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Book: Pediatric bipolar disorder

Diler, Rasim Somer

a global perspective

2007

Author's details	Rasim Somer Diler, ed
Keywords	Bipolar Disorder ; Cross-Cultural Comparison ; Child
Language	English
Size	X, 231 S. : graph. Darst.
Publisher	Nova Biomed. Books
Publishing place	New York
Publishing country	United States
Document type	Book
HBZ-ID	HT015711820
ISBN	978-1-59454-981-6 ; 1-59454-981-8
Database	Catalogue ZB MED Medicine, Health

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Book: Pediatric bipolar disorder

Diler, Rasim Somer

a global perspective

2007

Author's details	Rasim Somer Diler, editor
MeSH term(s)	Bipolar Disorder ; Cross-Cultural Comparison ; Child
Language	English
Size	x, 231 p. :, ill.
Publisher	Nova Biomedical Books
Publishing place	New York
Document type	Book
ISBN	9781594549816 ; 1594549818
Database	Catalogue of the US National Library of Medicine (NLM)

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Article: Panic disorder in children and adolescents.

Diler, Rasim Somer

Yonsei medical journal

2003 Volume 44, Issue 1, Page(s) 174–179

Abstract: Panic disorder (PD) in children and adolescents is a disabling and chronic condition, which is accompanied by psychosocial and academic difficulties both during adolescence and into adulthood. In this article, the prevalence, clinical characteristics, ... ...

Abstract	Panic disorder (PD) in children and adolescents is a disabling and chronic condition, which is accompanied by psychosocial and academic difficulties both during adolescence and into adulthood. In this article, the prevalence, clinical characteristics, risk factors, comorbid states, differential diagnosis, and treatment of PD are reviewed. Although PD was thought to be rare in children and adolescents, the prevalence of PD in community samples ranges between 0.5% and 5.0, and in pediatric psychiatric clinics from 0.2% to 10%. Panic attacks are reported to be equally prevalent in males and females. Clinical studies have shown that the majority of the PD pediatric patients receiving consultation in clinics are older adolescents, Caucasian, female, and middle class. Up to 90% of children and adolescents with PD have other anxiety disorders (generalized anxiety disorder/overanxious disorder, separation anxiety disorder, social phobia or agoraphobia), or mood disorders (major depressive disorder or bipolar disorder). PD patients can be misdiagnosed or having neurologic, cardiovascular, pulmonary, or gastrointestinal illness. Psychoeducation and psychosocial treatments are recommended, and it appears that selective serotonin reuptake inhibitors (SSRIs) are a safe and promising treatment for children and adolescents with PD. The clinical characteristics, long-term course, and treatment of PD in children and adolescents needs to be further assessed by well-designed studies.
MeSH term(s)	Adolescent ; Child ; Comorbidity ; Humans ; Panic Disorder/diagnosis ; Panic Disorder/etiology ; Panic Disorder/psychology ; Panic Disorder/therapy ; Prevalence
Language	English
Publishing date	2003-02
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	303740-x
ISSN	1976-2437 ; 0513-5796
ISSN (online)	1976-2437
ISSN	0513-5796
DOI	10.3349/ymj.2003.44.1.174
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Article ; Online: Index depressive episode and antidepressant exposure were associated with illness characteristics of pediatric bipolar disorder.

Acta psychiatrica Scandinavica

2021 Volume 145, Issue 2, Page(s) 200–208

Abstract: Objective: Pediatric bipolar disorder (PBD) is a serious, recurrent disorder leading to severe functional impairment. As a first mood episode, index episode could affect the long-term course of the illness. This study aimed to investigate the clinical ... ...

