Pediatric sychiatry

History

Kocaeli University Faculty of Medicine Department of Child Psychiatry, started working with Prof. Dr. Ayşen Coşkun under the auspices of adult psychiatry in 1995. It became a Department in January 1996. After becoming a department, it started to take research assistants and give specialization training with the Medical Specialization Examination as his main specialty. In 1999, Prof. Dr. Belma Ağaoğlu started to work in our department as a second faculty member.

After the Faculty of Medicine Hospital was moved to the Umuttepe Campus in 2005, outpatient services began to be carried out in the hospital building. Our polyclinic has been serving in the Child and Adolescent Psychiatry Clinic in the Morphology building since September 2006. In June 2007, KOU Child and Adolescent Psychiatry Day Clinic started to provide services within the body of the department, in addition to outpatient services.

Education, research and treatment services are carried out with an academic staff consisting of 3 professors (Prof. Dr. Ayşen Coşkun, Prof. Dr. Nursu Çakın Memik, Prof. Dr. Özlem Yıldız Gündoğdu), 1 associate professor(Assoc. Prof. Şahika Gülen Şişmanlar), 3 dr faculty members(Dr. Faculty Member İrem Damla Çimen, Dr. Faculty Member Burcu Kardaş, Dr. Faculty Member Ömer Kardaş) and 38 research assistants.

In our department, priority is given to both pre and post graduation education, and efforts are made to provide polyphonic, high-quality education that is open to change and follows scientific developments closely.

Education

Pre-Graduation

Term I

Dr. Aysen COSKUN

• Developmental Theories

Term II

Dr. Ozlem Yildiz GUNDOGDU

• School failure

Dr. Nursu Cakin MEMIK

• Attachment

Dr. Omer KARDAS

• Family systems and parental attitudes

Term III

Dr. Ozlem Yildiz GUNDOGDU

• Sleep and elimination disorders

Dr. Nursu CAKIN MEMIK

• Gender identity and gender dysphoria

Dr. Şahika Gülen SISMANLAR

• Neglect and abuse in children
• Early onset schizophrenia and dissociative disorder

Dr İrem Damla CİMEN

• Nutrition and eating disorders

Dr. Burcu KARDAS

• Tic disorders and speech disorders

Term IV

Dr. Aysen COSKUN

• Principles of mental examination, evaluation and interview in psychiatry in children and adolescents

Dr. Ozlem Yildiz GUNDOGDU

• Attention deficit hyperactivity disorder, conduct disorder and oppositional defiant disorder

Dr. Nursu CAKIN MEMIK

• Obsessive compulsive disorder and conversion disorder

Dr. Şahika Gülen FAT

• Autistic spectrum disorders

Dr İrem Damla CİMEN

• Psychopharmacology in children and adolescents
• Mood disorders, self-harming behaviors and grief

Dr. Omer KARDAS

Dr. Burcu KARDAS

• Anxiety disorders and post-traumatic stress disorder

Sayfa Başı

Post graduation

Department of Child Psychiatry and Diseases Postgraduate Education Curriculum

1st Year Education
1st Semester (January – June)

Code	Subject	Hour	Day	Lecturer
TCR 101	Theoretical and applied psychotherapy techniques	5	Monday	Dr. Aysen Coskun
TCR 105	Major mental disorders in children and adolescents	3	Monday	Dr. İrem D. Çimen
TCR 103	Family and developmental stages	5	Tuesday	Dr. Nursu Cakin Memik
TCR 113	Major mental disorders in children and adolescents	2	Tuesday	Dr. İrem D. Çimen
TCR 107	Psychiatric evaluation of the child and adolescent	5	Wednesday	Dr. Ozlem Y. Gundogdu
TCR 115	Major mental disorders in children and adolescents	3	Wednesday	Dr. Burcu Kardas
TCR 109	Psychological examination of children and adolescents	5	Thursday	Dr. Şahika G. Sismanlar
TCR 117	Major mental disorders in children and adolescents	2	Thursday	Dr. Burcu Kardas
TCR 111	Psychological tests	5	Friday	Dr. Omer Kardas

1st Year Education
2nd Semester (July-December)

