results: On every subscale of the PBS-AF victimization dimension, the SAD group’s mean scores were significantly higher than those of the controls. Regarding the PBSAF bullying dimension, the Physical Bullying and Sexual Bullying scores of the SAD group were significantly lower than the control group, but the Isolation/ Exclusion scores were significantly higher than the control group. Compared to the control group, the mean scores of Active Coping of CSA were significantly lower, while the mean scores of Negative Coping and Avoidant Coping were significantly higher in the SAD group. The SAS-A’s total score had a significant positive correlation with all subscales of the PBS-AF victimization dimension. Age, gender, academic performance, and psychiatric comorbidity had a predictive effect on some of the victimization dimension variables of peer bullying. Conclusion: This study has revealed that SAD is an important risk factor for peer victimization. The routine psychiatric examination of adolescents with SAD should also include a screening for peer bullying.Öğe Can Temperament and Character Traits Be Used in the Diagnostic Differentiation of Children With ADHD?(Lippincott Williams & Wilkins, 2021) Ucuz, Ilknur; Cicek, Ayla Uzun; Cansel, Neslihan; Kilic, Bahar; Colak, Cemil; Yazici, Ipek Percinel; Kilic, FatmaIn this study, it was aimed to determine the contributions of temperament and character traits to the diagnosis of attention deficit hyperactivity disorder (ADHD) in children. Thirty-six patients between the ages of 9 and 14 with a diagnosis of combined type ADHD and 39 healthy children were included in the study. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Version and the Turgay DSM-IV Disruptive Behavior Disorders Rating Scale parent form were used to assess hyperactivity/impulsivity and inattentiveness, and comorbid disorders. The Junior Temperament and Character Inventory-Revised form was used to evaluate temperament-character traits. The classification-based association rules (CBARs) method was used for finding rules predicting ADHD accurately. Low persistence and self-directedness scores, and higher disorderliness and fatigability subgroup scores were found in the ADHD group. In CBARs, the separation of children with ADHD from healthy controls could be made with 0.83 accuracy, 0.80 sensitivity, and 0.86 specificity. The results of our study support the view that temperament-character traits can help clinical diagnosis of ADHD.Öğe Determining the probability of juvenile delinquency by using support vector machines and designing a clinical decision support system(Churchill Livingstone, 2020) Ucuz, Ilknur; Cicek, Ayla Uzun; Ari, Ali; Ozcan, Ozlem Ozel; Sari, Seda AybukeIt is a known fact that individuals who engaged in delinquent behavior in childhood are more probable to carry on similar behavior in adulthood. If the factors that lead children to involve in delinquency are defined, the risk of dragging children into crime can be detected before they are involved in crime and delinquency can be prevented with appropriate preventive rehabilitation programs, in the early period. However, given that delinquent behavior occurs under the influence of multiple conditions and factors rather than a single risk factor; the need for diagnostic tools to evaluate multiple factors together is obvious. Artificial intelligence-based clinical decision support systems have already been used in the field of psychiatry as well as many other fields of medicine. In this study, we assume that thanks to artificial intelligence-based clinical decision support systems, children and adolescents at risk can be detected before the criminal behavior occurs by addressing certain factors. In this way, we anticipate that it can provide psychiatrists and other experts in the field.