I am a psychiatrist in Ankara Turkey. I work for Turkish Ministry of Health at Health Sciences Univesity Ankara Kecioren Training and Research Hospital.
The International Journal of Psychiatry in Medicine
Background Dietary total antioxidant capacity serves as an indicator for dietary quality and refl... more Background Dietary total antioxidant capacity serves as an indicator for dietary quality and reflects daily antioxidant intake. This study aimed to determine the oxidative stress status of patients with schizophrenia and to examine the relationship between dietary total antioxidant capacity (dTAC) and 8-hydroxy-2′-deoxyguanosine (8-OHdG), a marker for oxidative stress. Methods This study was conducted in Turkey and involved 40 patients diagnosed with schizophrenia or schizoaffective disorder according to the Diagnostic and Statistical Manual of Mental Disorders, 5th ed and 30 healthy controls matched for age and gender. The participants’ sociodemographic characteristics and nutritional habits were determined through face-to-face interviews and through the use of questionnaires. The dTAC and dietary oxidative balance scores were calculated using a three-day dietary intake record. 8-OHdG levels were analyzed in the serum samples collected from the subjects. Results Dietary ferric redu...
Vortioxetine is a new generation antidepressant that has 5-HT3, 5-HT1D, 5-HT7 antagonist, 5-HT1B ... more Vortioxetine is a new generation antidepressant that has 5-HT3, 5-HT1D, 5-HT7 antagonist, 5-HT1B partial agonsite and 5-HT1A receptor agonist features (Sanchez et al. 2015). The antagonist effect on 5-HT3 receptors causes nausea and vomiting, the most common side effect of vortioxetine (D'Agostino et al. 2015). In animal studies, it blocks 5-HT3 receptors, causing an increase in serotonin, dopamine, norepinephrine, acetylcholine, and histamine (Sanchez et al. 2015). It is known that manic or hypomanic switch may occur due to antidepressant treatment. Treatments that increase dopamine and norepinephrine levels can cause a manic shift (Allain et al. 2017). The features that increase the risk of manic or hypomanic switch due to antidepressants are female sex, young age, family history of psychiatric disorders, atypical features and three or more lifetime episode of depression (Pirdogan Aydin et al. 2019). The aim of this case report is to present a patient who presented to psychiat...
Background: The metabolic syndrome is a growing global public health problem and highly prevalent... more Background: The metabolic syndrome is a growing global public health problem and highly prevalent in patiens with bipolar disorder. There are a few studies about relationship between metabolic syndrome and bipolar disorder subtypes. Objective: The aim of this study was to investigate the prevalence of metabolic syndrome (MS) and its individual components in subjects with bipolar I (BD I) and bipolar II (BD II) disorder compared with non-psychiatric controls, and to determine the variables affecting MS. Methods: A total of 210 individuals (mean age 42.5 ± 11.87, 58.1% female) of whom 70 had BD I, 70 BD II, and 70 controls, were included in this study. MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the adapted ATP III (ATP III-A) and the International Diabetes Federation (IDF) criteria. Results: Participants with BD I had a significantly higher prevalence of MS when compared to individuals BD II and non-psychiatric controls according to the NCEP-ATP III, ATP III-A, and IDF criteria (ps < 0.01). In individuals with MS, increased waist circumference was the most common abnormality. Logistic regression analysis revealed that the presence of physical illness, age and number of cigarettes smoked significantly predicted the presence of MS. Discussion: This study showed that MS was more prevalent among BD I individuals compared to BD II and controls, and highlighted the importance of regular screening for MS in individuals with BD.
Background: Suicide is one of the major public health problems in young adults. Detecting the ris... more Background: Suicide is one of the major public health problems in young adults. Detecting the risk factors and correlates among university students might help identify students who are under risk and who need early interventions for suicide prevention.Aims: The current study aimed to investigate the cognitive style, self-esteem, hopelessness, rumination, cognitive reactivity, and personality characteristics of Turkish university students, who previously attempted suicide and who did not.Method: A total of 355 university students (34 previous suicide attempters) were recruited for this study, and they completed the Ten-Item Personality Inventory (TIPI), the Ruminative Response Scale (RRS), the Leiden Index of Depression Sensitivity–Revised (LEIDS-R), the Beck Hopelessness Scale (BHS), the Cognitive Style Questionnaire–Short Form (CSQ), the Rosenberg Self-Esteem Scale (RSES), and the Hospital Anxiety and Depression Scale (HADS).Results: Higher RRS, BHS, CSQ scores and lower TIPI-A and...
Objective: The aim of this research was to assess the characteristics of the consultations requir... more Objective: The aim of this research was to assess the characteristics of the consultations required in a psychiatric department of a university hospital, and the distribution of psychiatric disorders in hospitalized patients and patients admitted to the emergency room. Method: In the study, the data of 539 patients 18 years or older (48.67 ± 20.91 years) (46.8% women) who were hospitalized and who presented to the emergency room between 01/01/2015 and 31/12/2015, and for whom a psychiatric consultation was requested were recorded onto a structured form. Patients' electronic databases were reviewed retrospectively for the specified date range. Descriptive statistical analyzes (frequency of data, distribution, mean, standard deviation) were performed for the data examined in the study. Results: Medical departments (42.9%), surgical departments (31.7%) and the emergency medicine department (25.4%) were the most frequently psychiatric consultation requesting departments. The most frequent requests for consultation were agitation (15.4%), depressive symptoms and signs (14.7%) and suicide attempts (12.2%). The most frequent psychiatric diagnoses were depressive disorders (19.5%), delirium (18.2%) and schizophrenia and other psychotic disorders (7.4%). Musculoskeletal diseases (17.4%), mental disorders (15.0%), oncologic diseases (14.1%) and suicide attempts (12.2%) were the primary diagnoses of patients. Discussion: Consultation and liaison psychiatry services have an important role in our relationship with other departments in medicine. Priority to training of depressive disorders, delirium and suicide attempts should be offered to healthcare providers working in these departments.
