Search

Catatonia was first introduced by Karl Kahlbaum at 1874. Catatonia is a syndrome that includes catalepsy, waxy flexibility, stupor, negativism, mutism, and echolalia. At first, it was linked with just schizophrenia for many years but it is currently known that this disorder may occur with other medical conditions and psychiatric disorders especially mood disorders. Several complications especially pulmonary, genitourinary, gastrointestinal may occur with catatonia. Here, we aimed to report a case of urinary retention associated with catatonia and treated with ECT and benzodiazepine. As a result, urinary retention and globe vesicale should be considered in patients presented with catatonia and it should be treated urgently.

Objective: Mood stabilizers and antipsychotic drugs are known to have adverse effects on sexual function. However, patients often refrain from speaking about sexual complaints that may cause dose reduction and discontinuation of the drug without medical supervision. In this study we aimed to evaluate sexual functions of patients with bipolar disorder in remission period, considering prolactin levels and medications. Method: We recruited 52 patients with bipolar disorder in remission according to DSM-IV diagnostic criteria. Prolactin levels were measured in all patients. The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was used to assess sexual dysfunction. Results: Mean prolactin levels were 24.71 ± 4.25 and 19.96 ± 5.52 ng/ml respectively for females and males. Patients taking mood stabilizer (MS) and mood stabilizer plus antipsychotic (AP) treatment had different prolactin levels (p

The aim of this study was to compare the serum brain derived neurotropic factor (BNDF) levels of patients with schizophrenia who had never received an antipsychotic treatment with those of a control group. Also, to analyze the relationship between the Positive and Negative Symptom Scale (PANSS) scores and BDNF levels of the patients during the period they were drug-naive.The sample of the study comprised patients who presentedto the Psychiatry Clinic and were admitted after a distinctive schizophrenia diagnosis was made in accordance with the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) diagnosis classification and who were not using and never had any antipsychotic medicine. A total of 160 participants were included in the study, 80 of whom had schizophrenia patients and 80 constituted the age- and sex-matched healthy control group. Before the start of the treatment, the serum samples to be checked for the BDNF levels were collected from the patients.The difference between the average BDNF levels of the groups were statistically significant (t = -5.25; p˂.001). An analysis as to whether there was a relation between the BDNF levels and the drug-naïve duration indicated no correlations. An examination of the relationship between PANSS scores and BDNF levels of the patients yielded no correlations.Serum BDNF levels seem to be one of the indicators of schizophrenia and its progress; nevertheless, we still do not have sufficient information about this neurotropic factor. In light of our study, the neurodevelopmental changes that occur at disease onset of the illness prominently affect the progress of the illness, which highlights the importance of the treatment in the early stages.

INTRODUCTION[|]Distress tolerance and Discomfort tolerance are well-established psychological constructs that are related but distinct. Distress tolerance is defined as an individual's perceived capacity to withstand negative emotional states or the capacity to continue goal-directed behavior in the context of negative affect. As for discomfort tolerance, it mainly is about the capacity to withstand negative bodily sensations. Premenstrual dysphoric disorder (PMDD) which consists of bodily and psychological symptoms is a DSM-5 diagnosed disease determined under the category of depressive disorders.In this research article, we investigated the possible effects of premenstrual dysphoric disorder on distress and discomfort tolerance levels as well as dysfunctional attitudes on individuals with this disorder. [¤]METHODS[|]In our study, 218 people were interviewed in total. People who could possibly have PMDD according to Premenstrual Symptoms Screening Tool (PSST) were monitored for 8 weeks and 31 people were diagnosed with PMDD. People without PMDD and having under threshold symptoms for PMDD according to PSST who have matching age and BMI were also included in the study. Distress Tolerance Scale (DTS), Discomfort Intolerance Scale (DIS), Dysfunctional Attitude Scale-short forms (DAS-sf) were filled for each sample. [¤]RESULTS[|]DTS self-efficacy scores were found to be higher in group without PMDD than the groups with PMDD and having under threshold symptoms. DAS-total score was found to be higher in group with PMDD than the groups without PMDD group and having under threshold symptoms group. Discomfort avoidance subscale score of distress tolerance scale was found to be higher compared to participants without PMDD and participants having below threshold symptoms. [¤]DISCUSSION AND CONCLUSION[|]Women with PMDD may benefit from preventive treatment modalities that minimize discomfort and avoidance behaviours and facilitate their coping with negative bodily sensations of premenstrual syndrome and prevent the development of dysfunctional attitudes toward these bodily and mental disturbing sensations. [¤]

