Search

PubMedID: 31741346 OBJECTIVES: The purpose of the study was to evaluate any comorbid psychiatric disorders in patients with chronic pain and to examine the effects of sociodemographic details and the level of somatic sense perception on the severity of these diseases. METHODS: In this study, 51 chronic pain patients were evaluated in a consultation with a psychiatrist. Sociodemographic characteristics of the patients, such as age, gender, education level, and marital status were recorded, and Structured Clinical Interview for DSM-IV results were assessed. The patients' chronic pains were classified as idiopathic or secondary to organic etiology. In addition, the Symptom Checklist-90, Somatosensory Amplification Scale (SSAS), Hamilton Depression Rating Scale, and the Hamilton Anxiety Scale (HAM-A) were used. RESULTS: The incidence of psychiatric disorders in chronic pain patients was found to be 74.5%. Somatoform disorders were the most frequently diagnosed, at 37.3%. The rate of depressive and anxiety disorders was, respectively, 29.4% and 23.5%. Comorbid anxiety scores (p=0.019) and SSAS scores (p=0.046) were significantly higher in chronic pain patients with a somatoform disorder. HAM-A scores were found to be significantly higher in patients with depression (p=0.004). A positive and linear relationship was determined between the SSAS score and depression, anxiety, and the severity of mental symptoms. CONCLUSION: Structured or semi-structured interviews can be performed in pain polyclinics or psychiatric outpatient clinics to determine the level of perception of somatic sensations. This could be beneficial in the treatment of chronic pain and comorbid psychiatric disorders.

Objective: Bariatric surgery is used more commonly than recent years among obesity treatment methods. The prevalence of eating disorders and its effect on surgical outcomes in bariatric surgery candidates are frequently discussed.The present study was planned to assess the prevalence of eating disorders in bariatric surgery candi-dates. Methods: A psychiatrist in routine proce-dure evaluated 108 bariatric surgery patients. Eating disorders diag-nosis (binge eating disoder (BED), anorexia nervosa (AN), bulimia nervosa (BN)) were based to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and night eating syndrome (NES) diagnosis was based to Allison crieterias. Eating Attitudes Test (EAT) and Beck Depression Inventory (BDI) were administered to all participants. Results: The prevalence of any kind of eating disorder (BED, NES or both) was 23.1% (n=25). BED was 11.1% (n=12), NES 5.6% (n=6), both BED and NES 6.5% (n=7). We could not determine any patient with diagnose of AN or BN in our sample. There was no significant difference at Body Mass Index (BMI) between people with eating disorders and without eating disorders. The mean point of BDI score was 13.8±9.8. The 50% of sample had family history about psychiatric disease. 63.9% of the sample (n=69) had comorbid other medical conditions. Conclusion: Prevalence of eating disorders is substantially high in this group (23.1%). As we exactly not know the effect of eating disorders at surgery success and weight loss, it is important to determine the maladaptive eating behaviors at the beginning of surgery procedure. © 2018, Cukurova University, Faculty of Medicine. All rights reserved.

Objective: The impact of parental coexistence on overcoming the adolescence period is being discussed. The aim of this study is to examine if there is a statistically signi-ficant difference in the level of impulse control among the adolescent children of married and divorced couples and to investigate the effect of the socio-demographic characteristics of the divorce process on impulsivity of adolescents. Method: Fifty girls and 50 boys ages of 12-17 with divorced parents, 50 boys and 50 girls with undivorced parents were included in the study. This is a cross-sectional study. The impulse control levels of adolescents were compared with the Barrat Impulsiveness Scale (BIS). The effect of the educational status of the parents, the gender and the age of the adolescent, the parent with whom the adolescent live, time after divorce process on the level of impulse control were examined. The value of p