OBJECTIVES: We aimed to compare patients with bipolar disorder and major depressive disorder, who... more OBJECTIVES: We aimed to compare patients with bipolar disorder and major depressive disorder, who were either in an acute depressive episode or in remission, and a healthy control group on their cognitions related to depression and mania/hypomania, and on their response styles. METHODS: A total of 300 participants who presented to our outpatient psychiatry department were included in the study (100 participants with unipolar depression (DG), 100 with bipolar disorder, and 100 with no previous or current psychiatric disorder (CG)). The participants completed the Cognition Checklist (CCL), the Cognition Checklist for Mania (CCL-M-R), the Cognitive Distortions Questionnaire (CDQ), the Dysfunctional Attitude Scale (DAS), the Hypomanic Attitudes and Positive Predictions Inventory (HAPPI), the Brief Core Schemas Scale (BCSS), Ruminative Response Scale (RRS), and the Responses to Positive Affect Questionnaire (RPAQ). The groups were compared with each other by one-way analysis of variance, independent samples t-test, and chi-square tests. RESULTS: The DG scored higher than the other groups on the CCL, the frequency and intensity subscales of the CDQ, the DAS, and the negative-self and negative-others subscales of the BCSS, the RRS, and on the dampening subscale of the RPAQ. The clinical groups scored higher than the CG on the scores of the relationships subscale of the CCL-M-R, the total score of the CDQ, and the HAPPI. The CG scored higher than the clinical groups on the positive-self subscale of the BCSS, and on the emotion focused positive rumination subscale. CONCLUSIONS: These findings are important in the differential diagnosis of mood disorders, and for their treatment with cognitive behavioural psychotherapy.
Background: The metabolic syndrome is a growing global public health problem and highly prevalent... more Background: The metabolic syndrome is a growing global public health problem and highly prevalent in patiens with bipolar disorder. There are a few studies about relationship between metabolic syndrome and bipolar disorder subtypes. Objective: The aim of this study was to investigate the prevalence of metabolic syndrome (MS) and its individual components in subjects with bipolar I (BD I) and bipolar II (BD II) disorder compared with non-psychiatric controls, and to determine the variables affecting MS. Methods: A total of 210 individuals (mean age 42.5 ± 11.87, 58.1% female) of whom 70 had BD I, 70 BD II, and 70 controls, were included in this study. MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the adapted ATP III (ATP III-A) and the International Diabetes Federation (IDF) criteria. Results: Participants with BD I had a significantly higher prevalence of MS when compared to individuals BD II and non-psychiatric controls according to the NCEP-ATP III, ATP III-A, and IDF criteria (ps < 0.01). In individuals with MS, increased waist circumference was the most common abnormality. Logistic regression analysis revealed that the presence of physical illness, age and number of cigarettes smoked significantly predicted the presence of MS. Discussion: This study showed that MS was more prevalent among BD I individuals compared to BD II and controls, and highlighted the importance of regular screening for MS in individuals with BD.
Journal of Rational-Emotive & Cognitive-Behavior Therapy, 2017
Many studies have described grief and psychiatric symptomatology as a typical feature following m... more Many studies have described grief and psychiatric symptomatology as a typical feature following miscarriage. How women who had a miscarriage (MG) respond to trauma in terms of negative cognitions about their selves and the world, the coping strategies they employ to overcome the effects of the trauma, and what factors might be indicative of posttraumatic growth (PTG) in this population have not been extensively studied so far. We aimed to identify whether women who had a miscarriage (N = 74 vs. N = 82 control subjects) exhibited higher levels of psychological distress symptoms, dysfunctional cognitions, and maladaptive coping strategies, and whether women with lower PTG employed more maladaptive coping strategies, and reported higher levels of dysfunctional cognitions. Group comparisons according to the diagnostic groups based on selfreport measures for depression, anxiety, posttraumatic stress disorder and according to the level of PTG, and stepwise linear regression analyses with PTG as the outcome were performed. Our study demonstrated that the MG does not necessarily differ from the control group on some measures of psychopathology, coping mechanisms, dysfunctional cognitions, or PTG. Yet, the MG who exhibited higher levels of PTG had specific predictors, and women with a psychiatric diagnosis differed from participants with no diagnoses on some measures of dysfunctional cognitions, coping mechanisms, and PTG. Further studies with a prospective design could further clarify the needs of the MG requiring psychotherapeutic interventions.
