Social cognition in pervasive developmental disorders [Yaygin gelişimsel bozukluklarda sosyal biliş]

Pervasive developmental disorders (PDDs) and autistic disorder (AD) are neurodevelopmental disorders with genetic basis and abnormal brain development, and characterized by severe and permanent deficits in many interpersonal relation areas like communication, social cognition and processing of emotional signs. Cognitive impairments in AD and other PDDs are tried to be explained by neuropsychiatric models like theory of mind deficits, executive dysfunction and weak central coherence. This article aimed to review neurobiological bases of social cognition and theory of mind which try to explain social cognition. PubMed medical search engine was queried to find out the studies and review articles on social cognition and theory of mind in AD and PDDs. Social cognition may be defined as the ability to interact in complex social areas with understanding the others' intentions and thoughts. The mind deficit is theorized to be one of the basic difficulties in autism. Individuals with autism have deficits in recognizing mental processes and mental representations of self and others'. Patients with AD have deficits in social functions which an important part of interpersonal interactions and functioning within a social group; like face recognition, eye contact and emotional expression recognition. Frontal lobe, temporal lobe, anterior cingulate cortex, fusiform gyrus, amygdala, posterior association cortex and their internal associations are brain areas associated with social cognition. Fusiform gyrus and amygdala are effective in face perception and recognition. Studies suggest that a deficit in amygdala may lead to social perceptional deficits like face identity and emotional expression recognition. It is determined that individuals with PDDs have hypoactivation in fusiform gyrus during perception of faces. Amygdala has a regulatory effect on fusiform gyrus and in lesions of amygdala, the hypoactivation of fusiform gyrus for emotional salient faces are parallel to the level of amygdala lesion. The common result of many studies is that the hypoactivation of fusiform gyrus is based on some processes related to amygdala. Superior temporal sulcus hypoactivations and abnormal volume measures were found in patients with autistic disorder. Superior tempral sulcus has a role in perception of social stimulus from gaze directions, and eye and body movements of others'. Autism can be defined as a social cognition disorder and is caused by deficits at microscopic and/or macroscopic levels in these brain systems. The review of the neurobiology of social cognition in AD and other PPDs defisits in amygdala and in connections of amygdala with other temporal areas including fusiform gyrus, superior temporal sulcus in early infancy and that leads to a deficit or absence of infant's interest for faces and other stimuli which are socially significant. This causes abnormal development of brain areas like fusiform gyrus which needs a stimulus dependent activation. When studying social cognition deficits, it is important to note that autism is not a disorder of a unique neuroanatomical system or cyclus; but it is a neurodevelopmental disorder in which many pervasive neural systems are affected

Psychiatric evaluation of children with vernal keratoconjunctivitis [Vernal keratokonjonktivitli çocuklarda psikiyatrik degerlendirme]

Objective: To evaluate the psychiatric effects of vernal keratoconjunctivitis (VKC) in children. Material and Methods: Psychiatric evaluation forms were filled out through an interview with 25 children with vernal keratoconjunctivitis (VKC, study group) and 36 myopic (-0.50 and -1.50 D) and otherwise healthy children (control group). Both groups' mothers filled the Child Behavior Check List (CBCL). All children filled the Children Depression Inventory (CDI), the State-Trait Anxiety Inventory (STAI), and were interviewed using Kiddie Schedule for Affective Disorders and Schizophrenia. The Diagnostic and Statistical Manual for Psychiatric Disorders, 4th edition was used for psychiatric diagnosis. Results: The CBCL scores of activities (p<0.0001), and sociability (p=0.003) were significantly lower, and the scores of withdrawn (p=0.48), somatization (p<0.0001), anxiety depression (p=0.045), attention problems (p=0.001), total problems (p=0.020), internalizing (p=0.001) were significantly higher in the study group. The scores of STAI I (p<0.0001) and STAI II (p<0.0001) were significantly higher in the study group. The CDI scores of the study group were significantly higher (p<0.0001). A psychiatric diagnosis was made in 64.00% of the study group, and in 2.77% of the control group patients (p< 0.0001). Conclusion: VKC is a chronic disorder which affects the activity and sociability of children, and tends to cause depression and anxiety disorders. Ophthalmologists should be aware of the possible psychiatric effects of VKC in pediatric population, and should remember to consult these children to child psychiatrists. © 2013 by Türkiye Klinikleri

Psychiatric evaluation of children with vernal keratoconjunctivitis [Vernal keratokonjonktivitli çocuklarda psikiyatrik degerlendirme]