Code	Subject	Hour	Day	Lecturer
TCR 100	Parental attitudes	5	Monday	Dr.Aysen Coskun
TCR 110	Major mental disorders in children and adolescents	3	Monday	Dr.İrem D. Cimen
TCR 102	Theoretical and practical psychotherapy techniques	5	Tuesday	Dr.Nursu C. Memik
TCR 112	Major mental disorders in children and adolescents	2	Tuesday	Dr. İrem D. Cimen
TCR 104	Semiology	5	Wednesday	Dr.Ozlem Y. Gundogdu
TCR 114	Major mental disorders in children and adolescents	3	Wednesday	Dr. Burcu Kardas
TCR 106	Erikson's theory of psychosocial development	5	Thursday	Dr. Şahika G. Sismanlar
TCR 116	Piaget's theory of cognitive development	2	Thursday	Dr. Burcu Kardas
TCR 108	Freud's structural theory	5	Friday	Dr. Omer Kardas

2nd Year Education
1st Semester (January-June)

Code	Subject	Hour	Day	Lecturer
TCR 201	Freud's compartmental theory	5	Monday	Dr. Nursu C. Memik
TCR 211	Mourning	5	Monday	Dr. Ozlem Y. Gundogdu
TCR 203	Parental attitudes	5	Tuesday	Dr. Aysen Coskun
TCR 213	Cognitive behavioral treatment approaches in children and adolescents	2	Tuesday	Dr. Burcu Kardas
TCR 205	Post traumatic stress disorder	5	Wednesday	Dr. Şahika G. Sısmanlar
TCR 215	Cognitive behavioral treatment approaches in children and adolescents	3	Wednesday	Dr. Omer Kardas
TCR 207	Mental retardation	2	Thursday	Dr. Omer Kardas
TCR 217	Cognitive behavioral treatment approaches in children and adolescents	5	Thursday	Dr. İrem D. Cimen
TCR 209	Attention deficit hyperactivity disorder	3	Friday	Dr. Burcu Kardaş

2nd Year Education
2nd Semester (July-December)

Code	Subject	Hour	Day	Lecturer
TCR 200	Defense mechanisms	5	Monday	Dr. Nursu C. Memik
TCR 210	Cognitive behavioral treatment approaches in children and adolescents	5	Monday	Dr. Ozlem Y. Gundogdu
TCR 202	Theoretical and applied psychotherapy techniques	5	Tuesday	Dr. Aysen Coskun
TCR 212	Cognitive behavioral treatment approaches in children and adolescents	2	Tuesday	Dr. Burcu Kardas
TCR 204	Pervasive developmental disorders	5	Wednesday	Dr. Şahika G. Şişmanlar
TCR 214	Cognitive behavioral treatment approaches in children and adolescents	3	Wednesday	Dr. Omer Kardas
TCR 206	Play therapy	2	Thursday	Dr. Omer Kardas
TCR 216	Cognitive behavioral treatment approaches in children and adolescents	5	Thursday	Dr. İrem D. Cimen
TCR 208	Conduct disorder and oppositional defiant disorder	3	Friday	Dr. Burcu Kardas

3rd Year Education
1stSemester (January-June)

Code	Subject	Hour	Day	Lecturer
TCR 301	Specific learning disorders	5	Monday	Dr. Burcu Kardas
TCR 311	Psychopharmacological treatments in child and adolescent psychiatry	5	Monday	Dr. Şahika G. Sismanlar
TCR 303	Anxiety disorders	5	Tuesday	Dr. Ozlem Y. Gundogdu
TCR 313	Tic disorders	5	Tuesday	Dr.Omer Kardas
TCR 305	Bipolar affective disorders	5	Wednesday	Dr. Aysen Coskun
TCR 315	Psychopharmacological treatments in child and adolescent psychiatry	3	Wednesday	Dr. İrem D. Cimen
TCR 307	Speech disorders	5	Thursday	Dr. Nursu C. Memik
TCR 317	Family therapy	5	Friday	Dr. Aysen Coskun
TCR 309	Emergencies in child psychiatry	2	Friday	Dr. İrem D. Cimen

3rd Year Education
2nd Semester (July-December)

