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OBJECTIVE: To assess the levels of health anxiety and Beck depression according to demographic variables among a sample of healthcare workers during the COVID-19 pandemic. STUDY DESIGN: Cross-sectional, analytical study. PLACE AND DURATION OF STUDY: Firat University and Medical Park Hosspital, Elazig, Turkey, from March to April 2020. METHODOLOGY: A total of 270 healthcare workers (100 males and 170 females) filled out health anxiety inventory (HAI), Beck depression inventory (BDI), questionnaires. Evaluations of HAI and BDI were conducted according to demographic variables ( age, gender, marital status, jop, life style, smoking habits, sistemic disease). RESULTS: Female healthcare workers had higher HAI and BDI scores than male (p

There are few researches about the average length of stay of inpatients in psychiatric clinics and costs of their treatment. In addition, these are unknown in Gulhane Military Medical Academy (GMMA) and military hospitals. In this study, it is aimed to determine the average length of staying at hospital according to their diagnosis and the frequency of hospitalization of inpatients in psychiatric clinics of GMMA. In a one-year period between July 2004 and July 2005, all patients admitted to a psychiatric clinic GMMA prospectively were included in the study. In total 1311 records were examined. Findings: The average length of staying at hospital was 23.8±5.7 days and the average of the frequency of hospitalization was 1.5±0.5. 3.6% of inpatients were admitted involuntary, 22.1% of them were admitted for the forensic observation and %69.1 of them was admitted for the first time to the clinic. 47.5% of patients were discharged without medication, and 15.3% of them had multiple drug use were determined. The average length of stay of those admitted for forensic observation was 12.5 ± 4.2 days. Revolving door group was hospitalized frequently and long-term. Moreover, processing time of health institutions is too long. These two lead wastage. With the realistic determination of average cost of an inpatient and its burden to the national economy, resources can be used more efficiently and health care can be able to offer better quality. [Med-Science 2016; 5(2.000): 371-83]

Subject: Sleep disorders are common problems in post-traumatic stress disorder (PTSD) patients. The main symptoms associated with sleep disorders were reported as a reduction in total sleep time, prolonged sleep latency, increase in the number wakefulness, low sleep efficiency and a reduction in the percentage of deep sleep stages. A relation between sleep disorders and increased levels of aggression was determined. In this study, we aimed to examine the relationship between the quality of sleep and the level of aggression in patients with Post Traumatic Stress Disorder. Method: The study was included 48 patients with a diagnosis of PTSD who were hospitalized. Data were collected using post-traumatic stress disorder questionnaire scale, Pittsburgh sleep quality scale and the Buss-Perry Aggression Scale applied by the clinician. Data analysis was made using SPSS 15.0 package program. Descriptive statistics and Pearson's correlation test were used in statistical analysis. Results: The average age of the cases was 32.33 +/- 7.93, the average of the symptoms of post-traumatic stress disorder was 56.23 +/- 11.14, the average of sleep quality was 22.08 +/- 6.67 and the average of aggression levels was 51.67 +/- 7.48. There was a high level deterioration in sleep quality and aggression levels were medium/medium-high levels. It was determined that Buss-Perry Aggression Scale scores were positively correlated with Pittsburgh sleep quality and posttraumatic stress disorder total and hyper arousal subscale scores. Conclusion: In this study, it is stated that increase in overstimulation symptoms and degradation of sleep in PTSD patients cause increase in agression levels. Degradation of sleep is determined as an indicator of agression that is observed in TSSB patients. Associatively, in PTSD patients, use of interventions to improve the quality of sleep oriented agressive behaviours gain value [TAF Prev Med Bull 2015; 14(6.000): 433-437]