Objective: To evaluate the psychiatric effects of vernal keratoconjunctivitis (VKC) in children. Material and Methods: Psychiatric evaluation forms were filled out through an interview with 25 children with vernal keratoconjunctivitis (VKC, study group) and 36 myopic (-0.50 and -1.50 D) and otherwise healthy children (control group). Both groups' mothers filled the Child Behavior Check List (CBCL). All children filled the Children Depression Inventory (CDI), the State-Trait Anxiety Inventory (STAI), and were interviewed using Kiddie Schedule for Affective Disorders and Schizophrenia. The Diagnostic and Statistical Manual for Psychiatric Disorders, 4th edition was used for psychiatric diagnosis. Results: The CBCL scores of activities (p<0.0001), and sociability (p=0.003) were significantly lower, and the scores of withdrawn (p=0.48), somatization (p<0.0001), anxiety depression (p=0.045), attention problems (p=0.001), total problems (p=0.020), internalizing (p=0.001) were significantly higher in the study group. The scores of STAI I (p<0.0001) and STAI II (p<0.0001) were significantly higher in the study group. The CDI scores of the study group were significantly higher (p<0.0001). A psychiatric diagnosis was made in 64.00% of the study group, and in 2.77% of the control group patients (p< 0.0001). Conclusion: VKC is a chronic disorder which affects the activity and sociability of children, and tends to cause depression and anxiety disorders. Ophthalmologists should be aware of the possible psychiatric effects of VKC in pediatric population, and should remember to consult these children to child psychiatrists. © 2013 by Türkiye Klinikleri

Evaluation of parental attitudes in a clinical sample of adolescents with major depressive disorder [Majör depresif bozuklugu olan gençlerden oluşan bir klinik örneklemde anne baba tutumlarinin degerlendirilmesi]

Objective: Depression in adolescence is associated with a number of ethological factors such as genetic, biologic, environmental, and psychological. Recently, parent-child interaction models are considered as important contributors to depression in adolescents. The aim of this study was to investigate the characteristics of parental attitudes in depressed adolescents compared to healthy controls. Methods: One hundred and twenty adolescents participated: 60 major depression participants, and 60 healthy control participants without a history of any psychiatric disorder. Sixty adolescent outpatients (30 females, 30 males; mean age: 16.52±1.13 years; range: 14-18 years) fulfilling the DSM-IV criteria for MDD and 60 matched psychiatrically healthy adolescents (30 females, 30 males; mean age: 16.50±1.13 years; range: 14-18 years) were included in the study. Evaluations of adolescents were made using the Schedule for Affective Disorders and Schizophrenia for Kiddie and Young Adult, Beck Depression Inventory, and the parents have filled the Parental Attitude Research Instrument. Results: Our findings revealed that over parenting, marital discordancy and authoritarian attitudes scores were higher in depressed adolescents' parents than the control group. As another important result of this study, hostile, rejecting, and authoritarian attitudes were found to be related with suicidal behavior of depressed adolescents. Conclusion: These results suggest that certain aspects of parenting such as over parenting, marital discordancy and authoritarian attitudes contribute to the pathogenesis of major depression in Turkish adolescents. High levels of marital discordancy, over-parenting, and authoritarian attitudes in the study group may be associated with conflicts in family relations

Suça Sürüklenen Çocukların Sosyodemografik Özellikleri ve Ruhsal Değerlendirmeleri

Objective: The aim of this study was to investigate the factors associated with involvement in crime by examining the sociodemographic characteristics and psychiatric evaluation results of juvenile delinquents. Method: Files of 185 patients aged 12-18 years, were examined. Psychiatric diagnoses of the cases were made according to the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders-5. The intellectual capacity was evaluated with the Wechsler Intelligence Scale (WISC-R) for Children-New Version and Thematic Apperception Test was used for getting an idea about their inner conflicts, emotions and psychological needs. Results: In our study, 93.0% (n=172) of the cases were male and 53.0% of the cases were dropped out of school. The most common crime type was theft (40.0%, n=74). There was a recurrent crime history in 31.4%. WISC-R Total IQ scores were significantly lower in the cases with recurrent crime history (p<0.001, 60.26±20.72). Psychiatric diagnosis was found in 61.1% and there was a significantly higher rate of psychiatric disorders in cases with a history of crime (p=0.011). The theme of offensiveness, aggression and anger in the Thematic Apperception Test was statistically significantly higher in those with a previous crime history (p=0.004). Conclusion: In our study, finding a relationship between recurrent crimes and psychopathology is meaningful. Psychiatric follow-up and treatment are important in terms of reducing the probability of committing crimes again and bringing them to the society. © 2020, Istanbul Universitesi. All rights reserved