Öğe Does Involvement in Peer Bullying Invite Self-Injury? The Association Between Peer Bullying and Self-Injury in a Clinical Sample(Lippincott Williams & Wilkins, 2023) Cicek, Ayla Uzun; Ucuz, Ilknur; Sari, Seda Aybuke; Arslan, Semiha Comertoglu; Dogru, HicranPrevious studies have linked peer bullying to nonsuicidal self-injury (NSSI). However, the evidence is largely limited to population-based groups. This study examined whether there is a relationship between NSSI and being a victim of peer bullying among adolescents in a clinical sample and how this may be influenced by types of bullying. The sample consisted of 96 outpatients with NSSI and 107 healthy adolescents. The Inventory of Statements About Self-Injury, Peer Bullying Scale, and Rosenberg Self-Esteem Scale were applied. Whereas the scores of each bullying type of adolescents with NSSI were significantly higher, their self-esteem scores were significantly lower. Each victimization score of bullying had a negative correlation with NSSI-onset age and self-esteem scores and a positive correlation with self-injury scores. This study demonstrated that being a victim of any type of bullying is strongly associated with self-injury. It would be advisable to screen adolescents with self-injury for exposure to bullying, and vice versa.Öğe Emotional Dysregulation and Temperament-Character Traits in Adolescents With Functional Neurological Symptom Disorder (Conversion Disorder)(Lippincott Williams & Wilkins, 2024) Ucuz, Ilknur; Cicek, Ayla Uzun; Celik, Merve Komurcu; Akan, Mustafa; Kesriklioglu, Esma; Gungor, Serdal; Ozcan, Ozlem OzelThe purpose of this study was to evaluate emotion dysregulation and temperament-character traits in adolescents with functional neurological symptom disorder (FNSD). Forty adolescents with FNSD and 40 healthy adolescents were evaluated by a semiconstructed diagnosis interview, Temperament and Character Inventory (TCI), Difficulties in Emotion Regulation Scale (DERS), Regulation of Emotions Questionnaire (REQ), and Children's Somatization Inventory-24 (CSI-24). The external and internal dysfunctional emotion regulation scores of REQ, all subscales of DERS, except the awareness subscale, and CSI-24 scores were significantly higher in FNSD patients compared with healthy controls. There were significant differences between the groups in terms of harm avoidance and reward dependence subscale scores of TCI. Multiple logistic regression analysis showed that the external dysfunctional emotion regulation strategy, somatization, and reward dependence are significant predictors of FNSD. Our results provide evidence that adolescents with FNSD experience emotional dysregulation and that the differential value of some temperament-character traits in the diagnosis of FNSD.Öğe Evaluation of cognitive disengagement syndrome in children with obsessive-compulsive disorder: Clinical implications(Sage Publications Inc, 2023) Cicek, Ayla Uzun; Ucuz, Ilknur; Isik, Cansu Mercan; Temelli, GurkanCognitive disengagement syndrome (CDS) has been found to be associated with internalizing symptoms. Yet, no study thus far has focused on whether there is an association between obsessive-compulsive disorder (OCD) and CDS. The purpose of this study is to examine the symptom frequency and clinical implications of CDS in children with OCD. The study included sixty-one children with OCD and sixty-six typically developing children. Children were evaluated by a semi-constructed diagnosis interview, Obsessive-Compulsive Inventory, Barkley Child Attention Scale, and Stroop test. The frequency of elevated symptoms of CDS, and total time, total error, and total correction scores of the Stroop test were significantly higher in the OCD group compared to the controls. Elevated CDS symptoms were significantly associated with higher OCD symptom prevalence and poorer performance on the Stroop Test. Moreover, poor insight, hoarding symptoms, mental compulsions, and ADHD comorbidity were significantly higher in those with elevated CDS symptoms than in those without CDS in the OCD group. The findings of this study provide clinical implications that CDS symptoms may contribute to deficits in attentional orientation, conceptual flexibility, and cognitive processing speed in OCD.Öğe Investigation of Clinical Features and Comorbid Psychopathologies of Children with Sleep Terrors(2024) Cicek, Ayla Uzun; Abanoz, Elif; Ucuz, İlknur; Naralan, Yüksel Sümeyra; Şireli, ÖzlemGiriş ve Amaç: Bu çalışmada, uyku terörü tanısı konulan çocukların uyku ortamı ve uyku alışkanlıkları, eşlik eden psikiyatrik bozukluklar, diğer parasomnialar ve tedavi geçmişi dahil klinik özelliklerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, 2020-2024 yılları arasında 3 farklı Çocuk ve Ergen Psikiyatri polikliniğinde DSM-5 tanı kriterlerine göre uyku terörü tanısı konulmuş 51 çocuk dahil edilmiştir. Olguların sosyodemografik ve klinik özellikleri geriye dönük olarak dosya üzerinden incelenmiştir. Bulgular: Of the 51 participants, 30 (58.8%) were male, 21 (41.2%) were female and the mean age at the time of admission was 6.76±1.45 years (min-max: 3-10 years). Olguların15’inin (%29.4) gürültülü bir ortamda uyduğu, 41’inin (%80,4) uyku terörü atağı dışında uykularının kesintiye uğradığı belirlenmiştir. 