Objective: The data about sleep quality and suicide relationship in patients with obsessive-compulsive disorder (OCD) is limited. In this study, we aimed to investigate the hypothesis that there might be a relationship between sleep quality and suicide in the OCD patients with compare the control group. Methods: A total of 50 patients with OCD (31 female, 19 male) and 40 healthy (24 female, 16 male) individuals as a control group were included in the study. A data form for sociodemographic features, one other forms for clinical characteristics of OCD and Yale Brown Obsessive Compulsive Scale (YB-OCS) have been filled by clinician. After the interview, all patients com-pleted Pittsburgh Sleep Quality Index (PSQI) and Suicide Behavior Scale (SBS). Results: Six (12%) of the OCD patients had lifelong suicide attempts and twenty (40%) had lifelong suicide ideation. When OCD patients and healthy controls were compared, PSQI-2, PSQI-3, PSQI-5, PSQI-6, SBS-1, SBS-2, SBS3 and SBS total scores in patients with OCD were higher than healthy controls. In patients group with lifelong suicide ideations, PSQI-1 and PSQI-6 scores were higher. In patients group with lifelong suicide attempts, PSQI-6 scores were higher. In OCD patients, statistically significant correlations were detected between SBS-1 and PSQI-1, PSQI-6; SBS-3 and PSQI-6. This correlations were not observed in the control group. Conclusion: As a result of this study, it has been shown that the subjective sleep quality of the last 1 month in OCD patients and the intake of additional sleeping pills may be related to past suicidal thoughts and attempts. It may be appropriate to monitor OCD patients with subjective sleep quality impairment and use of additional medication more frequently in terms of suicide risk. In this issue, follow-up studies are needed to include more OCD patients. © 2018, Cukurova University, Faculty of Medicine. All rights resreved.

Objective: To determine the prevalence of impulse control disorders (ICDs) among medical students and evaluate the related sociodemographic and clinical features. Methods: A total of 277 students in the fourth and fifth year of medical school were included in the study. The study was conducted between September 2011 and June 2012 in Cukurova University Medical School, Adana, Turkey. A demographic data form has been completed. The Structured Clinical Interview for DSM-IV (SCID-I) was used to determine axis I psychiatric disorders. The prevalence rates of ICDs were investigated by using the modified version of the Minnesota Impulse Disorders Interview. All patients completed Barratt Impulsiveness Scale Version 11 (BIS-11) and Symptom Check List-90. Results: The lifetime prevalence of at least one ICD in our sample was 11.2% (n=31). When the participants with the diagnosis of ICDs not otherwise specified were excluded the prevalence rate decreased to 7.9%. The most common ICD was intermittent explosive disorder (6.1%), followed by trichotillomania (2.5%). History of suicide attempts was significantly higher in the group with ICD. There was statistically significant difference between comorbidity of other Axis I psychiatric disorders and a significant difference was observed in terms of total impulsivity, non-planning activity, and motor impulsivity scores as determined by BIS-11 between groups with or without ICDs. Conclusion: ICDs might be underdiagnosed in young adult populations. ICDs affect the quality of life, the course and outcome of comorbid disorders so it is important to ask for these disorders in regular psychiatric interviews and treating them in an appropriate and specific way. © 2017, Cukurova University, Faculty of Medicine. All rights reserved.

Objective: The aim of study as to determine the clinical and sociodemographic characteristics of the inpatients with the diagnosis of schizophrenia between the years 2010-2014. Patients were grouped according to the gender and age of onset and these groups were compared. Method: 208 patients who had been diagnosed with schizophrenia according to DSM IV TR between the years 2010-2014. Sociodemographic and clinical data form, Scale for the Assessment of Positive Symptoms(SAPS) and Scale for the Assessment of Negative Symptoms(SANS), Hamilton Depression Rating Scale and Insight Assessment Scale were filled by scanning previous patient files. Results: 107(51,4%) of the patients included in this study were male. Mean age of onset of schizophrenia was 23,82±9,78. There was no significant difference between men and women in terms of age at onset. The rate of patients with one or more delusions was 98,6 % (n:205), the rate of patients with one more halucinations was 59,6 % (n:124). Lifetime smoking, alcohol and substance abuse and legal problem rates were higher in male patients. Lifetime history of suicide and SAPS scores were higher in female patients. Family history of psychiatric disorders was higher in early onset schizophrenia patients(

Schizophrenia is an early onset disorder that impacts the individuals deeply for their lifetimes. The disorder causes setbacks in quality of life, social interactions, general hygiene and a number of other aspects without full recovery. Increase in mortality and lifetime reductions of up to 10 years are observed during this chronic and destructive process. Possible causes of death include medical conditions that affect general health as well as suicide. This paper reviews comorbid medical disorders and conditions in patients with schizophrenia. ©2017, Psikiyatride Güncel Yaklaşımlar.