Abstract	Objective: Pediatric bipolar disorder (PBD) is a serious, recurrent disorder leading to severe functional impairment. As a first mood episode, index episode could affect the long-term course of the illness. This study aimed to investigate the clinical characteristics of youth with PBD from our multicenter, nationwide, naturalistic follow-up samples and to identify (i) the effects of index mood episode and (ii) the effect of previous antidepressant treatments on the age at mania onset of PBD. Method: The study sample consisted of 271 youth with BD-I followed by the child and adolescent psychiatry clinics of seven different university hospitals and three research state hospitals, representing six geographic regions across Turkey. All diagnoses were made according to structured interviews, and all data were retrospectively obtained from clinical records by the clinicians. Results: When patients with index depressive/mixed episodes (IDE, n=129) and patients with index (hypo)manic episodes (IME, n=142) were compared, the total number of mood episodes and rapid cycling feature were significantly higher in the IDE group than in the IME group. The Cox regression analysis adjusted for sociodemographic and illness characteristics revealed female adolescents in the IDE group treated with antidepressants were more likely to have an earlier onset of mania (hazard ratio=2.03, 95% confidence interval=1.31-3.12, p=0.001). Conclusion: This is the first large-scale nationwide follow-up study in Turkey that indicated prior antidepressant treatments were associated with an earlier onset of mania in youth, particularly in adolescent females. Larger prospective studies are needed to identify neurodevelopmental processes underlying PBD and initiate prevention approaches.
MeSH term(s)	Adolescent ; Affect ; Antidepressive Agents/adverse effects ; Bipolar Disorder/drug therapy ; Bipolar Disorder/epidemiology ; Child ; Female ; Follow-Up Studies ; Humans ; Retrospective Studies
Chemical Substances	Antidepressive Agents
Language	English
Publishing date	2021-06-22
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	103-x
ISSN	1600-0447 ; 0001-690X
ISSN (online)	1600-0447
ISSN	0001-690X
DOI	10.1111/acps.13333
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Article: Pediatric bipolar disorders: from the perspective of Turkey.

Emiroglu, F Neslihan Inal / Diler, Rasim Somer

Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent

2009 Volume 18, Issue 3, Page(s) 206–214

Abstract: Introduction: In Turkey, there is much controversy and skepticism about the existence of mania in children and adolescents, and a paucity of rigorous data. Despite ongoing controversy, the view that pediatric Bipolar Disorder(BD) is rare or non-existent ...

Abstract	Introduction: In Turkey, there is much controversy and skepticism about the existence of mania in children and adolescents, and a paucity of rigorous data. Despite ongoing controversy, the view that pediatric Bipolar Disorder(BD) is rare or non-existent has been increasingly challenged not only by case reports but also by systematic research. Methods: Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria are usually employed in these research studies and case reports and it was strongly suggested that pediatric BD may not be rare but that it may be difficult to diagnose. Results: In concordance with the current literature, euphoric mood and episodic course is rare in Turkish children and adolescents and the affective phenomenology is often mixed and dysphoric, with affective storms and temper outbursts. Comorbidity (especially with ADHD) is a big issue in accurate diagnosis and treatment. Conclusion: There are promising treatment studies, but we need more studies in both prepubertal children and adolescents about phenomenology, etiology, and treatment of this important condition.
Language	English
Publishing date	2009-08-28
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2381637-5
ISSN	2293-6122 ; 1719-8429
ISSN (online)	2293-6122
ISSN	1719-8429
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Article ; Online: Characteristics of depression among offspring at high and low familial risk of bipolar disorder.

Diler, Rasim Somer / Goldstein, Tina R / Hafeman, Danella / Rooks, Brian Thomas / Sakolsky, Dara / Goldstein, Benjamin I / Monk, Kelly / Hickey, Mary Beth / Axelson, David / Iyengar, Satish / Birmaher, Boris

Bipolar disorders

2017 Volume 19, Issue 5, Page(s) 344–352

Abstract: Objectives: Having a parent with bipolar disorder (BP) is a very strong risk factor for developing BP. Similarly, depression among youth is a clinical risk factor for subsequent BP. We evaluated whether mood symptomatology in depressed youth is ... ...

