Social-emotional and behavioural problems in young children of healthcare worker mothers during the COVID-19 outbreak: a case-control study.

BACKGROUND: The pandemic has had a significant impact on the daily lives of children and their families, particularly the children of health care workers, due to changes in family routines as a result of their parents' work schedules. We aimed to explore the socioemotional and behavioural (SEB) problems of children of healthcare worker mothers (HCWM) during the COVID-19 pandemic and compare them with age-matched children and their mothers from other occupations. METHOD: A case-control study design was applied, and a snowball approach was used to enrol volunteered participants aged between 6 and 36 months of age, through a Google survey. We used the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) questionnaire to assess children's SEB problems and a Brief Symptom Inventory (BSI) to evaluate the psychological distress of mothers. Differences in BITSEA, BSI and MSPSS scores were examined using chi-square and Mann-Whitney U tests, as appropriate. A logistic regression model was used to identify independent predictors of children's behavioural and emotional problems. RESULTS: In total, 600 questionnaires were analysed. It was observed that children in the HCWM group were separated from their mothers more often and for longer periods of time than their counterparts (p < 0.010, p = 0.002). Changes in the child's structured outdoor activities during the pandemic period were more likely to be observed in the HCWM group (p < 0.05). The percentage of children with the BITSEA problem subscale above the subclinical cut-off, externalizing and dysregulation scores were significantly higher in the HCWM group (p = 0.044, p = 0.031, and p = 0.016). Moreover, each point increase in BSI global index scores (p < 0.001, RR:3.34, 95%CI:1.91-5.82) was found as a risk factor for clinically significant SEB problems. CONCLUSION: Overall, the current study suggests HCWM's have experienced occupational inequality, and young children of HCWM's were at increased risk for externalizing and dysregulation problems during the pandemic. Maternal psychological stress had a significant impact on their children's socio-emotional well-being.

Killing One's Own Baby: A Psychodynamic Overview with Clinical Approach to Filicide Cases. / Kendi Bebegini Öldürmek: Filisid Olgularina Psikodinamik Bakis ve Klinik Yaklasim.

OBJECTIVE: This review article discusses the multi-dimensional and complex pattern of filicide from a psychodynamic perspective with reference to the recent publications. Creating awareness to filicide among professionals will help to the correct assessment of the cases, recognition of and intervention on filicide before the act, and the development of preventive mechanisms. METHOD: Published articles between January 1960 and March 2020 were searched using the keywords 'filicide, infanticide, neonaticide, mother/ parent/ maternal/ paternal, psychodynamics' in the Google Scholar, EBSCHO-HOST, Science-Direct, PubMed and Web of Science databases. RESULTS: The term filicide refers to the murder of the offspring by the parent. Although it is a common belief that the children are murdered boy strangers, the reported figures may not be representing the truth. No families are detected in one fourth of all murdered infants within the first 24 hours. The death of abondoned children are classified as 'due to natural causes'. Some murders might not be reported properly and therefore, actual murders by own parents might have been missed on the records. It is known that filicide is a heterogeneous phenomenon requiring a multidimensional evaluation in being affected by cultural values, belief systems of the society as well as the bio-psycho-social and developmental variables. It is reported in the literature that filicide cases have a common profile and that training clinicians on this complex phenomenon would be effective on prevention strategies. CONCLUSION: The concept of filicide is controversial in many aspects and mental health professionals tend to distance themselves since the concept is associated with 'crime'. However it is crucial to elucidate the psychodinamic background on violence and discuss the risk factors, triggers, background dynamics and psychopathologies underlying this phenomenon.

Killing One's Own Baby: A Psychodynamic Overview with Clinical Approach to Filicide Cases. / Kendi Bebegini Öldürmek: Filisid Olgularina Psikodinamik Bakis ve Klinik Yaklasim.

OBJECTIVE: This review article discusses the multi-dimensional and complex pattern of filicide from a psychodynamic perspective with reference to the recent publications. Creating awareness to filicide among professionals will help to the correct assessment of the cases, recognition of and intervention on filicide before the act, and the development of preventive mechanisms. METHOD: Published articles between January 1960 and March 2020 were searched using the keywords 'filicide, infanticide, neonaticide, mother/ parent/ maternal/ paternal, psychodynamics' in the Google Scholar, EBSCHO-HOST, Science-Direct, PubMed and Web of Science databases. RESULTS: The term filicide refers to the murder of the offspring by the parent. Although it is a common belief that the children are murdered boy strangers, the reported figures may not be representing the truth. No families are detected in one fourth of all murdered infants within the first 24 hours. The death of abondoned children are classified as 'due to natural causes'. Some murders might not be reported properly and therefore, actual murders by own parents might have been missed on the records. It is known that filicide is a heterogeneous phenomenon requiring a multidimensional evaluation in being affected by cultural values, belief systems of the society as well as the bio-psycho-social and developmental variables. It is reported in the literature that filicide cases have a common profile and that training clinicians on this complex phenomenon would be effective on prevention strategies. CONCLUSION: The concept of filicide is controversial in many aspects and mental health professionals tend to distance themselves since the concept is associated with 'crime'. However it is crucial to elucidate the psychodinamic background on violence and discuss the risk factors, triggers, background dynamics and psychopathologies underlying this phenomenon.