WOS: 000359611700004 Objectives: Psychopathy is a distinct personality organization and differs from antisocial personality disorders in many aspects. Its diagnosis is challenging but also critical to predict criminality. In this context, Psychopathy Checklist Revised (PCL-R) is a useful tool in the diagnosis of psychopathy. Its reliability and validity was shown in various populations but has not been studied in a Turkish population. Our aim was to demonstrate the reliability and validity of PCL-R in a sample from Turkey. Methods: 425 male subjects with antisocial personality disorder and 125 controls without any psychiatric diagnoses were included in the study. DSM-5 diagnostic criteria were used and PCL-R was administered to all participants. The reliability of the Turkish version of PCL-R was determined by test-retest and internal consistency methods. In the ROC analysis performed with PCL-R, DSM-5 criteria were taken as a gold standard, the sensitivity; specificity and cut-off values of PCL-R were estimated. To evaluate the adequacy of the scale construct validity, Exploratory Factor Analysis and Kaiser-Meyer-Olkin (KMO) and Barlett tests were applied. Reproducibility of the test was evaluated by Pearson correlation coefficient. Re-testing was performed with 171 subjects two weeks after the first test. Results: In reliability analysis, the Cronbach's alpha internal consistency coefficient was calculated to be alpha=0.977. Pearson correlation coefficient of test-retest was r=0.94 (p

Objectives: Depression and anxiety are commonly seen among epileptic patients. These comorbidities have a negative effect on achievement of effective treatment and improvement in the quality of lif...

ABS TRACT: The impact of positive and negative affect on QT dispersion in healthy young adult men Objective: In this study, we aimed to determine whether QT dispersion known to be associated with development of coronary artery disease is related with positive (PA) and negative affect (NA) in healthy young adult men. Method: Two hundred and forty-four healthy males aged between 21-30 years were included in this study. Standard electrocardiographic (12 derivation and 50 mm/sec) and echocardiographic evaluations were performed. The duration of QT dispersion was measured digitally. Patients with sinus bradycardia, sinus tachycardia, bundle branch block, preexcitation and electrolyte imbalances were excluded. PA and NA scores of the subjects were determined by the Positive and Negative Affect Scale and clustered into “high” and “low” affect subtypes. Results: QT dispersion was significantly increased in subjects with high NA compared with those with low NA. There was no difference between the subjects having high PA and low PA. QT dispersion correlated positively with NA but not with PA. Conclusion: The results of this study have shown that there may be a relation between QT dispersion and NA in healthy young adult men.

ABS TRACT: Relationship between plasma levels of prolactin and the severity of negative symptoms in patients with schizophrenia Objective: The aim of this study was to evaluate the relationship between plasma levels of prolactin and negative symptoms. Methods: One hundred fourteen patients with schizophrenia were included in this crosssectional study. The patients were classified into groups with and without hyperprolactinemia. Plasma levels of prolactin and clinical features were compared between these groups. Results: Negative symptom scores in the group with hyperprolactinemia were significantly higher than in the non-hyperprolactinemic group. There was also a positive correlation between plasma levels of prolactin and negative symptom scores. However, there was no statistically significant difference between schizophrenia subtypes with regard to plasma prolactin levels. Patients treated with conventional neuroleptics or novel antipsychotics such as risperidone, paliperidone and amisulpride had higher prolactin levels than patients treated with aripiprazole, olanzapine, quetiapine, ziprasidone, and clozapine. Conclusion: This study indicated that we should be aware of prolactin levels, especially when negative symptoms are prominent in patients with schizophrenia. Plasma levels of prolactin could be an important biological marker for the severity of negative symptoms in the treatment of patients with schizophrenia. Thus, this finding may change the present pharmacotherapy for negative symptoms in schizophrenia based on prolactin levels.

Background: Leptin has attracted considerable interest in psychiatric disorders. It is expressed in the brain and an interaction between leptinergic and serotonergic systems has been demonstrated. Growing evidence now points to leptin as an important mediator in stress reactions and it has been postulated to modulate synaptic plasticity.Objective: In this study, our aim was to evaluate serum leptin levels in patients with antisocial personality disorder.Methods: The study included 72 patients and 75 controls. The patients met the fourth Diagnostic and Statistical Manual of Mental Disorders IV criteria for antisocial personality disorder. The HARE Psychopathy Checklist was performed and serum leptin was measured.Results: Mean serum leptin levels were significantly lower in patients than in healthy controls. Leptin levels were inversely correlated with the severity of antisocial personality disorder, as rated by the HARE Psychopathy Checklist.Conclusion: Our research points to a possible relationshi...