Background and objectives: We aimed to investigate the depression and anxiety levels and to explo... more Background and objectives: We aimed to investigate the depression and anxiety levels and to explore the coping strategies and personality traits of patients with euthyroid Hashimoto Thyroiditis (HT). Methods: The study population consisted of 108 outpatients with euthyroid HT. The participants completed the Hospital Anxiety and Depression Scale (HADS), the Big Five Personality Inventory (BFI), and the Coping With Problems Experienced Inventory (COPE). Results: Depression scores were negatively correlated with emotion-focused and problemfocused coping style scores. Emotion-focused and problem-focused coping style scores were negatively correlated with neuroticism, and positively correlated with openness scores. Emotion-focused coping style scores were also positively correlated with agreeableness scores. Dysfunctional coping style scores were negatively correlated with conscientiousness scores. Higher agreeableness and anxiety scores as well as lower neuroticism scores were predictive of emotion-focused coping style scores. Problem-focused coping style scores were predicted by lower depression scores. Dysfunctional coping style scores were predicted by lower conscientiousness scores. Conclusions: The present study points the importance of taking personality features and individual coping strategies into account when evaluating patients with HT. Determining the personality features and coping strategies might be useful for identifying patients in need of particular counseling and support.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2016
Gastrointestinal symptoms in psychiatry: comparison of direct applications and referrals Objectiv... more Gastrointestinal symptoms in psychiatry: comparison of direct applications and referrals Objective: Clinical experience and observations suggest that there are some discrepancies between patients who directly apply to psychiatry clinic, and who are referred from gastroenterology clinic to psychiatry clinic. Thus, we aimed to investigate differences related to the demographic and clinical characteristics of these patients. Method: The study included 115 consecutive patients aged between 18-65 years. Sixty-one of the patients applied directly to the psychiatry clinic, and 54 patients were referred for consultation to the psychiatry clinic. Primary gastrointestinal complaints, psychiatric diagnoses and personality features were recorded on the scoiodemographic data form, and the severity of psychiatric disorders were assessed by the Clinical Global Impression Scale-Severity Subscale. Results: Patients who directly applied to psychiatry clinic were more likely to be female, older, and married. They attributed their gastrointestinal symptoms also more likely to be of psychogenic origen. Patients who directly applied to psychiatry clinic suffered more likely from a sense of fullness/abdominal tension, while patients who were referred to psychiatry clinic more frequently complained of bloating, abdominal pain, and constipation. Patients who directly applied to psychiatry clinic were more frequently diagnosed with depressive disorders, trauma related disorders, and personality disorders, whereas referrals were more frequently diagnosed with psychotic disorders. Directly admitted patients were also more likely to exhibit impulsivity as a personality feature. Conclusion: Patients with gastrointestinal symptoms who directly presented to psychiatry differed from those who were referred from gastroenterology clinics on some of their demographic aspects, primary psychiatric diagnoses and personality traits.
Hıçkırık diyaframın ve interkostal kasların aralıklı olarak istemsiz biçimde kasılmasıdır. Hıçkır... more Hıçkırık diyaframın ve interkostal kasların aralıklı olarak istemsiz biçimde kasılmasıdır. Hıçkırık birçok olguda kendiliğinden geçerken, inatçı hıçkırık tedavisinde fiziksel girişimler ve ilaç tedavisi kullanılması gerekebilir. Literatürde serotonerjik sisteme etki eden ilaçlarla tedavi edilen inatçı hıçkırık olguları tanımlanmıştır. Bu yazıda, 28 yaşında bir psikotik özellikli majör depresif bozukluk hastasında, serotonin geri alım inhibitörü ilaçların (sırasıyla paroksetin, flouksetin ve sertraline) kullanımı sonrasında gelişen hıçkırık olgusunun sunulması amaçlanmıştır.
This study aims to identify the demographic and clinical data of patients presenting for mental h... more This study aims to identify the demographic and clinical data of patients presenting for mental health disability reports from these boards. Material and Methods: In this study, the records of the patients presenting to the medical board for disability due to mental health problems in 2014 were retrospectively investigated. Results: Among the 5670 patients over 18 years who presented to the medical board for disability, 795 (14.2%) of them were assigned a report due to mental health problems. Four hundred ninety one (61.8%) of them were male, and 304 (38.2%) were female. The most frequent reasons for presentation were for benefits related to law number 2022 (35.8%), and for social benefits / home care services (32.8%). The most frequently encountered diagnoses were mental retardation (52.2%), schizophrenia (18.4%), and depression-dysthymia (7.1%). Three hundred thirteen (39.4%) of the 795 patients with mental health problems were found to be severely disabled, and 510 (64.2%) of the reports were assigned for an indefinite period of time. Conclusion: We think that this report might be helpful for regulations related to disabled people, and might guide adult psychiatric services for patients who present to medical boards for disability due to mental health problems.
The International journal of social psychiatry, Jan 31, 2016
Expressed emotion (EE) predicts the outcome of treatment in patients with anxiety disorders. We a... more Expressed emotion (EE) predicts the outcome of treatment in patients with anxiety disorders. We aimed to investigate the relationship between EE and demographic and clinical characteristics of patients with panic disorder (PD), to determine whether there is a difference between PD, major depressive disorder (MDD) patients and healthy controls (HC) in terms of EE and to investigate the effect of EE on quality of life (QOL) in patients with PD. Our study involved a total of 150 participants (50 patients in each group). All participants were given the Level of Expressed Emotion (LEE) scale and the short-form health survey (SF)-36 . Furthermore, the EE scale was completed by the participant's key relatives. EE was associated with some sociodemographic and clinical variables in patients with PD. There was no significant difference between PD and MDD and between PD and HC in terms of the LEE and the EE and their subscale scores. It was also demonstrated that EE had no effect on the QO...
