Psychiatry and clinical psychopharmacology, Apr 30, 2018
Grief mania that is evaluated as psychogenic mania in the literature is related to manic episode ... more 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.
AİBÜ İzzet Baysal tıp fakültesi dergisi, Dec 21, 2021
GİRİŞ ve AMAÇ: Çalışmada tedavisiz obsesif kompulsif bozukluk (OKB) hastalarında nötrofil/lenfosi... more GİRİŞ ve AMAÇ: Çalışmada tedavisiz obsesif kompulsif bozukluk (OKB) hastalarında nötrofil/lenfosit oranı (NLR) ve platelet/ lenfosit oranının (PLR), sağlıklı kontroller ile karşılaştırılması amaçlanmıştır. Ayrıca içgörü düzeyleri ile NLR ve PLR arasındaki ilişki değerlendirilmiştir YÖNTEM ve GEREÇLER: Çalışmaya tedavi almayan ardışık 56 OKB hastası ve hasta grubu ile benzer sosyodemografik özelliklere sahip 56 sağlıklı kontrol dahil edildi. Hastalar ve kontrol grubu psikiyatrik bozukluklar ve hemogram parametreleri açısından değerlendirildi. Obsesif kompulsif belirtilerin şiddeti ve içgörü düzeyi Yale-Brown Obsesif Kompulsif Ölçeği ile değerlendirildi. BULGULAR: Ortalama OKB başlangıç yaşı 19,54±3,98 yıl, ortalama hastalık süresi 3,90±2,77 yıl olarak bulundu. OKB hastalarında ortalama NLR ve PLR düzeyleri sağlıklı kontrollere göre anlamlı derecede yüksekti (p<0,001). İçgörüsü olmayan veya zayıf olan OKB hastalarında PLR düzeyleri daha yüksek saptandı (p=0,012). TARTIŞMA ve SONUÇ: Bulgularımıza göre OKB hastalarında NLR, PLR değerlerinin yüksekliği ve içgörüsü yetersiz olan /olmayan hastalarda PLR yüksekliği etiyolojide inflamatuar süreçlerin rolü olabileceğini göstermektedir.
The Quality of Life in the Patients with Type II Diabetes Mellitus and Effects of Complications o... more The Quality of Life in the Patients with Type II Diabetes Mellitus and Effects of Complications on the Quality of Life Objective: The quality of life has been accepted an important survival indicator of disease in the patients with Diabetes Mellitus. The aim of this study was to investigate the effects of complications on the quality of life and other factors involving quality of life in the patients with type II Diabetes Mellitus. Method: Fifty patients with complication and fifty four patients without complication, total 104 patients with type II Diabetes Mellitus were involved to the study from Endocrinology outpatient unit in Suleyman Demirel University Medical Faculty. All patients were assessed using of sociodemographic data form, WHOQOL-BREF (TR) scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale. Results: It was found that WHOQOL-BREF (TR) scale physical health, psychological, social relationships, environment and environment (TR) domain and overall quality of life, general health, quality of life total scores were significantly low in patients with complication than without complication. In total patient group, social, environment (TR) domain, general health and quality of life total scores were found significantly more decreased in women than in men. It was determined that social, environment (TR) domain scores were significantly more decreased in patients with two different complications than in patients with one complication. It was determined that WHOQOL-BREF (TR) scale scores were inversely related to age, duration of diabetes, HbA1c and Hamilton Anxiety Rating Scale scores. Conclusions: Complications developed in diabetic patients have negative effects on the quality of life. Prevention and appropriate treatment of complications are important for improvement of quality of life in diabetic patients.
Depression may relate to neurocognitive impairment that results from alteration of N-methyl-D-asp... more Depression may relate to neurocognitive impairment that results from alteration of N-methyl-D-aspartate receptor (NMDAR) levels. Venlafaxine and escitalopram are two drugs commonly used to treat depression. The drugs may affect expression of NMDARs, which mediate learning and memory formation. The aim of the study was to examine whether the effects of venlafaxine and escitalopram treatments are associated with NMDARs in a rat model of depression. Forty male Wistar albino rats were randomly divided into four groups (n = 10) as follows: control group, chronic mild stress group (CMS), venlafaxine (20 mg/kg body weight per day) ? CMS, and escitalopram (10 mg/kg body weight per day) ? CMS. After induction of depression, a decrease in the concentration of NR2B was observed; venlafaxine treatment prevented the reduction of NR2B expression. Escitalopram treatment did not effect the reduced levels of NR2B resulting from depression. There was no significant difference in NR2A concentration among groups. The present data support the notion that venlafaxine plays a role in maintaining NR2B receptor in experimental depression. It may be possible that treatment with escitalopram has no effect on NMDARs in experimental depression.
Süleyman demirel üniversitesi sağlık bilimleri dergisi, Jul 27, 2023
Objective: The aim of this study is to evaluate the level of depression and the use of antidepres... more Objective: The aim of this study is to evaluate the level of depression and the use of antidepressants in the faculty of pharmacy. Material-Method: This study was an online cross-sectional survey and was conducted to Suleyman Demirel University Faculty of Pharmacy 4th and 5th grade students between 1-4 February 2023. The questionnaire consisted of questions about sociodemographic characteristics, Beck Depression Inventory (BDI), and antidepressant use. In the study, the cut-off point for depression was accepted as 17 and above. Results: The median BDI score of the students was 14 (7-22). 39.2% of the students were depressed and 30.4% were minimally depressed, 29.6% were mildly depressed, 30.4% were moderately depressed and 9.6% were severely depressed. The father's education level and monthly household income were found to be statistically significant in those with a BDI score of 17 and above, compared to a BDI score of 16 and below (p&lt;0.05). Eighteen (14.4%) students were using antidepressants and 38.9% of the students using antidepressants stated that they did not use antidepressants regularly. Conclusion: According to the results of our study, the level of depression in pharmacy faculty students was found to be high. Most of the students with moderate and severe depression were not taking antidepressant treatment. A significant portion of the students using antidepressants were using antidepressants irregularly. As the pharmacists of the future, they have important roles in patient education and patient compliance. Therefore, more emphasis should be placed on this subject in the courses in the faculty.
