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Öğe Assessment of suicide probability and related factors in male incarcerated adolescents; a sample of reformatory center in Turkey(Pergamon-Elsevier Science Ltd, 2021) Karatoprak, Serdar; Ayaz, Nusret; Donmez, Yunus Emre; Dogan, MustafaObjective: Suicidal behavior in adolescents is an important public health problem, and it ranks first among the causes of prison deaths in incarcerated adolescents(IAs). The aim of this study is to determine the probability of suicide and associated risk factors in IAs. Method: Seventy-one male adolescents in a reformatory center were contrasted with a matched group of 71 male adolescent with no psychiatric disorder and no criminal record. Suicidal probability and psychiatric symptomatology were assessed with the Suicide Probability Scale, SA-45 Questionnaire, respectively. Results: It was determined that the probability of suicide was higher in IAs, and depression and hostility symptoms, the presence of another individual involved in delinquency in family had predictive effects. It was also found that there was a positive correlation between the probability of suicide and the number of delinquencies, the number of incarceration, and a negative correlation between attending to school or work while in reformatory and being visited by relatives while in reformatory. Conclusions: The results suggest that when assessing suicide risk for IAS, it may be useful to pay attention to those with symptoms of depression or hostility, those with multiple delinquencies or entrance to reformatory, and those who have family members involved in delinquency.Öğe Clinical attendance rates and associated factors after discharge of patients treated in a child psychiatry clinic(2020) Uçur, Ömer; Soylu, Nusret; Karatoprak, Serdar; Algan, Zehra; Doğan, Özlem; Güngören, Sümeyra; Dönmez, Yunus Emre; Özel Özcan, ÖzlemAbstract: Aim: Continual attendance at clinical follow-ups of children and adolescents after inpatient psychiatric treatment is an important problem affecting morbidity and mortality. In this study we aimed to research the follow-up attendance rates after hospital discharge and influencing factors in a child and adolescent psychiatric inpatient clinic. Material and Methods: Patient data between 2013 and 2016 were retrospectively investigated and cases with at least 3 months of history after discharge were included in the study. After discharge, cases who attended the following first 2 consecutive clinic appointments were accepted as attending follow-up. Variables related to sociodemographic characteristics, psychiatric diagnosis, applied treatment, kind of admission and discharge, duration of stay, applied psychometric scale scores were also recorded. Results: Two-hundred and fourty-one cases (65.7%) attended the first two consecutive appointments, while 126 cases (34.3%) did not attend a total of 367 cases. Low socioeconomic level and alcohol use were found to be associated independently with lower attendance rates while pharmacotherapy, admission from outpatient clinic and those with first-degree relatives who had mental disorders associated independently with higher attendance rates. Conclusion: Regular and consistent follow-up after discharge from children and adolescents may be an important indicator of compliance with treatment. Studies have reported that repeated psychiatric admissions to hospital are lower among patients who are compliant with treatment compared to those who do not comply. We believe our study will contribute to the literature on understanding the attendance rates and effective factors for clinical check-ups after discharge.Öğe Comorbid Psychiatric Disorders and Related Sociodemographic Factors in Adolescents with Attention-Deficit Hyperactivity Disorder(2022) Karatoprak, Serdar; Dönmez, Yunus EmreObjective: Attention-deficit hyperactivity disorder (ADHD) disorder is a neuropsychiatric disorder that begins in early stages of life and has a lifelong effect. Previous studies have found that 50-70% of children and adolescents with ADHD have comorbid psychiatric disorders. The aim of this study is to identify comorbid psychiatric disorders in adolescents with ADHD and to compare the sociodemographic characteristics of ADHD cases with and without psychiatric comorbidity. Method: This study was conducted with 105 adolescents with ADHD. The Schedule for Affective Disorders and Schizophrenia for School-age Children-present and Lifetime-Turkish version was used to evaluate ADHD and comorbid psychiatric disorders. Results: The study was completed with 73 male and 32 female adolescents. The mean age of the participants was 13.75±1.45 years. It was determined that 41 cases (39%) had at least one comorbid psychiatric disorder. The most common comorbid