Tardive dyskinesia is characterized by involuntary movements which appear in connection with long-term blockage of dopamine 2 receptors following the use of antipsychotics. One of the treatment options in cases of tardive dyskinesia which occasionally induced by aripiprazole is clozapine. Clozapine is distinguished from other antipsychotics by its effective strength because of its unique receptor profile and its side effects. Clozapine may cause enuresis by various mechanisms. Among the pharmacological choices for the treatment of clozapine-related enuresis are desmopressin, oxybutynin, trihexyphenidyl, amitriptyline, aripiprazole, ephedrine, and verapamil. The patient’s psychiatric diagnosis determines the choice of medication with their possible side effects. © 2017, Derman Medical Publishing. All rights reserved.

Introduction: In this study, we aimed to investigate the effects of occupational therapy and psychosocial interventions on the interpersonal functioning and individual and social performance levels of corresponding patients under the heading of psychosocial treatment approaches in psychiatry clinics as well as the attitudes of the patients in regard to those interventions. Methods: In 2013, out of psychotic (schizophrenia, bipolar disorder/ mania) and nonpsychotic (depression, obsessive compulsive disorder, alcohol dependence) inpatients in our clinic, 48 patients who participated in occupational activities were included in the study group and 43 patients who did not participate in these activities were included in the control group. We prepared and implemented a 3-item questionnaire constructed by our team, which probed the patients’ thoughts on these occupational activities. The Interpersonal Functioning Scale (IFS) and Personal and Social Performance Scale (PSP) were applied to both groups on hospital admission and discharge; variations in scale scores were evaluated on par with sociodemographic variables, and the study and control groups were compared. Results: In total, 91% of the study group provided positive feedback regarding the aforementioned interventions. When comparing the study and control groups, the IFS variance score of the study group did not show a significant difference with respect to that of the control group. A statistically significant difference (p

OBJECTIVE: To report a case of persistent psychosis that developed during interferon alfa (IFN-α) therapy for chronic hepatitis B. CASE SUMMARY: A 26-year-old man who was diagnosed with active chronic hepatitis B began treatment with IFN-α. Five months after initiation of therapy, he developed acute psychosis with prominent persecutory delusions and auditory hallucinations. Despite discontinuation of IFN-α therapy and addition of antipsychotic drug treatment, only partial recovery from psychosis was observed after 4 months of hospitalization. DISCUSSION: Unlike many previously reported cases, this patient showed only partial recovery from psychosis, despite the discontinuation of IFN therapy. Except for receiving a relatively high dose of IFN-α (10 million units 3 times/wk), the patient did not have any previously proposed risk factors for developing psychiatric adverse effects. The Naranjo probability scale indicates a probable relationship between the acute psychosis and IFN therapy. CONCLUSIONS: Despite its rare occurrence, psychosis can emerge during IFN-α therapy. This adverse effect may persist for several months, even after appropriate medical management. IFN-α should be used with careful monitoring of patients' psychiatric status during all stages of therapy.

[No abstract available]

Objective: The aim of this study was to examine the prevalence of unwanted sexual intercourse, its reasons, some short term consequences and related sexual function disorder in a group of married women. Methods: Sixty three married women who have been working as research fellow in a university have participated in the study. A study form including sociodemographic features and information relevant to unwanted sexual experiences of cases were completed by participants. Arizona Sexual Experiences Scale were given to collect information about sexual life and experiences of subjects. Results: More than half of the cases revealed that they had unwanted sexual inter-course during their lifetime. The most common reasons for unwanted sexual intercourse were using sex as a way of showing their love and satisfying a need to be sensual. According to Arizona Sexual Experience Scale, women those have unwanted sexual intercourse had significantly lower sexual desire, arousal, orgasm and sexual satisfac-tion subscale as compared to women those did not have unwanted sexual intercourse. Discussion: This study has shown that all unwanted sexual intercourse may not be considered as traumatic and for some women it might be considered as positive sexual experience. However, in some cases it may lead to negative psychological conse-quences and sexual dysfunction. Thus, further studies are warranted to determine the factors leading an unwanted sexual course to be considered as a positive or negative experience. In psychiatric practice, evaluating unwanted sexual course might help psychiatrists to find out a precipitating factor for a sexual dysfunction and some psychiatric syndromes. © 2015, Cukurova University, Faculty of Medicine. All rights reserved.