Code	Subject	Hour	Day	Lecturer
TCR 300	Psychotic disorders	5	Monday	Dr. Burcu Kardas
TCR 310	Psychopharmacological treatments in child and adolescent psychiatry	5	Monday	Dr. Şahika G. Sismanlar
TCR 302	Obsessive compulsive disorder	5	Tuesday	Dr. Ozlem Y. Gundogdu
TCR 312	Tic disorders	5	Tuesday	Dr. Omer Kardas
TCR 304	Somatoform disorders	5	Wednesday	Dr. Aysen Coskun
TCR 314	Psychopharmacological treatments in child and adolescent psychiatry	3	Wednesday	Dr. İrem D. Cimen
TCR 306	Speech disorders	5	Thursday	Dr. Nursu C. Memik
TCR 316	Emergencies in child psychiatry	5	Friday	Dr. Aysen Coskun
TCR 308	Adoption	2	Friday	Dr. İrem D. Cimen

4th Year Education
1st Semester (January-June)

Code	Subject	Hour	Day	Lecturer
TCR 401	Forensic Psychiatry	2	Monday	Dr. Omer Kardas
TCR 411	Mood disorders and Suicide	2	Monday	Dr. İrem D. Cimen
TCR 403	Parental divorce	5	Tuesday	Dr. Şahika G. Sismanlar
TCR 413	Mood disorders and Suicide	3	Tuesday	Dr. İrem D. Cimen
TCR 405	Behavioral Therapy	5	Wednesday	Dr. Nursu C. Memik
TCR 415	Consultation-liaison	2	Wednesday	Dr. Burcu Kardas
TCR 407	Theoretical and practical psychotherapy techniques	3	Thursday	Dr. Omer Kardas
TCR 417	Somatic symptom disorders and related disorders	3	Thursday	Dr. Burcu Kardas
TCR 409	Substance use disorders	5	Thursday	Dr. Ozlem Y. Gundogdu

4th Year Education
1st Semester (July-December)

Code	Subject	Hour	Day	Lecturer
TCR 401	Forensic psychiatry	2	Monday	Dr. Ömer Kardaş
TCR 411	Mood disorders and suicide	2	Monday	Dr. İrem D. Cimen
TCR 403	Divorce	5	Tuesday	Dr. Şahika G. Sismanlar
TCR 413	Mood disorders and suicide	3	Tuesday	Dr. İrem D. Cimen
TCR 405	Behavioral therapy	5	Wednesday	Dr. Nursu C. Memik
TCR 415	Consultation-liaison	2	Wednesday	Dr. Burcu Kardas
TCR 407	Theoretical and applied psychotherapy techniques	3	Thursday	Dr. Omer Kardaa
TCR 417	Somatic symptom disorders and related disorders	3	Thursday	Dr. Burcu Kardaa

Case report: It is held between13.00-14.00 on monday

Supervision time: It is held between 13.00-14.00 on tuesday

Seminar presentation: It is held between 13.00-14.00 on wednesday

Health Board & article time: It is held between 13.00-14.00 on thursday

Training meeting: It is held between 13.00-14.00 on Friday.

Faculty members working at other universities contribute to postgraduate education as invited speakers every year.

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Units in Child and Adolescent Psychiatry Department

Polyclinic Study Program

In our department, outpatient services are carried out regularly, and follow-up and treatment services are provided in the Day Clinic when necessary. In addition, consultation and liaison studies with other departments are ongoing. Approximately 25,000 patients are seen annually in our department.

• Pre-Interview Polyclinic
• General Polyclinics
• Trauma Unit
• Child Protection Unit
• Day Clinic
• Psychometric Measurement and Evaluation Unit

General Polyclinics

There are six general polyclinics in our department. Patients are evaluated in our outpatient clinics, which lasts for approximately one hour and this service is provided together by advisor faculty members Prof. Özlem Yıldız Gündoğdu and Asst. Prof Ömer Kardaş. Evaluation of the patient when necessary is held together with faculty member Asst. Prof Ömer Kardaş. Follow-up patients are checked in the afternoon. Half an hour is provided to control patients for detailed evaluation and treatment. Patients whose evaluations are completed are transferred to specialized polyclinics when necessary.

Trauma Unit

Follow-up and treatment of our patients who have mental problems as a result of traumatic life events is carried in a separate polyclinic under the supervision of Faculty Member Prof. Ayşen Coşkun and faculty member Asst. Prof İrem Damla Çimen. In this polyclinic, mental disorders due to childhood mental traumas are approached in detail and current treatment modalities are applied. These can be counted as family treatments, individual psychotherapy, cognitive-behavioral therapy, play therapy and medication. In addition, consultancy is provided to families and their active participation in the treatment process is tried to be ensured.