psychiatric disorders were conduct disorder (14.3%), specific learning disorder (8.6%), obsessive compulsive disorder (3.8%) and elimination disorders (3.8%). While the prevalence of comorbid psychiatric disorders was compared according to sociodemographic characteristics, it was found that the prevalence of comobidity was significantly higher in adolescents with ADHD living in families with low socioeconomic levels. Conclusion: The findings of current study showed that adolescents with ADHD had a high rate of comorbid psychiatric disorders. We are opinion that presence of comorbid psychiatric disorder in ADHD will have negative effects on both ADHD and comorbid psychiatric problems. Therefore, all adolescents with ADHD should be evaluated for comorbid psychiatric disorders.Öğe A comparison of health behaviours in male adolescents with and without offending histories referred for adolescent health services in Turkey(Wiley, 2022) Ayaz, Nusret; Karatoprak, SerdarBackground: Offending and incarceration are important societal problems that might be reduced by improving early intervention. Most prior work identifying risk factors has focussed on early oppositional or aggressive behaviours and environmental problems. Among adults, it is well recognised that offenders have much poorer health than the wider population. This raises questions about whether behaviours that put health at risk while a teenager may also be good markers of subsequent offending. Aims: To examine the relationship between risky health behaviours and delinquency by comparing male teenage offenders with a history of incarceration and male teenagers with no criminal involvement. Methods: In this cross-sectional study, 66 male 12-18-yearold offenders with an incarceration history who were referred for evaluation to the Forensic Medicine Polyclinic in 2021 were compared with 74 similar aged adolescents without a criminal record but attending another clinic in the same hospital, using the Risky Health Behaviour Scale (RHBS). This covers dietary, road safety and sexual behaviours as well as exercise, substance use and violent behaviours. Negative items were reverse scored so that higher scores indicated more pro-health activities. Results: Total RHBS scores were significantly lower among the offender-group than the comparison teenagers (Means 93.19 +/- 17.00: 107.20 +/- 10.83; p = 0.001). This reflected significant differences in each of the subscale scores except dietary and risky sexual behaviour. Only substance use behaviours, however, were independently related to offender group membership, as was family socio-economic status. Conclusions: Our findings add indications of risky health-related behaviours to the already extensive literature on risky social behaviours in the history of young offenders. It is possible that focussing on young offenders referred to a health service, albeit one primarily directed at mental health, has exaggerated such differences, but if substantiated in larger and more diverse samples, these findings may open new avenues for early identification of young people at risk of offending and commensurate early interventions. Focus on substance use by young people seems especially important, but low family socio-economic status needs remedies too.Öğe Down sendromlu iki yenidoğanda nadir translokasyonlar(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2015) Yaşar, Emine; Ekici, Cemal; Savacı, Serap; Karatoprak, Serdar; Tekedereli, İbrahimTrizomi 21, insanlarda en sık görülen kromozomal anöploidi olup sıklığı yaklaşık olarak 700 canlı doğumda 1’dir (1:700). Olguların %95’i klasik tip Down sendromu olup, fazla olan 21. kromozom serbesttir. Kalan vakaların yaklaşık yarısı 14/21 translokasyonu ile meydana gelirken, yarısını ise 21/21, 15/21 gibi diğer Robertsonian tipi translokasyonlar ve mozaik trizomiler oluşturur. Klasik ya da translokasyon tipi Down sendromu arasında fenotipik fark olmamasına rağmen, translokasyon tipi Down sendromunda ebeveynlerin taşıyıcı olma ihtimali gözönüne alınarak, anne-baba kromozom analizi yapılması gereklidir. Bu çalışmada Down sendromu bulguları nedeni ile başvuran iki yenidoğanın tanı, komorbid durumlar ve genetik danışmanlık süreci literatür bilgileri ışığında değerlendirilerek sunulmuştur.