The comorbidity of bipolar disorder and anxiety disorders is a well known concept. Obsessive-compulsive disorder is the most commonly seen comorbid anxiety disorder in bipolar patients. Some genetic variants, neurotransmitters especially serotonergic systems and second-messenger systems are thought to be responsible for its etiology. Bipolar disorder alters the clinical aspects of obsessive compulsive disorder and is associated with poorer outcome. The determination of comorbidity between bipolar disorder and obsessive compulsive disorder is quite important for appropriate clinical management and treatment. © 2013, Psikiyatride Güncel Yaklaşi{dotless}mlar.

Bipolar disorder is a chronic mood disorder with the peak age of onset between 20 and 40 years. The majority of patients have onset prior to age 50. Age of onset can have a significant impact on the etiology, nature and course of the illness. Mania in old age needs a careful assessment for underlying neurological diseases, especially cerebrovascular disease. A 84 year old woman who had complaints of excessive and meaningless talking, irritability, restlessness, anger and insomnia for the first time in her life is presented in this case report. The patient was evaluated and diagnosed as first episode manic attack. Rarity of first manic attack in old age is the significant aspect of the case. Taking notice of items about diagnosing and treating in this kind of patients are discussed in this case report.

WOS: 000209470200648 …

[No abstract available]

Oculogyric crisis (OGC) is a type of acute dystonic reaction which is usually a side effect of an antipsychotic treatment. There are case reports on OCG with almost all antipsychotic drugs, especially with the highly potent ones. In psychotic patients, there are cases of OCG accompanied by psychotic exacerbation during antipsychotic treatment Besides, there are cases of OCG after cessation of antipsychotic treatment However, to our knowledge, there are no cases of OCG associated with psychotic exacerbation following antipsychotic drug withdrawal. We present a 26-year-old patient who had psychotic exacerbation accompanied by OCG after cessation of his 2-year amisulpiride treatment He was in remission for two years before he developed auditory hallucinations, reference delusions and repetitious OCG just after stopping his medication. In this study, we investigated the possible reasons for these symptoms and we assume that they may be related to dopamine receptor supersensitivity which is the result of long-term antipsychotic treatment. © Archives of Neuropsychiatry.

5th Biennial Conference of the International-Society-for-Bipolar-Disorders -- MAR 14-17, 2012 -- Istanbul, TURKEY WOS: 000301531000272 … Int Soc Bipolar Disorders

There are few publications about sexual impulse and sexual acts, related to sexuality in bipolar disorder (BPD) except from hypersexuality. There have been rare reports of paraphilia and transsexuality associated with BPD in literature. This association is commonly evaluated as comorbidity and handled as a curable sign of BPD, because of good response to mood stabilizers. In this paper we presented two cases that had transsexual acts only during manic episodes. Both patients dropped their behaviour after antimanic treatment and regretted what they had done. Therefore we have evaluated transsexual acts of these patients in BPD symptomatology and tried to explain these activities by biologic and psychodynamic basis.

WOS: 000311020700021 PubMed ID: 23090814 Despite its serious side effects, clozapine is still the golden standard in treatment of schizophrenia due to its effectiveness and lack of extrapyramidal side effects. Some studies have mentioned withdrawal symptoms, including withdrawal psychosis after stopping clozapine, and have tried to explain this severe symptom through dopamine receptor supersensitivity. This phenomenon, called supersensitivity psychosis, can be explained by the development of tolerance towards the effect of the medication. In literature, there are several cases of supersensitivity psychosis while using other neuroleptics. However, to our knowledge, there are no published cases reporting an association between clozapine and supersensitivity psychosis. The current patient, who has been diagnosed as resistant schizophrenia, responded well to the clozapine in the beginning of treatment. Due to an effective dose of clozapine, he had psychotic exacerbation with significant positive symptoms. We discuss the probable reasons causing this situation and the relationship between tolerance to the treatment effect and the dopamine supersensitivity.