Child Protection Unit

In our Child Protection Unit related to the Rectorate, service is provided together with the Forensic Medicine Department and other related departments. Children and young people who are referred by the judicial authorities are evaluated and their reporting is completed. In addition, cases of neglect and abuse directed from institutions and organizations working with children interior and exterior of the hospital are also evaluated.

Day Clinic

The day clinic is applied for the treatment of children and adolescents whose disease is not severe enough to require inpatient treatment but difficult to handle under outpatient conditions.

It has an important place in the field of treatment of child and adolescent mental health in western countries.

It was established for the first time in Turkey in the Department of Child and Adolescent Psychiatry at Kocaeli University in 2007 and has been the only one in the field since its establishment.

The staff of our clinic consists of 1 nurse, 1 psychologist, 1 classroom teacher, 5 research assistants, 2 faculty members (Prof. Nursu Çakın Memik, Asst. Prof Burcu Kardaş). The number of patients followed in our clinic is between 10 to 12 people.

A multidirectional treatment program is implemented in the day clinic. While the patients participate in activities such as sports activities, handicrafts, culinary practices, games and group activities, their mental treatment is organized by the treatment team. In our service, therapy methods such as cognitive behavioral therapy, psychoeducation, occupational therapy, ambient therapy (mileu therapy), pharmacotherapy (drug therapy) are applied.

When the patient enter in to our clinic, interviews are held with its parents, teachers and if necessary with other family members. Problems and possible causes are evaluated in detail in the parent meetings, and information is obtained from the teachers about the patient's attitude, behavior and academic success in the school.

By making daily individual interviews with the patients, patients are supported in transferring to daily life what they have learned during the treatment process, and from time to time it is also ensured that the patients practice together with the therapist. In addition, exercises are carried out to increase adaptation to the changes that occur with treatment. The exercise planned to be made in the interviews are discussed with the patient the next day. In which areas he has difficulties and the benefits of the practise are discussed with the patient during the exercise. The patients plan the week and determine the activities and tasks together with the treatment team at the beginning of the week.

General evaluation visits are held twice a week. In these visits, the treatment team and the patient come together and the homework given to the patient, the difficulties experienced by the patient, the skills that are planned to be acquired, the effects and side effects of the drug used are evaluated.

During the treatment process, the patient's family is interviewed once a week to provide necessary information about the difficulties that may be experienced, the responsibilities that the family must fulfill, and treatment planning. Thus, effective participation of the family in the treatment process is ensured.

In summary, children and adolescents followed in the day clinic are treated without leaving their families and the environment they are accustomed to. This makes it easier for the patient to overcome the difficulties experienced and ensures that the patient's well-being continues after he returns to his own life.

Behavioral Addictions Polyclinic

In our department, treatment services for internet, gaming, gambling disorder and other behavioral addictions are offered. After being evaluated in other outpatient clinics, cases with specific behavioral addictions are referred to this outpatient clinic. One day a week Dr. This polyclinic is consulted by Faculty Member Ömer Kardaş. Group meetings are planned for the patients followed up in this polyclinic and their families.

Psychometric Measurement and Evaluation Unit

The most commonly used psychometric assessment measurement tools in our clinic are the Denver II Developmental Screening Test and the WISC-4 test.

Developmental screening tests should be used regularly in order to monitor development in children and to detect deviations from normal early. Denver II Developmental Screening Test is an assessment tool used to determine possible developmental delays in children aged 0-6 years. The purpose of the application is to determine the developmental delay and enable the child to benefit from early diagnosis and treatment opportunities.

The Wechsler Intelligence Scale for Children 4 (WISC-4) is used in the 6-16 age group as an important assessment tool to measure intelligence. WISC-4 consists of 4 parts: verbal comprehension, perceptual reasoning, working memory, and processing speed and is applied in our clinic.

