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Karakılıç Özturan E, Öztürk AP, Baş F, Erdoğdu AB, Kaptan S, ardelen Al AD, Poyrazoğlu Ş, Yıldız M, Direk N, Yüksel Ş, Darendeliler F. In response to: “Letter to: Endocrinological Approach to Adolescents with Gender Dysphoria: Experience of a Pediatric Endocrinology Department in a Tertiary Center in Turkey”. J Clin Res Pediatr Endocrinol 2023; 15:451-452. [PMID: 37752752 PMCID: PMC10683545 DOI: 10.4274/jcrpe.galenos.2023.2023-9-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 09/28/2023] Open
Affiliation(s)
- Esin Karakılıç Özturan
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Ayşe Pınar Öztürk
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Firdevs Baş
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Ayşe Burcu Erdoğdu
- Marmara University, Pendik Training and Research Hospital, Clinic of Child and Adolescent Psychiatry, İstanbul, Turkey
| | - Seven Kaptan
- Psychiatrists in Private Practice, İstanbul, Turkey
| | - Aslı Derya ardelen Al
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Şükran Poyrazoğlu
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Melek Yıldız
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Neşe Direk
- İstanbul University, İstanbul Faculty of Medicine, Department of Psychiatry, İstanbul, Turkey
| | - Şahika Yüksel
- İstanbul University, İstanbul Faculty of Medicine, Department of Psychiatry, Psychiatrist in Private Practice, Emeritus Professor, İstanbul, Turkey
| | - Feyza Darendeliler
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
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Karakılıç Özturan E, Öztürk AP, Baş F, Erdoğdu AB, Kaptan S, Kardelen Al AD, Poyrazoğlu Ş, Yıldız M, Direk N, Yüksel Ş, Darendeliler F. Endocrinological Approach to Adolescents with Gender Dysphoria: Experience of a Pediatric Endocrinology Department in a Tertiary Center in Turkey. J Clin Res Pediatr Endocrinol 2023; 15:276-284. [PMID: 36987788 PMCID: PMC10448553 DOI: 10.4274/jcrpe.galenos.2023.2023-1-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
Objective A significant rise in the number of trans adolescents seeking medical interventions has been reported in recent years. The aim of this study was to report the clinical features, treatment, and follow-up of adolescents with gender dysphoria (GD) with our increased experience. Methods Twenty-six male-to-female (MTF) and twenty-seven female-to-male (FTM) adolescents who were referred to the GD-outpatient clinic between 2016 and 2022 were reviewed. The clinical and laboratory findings of thirty transgender adolescents (15 FTM /15 MTF) who received medical intervention were evaluated retrospectively. Results Most individuals (60.4%) were admitted between 2020 and 2022, and the remaining (39.6%) were admitted between 2016 and 2019. At the time of referral, median age was 16.3 years [interquartile range (IQR) 1.53; range 13.2-19.4] in 26 MTF, and 16.4 years (IQR 1.74; range 11.7-21.6) in 27 FTM adolescents. The median age at pubertal blockage with gonadotropin-releasing hormone analog and androgen receptor blocker was 16.4 years (IQR 1.4; range 11.7-17.8) in 22 adolescents (9 MTF, 13 FTM), and 17.4 years (IQR 1.4; range 15.5-19.4) in 6 MTF individuals, respectively. Cross-sex hormone therapy was commenced in 21 adolescents (12 MTF, 9 FTM) at the median age of 17.7 years (IQR 0.61; range 16-19.5). Fifteen individuals (8 MTF, 7 FTM) have been transferred to the adult endocrinology department in transition clinics. Conclusion All treatments were generally well tolerated and effective, including bicalutamide, and no significant side effects were observed. Transition clinics played an important role in the better management of gender reassignment processes.