Objective: In recent years, interest on prevalence and comorbidity of impulse control disorders is constantly increasing. The aim of this study was to investigate the prevalence of impulse control disorders and its association with the existence of comorbid axis I disorders in young adult university exam preparatory course students. Met hods: Two hundred and twenty-six preparatory course students aged 18-27 (mean age: 19.2) years were included in this study. Axis I diagnoses were evaluated using the Structured Clinical Interview for DSM-IV (SCID-I). Lifetime impulse control disorders were investigated using the modified version of Minnesota Impulsive Disorders Interview. Impulsivity was measured with the Barratt Impulsiveness Scale Version 11(BIS-11). Results: The prevalence rate of all impulse control disorders in our sample was 23.4% (n=55). The most common impulse control disorder subtype was impulse control disorder not otherwise specified ICD-NOS (%16.8), followed by trichotillomania and intermittent explosive disorder. The most common ICD-NOS subtype was compulsive buying. There was no statistically significant difference between the diagnoses of axis I disorders in students with and without impulse control disorders. A statistically significant difference was found between groups with and without impulse control disorders in terms of total impulsivity and nonplanning scores determined by the BIS-11. C onc lu si on: Considering early age onset and decreasing prevalence with progressive aging, impulse control disorders are expected to be common in the young adult population. Prevalence rates determined at the end of this study were found to be higher in comparison with the peer group in literature. However, the prevalence rates obtained in our study may not be generalized tothe society because of the statistical limitation concerning our sample size. Large-scale, epidemiologic studies are required to be performed on this topic. © Archives of Neuropsychiatry, published by Galenos Publishing.

Nowadays, even though compulsive buying disorder itself is not placed under a separate diagnostic category in DSM-IV-TR, it is classified under the heading of impulse control disorders not otherwise specified. In these cases, there is excessive buying and shopping, or inappropriate buying or shopping impulse or behaviors. The buying preoccupation, behaviors and impulses cause stress, social, professional and financial problems and are time-consuming. In these cases, the rate of psychiatric comorbidity is high. Especially major depression, mood disorders, anxiety disorder (particularly obsessive compulsive disorder), substance use, eating disorder (mainly bulimia) and personality disorders are frequently encountered. It was shown that compulsive buying is frequently seen in individuals with obsessive compulsive disorder. To draw attention that this subject is also a problem in our country, we reported a case followed in our outpatient clinic with the diagnosis of obsessive compulsive disorder and who showed depressive characteristics discordant with obsessive compulsive symptoms during follow-up controls, and in whom, after detailed evaluations, accompanying compulsive buying disorder was detected. This case is a good example to emphasize the importance of detecting comorbidities while developing treatment plan for psychiatric diseases. © Archives of Neuropsychiatry, published by Galenos Publishing.

Objective: The purpose of this study was to find out the level of death anxiety evaluate its relationship with several sociodemographic and clinical variables among elderly patients who have been referred to psychiatry outpatient clinics with consultation from other outpatient clinics in an university hospital. Methods: Two hundred patients (117 male, 83 female) who have been referred to Çukurova University Medical Faculty Psychiatry outpatient clinics via consultation were included in the present study. A formal psychiatric interview were conducted with all cases, and demographic and clinical variables were recorded thereafter. After the interview, all patients completed Geriatric Depression Scale (GDS), State and Trait Anxiety Inventory (STAI), Templer Death Anxiety Scale (DAS), Death Depression Scale (DDS) and Short Form-36 (SF-36) quality of life scale. Results: Of all patients included in the present study, 58,5% were female with an average age of 67.16±5.0 for whole group. The mean DAS score for whole group was 7.7. There was a mild positive correlation between SF-36 and DAS scores. The same correlation was alos valid between SF-36 and DDS scores. Evaluation of the relationship between demographic variables and scale scores revealed positive correlation between DAS score and the number of children of the patients, while a negative correlation was present between DAS and length of education. There were no significant differences in DAS and DDS scores with regards to physical disorder type. The presence of bereavement within one year time was not a significant factor for change in DAS scores while there was a significant increase in death anxiety among patients who had frequent death thoughts in the last month. Conclusion: The results of this study presented significant relationship between death anxiety and length of education, number of children and frequency of death thoughts among elderly patients. No such relationship could be determined for the type of physical disease. Prospective studies carefully searching for different variables in elderly cases would reveal and help us to understand the importance of death anxiety and its impact on courses of physical and mental disorders.