Aripiprazole is a second generation antipsychotic widely prescribed for the treatment of psychiat... more Aripiprazole is a second generation antipsychotic widely prescribed for the treatment of psychiatric diseases. It is generally known that antipsychotics have hypotensive effects. In this case report, however, we present the case of a medically healthy patient with schizophrenia who developed hypertension (HT) after the initiation of aripiprazole. The patient's blood pressure returned to normal after discontinuation of aripiprazole, suggesting that aripiprazole may have led to asymptomatic acute HT.
Capgras syndrome (CS) is characterized by the delusional belief that a person, usually very close... more Capgras syndrome (CS) is characterized by the delusional belief that a person, usually very close to the patient, has been replaced by a double who is physically very similar to the original. CS is relatively rare, occurring predominantly in course of schizophrenia, particularly of the paranoid sub-type, and less frequently in association with schizoaffective and affective disorder. Recent years have witnessed a sharp increase in the number of published CS cases with an organic etiology; however, CS was considered to have its origins in psychodynamic conflict. We present a patient with the CS and brain SPECT findings whom without psychiatric disorder. As an evaluation of brain SPECT, there have been found a significantly decreased blood flow in bilateral parietal regions and slightly decreased blood flow in bilateral posterior frontal regions. Cerebral dysfunction is proposed to be a central role in CS development. Unilateral right hemisphere lesions occur more frequently than the left; however, the majority of CS cases show bilateral involvement. Pathology involves many parts of the brain, most notably frontal and parietal cortex. Our findings support that frontoparietal dysfunction could be important in the pathogenesis of CS. We reviewed the neurobiology of CS and discussed our findings in this article. CS studies will give a better understanding of the neurobiological basis of psychotic experiences and may contribute to develop a paradigm on researches about other psychotic disorders.
Objective: To explore specific psychiatric comorbidity among type II DM patients with poor and go... more Objective: To explore specific psychiatric comorbidity among type II DM patients with poor and good glycemic control. Method: One hundred four patients with type II DM attending outpatient department of the Endocrinology Unit of Süleyman Demirel University Medical Faculty were included in this study. Patients were divided into two groups according to HbA1c level: >7% defined group 1 with poor glycemic control (n=40), and <7% defined group 2 with good glycemic control (n=64). All patients were assessed using a semi structured sociodemographic data form, the Structured Clinical Interview for DSM-IV-Clinical Version (SCID-I/CV), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS) and the Minimental State Examination Scale. Results: The prevalence rate of psychiatric disorders were as follows: major depressive disorder 67.5%, dysthymic disorder 10.0%, generalized anxiety disorder 7.5%, obsessive compulsive disorder 5%, social phobia 2.5% and nicotine dependence 5% in group 1 patients; and major depressive disorder 43.8%, dysthymic disorder 10.9%, paranoid disorder 3.1%, obsessive compulsive disorder 6.3%, social phobia 4.7%, generalized anxiety disorder 6.3%, nicotine dependence 9.4% and alcohol dependence 3.1% in group 2 patients. Major depressive disorder frequency was significantly higher in group1 patients than group 2 patients. HDRS and HARS scores were significantly higher in group 1 patients than in group 2 patients. Significant positive correlations were found between HDRS, HARS scores, number of depressive episodes and the level of HbA1c in the diabetic patients. Conclusion: Major depressive disorder was more frequent in diabetic patients with poor glycemic control than in those with good glycemic control. There was a strong association between level of HbA1c and depression and anxiety symptom level.
Objective: Suicide is a complex process from the initiation of ideation to planning, and finally ... more Objective: Suicide is a complex process from the initiation of ideation to planning, and finally to an attempt. This study aimed to investigate the prevalence of death ideation, attempted suicide, and the associated risk factors in Isparta, Turkey. Materials and methods: The study included 600 participants aged 18-65 years representative of the population of central Isparta that were selected via the stratified simple randomized sampling method. The participants were administered a questionnaire for collecting demographic data, and the participant's experiences of death ideations and suicide attempts, and the clinical version of SCID were used. Results: The lifetime prevalence of attempted suicide and death ideations was 4.3% and 27.5%, respectively. Death ideas and attempted suicide were both more prevalent among women and younger adults. All those that attempted suicide were exposed to a stress factor prior to the attempt. The rates of death ideation and attempted suicide were lower among the participants that had children. A family history of attempted suicide was associated with an increase in the frequency of death ideations and attempted suicide. Attempted suicide and death ideas were more common among those with major depressive disorder. Generalized anxiety disorder was observed significantly more frequently among those that had attempted suicide. Panic disorder and a specific phobia were also significantly associated with death ideation. Conclusion: The present study's findings indicate that there were common risk factors for attempted suicide and death ideations in the study group. Determination of the prevalence of attempted suicide and death ideation in a population, identification of the associated risk factors and assessment of their relationship to mental disorders can facilitate a better understanding of suicidal behaviour.
Therapeutic Advances in Psychopharmacology, Dec 28, 2015
Objective: Clozapine is a second-generation antipsychotic used for treatment-resistant schizophre... more Objective: Clozapine is a second-generation antipsychotic used for treatment-resistant schizophrenia. Despite its effectiveness, clozapine is largely underused due to serious side effects such as leukopenia or neutropenia. We aimed to review whether to continue, discontinue or rechallenge clozapine treatment after such haematological side effects. Methods: We reviewed and summarized the literature on the use of clozapine, how to deal with its side effects, and suitable options in case of any haematological problems. Then, we described several cases successfully treated with clozapine and lithium after development of neutropenia or leukopenia Results: We present three patients with treatment-resistant schizophrenia. While they had demonstrated poor response to multiple antipsychotic trials, clozapine was started. Clozapine induced neutropenia; or leukopenia developed in some cases that was successfully reversed after lithium onset. Increased serious side effects related with coprescription of lithium and clozapine were not observed. Conclusion: Lithium increases neutrophil and total white blood cell count as a side effect that may be useful in patients who develop neutropenia or leukopenia while being treated with clozapine.
Irritable bowel syndrome (IBS) and fibromyalgia (FM) are common functional diseases in adult wome... more Irritable bowel syndrome (IBS) and fibromyalgia (FM) are common functional diseases in adult women. The aim of this study was to investigate whether female predominance in IBS is related to FM. Fifty patients with IBS and 50 healthy controls were enrolled. All participants answered questionnaires including personal and medical history. In addition, psychiatric interviews were conducted. Patients were divided into two groups according to the coexistence of FM ( IBS+FM or IBS only). The data obtained from patients with or without FM and the control group were compared. There was a significant female predominance in patients with IBS+FM (83.4%, F:M=5:1), but IBS-only patients consisted mainly of males (59.4%, F:M=2:3) ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). Comparison of IBS+FM and IBS-only patients showed no significant difference in depression and anxiety status. However, both anxiety and depression scores were found to be higher in female IBS patients than their male counterparts ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01 and P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05, respectively). Our findings suggest that the female predominance in IBS patients may result from coexisting FM.