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Common Mental Disorders in Children and Adolescents

Anxiety Disorders

Anxiety/anxiety; It is the expectation that something bad is going to happen, and it is accepted as a natural reaction in daily life. If the duration of anxiety is prolonged, its severity increases and it prevents the fulfillment of daily functions, pathological anxiety and the presence of anxiety disorder can be mentioned. Anxiety disorders are the most common mental illness group in society. It is seen with a frequency of 5-15% in the childhood-adolescence period. Disorders in this group:

• Separation Anxiety Disorder
• Generalized Anxiety Disorder
• Phobic Disorders
• Panic disorder
• Acute Stress Disorder
• Post Traumatic Stress Disorder

In the treatment of anxiety disorders, methods such as individual therapy, family therapy, behavioral-cognitive therapy are used, and drug therapy is added to these if necessary.

Major Depressive Disorder

Major depressive disorder is very common in children and adolescents, can lead to significant loss of function, often coexists with other mental disorders, can lead to serious consequences such as suicide attempts and substance use, often recurs, can continue into adulthood, and for these reasons, early diagnosis and treatment are important. It is a serious mental disorder.

The main symptoms are unhappiness or irritability, introversion, inability to enjoy activities, sleep and appetite changes, loss of energy, restlessness, difficulty concentrating, thoughts of worthlessness/guilt, and suicidal thoughts.

Psychotherapy, cognitive behavioral therapy and drug therapy are used in the treatment.

Attention Deficit Hyperactivity Disorder (ADHD)

The main feature of Attention Deficit Hyperactivity Disorder is persistent and persistent symptoms of inattention and/or more frequent and severe mobility and impulsive behaviors compared to children of similar developmental level.

These children make careless mistakes in school or other homework that requires detail. They continue their work in an unplanned, irregular and complex way, and have difficulty completing the work they have started. They act as if their minds are elsewhere and not hearing what is being said. They cannot listen to others, they cannot concentrate on speaking. They can be easily distracted by an unrelated stimulus. They are often forgetful in daily activities.

Hyperactivity is manifested by the symptoms of not being able to sit comfortably, fidgeting even when sitting, and being in constant motion as if the motor is stuck. These children have difficulty sitting, standing, and often stand up and walk around or shake their feet. They talk a lot and get bored quickly and make noise during quiet activities (listening to fairy tales, etc.).

Impulsive behavior manifests itself as impatience, difficulty in delaying responses, and difficulty in waiting one's turn. They do not listen to instructions, they start talking at inappropriate times, they interrupt people's conversations. They engage in potentially dangerous activities without considering the possible consequences.

The incidence of ADHD in school-age children is 3-5%. In general, the disorder is recognized by the disruption of the child's adaptation to school during the primary school period. Symptoms decrease during puberty. A very few cases show all the symptoms in adulthood. Drug therapy, family education, individual therapy are the treatment methods applied.

Conduct Disorder

Conduct Disorder can be defined as the presence of recurrent or persistent behavioral problems in which the fundamental rights of others are attacked or the basic social values appropriate for their age are disregarded. Relations with family and society deteriorate gradually due to rebellion, opposition and behaviors against the society in children or adolescents.

These children and adolescents often exhibit aggressive behavior and try to get what they want by intimidating others. They often start fights. They treat animals and people cruelly, and may use physical and sexual violence. They can knowingly damage the property of others, start a fire for this purpose, break car windows, damage school belongings. Theft and fraud are common. Behaviors of running away from home and school can be seen.

The five most common symptoms are lying, stealing unseen, bullying, starting fights, and truancy.

Its incidence in the community is 5-15%. It is more common in cities than rural areas. It is 4-5 times more common in boys than girls.

Both biological, psychological, familial and social factors play a role in the formation of this disorder.

The onset of conduct disorder at an early age may be a precursor to antisocial personality disorder and substance use disorders in adult life.

There is no single treatment method that will provide significant and long-lasting results in this disorder. Medication, family education, individual psychotherapy, social assistance treatments, physical education programs are used for therapeutic purposes.

Oppositional-Defiant Disorder

The main feature of this disorder is repetitive, negative opposition, disobedience and hostile behavior patterns towards adults. Negative attitudes and defiant behaviors are in the form of persistent stubbornness, resistance to directions, inconsistency, unwillingness, and disagreement with adults and friends. Defiance is also manifested by deliberate and persistent pushing of boundaries, ignoring duties, fighting and arguing, or blaming others. This disorder manifests itself more in the home environment. It may not be observed at school or in the community. Symptoms of this disorder typically occur in a person's relationships with well-known adults or friends. These individuals generally do not consider themselves to be opposing people, and even try to defend their unwarranted wishes or unfair attitudes.

