Three adolescent cases of a very rare disorder: Trichotemnomania

Trichotemnomania (TT) is characterized as the cutting or shaving of hair, which is an obsessive-compulsive habit. TT takes its name from a fusion of Greek words: thrix (hair), temnein (to cut), and mania (madness). TT is a very rare disease with only five case studies reported in the literature and to the best of our knowledge; no data are available on adolescents. This study focuses on three cases of adolescents with TT. All patients have been evaluated by a dermatologist and two child and adolescent psychiatrists. Dermatological examinations included medical history, physical examination, dermoscopy assessment, and laboratory investigations. Detailed psychiatric assessments consisted of socio-demographic data, clinical history, semi-structured interviews, and psychometric tests. Three cases with TT were both diagnosed with obsessive-compulsive disorder. Two of them diagnosed comorbid social anxiety disorder (in cases 1 and 2), and one case diagnosed with comorbid general anxiety disorder (in case 3) and agoraphobia (in case 3). Cases 1 and 2 were prescribed 50 mg/day of sertraline; however, case 3 refused the treatment. In conclusion, TT may be confused with trichotillomania or other disorders presented with alopecia. Differential diagnoses may be due to histopathological changes or dermoscopic assessment. Dermatologists should consider TT when a supposed alopecia areata looks somewhat unusual and should refer these patients for psychiatric evaluation

Case report: differential diagnosis of obsessive-compulsive symptoms confounded by delusion-like fixations and somatic symptoms in an adolescent

Obsessive-compulsive symptoms can at times be confounded by delusional symptoms, which can be especially challenging to interpret correctly in children and adolescents, who may struggle to articulate the intrusive or unreasonable nature of their obsessions. Obsessions, overvalued ideas and delusions can have an overlap. Persistent headaches are not uncommon amongst patients presenting with anxiety disorders and psychosomatic symptoms are frequently reported by children. Psychosomatic complaints, such as enduring headaches, can also have an undesirable impact on therapeutic approach and delay access to the correct treatment. In this case we discuss diagnostic pitfalls in an adolescent girl presenting with obsessive-compulsive symptomatology and a successful treatment of enduring symptoms with psycho-education and medication. We will argue that psycho-education for young people and their families based on a correct diagnosis of obsessive compulsive disorder (OCD) is essential to provide reassurance, to help young people regain self-confidence and re-establish constructive relationships within the family unit. Selective serotonin re-uptake inhibitors (SSRI) are the drug of choice for pharmacological treatment of OCD in this age group. We conclude that a correct diagnosis of the condition as "anxiety-driven" was of paramount importance for psychological approach and pharmacological management of this case.Obsesif Kompulsif Semptomlar, özellikle de zorlayıcı nedensiz obsesyonlarını açıklamada güçlük çeken çocuk ve ergenlerde olmak üzere sanrılar ile karışabilmektedir. Obsesyonlar, aşırı zihinsel uğraşlar ve sanrılar ile karışabilmektedir. Psikosomatik semptomlar çocuklar tarafından sıklıkla belirtilen bir durumdur ve sürekli baş ağrıları anksiyete bozukluğu olan kişilerde nadir değildir. Sürekli baş ağrıları terapotik yaklaşımı olumsuz olarak etkileyebilmektedir ve aynı zamanda doğru tedaviye de ulaşmayı güçleştirmektedir. Bu olguda obsesif kompulsif semptoloji ile başvuran bir kız ergendeki tanısal güçlükleri ile bu semptomların psikoeğitim ve farmakoterapi ile başarılı bir şekilde tedavisi tartışılmaktadır. Aynı zamanda obsesif kompulsif bozukluğun (OCD) doğru tanısı ile ergenler ile ailelerine psikoeğitim verilmesinin bu gençlerin öz güvenlerine kavuşmaları ve aileleri ile tekrar yapılandırılmış bir ilişki kurmaları için önemi tartışılacaktır. Bu yaş bireylerde OKB’nin farmakolojik tedavisinde seçilecek ajan Selektif Serotonin Geri Alım İnhibitöreleridir (SSRI). Son olarak bu olgunun anksiyete ile ilişkili bir durum olarak doğru şekilde tanımlanması ve psikolojik yaklaşımı ile farmakolojik yönetimi oldukça önemlidir

Mental assessment of child and adolescents in health measure

Conclusion: The study has shown that a large proportion of the examined children were diagnosed with at least one psychiatric disorder. Further studies are needed in order to determine the risks and the protective factors that affect the admitted children to the child protection system psychologically

Posttraumatic stress and depression in Yazidi refugees

Conclusion: Most of the refugee children had experienced serious traumatic events in their home country. PTSD, depression, and comorbid mental problems are frequently seen in refugee children

