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This exploratory study aimed to evaluate factors related with child marriage compared to unmarried status in female adolescent residents in a refugee camp in Turkey. The rate of child marriage and developmental status of offspring from those marriages were reported. A research team evaluated married female youth and their offspring for psychopathologies according to DSM-5 criteria and ascertained lifetime traumatic events among mothers. We compared the traumatic experiences and psychopathologies of married females and controls. Post-traumatic stress disorder (PTSD) was the most common diagnosis in both groups and child brides reported greater cumulative traumatic experiences and elevated rates of PTSD. More than one-tenth (i.e., 15.1%) of offspring of child brides displayed developmental delays and 12.1% were diagnosed with global developmental delay. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood, which is generally treated with stimulant and non-stimulant medications. However, 10–30% of patients in clinical setting do not present with adequate response to initial stimulant treatment. Thereby, clonidine may be considered for those patients who have failed to respond to psychostimulant/atomoxetine monotherapy or as an augmentation for inadequate response/comorbidity. This observational study evaluated its effectiveness as a single drug in ADHD cases unresponsive to previous treatment trials. Seventeen ADHD cases that were non-responders to stimulant, non-stimulant and combination therapy for the primary symptoms of ADHD were included in the study. Four cases dropped out before follow up, leaving thirteen cases who were administered immediate release clonidine treatment alone with a mean dose of 0.2 ± 0.05 mg/day at baseline. The trial lasted for 12 weeks, and treatment outcomes were evaluated by the Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S) and the Clinical Global Impressions-Severity (CGI-S) and Improvement (CGI-I) scales. Mean age of the sample was 12.5 years (SD = 3.0) and eleven of the subjects had another comorbid psychopathology. Only two cases were evaluated as "very much improved", while another patient was judged to be "minimally improved" after 12 weeks of clonidine treatment. Attrition during follow-up was associated with higher median scores on the hyperactivity and impulsivity subscales (Mann-Whitney U test, p = 0.02). According to the T-DSM-IV-S, CGI-S, and CGI-I scales, clonidine treatment by itself had minimal benefits in this sample of treatment of refractory cases with ADHD evaluated at the study center. Clonidine is not available in Turkey pharmaceutical marketing system and patients' access to drug is limited. Our results provide first data regarding the use of clonidine in Turkish ADHD patients. [ABSTRACT FROM AUTHOR]

The factors such as having family problems, growing up in a disintegrated family, having parents with personality disorders, expressing physical and mental deficiencies, history of alcohol and substance abuse, previous history of sexual abuse, and lack of social support may increase the risk of being exposed to sexual abuse. According to the previous studies about one-third of children who are subjected to abuse may become abusers in the future. In such a condition, a dilemma of abuse-abuser has been experienced. Importantly, additional medical mistakes and lack of experience in such cases make legal evaluation processes more complex. In this case report, we discussed a pediatric patient who was abused by a babysitter with a history of abuse in her adolescence. Early recognition of sexual abuse, treatment of developing psychiatric disorders, and a follow-up program are necessary to minimize the vicious cycle of abused-abuser. [ABSTRACT FROM AUTHOR]

Objective: In the present study, the aim was to evaluate the beliefs and attitudes of school counselors about mental illnesses, and reasons why counselors referred students to psychiatrists. Method: The study was carried out with 118 school counselors. Data were collected with sociodemographic information form and Beliefs toward Mental Illness Scale (BMIS). Results: According to study results, 15.3% of school counselors stated that they referred to a psychiatrist for their own psychological problems atsome time, and 32% of subjects referred their own children to a child and adolescent psychiatrist. The proportion of teachers who referred their students to a child and adolescent psychiatrist was 89.8%. Scores of school counselors were80.41±9.32 in overall BMIS, 28.82±5.35 in dangerousness, 43.83±4.93 in poor social and interpersonal skills, and 7.76±1.81 points in incurability subscales. No statistically significant relationship was determined between mean scores of participants and gender, age, marital status, institution where they work, working duration, and graduate program they attended. The four most frequent student referral causes were conduct disorder (31.10%), attention deficit (16.10%), depressive mood (14.72%) and hyperactivity (12.20%). Conclusion: It is noticed that school counselors have negative beliefs about mental disorders, feel shame because of them, and they regard these patients dangerous. On the other hand, participants believe that these disorders lead to despair in individuals and impair interpersonal communication. According to the literature search, this study is the first investigating beliefs and attitudes of school counselors about mental illnesses, and reasons why they refer students to psychiatrists. [ABSTRACT FROM AUTHOR]