Objectives: Today, management of epilepsy treatment is still a major problem. The level of knowledge of epilepsy is important within healthcare providers and patients with epilepsy. In this study we aimed to evaluate the level of knowledge and attitudes towards the disease.Methods: A face to face questionnaire (consisted 9 questions) was applicated to 61 patients with epilepsy by a neurologist. Patients included were ones who applied to the neurology out-patient clinic during September 2010 and January 2011. Questioned 91 health care professionals were medical doctors, nurses, medical technicians and medical officers.Results: We found that the ratio of wrong answers in patient-questionaire was significantly higher than of medical professionals. Level of education versus ratio of wrong answers among patients with epilepsy and medical professionals also revealed an inverse significant correlation.Conclusion: Results of the present study showed that knowledge of medical professionals about epilepsy was better than of the patientgroup. Although this difference is not a totally unexpected finding, results also favored the need for amelioration of regular education programs for the management of epilepsy, not only for patients but also the health professionals.

WOS: 000376663300005 Objective: The number of studies investigating the traumatic events experienced during childhood period in patients with bipolar disorder (BD) are limited and to our knowledge no previous study was conducted about alexithymia and dissociative experiences of these patients as well. Besides investigation of childhood traumas and associated dissociative and alexithymic properties, identification of the differences between BD patients with and without childhood trauma (CT) was aimed in this study. Methods: Among the admissions to the psychiatry outpatient clinic, 70 BD patients and 70 healthy control subjects were included into the study. Structured Clinical Interview for DSM-IV Axis-I Disorders, Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ) and Toronto Alexithymia Scale (TAS-20) were administered. Results: Mean subscale and total scores of patients with BD in both CTQ and TAS-20, and mean DES score were found to be significantly higher than healthy control subjects. Psychopathological acts, number of episodes and suicide attempts were higher in the BD patients with childhood trauma history than that of the BD patients without any history of childhood trauma. Additionally, positive correlations were found between 'sexual abuse' and alexithymia total score along with 'difficulty identifying feelings' subscale score. Moreoever, mean DES score was also found to be positively correlated with 'difficulty identifying feelings' subscale score, 'difficulty to describe feelings' subscale score, alexithymia total score, and episode frequency. Conclusion: These results highlight the importance of protective mental health in the treatment of BD and reveal that childhood traumas should be questioned when evaluating patients especially with the diagnosis of BD.

Background: Several lines of evidence suggest that clozapine is more effective than both first- and second-generation antipsychotic drugs in treatment-resistant schizophrenia (TRS). However, clinicians appear to be hesitant to prescribe this drug. It would therefore be extremely valuable if predictors of response to clozapine could be identified. The aim of this study was to evaluate the predictive factors of clinical responses to clozapine in a group of Turkish patients with TRS. Methods: This was a 16-week uncontrolled open study carried out among 97 TRS patients (80 males and 17 females; DSM-IV diagnosis). All patients fulfilled the criteria for refractory schizophrenia according to the UK guidelines for the National Institute of Clinical Excellence (NICE). After all previous antipsychotic medications had run their course, the patients were started on clozapine according to a standardized titration and dosage schedule. Psychopathology was evaluated before the initiation of clozapine therapy and once every 4 weeks using the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment for Positive Symptoms, and the Scale for the Assessment of Negative Symptoms. Results: Of the TRS patients on clozapine, 55.7% achieved a clinical response, defined as at least a 20% decrease in BPRS. We observed a favorable effect of clozapine on both positive and negative symptoms. Logistic regression analysis showed that a good clozapine response was more likely when schizophrenia began at a later age, when negative symptoms were severe, and when patients had an early response at 4 weeks. Conclusion: A combination of demographic, baseline clinical, and acute treatment response variables may accurately predict response to clozapine in TRS. Priority should be given to initiating clozapine at the earliest phase of TRS, especially for patients with evident negative symptoms. © 2007 Elsevier Inc. All rights reserved.