Diabetes mellitus (DM) is a frequently encountered metabolic disease with chronic features and in... more Diabetes mellitus (DM) is a frequently encountered metabolic disease with chronic features and involves numerous complications throughout its course, which causes severe restriction and disability in an individual's life. It has been reported that the incidence of depression is higher in diabetic patients and that diabetes is one of the risk factors in the development of depression. It has also been reported that co-morbid psychiatric disorders cause further deterioration in the quality of life in diabetic patients. The aim of this study was to investigate the effects of depression on the quality of life in type II DM patients. Sixty patients (30 females and 30 males) with current major depressive episode diagnosed according to DSM-IV criteria, and 48 type II DM patients (30 females and 18 males) without a major depressive episode (non-depressed group) were included in the study. All patients were evaluated with a semi-structured interview form to assess the clinical features of DM, Hamilton Rating Scale for Anxiety (HRSA), Hamilton Rating Scale for Depression (HRSD), and the Turkish version of The World Health Organization Quality of Life Assessment-Brief (WHOQOL-BREF). The HRSD and HRSA scores in the depressed group were 24.8774.83 and 21.0775.44, respectively, whereas those in the nondepressed group were 7.8373.92 and 6.8873.43, respectively. The physical health, psychological health, social relationship, environmental and social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores were found significantly lower in the depressed group than the non-depressed group. There were significant negative correlations between HRSD and HRSA scores and physical health, psychological health, social relationship, environmental and social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores. Furthermore, there were significant negative correlations between the HbA1c level and physical health, social relationship, environmental domain, social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores. However, there was a significant positive correlation between the level of education and physical health, psychological health, social relationship, environmental social pressure domain, overall quality of life, and WHOQOL-BREF total scores. There were significant negative correlations between social relationship domain score, and age and duration of illness. Our study demonstrates that the presence of depression in
Objective: We aimed to determine the frequency and clinical effects of childhood and adulthood at... more Objective: We aimed to determine the frequency and clinical effects of childhood and adulthood attention deficit hyperactivity disorder (ADHD) in male heroin-dependent patients, and to evaluate the clinical conditions that may affect the severity of addiction such as aggression, impulsivity, childhood traumas, anxiety sensitivity, anxiety and depression symptoms. Method: The study was completed with 100 consecutive male volunteers with heroin dependence, who were in the buprenorphine/naloxone stabilization treatment period. Sociodemografic form, Addiction Severtiy Index (ASI), Wender-Utah Rating Scale (WURS), Adult ADHD Self-Report Scale (ASRS), Barratt Impulsiveness Scale, Version 11 (BIS-11), Diagnostic Interview for ADHD in Adults-2.0 Turkish version (DIVA 2.0-Turksih) , Childhood Trauma Questionnare (CTQ) , Buss-Perry Agression Questionnare (BPAQ), Anxiety Sensitivity Index-3 (ASI-3), Medical Outcomes Study Short Form-36 (SF-36) Health Survey Questionnare, Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS) were administered to the participants. Results: A history of childhood ADHD was found in 30% and a diagnosis of adult ADHD was found in 14% of the participants who were administered the DIVA 2.0-Turkish. While the non-ADHD group had higher scores in the SF-36 social function and mental health domains (48.21±24.56, 52.15±19.05, respectively), had lower scores in the ASI legal and psychiatric status domains (4.69±1.75, 3.11±1.16, respectively). In the regression analysis, total score of the BPAQ was found to be an important variable that affecting four of the six ASI dimensions (employment/support status, legal status, drug use and psychiatric status). Conclusion: ADHD should be carefully evaluated in heroin-dependent patients. In the treatment of heroin addiction, which is a multidimensional disorder, it would be benefical to specifically address aggression. Keywords: Attention deficit hyperactivity disorder, heroin dependence, quality of life Öz Amaç: Çalışmamızda erkek eroin bağımlılarında çocukluk ve erişkinlik dönemi dikkat eksikliği hiperaktivite bozukluğu (DEHB) sıklığını ve klinik etkilerini araştırmayı bununla birlikte agresyon, dürtüsellik, çocukluk çağı travmaları, anksiyete duyarlılığı, anksiyete ve depresyon belirtileri gibi bağımlılık şiddetini etkileyebilecek klinik durumları değerlendirmeyi amaçladık. Yöntem: Çalışma, eroin bağımlılığı bulunan, buprenorfin/nalokson stabilizasyon tedavi dönemindeki, ardışık 100 erkek gönüllü ile tamamlanmıştır. Görüşmelerde katılımcılara sosyodemografik veri formu, Bağımlılık Şiddetini Belirleme Ölçeği (BŞBÖ), Wender-Utah Derecelendirme Ölçeği (WUDÖ), Erişkin Dikkat Eksikliği Hiperaktivite Bozukluğu Kendi Bildirim Ölçeği (ASRS), Barratt Dürtüsellik Ölçeği-11 (BIS-11), Yetişkinlerde DEHB için Tanısal Görüşme Aracı-2.0 Türkçe (DIVA Bağımlılık Dergisi | Journal of Dependence 2.0-Türkçe), Çocukluk Çağı Ruhsal Travmaları Ölçeği (ÇÇTÖ), Buss-Perry Agresyon Ölçeği (AÖ), Anksiyete Duyarlılığı İndeksi-3 (ADI-3), Kısa Form-36 (KF-36), Hamilton Depresyon Derecelendirme Ölçeği (HDDÖ) ve Hamilton Anksiyete Değerlendirme Ölçeği (HADÖ) uygulandı. Bulgular: DIVA 2.0-Türkçe uygulanan katılımcıların, %30'unda çocukluk çağı DEHB öyküsü, %14'ünde ise erişkin DEHB tanısı saptandı. DEHB olmayan grup KF-36 sosyal fonksiyon ve mental sağlık alanlarında daha yüksek puanlara sahipken (48,21±24,56, 52,15±19,05, sırasıyla), BŞBÖ yasal ve psikiyatrik durum alanlarında daha düşük puanlara (4,69±1,75, 3,11±1,16, sırasıyla) sahipti. Regresyon analizinde Buss-Perry Agresyon Ölçeği toplam puanının, altı BŞBÖ boyutundan dördünü (yasal durum, iş/destek durumu, madde kullanımı, psikiyatrik durum) etkileyen önemli bir değişken olduğu bulundu. Sonuç: Bulgularımız, eroin bağımlılığı olanlarda DEHB'nin dikkatle değerlendirilmesi gerektiğini göstermektedir. Çok boyutlu bir bozukluk olan eroin bağımlılığının tedavisinde agresyonun özellikle ele alınması yararlı olacaktır. Anahtar kelimeler: Dikkat eksikliği hiperaktivite bozukluğu, eroin bağımlılığı, yaşam kalitesi