Clinical follow-up findings of inpatient treatment in abuse cases

TEZ8430Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2011.Kaynakça (s.57-70) var.vii, 81 s. ; 29 cm.Introduction: Although there are many residential centers for abused and neglected children, the first residential institution of Turkey ""Oguz Kagan Koksal Social Cere and Rehabitation Center"" has been established in Adana city. Psychiatric care has been provided by Cukurova University Medical Faculty Child and Adolescent Psychiatry Department in this center. In this study, the clinical and demographic characteristics, and follow-up findings of patients who treated in the center since six years will be presented. Material and Methods: Total 152 girls aged 8-18 were included in this study. Abuse-specific variables, demographic data were obtained from file records. Results: The history of sexual abuse was reported by 78.9% of cases. 75 of girls have been iagnosed as Posttraumatic Stress Disorder, 36 as Borderline Personality Disorder 32 as estructive Behavior Disorders, and 14 as Mood Disorder. Posttraumatic Stress Disorder and Borderline Personality Disorder were more common among the girls who reported exual abuse history than who had no. Psychotropic drugs were used in treatment of 94.5% of cases. Antipsychotics were given in treatment of 81.4% of girls, and it was most frequently chosen drugs. The rate of cases who used mood stabilizers was determined as %51.7%, antidepressants as 25.5%. The mean treatment duration was 7.7 months; and it was longer in the girls who used drugs than who had no. Conclusion: Residential treatments are different from the other treatments with to keep a combination of several applications. The experiences of the center which presented in here are important because it is first institution of our country that worked on child and adolescents victims of abuse. Treatment and rehabilitation centers should promote across the country. The findings of this study are supported the possible usefulness of the presented treatment system.Amaç: Dünyada istismar ve ihmale uğramış çocuklara yönelik birçok rezidental merkez bulunmasına karşın, Türkiye'nin ilk rezidental kurumu olan ""Oğuz Kağan Köksal Sosyal Bakım ve Rehabilitasyon Merkezi"" Adana ilinde kurulmuştur. Söz konusu merkezde psikiyatrik tedaviler Çukurova Üniversitesi Tıp Fakültesi Çocuk Ergen Psikiyatrisi nabilim Dalı tarafından yürütülmektedir. Bu çalışmada merkezde altı yıldan bu yana tedavi gören hastaların klinik ve sosyodemografik özellikleri ve izlem bulguları sunulmuştur. Gereç ve Yöntem: Çalışmaya 8-18 yaşlarında toplam 152 kız olgu alındı. İstimara özgü değişkenlere ve demografik bilgilere dosya kayıtlarından ulaşıldı. Bulgular: Olguların %78.9'i cinsel istismar öyküsü bildirdi. 75 olgu Travma Sonrası Stres Bozukluğu, 36 olguya Sınırda Kişilik Bozukluğu, 32 olguya Yıkıcı Davranış Bozukluğu ve 14 olguya Duygudurum Bozukluğu tanısı konmuştur. Travma Sonrası Stres Bozukluğu ve Sınırda Kişilik Bozukluğu tanısı tanıları cinsel istismar öyküsü bildirenlerde diğerlerinden daha yüksek oranlarda belirlenmiştir. Olguların %95.4'ünün tedavisinde psikotrop ilaçlar kullanılmıştır. Olguların %81.4'ünün tedavisinde kullanılan antipsikotikler en sık ullanılan ilaç tedavisidir. Duygudurum düzenleyiciler %51.7, antidepresanlar %25.5 oranlarında kullanılmıştır. Ortalama tedavi süresi 7.7 aydır. İlaç tedavisi alanların ortalama tedavi süresi diğerlerinden anlamlı biçimde daha uzundur. Sonuç: Rezidental tedaviler pek çok uygulamayı bir arada bulundurması ile diğer tedailerden ayrılır. Burada sunulan deneyimler ülkemizde istismar mağduru çocuk ve gençlerle çalışan ilk kuruma ait olması nedeni ile önemlidir. Tedavi ve rehabilitasyon merkezlerinin ülke genelinde yaygınlaştırılması gerekmektedir. Çalışmadan elde edilen izlem bulguları uygulanan programın faydalarının olabileceğini desteklemektedir

The number of war-related traumatic events is associated with increased behavioural but not emotional problems among Syrian refugee children years after resettlement