Oppositional Defiant Disorder occurs before the age of 8 years and does not appear after adolescence. Onset is typically slow, often occurring over months or years. It is a developmental precursor of Conduct Disorder in a significant number of cases.

The primary treatment for Oppositional Defiant Disorder is individual psychotherapy for the child and adolescent, as well as counseling for parents.

Autism Spectrum Disorder

Autism is accepted as a developmental disorder that begins in the early stages of life and continues throughout life, leading to delays and deviations in social relations, communication, behavior and cognitive development. As a result, children live in their own world, as if they are not very aware of their surroundings, and remain indifferent in social relations. They see people as objects that satisfy their needs. They may spend their time repeating repetitive behaviors such as turning, turning, flapping their arms, shaking things, or playing with their hands and fingers. They enjoy arranging objects, turning the pages of books and magazines, watching advertisements, listening to music; While doing this, they remain indifferent to what is going on around them. Some have words. However, some of them repeat what they hear and do not use words to express their needs. While some can say advertising words or phrases, they do not speak for social communication. Some of them have very strong memories; They show that they remember roads, places they see, and they easily memorize what they hear, especially things like rhymes.

The main symptoms are;

• Appropriate facial expression, use of gestures and avoidance of eye contact,
• Difficulty in establishing age-appropriate relationships with peers,
• No sharing with other people,
• Inability to express his feelings,
• Retardation in language development,
• Inability to set up a game in accordance with its purpose,
• Having a narrow field of interest

Formal and special education of the child is planned for treatment purposes, information and counseling are given to the family about the disorder, psychotherapies and drug treatments are applied for additional problems of the patient.

Obsessive compulsive disorder

Obsession (obsession-obsession): thoughts, dreams, wishes or images that appear in the mind over and over again without the will of the person and cause discomfort to the person. Compulsions: repetitive behaviors to eliminate bad thoughts and feelings created by obsessions. The prevalence of OCD in the general population varies between 1-3%. It is more common in children than is thought. It often begins in childhood or adolescence.

Common obsessions and compulsions are: fear of contamination, doubt, need for symmetry or certainty, sexual and religious thoughts, thoughts about harm or harm, need to wash and clean, checking, counting, correcting, hoarding, and asking questions. Obsessions and compulsions can be together, or a person can have only one. It causes serious functional loss in the person.

Individual psychotherapy, family therapy, cognitive behavioral therapy and medical treatment methods are used in the treatment.

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Stuttering

Stuttering is a speech disorder that usually begins between the ages of 3-5. Characterized by stuttering, hesitation and prolongation in the first word or between sentences; a condition triggered by loneliness, tension, and uneasiness. The emergence of stuttering may hinder the child's social adaptation. The child may hesitate to speak for fear of being ridiculed. It significantly affects the child's friendship relations and school success. In children who are reserved, insecure, and brought up under pressure, noncompliance may become even more pronounced. In children who are reserved, insecure, and brought up under pressure, non-compliance may become even more pronounced.

However, the recovery rate in severe stuttering remains at 50 percent.Most stuttering is temporary. The majority of stuttering that appears between the ages of two and three is physiological stuttering and may disappear completely in a short time.

It is very difficult to predict how long it will take for stuttering to improve. It is recommended that a child mental health practitioner be consulted as soon as stuttering begins. A thorough examination of the child's mental problems and a review of parents' attitudes can help stuttering progress.

Childhood Schizophrenia

People with schizophrenia live a unique world of introversion, moving away from interpersonal relationships and reality; it is a disease in which significant disorders in thought, perception and behavior are seen.

It usually starts in adolescence. The age of onset in men is earlier than in women. If the picture starts in childhood, it is called “Childhood Schizophrenia”, it is much rarer.

The onset in children is insidious. The symptoms in the initial period may have features that are not specific to the disease (such as apathy, indifference to the lesson..) and make the diagnosis difficult at this stage.

In hallucinations, which is one of the most common symptoms of the disease, the patient perceives what does not exist in reality. These misperceptions are often of an auditory and/or visual nature. Patients may have distorted or unrealistic thoughts (like self-harm).