Medicine Science | International Medical Journal, 2020
Caregiver burden is a complex concept that is influenced by many different factors. This study ai... more Caregiver burden is a complex concept that is influenced by many different factors. This study aimed to evaluate caregiving burden in caregivers of schizophrenia patients and to examine the effect of gender and other socio-demographic and clinical characteristics on caregiving burden. This study included 100 (50 female, 50 male) patients, who had been diagnosed with schizophrenia and their caregivers. The Zarit Caregiver Burden Scale (ZCBS), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), and Symptom Checklist-90-Revised (SCL-90-R) were administered to the caregivers. Insight Rating Scale (IRS), Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), Functional Recovery Scale in Schizophrenia (FRSS), Global Assessment Scale (GAS) were administered to the patients. The caregivers of male patients had significantly higher HAM-A, HAM-D, ZCBS total and all subscale, and SCL-90-R total and all subscale scores. The male patients had significantly higher PANSS general psychopathology subscale and CDSS and lower IRS scores. Multiple regression analysis revealed that male patient gender, living in urban areas and HAM-D scores of the caregivers were predictive of ZCBS total scores. This study found that schizophrenia has a significant burden. In addition, male patient and depression level of the caregivers were determined as the predictors of the caregiven burden.
Introduction: Compared to the general population, cardiovascular diseases are more common in schi... more Introduction: Compared to the general population, cardiovascular diseases are more common in schizophrenia patients and the mortality rate is higher than the general population. One of the explanations for increased cardiovascular events in patients with schizophrenia is the increase in platelet activity. Platelets are essential for progression of atherosclerotic lesions, plaque destabilization, and thrombus formation. Mean platelet volume (MPV) is a measure of platelet size and a good marker of platelet function and activation, which increases in cardiovascular diseases. MPV is routinely reported during complete blood count analysis. The aim of the present study was to evaluate MPV values of patients with schizophrenia. Methods: In this retrospective study, hospital-records of the patients who were consecutively admitted to psychiatry inpatient clinic between January 2015 and January 2017 with the diagnosis of schizophrenia were reviewed. Healthy subjects with no personal history of psychiatric disorder were included as a control group. Results: A total of 100 (59 female, 41 male) schizophrenic patients who had been consecutively admitted to the psychiatry inpatient clinic and 37 (20 female, 17 male) healthy controls were included in this retrospective study. There were no significant differences between the patient group and control group in the terms of age (mean age patient group vs control group: 37.72 vs 35.03, p=0.081) and sex (p=0.603). Body mass index (BMI) was found to be significantly different between groups, higher in the patient group (p=0.001). The MPV was found to be significantly higher in patient group compared with the control group (MPV, patient group vs control group: 10.34 fL vs 9.97 fL, p=0.041). Platelet count (PC) was significantly lower in the patient group (PC, patient group vs control group: 234.36 vs 267.38, p=0.008) There was no correlation between MPV and BMI (p=0.354, r=0.10), and duration of illness (p=0.530, r=0.06). Conclusions: As a result, increased MPV and decreased PC were found in a group of schizophrenic patient in this study. Since increased MPV and decreased PC are evaluated as risk factors for cardiovascular diseases in the general population, they can also be considered as a predictor of risk factors for cardiovascular diseases that are more frequently encountered in schizophrenia.
Personality and Individual Differences, Oct 1, 2017
The ratio of the length of the index finger to ring finger (2D:4D) is considered to be an indicat... more The ratio of the length of the index finger to ring finger (2D:4D) is considered to be an indicator of prenatal testosterone exposure. The androgen theory suggests that the masculinizing effects of fetal androgens may play a role in certain psychiatric disorders. We have examined the relationship between impulsiveness, aggression and adult attention deficit along with the 2D:4D digit ratios in male heroin abusers. The study included 62 male patients with heroin dependence and a control group comprising of 50 healthy individuals having similar socio-demographic features. Scores of the Barratt impulsiveness scale, Buss Perry Aggression Scale and attention deficit hyperactivity disorder (ADHD) self-report scale were obtained from the participants. The lengths of second and fourth digits of the right hands were measured. The patients group had significantly higher scores of impulsiveness, aggression and ADHD compared to the healthy control group; and their digit ratios were significantly lower. No correlations were found between digit ratios of heroin addicts and their impulsiveness, aggression and ADHD scores. Our study is the first to examine the relationship between digit ratio and impulsiveness, aggression and ADHD levels in patients with heroin dependence. Prenatal high testosterone exposure might have a role in the etiology of heroin addiction.
Psychiatry and clinical psychopharmacology, Jun 16, 2017
Objectives: This study aims at researching the inflammatory cells and their ratios as inflammatio... more Objectives: This study aims at researching the inflammatory cells and their ratios as inflammation markers in different phases of patients with bipolar disorder (BD). Methods: In this retrospective study, 79 manic, 61 depressed, 59 euthymic drug-naive patients with BD, and 86 control subjects have been evaluated for their complete blood count. Results: Neutrophil/lymphocyte ratio (NLR) was found to be significantly higher in manic, euthymic, and depressed patients with BD compared to control group. However, no difference was found between all patient and control groups regarding platelet/lymphocyte ratio (PLR). There was no difference among different phases of patient groups in terms of NLR and PLR. Conclusions: Our findings suggest that inflammatory process may have a role in all mood episodes of BD and NLR may be a useful trait inflammation marker for BD independent of mood episodes. However, further studies need to be conducted on the effect of inflammatory mechanisms on mood states of BD.
