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Öğe Atomoxetine Treatment in a Patient with the Comorbidity of Attention Deficit Hyperactivity Disorder and Fragile X Syndrome(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2019) Okyar, Esra; Bozatli, Leyla; Gorker, IsikFragile X Syndrome is a genetic disease defined by cognitive and behavioral characteristics that accompany apparent physical features. Male individuals are affected by this syndrome more severely, and it is the most common cause of mental retardation in men. The most common accompanying psychiatric conditions are mental retardation, autism, Attention Deficit Hyperactivity Disorder (ADHD), anxiety disorder, depression, sleep disorders and aggression. Anxiety, depression, shyness and social withdrawal are more common in female individuals. The diagnosis and treatment of the ADHD and selective mutism in a female adolescent patient who was Fragile X full mutant will be discussed in this case report.Öğe Dikkat eksikliği hiperaktivite bozukluğu tanılı çocuklarda ve ebeveynlerinde otizm spektrumuna ilişkin bulguların incelenmesi(2019) Okyar, Esra; Görker, IşıkÇalışmamızda polikliniğimizde Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) tanısı ile izlenen çocuklarda ve ebeveynlerinde otizm belirtileri incelenmiştir. Araştırma grubu olarak polikliniğimizde DEHB tanısıyla takip edilen ve kronik hastalığı bulunmayan 6-15 yaş aralığındaki 66 olgu ve ebeveynleri ile kontrol grubu olarak tıbbi ve psikiyatrik hastalığı olmayan, yaş ve cinsiyet açısından benzer 33 olgu ve ebeveynleri dahil edildi. Çalışmaya alınan araştırma ve kontrol grubu olgularına sosyodemografik veri formu, Çocuk ve Ergenlerde Davranım Bozuklukları İçin DSM-IV’e Dayalı Tarama ve Değerlendirme Ölçeği ve Otizm Davranış Kontrol Listesi (ODKL) uygulandı. Olguların anne ve babalarına Erişkin DEHB Ölçeği, Wender Utah Derecelendirme Ölçeği (WUDÖ) ve Otizm Anketi (OA) uygulandı. DEHB’li olgularda ODKL toplam ve alt ölçek puanları kontrol grubuna göre anlamlı olarak yüksek saptandı. DEHB grubunda erkek cinsiyette ve karşıt olma karşı gelme bozukluğu varlığında, ODKL toplam puanı daha yüksekti. Gebelikte sigara maruziyeti, doğumda komplikasyon ve doğum sonrası sorun olmasının daha yüksek ODKL puanı ile ilişkili olduğu saptandı. DEHB’li olguların anne ve babalarında WUDÖ ve Erişkin DEHB Ölçeği puanları kontrol grubu ebeveynlerinden daha fazlaydı. OA alt ölçek ve toplam puanları arasında DEHB grubu ile kontrol grubu anne ve babaları arasında istatistiksel olarak anlamlı fark saptanmadı. Maternal ve paternal WUDÖ ve Erişkin DEHB ölçeği toplam puanları ile ODKL puanları arasında anlamlı korelasyon gözlendi. Maternal ve paternal OA puanları ile ODKL arasında korelasyon saptanmadı. Çalışmamız sonucunda polikliniğe başvuran DEHB tanılı çocuklarda DEHB tanısı olmayan kontrol grubuna kıyasla daha fazla otizm belirtisi olduğu bulunmuştur. DEHB tanılı çocukların ebeveynlerinde daha fazla DEHB belirtisi saptanırken, otizm belirtileri açısından kontrol grubu ebeveynlerinden farklılık göstermedikleri saptanmıştır.Öğe Drug-refractory irritability and related factors in autistic children(Taylor & Francis Ltd, 2024) Aykutlu, Hasan C.; Bozatli, Leyla; Gorker, Isik; Okyar, Esra; Uzun-Cicek, Ayla; Ucuz, Ilknur; Dogru, HicranObjectivesAutistic children frequently exhibit irritability, which can manifest as aggression, self-injurious behaviour, and severe tantrums, leading to significant impairments. Two atypical antipsychotics have been licensed by the Food and Drug Administration for the treatment of irritability in autistic children, although a significant percentage of these children do not respond to this treatment. This study aimed to determine the frequency of drug refractory irritability (DRI) and identify the risk factors in a large clinical sample of autistic children.MethodsThe medical records of 1279 children aged 2-18 years diagnosed with autism and undergoing clinical follow-up were retrospectively analysed. Socioeconomic and clinical characteristics, co-occurring psychiatric disorders and physical conditions were recorded.Results55% of the sample used antipsychotics to treat irritability, and 8.2% met the DRI criteria. Older age, severe support requirement for autism, language impairment, anxiety disorders, sleep difficulties, gastrointestinal system, and dental problems were found to significantly increase the risk of DRI.ConclusionOur findings indicate that a significant proportion of the clinical sample of autistic children had DRI. The physical, psychiatric, and environmental risk factors identified in our study also highlight heterogeneity in the etiology of DRI. Further research on DRI is needed to develop treatment and prevention strategies.Öğe Examining the autistic traits in children and adolescents diagnosed with attention-deficit hyperactivity disorder and their parents(Bmc, 2020) Okyar, Esra; Gorker, IsikBackgroundAttention-Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are two of the most frequently-observed neurodevelopmental disorders. Autistic traits are detected frequently in children who have ADHD. This study aimed to examine autism symptoms in children diagnosed with ADHD and their parents; and also, to investigate parental risk factors that increase autistic traits in children. Besides the risk factors related to pregnancy, birth and developmental history were examined.MethodsTwo groups were created consisting of 66 children diagnosed with ADHD and 33 children not diagnosed with ADHD and their parents. Autism symptoms were screened with the Autism Behavior Checklist (ABC) in children, and Autism Spectrum Quotient (AQ) in parents. Also, Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale and Wender Utah Rating Scale (WURS) were used to determine ADHD symptoms in parents.ResultsIt was determined that there were more autism symptoms in children who were diagnosed with ADHD than in the control group without ADHD. There were more autistic symptoms in boys and the presence of Oppositional Defiant Disorder (ODD). Although there were more ADHD symptoms in the parents of children diagnosed with ADHD, it was determined that they did not differ from parents in the control group in terms of autism symptoms. It was also determined that maternal and paternal ADHD symptoms were predictive for autism symptoms in children. It was also shown that maternal smoking during pregnancy is associated with more autistic traits.ConclusionASD and ADHD show high levels of comorbidity. The etiology remains unclear. Both ADHD and ASD show strong hereditary transition. We found that maternal and paternal ADHD symptoms predict autism symptoms in children with ADHD. However, more studies are needed to reveal the etiology.Öğe Psychogenic polydipsia associated with sertraline treatment: a case report(Taylor & Francis Ltd, 2019) Okyar, Esra; Bozatli, Leyla; Gorker, Isik; Okyar, SerapPsychogenic polydipsia (PP) is a clinical condition characterized by excessive fluid intake in the absence of physiological stimuli to drink. The etiology of compulsive water drinking is not known yet. It is common in people with chronic mental illness, especially in schizophrenia. Obsessive-compulsive disorder (OCD) is characterized by the presence of recurrent obsessions and compulsions which may cause anxiety in the person. The age of onset is bimodal, before puberty and early adulthood. In this case report, we will discuss the PP situation after the start of sertraline treatment in a case of 12-year-old girl who started sertraline treatment with the diagnosis of OCD.