ObjectivesData regarding schizophrenia treatment has been increasing whereas the information about predictors of treatment response is limited. In this study, our aim is to investigate the serum levels of reproductive hormones as a biological predictor in terms.MethodsThirty-three hospitalized male patients in GATA Haydarpasa Training Hospital with the diagnosis of first episode psychosis were included into the study. The study was prospective and naturalistic in design. The clinical course was recorded by means of Positive and Negative Symptom Scale (PANSS) in pretreatment period, 2nd and 6th weeks of the study. Prolactin, FSH, LH, estrogen, testesterone and oxytocin serum levels were also measured at the same dates.ResultsTreatment response was assessed as unresponsive when PANSSttl scores were lower than 25%, partial response when PANSSttl scores were between 25%-40% changes, and response when PANSSttl scores were higher than 40%. Patients were grouped according to those cut-off points. There was a significant positive correlation between oxytocin, FSH serum levels and positive symptoms (ρ = 0.437, P = 0.011; r = 0.385, P = 0.027). There was also significant negative correlation between testesterone serum levels and negative and total psychopathology scores (r = −0.352, P = 0.044; r = −0.429, P = 0.013). It was seen that pretreatment testerone levels had a significant biological marker on predicting remission when the serum levels were lower than 460,91 ng/dL.ConclusionsThis study shows that hypothalamo-hypophysial-gonadal axis hormones and reproductive hormones, especially testesterone, may be an important biological marker of treatment response prediction in first episode psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Neuroleptic Malignant syndrome (NMS) is a rare but potentially fatal adverse effect of antipsychotics. In addition, hypernatremia may play a significant role before occurrence of NMS or it may deve...

Objective: The studies investigating antisocial personality disorder are mostly applied to subjects in prison. In this study, we aimed to investigate comorbid disorders in a Turkish patient sample with the diagnosis of antisocial personality disorder (ASPD) who are not in prison and we investigated its relationship with psychopathy levels. Method: 140 male subjects were included in the study. None of them had been in the prison on admission. They all had the diagnoses of ASPD according to DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-IV) diagnostic criteria. Socio-demographic data form, Structured Clinical Interview for DSM- Axis 1 Disorders and Axis 2 Disorders (SCID-I, SCID-II), and Hare Psychopathy Checklist-Revised (PCL-R) were applied. Results: Most commonly seen comorbid disorders were as follows: substance use disorders (66,9%), alcohol use disorders (65,4%) and adjustment disorders (36,4%). In the high psychopathy group "Current and Lifetime Alcohol and Substance Use Disorder" and "Generalized Anxiety Disorder" were detected significantly more than those of the low psychopathy group. Conclusion: This study supplies important epidemiological data about ASPD comorbidity. Of note, none of the subjects were in the prison during the study. Psychopathy also seems like a predictor in comorbid situations.

Tardive dyskinesia (TD) or late dyskinesia are involuntary swirl or convolution movements which usually depends on the usage of antipsychotics and occurs in the further stage of treatment affecting often the mouth, tongue, face and sometimes the extremities and trunk. A tremor is an involuntary, rhythmic oscillations which is typically observed within the distal extremities but less frequently in the head, neck, jaw, and vocal cords. Aripiprazole is in the atypical antipsychotics group and known to cause less extrapyramidal side effects and TD. However, a growing number of articles are published concerning TD due to the usage of aripiprazole. In this article with its clinical features and follow up we present a case of schizophrenia patient who had been delivered aripiprazole for almost a year and who had developed TD and tremor.