Psychiatry and clinical psychopharmacology, Apr 30, 2018
Grief mania that is evaluated as psychogenic mania in the literature is related to manic episode ... more 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.
AİBÜ İzzet Baysal tıp fakültesi dergisi, Dec 21, 2021
GİRİŞ ve AMAÇ: Çalışmada tedavisiz obsesif kompulsif bozukluk (OKB) hastalarında nötrofil/lenfosi... more GİRİŞ ve AMAÇ: Çalışmada tedavisiz obsesif kompulsif bozukluk (OKB) hastalarında nötrofil/lenfosit oranı (NLR) ve platelet/ lenfosit oranının (PLR), sağlıklı kontroller ile karşılaştırılması amaçlanmıştır. Ayrıca içgörü düzeyleri ile NLR ve PLR arasındaki ilişki değerlendirilmiştir YÖNTEM ve GEREÇLER: Çalışmaya tedavi almayan ardışık 56 OKB hastası ve hasta grubu ile benzer sosyodemografik özelliklere sahip 56 sağlıklı kontrol dahil edildi. Hastalar ve kontrol grubu psikiyatrik bozukluklar ve hemogram parametreleri açısından değerlendirildi. Obsesif kompulsif belirtilerin şiddeti ve içgörü düzeyi Yale-Brown Obsesif Kompulsif Ölçeği ile değerlendirildi. BULGULAR: Ortalama OKB başlangıç yaşı 19,54±3,98 yıl, ortalama hastalık süresi 3,90±2,77 yıl olarak bulundu. OKB hastalarında ortalama NLR ve PLR düzeyleri sağlıklı kontrollere göre anlamlı derecede yüksekti (p<0,001). İçgörüsü olmayan veya zayıf olan OKB hastalarında PLR düzeyleri daha yüksek saptandı (p=0,012). TARTIŞMA ve SONUÇ: Bulgularımıza göre OKB hastalarında NLR, PLR değerlerinin yüksekliği ve içgörüsü yetersiz olan /olmayan hastalarda PLR yüksekliği etiyolojide inflamatuar süreçlerin rolü olabileceğini göstermektedir.
The Quality of Life in the Patients with Type II Diabetes Mellitus and Effects of Complications o... more The Quality of Life in the Patients with Type II Diabetes Mellitus and Effects of Complications on the Quality of Life Objective: The quality of life has been accepted an important survival indicator of disease in the patients with Diabetes Mellitus. The aim of this study was to investigate the effects of complications on the quality of life and other factors involving quality of life in the patients with type II Diabetes Mellitus. Method: Fifty patients with complication and fifty four patients without complication, total 104 patients with type II Diabetes Mellitus were involved to the study from Endocrinology outpatient unit in Suleyman Demirel University Medical Faculty. All patients were assessed using of sociodemographic data form, WHOQOL-BREF (TR) scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale. Results: It was found that WHOQOL-BREF (TR) scale physical health, psychological, social relationships, environment and environment (TR) domain and overall quality of life, general health, quality of life total scores were significantly low in patients with complication than without complication. In total patient group, social, environment (TR) domain, general health and quality of life total scores were found significantly more decreased in women than in men. It was determined that social, environment (TR) domain scores were significantly more decreased in patients with two different complications than in patients with one complication. It was determined that WHOQOL-BREF (TR) scale scores were inversely related to age, duration of diabetes, HbA1c and Hamilton Anxiety Rating Scale scores. Conclusions: Complications developed in diabetic patients have negative effects on the quality of life. Prevention and appropriate treatment of complications are important for improvement of quality of life in diabetic patients.
Depression may relate to neurocognitive impairment that results from alteration of N-methyl-D-asp... more Depression may relate to neurocognitive impairment that results from alteration of N-methyl-D-aspartate receptor (NMDAR) levels. Venlafaxine and escitalopram are two drugs commonly used to treat depression. The drugs may affect expression of NMDARs, which mediate learning and memory formation. The aim of the study was to examine whether the effects of venlafaxine and escitalopram treatments are associated with NMDARs in a rat model of depression. Forty male Wistar albino rats were randomly divided into four groups (n = 10) as follows: control group, chronic mild stress group (CMS), venlafaxine (20 mg/kg body weight per day) ? CMS, and escitalopram (10 mg/kg body weight per day) ? CMS. After induction of depression, a decrease in the concentration of NR2B was observed; venlafaxine treatment prevented the reduction of NR2B expression. Escitalopram treatment did not effect the reduced levels of NR2B resulting from depression. There was no significant difference in NR2A concentration among groups. The present data support the notion that venlafaxine plays a role in maintaining NR2B receptor in experimental depression. It may be possible that treatment with escitalopram has no effect on NMDARs in experimental depression.
Süleyman demirel üniversitesi sağlık bilimleri dergisi, Jul 27, 2023
Objective: The aim of this study is to evaluate the level of depression and the use of antidepres... more Objective: The aim of this study is to evaluate the level of depression and the use of antidepressants in the faculty of pharmacy. Material-Method: This study was an online cross-sectional survey and was conducted to Suleyman Demirel University Faculty of Pharmacy 4th and 5th grade students between 1-4 February 2023. The questionnaire consisted of questions about sociodemographic characteristics, Beck Depression Inventory (BDI), and antidepressant use. In the study, the cut-off point for depression was accepted as 17 and above. Results: The median BDI score of the students was 14 (7-22). 39.2% of the students were depressed and 30.4% were minimally depressed, 29.6% were mildly depressed, 30.4% were moderately depressed and 9.6% were severely depressed. The father's education level and monthly household income were found to be statistically significant in those with a BDI score of 17 and above, compared to a BDI score of 16 and below (p&lt;0.05). Eighteen (14.4%) students were using antidepressants and 38.9% of the students using antidepressants stated that they did not use antidepressants regularly. Conclusion: According to the results of our study, the level of depression in pharmacy faculty students was found to be high. Most of the students with moderate and severe depression were not taking antidepressant treatment. A significant portion of the students using antidepressants were using antidepressants irregularly. As the pharmacists of the future, they have important roles in patient education and patient compliance. Therefore, more emphasis should be placed on this subject in the courses in the faculty.