Amaç: Bu araştırmanın amacı, yatarak tedavi gören erkek alkol bağımlılarında tedavi motivasyonu, bağımlılık özellikleri, aşerme ve mizaç özellikleri arasındaki ilişkiyi incelemektir.Gereç ve Yöntem: Ankara Numune Eğitim ve Araştırma Hastanesi, Alkol-Madde Araştırma, Tedavi ve Eğitim Merkezi’nde (AMATEM) yatarak tedavi gören DSM-IV-TR’ye göre alkol bağımlılığı tanısı almış erkek hastalar çalışmaya dahil edilmiştir. Hastalar, sosyodemografik veri formunun yanı sıra, Penn Alkol Aşerme Ölçeği (PAAÖ), Bağımlılık Profil İndeksi (BAPİ), Değişime Hazır Olma ve Tedavi İsteği Ölçeği (SOCRATES), Memphis, Pisa, Paris ve San Diego - Self Mizaç Değerlendirme Ölçeği (TEMPS-A) kullanılarak değerlendirildi.Bulgular: Çalışmaya 85 erkek hasta dahil edildi. Çalışma kapsamındaki hastaların ortalama yaşı 46.36 ± 9.66’ydı. Katılımcıların ortalama alkol kullanma süreleri ise 23.32 ± 10.33 yıldı. Çalışmanın sonuçlarına göre BAPİ toplam puanı ve PAÖÖ toplam puanı arasında pozitif korelasyon hesaplanmıştır.Sonuç: Bağımlılık şiddetinin artmasıyla aşerme şiddetinin artması bağımlılık şiddeti yüksek olan hastalarda aşerme konusunda daha dikkatli olmak gerektiğini düşündürebilir. Baskın mizaç özelliğine sahip olup olmamanın aşerme, motivasyon ve bağımlılık şiddeti ile olan ilişkisi çalışmamızda saptanmamıştır.

Risperidone is a second-generation antipsychotic agent, widely used in psychiatric disorders like schizophrenia, bipolar disorder, and aggression. Edema has been reported as a side effect of risperidone in a few case reports in the literature. In most of these cases, another drug was combined with risperidone and edema was located in a specific zone. Here we aimed to report a case of generalized edema due to risperidone oral monotherapy and reviewed the relevant literature.

OBJECTIVE: Opioid addiction is a disease that is increasing in our country, Turkey, and around the world, which it is difficult to treat in medical, social, and economic terms. Pregabalin is a preparation used for the treatment of epilepsy, neuropathic pain, and anxiety disorders. In opioid users, pregabalin is increasingly being self-administered off-label due to its euphoria effect at high doses. We investigated the effects of pregabalin on addiction profile and opioid withdrawal severity by comparing patients with opioid addiction who were and were not using off-label pregabalin. METHODS: Between July and August 2016, a total of 120 patients (60 patients were pregabalin users and 60 patients were non-users) who presented to Ankara Numune Training and Research Hospital Psychiatry Clinic Alcohol and Substance Addiction Treatment Center and were diagnosed with opioid use disorder according to the DSM-5, were included in the study. Patients who were using other substances were excluded from the study. A sociodemographic data form, the Clinical Opiate Withdrawal Scale, and Addiction Profile Index (API) were applied to the patients. RESULTS: There was no statistically significant difference between pregabalin users and pregabalin non-users in terms of age, sex, age of onset, working status, and whether previous treatment had been received. In the pregabalin user group, the severity of opioid withdrawal, API substance use characteristics, diagnosis, effects on life, craving, motivation subscale scores, and API total score were found to be significantly higher than in the non-user group. CONCLUSION: Off-label pregabalin use among patients with opioid addiction is becoming more common. Off-label, high-dose pregabalin use may worsen existing opioid addiction, create a new area of ⁣⁣addiction, and an illegal market. Highlights We aimed to investigate the effects of pregabalin on addiction profile and opioid withdrawal severity by comparing patients with opioid addiction who were and were not using off-label pregabalin. In the pregabalin user group, the severity of opioid withdrawal, and API total score were found to be significantly higher than in the non-user group. The use of off-label, high-dose pregabalin may worsen existing opioid addiction.

