This study examines the associations between prenatal attachment and child development, socioemotional behavioral problems, and competence at early childhood. It also inquires whether maternal depression and anxiety at the prenatal period and at early childhood are associated with child outcomes. The study consisted of 83 mothers and their children. Data regarding the prenatal attachment, depression, and anxiety were collected during Weeks 28 to 40 of gestation. When the children were 21 to 31 months old, the Brief Infant and Toddler Social Emotional Assessment (BITSEA) and the Ankara Developmental Screening Inventory (ADSI) were applied to children along with Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) administered to mothers. Results showed that prenatal attachment scores significantly correlated with BITSEA‐Competency subscale scores and ADSI total scores at early childhood, r(83) = 0.246, P = .025, and r(82) = 0.316, P = .004, respectively. Prenatal attachment levels were found to be the predictors of both behavioral and emotional competence and development at early childhood, b = 0.081, t(83) = 2.273, P = .014, and b = 0.281, t(83) = 3.225, P = .002, respectively. In addition, prenatal attachment was shown to be even a stronger predictor of development than was worsening maternal depression at early childhood, b = −0.319, t(83) = 2.140, P = .035. Our results indicate that fostering prenatal attachment may be beneficial for better infant outcomes at early childhood.
Trichotillomania is characterized by recurring hair pulling behavior and repeated attempts to decrease or stop the behavior. This behavior can cause a trichobezoar, which is a mass of hair found in the stomach. Patients with diagnosed celiac disease may have an urge to swallow their hair due to iron or folat deficiency, which is called pica. We report a case of an 11-year old girl with celiac disease who has had trichotillomania for a duration of 2 years, and required an operation due to residual gastric hair mass. In this case trichotillomania was more likely caused by behavioral disorders secondary to celiac disease, rather than the iron deficiency due to malabsorption.
Early diagnosis of autism certainly stands as one of the most important determinants to ensure a better prognosis of the disorder, it is common that the screening programs to ensure this, end up not being implemented in health systems of many countries. This may stem from the disadvantages of classically suggested scale‐based screening (SBS) programs. This study presents a nationwide recognition and referral model for early diagnosis of autism spectrum disorders (ASD), in order to meet the obvious need for new methods. The model consists of interactive video‐based training (IVBAT) of health care workers (HCW), a system where family physicians (FPs) record five probable indicators of autism in their family medicine information system; and is therefore, a practical referral system in which the FP may refer a child with any suggestive finding to a child psychiatrist and may well continue to monitor recently diagnosed cases. The autism teams consist of trained child psychiatrists and coordinators, who delivered trainings to 29,612 FPs and 23,511 nurses countrywide. Of 98.8% FPs were trained throughout the country. Total of 1,863,096 children were reported to have a brief examination of autism signs in Family Medicine Units by trained FPs and nurses. A total of 55,314 (2.96%) these children were deemed at risk for ASD and were referred to child psychiatrists. In the evaluation of 55,314 children by child psychiatrists, 10,087 cases were diagnosed with developmental disorders, while 3226 of children at risk were diagnosed with autism. The results of this study, which reached to the largest sample to date, suggest that some other alternative methods, in addition to SBS should also be tested in order to screen ASD. Lay Summary In this study, a nationwide recognition and referral model for early identification of autism spectrum disorders (ASD) is presented. Scale‐based screening (SBS) is the most recommended model for autism, however, it is clear that most countries can not implement this model in their health system. The results of this study, which reached to the largest sample to date, suggest that SBS may not be the only me for screening ASD and that alternative methods should be tried, as there is an obvious need for exploratory approaches.