Background: Turkey is the leading refugee-hosting country in the world. However, there are few studies which investigate mental wellbeing of refugee children in Turkey. Objective: The paper aims to examine the prevalence of emotional and behavioural problems and associated risk factors among Syrian refugee minors in Turkey. Methods: The research involved 85 students from 2th to 8th grades. We investigated emotional and behavioural problems with parent-reported Arabic form of Strength and Difficulties Questionnaire (SDQ). Socio-demographical findings and children's war-related experiences were also examined. Results: The study sample consisted of 49 (63.6%) girls, and 28 (36.4%) boys (total 77) from age 7 to 17. Average time after resettlement was 29.8 +/- 11.2 (5 to 50 months) months. 66 (85.7%) children reported to had lost at least one familiar person due to the war. The mean experienced war-related traumatic events were calculated as 2.92 +/- 1.86. Total difficulty scores of 30 (39.0%) children were above the cut off values. The rates of children whose SDQ problem scores exceeded the cut-off values were as high as 45.5% (35) for Emotional problems, 64.9% (50) for Peer, 27.3% (21) for conduct and 19.5% (15) for Hyperactivity problems. Discussion: Results indicate high prevalence rates of severe traumatic experiences and possible psychiatric disorders among child survivors of Syrian war which in its seventh year now

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

Case report: differential diagnosis of obsessive-compulsive symptoms confounded by delusion-like fixations and somatic symptoms in an adolescent

Obsessive-compulsive symptoms can at times be confounded by delusional symptoms, which can be especially challenging to interpret correctly in children and adolescents, who may struggle to articulate the intrusive or unreasonable nature of their obsessions. Obsessions, overvalued ideas and delusions can have an overlap. Persistent headaches are not uncommon amongst patients presenting with anxiety disorders and psychosomatic symptoms are frequently reported by children. Psychosomatic complaints, such as enduring headaches, can also have an undesirable impact on therapeutic approach and delay access to the correct treatment. In this case we discuss diagnostic pitfalls in an adolescent girl presenting with obsessive-compulsive symptomatology and a successful treatment of enduring symptoms with psycho-education and medication. We will argue that psycho-education for young people and their families based on a correct diagnosis of obsessive compulsive disorder (OCD) is essential to provide reassurance, to help young people regain self-confidence and re-establish constructive relationships within the family unit. Selective serotonin re-uptake inhibitors (SSRI) are the drug of choice for pharmacological treatment of OCD in this age group. We conclude that a correct diagnosis of the condition as "anxiety-driven" was of paramount importance for psychological approach and pharmacological management of this case.Obsesif Kompulsif Semptomlar, özellikle de zorlayıcı nedensiz obsesyonlarını açıklamada güçlük çeken çocuk ve ergenlerde olmak üzere sanrılar ile karışabilmektedir. Obsesyonlar, aşırı zihinsel uğraşlar ve sanrılar ile karışabilmektedir. Psikosomatik semptomlar çocuklar tarafından sıklıkla belirtilen bir durumdur ve sürekli baş ağrıları anksiyete bozukluğu olan kişilerde nadir değildir. Sürekli baş ağrıları terapotik yaklaşımı olumsuz olarak etkileyebilmektedir ve aynı zamanda doğru tedaviye de ulaşmayı güçleştirmektedir. Bu olguda obsesif kompulsif semptoloji ile başvuran bir kız ergendeki tanısal güçlükleri ile bu semptomların psikoeğitim ve farmakoterapi ile başarılı bir şekilde tedavisi tartışılmaktadır. Aynı zamanda obsesif kompulsif bozukluğun (OCD) doğru tanısı ile ergenler ile ailelerine psikoeğitim verilmesinin bu gençlerin öz güvenlerine kavuşmaları ve aileleri ile tekrar yapılandırılmış bir ilişki kurmaları için önemi tartışılacaktır. Bu yaş bireylerde OKB’nin farmakolojik tedavisinde seçilecek ajan Selektif Serotonin Geri Alım İnhibitöreleridir (SSRI). Son olarak bu olgunun anksiyete ile ilişkili bir durum olarak doğru şekilde tanımlanması ve psikolojik yaklaşımı ile farmakolojik yönetimi oldukça önemlidir

Forensic reporting of a case of sexual abuse broadcast on periscope

Children who are investigated or prosecuted for an action that is considered a crime by the law, or children who were placed in security facilities due to his/her actions are defined as "children forced into crime". The period between ages 12-18 years is adolescence, during which crime rates are relatively high. The incidence of sexual behavior of adolescents on social media, which may be considered a crime, has increased in recent years due to technological improvements and increase in the use of social media. Also, the crime rates involving adolescents have increased due to environmental influences, familial factors, and mental disorders. Mental disorders such as conduct disorder, attention deficit hyperactivity disorder, and mood disorders have been found to be associated with sexual abuse in young persons in previous literature. In this study, we present the case of a boy who sexually abused his younger brother at the age of 14 years 2 months and broadcast this abuse on "Periscope". In this case study, we aimed to discuss the relationships between sexual abuse, social media, and psychiatric disorders