Optical coherence tomography (OCT) is a relatively new, noninvasive imaging technique that has be... more Optical coherence tomography (OCT) is a relatively new, noninvasive imaging technique that has been used increasingly to diagnose and manage a variety of retinal diseases. Since the axons in retinal nerve fiber layer (RNFL) are nonmyelinated within the retina, OCT has been used in various neurodegenerative diseases to visualize the process of neurodegeneration. Decreases in RNFL and ganglion cell inner plexiform layer (GCIPL) thicknesses were observed in patients with schizophrenia. To date, there is no clinical research investigating OCT parameters in patients with MD. We compared the RNFL thickness, GCIPL thickness in 58 MD patients and 57 healthy controls, and investigated their correlation with clinical variables of depression. Depressed patients were not different from the healthy controls with regard to OCT parameters. GCIPL and nasal RNFL were correlated with the duration of the latest depressive episode. Some measures of OCT were negatively associated with clinical variables like a family history of psychiatric diagnosis and the duration of the latest episode. Larger studies including depressed patients of different severity, including structured interviews and controlling for the effect of antidepressant treatment will provide better results.
Seasonal affective disorder (SAD) is defined as a subtype of mood disorders in DSM 5, and it is c... more Seasonal affective disorder (SAD) is defined as a subtype of mood disorders in DSM 5, and it is characterized by a seasonal onset. SAD is proposed to be related to the seasonal changes in naturally occurring light, and the use of bright light therapy for depressive symptoms has been shown to reduce them in placebo controlled trials. Cognitive behavioral therapy has also been demonstrated to be effective in SAD. This review article aims to focus on the psychopharmacological treatment options for SAD. According to clinical trial results, first line treatment options seem to be sertraline and fluoxetine, and are well tolerated by the patients. There is some evidence that other antidepressants (e.g. bupropion) might be effective as well. Although clinical trials have shown that some of these antidepressants may be of benefit, a recent review has concluded that there is not enough evidence to support the use of any of these agents for the treatment of SAD yet. Moreover, more studies are ...
Background Sexual dysfunction is a common condition in patients taking antipsychotic medication, ... more Background Sexual dysfunction is a common condition in patients taking antipsychotic medication, with a reported prevalence of 45-80% in males, and 30-80% in females (1). Ziprasidone induced spontaneous orgasm (2) and priapism (3) were reported in the literature. Here, we report a case of increased sexual arousal after ziprasidone treatment. Case A twenty-three-year old, single, female patient was admitted to our clinic with reference and persecutory delusions, auditory and visual hallucinations. Her complaints had been persisting for about one month. Her mental status examination revealed the following: attention and concentration were diminished, speech was slow, delusions of reference and other Schneiderian first-rank symptoms, and hallucinations were present, reality testing was impaired, judgment and abstract thinking skills partially preserved. The patient was not able to tolerate her treatment due to side effects. Therefore, it was changed to ziprasidone 40 mg/day and the dosage was increased gradually. After increasing the ziprasidone dose to 60 mg/day, she complained about increased sexual arousal. No other symptoms suggestive of a manic episode were present, and no other medical causes were detected. The patient also said that she never had a similar period in her life previously. Ziprasidone was tapered slowly, and quetiapine 300 mg/day was started. She indicated that increased sexual arousal disappeared after the cessation of ziprasidone. Discussion Ziprasidone has been reported to cause sexual dysfunction at a much lower rate than other antipsychotics. To the best of our knowledge, this is the first case report of increased sexual arousal with ziprasidone.
Objective: The metabolic syndrome (MS) is highly prevalent among patients with bipolar disorder (... more Objective: The metabolic syndrome (MS) is highly prevalent among patients with bipolar disorder (BD), and may affect progression, functioning, and comorbid conditions in BD. The aim of this study was to investigate the effect of clinical variables and MS on overall functioning and specific areas of functioning in patients with BD. Methods: A total of 210 participants (140 participants with BD I and BD II in remission and 70 nonpsychiatric control subjects) were included. The investigators administered the Young Mania Rating Scale (YMRS), the Bipolar Depression Rating Scale (BDRS), the Global Assessment of Functioning Scale (GAF), and the Bipolar Disorder Functioning Scale (BDFS). The participants completed the Beck Depression Scale (BDS) and the Beck Anxiety Scale (BAS). MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Hierarchical regression analysis was used to investigate potential correlations of comorbid MS with clinical variables and level of functioning. Results: Level of functioning did not differ between patients with and without MS. However, there were significant correlations between the level of functioning subscales and the number of depressive episodes (p = 0.033), level of general functioning (p = 0.012), duration of illness (p = 0.012), BDS (p = 0.005), BDRS (p = 0.021), BAS total scores (p = 0.021), number of hypomanic episodes (p = 0.022), number of hospitalizations (p = 0.003), employment status (p = 0.032), and diagnosis of BD I (p = 0.007) and BD II (p = 0.044). Conclusion: Our findings suggest that clinical variables had a greater effect on functioning than MS in BD patients.
The essential feature for the diagnosis of kleptomania is a recurrent failure to resist impulses ... more The essential feature for the diagnosis of kleptomania is a recurrent failure to resist impulses to steal items, even though those items are not needed for personal use or for their monetary value. The individual experiences an increasing sense of tension just prior to the theft and feels pleasure, gratification, or relief when committing the theft. These patients are usually referred to psychiatry for the evaluation of criminal liability by a court order. The content of the court file as well as the act defined by the subject and the presence of a mental disorder should be taken into account. In case of shoplifting, malingering must be ruled out first even if the subject has a previously confirmed diagnosis of kleptomania. Here we present a different case of a patient with kleptomania who was referred to us by a court order to determine her criminal liability for shoplifting.