Objective: This study aims to examine the psychopathology, quality of life perception, eating behaviors and self-image of children and adolescents who are diagnosed with obesity; as well as their parents' behaviour, coping skills and the relations between these conditions. Methods: In this study, 30 patients between the ages of 8 -18 who have consulted the University of Akdeniz Pediatric Endocrinology Department and had BMI standard deviation above 2 and had no mental retardation or received no previous psychiatric consultations on the obesity were enrolled. Our control group included 30 healthy children and adolescents who were matching on the same demographic information (gender and age) with the treatment (patient) group, and they had no previous medical or psychiatric illnesses. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version was administered to both groups, and the Rosenberg Self Image Scale was used to determine their self-images. The Quality of Life Scale for Children was administered to the children and adolescents as well as to their parents. To determine the methods of child rearing and coping strategies with stress, parents were administered the Family Life and Child Rearing Demeanours Scale and the Coping Strategies Scale. Results: There were no significant sociodemographic differences between the two groups except for parents' educational level and socioeconomic status. As we found no differences on parenting styles and coping strategies, a higher percentage of psychiatric illnesses were detected in our study and the quality of life perception of parents was found lower in the obese group. Self-image scores were not varied between obese children and healthy controls. İt was observed that obese group children's mother have more likley high obesity rates than the mothers in the control group children. Conclusions: As a result of this study, psychiatric disorders were observed more frequently in obese children and adolescents. The perception of quality of life for obese children and adolescents seem alike with control groups' perception. However, the fact that obese children and adolescents' parents claim that their children's quality of life is not equal to other groups shows that obese children and adolescents are less aware of health condition and following problems they have and might possible attain in the future.[Abstract:0106][Addiction]
Objective: Many individuals with cigarette addiction are known for beginning to smoke cigarettes during adolescence years. In this study, we aimed to present the clinical outcomes of smoking cessation project conducted in an Anatolian school in Kartal district of Istanbul, Turkey. Methods: Social and motivational studies were carried out on adolescent smokers after scanning in terms of smoking in an Anatolian school and 44 of these adolescents who are clinical requirements were evaluated and followed by Chest disease and child and adolescent mental health for six months. Carbonmonoxide (CO) measurements in the expiratory air and carboximeter (piCO smokerlyzer, Bedfont Scientific Ltd, England) were made at the first visit and follow-up. Simultaneously, K-SADS PL (Schedule for Schizophrenia and Affective disorders for School Age Children) was administered diagnostically in mental health evaluation. Results: A total of 44 adolescents, 13 girl (29.5%) and 31 boy (70.5%), with a mean age of 17.31 were followed up. The mean age of initiation of cigarette smoking was 14.2 ± 1 and 32 (82.7%) adolescent were found to have at least one smoker in their home. While 22.7% of adolescents did not try smoking cessation, 77.3% of them did. Six of these adolescents indicated that they did not smoke during the six months; 55.5% of these adolescents have at least one mental illness; the most common diagnoses were 25.0% (n = 11) of ADHD (Attention Deficit Hyperactivity Disorder) and 20% (10) of MD (Major Depression). While depression was significantly frequent in girls (p = 0.043), the frequency of ADHD was not significant in terms of gender. Depression presence was associated with early onset of cigarette smoking in males (p = 0.019), but not with females (p = 0.394). There was a statistically significant correlation between smoking cessation effort and age in the follow-up period (p = 0.022), and earlier adolescents stated that they wanted to quit smoking more. While there is no significant association between smoking cessation effort and mental disease, there was a statistically close relation with parent and sibling smoking (p = 0.07) and significant correlation with motivation and smoking cessation effort (p = 0.016). Conclusions: Smoking cessation work in adolescents is much more difficult than in adults. Biological and social factors and peer impact influence interventions. In our study, very few adolescents stated to quit smoking for 6 months, and the rate of psychiatric illnesses among adolescents and the presence of individuals smoking at home were found to be quite high. It has been the result of these factors also affecting the success of adolescents to start smoking and to quit smoking.