Abstract	Objectives: Having a parent with bipolar disorder (BP) is a very strong risk factor for developing BP. Similarly, depression among youth is a clinical risk factor for subsequent BP. We evaluated whether mood symptomatology in depressed youth is different between those at high and low familial risk to develop BP. Methods: The most severe major depressive episode in BP offspring (N=61) and community control offspring (N=20) was evaluated using expanded depression and mania rating scales derived from the Schedule for Affective Disorders and Schizophrenia for Children Present Version. The results were adjusted for any between-group significant demographic differences and for multiple comparisons. Results: The severity of depressive symptoms and the percentage of offspring with severe depressive symptoms, especially atypical depressive features, were significantly higher in the depressed offspring of BP parents compared to the depressed controls (P Conclusions: Depressed BP offspring had more severe depression including atypical depressive symptoms, and were more likely to have subsyndromal mixed manic symptoms than depressed control offspring. Prospective studies to evaluate whether these youth are at high risk to develop BP are warranted. If replicated, the results of this study have important clinical (e.g., treatment of depression in depressed offspring of BP parents) and research implications.
MeSH term(s)	Adolescent ; Adult ; Bipolar Disorder/diagnosis ; Bipolar Disorder/etiology ; Bipolar Disorder/psychology ; Child ; Child of Impaired Parents/psychology ; Depression/diagnosis ; Depression/etiology ; Depression/psychology ; Diagnostic and Statistical Manual of Mental Disorders ; Family Health/statistics & numerical data ; Female ; Humans ; Male ; Parents/psychology ; Prospective Studies ; Psychiatric Status Rating Scales ; Risk Assessment/methods ; Risk Factors ; Symptom Assessment/methods ; United States
Language	English
Publishing date	2017-06-14
Publishing country	Denmark
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1472242-2
ISSN	1399-5618 ; 1398-5647
ISSN (online)	1399-5618
ISSN	1398-5647
DOI	10.1111/bdi.12508
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Article ; Online: Adjunctive Bright Light Therapy for Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Trial.

Sit, Dorothy K / McGowan, James / Wiltrout, Christopher / Diler, Rasim Somer / Dills, John Jesse / Luther, James / Yang, Amy / Ciolino, Jody D / Seltman, Howard / Wisniewski, Stephen R / Terman, Michael / Wisner, Katherine L

The American journal of psychiatry

2017 Volume 175, Issue 2, Page(s) 131–139

Abstract: Objective: Patients with bipolar disorder have recurrent major depression, residual mood symptoms, and limited treatment options. Building on promising pilot data, the authors conducted a 6-week randomized double-blind placebo-controlled trial to ... ...

Abstract	Objective: Patients with bipolar disorder have recurrent major depression, residual mood symptoms, and limited treatment options. Building on promising pilot data, the authors conducted a 6-week randomized double-blind placebo-controlled trial to investigate the efficacy of adjunctive bright light therapy at midday for bipolar depression. The aims were to determine remission rate, depression symptom level, and rate of mood polarity switch, as well as to explore sleep quality. Method: The study enrolled depressed adults with bipolar I or II disorder who were receiving stable dosages of antimanic medication (excluding patients with hypomania or mania, mixed symptoms, or rapid cycling). Patients were randomly assigned to treatment with either 7,000-lux bright white light or 50-lux dim red placebo light (N=23 for each group). Symptoms were assessed weekly with the Structured Interview Guide for the Hamilton Depression Scale With Atypical Depression Supplement (SIGH-ADS), the Mania Rating Scale, and the Pittsburgh Sleep Quality Index. Remission was defined as having a SIGH-ADS score of 8 or less. Results: At baseline, both groups had moderate depression and no hypomanic or manic symptoms. Compared with the placebo light group, the group treated with bright white light experienced a significantly higher remission rate (68.2% compared with 22.2%; adjusted odds ratio=12.6) at weeks 4-6 and significantly lower depression scores (9.2 [SD=6.6] compared with 14.9 [SD=9.2]; adjusted β=-5.91) at the endpoint visit. No mood polarity switches were observed. Sleep quality improved in both groups and did not differ significantly between them. Conclusions: The data from this study provide robust evidence that supports the efficacy of midday bright light therapy for bipolar depression.
MeSH term(s)	Adult ; Antimanic Agents/therapeutic use ; Bipolar Disorder/psychology ; Bipolar Disorder/therapy ; Combined Modality Therapy ; Depression/psychology ; Depression/therapy ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Phototherapy/methods ; Sleep ; Treatment Outcome
Chemical Substances	Antimanic Agents
Language	English
Publishing date	2017-10-03
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	280045-7
ISSN	1535-7228 ; 0002-953X
ISSN (online)	1535-7228
ISSN	0002-953X
DOI	10.1176/appi.ajp.2017.16101200
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Article: Selective serotonin reuptake inhibitors in children and adolescents.