17’sinde (%33,3) en az bir psikiyatrik bozukluk saptanmış olup, en sık [n=5 (%9,8)] komorbid psikiyatrik bozukluk dikkat eksikliği hiperaktivite bozukluğudur. 14’ünde (%27,5) diğer parasomnilerin eşlik ettiği belirlenmiştir. Olguların klinik özellikleri yaş grubuna göre karşılaştırıldığında, okul öncesi dönemdekilerde tam retrograd amnezinin, okul çağındakilerinde ise atak sırasındaki motor aktivitenin, bedensel yaralanma ve/veya maddi hasarın, atak esnasında tam uyanmanın anlamlı olarak yüksek olduğu saptanmıştır. Ebeveynlerin %64,7’sinin atak esansında yanlış müdahalede bulunduğu, olguların %29,4’ünde, tedavi geçmişinde yanlış ilaç uygulandığı belirlenmiştir. Sonuç: Çocukluk dönemi uyku teröründe, tanısal değerlendirme sürecinde olası tetikleyici etmenlerin tespiti, eşlik eden psikiyatrik bozuklukların saptanması, tedavide ebeveynlerin psikoeğitimi, gerekli olduğu durumlarda medikasyonda uygun ilaç seçimi oldukça önemlidir.Öğe Prevalence of psychiatric comorbidity and related variables in children with specific learning disabilities(Cukurova Univ, Fac Medicine, 2024) Akkus, Serdar; Cicek, Ayla Uzun; Ucuz, Ilknur; Isik, Cansu MercanPurpose: Psychiatric comorbidity is more common in specific learning disabilities (SLDs) than in the general population. It is extremely common. Psychiatric disorders associated with SLD cause more cognitive, social, and emotional difficulties, further impair functionality and worsen prognosis. This study aimed to examine the frequency of psychiatric comorbidity and the sociodemographic characteristics and clinical variables associated with comorbidity in children with SLD. Materials and Methods: This study included 226 children and adolescents aged 7-17 years who were diagnosed with specific learning disabilities and who applied to our outpatient clinic between March 2021 and August 2021. A battery of tests was administered to all participants, including the Reading Test, Writing Test, Mathematics Test, Clock Drawing Test, Head Right-Left Discrimination Test, and Bender Gestalt Visual-Motor Perception Test. In addition, the Kent-EGY Test-Porteus Maze Test (PMT) or the Weschler Intelligence Scale for Children (WISC-R) were administered. A semi-structured diagnostic interview was conducted with the participants and their parents to investigate the presence of any psychopathology in the past and present (Turkish version of the Turkish version of the Schedule for the Interview for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (DSM-5-K-SADSPL-DSM-5-T) was applied. Results: There was at least one comorbid psychiatric disorder in 81.4% of the participants. The most common comorbid disorder was attention deficit hyperactivity disorder, with a frequency of 73.5%. Other common disorders were disruptive behavior disorders, elimination disorders, anxiety disorders, depressive disorders, and tobacco use disorders. Severe types of SLD were more common in those with psychiatric comorbidities, and the mean age was significantly higher than in those without. Conclusion: Being aware of the psychiatric comorbidity that children with SLD are called to face is essential for drawing up proper standards of assessment, hence ensuring these children have personalized psychiatric care and enhancing their quality of life.Öğe Sociodemographic variables, clinical characteristics, and treatments in children with trichotillomania in terms of age and gender: a multicenter study(Taylor & Francis Ltd, 2023) Arslan, Semiha Comertoglu; Cicek, Ayla Uzun; Ucuz, Ilknur; Dogru, HicranObjective Although trichotillomania (TTM) is a common, typically pediatric-onset disorder, data on the phenomenology of TTM in children, accompanying comorbid psychiatric disorders, and treatment options are extremely limited. In our study, it was aimed to investigate these variables and related factors in patients undergoing psychiatric evaluation and follow-up. Method The study included 79 children and adolescents between the ages of 4 and 17 who were diagnosed with TTM and followed up in four different Child and Adolescent Psychiatry outpatient clinics between 2015 and 2020. The sociodemographic characteristics of these patients, clinical features