Dullness in facial expression, decreased interest in pleasurable activities, sleep problems, strange behaviors, outbursts of anger, withdrawal from peer relationships, lack of self-care and cleanliness are some of the other symptoms of the disease.

It is thought that multiple factors play a role in the formation of the disease. One of the most important factors is genetic predisposition. While the risk of being seen in the community is 0.5-1%, this risk is 5-10 times higher in first-degree relatives of the patients. It is stated that psychological and environmental factors also play a role. The gene responsible for the disease has not yet been found. Schizophrenia is a chronic disease with periods of exacerbation and remission.

Sleep and Wakefulness Disorders

Sleep; It is a dynamic process that repeats regularly and is easily reversible. It is a natural state that awareness and response to the environment decrease reversibly. Sleep disorders are very common in the general population. It has been reported that 30% of the general population has sleep disturbances at least a few nights per month. It has been reported in various studies that 20-30% of children have sleep disorders, 27% of children between the ages of 2-15 have difficulty falling asleep and 25% have frequent awakenings at night.

Types of sleep disorders include:

• Insomnia disorder (Insomnia)
• Hypersomnolence disorder (Excessive Sleeping)
• Narcolepsy (Sudden sleep attacks, falling)
• Respiratory-related sleep disorders
• Sleep-wake cycle disorder
• Parasomnias:
• 1) Nightmare
• 2) Night Fear
• 3) Sleepwalking
• Restless legs syndrome
• Substance/Drug-related sleep disorder

In the evaluation of sleep disorder, the history is taken from the child or adolescent herself/himself and her/his family. The habitual sleep-wake patterns of the child and adolescent, with who and where they sleep, habits about bedtime and the changes that occur in this order are questioned. Changes; It may be for developmental reasons, it may be temporary, it may be a symptom of a specific sleep disorder or a mental or physical illness. The first step in the treatment of primary sleep disorders is to provide sleep hygiene. If necessary, medical treatment should be planned.

Nutrition and Eating Disorders

Healthy eating is the foundation of growth. Nutrition is of great importance in terms of emotional development as well as providing the necessary food for physical development. Nutrition provides important opportunities for parents to spend quality time with their babies and to improve the existing relationship.

The signs of eating problems in children and adolescents change with age.

Nutrition and Eating Disorders:

1. Pica (consumption of non-food items)
2. Regurgitation (rumination) disorder
3. Avoidant/restricted food intake disorder
4. Anorexia nervoza
5. Bulimia nervoza
6. Binge eating disorder
7. Other identified feding and eating disorder
8. Unidentified nutritional disorder

Treatment includes psychotherapy, family therapy and medication.

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Bedwetting (Enuresis)

Generally, children wet their bottoms at night until bladder control is achieved, that is, until they are two or three years old on average. Daytime bladder control is gained around the age of two; night control can continue until the age of five. Continuation of bedwetting after the age of five is called 'enuresis'. Enuresis is important in that it is common and is a difficult situation both for the child and the parents.

Enuresis can be seen in two forms. The first of these is 'primary enuresis'. It may result from a delay in the development of neuromuscular control and continues from birth. This delay may also occur as a result of irregular or inadequate toilet training received from the parents. Primary enuresis disappears over time and toilet control reaches the level of other children. The other type of enuresis is called 'secondary enuresis'. In this type of bedwetting, there is a regression after toilet control occurs.

Studies show that there is a close relationship between the problem of bedwetting and the emotional world of the child. It is known that toilet training at an early age and with a harsh approach is harmful. In the treatment of enuresis, it is important to first investigate the organic cause and to treat if there is one. In order to prevent emotional struggle, parents should be educated and guided about attitudes and behaviors. During the treatment process, we also work with the child. When secondary enuresis is present, psychosocial factors causing regression should also be addressed.

The emergence of significant emotional or behavioral symptoms after mental or social stressors is defined as an 'adjustment disorder'. Examples of stress factors that may cause adjustment disorder in childhood are parental death, parental divorce, sibling birth, physical illness, injuries, separation from parents, and starting school. In children, symptoms such as being unhappy, dejected, looking distressed, frequent crying, hopelessness, newly emerging fears, behavioral problems, introversion, aggression, and hyperactivity within 3 months after events that cause such stress and anxiety suggest adjustment disorder.