Corticosteroids are routinely used in the treatment of peripheral facial palsy. Affective symptoms have been reported as a possible side effect due to use of corticosteroids. After corticosteroid use psychiatric symptoms are often seen in the first weeks. More than half of them are seen in the first two weeks. Euphoria and hypomania are reported as the most common side effects of short-term steroid therapy and in chronic use depression is observed more frequently than mania. Lithium and olanzapine are used effectively in the management of psychosis related to the use of corticosteroids. Clinical aspects and response to olanzapine and lithium treatment have been discussed in a patient with peripherial facial palsy, who developed mixed mania due to short term use of corticosteroid treatment., Kortikosteroidler rutin olarak periferik yüz felcinin tedavisinde kullanılmaktadır. Literatürde kortikosteroid kullanımına bağlı ortaya çıkan duygulanım belirtileri yan tesir olarak bildirilmiştir. Kortikosteroid kullanımı sonrası psikiyatrik belirtiler sıklıkla ilk haftalarda görülmektedir. Yarıdan fazlası ilk iki haftada belirti vermektedir. Kısa süreli steroid tedavisinin en sık yan etkisinin öfori ve hipomani olduğu ve süregen kullanımda maniden daha çok depresyon görüldüğü bildirilmektedir. Lityum ve olanzapin kortikosteroid kullanımıyla bağlantılı psikozun engellenmesinde ve tedavisinde başarıyla kullanılmaktadır. Periferik yüz felci geçirmiş olan olgumuzda kortikosteroid kullanımı sonrasında ortaya çıkan karma maninin klinik özellikleri, olanzapin ve lityum ile tedavisine yanıt ve seyri tartışılmıştır.

Objective: Essential tremor (ET), characterized by postural and kinetic tremor seen on hands and arms, is the most common movement disorder that causes significant disability. Besides the motor symptoms such as tremor, ET is also often accompanied by psychiatric symptoms such as anxiety and depression. We identified our objectives as to compare the level of anxiety and depression in young male patients with ET with the normal and to determine the relationship between this level and tremor severity and duration of illness. Method: 37 male patients with ET who were admitted to neurology clinic of our hospital and diagnosed according to Washington Heights-Inwood Genetic Study of Essential Tremor (WHIGET) diagnostic criteria and 32 healthy volunteers that were matched for age, gender and education level with this patient group have been included in this study. The tremor severity scores of ET patients were determined. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were administered to the both groups. The results were compared between two groups. Results: Both groups were similar in terms of their age and level of education. The BAI and BDI scores of the patient group were 21.83±13.01 and 17.45±1.66 in order, and 11.03±9.19 and 9.68±8.67 in the control group respectively. The BAI and BDI scores of the patient group were significantly higher than those of the control group (in order p: 0.000 and p: 0.003). Both the BAI and BDI scores didn’t correlate with the disease duration and total tremor scores. Conclusion: The level of anxiety and depression was significantly higher in young male patients with ET when compared to control group. The anxiety and depression scores were not correlated with the duration of illness and tremor severity., Amaç: Esansiyel tremor (ET) el ve kollarda pozisyonel ve hareketle ilişkili tremorla karakterize, belirgin yeti yitimine neden olan ve en sık görülen hareket bozukluğudur. ET’ye tremor gibi motor belirtilerin yanında anksiyete ve depresyon gibi psikiyatrik belirtiler de sıklıkla eşlik etmektedir. Çalışmamızın amacını; genç erkek ET hastalarında anksiyete ve depresyon düzeylerinin normallerle karşılaştırılması ve bu düzeylerin tremor şiddeti ve hastalık süresi ile ilişkisinin saptanması olarak belirledik. Yöntem: Bu çalışmaya hastanemizin nöroloji polikliniğine başvuran ve Washington Heights-Inwood Genetic Study of Essential Tremor (WHİGET) tanı kriterlerine göre tanısı konulmuş 37 erkek ET hastası ve bu hasta grubu ile yaş, cinsiyet ve eğitim düzeyi açısından eşleşen 32 sağlıklı gönüllü dâhil edildi. ET hastalarının tremor şiddet puanları belirlendi. Her iki gruba Beck Anksiyete Ölçeği (BAÖ) ve Beck Depresyon Ölçeği (BDÖ) uygulandı. Sonuçlar iki grup arasında karşılaştırıldı. Bulgular: Her iki grup yaş ve eğitim düzeyi açısından benzerdi. Hasta grubunun BAÖ ve BDÖ skorları sırasıyla 21.83±13.01 ve 17.45±1.66, kontrol grubunun BAÖ ve BDÖ skorları ise sırasıyla 11.03±9.19 ve 9.68±8.67 idi. Hasta grubunun BAÖ ve BDÖ skorları kontrol grubuna göre anlamlı olarak yüksekti (sırasıyla p=0.000 ve p=0.003). BAÖ ve BDÖ skorlarının her ikisinin hastalık süresi ve toplam tremor puanları ile ilişkisi saptanmadı. Sonuç: Genç erkek ET hastalarında kontrol grubuna göre anksiyete ve depresyon düzeyleri belirgin olarak yüksek saptandı. Anksiyete ve depresyon skorları hastalık süresi ve tremor şiddet puanı ile ilişkili değildi.