Öğe The effects of attention deficit/hyperactivity disorder on adolescents exposed to peer victimization(2022) Karatoprak, Serdar; Akyıldız, Abdulbaki; Dönmez, Yunus EmreAim: Peer victimization is more common in adolescents with ADHD. Since more internalizing behaviors, externalizing behaviors and academic problems are observed in adolescents exposed to peer victimization, these problems may occur more severely in adolescents with ADHD who are exposed to peer victimization. In this study, it was aimed to investigate the effects of ADHD on internalizing and externalizing behaviors, depression, academic problems in adolescents with ADHD who were exposed to peer victimization. Materials and Methods: This cross-sectional study was conducted with 169 adolescents. Participants completed Socio-demographic Data Form, Olweus Bully/Victim Questionnaire, Strengths and Difficulties Questionnaire-Adolescent Form and Children’s Depression Inventory. The diagnosis of ADHD was determined according to the diagnostic criteria in DSM-V. Results: The study was completed with 41 adolescents with ADHD exposed to peer victimization, 69 adolescents without ADHD exposed to peer victimization, 59 adolescents without ADHD and were not exposed to peer victimization. There was no statistically significant difference between groups in terms of sociodemographic characteristics. School absenteeism was more common in ADHD group. Externalizing behaviors were found to be statistically significantly higher in the ADHD group. Conclusion: The results of this study have revealed that adolescents with ADHD who are exposed to peer victimization exhibit more severe externalizing behaviors. Therefore, ADHD should be specifically investigated in adolescents exposed to peer victimization who develop more severe externalizing behaviors.Öğe The effects of information resources on children and adolescent mental health in pandemics; Covid-19 sample(Polskie Towarzystwo Psychiatryczne-Polish Soc Psychiatry, 2023) Karatoprak, Serdar; Donmez, Yunus EmreAims: Pandemics have negative physical and mental effects on children and adolescents. However, our know-ledge about the factors related to the mental problems experienced in this process is limited. This study aimed to examine the association between resources of Covid-19 related information exposure and sociodemograph-ic characteristics and mental health problems during pandemics. Method: This study was carried out with 1030 children. The sociodemographic characteristics of the partic-ipants and exposure to information flow about the Covid-19 pandemic were recorded. Psychiatric problems were assessed using the DSM-5 Level-2 Anxiety Scale, DSM-5 Level-2 Depression Scale, DSM-5 Level-2 Sleep Disorder Scale. Results: The mean age was found as 10.45 years. It was determined that 33% of the participants had moder-ate/high level anxiety symptoms and 16.1% had moderate/high level depressive symptoms. Girl gender was related with anxiety-depression symptoms and sleep disorders, living in urban area was related with anxie-ty symptoms, increasing age and presence of death due to Covid-19 were associated with depression symp-toms. It was determined that information exposure through TV, internet and peer conversations is associated with anxiety-depression symptoms, and information exposure via internet and family conversations was as-sociated with sleep disorder symptoms. Conclusion: Measures to be taken for both sociodemographic risk factors and the negative consequences of resources of information exposure may reduce the negative psychological effects of pandemics on children.Öğe Evaluation of Incest Cases: 4-Years Retrospective Study(Routledge Journals, Taylor & Francis Ltd, 2020) Celbis, Osman; Altin, Ismail; Ayaz, Nusret; Bork, Turgay; Karatoprak, SerdarIncest is specific type of sexual abuse. The aim of this study was to evaluate the sociodemographic data and examination findings of cases referred to our hospital as forensic court cases of incest, and to measure the effect on mental health disorders of the nature of the sexual abuse. Retrospective examination was made of the records of 40 cases of incest victims. Evaluation was made of the age, gender, incident suffered, the perpetrator, form of abuse, examination findings, and mental status. The cases comprised 36 girls and 4 boys. Without penetration sexual abuse was determined in 25 cases and with penetration sexual abuse in 15 cases. At least one mental health disorder was determined in 20 of the cases of simple sexual abuse and in 11 of the major sexual abuse type cases. The most frequently seen mental health disorder was post-traumatic stress disorder (PTSD) in 21 cases. Mental health disorders were determined in 77.5% of the incest cases in this study, at a greater rate 80% in cases of without penetration sexual abuse than in cases of with penetration sexual abuse 74.33%. Therefore, all cases of incest must be followed up carefully without differentiation of without or with penetration abuse.