Bu çalışmada, trikotillomani tanısı alan çocukların aile özellikleri, ebeveyn tutumları ve aile uyumlarının sağlıklı kontrollerle karşılaştırılarak incelenmesi amaçlanmıştır. Yöntem: Çalışmaya saç koparma nedeniyle başvuran 4-12 yaş aralığında 24 çocuk ile aynı hastanelerin farklı polikliniklerine başvuran ve çalışmaya katılmayı kabul eden; yaş ve cinsiyet olarak benzer 54 sağlıklı çocuk ile aileleri katılmıştır. Olgu grubunun hastalık şiddeti Klinik Global İzlenim Ölçeği hastalık şiddeti indeksi (CGI-SI) ile belirlenmiştir. Ailelerin ebeveyn tutumları ve anne baba çocuk uyumları çocuk uyumu ve anne baba yeterlik ölçeği (CAPES-TR) ve anne babalık ve aile uyum ölçeği (PAFAS) ile araştırılmıştır. Bulgular: Trikotillomani olgularının CGI-SI puanı ortalaması 4.00±1.02'dir. Olgu grubunun ebeveynlerinin aile yapısı ve eş ilişkisi kontrol grubundan istatistiksel açıdan anlamlı düzeyde farklıdır (sırasıyla p=0.025, p=0.018). Olgu grubu ebeveynleri PAFAS alt ölçeklerinden zorlayıcı anne babalık, anne baba çocuk ilişkisi, anne baba duygusal uyum ve takım çalışması alanlarında kontrol grubuna göre anlamlı olarak farklıdır (sırasıyla p=0.001, p=0.000, p=0.000, p=0.009). Benzer şeklide CAPES-TR alt ölçeklerinden duygusal ve davranışsal uyum ve ebeveyn öz yeterliliği trikotillomani grubunda kontrol grubuna göre anlamlı düzeyde daha bozuktur (sırasıyla p=0.001, p=0.000, p=0.000). CGI-SI puanları ile PAFAS alt ölçeklerinden zorlayıcı anne babalık, anne baba çocuk ilişkisi, anne baba duygusal uyumu ve takım çalışması ilişkiliyken (sırasıyla p=0.003, p=0.000, p=0.000, p=0.008); CGI-SI ile CAPES-TR alt ölçeklerinden davranışsal ve duygusal uyum ve ebeveyn öz yeterliliği puanları ilişkilidir (sırasıyla p=0.000, p=0.001, p=0.000). Sonuç: Trikotillomani tanısı alan çocuklar ile sağlıklı çocukların aile özellikleri, ebeveyn tutumları ve aile uyumlarının ele alınması, olguların tedavisinde kullanılan ilişkisel ve davranışsal müdahalelere katkı sunabilir.
It is suggested that in case of blockage in an energy center, illness or imbalance may occur and it may be treated by touching by hand according to Reiki. In this case, the first episode of psychosis with intense occupation of reiki will be presented. A 57 year-old woman presented with the complaints of auditory hallucinations, decreased need for sleep, and skepticism. In psychiatric examination; poor self-care, irritable affect, decreased psychomotor activity, flight of associations, mystic delusions, and auditory illusions were noted. It was her first psychiatric administration and her complaints were exacerbated 10 days ago. According to her family, the patient, who has no intimate friendship, has been busy with reiki for 4 years. As the level of reiki goes up, the patient, who predicts the increase of the auditory hallucinations as a reward, has tried to heal the patients through the energy and has tried to eat the earth and to throw herself from 3 meters high. For a possible organic etiology, no pathological findings were found in the results of the blood tests and cranial MRI. Haloperidol 20 mg/day, biperidene 4 mg/day quetiapine 100 mg/day was recommended for the patient who was diagnosed as atypical psychosis. Within a week, her complaints were down. The beginning of the psychotic manifestations of our case, such as hearing the voices, may suggest that a mission like healing in this ritual leads the patient to a psychotic life. From another point of view, the fact that the patient's introverted prodromal period may suggest that there is a psychotic pattern with negative symptoms in the beginning, and perhaps the patient may turn to this area for self-medication. It may be appropriate to evaluate Reiki healing technique from the perspective of psychosis in addition to healing activity.
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