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.

Cognitive and behavioral impairment in mild hyperphenylalaninemia.

Evinç SG, Pektas E, Foto-Özdemir D, Yildiz Y, Karaboncuk Y, Bilginer-Gürbüz B, Dursun A, Tokatli A, Coskun T, Öktem F, Sivri HS. Cognitive and behavioral impairment in mild hyperphenylalaninemia. Turk J Pediatr 2018; 60: 617-624. As elevated phenylalanine (Phe) is detrimental to brain functions, determining a safe upper limit of blood Phe is important for initiation of treatment plans and setting Phe targets in hyperphenlalaninemic patients. It is accepted that Phe levels below 360 µmol/L does not impair brain function and hence does not require treatment. Therefore, we aimed to compare cognitive functions and attention-related problems among healthy children and untreated patients with hyperphenylalaninemia (HPA). This study included 41 hyperphenylalaninemic patients (`all HPA group`) aged 6-16 years with untreated blood Phe between 240 and 600 µmol/L and 29 healthy controls. `All HPA group` was further divided into 2 subgroups according to their lifetime median blood Phe levels as `Phe 360-600 µmol/L` and `Phe 240-360 µmol/L` groups. Wechsler Intelligence Scale for Children-IV (WISC-IV), Conners` Continuous Performance Test (CPT), Strength and Difficulties Questionnaire (SDQ) and Schedule for Affective Disorders and Schizophrenia for School-Age Children: Present and Lifetime Version (K-SADS-PL) were performed as a comprehensive neurocognitive, attention and behavioral assessment. The study illustrated that `all HPA` patients had significantly lower scores on all WISC-IV indexes compared to controls, except for Working Memory. Both `Phe 360-600 µmol/L` and `Phe 240-360 µmol/L` subgroups had lower Full Scale intelligence quotient (IQ) and Verbal Comprehension scores compared to controls. `All HPA` patients also had longer reaction times and more peer problems than controls, indicating attention deficits and behavioral problems. Since the results demonstrated that children with untreated Phe levels between 240-360 µmol/L are at higher risk for cognitive and attention-related problems, lowering the `safe` upper Phe level should be considered.

Child maltreatment and associated factors among children with ADHD: a comparative study.

This study aimed to compare the mothers of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and the mothers of children with no psychiatric diagnosis with respect to abusive discipline attitudes. One hundred children with ADHD, 25 children with no psychiatric diagnosis, and their mothers answered the questionnaires and open-ended standard questions about the type and frequency of parental abusive discipline. Conners scores of the children were associated with characteristics of the children, maternal characteristics, and maternal use of verbal discipline. Maternal approval scores on verbally abusive disciplinary acts were predicted by maternal past experiences, maternal characteristics and Conners scores of children. Similarly, characteristics of the children and the mothers predicted maternal approval scores on physical disciplinary acts. ADHD symptoms increase the risk of parental verbally and physically abusive discipline. Vice versa, verbal discipline also predicts increased ADHD symptoms. Understanding the risk factors may help in developing more effective intervention and prevention programs.

[A case of Munchausen Syndrome by proxy in the context of folie a famille]. / Paylasilmis ailesel psikoz kapsamindabir "bakim verenin yapay bozuklugu" olgusu.

The occurrence of similar psychotic symptoms in two or more people is called shared paranoid disorder. In this disease, the person who exhibits psychotic symptoms first is the "primary patient". The symptoms are contracted by the other people through persuasion. This disorder is seen among people who share the same house or are emotionally bound. In some cases, shared paranoid disorder may include other diagnoses, such as Munchausen Syndrome. This report discusses the case of a six-year-old, sexually abused boy who, when admitted to the hospital at the age of 10, claimed to have been repeatedly sexually harassed by several different people. His family's frequent changes in hospitals, negative perceptions of and accusations against medical staff, and improper methods of responding to harassment led clinicians to a diagnosis of Munchausen by proxy syndrome. In addition, both parents believed the abuse story, suggesting a potential diagnosis of shared psychotic disorder. In the literature, Munchausen by proxy has rarely been reported with symptoms of sexual abuse. The psychotic symptoms were shared by the family, complicating the case. This report emphasizes that psychodynamic evaluations of Munchausen by proxy and shared psychotic disorder may be helpful in understanding underlying factors.