Öğe Internet addiction and comorbid pyschiatric disorders in adolescents(2020) Karatoprak, Serdar; Donmez, Yunus EmreAim: Internet addiction (IA) has become an increasing problem in adolescents. However, there are few studies conducted in clinical samples and examined comorbid psychiatric disorders in adolescents with IA. The aim of this study was to determine the sociodemographic characteristics and comorbid psychiatric disorders in adolescents with IA and to compare them according to gender.Material and Methods: This cross-sectional study was conducted with 80 adolescents aged 12-18 years. Participants with a Young Internet Addiction Scale score ≥ 50 were considered as internet addicts and were included in the study. Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version was used to evaluate psychiatric disorders.Results: The study was completed with 40 male and 40 female adolescents with IA. The mean age of the participants was 14.7. 83.3% of participants use the internet every day and 46.7% of participants use the internet more than six hours a day. The mean YIAS score of the participants was 63.0. All participants met criteria for at least one psychiatric disorder. The most common comorbid psychiatric disorders were depressive disorder (37.5%), ADHD (26.2%) and anxiety disorders (23.8%). When comorbid psychiatric disorders were compared according to gender, it was found that ADHD was significantly higher in boys and depressive disorder was significantly higher in girls.Conclusion: The results of the present study showed that adolescents with IA had a high rate of comorbid psychiatric disorders. Coexistence of addiction and psychiatric disorders has negative effects on the treatment of both addictions and psychiatric disorders. Therefore, all adolescents with IA should be evaluated for comorbid psychiatric disorders. Further studies are needed to explain the causal relationship between IA and psychiatric disorders.Öğe Neutrophil-lymphocyte and Platelet-lymphocyte Ratios among Adolescents with Substance Use Disorder: A Preliminary Study(Korean Coll Neuropsychopharmacology, 2021) Karatoprak, Serdar; Uzun, Necati; Akinci, Mehmet Akif; Donmez, Yunus EmreObjective: Substance use disorder (SUD) is a serious public health problem affecting both the individual and the society, and substance use-related deaths and disability have been shown to increase gradually. Recent etiologic studies have reported that there is a relation between inflammatory parameters and psychiatric disorders. The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) used as an indicator of inflammation have been shown to be increased in various psychiatric disorders. In this study, we aimed to investigate the NLR and PLR in adolescents with SUD. Methods: This study was conducted by retrospectively examining the records of 55 male adolescents who were followed up with SUD in a child and adolescent psychiatry outpatient clinic between November 2019-June 2020. Patients who had comorbid psychiatric disorder were included, and those who received any psychotropic medication were excluded. A total of 61 healthy male adolescents in the same age range without any psychiatric disorders were recruited as a control group. Neutrophil-lymphocyte-platelet counts were noted retrospectively from complete blood tests, and NLR-PLR were calculated. Results: The NLR and PLR of adolescents with SUD were significantly higher than the healthy adolescents (p < 0.01, p < 0.01, respectively). In addition, conduct disorder, depression, and attention deficit/hyperactivity disorder, which were determined as the most common comorbid psychiatric disorders had no effects on NLR (p = 0.513, p = 0.584, p = 0.394, respectively) and PLR (p = 0.210, p = 0.346, p = 0.359, respectively). Conclusion: The results of current study indicate that inflammatory processes may have a key role in the pathophysiology of SUD.Öğe The predictive effect of internet addiction and psychiatric disorders on traditional peer bullying(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2020) Karatoprak, Serdar; Donmez, Yunus Emre; Ozcan, Ozlem OzelObjective: Traditional peer bullying (TPB) is a worldwide problem and 20-56% of adolescents are thought to be affected. Some studies suggest that internet addiction may be related to negative behaviors such as bullying. This study aimed to determine the prevalence of TPB in the clinical psychiatric sample of adolescents and to investigate the predictive effect of age, gender, psychiatric diseases and (internet addiction) IA on roles in TPB. Methods: This cross-sectional study conducted with 214 adolescents in the age range of 12-16 years. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version were used for psychiatric evaluations of the participants. Olweus Bully/Victim Questionnaire (OBVQ) and Young Internet Addiction Scale were carried out to all participants. The predictive effect of age, gender, IA and psychiatric disorders on roles in TPB was evaluated by multinomial logistic regression analysis. Results: The mean age of the participants was 14.5 years. According to the results of the OBVQ, 49% of the participants were involved in TPB (victims: 35%, bullies: 14%). Regression analysis revealed that age and gender had no effect on roles in TPB, but IA had a predictive effect on both victimization (p<0.001) and bullying (p<0.001). It was found that depressive disorder had a predictive role in victims (p<0.05) and disruptive behavior disorders (DBD) had a predictive role in bullies (p<0.05). Discussion: Peer bullying was a serious problem (one of two adolescents) in psychiatric clinical population of adolescents and IA positively predicted being a victim and a bully. When peer bullying was evaluated by roles, it was observed that psychiatric problems related to these roles were different. Depressive disorder has predictive effect in victims and disruptive behavior disorder in bullies. The findings of this study may be useful in the development of prevention and intervention programs for adolescents affected by TPB.Öğe PTPN11 gen mutasyonu: Noonan sendrom’lu bir olgu(İnönü Üniversitesi Sağlık Bilimleri Dergisi, 2015) Karatoprak, Serdar; Yaşar, Emine; Tekedereli, İbrahimNoonan Sendromu, boy kısalığı, düşük arka saç çizgisi, yele boyun, göğüs duvarı deformiteleri, koagülasyon ve konjenital kalp defektleri ile karakterize ender bir genetik hastalıktır. Benzer klinik bulgular nedeniyle toplumda daha sık olarak karşılaşılan Turner sendromu ile karıştırılmaktadır. Bu çalışmada boy kısalığı nedeni ile kliniğimize başvuran 17 yaşında Noonan Sendromu tanısı alan bir olgu sunulmuştur.Öğe Rare Translocations in Two Newborns with Down Syndrome(2015) Yaşar, Emine; Ekici, Cemal; Savacı, Serap; Karatoprak, Serdar; Tekedereli, İbrahimAbstract: Trizomi 21, insanlarda en sık görülen kromozomal anöploidi olup sıklığı yaklaşık olarak 700 canlı doğumda 1'dir (1: 700). Olguların %95'i klasik tip Down sendromu olup, fazla olan 21. kromozom serbesttir. Kalan vakaların yaklaşık yarısı 14/21 translokasyonu ile meydana gelirken, yarısını ise 21/21, 15/21 gibi diğer Robertsonian tipi translokasyonlar ve mozaik trizomiler oluşturur. Klasik ya da translokasyon tipi Down sendromu arasında fenotipik fark olmamasına rağmen, translokasyon tipi Down sendromunda ebeveynlerin taşıyıcı olma ihtimali gözönüne alınarak, anne-baba kromozom analizi yapılması gereklidir. Bu çalışmada Down sendromu bulguları nedeni ile başvuran iki yenidoğanın tanı, komorbid durumlar ve genetik danışmanlık süreci literatür bilgileri ışığında değerlendirilerek sunulmuştur.Öğe Yatış Süresinin Klinik-Demografik Özelliklerle İlişkisi: Bir Çocuk ve Ergen Psikiyatrisi Yataklı Servis Bulguları(2021) Uçur, Ömer; Soylu, Nusret; Güngören, Sümeyra; Doğan, Özlem; Alğan, Zehra; Karatoprak, Serdar; Özcan Özel, ÖzlemÖz: Amaç: Çocuk ve ergen psikiyatrisinde hastaların yatırılarak takip edilmeleri sağaltımda önemlidir. Olguların yatış sürelerinin uzunluğudemografik ve klinik özelliklere bağlı olarak değişebilir. Bu çalışmada bir çocuk ve ergen psikiyatri yataklı servisinde olguların yatış süresininklinik ve demografik özellikler ile ilişkisine ait verilerin paylaşılması amaçlanmıştır.Gereç ve Yöntem: İnönü Üniversitesi Tıp Fakültesi, Çocuk ve Ergen Ruh Sağlığı Yataklı Servisi’nde yatırılarak takip ve tedavi edilmiş olgularınkayıtları incelendi. 2013 sonundan 2017 ortasına kadar yatırılmış ve taburcu edilmiş 379 olgunun demografik ve klinik özellikleri (ruhsaltanılar, bilişsel davranışçı terapi ve psikofarmakolojik tedavi, yatış özellikleri, psikometrik ölçek puanları) kaydedildi. Tüm değişkenlerin yatışsüresine olan etkisi değerlendirildi. Yatış sürelerinin karşılaştırmalarında non-parametrik bir test olan Mann-Whitney U testi kullanıldı.Uygulanan psikometrik testlerin yatış süresi ile ilişkisine Pearson korelasyon katsayısı ile bakıldı.Bulgular: Tüm olguların ortalama yatış süresi 20,05±19,69 gün idi. Olguların en kısa yatış süresi 1 gün iken en uzun yatış süresi 135 gündü.Adölesanlarda, örgün eğitimine devam edenlerde, ruhsal tanılardan şizofreni ve diğer psikotik bozukluklar, beslenme ve yeme bozuklukları iletravma ve stres ile ilişkili bozuklukları olanlarda, bilişsel davranışçı terapi ve psikofarmakolojik tedavi (antipsikotik, antidepresan, anksiyolitik)alan olgularda yatış süresi anlamlı olarak daha uzundu. Nörogelişimsel bozukluklar ve anlıksal yeti yitimi olan olgularda yatış süresi dahakısaydı. Çocuklarda Depresyon Ölçeği, Çocuklar için Durumluk-Sürekli Kaygı Envanteri, Çocuklar için Travma Sonrası Stres Tepki Ölçek’leripuanlarının yatış süresinin uzunluğu ile pozitif yönde korele olduğu saptandı.Sonuç: Ruhsal tanılar ve tedavi şekilleri yatış süresinin uzunluğunda belirleyici olabilir. Ülkemizde çocuk ve ergenlerde yataklı psikiyatriservisleri oldukça kısıtlı sayıdadır. Yatış süresinin demografik ve klinik özelliklerle ilişkisinin incelendiği daha fazla çalışmaya ihtiyaç vardır.