of the disease, comorbid psychiatric disorders, and treatment approaches have been studied. Results Our results showed that TTM was more common in girls, hair and eyebrow plucking was the most common, and symptoms and features accompanying TTM changed with age, but not with gender. Again, 79.7% of these children had at least one psychiatric comorbid disorder (most common being anxiety disorders and Attention Deficit/Hyperactivity Disorder), comorbidity was closely related to TTM severity, 93.7% used at least one pharmacotherapeutic agent, and positive response rates to treatment were found to be low. Moreover, TTM severity was found to increase with age and disease duration. Conclusion Study findings support that clinical presentation, disease severity and comorbidity rates may change with age in children and adolescents with TTM, and early intervention is important to prevent clinical progression/worsening and mental health sequela.Öğe Uyaran Eksikliği Belirleme Ölçeği-Ebeveyn Formunun geliştirilmesi: Psikometrik değerleri(2025) Sarıçam, Hakan; Cicek, Ayla Uzun; Abanoz, Elif; Ucuz, İlknur; Korğalı, Elif Ünver; Cömertoğlu Arslan, Semiha; Işık, Cansu MercanAmaç: Türkiye’de uyaran eksikliğini belirlemeye ve değerlendirmeye yönelik psikometrik bir ölçek veya ölçüm aracı bulunmamaktadır. Bu çalışmanın amacı uyaran eksikliği için değerlendirme ölçeği geliştirilmesi ve psikometrik özelliklerinin belirlenmesidir. Bu amaç doğrultusunda Uyaran Eksikliği Belirleme Ölçeği-Ebeveyn Formu (UEBÖ-EF) oluşturulmuş ve kapsam geçerliği, yapı geçerliği, ölçüt geçerliği, iç tutarlık ve madde analizi ile psikometrik değerler sunulmaya çalışılmıştır. Yöntem: Araştırma metodolojik tiptedir ve örneklemini 24-48 aylık çocuğu olan 504 ebeveyn oluşturmuştur. Ölçüt bağıntılı geçerlik için Kısa 1-3 Yaş Sosyal ve Duygusal Değerlendirme Ölçeği-Türkçe kullanılmıştır. Yapı geçerliliği için Açıklayıcı Faktör Analizi (AFA) ve Doğrulayıcı Faktör Analizi (DFA) yapılmıştır. Bulgular: Açıklayıcı faktör analizi sonucu toplam varyansın %77.96’sını açıklayan 21 madde ve tek boyutlu bir model oluşmuştur. DFA sonucu bu modelin uyum iyiliği değerleri CMIN=1986.29, sd=482, CMIN/sd=4.12 (p=.00), SRMR=.07, CFI=.92, IFI=.92, NFI=.92, RFI=.90, TLI=.91, RMSEA=.97 çıkmıştır. Madde faktör yükleri ise .67 ila .97 arasında değişmektedir. UEBÖ-EF ile psikiyatrik sorunlar ve psikososyal gelişim arasında ilişkiler (r=.54, r=-.23; p<.01) saptanmıştır. Ölçeğin iç tutarlık güvenirlik Cronbach’s alfa değeri α=.98 olarak bulunmuştur. Düzeltilmiş madde toplam korelasyon katsayıları .59 ila .96 arasındadır. Sonuçlar: Sonuç olarak UEBÖ-EF’nin uyaran eksikliğini belirlemede kullanılabilecek geçerli ve güvenilir bir ölçme aracı olduğu söylenebilir.Öğe Uyku Bruksizmli Çocuk ve Ergenlerde Komorbid Psikopatolojilerin, Psikososyal Faktörlerin ve Psikiyatrik Tedavi Yaklaşımının Değerlendirilmesi(2024) Cicek, Ayla Uzun; Abanoz, Elif; Ucuz, İlknur; Şireli, ÖzlemAmaç: Önceki araştırmalar çeşitli psikopatolojiler ve psikososyal faktörler ile bruksizm arasında yakın bir ilişki olduğunu ortaya koymuştur. Bununla birlikte, bruksizmli çocuk ve ergenlerde psikososyal faktörler ve psikiyatrik zorluklar yeterince araştırılmamıştır. Bu çalışmada uyku bruksizmli çocuk ve ergenlerin sosyodemografik özelliklerini, psikososyal faktörlerini ve komorbid psikopatolojilerini araştırmayı amaçladık. Materyal ve Metod: Çalışmaya 2018-2024 yılları arasında iki farklı Çocuk ve Ergen Psikiyatrisi polikliniğinde uyku bruksizmi tanısı konulan ve takip edilen 4-17 yaş arası 67 çocuk ve ergen dahil edildi. Bu hastaların davranışsal ve duygusal özellikleri, komorbid psikiyatrik bozuklukları, bruksizmin klinik özellikleri ve bruksizme yönelik tedavi yaklaşımlarına ilişkin veriler retrospektif olarak incelendi. Bulgular: Sonuçlarımız örneklemin %41.8'inde en az bir psikiyatrik bozukluk ve %10,4'ünün eşik altı psikiyatrik belirtiler olduğunu gösterdi. En sık komorbid psikiyatrik bozukluklar anksiyete bozuklukları, dikkat eksikliği hiperaktivite bozukluğu, nokturnal enürezisi ve davranım bozukluklarıydı. Olguların %41.8'inde bruksizm psikososyal faktörlerle bağlantılıydı. Eşlik eden psikiyatrik bozukluklar okul ve ergen yaş gruplarında okul öncesi çocuklara göre anlamlı derecede daha yaygındı. Benzer şekilde, bruksizm ile psikososyal faktörler arasındaki bağlantı yaş ilerledikçe daha da belirginleşti. Ailede pozitif bruksizm öyküsü %44.8 idi. Bruksizme tedavi seçeneği