4 results
Title: Is bariatric surgery an option for obesity in autism spectrum disorder?: A case report
- Z. I. Erbasan, B. N. Özbaran, D. R. Gökşen Şimşek, H. G. Balkı
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S280-S281
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by early onset difficulties in social communication, restricted repetitive behaviors and interests, and sensory sensitivities/differences (1). It has been determined that 90% of children with ASD have nutritional problems (2). There are many factors affecting nutrition in children with ASD, such as gastrointestinal problems, food allergies, metabolic anomalies, drug side effects such as increased appetite, problematic eating behavior, sensory processing difficulties, and family factors (3).
ObjectivesIn this case report; we aimed to represent multidisciplinary medical and psychiatric treatment of a 16 years old adolescent with autism spectrum disorder and obesity who was consulted for bariatric surgery. It is thought that this case will be useful for clinicians as an example of a multidisciplinary approach in the management of obesity, primarily with non-surgical, psychiatric approaches and therapeutic environment.
MethodsIn our patient, it was decided to prefer non-surgical approaches primarily, considering the diagnosis of ASD, MID, and ADHD, difficulties in impulse control, the concern about the continuation of the poor lifestyle habits after bariatric surgery, and the difficulties that the family may experience in providing adequate postoperative care. Patient received Metformin 2000 mg/day for insulin resistance, Amlodipine 10 mg/day, Enalapril 5 mg/day, Perindopril 5 mg/day and Indapamide 1.25 mg/day combination for hypertension, Haloperidol 0.6 mg/day in case of impulse control problems and aggression, Topiramate 50 mg/day to take advantage of its appetite suppressing effect and Methylphenidate 10 mg/day for attention deficit hyperactivity disorder (ADHD) during hospitalization in the endocrinology clinic and the same time diet and exercise programs were applied. When his rate of weight loss decreased around 4th week, Exenatide 10 mcg/day was added to his treatment.
ResultsIt was observed that the patient lost 15 kilograms at the end of 3 weeks, and his BMI decreased from 60.9 to 56.1 (BMI SDS: +4,18) and the total TG level decreased from 195 mg / dl to 154 mg / dl.
ConclusionsObesity, which is an important public health problem, is also becoming a serious problem in individuals with ASD. There is no standard treatment approach for the coexistence of ASD and obesity. Whether psychopathologies constitute a definite contraindication for bariatric surgery is a controversial issue. In our patient, it was decided to prefer non-surgical approaches primarily. It can be concluded that; In children and adolescents with autism and intellectual disability, effective weight loss can be achieved without bariatric surgery with medical and psychiatric approaches.
Disclosure of InterestNone Declared
Anorexia nervosa in the times of COVID-19 pandemic is it different than before?
- H. Y. Yılancıoğlu, S. H. Tokmak, B. Yuluğ Taş, D. Çek, B. Özbaran
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S426-S427
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
The COVID-19 pandemic control measures such as isolation and social restrictions are related to an increase in the incidence of anorexia nervosa and deteriorating symptoms by increased social media exposure, limited access to psychiatric services, disruptions in relationships between families and adolescents.
ObjectivesAim of study was to investigate the psychiatric and psychosocial impacts and clinical changes in anorexia nervosa patients, who applied to the Ege University Child and Adolescent Psychiatry for the first time in 2018, during the 2019-2022 pandemic period.
MethodsOur study was carried out 35 anorexia nervosa patients. Voluntary written informed consent, self-report form; using The Visual Analog Scale (VAS), Screen for Child Anxiety Related Disorders Scale (SCARED), Eating Attitudes Test (EAT), The Quality of Life Scale (QOLS), The Difficulties in Emotion Regulation Scale (DERS), The Autism Spectrum Screening Questionnaire (ASSQ), Atilla Turgay DSM-4 Based Screening and Evaluation Scale for Behavioral Disorders in Children and Adolescents (TURGAY) forms filled out online. Clinical diagnosis and progress are obtained through archieve records by The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) and Clinical Global Impression (CGI) scales. Approval number is 22-6T/7, Ege University Ethics Committee.
ResultsIn 35 patients;15 female patients completed all the forms. The mean age was 16.67±1.63 years. 11 (73.33%) patients have at least one comorbidity; 7 (46.66%) patients have major depressive disorder, 3 (20.00%) anxiety disorder, 2 (13.33%) attention deficit and hyperactivity disorder, 1 (6.66%) mood disorder. The SCARED score was 37.23±12.67, and the CDI score was 17.23±10.85. When comparing the pre-pandemic period, obsession level (z=-2.254, p=.024), exercise level (z=-2.508, p=.012), technology exposure (z=-2.290, p=.022) is increased; level of social activity (z=-2.206, p=.027), the quality of education (z=-2.167, p=.030), and the perception of learning (z=-3.301, p=.008) decreased during pandemic. Quality of life scores was inversely correlated with eating attitudes scores (r=-.601, p=.039). It was noteworthy that number of admissions from the first appointments was higher in participants, compared to the patients who did not participate in the study (n=20) (p=.033). The first admission BMI values were negatively correlated with CGI scores of the patients (r=-.743, p=.002).