Objective: Psychiatric symptoms, such as anxiety and depression, are seen more in migraine patients than general population. Establishing of these symptoms is important in terms of successful management. The aim of our study is to compare the levels of anxiety, depression and obsessive-compulsive disorder symptoms between migraine patients and normal population and between migraine with aura and migraine without aura and to detect the relationship of the levels of these disorders with duration of disease and frequency of the attacks . Method: We included 66 male migraine patients (13 with aura; 53 without aura) diagnosed according to the diagnostic criteria of The International Headache Society-2004 (IHS 2004) in our neurology outpatient clinic and 32 healthy males with similar age and education level. Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Maudsley Obsessive-Compulsive Question List (MOCQL) had been applied to both groups by a psychologist. The frequency of the attacks in migraine group was accepted as rare if it was less than 4 in a month and frequent if it was more than 5 in a month. The inventory results of migraine patients vs. normal population and migraine with aura vs. migraine without aura had been compared and the relationship of the scores with the duration of the disease and the frequency of the attacks had been examined. Results: The scores of anxiety were higher but statistically insignificant in migraine group. The scores of MOCQL were statistically insignificant between the groups, but depression was found to be significantly higher in the migraine group. There was no significant correlation between the duration of the disease and depression, whereas patients with frequent attacks (more than 5 in a month) had higher levels of depressive symptoms. All test scores of migraine with aura and migraine without aura are similar. There was no difference in terms of BAI and MOCQL between patients having frequent attacks and rare attacks. Depression and anxiety levels were significantly related to each other in a strong positive way. Conclusion: Levels of depressive symptoms is high in migraine patients and its frequency increases as the frequency of the attacks increase. There is no relationship between levels of depressive symptoms and disease duration in migraine patients; whereas levels of depression symptoms and anxiety levels has a positive relation. It is important to examine and treat the anxiety and depressive symptoms in migraine patients., Amaç: Migren hastalarında anksiyete ve depresyon gibi çeşitli psikiyatrik belirtiler genel toplumdan daha sık görülmektedir. Bu belirtilerin tespiti, tedavinin başarısı açısından önemlidir. Çalışmamızın amacını migren ile normal bireyler ve auralı migren ile aurasız migrenliler arasında anksiyete, depresyon ve obsesif-kompulsif bozukluk belirti düzeylerinin karşılaştırılması ve bu düzeylerin hastalık süresi ve atak sıklığı ile ilişkisinin incelenmesi olarak belirledik. Gereç ve Yöntem: Çalışmamıza hastanemizin nöroloji polikliniğine ardı sıra başvuran ve Uluslararası Baş Ağrısı Topluluğu’nun (International Headache Society-IHS) 2004 tanı ölçütlerine göre tanısı konulan 66 erkek migren hastası (13 auralı, 53 aurasız) ve bu hastalarla benzer yaş ve eğitim düzeyine sahip 32 erkek sağlıklı kontrol grubu dâhil edildi. Her iki gruba psikolog tarafından Beck Anksiyete Ölçeği (BAÖ), Beck Depresyon Ölçeği (BDÖ) ve Maudsley Obsesif Kompulsif Soru Listesi (MOKSL) uygulandı. Migren grubunda atak sıklığı; ayda 4 ve altında atak geçirenler seyrek, 5 ve üzerinde atak geçirenler sık olarak belirlendi. Migren ile kontrol grubu ve auralı migren ile aurasız migrenliler arasında ölçek sonuçları birbirleri ile karşılaştırıldı ve migren grubunda skorların hastalık süresi ve atak sıklığı ile ilişkisi incelendi. Bulgular: Anksiyete düzeyleri migren grubunda kontrol grubuna göre yüksek olsa da istatistiksel olarak anlamlı değildi. Gruplar arasında MOKSL düzeyleri açısından istatistiksel anlamlılık bulunmazken, depresif belirti düzeyleri migren grubunda anlamlı olarak yüksek bulundu. Hastalık süresi ile depresif belirti düzeyleri arasında anlamlı ilişki saptanmazken, migren atakları sık olanlarda (ayda 5 ve üzeri) depresif belirti düzeyleri daha yüksek saptandı. Auralı ve aurasız migrenlilerin tüm test sonuçları benzerdi. Migren atak sıklığı sık ve seyrek olanların BAÖ ve MOKSL düzeyleri açısından farklılık yoktu. Depresif belirti ile anksiyete düzeyleri arasında pozitif yönde güçlü ve istatistiksel olarak anlamlı bir ilişki saptanmıştır. Sonuç: Depresif belirti düzeyleri migren hastalarında yüksektir ve migren atakları sık olanlarda artmaktadır. Migrenlilerde depresif belirti düzeyleri hastalık süresi ile ilişkisiz olup anksiyete düzeyleri ile pozitif ilişkilidir. Migren hastalarında anksiyete ve depresif belirtilerin sorgulanması ve tedavi edilmesi önemlidir.