Aripiprazole is a second generation antipsychotic widely prescribed for the treatment of psychiat... more Aripiprazole is a second generation antipsychotic widely prescribed for the treatment of psychiatric diseases. It is generally known that antipsychotics have hypotensive effects. In this case report, however, we present the case of a medically healthy patient with schizophrenia who developed hypertension (HT) after the initiation of aripiprazole. The patient's blood pressure returned to normal after discontinuation of aripiprazole, suggesting that aripiprazole may have led to asymptomatic acute HT.
Capgras syndrome (CS) is characterized by the delusional belief that a person, usually very close... more Capgras syndrome (CS) is characterized by the delusional belief that a person, usually very close to the patient, has been replaced by a double who is physically very similar to the original. CS is relatively rare, occurring predominantly in course of schizophrenia, particularly of the paranoid sub-type, and less frequently in association with schizoaffective and affective disorder. Recent years have witnessed a sharp increase in the number of published CS cases with an organic etiology; however, CS was considered to have its origins in psychodynamic conflict. We present a patient with the CS and brain SPECT findings whom without psychiatric disorder. As an evaluation of brain SPECT, there have been found a significantly decreased blood flow in bilateral parietal regions and slightly decreased blood flow in bilateral posterior frontal regions. Cerebral dysfunction is proposed to be a central role in CS development. Unilateral right hemisphere lesions occur more frequently than the left; however, the majority of CS cases show bilateral involvement. Pathology involves many parts of the brain, most notably frontal and parietal cortex. Our findings support that frontoparietal dysfunction could be important in the pathogenesis of CS. We reviewed the neurobiology of CS and discussed our findings in this article. CS studies will give a better understanding of the neurobiological basis of psychotic experiences and may contribute to develop a paradigm on researches about other psychotic disorders.
Objective: To explore specific psychiatric comorbidity among type II DM patients with poor and go... more Objective: To explore specific psychiatric comorbidity among type II DM patients with poor and good glycemic control. Method: One hundred four patients with type II DM attending outpatient department of the Endocrinology Unit of Süleyman Demirel University Medical Faculty were included in this study. Patients were divided into two groups according to HbA1c level: >7% defined group 1 with poor glycemic control (n=40), and <7% defined group 2 with good glycemic control (n=64). All patients were assessed using a semi structured sociodemographic data form, the Structured Clinical Interview for DSM-IV-Clinical Version (SCID-I/CV), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS) and the Minimental State Examination Scale. Results: The prevalence rate of psychiatric disorders were as follows: major depressive disorder 67.5%, dysthymic disorder 10.0%, generalized anxiety disorder 7.5%, obsessive compulsive disorder 5%, social phobia 2.5% and nicotine dependence 5% in group 1 patients; and major depressive disorder 43.8%, dysthymic disorder 10.9%, paranoid disorder 3.1%, obsessive compulsive disorder 6.3%, social phobia 4.7%, generalized anxiety disorder 6.3%, nicotine dependence 9.4% and alcohol dependence 3.1% in group 2 patients. Major depressive disorder frequency was significantly higher in group1 patients than group 2 patients. HDRS and HARS scores were significantly higher in group 1 patients than in group 2 patients. Significant positive correlations were found between HDRS, HARS scores, number of depressive episodes and the level of HbA1c in the diabetic patients. Conclusion: Major depressive disorder was more frequent in diabetic patients with poor glycemic control than in those with good glycemic control. There was a strong association between level of HbA1c and depression and anxiety symptom level.
Objective: Suicide is a complex process from the initiation of ideation to planning, and finally ... more Objective: Suicide is a complex process from the initiation of ideation to planning, and finally to an attempt. This study aimed to investigate the prevalence of death ideation, attempted suicide, and the associated risk factors in Isparta, Turkey. Materials and methods: The study included 600 participants aged 18-65 years representative of the population of central Isparta that were selected via the stratified simple randomized sampling method. The participants were administered a questionnaire for collecting demographic data, and the participant's experiences of death ideations and suicide attempts, and the clinical version of SCID were used. Results: The lifetime prevalence of attempted suicide and death ideations was 4.3% and 27.5%, respectively. Death ideas and attempted suicide were both more prevalent among women and younger adults. All those that attempted suicide were exposed to a stress factor prior to the attempt. The rates of death ideation and attempted suicide were lower among the participants that had children. A family history of attempted suicide was associated with an increase in the frequency of death ideations and attempted suicide. Attempted suicide and death ideas were more common among those with major depressive disorder. Generalized anxiety disorder was observed significantly more frequently among those that had attempted suicide. Panic disorder and a specific phobia were also significantly associated with death ideation. Conclusion: The present study's findings indicate that there were common risk factors for attempted suicide and death ideations in the study group. Determination of the prevalence of attempted suicide and death ideation in a population, identification of the associated risk factors and assessment of their relationship to mental disorders can facilitate a better understanding of suicidal behaviour.
Therapeutic Advances in Psychopharmacology, Dec 28, 2015
Objective: Clozapine is a second-generation antipsychotic used for treatment-resistant schizophre... more Objective: Clozapine is a second-generation antipsychotic used for treatment-resistant schizophrenia. Despite its effectiveness, clozapine is largely underused due to serious side effects such as leukopenia or neutropenia. We aimed to review whether to continue, discontinue or rechallenge clozapine treatment after such haematological side effects. Methods: We reviewed and summarized the literature on the use of clozapine, how to deal with its side effects, and suitable options in case of any haematological problems. Then, we described several cases successfully treated with clozapine and lithium after development of neutropenia or leukopenia Results: We present three patients with treatment-resistant schizophrenia. While they had demonstrated poor response to multiple antipsychotic trials, clozapine was started. Clozapine induced neutropenia; or leukopenia developed in some cases that was successfully reversed after lithium onset. Increased serious side effects related with coprescription of lithium and clozapine were not observed. Conclusion: Lithium increases neutrophil and total white blood cell count as a side effect that may be useful in patients who develop neutropenia or leukopenia while being treated with clozapine.
Irritable bowel syndrome (IBS) and fibromyalgia (FM) are common functional diseases in adult wome... more Irritable bowel syndrome (IBS) and fibromyalgia (FM) are common functional diseases in adult women. The aim of this study was to investigate whether female predominance in IBS is related to FM. Fifty patients with IBS and 50 healthy controls were enrolled. All participants answered questionnaires including personal and medical history. In addition, psychiatric interviews were conducted. Patients were divided into two groups according to the coexistence of FM ( IBS+FM or IBS only). The data obtained from patients with or without FM and the control group were compared. There was a significant female predominance in patients with IBS+FM (83.4%, F:M=5:1), but IBS-only patients consisted mainly of males (59.4%, F:M=2:3) ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). Comparison of IBS+FM and IBS-only patients showed no significant difference in depression and anxiety status. However, both anxiety and depression scores were found to be higher in female IBS patients than their male counterparts ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01 and P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05, respectively). Our findings suggest that the female predominance in IBS patients may result from coexisting FM.