The International Journal of Psychiatry in Medicine
Background Dietary total antioxidant capacity serves as an indicator for dietary quality and refl... more Background Dietary total antioxidant capacity serves as an indicator for dietary quality and reflects daily antioxidant intake. This study aimed to determine the oxidative stress status of patients with schizophrenia and to examine the relationship between dietary total antioxidant capacity (dTAC) and 8-hydroxy-2′-deoxyguanosine (8-OHdG), a marker for oxidative stress. Methods This study was conducted in Turkey and involved 40 patients diagnosed with schizophrenia or schizoaffective disorder according to the Diagnostic and Statistical Manual of Mental Disorders, 5th ed and 30 healthy controls matched for age and gender. The participants’ sociodemographic characteristics and nutritional habits were determined through face-to-face interviews and through the use of questionnaires. The dTAC and dietary oxidative balance scores were calculated using a three-day dietary intake record. 8-OHdG levels were analyzed in the serum samples collected from the subjects. Results Dietary ferric redu...
Vortioxetine is a new generation antidepressant that has 5-HT3, 5-HT1D, 5-HT7 antagonist, 5-HT1B ... more Vortioxetine is a new generation antidepressant that has 5-HT3, 5-HT1D, 5-HT7 antagonist, 5-HT1B partial agonsite and 5-HT1A receptor agonist features (Sanchez et al. 2015). The antagonist effect on 5-HT3 receptors causes nausea and vomiting, the most common side effect of vortioxetine (D'Agostino et al. 2015). In animal studies, it blocks 5-HT3 receptors, causing an increase in serotonin, dopamine, norepinephrine, acetylcholine, and histamine (Sanchez et al. 2015). It is known that manic or hypomanic switch may occur due to antidepressant treatment. Treatments that increase dopamine and norepinephrine levels can cause a manic shift (Allain et al. 2017). The features that increase the risk of manic or hypomanic switch due to antidepressants are female sex, young age, family history of psychiatric disorders, atypical features and three or more lifetime episode of depression (Pirdogan Aydin et al. 2019). The aim of this case report is to present a patient who presented to psychiat...
Background: The metabolic syndrome is a growing global public health problem and highly prevalent... more Background: The metabolic syndrome is a growing global public health problem and highly prevalent in patiens with bipolar disorder. There are a few studies about relationship between metabolic syndrome and bipolar disorder subtypes. Objective: The aim of this study was to investigate the prevalence of metabolic syndrome (MS) and its individual components in subjects with bipolar I (BD I) and bipolar II (BD II) disorder compared with non-psychiatric controls, and to determine the variables affecting MS. Methods: A total of 210 individuals (mean age 42.5 ± 11.87, 58.1% female) of whom 70 had BD I, 70 BD II, and 70 controls, were included in this study. MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the adapted ATP III (ATP III-A) and the International Diabetes Federation (IDF) criteria. Results: Participants with BD I had a significantly higher prevalence of MS when compared to individuals BD II and non-psychiatric controls according to the NCEP-ATP III, ATP III-A, and IDF criteria (ps < 0.01). In individuals with MS, increased waist circumference was the most common abnormality. Logistic regression analysis revealed that the presence of physical illness, age and number of cigarettes smoked significantly predicted the presence of MS. Discussion: This study showed that MS was more prevalent among BD I individuals compared to BD II and controls, and highlighted the importance of regular screening for MS in individuals with BD.
Background: Suicide is one of the major public health problems in young adults. Detecting the ris... more Background: Suicide is one of the major public health problems in young adults. Detecting the risk factors and correlates among university students might help identify students who are under risk and who need early interventions for suicide prevention.Aims: The current study aimed to investigate the cognitive style, self-esteem, hopelessness, rumination, cognitive reactivity, and personality characteristics of Turkish university students, who previously attempted suicide and who did not.Method: A total of 355 university students (34 previous suicide attempters) were recruited for this study, and they completed the Ten-Item Personality Inventory (TIPI), the Ruminative Response Scale (RRS), the Leiden Index of Depression Sensitivity–Revised (LEIDS-R), the Beck Hopelessness Scale (BHS), the Cognitive Style Questionnaire–Short Form (CSQ), the Rosenberg Self-Esteem Scale (RSES), and the Hospital Anxiety and Depression Scale (HADS).Results: Higher RRS, BHS, CSQ scores and lower TIPI-A and...
Objective: The aim of this research was to assess the characteristics of the consultations requir... more Objective: The aim of this research was to assess the characteristics of the consultations required in a psychiatric department of a university hospital, and the distribution of psychiatric disorders in hospitalized patients and patients admitted to the emergency room. Method: In the study, the data of 539 patients 18 years or older (48.67 ± 20.91 years) (46.8% women) who were hospitalized and who presented to the emergency room between 01/01/2015 and 31/12/2015, and for whom a psychiatric consultation was requested were recorded onto a structured form. Patients' electronic databases were reviewed retrospectively for the specified date range. Descriptive statistical analyzes (frequency of data, distribution, mean, standard deviation) were performed for the data examined in the study. Results: Medical departments (42.9%), surgical departments (31.7%) and the emergency medicine department (25.4%) were the most frequently psychiatric consultation requesting departments. The most frequent requests for consultation were agitation (15.4%), depressive symptoms and signs (14.7%) and suicide attempts (12.2%). The most frequent psychiatric diagnoses were depressive disorders (19.5%), delirium (18.2%) and schizophrenia and other psychotic disorders (7.4%). Musculoskeletal diseases (17.4%), mental disorders (15.0%), oncologic diseases (14.1%) and suicide attempts (12.2%) were the primary diagnoses of patients. Discussion: Consultation and liaison psychiatry services have an important role in our relationship with other departments in medicine. Priority to training of depressive disorders, delirium and suicide attempts should be offered to healthcare providers working in these departments.