Objective: The aim of this study was to determine the prevalence rates of impulse control disorders among patients with major depression and evaluate the effect of comorbidity on the onset and the clinical course of depression. Methods: The study included 150 consecutive depressive psychiatric patients who have presented to our outpatient clinics within a one-year period. A demographic data form has been completed along with a structural clinical interview (SCID-I) to evaluate axis I psychiatric disorders according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). To determine the impulse control disorders and depression, the Minnesota Impulse Control Disorders Interview and the Hamilton Depression Rating Scale have been applied to all patients. Besides, all patients completed the Symptom Check List-90, the Beck Depression Inventory, the Zuckerman's Sensation Seeking Scale Form-V, the Barratt Impulsiveness Scale-11 and the Mood Disorders Questionnaire to help us find out the levels of psychopathology. Results: In a one-year period, 34.7% of depressive outpatients in our clinics had at least one comorbid impulse control disorder. The inclusion of patients with a diagnosis of impulse control disorders not otherwise specified increased the rate of comorbid impulse control disorders to 56.7%. The most common impulse control disorder in our sample was intermittent explosive disorder (31.3%) followed by skin picking (28%) and compulsive buying (14%). Depressive patients with a comorbid impulse control disorder had an earlier age of onset of the disorder than patients without any impulse control disorder. There were no differences between the groups in terms of gender, marital status, education level and number of hospitalizations. Pathological gambling was more common in male patients, whereas compulsive buying was more frequently seen in female patients. Lifetime suicide attempt rates were two times more common in d epressive patients with comorbid impulse control disorder than in patients without it, but this difference did not reach statistical significance. Though there was not any statistically significant difference between these two groups, levels of general psychopathology, impulsivity scores and mood disorder questionnaire scores were significantly higher in patients with comorbid impulse control disorder. Conclusion: The results of this study show that one third of depressive patients who presented to our outpatient clinics within a one-year period were diagnosed with at least one lifetime comorbid impulse control disorder according to DSM-IV. Since impulse control disorders are frequently seen, in order to avoid eventual complications in the course of comorbid depression and establish proper treatment plans, close evaluation and recognition of impulse control disorders are necessary. © Archives of Neuropsychiatry, published by Galenos Publishing.

Although too many studies were performed to search for the frequency of Axis I comorbidity in major depressive disorder, studies including impulse control disorder, which is a special cluster of axis I disorders, are quite limited. The aim of this study was to search for the frequency of life-time comorbid Axis I disorders in major depressive disorders including impulse control disorders. Also it was aimed to demonstrate the effect of comorbidity on the initiation and duration of depression together with the difference between males and females. In this study, 150 patients between 18-65 ages were included with recurrent attacks diagnosed as major depression due to DSM-IV criteria, who admitted the Psychiatric clinics of Cukurova University Faculty of Medicine in one year time. During the first interview, Sociodemographical data form, Structural clinical interview (SCID-I) prepared for DSM-IV Axis I disorders were applied. In order to detect impulse control disorders, some scales like arranged form of Minnesota Impulse control disorder interview (MIDI), Symptom check list (SCL-90), Beck depression İnventory (BDI), Hamilton depression scale interview (HDI), Zuckerman Sensation Seeking scale (ZSS), Barratt Impulsiveness scale-11 (BIS-11) were used. Comorbidity was %73,3 in whole group. All anxiety disorders were detected to be %56. Severe anxiety disorder (GAD) was detected in %46.7 of the patients, as the most common of anxiety disorders in whole group. In whole group, alcohol consumption was %12, Somatoform disorder was %9,3 of the cases. Impulse control disorders (ICD) were detected in %56,7 of cases. When the impulse control disorders not otherwise specified were excluded, the ratio in whole group was %34,4. in whole group, intermittent explosive disorder was found to be %31,3, followed by skin picking as %28 and compulsive buying as %14. It was observed that anxiety disorders high frequently accompany both alcohol intake and impulse control disorders. Comorbidity is high frequently seen in patients with major depressive disorder. Any comorbid diagnosis increases tendency to another comorbid diagnosis. Comorbidity affects both the progress and also the treatment strategy of major depressive disorder. Therefore, detection of comorbid conditions enables patient follow-up and treatment strategy in major depressive disorders.

Psychosis in epilepsy can be categorized in relation to seizures or the treatment: ictal psychosis, postictal pyschosis, interictal (chronic) psychosis, "forced normalization" or "alternative psychosis", and de novo psychosis following epilepsy surgery. A schizophrenic condition with permanent psychotic symptoms that occurs in between the seizures or that has no direct relation with the seizures is termed as "interictal pychosis". Such definitions as "schizophrenia-like psychosis of epilepsy" or "chronic (interictal) psychosis" are also proposed for interictal psychosis. The concept of "forced normalization" is described as the decrease or complete normalization of electroencephalographic abnormalities present during the seizures in a patient with epilepsy, concurrent with the onset of psychotic signs. This concept, also called as "alternative psychosis" or "paradoxic normalization", has recently attracted more attention. The psychiatric disorders reported are mostly psychoses. Frequently, this phenomenon of psychosis takes the form of a brief psychotic disorder. Chronic psychosis is a rarely seen condition. In this report, a case with chronic (interictal) psychosis and comorbid phenomenon of forced normalization has been presented. Copyright © 2010 by Türkiye Klinikleri.