First, a detailed psychiatric evaluation is made during the treatment. The next step (where possible) is the elimination of the stress factor. In situations where the stress factor cannot be removed (such as loss of a parent, divorce, chronic diseases, etc.) various therapy and interview techniques are used to strengthen coping mechanisms and provide appropriate family support. If necessary, medication can be used.

Stereotypic Movement Disorder

Repetitive behaviors that do not have a social purpose and that occur constantly are defined as stereotypical behaviors (such as shaking hands, shaking hands, rocking in one's seat, hitting oneself, biting nails). Although stereotypical behaviors are not harmful to the individual and the environment, they negatively affect the lives of both the individual and those around her, such as not being accepted in social environments, being excluded, and making limited use of education and training opportunities. These behaviors interrupt the individual's learning opportunities and prevent socialization, especially in educational environments. Different treatment approaches are applied to patients with concomitant diagnoses, and behavioral methods are used in the first stage of treatment.

Infant Psychiatry

Some mental problems are also encountered in infants and young children aged 0-3. These include sleep and eating problems, motor and mental development problems, language and speech problems, attachment disorder, and an autism spectrum disorder.

It is very important to identify such difficulties in the early period and take the necessary precautions to prevent more serious mental problems that the child will develop at later ages.

The Sexual Development and Education

Generally, around the age of 3, children sense the gender difference between boys and girls and begin to examine it, and they show their interest in sexual issues with their questions and behaviors. Then they start asking where and how babies come from. Families' reactions to these questions are very important. The parents fear that as they get answers to the child's questions, they will take things forward and ask tough questions. However, the child is away from sexual matters at the age of 3-4.

Most families falter, feeling the need to make complex explanations. Some families also stimulate the child's curiosity unnecessarily by talking about sexuality in the presence of the child. Children who do not ask questions about sexual matters often remain silent because they cannot find answers to their questions. If questions are not answered when asked, the child may become more curious. He can show his curiosity not with words but with his actions. He may try to find the answers he is looking for in games of house or doctor.

Child sexual interest is most intense in preschool age. With the start of school, there is a decrease in interest and curiosity. Sexual interests seem to have gone to sleep.

The child will adopt the identity of a boy or a girl as long as the tendencies of his own gender are supported. Being born a boy or a girl is a condition for gaining sexual identity, but it is not sufficient and the only condition. It is known that sexual feelings and tendencies are effective and important in personality development. It has been observed that conflicts and obsessions related to sexual feelings in children can deviate mental development from its path. Therefore, it is important for families to be informed about teaching their children about sexuality.

Alcohol Substance Use Disorder

Alcohol and substance use disorder in adolescents has become a serious public health problem in recent years. Cigarettes, alcohol and addictive substances are usually first used during adolescence. Brain development continues during adolescence. In particular, the region of the brain responsible for tasks such as impulse control and decision making has not yet completed its development.

Some risk factors responsible for adolescent addiction have been identified. These factors are; can be divided into individual, familial and environmental factors. Individual factors include mental illnesses (ADHD, depression, anxiety disorders, etc.), genetics, and migration. While parental substance use and inconsistent parental attitudes are among familial factors, peer influence, friends using substance, media, insufficient control, accessibility and acceptance are environmental factors.

The situations listed below can be seen as normal in adolescence and can also be stimulating in terms of substance use disorder.

• Change in friend circle
• Change in course success
• Change in self-care
• Change in sleep-wake cycle
• Appetite disorders
• Finding materials related to substance use in the adolescent's living space
• Decreased time spent with family
• Loss of valuables
• Improper loss of youthful technological items

As with other psychiatric disorders, substance use disorder can also be treated. In this regard, child and adolescent psychiatrists, Child and adolescent substance addiction treatment centers (ÇEMATEM) should be applied.

 

Academic Staff:

• Professor.Dr. Özlem Yıldız GÜNDOĞDU  (Head of the Department)

• Professor.Dr. Ayşen COŞKUN

• Professor.Dr. Nursu ÇAKIN MEMİK

• Associate Professor. Dr. Şahika GÜLEN ŞİŞMANLAR

• Asst.Professor.Dr. İrem Damla ÇİMEN

• Asst.Professor.Dr. Burcu KARDAŞ

• Asst.Professor.Dr. Ömer KARDAŞ

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