OBJECTIVES: We aimed to compare patients with bipolar disorder and major depressive disorder, who... more OBJECTIVES: We aimed to compare patients with bipolar disorder and major depressive disorder, who were either in an acute depressive episode or in remission, and a healthy control group on their cognitions related to depression and mania/hypomania, and on their response styles. METHODS: A total of 300 participants who presented to our outpatient psychiatry department were included in the study (100 participants with unipolar depression (DG), 100 with bipolar disorder, and 100 with no previous or current psychiatric disorder (CG)). The participants completed the Cognition Checklist (CCL), the Cognition Checklist for Mania (CCL-M-R), the Cognitive Distortions Questionnaire (CDQ), the Dysfunctional Attitude Scale (DAS), the Hypomanic Attitudes and Positive Predictions Inventory (HAPPI), the Brief Core Schemas Scale (BCSS), Ruminative Response Scale (RRS), and the Responses to Positive Affect Questionnaire (RPAQ). The groups were compared with each other by one-way analysis of variance, independent samples t-test, and chi-square tests. RESULTS: The DG scored higher than the other groups on the CCL, the frequency and intensity subscales of the CDQ, the DAS, and the negative-self and negative-others subscales of the BCSS, the RRS, and on the dampening subscale of the RPAQ. The clinical groups scored higher than the CG on the scores of the relationships subscale of the CCL-M-R, the total score of the CDQ, and the HAPPI. The CG scored higher than the clinical groups on the positive-self subscale of the BCSS, and on the emotion focused positive rumination subscale. CONCLUSIONS: These findings are important in the differential diagnosis of mood disorders, and for their treatment with cognitive behavioural psychotherapy.
Background: The metabolic syndrome is a growing global public health problem and highly prevalent... more Background: The metabolic syndrome is a growing global public health problem and highly prevalent in patiens with bipolar disorder. There are a few studies about relationship between metabolic syndrome and bipolar disorder subtypes. Objective: The aim of this study was to investigate the prevalence of metabolic syndrome (MS) and its individual components in subjects with bipolar I (BD I) and bipolar II (BD II) disorder compared with non-psychiatric controls, and to determine the variables affecting MS. Methods: A total of 210 individuals (mean age 42.5 ± 11.87, 58.1% female) of whom 70 had BD I, 70 BD II, and 70 controls, were included in this study. MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the adapted ATP III (ATP III-A) and the International Diabetes Federation (IDF) criteria. Results: Participants with BD I had a significantly higher prevalence of MS when compared to individuals BD II and non-psychiatric controls according to the NCEP-ATP III, ATP III-A, and IDF criteria (ps < 0.01). In individuals with MS, increased waist circumference was the most common abnormality. Logistic regression analysis revealed that the presence of physical illness, age and number of cigarettes smoked significantly predicted the presence of MS. Discussion: This study showed that MS was more prevalent among BD I individuals compared to BD II and controls, and highlighted the importance of regular screening for MS in individuals with BD.
Journal of Rational-Emotive & Cognitive-Behavior Therapy, 2017
Many studies have described grief and psychiatric symptomatology as a typical feature following m... more Many studies have described grief and psychiatric symptomatology as a typical feature following miscarriage. How women who had a miscarriage (MG) respond to trauma in terms of negative cognitions about their selves and the world, the coping strategies they employ to overcome the effects of the trauma, and what factors might be indicative of posttraumatic growth (PTG) in this population have not been extensively studied so far. We aimed to identify whether women who had a miscarriage (N = 74 vs. N = 82 control subjects) exhibited higher levels of psychological distress symptoms, dysfunctional cognitions, and maladaptive coping strategies, and whether women with lower PTG employed more maladaptive coping strategies, and reported higher levels of dysfunctional cognitions. Group comparisons according to the diagnostic groups based on selfreport measures for depression, anxiety, posttraumatic stress disorder and according to the level of PTG, and stepwise linear regression analyses with PTG as the outcome were performed. Our study demonstrated that the MG does not necessarily differ from the control group on some measures of psychopathology, coping mechanisms, dysfunctional cognitions, or PTG. Yet, the MG who exhibited higher levels of PTG had specific predictors, and women with a psychiatric diagnosis differed from participants with no diagnoses on some measures of dysfunctional cognitions, coping mechanisms, and PTG. Further studies with a prospective design could further clarify the needs of the MG requiring psychotherapeutic interventions.