Giriş: Antipsikotik ilaca yanıt alınamaması ya da tedaviyle ilişkili yan tesirlerin ortaya çıkmasını öngörebilecek sitokrom P450 (CYP) genetik polimorfizmleri bulunmaktadır. Amaç: Bu çalışmada klozapin tedavisine yanıt ile CYP1A2*1F genetik polimorfizmi arasındaki ilişki araştırılmıştır. Yöntem: Şizofreni tanısı almış 55 hasta, Kısa Psikiyatrik Değerlendirme Ölçeği (BPRS), Pozitif Belirtileri Değerlendirme Ölçeği (SAPS), Negatif Belirtileri Değerlendirme Ölçeği (SANS), vital bulgular, rutin biyokimyasal incelemelerle değerlendirildi. Olgular 18 hafta süre ile takip edildi. Ölçümler tedavi öncesi ve tedavi sonrası yapıldı. Klozapin 200-600 mg/gün doz aralığında kullanıldı. Daha önceden klozapin kullanan 45 hasta retrospektif olarak değerlendirildi. Onsekizinci hafta sonunda, tedavi öncesine göre BPRS, SANS, SAPS puanlarından birisinde %20lik azalma tedaviye yanıt kriteri olarak alındı. Bulgular: Olgular, klozapin başlanmasından 18 hafta sonra tekrar değerlendirildiğinde, tedavinin CYP1A2*1F*1F genotipini taşıyanlarda, en az bir yabanıl tip alel taşıyan bireylere oranla (*1*1 ya da *1*1F) ortalama 2,4 kat daha başarısız olduğu gözlenmiştir (p=0.02). Sigara kullanımı tedaviye cevap oranını %15 oranında anlamlı olarak azaltmıştır (p=0.014). Sonuç: Özellikle sigara kullanan hastalarda CYP1A2*1F*1F genotipini taşıyor olmak klozapin tedavisinin başarısız olması için bir risk faktörü olabilir.

Introduction: Genetic polymorphisms of cytochrome P450 (CYP) may predict the treatment response or occurrence of side effects of antipsychotic drugs. Aim: We studied the association of response to clozapine treatment in schizophrenic patients in relation to polymorphisms in the CYP1A2 gene. Methods: The degree of psychosis of the patients (n=55) was assessed using the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS) and routine biochemistry. The patients were monitored for 18 weeks and the scales were applied before starting the treatment and at the end of the follow up period. Clozapine was used at doses of 200 to 600 mg/day. A positive response was defined as a 20% decrease in pre-and posttreatment scores of one of the BPRS, SANS, or SAPS scores. In addition, 45 patients, who were already on clozapine treatment, were assessed retrospectively. Results: As assessed at the 18th week after start of therapy, lack of response to clozapine treatment was 2.4 fold higher in the patients carrying the CYP1A2*1F*1F genotype (p=0.02) compared to patients carrying at least one wild type allele (i.e. *1/*1 or *1/*1F). Smoking decreased the response rate by about 15% (p=0.014). Conclusion: The results of our study suggest that the CYP1A2*1F/*1F genotype may be a risk factor for lack of response to clozapine treatment in psychotic patients, especially in cigarette smokers.