OBJECTIVE: Cannabis (C) and synthetic cannabinoids (SCs) are commonly used substances. Pharmacodynamic and pharmacokinetic differences predict that SCs involve a greater risk of dependence than C. Dissociative symptoms and suicidality are also frequent in treatment-seeking substance users, however, there is not enough data about the dissociative effects of C and SCs. The present study aimed to examine SC users in terms of demographic features and severity of dissociative symptoms in comparison to C users. It was also aimed to explore the relationships between dissociation and suicide attempts. METHODS: The study was performed at the Alcohol and Substance Research, Treatment, and Training Centre of Ankara Numune Training and Research Hospital, Turkey. 84 patients with C or SC use disorder included in the study and all the participants were administered a sociodemographic data form assessing also substance use features and suicide attempts and Dissociative Experiences Scale (DES). The patients were separated into three groups as only C users (CU), only SC users (SCU) and both C and SC users (C&SCU) and also categorized as DES score

OBJECTIVE: Schizophrenia is a neurodegenerative and neurodevelopmental disorder. For this reason, it is important to determine the level of markers that are neuroprotective and have been altered in other neurodegenerative diseases in inspecting the etiology of schizophrenia. Secretagogin (SCGN), is a member of Calcium (Ca) binding proteins and thought to have a neuroprotective effect. In this study, we aimed to compare the level of secretagogin (SCGN) between age and gender-matched schizophrenia and control group. METHODS: Fifty-three patients with schizophrenia who applied to outpatient clinics of our hospital and 37 healthy controls included in the study. Schizophrenia diagnoses of the patients were verified using the DSM-5 criteria. Serum secretagogin levels were measured with the enzyme-linked immunosorbent assay (ELISA) test. The Body Mass Index (BMI) of the patient group was measured. RESULTS: There was no significant difference between the controls and patients in terms of fasting blood glucose and insulin levels. We did not find any difference in terms of the levels of serum secretagogin between patients with schizophrenia and controls. Negative correlations were found between the level of secretagogin and PANSS positive score, PANSS negative score, PANSS general psychopathology score. CONCLUSION: There is increasing evidence that SCGN may play a role in central nervous system (CNS) activity. Future studies might help to explicitly present the relationship between secretagogin and schizophrenia.

Background: Formal thought disorder (FTD) is considered to be a fundamental feature of schizophrenia. This study aims to analyze psychometric properties of the Turkish version of “Thought and Language Disorder Scale (TALD)” and investigate the relationship between FTD and various clinical characteristics in patients with schizophrenia. Methods: TALD was adapted into Turkish and applied to a total of 149 participants of which 114 had DSM-5 psychiatric diagnoses (schizophrenia N = 70, mania N = 20, depression N = 24) and 35 were healthy controls. Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale, Young Mania Rating Scale, and Clinical Global Impression were administered to detect illness severity. Results: The principal component analyses revealed that the Turkish version of TALD (TALD-TR) consisted of four factors including the Objective Positive (OP), Subjective Negative (SN), Objective Negative (ON) and Subjective Positive (SP) symptom dimensions which were in line with the original TALD factorial structure. It was concluded that TALD-TR shows strong construct validity and high interrater reliability. The correlation analyses with TALD-TR and PANSS showed that there are positive correlations between the TALD-TR total score and the PANSS total and subscale scores. Each diagnostic group showed the distinct pattern of FTD. The mania group exhibited the highest mean total score in the OP, whereas the schizophrenia group exhibited the highest mean total score in the ON factor. In the schizophrenia group, the severity of FTD correlated positively with duration of illness and negatively with age at onset of illness. Conclusion: Adaptation of TALD into different languages seems to be possible, bringing in an international tool for research on FTD. Keywords: Formal thought disorder, Schizophrenia, Mania, Depression, Language processing

OBJECTIVES: Bipolar disorder (BD) carries a high rate of morbidity and mortality, and the clarification of its aetiology continues to be an important field of research. In recent studies, the clinical characteristics of BDs have been explained through a number of underlying factors, including cytokines, steroids, neurotrophins, mitochondrial energy generation, oxidative stress, and neurogenesis. In this study, we aimed to investigate potential associations between BDs and inflammatory processes. METHODS: Patients with mania or in remission who attended outpatient clinics of the Department of Psychiatry of the Ankara Numune Training and Research Hospital, and who were diagnosed with BD according to the DSM-V criteria, were included in the study. IBM SPSS Statistics 23 software was used for statistical analyses of the data. The normality of the distribution of continuous and discrete numerical variables was tested with a Shapiro–Wilk Test. RESULTS: In this study, the measurements and statistical analyses revealed significantly lower 15-deoxy delta12, 14-prostaglandin J2 (15d-PGJ2) and Peroxisome Proliferator-Activated Receptor-Gamma (PPARγ) levels in patients with mania in comparison to healthy controls and patients in remission. Group comparisons did not reveal any significant differences between IL-4 levels. CONCLUSIONS: This study was not a longitudinal study evaluating the same patients during both relapse and remission periods; no group of patients in a depressive episode of BD were included in the group comparisons either. Although this evidence is not adequate for a definite conclusion, the available evidence suggests that anti-inflammatory markers such as 15d-PGJ2 and IL-4 and nuclear PPARγ receptors are potential biomarkers to clarify the aetiology of BD, and these markers may be included among the therapeutic targets for future pharmacological modulations. Further studies are required in this area.