Diabetes mellitus (DM) is a frequently encountered metabolic disease with chronic features and in... more Diabetes mellitus (DM) is a frequently encountered metabolic disease with chronic features and involves numerous complications throughout its course, which causes severe restriction and disability in an individual's life. It has been reported that the incidence of depression is higher in diabetic patients and that diabetes is one of the risk factors in the development of depression. It has also been reported that co-morbid psychiatric disorders cause further deterioration in the quality of life in diabetic patients. The aim of this study was to investigate the effects of depression on the quality of life in type II DM patients. Sixty patients (30 females and 30 males) with current major depressive episode diagnosed according to DSM-IV criteria, and 48 type II DM patients (30 females and 18 males) without a major depressive episode (non-depressed group) were included in the study. All patients were evaluated with a semi-structured interview form to assess the clinical features of DM, Hamilton Rating Scale for Anxiety (HRSA), Hamilton Rating Scale for Depression (HRSD), and the Turkish version of The World Health Organization Quality of Life Assessment-Brief (WHOQOL-BREF). The HRSD and HRSA scores in the depressed group were 24.8774.83 and 21.0775.44, respectively, whereas those in the nondepressed group were 7.8373.92 and 6.8873.43, respectively. The physical health, psychological health, social relationship, environmental and social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores were found significantly lower in the depressed group than the non-depressed group. There were significant negative correlations between HRSD and HRSA scores and physical health, psychological health, social relationship, environmental and social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores. Furthermore, there were significant negative correlations between the HbA1c level and physical health, social relationship, environmental domain, social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores. However, there was a significant positive correlation between the level of education and physical health, psychological health, social relationship, environmental social pressure domain, overall quality of life, and WHOQOL-BREF total scores. There were significant negative correlations between social relationship domain score, and age and duration of illness. Our study demonstrates that the presence of depression in
Objective: We aimed to determine the frequency and clinical effects of childhood and adulthood at... more Objective: We aimed to determine the frequency and clinical effects of childhood and adulthood attention deficit hyperactivity disorder (ADHD) in male heroin-dependent patients, and to evaluate the clinical conditions that may affect the severity of addiction such as aggression, impulsivity, childhood traumas, anxiety sensitivity, anxiety and depression symptoms. Method: The study was completed with 100 consecutive male volunteers with heroin dependence, who were in the buprenorphine/naloxone stabilization treatment period. Sociodemografic form, Addiction Severtiy Index (ASI), Wender-Utah Rating Scale (WURS), Adult ADHD Self-Report Scale (ASRS), Barratt Impulsiveness Scale, Version 11 (BIS-11), Diagnostic Interview for ADHD in Adults-2.0 Turkish version (DIVA 2.0-Turksih) , Childhood Trauma Questionnare (CTQ) , Buss-Perry Agression Questionnare (BPAQ), Anxiety Sensitivity Index-3 (ASI-3), Medical Outcomes Study Short Form-36 (SF-36) Health Survey Questionnare, Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS) were administered to the participants. Results: A history of childhood ADHD was found in 30% and a diagnosis of adult ADHD was found in 14% of the participants who were administered the DIVA 2.0-Turkish. While the non-ADHD group had higher scores in the SF-36 social function and mental health domains (48.21±24.56, 52.15±19.05, respectively), had lower scores in the ASI legal and psychiatric status domains (4.69±1.75, 3.11±1.16, respectively). In the regression analysis, total score of the BPAQ was found to be an important variable that affecting four of the six ASI dimensions (employment/support status, legal status, drug use and psychiatric status). Conclusion: ADHD should be carefully evaluated in heroin-dependent patients. In the treatment of heroin addiction, which is a multidimensional disorder, it would be benefical to specifically address aggression. Keywords: Attention deficit hyperactivity disorder, heroin dependence, quality of life Öz Amaç: Çalışmamızda erkek eroin bağımlılarında çocukluk ve erişkinlik dönemi dikkat eksikliği hiperaktivite bozukluğu (DEHB) sıklığını ve klinik etkilerini araştırmayı bununla birlikte agresyon, dürtüsellik, çocukluk çağı travmaları, anksiyete duyarlılığı, anksiyete ve depresyon belirtileri gibi bağımlılık şiddetini etkileyebilecek klinik durumları değerlendirmeyi amaçladık. Yöntem: Çalışma, eroin bağımlılığı bulunan, buprenorfin/nalokson stabilizasyon tedavi dönemindeki, ardışık 100 erkek gönüllü ile tamamlanmıştır. Görüşmelerde katılımcılara sosyodemografik veri formu, Bağımlılık Şiddetini Belirleme Ölçeği (BŞBÖ), Wender-Utah Derecelendirme Ölçeği (WUDÖ), Erişkin Dikkat Eksikliği Hiperaktivite Bozukluğu Kendi Bildirim Ölçeği (ASRS), Barratt Dürtüsellik Ölçeği-11 (BIS-11), Yetişkinlerde DEHB için Tanısal Görüşme Aracı-2.0 Türkçe (DIVA Bağımlılık Dergisi | Journal of Dependence 2.0-Türkçe), Çocukluk Çağı Ruhsal Travmaları Ölçeği (ÇÇTÖ), Buss-Perry Agresyon Ölçeği (AÖ), Anksiyete Duyarlılığı İndeksi-3 (ADI-3), Kısa Form-36 (KF-36), Hamilton Depresyon Derecelendirme Ölçeği (HDDÖ) ve Hamilton Anksiyete Değerlendirme Ölçeği (HADÖ) uygulandı. Bulgular: DIVA 2.0-Türkçe uygulanan katılımcıların, %30'unda çocukluk çağı DEHB öyküsü, %14'ünde ise erişkin DEHB tanısı saptandı. DEHB olmayan grup KF-36 sosyal fonksiyon ve mental sağlık alanlarında daha yüksek puanlara sahipken (48,21±24,56, 52,15±19,05, sırasıyla), BŞBÖ yasal ve psikiyatrik durum alanlarında daha düşük puanlara (4,69±1,75, 3,11±1,16, sırasıyla) sahipti. Regresyon analizinde Buss-Perry Agresyon Ölçeği toplam puanının, altı BŞBÖ boyutundan dördünü (yasal durum, iş/destek durumu, madde kullanımı, psikiyatrik durum) etkileyen önemli bir değişken olduğu bulundu. Sonuç: Bulgularımız, eroin bağımlılığı olanlarda DEHB'nin dikkatle değerlendirilmesi gerektiğini göstermektedir. Çok boyutlu bir bozukluk olan eroin bağımlılığının tedavisinde agresyonun özellikle ele alınması yararlı olacaktır. Anahtar kelimeler: Dikkat eksikliği hiperaktivite bozukluğu, eroin bağımlılığı, yaşam kalitesi