ConclusionsAs a result, Covid-19 has negative psychosocial effects in anorexia nervosa symptoms such as increased excercise at home and technology exposure; decreased in social activity. Sharing clinical experiences about our patients’ mental health may be beneficial in planning the treatment processes and approach for further unexpected extraordinary situations.
Disclosure of InterestNone Declared
Separation-Individuation in Patterns in Turkey: An Investigation of Developmental, Gender and Contextual Differences
- T. Bildik, B. Şentürk Pilan, B. Özbaran, Z. Yüncü, S. Köse
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S747
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
There is still a paucity of studies exploring the impacts of teenage employment on mental health and development. In many developing countries, youths participate intensively in the teenage labor force. The involvement of adolescent in the world of work would promote the development of responsibility and prepare the young person to function more effectively in adult roles.
ObjectivesThe purposes of the present study were to examine the adolescent separation-individuation among an understudied and vulnerable population; and to examine the Separation-Individuation Test of Adolescence (SITA) for revealing the differentiation working male group from student male group.
MethodsParticipants completed the SITA. The group of study 1 consisted of 618 high school and 252 university students between the ages of 14 and 24, 489 of which were girls and 381 were boys. In Study 2, participants were 269 male adolescents between the ages of 15 and 17, 141 of which were full-time worker and 128 high school students. In study 1, these results were consistent with the rapprochement subphase of the separation-individuation process in adolescence -the striking desires for intimacy and independence.
ResultsOur results support the gender specific patterns of identity formation and the argument that connectedness in close relationships plays a central role in the female identity development. Interestingly, there were no significant gender differences in the tendency to view close interpersonal relationships as threatening to their sense of independence and selfhood, and to deny or avoid dependency needs. The reason for this might be the cultural differences between the individualistic and collectivistic cultures. In study 2, working males could be distinguished from student counterparts by their increased tendency to seek close interpersonal ties with caretakers. The finding also suggested that student males reflected characteristics of the traditional view of adolescents’ independence striving. Across both studies it was found that the traditional Turkish child-rearing patterns have been characterized by an emphasis on interpersonal relationships and close ties with family than individualistic cultures
ConclusionsOur results revealed that the subscales of SITA –especially dependency denial, rejection expectancy, nurturance seeking, engulfment anxiety, and teacher enmeshment- can help clinicians for assessing the adolescent separation-individuation process in a reliable way. We suggested that adolescent employment would lead to the difficulties in developing bonds with parents because of the adolescents’ long work hours, the early involvement with the world of work would lead to the withdrawal from the more dependent, preadultlike student role, and student adolescents would reflect characteristics of the traditional view of adolescents’ independence striving.
Disclosure of InterestNone Declared
Differential diagnosis of recurrent hypersomnia. Case report of primary narcolepsy and acute transient psychotic attack
- J. Kıyak, S. Köse, B. Özbaran
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S354
-
- Article
-
- You have access Access
- Export citation
-
Introduction
We report a case of 17-year-old boy with excessive daytime sleepiness.
ObjectivesCase presented in our study is an example of atypical narcolepsy with coexistence of psychotic symptoms that were especially prominent during the first attack. Excessive daytime sleepiness period was followed by psychotic symptoms including delusions of reference and persecution, as well as visual and acoustic hallucinations. However, during the second attack, negative psychotic symptoms were more prominent.
AimsClinicians should not forget that child and adolescent patients, which demonstrate psychotic symptoms and excessive daytime sleepiness component, should be evaluated for a diagnosis of primary hypersomnia.
MethodPatient did not exhibit any comorbidities that would match with secondary hypersomnia. The initial sleep study did however reveal increased REM sleep latency (43% of total sleep time). The result of polysomnographic study was abnormal and suggestive of narcolepsy. In multi-sleep latency test mean REM latency was 1.7 min, sleep-onset REM (SOREM) was observed 3 times. Between the tests he had no episodes of cataplexy.
ResultPatient was diagnosed with primary hypersomnia-narcolepsy without cataplexy. We found that mixed symptoms of narcolepsy and psychotic attack improved with anti-psychotic agent treatment.
ConclusionChild and adolescent patients, which demonstrate psychotic symptoms and excessive daytime sleepiness component, should be evaluated for a diagnosis of primary hypersomnia following a multidisciplinary cooperation of neurologists, pediatricians and psychiatrists.
Disclosure of interestThe authors have not supplied their declaration of competing interest.