Objective Anticholinergic side effects of antipsychotic drugs has long been known. Although dry mouth and constipation due to the anticholinergic side effects are common, dry eye has not been reported in the literature as far as we investigate. Case A 41-year-old, married, with two children, male patient. Outpatient clinic follow-up were performed for five years with a diagnosis of psychosis with complaints of suspiciousness, agitation, restlessness, drowsiness, emotional numbing, insomnia and feeling guilty. He was in remission with the treatment of olanzapine 5 mg/day. The patient was admitted with the complaints of eye blinking, eye burning sensation, sensitivity to light increasing over the past year. Discussion and conclusion We discussed treatments applied after the development of dry eye, clinical course and whether or not ocular dryness was due to the use of antipsychotic in a patient using olanzapine 5 mg/day for five years. To our knowledge, antipsychotic-induced dry eye case has not been reported in the literature. We believe that our patient was a case of dry eye developed by antipsychotics. Common side effects of antipsychotics as well as the side effects that are less common and less taken into account should be considered, they should be assessed in co-operation with other clinics and it should be noted that besides monitoring psychotic symptoms and signs, being vigilant in terms of the side effects and adverse events and following them is extremely important for the quality of life of patients.

Objective Migraine is one of the most common primary headaches which worldwide affects more than 10% of people. Anxiety disorder and depression often accompany this disease and increase the number and severity of migraine attacks. Detection and treatment of psychiatric disorders with migraine provides a major contribution to effective pain control. The purpose of this study is to determine the prevalence of anxiety and depression disorders in patients with migraine. Methods Two groups are formed with migraine patients and healthy volunteers. So far 51 patients are included to migraine group by the neurologist according to “The International Classification of Headache Disorders, 2nd edition” (ICHD-2). There are 60 subjects in the healthy control group. After being examined by the psychiatrist both of the groups meet the psychologist and have the Beck Depression Inventory (BDI)and Beck Anxiety Inventory (BAI). Results Until now, in the migraine group BAI is high with 15 patients (29%) and BDI is high with 19 patients (37%) whereas in the control group BAI is high with 6 subjects (10%) and BDI is high with 10 subjects (16%). Both test scores are significantly higher in the migraine group than the control group (p Discussion The study is ongoing and according to the current findings the prevalence of anxiety and depression in patients with migraine is higher than the normal population. For this reason migraine patients should also be questioned and treated at psychological aspects.

Objective Migraine is one of the most common primary headaches which worldwide affects more than 10% of people. Anxiety disorder and depression often accompany this disease and increase the number and severity of migraine attacks. Detection and treatment of psychiatric disorders with migraine provides a major contribution to effective pain control. The purpose of this study is to determine the prevalence of anxiety and depression disorders in patients with migraine. Methods Two groups are formed with migraine patients and healthy volunteers. So far 51 patients are included to migraine group by the neurologist according to “The International Classification of Headache Disorders, 2nd edition” (ICHD-2). There are 60 subjects in the healthy control group. After being examined by the psychiatrist both of the groups meet the psychologist and have the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Results Until now, in the migraine group BAI is high with 15 patients (29%) and BDI is high with 19 patients (37%) whereas in the control group BAI is high with 6 subjects (10%) and BDI is high with 10 subjects (16%). Both tests have significantly higher scores than the control group (p Discussion The study is ongoing and according to the current findings the prevalence of anxiety and depression in patients with migraine is higher than the normal population. For this reason migraine patients should also be questioned and treated at psychological aspects.