Diler, Rasim Somer / Avci, Ayse

Swiss medical weekly

2002 Volume 132, Issue 33-34, Page(s) 470–477

Abstract: This article will review the tolerability, side effects, and effectiveness of selective serotonin reuptake inhibitors (SSRIs) in children and adolescents. We aimed to familiarise the readers with the available data on the pharmacological treatment of ... ...

Abstract	This article will review the tolerability, side effects, and effectiveness of selective serotonin reuptake inhibitors (SSRIs) in children and adolescents. We aimed to familiarise the readers with the available data on the pharmacological treatment of childhood psychiatric disorders, especially of depressive disorder and obsessive compulsive disorder. Tricyclic antidepressants (TCAs) have questionable efficacy, definite problems with safety (e.g., cardiotoxicity, lethality in overdose, anticholinergic side effects), and compliance issues. Therefore it is suggested suggest that SSRIs should be the first-line treatment for these disorders in children and adolescents. Studies have shown a significant clinical response to SSRIs and their efficiency has been demonstrated in open and controlled trials. It is often recommended that clinicians should start low and go slow when using SSRIs, and maintain the patient in a symptom-free state for at least six months. The side effects of SSRIs are generally mild, manageable, and seldom require discontinuation of treatment. Children should be monitored closely for infrequent side effects such as gastrointestinal upset, headache, and behavioural activation which may be as severe as mania. There is a great need for controlled trials in childhood psychiatric disorders, especially in anxiety disorders.
MeSH term(s)	Adolescent ; Antidepressive Agents, Tricyclic/adverse effects ; Antidepressive Agents, Tricyclic/therapeutic use ; Anxiety Disorders/drug therapy ; Child ; Child Behavior Disorders/drug therapy ; Depressive Disorder/drug therapy ; Female ; Humans ; Male ; Obsessive-Compulsive Disorder/drug therapy ; Psychology, Adolescent ; Psychology, Child ; Selective Serotonin Reuptake Inhibitors/adverse effects ; Selective Serotonin Reuptake Inhibitors/therapeutic use
Chemical Substances	Antidepressive Agents, Tricyclic ; Serotonin Uptake Inhibitors
Language	English
Publishing date	2002-08-24
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2036179-8
ISSN	1424-3997 ; 1424-7860
ISSN (online)	1424-3997
ISSN	1424-7860
DOI	10.4414/smw.2002.09937
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Article: Sociodemographic and clinical characteristics of Turkish children and adolescents with obsessive-compulsive disorder.

Diler, Rasim Somer / Avci, Ayse

Croatian medical journal

2002 Volume 43, Issue 3, Page(s) 324–329

Abstract: Aim: To assess clinical and demographic characteristics of Turkish children and adolescents with obsessive-compulsive disorder.: Method: The study comprised 47 children and adolescents (31 boys and 15 girls) aged between 9 and 15 years, who were ... ...