An examination of the characteristics of mothers neglecting their children.

BACKGROUND: This study is aimed to recognize families who have neglected their children in the early period, to raise awareness among experts especially pediatricians-working in this field about the reasons contributing to the neglect. METHODS: For this purpose, data were collected by quantitative and qualitative methods. The mothers of 32 neglected children and 30 children who were not neglected were included in to the study. Sociodemographic Information Form, Neglect Assessment Tool, Close Relationships Inventory, Perceived Social Support Scale, Marital Adjustment Scale, Childhood Trauma Survey Scale, Semi Structured Interview Form, SCID I and SCID II were used as data collection tools. T-test, ANOVA, Chi-square test, Kruskal Wallis, Pearson Correlation test were used for quantitative analysis and descriptive analysis method was used in the analysis of qualitative data. RESULTS: In the quantitative findings obtained; mothers of neglected children and control group mothers differed in terms of their age, income perceptions, multidimensional perceived social support, marital adjustment, physical and emotional abuse subscales on the scale of childhood abuse, adult attachment patterns, however; it was found that there was no difference in terms of mental illness and personality disorder, and scores on sexual abuse subscale of child abuse. Qualitative results demonstrated that most of the mothers did not consider themselves adequate for parenting, were not satisfied with their parenting role, had insufficient emotional investment in their children and could not balance their roles. CONCLUSIONS: It was concluded that the mothers of neglected children had problems in the areas of social support, marital adjustment, adult attachment patterns and they were also exposed to physical and emotional abuse during their own childhood and these problems negatively affected the quality of their childcare. For this reason, it is important to provide support to neglectful families and family interventions should be established.

[Prevalence, comorbidity and severity of psychosomatic disorders in outpatients with Turkish migration background]. / Prävalenz, Komorbidität und Ausprägungsgrad psychosomatischer Erkrankungen bei ambulanten Patienten mit türkischem Migrationshintergrund.

In this study the prevalence and comorbidity of mental disorders were examined for the first time with the Structured Clinical Interview for DSM-IV (SCID-I) in a consecutive sample of Turkish speaking patients (n=51). The symptom severity of the depressiveness was measured with the Beck Depression Inventory (BDI), of the somatoform complaints with the Screening for Somatoform Symptoms (SOMS) and of the posttraumatic stress disorder (PTSD) with the Essen Trauma Inventory (ETI). The most common current diagnoses were the somatization disorder (41.2%; n=21), a single episode of major depression (37.3%; n=19) and the PTSD (31.4%; n=16). In 80.4% (n=41) of the patients at least one comorbid mental disorder was documented. In comparison with German reference values the Turkish patients showed a significant higher severity of the depressive and posttraumatic, however not of the somatoform symptomatology.

[Differences in cerebral blood flow following risperidone treatment in children with autistic disorder]. / Otistik bozuklugu olan cocuklarda risperidon tedavisinin beyin kan akimi ile degerlendirilmesi]

OBJECTIVE: Functional changes in the brains of autistic children due to risperidone treatment and theirs relationship to the symptom clusters are yet unknown. In this autistic disorder case series we aimed to comparatively evaluate the clinical findings before and after risperidone treatment, and regional cerebral blood flow (rCBF) findings with 99mTc-hexamethylpropyleneamine oxime (HMPAO) brain SPECT. METHOD: Eleven autistic patients (age range: 6-7 years; 4 girls, 7 boys) received risperidone therapy (1.5-2.5 mg d(-1)) and were followed-up for 3 months. All the patients underwent neurologic examinations, psychometric examinations, and SPECT imaging, both at the start of risperidone treatment and 3 months after the treatment started. Clinical observations, and the observations of parents and teachers were recorded. These results were compared with cerebral perfusion indices obtained from SPECT data. RESULTS: After 3 months of treatment changes in rCBF were observed in various regions and to varying degrees. We observed relationships between clinical symptoms and pre-therapy rCBF findings, and between clinical improvement and rCBF changes. CONCLUSION: Findings in the present case series are the first to demonstrate a relationship between clinical improvement and regional perfusion patterns after risperidone treatment. We think that these findings may contribute to the understanding of the neurofunctional mechanisms and hypothetical models of autism.

Psychiatric findings related to neurological complications in Behcet's disease: A short review and a case presentation.

Behcet's disease affects the skin, mucosa, joints, vascular system, eyes, the central nervous system (CNS) and gastrointestinal system. In Behcet's disease, the obvious illness mechanism in all organ systems is occlusive vasculitis of unknown etiology. CNS involvement in Behcet's disease sometimes causes psychiatric disorders. In this paper we discuss a case with neurobehcet disease who was admitted with psychotic symptoms. This 29-year-old male patient had symptoms of Behcet's disease and concomitant psychiatric symptoms. An advanced evaluation of the CNS was performed following unresponsiveness to antipsychotic treatment. It was concluded that the psychotic picture was a result of CNS involvement related to Behcet's disease. Colchicine was added to the treatment and upon discharge the case was in remission. Differences in treatment and prognosis between psychiatric disorder due to Behcet's disease and psychiatric disorders comorbid to Behcet's disease are discussed.