Neurotransmitters and neuroreceptors involved in the pathophysiology of hiccups are not well defined. However, dopamine and serotonin are reported to have roles in activating hiccups, and recent case reports suggest that some psychopharmacologic medications --such as antipsychotics-- may trigger hiccups in many cases. Our case describes the activation of hiccups in a young male with schizophrenia while being treated with aripiprazole. The patient was switched from risperidone to aripiprazole due to excessive sedation, hiccups started within 48 hours of initiation of treatment with aripiprazole at a dosage of 15 mg/day, and no change in the hiccups was observed despite a dose reduction. Discontinuation of aripiprazole treatment resulted in complete relief from hiccups. This case report shows that antipsychotics may trigger hiccups. [ABSTRACT FROM AUTHOR]

Tuberous sclerosis is a multi-system-genetic disease occurring early in life with the classic triad of seizures, intellectual disability, and cutaneous angiofibroma. One of the most important psychiatric comorbidities in tuberous sclerosis is aggressive/disruptive behavior disorder. In this case report, treatment of a 14-years-old male with tuberous sclerosis, who was referred with severe behavioral problems secondary to mental retardation using clonidine is presented. [ABSTRACT FROM AUTHOR]

Mental retardation is diagnosed before age of 18 that includes below-average general intellectual function and a lack of the skills necessary for daily living. It is also characterized with impairment of environmental adaptation and behaviors. Approximately, it affects 1-3 % of the general population. Studies have also shown a male preponderance for all types of mental retardation (MR) and males are 1.6-1.7 times more vulnerable as compared with females. Relative to the general population, people with MR are more likely to show psychosis, autism and attention-disruptive disorders and less apt to be diagnosed with substance abuse and affective disorders. Rates of Attention Deficit Hyperactivity Disorder (ADHD) range from 7% to 15% in children with MR. Behavioral problems are frequently detected and communication disorders are seen nearly 50% of people with MR. No data so far about the rate of suicide attempts in this group have been published. Aripiprazole's mechanism of action is different from the other FDA-approved atypical antipsychotics (e.g., clozapine, olanzapine, quetiapine, ziprasidone, and risperidone). Rather than antagonizing the D2 receptor, aripiprazole acts as a D2 partial agonist. Aripiprazole is also a partial agonist of 5-HT1A receptor and like the other atypical antipsychotics displays an antagonist profile of 5-HT2A receptor. Aripiprazole is used increasingly for the treatment of ADHD, mood disorders, schizophrenia, conduct disorder, tic disorders, pervasive developmental disorders and anxiety disorders at child and adolescent psychiatry clinics. Aripiprazole is thought to be useful for psychiatric disorders affecting cognitive functions like ADHD because of its unique receptor binding profile. Aripiprazole has shown less adverse effects compared with other typical and atypical antipsychotics. Studies pointed that it causes minimal sedation, lesser metabolic side effects like weight gain and no alteration in prolactin serum levels. Here, we present a male case with 46,XY,YQ+ with borderline mental capacity, ADHD, Oppositional Defiant Disorder, Phonological Disorder and two suicide attempts while on the treatment with OROS methylphenidate at the dose of 18 mg/day. He was obese and had bilateral gynecomastia and some genetic stigmas like brachydactyly, clinodactyly, synophrys and low frontal hairline. He had used risperidone, haloperidole and quetiapine intermittently combined with methylphenidate since he was 5 because of his temper tantrums, impulsivity and stereotypic hand movements. All of these medications caused him weight gain and sedation during daytime; thereby his family discontinued these treatments due to these side effects. Of note, he has used methylphenidate for ADHD and found it useful for his attention at the school. We prescribed aripiprazole 5 mg/day treatment adjunctive to methylphenidate to control his temper tantrums, impulsivity and other behavioral problems. After starting aripiprazole he did not gain weight and feel sleepy at school. Moreover, his cognitive functions, social relationships and temper management were better than before as defined during routine controls at our clinic. His hand movements were not altered. In conclusion, it is likely that aripiprazole will be used in child and adolescent psychiatry clinics for many of the same target symptoms described earlier for risperidone. [ABSTRACT FROM AUTHOR]

