European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment

To develop a European guideline on pharmacologic treatment of Tourette syndrome (TS) the available literature was thoroughly screened and extensively discussed by a working group of the European Society for the Study of Tourette syndrome (ESSTS). Although there are many more studies on pharmacotherapy of TS than on behavioral treatment options, only a limited number of studies meets rigorous quality criteria. Therefore, we have devised a two-stage approach. First, we present the highest level of evidence by reporting the findings of existing Cochrane reviews in this field. Subsequently, we provide the first comprehensive overview of all reports on pharmacological treatment options for TS through a MEDLINE, PubMed, and EMBASE search for all studies that document the effect of pharmacological treatment of TS and other tic disorders between 1970 and November 2010. We present a summary of the current consensus on pharmacological treatment options for TS in Europe to guide the clinician in daily practice. This summary is, however, rather a status quo of a clinically helpful but merely low evidence guideline, mainly driven by expert experience and opinion, since rigorous experimental studies are scarce

Mental assessment of girls consulting for early marriage and identifying risk factors

Objective: The aim of this study is to analyze socio demographic characteristics and mental disorder diagnoses for girls between 16 and 17 years old who had been referred for a report stating whether any obstacles existed to their marriage. Methods: Eighty cases between January 1st 2010 and January 1st 2016 seeking a juridical report identifying any condition that might be obstacle to the marriage of girls aged 16 and 17 have been included within the scope of this Sakarya University Child and Adolescent Psychiatry clinic study. The adolescents were examined by 5 different children and adolescent child psychiatrists working in the relevant hospitals for 6 years. The cases were diagnosed in DSM-IV criteria. Results: In 53.8% (n=43) of the cases no mental disorder was identified. Among the rest, the following was detected 18.8% (n=15) attention deficiency hyperactivity disorder (ADHD), 5% (n=4) conduct disorder, 3.8% (n=3) anxiety disorder, 2.5% (n=2) depressive disorder, 1.3% (n=1) adjustment disorder, 6.2% (n=6) mental retardation and 19.8% (n=16) borderline intelligence. Discussion: It should be well considered and kept in mind that the girls who have not married also yet to show significant mental disorders. In an attempt to prevent early marriages for girls, close follow-up of children's education and social and mental health must be conducted

Comparison of Psychiatric Disorders Between Children with a History of Parental Divorce and Parental Death

Objective: This study is aimed to compare the rate of psychiatric diagnoses between children and adolescents with parentaldeath and parental divorce. The study additionally examines the differences in psychiatric diagnosis of children between preand post-parental divorce.Methods: The files of 4,160 children and adolescents referred to child psychiatry outpatient clinic between September 2014and September 2016 were examined retrospectively. Six hundred thirty eight children and adolescents with parental divorceor parental death were compared in terms of psychiatric disorders. The relationship between age, gender, living with motheror father, parental remarriage and psychopathology in children and adolescents was evaluated. Psychiatric diagnoses werecompared in cases with parental divorce before and after the divorce.Results: There were no significant differences between groups in terms of current psychiatric disorders. In both groups,disruptive behavior disorders were the most common diagnosis, followed by internalizing disorders such as depression andanxiety disorders. Younger age and living with the father were factors associated with psychiatric disorder in children.Discussion: Supportive approaches towards children with younger age and living with the father and their parents may beespecially important in reducing the risk of developing psychiatric disorder

Importance of Attachment: Two Cases, Attached to Different Parents and Given to Their Biological Parents at the Age of Four

Attachment between mother and the baby is important regarding the healthy development of the child. Importance of attachment was aimed to be investigated. Two male children, who were given to other families after birth and given back to their biological families at the age of four by court order, were observed with their families and evaluated regarding their attachment, coherence in their new families, and other problems. The follow-up continued by clinical evaluations. Denver II, Maternal Attachment Inventory, Adult Attachment Style Scale, Child Behavior Checklist (CBCL), Parental Attitude Research Instrument (PARI) were used. Informed consents were taken from the families for research purposes. As a result, children who were raised by other parents then their biological parents, were determined to attach to the parents who raised them. It was established that there were problems regarding separation from the families who were the children attached to and reattachment to the biological parents were risen in the process. The importance of attachment between mother and children, regarding the psychiatric development of children was discussed. The problems which were caused by the separation from parents who the children were attached to and the difficulty of re-attachment after four years were reviewed

Determining Maslach Burnout Inventory usability of parents of autistic spectrum disorder children

Objective: The purpose of this study is to examine the usefulness of the Maslach Burnout Inventory in determining the burnout of parents with autism spectrum disorders in their children. Methods: Data were collected from 236 participants in order to reveal the psychometric properties of the inventory. Confirmatory factor analysis was performed on the asymptotic covariance matrix to obtain evidence of the construct validity of the data, and the Satorra-Bentler chi(2) statistic was used for model adaptation. Cronbach's alpha internal consistency coefficients were calculated to obtain evidence of reliability. Results: When the evidence of reliability and validity obtained were evaluated together, it was found that the scale factor met the good measure of burnout and that the factor design of Maslach Burnout Inventory was confirmed. Discussion: With these features, the scale can be used to determine the burnout of parents with autism spectrum disorder in their children

Determinants of psychiatric disorders in children refugees in Turkey's Yazidi refugee camp

Objective: To examine the mental health states of a sample of Yazidi refugee children and adolescents who migrated from war-torn Iraq's Sinjar region and to determine the risk and protective factors for psychiatric disorders among the refugee children and adolescents. Method: The participants of this research were children and adolescents between ages 6 and 17 who live in a refugee camp in Turkey. Their parents/guardians provided written informed consents for the research. The research was approved by the Ethics Council of Sakarya University. Participants with intellectual disabilities and autism spectrum disorders were excluded from the study. Two child and adolescent psychiatrists speaking their native language interviewed and evaluated each of the participants. Collected data included socio-demographic information about previous and current living situations, Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime - Turkish Version (K-SADS-PL). Results: One hundred and thirty-six children and adolescents (76 boys, 63 girls; mean age=11.05 +/- 3.11(SD)). At the time of the assessment, 43.4% had posttraumatic stress disorder (PTSD) (n=59), 27.9% depression (n=38), 10.3% nocturnal enuresis (n=14), 9.6% behavioural problems (n=7), and 5.1% anxiety disorders (n=13). Conclusions: Many of the refugee children and adolescents had developed psychiatric disorders, or are at risk for PTSD and depression. Also, the ongoing ambiguity regarding their living conditions, interruption of their education, a lack of hope for the future and anxiety regarding the ones they left behind are considered to be risk factors for the development of psychiatric and social problems in the future. Living with family members and not having losses from the immediate family are protective factors