The definition of neuroacanthocytosis syndromes is used to describe a group of diseases, which is characterized by acanthocytosis and neurological abnormalities. Neuroacanthocytosis syndromes are progressive, degenerative and genetically heterogeneous diseases that generally begin at the 3rd or 4th decade of life. Age at onset, clinical and laboratory findings, family history, neurological and systemic involvement, and treatment options differ according to the subtypes. The treatment of neuroacanthocytosis syndromes is totally symptomatic and pharmacotherapy and surgery are used. In the literature, half of the neuroacanthocytosis cases are accompanied by vague psychiatric symptoms as beginning signs or full-blown psychiatric symptoms during the course of the disease. In this case series, we present three patients who displayed different psychiatric aspects in a short period of 6 months and were diagnosed with neuroacanthocytosis after thorough investigations in our psychiatry clinic. Common features and differential characteristics of the cases are discussed in the light of relevant literature. © Archives of Neuropsychiatry, published by Galenos Publishing.

Objective: The aim of this study was to assess knowledge, views, and behaviour of psychiatrists on authorship, to determine the authorship problems experienced, and to evaluate their views on which contributions to research merit authorships and their perceptions about gift authorship and strategies for preventing it. Methods: A total of 87 academic psychiatrists and psychiatry specialists in Turkey participated in this study. A questionnaire form consisting of 36 questions, developed by the researchers and based on previous studies, was sent to all participants via e-mail. The returned forms have been evaluated for this study. Results: Gift authorship was considered unethical by all participants, and 42 (48%) of participants experienced authorship problems. Conceiving the research idea, designing the study, collecting data, providing statistical analysis, interpretation of statistical data, drafting the article or revising it critically were assumed to be enough to merit authorship. 81 (93.1%) of participants perceived gift authorship as a common problem promoted by pressure to publish and enhancing the chances of publication. The respondents suggested that requiring researchers to sign a statement justifying authorship and to specify the actual contribution of each author were effective strategies for reducing/preventing gift authorship. Conclusion: Authorship problems are common and gift authorship was perceived as unethical by academic psychiatrists and psychiatry specialists. There is a need for tight control as well as more comprehensive research studies and extensive education on authorship ethics. © Archives of Neuropsychiatry, published by Galenos Publishing.

The Psychopathology in Patients with Chronic Renal Failure Treated with HemodialysisIn the present study, we propose to assess anxiety, depression and other psychopathologies commonly observed in patients with chronic renal failure whom were treated primarily through dialysis by comparing with chronic renal failure patients who were treated with treatment modalities (like drug, diets) other Uran dialysis. Study group included 40 dialysands between 15-65 years of age, and control group included 40 patients with chronic renal failure who were treated conservatively and did not require dialysis at the time of study. Both groups did not differ from each oilier in age and sex distribution. Beck Depression Inventory(BDI), State and Trait Anxiety Inventory (STAI), Symptom Check List (SCL-90-R), Toronto Alexitlrymia Scale (TAS), and sociodemographic data form were administered to all subjects. All scales were applied to dialysands during hemodialysis or just after. There were no statistically significant differences between conservative and dialysis group in mean scores of SCL-90-R general index and sub scales scores, BDI, STAI, and TAS scores. Nevertheless, an important finding obtained in this study was that the increase in behavioral changes observed in patients were in harmony with the increase in the length of time passed from the beginning of entering dialysis. That is why, we believed that patients who reported or were observed to have significant behavioral changes should be evaluated carefully in terms of psychopathology. Detailed mental examination is warranted.Bu çalışmada hemodiyalize giren kronik böbrek yetmezlikli hastalarda görülen anksiyete. depresyon ve diğer psikopatolojilerin, hemodiyalize girmeyen tedavisi diyaliz dışı kon-servatif yöntemlerle sürdürülen (ilaç, diyet v.b.) kronik böbrek yetmezliği olan hastalarla karşılaştırılarak değerlendirilmesi amaçlanmıştır. Çalışma grubu olarak kronik böbrek hastalığı olup düzenli hemodiyalize giren 15-65 yaşları arasındaki 40 hasta, kontrol grubu olarak ise henüz diyalize girmemiş olan ve konservatif olarak tedavileri sürdürülen kronik böbrek hastalarından yaş ve cinsiyet olarak çalışma grubu ile uyumlu 40 hasta alınmıştır. Tüm hastalara Beck depresyon ölçeği (BDÖ), durumluk ve sürekli anksiyete ölçeği (DSAÖ) , SCL-90-R ruhsal belirti tarama listesi, Toronto aleksitimi ölçeği (TAÖ). ve sosyodemografik veri formu verilerek psikopatoloji düzeyleri incelenmiştir. Konservatif tedavi grubu ile diyalize girenler arasında SCL-90-R genel puanı ve tüm alt ölçeklerde, BDÖ, DSAÖ, ve TAÖ ortalama puanları yönünden istatistiksel açıdan anlamlı bir farklılık olmadığı belirlenmiştir. Bununla birlikte, elde edilen bir diğer önemli bulgu diyalize başlanmasından itibaren geçen toplam sürenin uzamasına paralel olarak hastalardaki davranış değişikliklerinin artmasıdır. Diyaliz grubunda davranış değişikliği bildiren hastalar, hemen hemen tüm ölçeklerde davranış değişikliği bildirmeyenlere oranla daha yüksek puan almışlardır. Bu nedenle, davranış değişikliği gözlenen ya da bildiren hastaların psikopatoloji yönünden daha ayrıntılı değerlendirilmesi ve yakından izlenmesinin gerektiği düşünülmüştür.