Objective: Androgenic neurosteroids have been shown to have involvement in the etiopathogenesis of many psychiatric disorders. To be able to tell if changes seen in adults could also be shown in the pediatric age group is substantially important in elucidating the etiology. However, we did not come across any study that inspected neurosteroid levels in pediatric obsessive-compulsive disorder (OCD) patients. Consequently, in this study, we planned to study the levels of cortisol, testosterone and DHEA-S in pediatric OCD patients. Methods: In this study, children between 7 and 16 years of age, 39 of whom were OCD patients and 37 healthy, have been included, with both groups having a similar distribution of age and sex. Total serum testosterone, cortisol and DHEA-S levels were measured using the ELISA method, and the relationship with the clinical data was investigated. Results: No statistically significant difference could be established between the patients and the control group in testosterone, DHEA-S or cortisol levels. (p=0,175, p=0,642, p=0,842 respectively). Conclusion: This first study found out that levels of cortisol, testosterone and DHEA-S in the pediatric patients were no different than they were in the control group. However, considering that the levels of these neurosteroids have been shown to be different in the adult patients before, it is likely that the change in neurosteroid levels is a finding emerging in the course of the anxiety disorders. [ABSTRACT FROM AUTHOR]

Objective: The neurobiological basis of tic disorders is thought to be a series of interactions including genetic, environmental and gender-related factors. Male gender is thought to be an especially important risk factor in the pathogenesis of the tics. Our aim in this study was to investigate the gender-related hormones of testosterone, dehydroepiandrosterone sulfate (DHEA-S) and cortisol gender hormones in tic patients. Methods: A total of 26 patients aged 7-12 years who had not entered puberty and were diagnosed with chronic motor or vocal tic disorder (CMVTD) or Tourette syndrome (TS) and 22 healthy children of similar age and gender were included in the study. Serum total testosterone, cortisol and DHEA-S levels were measured with the ELISA method and the relationship with clinical data was investigated. Results: The testosterone and DHEA-S level of the patient group was higher than that of the control group (p=0.019, p=0.025) but no statistically significant difference was found between the cortisol levels (p=0.642). No statistically significant correlation was found between DHEA-S and testosterone levels and the total tic severity, general disturbance and movement tic subscale scores (p=0.954, p=0.669, p=0.909 respectively for testosterone; p=0.77, p=0.45, p=0.819 respectively for DHEA-S). Conclusion: The results of this study reveal an elevation of testosterone and DHEA-S in CMVTD and TS patients. Future studies with a larger number of patients can help elucidate the importance of these androgens in tic disorder. [ABSTRACT FROM AUTHOR]

Objective: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders during childhood. It was shown that depression frequency and stress level is higher among mothers of children with ADHD and ADHD affects mental health of mothers of children with ADHD. The aim of this study is to compare depression and burn-out levels of mothers of children with ADHD pre-treatment and second month post-treatment Method: Forty children between the ages of 4 and 10 years diagnosed to have ADHD according to DSM IV and their mothers admitted to child and adolescent psychiatry clinic of Gaziantep University composed the study sample. All mothers of children with ADHD were conveyed to fill Beck Depression Scale, Maslach Burnout Inventory and Turgay DSM IV Based Child and Adolescent Behaviour Disorders Screening and Rating Scale. Results: While mothers'post-treatment Beck Depression Scores and Maslach-emotional exhaustion subscale and depersonalization subscale scores were found to be statistically significantly lower than pre treatment scores. Maslach-personal accomplishment subscale scores were found to be statistically significantly higher than pre-treatment scores. Turgay DSM IV Based Child and Adolescent Behaviour Disorders Screening and Rating Subscales Scores were significantly lower at second month posttreatment compared with pre-treatment. Conclusion: This study showed that the treatment of children with ADHD positively affected their mothers'depression scores and burnout levels. It is known that psychiatric disorders of mothers poorly affects ADHD prognosis and treatment period. It is important for prognosis that the treatment both decreases ADHD symptoms in children and improves their mothers'mental health. [ABSTRACT FROM AUTHOR]