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ÖZET Amaç: Bu çalışmada DSM-5 tanı ölçütlerine göre yeniden düzenlenen Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi (6-18 Yaş) -Şimdi ve Yaşam Boyu Şekli-DSM-5 Kasım 2016-Türkçe Uyarlaması'nın (ÇDŞG-ŞY-DSM-5-T) geçerlik ve güvenirliğinin değerlendirilmesi amaçlanmıştır. Yöntem: Yaşları 6-17 arasındaki, 150 çocuk ve ergene ÇDŞG-ŞY-DSM-5-T uygulanmıştır. ÇDŞG-ŞY-DSM-5-T ile konulan tanıların geçerliği, klinik değerlendirme ile konulan DSM-5 tanıları (uyum geçerliği) ve o tanıyı değerlendiren ölçek puanları (eş zaman geçerliği) dikkate alınarak değerlendirilmiştir. Değerlendiriciler arası güvenirlik seçkisiz yöntemle belirlenen 20 katılımcıda incelenmiştir. Ayrıca aynı yöntemle seçilen 20 farklı katılımcıyla yapılan ilk değerlendirmeden üç hafta sonra ÇDŞG-ŞY-DSM-5-T uygulanarak test-tekrar test güvenirliği araştırılmıştır.Bulgular: ÇDŞG-ŞY-DSM-5-T ile yapılan görüşme ile konulan tanıların uyumunun yeme bozuklukları, seçici konuşmazlık ve otizm spektrumu bozuklukları açısından çok iyi (κ=0,92-1,0), dışa atım bozuklukları, obsesif kompulsif bozukluk, karşıt olma/karşı gelme bozukluğu, yaygın anksiyete bozukluğu, sosyal anksiyete bozukluğu, depresif bozukluklar, yıkıcı duygudurum düzensizliği bozukluğu ve dikkat eksikliği hiperaktivite bozukluğu açısından iyi (κ=0,67-0,80) düzeyde olduğu gözlenmiştir. Değerlendiriciler arası güvenirliğin seçici konuşmazlık için çok iyi (κ=1,0), karşıt olma/karşı gelme bozukluğu, yıkıcı duygudurum düzensizliği bozukluğu, dikkat eksikliği hiperaktivite bozukluğu ve depresif bozukluklar için iyi derecede (κ=0,63-0,73) olduğu; test-tekrar test güvenirliğinin de otizm spektrumu bozuklukları için çok iyi derecede (κ=0,82), dikkat eksikliği hiperaktivite bozukluğu, karşıt olma/karşı gelme bozukluğu, depresif bozukluklar ve yaygın anksiyete bozukluğu ve için iyi derecede (κ=0,62-0,78) olduğu görülmüştür.Sonuç: Bu çalışmanın sonuçları ÇDŞG-ŞY-DSM-5-T'nin görüşme çizelgesine yeni eklenen seçici konuşmazlık, yıkıcı duygudurum düzensizliği bozukluğu ve otizm spektrumu bozuklukları dâhil birçok tanı grubu için geçerli ve güvenilir veri sağladığını düşündürmüştür. Method:A total of 150 children and adolescents between 6 and 17 years of age were assessed with K-SADS-PL-DSM-5-T. The degree of agreement between the DSM-5 criteria diagnoses and the K-SADS-PL-DSM-5-T diagnoses were considered as the measure of consensus validity. In addition, concurrent validity was examined by analyzing the correlation between the diagnoses on K-SADS-PL-DSM-5-T and relevant scales. Interrater reliabilities were assessed on randomly selected 20 participants. Likewise, randomly selected 20 other participants were interviewed with K-SADS-PL-DSM-5-T three weeks after the first interview to evaluate test-retest reliability. Results:The consistency of diagnoses was almost perfect for eating disorders, selective mutism and autism spectrum disorder (κ=0.92-1.0), substantial for elimination disorders, obsessive-compulsive disorder, oppositional defiant disorder, generalized anxiety disorder, s...