Comorbidity and continuity of attention deficit hyperactivity disorder (ADHD) from childhood to adolescence in Turkey.

The aim of this study was to examine clinical outcomes, psychiatric comorbidity and neuropsychological characteristics in Turkish adolescents with an attention deficit hyperactivity disorder (ADHD) diagnosis in childhood. A total of 45 children with ADHD diagnosis and 28 children with a psychiatric diagnosis other than ADHD in a 1-year cohort of 7-10-year-olds were reevaluated 6 years later using Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version and Wechsler Intelligence Scale for Children-Revised and Stroop Test TBAG version. This study shows that the clinical outcomes and the comorbidity patterns for ADHD from childhood to adolescence in Turkey are similar to reported rates in the Western countries. In the ADHD group, 75.6 % still has impairing ADHD symptoms and 46.6 % has comorbid psychiatric disorders. The main difference is anxiety disorders being the most common comorbid disorders (37.8 %) in Turkish ADHD youth. These findings stress the high comorbidity associated with ADHD and support the importance of assessment and treatment for ADHD and comorbidities during adolescence.

The analysis of child abuse and neglect cases assessed by a multidisciplinary study group between 2005-2008.

This study aimed to evaluate the diagnosis, treatment and follow-up of child abuse and neglect (CAN) cases. Subjects were 102 cases that were clinically assessed by the multidisciplinary hospital team. Early and late childhood cases (according to the age at first abuse) were compared by means of characteristics of abuse. Among the 102 subjects, 64 were female and 38 were male (mean age: 8.68 years). Being abused by someone within the family was found to be significantly higher in preschool children compared to children in late childhood. 27.5% (n: 28) of the cases concomitantly had low socioeconomic and educational level and high parental psychological problems and 64.8% had psychiatric problems. A limited number of studies have compared characteristics of early and late childhood abuse considering the age of onset of maltreatment. Consistent with the literature, our study showed that early age of onset of maltreatment is a poor prognostic factor in many ways.

[WISC-R profiles of children with attention deficit hyperactivity disorder: a comparative study]. / Dikkat Eksikligi Hiperaktivite Bozuklugu Tanisi Alan Cocuklarin WISC-R Profillerinin, Farkli Bir Psikiyatrik Tani Alan ve Herhangi Bir Tanisi Olmayan Cocuklarla Karsilastirilmasi.

OBJECTIVE: In clinical practice the Wechsler Intelligence Scale for Children-Revised Form (WISC-R) is a frequently used instrument for the identification of ADHD (attention deficit hyperactivity disorder). In order to observe the discriminative power of WISC-R profiles for ADHD, this study aimed to compare WISC-R performance of 3 groups (children with ADHD, children with different psychiatric diagnoses, children with no psychiatric diagnosis). METHOD: Participants ranged in age from 6 to 16 years. The study included 59 children with ADHD and 51 children with different psychiatric diagnoses whose data were obtained from their files at the Hacettepe University Hospital, Department of Child Mental Health Services. The data of 43 other children were obtained from a previous study conducted at the same hospital in which they were found to have no psychiatric diagnosis. RESULTS: WISC-R profiles of these 3 groups were compared via MANOVA. Results of the analyses indicated that in general, WISC-R profiles of children with no diagnosis were higher than both children with ADHD and those with different psychiatric diagnoses. On the other hand, WISC-R profiles of children with ADHD and children with different psychiatric diagnoses did not significantly differ from each other. CONCLUSION: These results indicated that WISC-R profiles discriminate children without any psychiatric diagnosis from those with a psychiatric diagnosis; however, this discrimination is not specific to ADHD. Thus, it is proposed that WISC-R by itself may not be an adequate assessment device for the identification of ADHD, and diagnosis made solely on the basis of WISC-R profiles may not be accurate.