olarak, olguların %88.1'inde davranışsal yaklaşım ve farmakoterapi tercih edilirken, %11.9'una yalnızca davranışsal yaklaşım uygulandı. Farmakoterapide en sık kullanılan ilaçlar hidroksizin, trisiklik antidepresanlar, antipsikotikler, atipik antidepresanlar ve melatonindi. Tedaviye yanıt açısından örneklemin %83.6'sı (tam veya kısmi) yanıt verirken, %16.4'ü yanıt vermedi veya tedaviye dirençliydi. Sonuç: Bu çalışma uyku bruksizmli pediatrik popülasyonda psikiyatrik komorbiditenin oldukça yaygın olduğunu ortaya koymuştur. Sonuçlar bruksizmin sadece dental bir problem olmadığını, aynı zamanda çeşitli psikopatolojiler ve psikososyal faktörlerle de ilişkili olduğunu göstermektedir. Bu nedenle bruksizmle karşılaşabilecek sağlık profesyonellerinin bruksizm ile psikopatolojiler ve psikososyal faktörler arasındaki ilişkinin farkında olması gerekmektedir. Bruksizmli çocukların biyo-psiko-sosyal perspektiften multidisipliner ve bütüncül bir yaklaşımla dikkatle incelenmesi ve psikososyal ve psikiyatrik zorluklar açısından taranması önerilmektedir.Öğe What Do Parents Know and Perceive About Child and Adolescent Psychiatry and Treatments?(Wiley, 2025) Cicek, Ayla Uzun; Bozok, Beyza Karatas; Bozok, Suleyman Emre; Abanoz, Elif; Arslan, Semiha Comertoglu; Ucuz, Ilknur; Sireli, OzlemPurpose: Parents' knowledge, understanding and attitudes have a strong influence on treatment outcomes in child and adolescent psychiatry (CAP). However, little is known about parents' knowledge, perceptions and awareness regarding assessment, intervention and treatment options in CAP. Methods: We evaluated 1872 parents (1104 mothers [59.0%], 768 fathers [41.0%]) who were over 18 years of age and had at least one child between the ages of 0-18, regardless of whether their child had previously received CAP treatment, using a questionnaire containing 29 questions. Results: The most common misconceptions about CAP application records were that psychiatric records would cause difficulties in getting a job (92.6%) and would be obstacles to appointment to civil service (65.8%) and to getting driver's licence (34.8%). Regarding CAP drug treatments, the most frequently reported false beliefs were that psychiatric drugs cause weight gain (80.1%), are addictive (65.1%), cause long-lasting side effects (53.5%), numb the mind and cause drowsiness (52.7%), alter children's personalities (44.4%) and increase suicide risk (42.9%). Furthermore, 1105 (59.0%) participants answered 'Psychiatric disorders cannot be treated effectively even if psychiatric medications are used.' Conclusions: Our results indicated that parents' knowledge level was inadequate, and their attitudes and beliefs were negative and limited regarding CAP and treatments; in turn, they avoided treatment and did not engage in help-seeking behaviours. This study shows an urgent need for mental health education programs to increase parents' awareness and understanding of CAP and promote appropriate access to services.Öğe Who Is Most at Risk? Exploring the Prevalence of Psychiatric Comorbidities in Children With Intellectual Disability by Age, Sex, Severity, and Socioeconomic Background(Wiley, 2026) Abanoz, Elif; Cicek, Ayla Uzun; Ucuz, Ilknur; Arslan, Semiha Comertoglu; Sari, Seda Aybuke; Sireli, OzlemBackground Data on psychiatric comorbidities in children with intellectual disability (ID) across subgroups remain limited. Thus, we aimed to investigate comorbidity prevalence by age, sex, ID severity, and socioeconomic status.Methods This multicentre, cross-sectional study included 1742 children with ID consecutively recruited from child psychiatry outpatient clinics. Participants were assessed using comprehensive psychiatric interviews, the Strengths and Difficulties Questionnaire, and Clinical Global Impression.Results Comorbid psychiatric disorders were present in 86.2% of the sample; 24.7% had one, and 61.5% had two or more. The most common diagnoses were ADHD (44.3%), anxiety disorders (40.0%), oppositional defiant disorder (36.7%), and conduct disorder (29.2%). Comorbidity rates were significantly higher in males, adolescents, those with severe ID, and those from higher-income families. Internalising disorders were more common in females; externalising disorders in males and adolescents.Conclusions Our findings suggest the integration of systematic, developmentally sensitive psychiatric screening into standard clinical care for children with ID.