Background and objectives: We aimed to investigate the depression and anxiety levels and to explo... more Background and objectives: We aimed to investigate the depression and anxiety levels and to explore the coping strategies and personality traits of patients with euthyroid Hashimoto Thyroiditis (HT). Methods: The study population consisted of 108 outpatients with euthyroid HT. The participants completed the Hospital Anxiety and Depression Scale (HADS), the Big Five Personality Inventory (BFI), and the Coping With Problems Experienced Inventory (COPE). Results: Depression scores were negatively correlated with emotion-focused and problemfocused coping style scores. Emotion-focused and problem-focused coping style scores were negatively correlated with neuroticism, and positively correlated with openness scores. Emotion-focused coping style scores were also positively correlated with agreeableness scores. Dysfunctional coping style scores were negatively correlated with conscientiousness scores. Higher agreeableness and anxiety scores as well as lower neuroticism scores were predictive of emotion-focused coping style scores. Problem-focused coping style scores were predicted by lower depression scores. Dysfunctional coping style scores were predicted by lower conscientiousness scores. Conclusions: The present study points the importance of taking personality features and individual coping strategies into account when evaluating patients with HT. Determining the personality features and coping strategies might be useful for identifying patients in need of particular counseling and support.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2016
Gastrointestinal symptoms in psychiatry: comparison of direct applications and referrals Objectiv... more Gastrointestinal symptoms in psychiatry: comparison of direct applications and referrals Objective: Clinical experience and observations suggest that there are some discrepancies between patients who directly apply to psychiatry clinic, and who are referred from gastroenterology clinic to psychiatry clinic. Thus, we aimed to investigate differences related to the demographic and clinical characteristics of these patients. Method: The study included 115 consecutive patients aged between 18-65 years. Sixty-one of the patients applied directly to the psychiatry clinic, and 54 patients were referred for consultation to the psychiatry clinic. Primary gastrointestinal complaints, psychiatric diagnoses and personality features were recorded on the scoiodemographic data form, and the severity of psychiatric disorders were assessed by the Clinical Global Impression Scale-Severity Subscale. Results: Patients who directly applied to psychiatry clinic were more likely to be female, older, and married. They attributed their gastrointestinal symptoms also more likely to be of psychogenic origen. Patients who directly applied to psychiatry clinic suffered more likely from a sense of fullness/abdominal tension, while patients who were referred to psychiatry clinic more frequently complained of bloating, abdominal pain, and constipation. Patients who directly applied to psychiatry clinic were more frequently diagnosed with depressive disorders, trauma related disorders, and personality disorders, whereas referrals were more frequently diagnosed with psychotic disorders. Directly admitted patients were also more likely to exhibit impulsivity as a personality feature. Conclusion: Patients with gastrointestinal symptoms who directly presented to psychiatry differed from those who were referred from gastroenterology clinics on some of their demographic aspects, primary psychiatric diagnoses and personality traits.
Hıçkırık diyaframın ve interkostal kasların aralıklı olarak istemsiz biçimde kasılmasıdır. Hıçkır... more Hıçkırık diyaframın ve interkostal kasların aralıklı olarak istemsiz biçimde kasılmasıdır. Hıçkırık birçok olguda kendiliğinden geçerken, inatçı hıçkırık tedavisinde fiziksel girişimler ve ilaç tedavisi kullanılması gerekebilir. Literatürde serotonerjik sisteme etki eden ilaçlarla tedavi edilen inatçı hıçkırık olguları tanımlanmıştır. Bu yazıda, 28 yaşında bir psikotik özellikli majör depresif bozukluk hastasında, serotonin geri alım inhibitörü ilaçların (sırasıyla paroksetin, flouksetin ve sertraline) kullanımı sonrasında gelişen hıçkırık olgusunun sunulması amaçlanmıştır.
This study aims to identify the demographic and clinical data of patients presenting for mental h... more This study aims to identify the demographic and clinical data of patients presenting for mental health disability reports from these boards. Material and Methods: In this study, the records of the patients presenting to the medical board for disability due to mental health problems in 2014 were retrospectively investigated. Results: Among the 5670 patients over 18 years who presented to the medical board for disability, 795 (14.2%) of them were assigned a report due to mental health problems. Four hundred ninety one (61.8%) of them were male, and 304 (38.2%) were female. The most frequent reasons for presentation were for benefits related to law number 2022 (35.8%), and for social benefits / home care services (32.8%). The most frequently encountered diagnoses were mental retardation (52.2%), schizophrenia (18.4%), and depression-dysthymia (7.1%). Three hundred thirteen (39.4%) of the 795 patients with mental health problems were found to be severely disabled, and 510 (64.2%) of the reports were assigned for an indefinite period of time. Conclusion: We think that this report might be helpful for regulations related to disabled people, and might guide adult psychiatric services for patients who present to medical boards for disability due to mental health problems.
The International journal of social psychiatry, Jan 31, 2016
Expressed emotion (EE) predicts the outcome of treatment in patients with anxiety disorders. We a... more Expressed emotion (EE) predicts the outcome of treatment in patients with anxiety disorders. We aimed to investigate the relationship between EE and demographic and clinical characteristics of patients with panic disorder (PD), to determine whether there is a difference between PD, major depressive disorder (MDD) patients and healthy controls (HC) in terms of EE and to investigate the effect of EE on quality of life (QOL) in patients with PD. Our study involved a total of 150 participants (50 patients in each group). All participants were given the Level of Expressed Emotion (LEE) scale and the short-form health survey (SF)-36 . Furthermore, the EE scale was completed by the participant's key relatives. EE was associated with some sociodemographic and clinical variables in patients with PD. There was no significant difference between PD and MDD and between PD and HC in terms of the LEE and the EE and their subscale scores. It was also demonstrated that EE had no effect on the QO...