Medicine Science | International Medical Journal, 2020
Caregiver burden is a complex concept that is influenced by many different factors. This study ai... more Caregiver burden is a complex concept that is influenced by many different factors. This study aimed to evaluate caregiving burden in caregivers of schizophrenia patients and to examine the effect of gender and other socio-demographic and clinical characteristics on caregiving burden. This study included 100 (50 female, 50 male) patients, who had been diagnosed with schizophrenia and their caregivers. The Zarit Caregiver Burden Scale (ZCBS), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), and Symptom Checklist-90-Revised (SCL-90-R) were administered to the caregivers. Insight Rating Scale (IRS), Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), Functional Recovery Scale in Schizophrenia (FRSS), Global Assessment Scale (GAS) were administered to the patients. The caregivers of male patients had significantly higher HAM-A, HAM-D, ZCBS total and all subscale, and SCL-90-R total and all subscale scores. The male patients had significantly higher PANSS general psychopathology subscale and CDSS and lower IRS scores. Multiple regression analysis revealed that male patient gender, living in urban areas and HAM-D scores of the caregivers were predictive of ZCBS total scores. This study found that schizophrenia has a significant burden. In addition, male patient and depression level of the caregivers were determined as the predictors of the caregiven burden.
Introduction: Compared to the general population, cardiovascular diseases are more common in schi... more Introduction: Compared to the general population, cardiovascular diseases are more common in schizophrenia patients and the mortality rate is higher than the general population. One of the explanations for increased cardiovascular events in patients with schizophrenia is the increase in platelet activity. Platelets are essential for progression of atherosclerotic lesions, plaque destabilization, and thrombus formation. Mean platelet volume (MPV) is a measure of platelet size and a good marker of platelet function and activation, which increases in cardiovascular diseases. MPV is routinely reported during complete blood count analysis. The aim of the present study was to evaluate MPV values of patients with schizophrenia. Methods: In this retrospective study, hospital-records of the patients who were consecutively admitted to psychiatry inpatient clinic between January 2015 and January 2017 with the diagnosis of schizophrenia were reviewed. Healthy subjects with no personal history of psychiatric disorder were included as a control group. Results: A total of 100 (59 female, 41 male) schizophrenic patients who had been consecutively admitted to the psychiatry inpatient clinic and 37 (20 female, 17 male) healthy controls were included in this retrospective study. There were no significant differences between the patient group and control group in the terms of age (mean age patient group vs control group: 37.72 vs 35.03, p=0.081) and sex (p=0.603). Body mass index (BMI) was found to be significantly different between groups, higher in the patient group (p=0.001). The MPV was found to be significantly higher in patient group compared with the control group (MPV, patient group vs control group: 10.34 fL vs 9.97 fL, p=0.041). Platelet count (PC) was significantly lower in the patient group (PC, patient group vs control group: 234.36 vs 267.38, p=0.008) There was no correlation between MPV and BMI (p=0.354, r=0.10), and duration of illness (p=0.530, r=0.06). Conclusions: As a result, increased MPV and decreased PC were found in a group of schizophrenic patient in this study. Since increased MPV and decreased PC are evaluated as risk factors for cardiovascular diseases in the general population, they can also be considered as a predictor of risk factors for cardiovascular diseases that are more frequently encountered in schizophrenia.
Personality and Individual Differences, Oct 1, 2017
The ratio of the length of the index finger to ring finger (2D:4D) is considered to be an indicat... more The ratio of the length of the index finger to ring finger (2D:4D) is considered to be an indicator of prenatal testosterone exposure. The androgen theory suggests that the masculinizing effects of fetal androgens may play a role in certain psychiatric disorders. We have examined the relationship between impulsiveness, aggression and adult attention deficit along with the 2D:4D digit ratios in male heroin abusers. The study included 62 male patients with heroin dependence and a control group comprising of 50 healthy individuals having similar socio-demographic features. Scores of the Barratt impulsiveness scale, Buss Perry Aggression Scale and attention deficit hyperactivity disorder (ADHD) self-report scale were obtained from the participants. The lengths of second and fourth digits of the right hands were measured. The patients group had significantly higher scores of impulsiveness, aggression and ADHD compared to the healthy control group; and their digit ratios were significantly lower. No correlations were found between digit ratios of heroin addicts and their impulsiveness, aggression and ADHD scores. Our study is the first to examine the relationship between digit ratio and impulsiveness, aggression and ADHD levels in patients with heroin dependence. Prenatal high testosterone exposure might have a role in the etiology of heroin addiction.
Psychiatry and clinical psychopharmacology, Jun 16, 2017
Objectives: This study aims at researching the inflammatory cells and their ratios as inflammatio... more Objectives: This study aims at researching the inflammatory cells and their ratios as inflammation markers in different phases of patients with bipolar disorder (BD). Methods: In this retrospective study, 79 manic, 61 depressed, 59 euthymic drug-naive patients with BD, and 86 control subjects have been evaluated for their complete blood count. Results: Neutrophil/lymphocyte ratio (NLR) was found to be significantly higher in manic, euthymic, and depressed patients with BD compared to control group. However, no difference was found between all patient and control groups regarding platelet/lymphocyte ratio (PLR). There was no difference among different phases of patient groups in terms of NLR and PLR. Conclusions: Our findings suggest that inflammatory process may have a role in all mood episodes of BD and NLR may be a useful trait inflammation marker for BD independent of mood episodes. However, further studies need to be conducted on the effect of inflammatory mechanisms on mood states of BD.
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