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Affiliation(s)
- Esin Karakılıç Özturan
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Ayşe Pınar Öztürk
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Firdevs Baş
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Ayşe Burcu Erdoğdu
- Marmara University, Pendik Training and Research Hospital, Clinic of Child and Adolescent Psychiatry, İstanbul, Turkey
| | - Seven Kaptan
- Psychiatrists in Private Practice, İstanbul, Turkey
| | - Aslı Derya Kardelen Al
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Şükran Poyrazoğlu
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Melek Yıldız
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
| | - Neşe Direk
- İstanbul University, İstanbul Faculty of Medicine, Department of Psychiatry, İstanbul, Turkey
| | - Şahika Yüksel
- İstanbul University, İstanbul Faculty of Medicine, Department of Psychiatry, Psychiatrist in Private Practice, Emeritus Professor, İstanbul, Turkey
| | - Feyza Darendeliler
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
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Tüğen LE, Göksu M, Erdoğdu AB. The level of anxiety in healthcare workers and their children during the COVID-19 pandemic. Psychiatry Res 2023; 326:115309. [PMID: 37399766 PMCID: PMC10279462 DOI: 10.1016/j.psychres.2023.115309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/05/2023]
Abstract
During the early stages of the COVID-19 pandemic, healthcare workers (HcWs) reported having high levels of psychological stress caused by the risk of being infected and infecting their families, social isolation, and inadequate protective equipment. This study aimed to determine the level of anxiety and related factors in HcWs and their children during the first phase of the COVID-19 pandemic in Turkey. Online questionnaires were sent to HcWs with children aged 8-18 years via e-mail and WhatsApp messages. In total, 144 HcWs and 135 of their children participated in this study. HcWs completed the State-Trait Anxiety Inventory state subscale (STAI-S) and the COVID-19 Risk Perception Scale. Their children completed the Screen for Child Anxiety-Related Emotional Disorders (SCARED). STAI-S and COVID-19 Risk Perception Scale scores of the HcWs in direct contact with COVID-19 patients were significantly higher than of those not in direct contact. Moreover, the children of HcWs that were in direct contact with COVID-19 patients had significantly higher SCARED subscale scores than those whose parents were not in direct contact. There was a significant correlation between the SCARED somatic/panic subscale scores and HcW STAI-S scores. The presence of a mental illness and direct contact with COVID-19 patients were the 2 main predictors of COVID-19 risk perception and the level of anxiety in HcWs. During the COVID-19 pandemic the children of HcWs were observed to be a mentally sensitive group, and preventive mental health programs should be developed.
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Affiliation(s)
- Leyla Ezgi Tüğen
- School of Medicine, Department of Child and Adolescent Psychiatry, Medipol University, Kavacık, Ekinciler Cd. No:19 Beykoz, Istanbul 34810, Turkey.
| | - Muhsine Göksu
- School of Medicine, Department of Child and Adolescent Psychiatry, Marmara University, Istanbul, Turkey
| | - Ayşe Burcu Erdoğdu
- School of Medicine, Department of Child and Adolescent Psychiatry, Marmara University, Istanbul, Turkey
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Cervin M, Miguel EC, Güler AS, Ferrão YA, Erdoğdu AB, Lazaro L, Gökçe S, Geller DA, Yulaf Y, Başgül ŞS, Özcan Ö, Karabekiroğlu K, Fontenelle LF, Yazgan Y, Storch EA, Leckman JF, do Rosário MC, Mataix-Cols D. Towards a definitive symptom structure of obsessive-compulsive disorder: a factor and network analysis of 87 distinct symptoms in 1366 individuals. Psychol Med 2022; 52:3267-3279. [PMID: 33557980 PMCID: PMC9693708 DOI: 10.1017/s0033291720005437] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/18/2020] [Accepted: 12/22/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques. METHODS A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM). RESULTS Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e. had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables. CONCLUSIONS Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology and treatment of OCD.