Optical coherence tomography (OCT) is a relatively new, noninvasive imaging technique that has be... more Optical coherence tomography (OCT) is a relatively new, noninvasive imaging technique that has been used increasingly to diagnose and manage a variety of retinal diseases. Since the axons in retinal nerve fiber layer (RNFL) are nonmyelinated within the retina, OCT has been used in various neurodegenerative diseases to visualize the process of neurodegeneration. Decreases in RNFL and ganglion cell inner plexiform layer (GCIPL) thicknesses were observed in patients with schizophrenia. To date, there is no clinical research investigating OCT parameters in patients with MD. We compared the RNFL thickness, GCIPL thickness in 58 MD patients and 57 healthy controls, and investigated their correlation with clinical variables of depression. Depressed patients were not different from the healthy controls with regard to OCT parameters. GCIPL and nasal RNFL were correlated with the duration of the latest depressive episode. Some measures of OCT were negatively associated with clinical variables like a family history of psychiatric diagnosis and the duration of the latest episode. Larger studies including depressed patients of different severity, including structured interviews and controlling for the effect of antidepressant treatment will provide better results.
Seasonal affective disorder (SAD) is defined as a subtype of mood disorders in DSM 5, and it is c... more Seasonal affective disorder (SAD) is defined as a subtype of mood disorders in DSM 5, and it is characterized by a seasonal onset. SAD is proposed to be related to the seasonal changes in naturally occurring light, and the use of bright light therapy for depressive symptoms has been shown to reduce them in placebo controlled trials. Cognitive behavioral therapy has also been demonstrated to be effective in SAD. This review article aims to focus on the psychopharmacological treatment options for SAD. According to clinical trial results, first line treatment options seem to be sertraline and fluoxetine, and are well tolerated by the patients. There is some evidence that other antidepressants (e.g. bupropion) might be effective as well. Although clinical trials have shown that some of these antidepressants may be of benefit, a recent review has concluded that there is not enough evidence to support the use of any of these agents for the treatment of SAD yet. Moreover, more studies are ...
Background Sexual dysfunction is a common condition in patients taking antipsychotic medication, ... more Background Sexual dysfunction is a common condition in patients taking antipsychotic medication, with a reported prevalence of 45-80% in males, and 30-80% in females (1). Ziprasidone induced spontaneous orgasm (2) and priapism (3) were reported in the literature. Here, we report a case of increased sexual arousal after ziprasidone treatment. Case A twenty-three-year old, single, female patient was admitted to our clinic with reference and persecutory delusions, auditory and visual hallucinations. Her complaints had been persisting for about one month. Her mental status examination revealed the following: attention and concentration were diminished, speech was slow, delusions of reference and other Schneiderian first-rank symptoms, and hallucinations were present, reality testing was impaired, judgment and abstract thinking skills partially preserved. The patient was not able to tolerate her treatment due to side effects. Therefore, it was changed to ziprasidone 40 mg/day and the dosage was increased gradually. After increasing the ziprasidone dose to 60 mg/day, she complained about increased sexual arousal. No other symptoms suggestive of a manic episode were present, and no other medical causes were detected. The patient also said that she never had a similar period in her life previously. Ziprasidone was tapered slowly, and quetiapine 300 mg/day was started. She indicated that increased sexual arousal disappeared after the cessation of ziprasidone. Discussion Ziprasidone has been reported to cause sexual dysfunction at a much lower rate than other antipsychotics. To the best of our knowledge, this is the first case report of increased sexual arousal with ziprasidone.
Objective: The metabolic syndrome (MS) is highly prevalent among patients with bipolar disorder (... more Objective: The metabolic syndrome (MS) is highly prevalent among patients with bipolar disorder (BD), and may affect progression, functioning, and comorbid conditions in BD. The aim of this study was to investigate the effect of clinical variables and MS on overall functioning and specific areas of functioning in patients with BD. Methods: A total of 210 participants (140 participants with BD I and BD II in remission and 70 nonpsychiatric control subjects) were included. The investigators administered the Young Mania Rating Scale (YMRS), the Bipolar Depression Rating Scale (BDRS), the Global Assessment of Functioning Scale (GAF), and the Bipolar Disorder Functioning Scale (BDFS). The participants completed the Beck Depression Scale (BDS) and the Beck Anxiety Scale (BAS). MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Hierarchical regression analysis was used to investigate potential correlations of comorbid MS with clinical variables and level of functioning. Results: Level of functioning did not differ between patients with and without MS. However, there were significant correlations between the level of functioning subscales and the number of depressive episodes (p = 0.033), level of general functioning (p = 0.012), duration of illness (p = 0.012), BDS (p = 0.005), BDRS (p = 0.021), BAS total scores (p = 0.021), number of hypomanic episodes (p = 0.022), number of hospitalizations (p = 0.003), employment status (p = 0.032), and diagnosis of BD I (p = 0.007) and BD II (p = 0.044). Conclusion: Our findings suggest that clinical variables had a greater effect on functioning than MS in BD patients.
The essential feature for the diagnosis of kleptomania is a recurrent failure to resist impulses ... more The essential feature for the diagnosis of kleptomania is a recurrent failure to resist impulses to steal items, even though those items are not needed for personal use or for their monetary value. The individual experiences an increasing sense of tension just prior to the theft and feels pleasure, gratification, or relief when committing the theft. These patients are usually referred to psychiatry for the evaluation of criminal liability by a court order. The content of the court file as well as the act defined by the subject and the presence of a mental disorder should be taken into account. In case of shoplifting, malingering must be ruled out first even if the subject has a previously confirmed diagnosis of kleptomania. Here we present a different case of a patient with kleptomania who was referred to us by a court order to determine her criminal liability for shoplifting.
Uploads
Papers by Emrah Songur