OBJECTIVE: This study aims to examine how internalized stigma differs in opioid use disorder (OUD) based on sociodemographic and clinical variables, and to what extent internalized stigma is related to treatment motivation, perceived social support, depression, and anxiety levels. METHODS: One hundred forty-five individuals with OUD included. Sociodemographic and clinical data form, the Internalized Stigma of Mental Illness Scale (ISMI), Treatment Motivation Questionnaire (TMQ), Multidimensional Scale of Perceived Social Support, the Beck Depression Inventory, and the Beck Anxiety Inventory were utilized in the study to collect data. Bivariate and partial correlation coefficients between variables were computed. ISMI and TMQ scores were compared between patients with depressive symptoms and patients without depressive symptoms by using t-test and Mann Whitney U test. RESULTS: Internalized stigma was high among male patients with heroin use disorder. There was a positive correlation between internalized stigma score and treatment motivation, depression, and anxiety levels. On the other hand, there was a negative correlation between internalized stigma score and multidimensional perceived social support. CONCLUSION: Internalized stigma occupies an important place in the treatment of OUD, which occurs with frequent relapses and which is hard to treat. Not only application for treatment but also adherence to treatment and treatment motivation at maintenance phase bestow a complicated relationship with depression and anxiety. In the struggle against internalized stigma, it plays a vital role to mobilize people’s social support systems, to educate families on the issue and to get in touch with support units exclusive to heroin users.

OBJECTIVE Glial cell line-derived neurotrophic factor (GDNF), being a protective of dopaminergic neurons, is reported to modulate addictive behaviours and have a role as a negative regulator for biochemical and behavioural adaptations to drug abuse. We aimed to reveal impulsivity and serum GDNF levels in patients with heroin addiction and investigate their relationships in order to contribute to the understanding of behavioural aspects and biological mechanisms in heroin addiction via this study. METHODS This study was performed at the Department of Psychiatry of Ankara Numune Training and Research Hospital, Turkey. We recruited 129 heroin-dependent patients and 90 age, sex, and smoking-matched healthy controls with no major psychopathology. Barratt Impulsivity Scale-11, Hospital Anxiety and Depression Scale (HADS) and sociodemographic data form were applied to all participants. Laboratory analysis for serum GDNF levels was performed for each participant’s blood sample. RESULTS Total impulsivity scores and scores of Attentional Impulsivity, Motor Impulsivity, and Unplanned Impulsivity subscales were all higher in heroin addicts compared to the controls. Heroin addicts had also lower serum GDNF levels and lower GDNF levels were associated with high impulsivity and high HADS scores in heroin addicts. CONCLUSION Decrement in GDNF levels in heroin addiction seems as to be an important data which could be associated with impulsivity, anxiety, and depressive symptoms. GDNF could find a prominent place among the target molecules in the treatment of heroin addiction.

A Duloxetine is a balanced and potent dual reuptake inhibitor of serotonin and norepinephrine (SNRI) that has previously been shown to be effective in the treatment of major depressive disorder (MDD), generalized anxiety disorder, and diabetic peripheral neuropathic pain (DPNP). Cycloplegia is paralysis of the ciliary muscle of the eye, resulting in a loss of accommodation. Here, we present a reversible cycloplegia case caused by duloxetine use. The patient was a 24 years-old woman with MDD diagnosis. Patient had somatic symptoms like fatigue, myalgia, and headache, besides her depressive symptoms for the last two months. Escitalopram and sertraline were used for her MDD before and she had to quit both owing to side effects such as nausea and drowsiness. Duloxetine 30mg/day treatment was started in our outpatient clinic. In her first follow-up exam, she reported light sensitivity and increased visual impairment. The visual impairment led dizziness and an increase in headache. She was consulted to ophthalmology unit of our hospital and cycloplegia was detected in her eye examination. Duloxetine was stopped in the ninth day of treatment but cycloplegia negatively affected the patient's daily life for almost 4 weeks and impaired her functionality. Because of the paralysis of the ciliary muscle, the curvature of the lens can no longer be adjusted to focus on nearby objects. Eye pain, changes in vision and swelling or redness in or around the eye are mentioned as possible visual side effects in the medication of duloxetine. The ocular and visual side effects from a patient's systemic medication can range from mild to severe. These side effects may or may not be serious enough to warrant discontinuing treatment. Cycloplegia seems as a rare adverse effect in antidepressant treatment and may take a long time to wash out. Recognition of ocular and visual side effects is important to prevent and minimize serious complications. In such visual disturbances, eye examination of the patient should be performed and the responsible drug should be discontinued as early as possible.