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Affiliation(s)
- Matti Cervin
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Euripedes C. Miguel
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | - Ygor A. Ferrão
- Department of Clinical Medicine (Neurosciences), Porto Alegre Health Sciences Federal University, Porto Alegre, Brazil
| | - Ayşe Burcu Erdoğdu
- Department of Child and Adolescent Psychiatry, Marmara University, Istanbul, Turkey
| | - Luisa Lazaro
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Sebla Gökçe
- Department of Child and Adolescent Psychiatry, Maltepe University, Istanbul, Turkey
| | - Daniel A. Geller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Yasemin Yulaf
- Department of Psychology, Gelişim University, Istanbul, Turkey
| | | | - Özlem Özcan
- Department of Child and Adolescent Psychiatry, İnönü University, Malatya, Turkey
| | - Koray Karabekiroğlu
- Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University, Samsun, Turkey
| | - Leonardo F. Fontenelle
- Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
- D'Or Institute for Research and Education (IDOR) and Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Yankı Yazgan
- Güzel Günler Clinic, Istanbul, Turkey
- Yale Child Study Center, New Haven, CT, USA
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - James F. Leckman
- Departments of Psychiatry, Pediatrics & Psychology, Child Study Center, Yale University, New Haven, CT, USA
| | | | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
- Health Care Services, Region Stockholm, Stockholm, Sweden
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Poyraz Fındık OT, Erdoğdu AB, Fadıloğlu E, Rodopman Arman A. Emergency Department Visits for Non-suicidal Self-harm, Suicidal Ideation, and Suicide Attempts in Children and Adolescents. Child Psychiatry Hum Dev 2022; 53:289-299. [PMID: 33523341 DOI: 10.1007/s10578-021-01125-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/26/2022]
Abstract
Self-harm presentations to emergency departments (ED) have become a growing concern, yet little is known about self-harm visits in pediatric EDs. This study aimed to investigate the clinical and demographic characteristics of patients who presented to the pediatric ED between 2012 and 2017 with non-suicidal self-harm (NSSH, n = 63, 60.3% female, M = 14.25 years), suicidal ideation (SI, n = 75, 57.3% female, M = 14.83 years), and suicide attempts (SA, n = 461, 82.9% female, M = 15.41 years). Also, predictors of SA were investigated. Of the patients, 79.4% had at least a psychiatric disorder. Depression was the most common diagnosis in the SI and SA groups, and autism spectrum disorder and intellectual disability were the leading diagnoses in the NSSH group. Self-poisoning was the most common method, and older age, female sex, having relational problems, and prior or current psychiatric admissions were the most important predictive factors of SA. NSSH, SI, and SA exhibit different features in early life. EDs provide an important opportunity for initiating developmentally appropriate interventions to reduce future risks.
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Affiliation(s)
- Onur Tuğçe Poyraz Fındık
- Department of Child and Adolescent Psychiatry, Marmara University, School of Medicine, Pendik Research and Training Hospital, Istanbul, Turkey.
| | - Ayşe Burcu Erdoğdu
- Department of Child and Adolescent Psychiatry, Marmara University, School of Medicine, Istanbul, Turkey
| | - Eray Fadıloğlu
- Child and Psychiatry Clinic, University of Health Sciences, Van Research and Training Hospital, Van, Turkey
| | - Ayşe Rodopman Arman
- Department of Child and Adolescent Psychiatry, Marmara University, School of Medicine, Istanbul, Turkey
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Ünver H, Rodopman Arman A, Erdoğdu AB, İlbasmış Ç. COVID-19 pandemic-onset anorexia nervosa: Three adolescent cases. Psychiatry Clin Neurosci 2020; 74:663-664. [PMID: 33000521 PMCID: PMC7537180 DOI: 10.1111/pcn.13160] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/01/2020] [Accepted: 09/27/2020] [Indexed: 01/29/2023]
Affiliation(s)
- Hatice Ünver
- Child and Adolescent Psychiatry Clinic, Marmara University Pendik Research and Training Hospital, Istanbul, Turkey
| | - Ayşe Rodopman Arman
- Child and Adolescent Psychiatry Department, Marmara University Medical Faculty, Istanbul, Turkey
| | - Ayşe Burcu Erdoğdu
- Child and Adolescent Psychiatry Department, Marmara University Medical Faculty, Istanbul, Turkey
| | - Çağla İlbasmış
- Child and Adolescent Psychiatry Department, Marmara University Medical Faculty, Istanbul, Turkey
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