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Objective: Attention-deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in school-age children. It is accepted that sensory-motor and attention functions are closely associated and up to two thirds of children with ADHD suffer motor skill problems that adversely affect their social adaptation, peer relations, and academic skills. Atomoxetine (ATX) and methylphenidate (MPH) are preferentially used drugs for treatment. MPH is a central nervous system stimulant, whereas ATX is a non-stimulant selective norepinephrine reuptake inhibitor that is used to treat ADHD. The impact of ATX and MPH on attention and ADHD symptoms is well documented. However, the effects of MPH on motor skills are less studied and no data are currently available on the effects of atomoxetine on motor skills. The aim of this study is to investigate the effects of MPH and ATX on gross and fine motor skills in school-aged children with ADHD. Methods: Participants were 36 right-handed boys with ADHD (aged between 6 and 10 years, mean 7.88 years). The Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version was used to confirm the diagnosis and rule out other comorbid psychiatric disorders. Gross and fine motor skills were assessed with the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2). Twenty-five boys were treated with ATX and 11 with methylphenidate. BOT-2 was applied to both groups before and after 8-12 weeks of treatment. Results: There were no statistically significant differences between the ATX and the MPH groups for all subtests of BOT-2 pre-and post-medication. When both groups were compared in terms of preand post-treatment gross and fine motor skills, the scores for fine manual control of 12 (48%) children in ATX group increased but did not reach statistical significance. The scores for fine manual control of 5 (45%) children in MPH group increased but did not reach statistical significance. Surprisingly, statistically significant decrease was found in running speed and agility, strength, and body coordination scores in the ATX group, and statistically significant decrease was found in body coordination score in the MPH group. Conclusion: Motor coordination is important in daily life and poor motor skills have a negative impact on a child's daily living and academic performance. Furthermore, this problem may persist into adulthood with an increase in problems associated with psychosocial adjustment. Our preliminary results revealed that although there was an increase of fine motor control scores after treatment in both groups, statistically significant difference was not found between before and after treatment. Significant decrease in speed and agility and strength scores may be due to reduced impulsivity. While few studies have revealed an improvement on standardized evaluation of attention and motor skills in children taking MPH, more research is needed to gain an understanding of the relationship between motor skills deficits, attention, ...

Objective: It has been proposed that anything does not kill you make you stronger. Although it might be true in adult cases, children whose psychological life begin in the parental mind and shaped by the experiences during the early period of life are not as strong as adult against adverse effects of stressful events. Internalization of objects and emerging of internally working models, concept of normality and abnormality that will be the main ground for the understanding of the world in later life are emerged during childhood. That is why anything does not kill a child will shape its mind that might have everlasting effects on child. The clinical characteristics and pharmacological treatment process of a 10-yearold boy with Autism Spectrum Disorder who had drug refractory self-injurious behaviour Hasan Cem Aykutlu and Işık GörkerDepartment of Child and Adolescent Psychiatry, Trakya University School of Medicine, Edirne, Turkey E-mail address: hasancemay@hotmail.com ABSTRACT Objective: Irritability is the most common co-occurring symptom and common target of pharmacotherapy in children with Autism Spectrum Disorders (ASD) [1][2][3]. FDA-approved agents risperidone and aripiprazole are commonly used in irritability and became the firstline treatment, but the growing evidence has shown that a group of children with ASD comorbid, especially with intellectual disability, do not respond to the treatment [1,3]. In a recent research, drug refractory behaviours in children with ASD defined as aggression, selfinjury, and tantrums requiring medication adjustment despite trials of risperidone and aripiprazole or three or more psychotropic drugs targeting irritability [1]. In this presentation, it is aimed to review current literature with the case report of a child with ASD who had drug refractory self-injurious behaviour. Case presentation: Ten-year-old boy, who diagnosed with ASD and attention-deficit/hyperactivity disorder (ADHD) and intellectual disability, has been followed in our outpatient clinic since he was 3 years old. He had been prescribed risperidone up to 2 mg/day for irritability and hyperactivity between 3 and 9 years old, and had responded well to the treatment. At age 10, his family described the increase in irritability, aggression, tantrums, and severe self-injurious behaviour with his ongoing treatment. His Clinic Global Impression (CGI)-Severity score was 7/7, Aberrant Behaviour Checklist (ABC)-Irritability score was 41/45 and ABC-Hyperactivity score was 40/48. Neurological and medical comorbidities were not detected in the examination. There was limited or no response to the treatment with various trials of risperidone, aripiprazole, haloperidol, zuclopenthixol, benzodiazepines, methylphenidate, atomoxetine, valproate, and PSYCHIATRY AND CLINICAL PSYCHOPHARMACOLOGY, 2018 VOL. 28, NO. S1, 297-391 https://doi.org/10.1080/24750573.2018 naltrexone. After the combined treatment of risperidone 2 mg/day with clonidine 0.3 mg/day, well and sustainable treatment response of irritability and self-in...