Schizophrenia has influenced approximately 1% of the general population. If the schizophrenia spectrum disorders (schizoid personality disorder, schizotypal personality disorder, schizoaffective disorder and paranoid disorder) have been included, this rate would increase to 5%. Psychiatric disorders, sun light deficiency, inadequate exercise, smoking and polidipsia are predisposing factors for decreased bone mineral density and disruption in bone metabolism of patients with schizophrenia and schizoaffective disorders. The effects of antipsychotic drugs on bone metabolism are closely associated with hyperprolactinemia and hypogonadal states. Although in this group of patients hyperprolactinemia is seen commonly, bone metabolism disorders are not investigated and not included among routine procedures. That way they are usually missed out of sight. Recently, interest on bone metabolism disorders increase. Patients with bone metabolism disorder should be acknowledged that they must add calcium and vitamin D supplements to diet; regularly lose weight, do exercise, avoid cigarette, caffeine and alcohol; benefit good enough of sunshine. Using antipsychotics with no effect on prolactine levels, hormone replacement therapy and biophosphonate supplement is recommended for the treatment of this situation.

19th World Congress of Neurology -- OCT 24-30, 2009 -- Bangkok, THAILAND WOS: 000272521300591 …

Objective: Impulsivity as an important component in the initiation of behavior plays a central role in the pathogenesis of mood disorders, particularly bipolar disorder. The association between bipolar disorder and impulsivity has been clearly presented; however, there are still contradictory findings about the presence of impulsivity in bipolar patients during inter-episodic periods and whether it presents a risk factor for the development of multiple mood episodes (depressive, manic or mixed). The aim of this study was to assess the presence of impulsivity and the relationship with impulsivity-related characteristics in patients with bipolar disorder. Methods: The study was carried out in the Psychiatry Clinics of Çukurova University Faculty of Medicine and Erenköy Training and Research Hospital for Psychiatric and Neurological Diseases. All consecutive patients gave written informed consent. The study group was composed of 60 consecutive bipolar disorder patients (29 female, 31 male) whereas the healthy control group consisted of 60 subjects (32 female, 28 male). The subjects were evaluated by using the Turkish version of the Barratt Impulsivity Scale-11 (BIS-11), Eysenck Personality Questionnaire Revised-Abbreviated Form (EPQR-A), Aggressions Questionnaire (AQ), Spielberger State-Trait Anger Expression Inventory (STAXI) and sociodemographic data form. Results: The two groups were similar to each other in means of gender ratio, age, marital and economical status except for education period. In the bipolar disorder group, the scores of impulsivity, aggression, dimensions of personality and anger were significantly higher than other groups. Correlations between scores of all scales were also significant. Conclusion: The present findings suggest that patients with bipolar disorder still present impulsive traits in interepisodic remission period. There were also significant correlations between impulsivity and other related-characteristics like aggression and anger.