Abstract	Aim: To assess clinical and demographic characteristics of Turkish children and adolescents with obsessive-compulsive disorder. Method: The study comprised 47 children and adolescents (31 boys and 15 girls) aged between 9 and 15 years, who were diagnosed with obsessive-compulsive disorder according to Diagnostic and Statistical Manual of Mental Disorders-IV. At the first interview, sociodemographic data of patients were recorded and Maudsley Obsession Compulsive Questionnaire (MOCQ), Child Depression Inventory (CDI), and State and Trait Anxiety Inventory for Children (STAI-C) were administered concurrently. Afterwards, the comorbid diagnosis and clinical characteristics of obsessive-compulsive disorder were investigated in detail during a psychiatric interview. Results: The obsessive-compulsive disorder prevalence among 1,739 outpatients seen for the first time at our clinics between January 1998 and April 1999 was 2.7% (n=47). Initial complaints with a content of obsession or compulsion were observed in only 14.9% (n=7) of the patients. Contamination (48.9%) and cleaning (68.1%) were the most common symptoms. Thirty-one patients (65.9%) had at least one comorbid disorder with obsessive-compulsive disorder, the most common being major depression (29.8%). There were no significant differences between the patients with and those without comorbid disorder in terms of MOCQ and subscales scores. Children under age of 13 had higher scores on cleanliness subscale on MOCQ, whereas children with migration history had higher state anxiety scores. There were no differences in STAI-C and CDI scores between boy and girls, children (<13 years) and adolescents (13 years), and firstborn and other children in a family. Conclusion: Obsessive-compulsive disorder is a serious clinical problem in childhood and practitioners, pediatricians, and psychiatrists should explicitly ask about the presence of symptoms characteristic to obsessive-compulsive disorder. Given the high rates of various comorbid states, such as anxiety, mood and tic disorders, comorbidities should also be taken into account during psychiatric evaluation of a child patient.
MeSH term(s)	Adolescent ; Age Distribution ; Child ; Data Collection ; Female ; Humans ; Incidence ; Male ; Obsessive-Compulsive Disorder/diagnosis ; Obsessive-Compulsive Disorder/epidemiology ; Probability ; Risk Factors ; Severity of Illness Index ; Sex Distribution ; Socioeconomic Factors ; Surveys and Questionnaires ; Turkey/epidemiology
Language	English
Publishing date	2002-06
Publishing country	Croatia
Document type	Comparative Study ; Journal Article
ZDB-ID	1157623-6
ISSN	1332-8166 ; 0353-9504
ISSN (online)	1332-8166
ISSN	0353-9504
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Article ; Online: Mania profile in a community sample of prepubertal children in Turkey.

Diler, Rasim Somer / Uguz, Sukru / Seydaoglu, Gulsah / Avci, Ayse

Bipolar disorders

2008 Volume 10, Issue 4, Page(s) 546–553

Abstract: Background: Mania in youth is increasingly recognized and accompanied by substantial psychiatric and psychosocial morbidity. There are no data on prepubertals in the general population and we aimed to search for mania symptoms and its clinical ... ...

Abstract	Background: Mania in youth is increasingly recognized and accompanied by substantial psychiatric and psychosocial morbidity. There are no data on prepubertals in the general population and we aimed to search for mania symptoms and its clinical correlations in a community sample of prepubertal Turkish children. Methods: Among all children (n = 56,335) aged 7-11 in Adana, Turkey, 2,468 children (48% girls) were randomly included. Parents completed Child Behavior Checklist (CBCL) 4-18 and Parent-Young Mania Rating Scale (P-YMRS). Cut-off scores of 17 and 27 on total P-YMRS were defined as efficient (probable-mania group) and specific (mania group), respectively, for bipolar profile. We searched for clinical correlations and used logistic regression to show how well each CBCL subscale predicted the presence of mania and probable-mania, after adjusting for any demographic differences. Results: Parent-Young Mania Rating Scale scores were > or =17 but <27 (probable-mania) in 155 (6.3%) children and > or =27 (mania) in 32 (1.3%) children. Elevated mood, increased activity levels, and poor insight were the most frequent manic symptoms in our sample. Children with probable-mania and mania had higher scores on all CBCL subscales and the CBCL-Pediatric Bipolar Disorder (CBCL-PBD) profile (sum of attention, aggression, and anxiety/depression subscales). Logistic regression analysis revealed only thought problems on CBCL that predicted probable-mania and mania. Conclusion: Our study shows that mania profile is common in the community sample of Turkish prepubertal children and does not support the thought that mania is rare outside the US. We need further population-based studies that will use diagnostic interviews and multiple informants.
MeSH term(s)	Bipolar Disorder/epidemiology ; Child ; Female ; Humans ; Male ; Psychiatric Status Rating Scales ; Residence Characteristics ; Turkey/epidemiology
Language	English
Publishing date	2008-06
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	1472242-2
ISSN	1399-5618 ; 1398-5647
ISSN (online)	1399-5618
ISSN	1398-5647
DOI	10.1111/j.1399-5618.2008.00580.x
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