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    Decreased serum levels of glial markers and their relation with clinical parameters in patients with schizophrenia
    (Klinik Psikiyatri Dergisi, 2023) Cetin, Ihsan; Demirel, Omer Faruk; Saglam, Tarik; Yildiz, Nazim; Duran, Alaattin
    Objective: The neurodevelopmental hypothesis of schizophrenia suggests that alterations of glial fibrillary acidic protein (GFAP) and glial cell line-derived neurotrophic factor (GDNF) functions may play a role in the pathogenesis of schizophrenia. However, there is limited information about the relationship of these molecules with the clinical features of schizophrenia. In this study, it was aimed to compare patients with schizophrenia and healthy controls in terms of serum GFAP and GDNF levels and to investigate the effects of clinical parameters on serum levels of molecules in patients with schizophrenia. Method: 37 patients with schizophrenia followed in the psychosis unit and 37 age- and sex-matched healthy controls without a history of psychiatric disease were recruited in study. The patients evaluated through the Turkish version of positive and negative syndrome scale. On the other hand, sociodemographic question form was applied to both the patients and the healthy controls. Results: Serum GDNF and GFAP levels of patients with schizophrenia were significantly lower than those of healthy controls. Furthermore, serum GDNF levels were negatively correlated with general and negative syndrome scales (PANSS) in these patients. Conclusion: It has been observed that there is a relationship between PANSS and changes in the GDNF levels of schizophrenia patients. However, larger clinical studies in which these markers are also measured in cerebrospinal fluid are needed to understand the biological mechanisms underlying these associations and to understand whether glial markers could be useful as biomarkers for the diagnosis of schizophrenia.
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    Offending and clinical characteristics of adults with autism spectrum disorder: Experience at forensic psychiatry center in Türkiye between 2012 and 2022
    (John Wiley and Sons Inc, 2025) Boylu, Muhammed Emin; Görmez, Aynur; Turan, Şenol; Yeşilkaya, Ümit Haluk; Boylu, Fatma Betül; Duran, Alaattin
    The forensic and clinical need for better understanding of criminal offending in adults with ASD is increasingly recognized. To date, few studies have examined the differences and similarities between criminal offenders with and without ASD with respect to demographics, offending profiles, and clinical characteristics. This study, conducted in Turkey, is the first to conduct such as comparison using a national database of forensic files. Computerized search of the forensic records of 11,853 adults assessed between January 1, 2012, and January 1, 2022, for criminal responsibility by the Turkish Council of Forensic Medicine found 74 adults diagnosed with ASD; they ranged in age from 18 to 40. [Correction added after first online publication on 04 December 2024. The value 11,583 has been revised to 11,853.] The demographic, clinical, and offending characteristics of these adults were compared to 100 adults without ASD selected from the remaining 11,779 records based on age (18–40 years) and year of assessment (10 from each year). The ASD group was younger, more likely to be unemployed and not living on their own. The ASD group was more likely to have co-morbid intellectual disability, ADHD, and OCD, while the non-ASD group was more likely to have co-morbid personality disorders, The ASD group was more likely to commit unplanned simple (non-penetrative) sexual and violent offenses against strangers; the non-ASD group was more likely to commit planned, qualified (penetrative) crimes against known persons. Impulsivity and manipulability were more often contributory in persons with ASD; revenge was more often contributory in persons without ASD. Adults with ASD were more likely to commit crimes on social media. In conclusion, this study found that adult offenders with and without ASD differed in demographics, psychiatric co-morbidities, and types of offending behaviors. These differences may have implications for the prevention of criminal offending in persons with ASD and addressing their needs once they are in the criminal justice system. © 2024 International Society for Autism Research and Wiley Periodicals LLC.
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    Silent abuse in the blind spot between medicine and law: A case series of Munchausen syndrome by proxy from Türkiye
    (WILEY, 2025) Asan, Oemer; Kavla, Yasin; Boylu, Muhammed Emin; Sahin, Hueseyin Cagri; Cirakoglu, Emre; Oezcanli, Tuba; Duran, Alaattin
    Munchausen syndrome by proxy is a rare but dangerous form of child abuse in which a caregiver exaggerates, fabricates, or induces medical symptoms in a dependent individual, typically a child. It is of the utmost importance to recognize and address this syndrome, which has significant legal and medical consequences. The failure to identify cases in a timely manner and to implement appropriate intervention strategies may result in irreparable harm or even fatal consequences. This study examined four cases involving 15 child victims and four perpetrators. All individuals were referred to the Turkish Council of Forensic Medicine for evaluation of criminal responsibility. The data were sourced from the National Judicial Network Project and case files spanning a decade. A comprehensive review of the clinical and forensic records was conducted. The four perpetrators, all females aged 27-34, exhibited histories of adverse childhood experiences, early marriage, limited education, and neglect. The clinical manifestations in children included apnea, immobility, bleeding, and bruising. Eleven children died before the abuse was detected, and four children were removed from their homes and placed under the protection of the state. MSBP is still frequently overlooked in clinical practice, which can result in irreparable harm and even death among affected children. The severe cases, as illustrated in this manuscript, demonstrate a recurrent pattern of abuse that persists until the cases are identified. An integrated multidisciplinary approach, involving medical and forensic services, is of paramount importance to facilitate the recognition and prevention of this form of child abuse.