Divalproex sodium/valproic acid (VPA) is an antiepileptic drug which is frequently prescribed in neurology and psychiatric clinics. Common side effects of VPA are side effects of the digestive system, weight gain, tremor, sedation, hematologic side effects and hair loss. Valproate-induced hyperammonemia is almost seen in 50% of patients treated with VPA, some of which may develop encephalopathy. Valproate-induced hyperammonemic encephalopathy (NE) is a well-known subject and there are numerous publications in the current literature. Although there is substantial evidence for this side effect in patients with neurological disorders, the data in the psychiatric area are limited. When we look at publications, it seems that VHE is seen more often because it starts earlier in psychiatric patients, but we think that it is often missed. Here, we presented five cases in which we followed up and treated with VHE diagnosis in our clinic within one year and other reports published previously in a table.

Objective: The aim of this study was to investigate the relationship between symptomatology and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) cognitive profiles in Attention Deficit and Hyperactivity Disorder (ADHD), taking into account clinical heterogeneity. Method: The WISC-IV was administered to 60 children aged 6 to 13 years with ADHD who had not previously taken psychotropic medication. Conners Teacher-Rating Scale (CTRS-R/L) and Conners Parent-Rating Scale (CPRS-R/L) were completed by parents and teachers. Results: We found a statistically significant positive correlation between the symptoms of hyperactivity/impulsivity and PSI (Processing Speed Index). A statistically significant negative correlation was found between the CTRS-R/L’s DSM-IV Inattentive subscale and PRI (Perceptual Reasoning Index). No relationship was found between the inattention or hyperactivity/impulsivity symptomatology with Working Memory Index (WMI). WMI stood out as the most frequently reported weakness among the four index scores. Conclusion: Considering the relationship between the cognitive domains of RDoC (Research Domain Criteria) and dimensions of HiTOP with the ADHD symptom clusters, the assessment of cognitive and behavioral symptoms may be useful for phenotyping ADHD. According to the CHC (Cattell-Horn-Carroll) theory; the positive correlation level between PSI, which is accepted as Gs, and hyperactivity/impulsivity symptoms in people with ADHD may be due to the fact that hyperactivity is one of the narrow cognitive domains of Gps.

Background: Clinical experiences emphasize the possible role of parental attitudes and behaviours in shaping stuttering behaviors however, the number of studies in this area is still insufficient. Objective: Our aims were to compare parental attitudes in children with and without stuttering and to determine the effect of parental attitudes on stuttering severity. Methods: We used an age and gender matched case control design with 24 children with stuttering and 22 healthy school children. Demographic information form and Parental Attitude Research Instrument (PARI) were enrolled by the mothers. Results: According to our results; there was a statistically significant difference in parental attitudes of children with and without stuttering. Our results showed that excessive maternal control of the child and the expectations of obedience from the child more frequently observed in parents of the children with stuttering. Also there was a significant positive correlation with the severity of stuttering and excessive maternal control of the child, the expectations of obedience from the child and marital conflict. Discussion: In conclusion, there was an important difference in parental styles of study group and this difference was related to the severity of stuttering. Clinicans should address parental attitudes in this samples.

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Grief mania that is evaluated as psychogenic mania in the literature is related to manic episode that emerges after the loss of a loved one. There are not many cases that associate causality of beginning of mania and mourning in the literature. It is known that mania is induced by traumatic events but the cases that do not suit stages of development of grief process are evaluated as pathological grief. In this case, the woman who experienced manic episode after her son's death is presented. This case is prepared because mania should be considered as possible grief reaction. Case presentation: A patient who is 40 years old, married, mother of 4 children is brought by relatives because of aggressiveness, tension, insomnia for 4 days, fast and talk a lot and nonsense laughing attacks. She was presented to hospital for stressful life events 2 years ago and started to be on medication (escitalopram 10 mg) because of depression and fibromiyaliji diagnosis. She used medication for 1.5 years and she did not use any medication for the last 6months. There is no history for mental disorder in her family. Psychological examination: her interest for the environment was increased, self-care ability got better, her temperament was cheerful, her sociability was respectful, amount of talking and tone of voice increased, mimic and gesture was appropriate for her temperament, sleeping decreased, thought flow increased and achieved goal of conversation late. Moreover, there were grandiose delusions and hypervigilance, affect was close to euphoria, her psychomotor behaviours increased and social functioning decreased. According to biochemical and radiological workup, there was no pathological situation. The client started to use Lithium 900 mg/day and Olanzapin 10 mg/day because of the bipolar disorder diagnosis. The patient's blood lithium level was 0.8mEq/L and lithium was used 1200 mg/day and then 10 days later the patient's blood lithium level was 0.72 mEq/L. According to clinical observations, the patient's manic symptoms remained. Furthermore, the patient started to cry occasionally after 1 month and her grandiosity disappeared. The patient was discharged from the hospital after 45 days. The patient met the criteria for manic episode in DSM 5. The patient did not take any medication for last 6 months. Thus, it is considered that this situation was not induced by medication. It puts the patient into risk group because she was treated for depression before but it is not considered as bipolar depression because there were psychiatric history in the family and depression that experienced 2 years ago was related to stressful life events. It is considered that this case experienced grief/funeral mania because there was contiguity between loss of her son and manic episode, the patient did not react this way to previous challenging life events and the patient was outside of the ordinary 5 stages of grief process.