Ahmet Bulent Yazici

Untreated depression in the first trimester of pregnancy leads to postpartum depression: high rates from a natural follow-up study

Background This is a natural follow-up study that presents the postpartum results of women who experienced depression during pregnancy. Methods This study involved 78 women diagnosed with depression in the first trimester of pregnancy. All patients were diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) in the first trimester and all were referred to a psychiatric center for treatment. Of the 78, 73 were contacted postpartum and reassessed by SCID-I. Treatment anamnesis was evaluated retrospectively. Results The women were divided into two groups at the postpartum evaluation according to anamnesis of psychiatric treatment. Twenty-one of the 73 (28.7%) had received treatment during pregnancy (treated group). Fifty-two women had not been treated (untreated group). In the treated group, no postpartum depression was determined (0%). In the untreated group, 92% (n=48) of women had a depressive disorder postpartum (P<0.01). In addition, scores regarding depression, functionality, and perceived social support were worse postpartum for the untreated group. Conclusion Untreated depression during pregnancy is an important predictor of postpartum depression. This natural follow-up study is important because it presents very striking rates of postpartum depression. Referral of patients with depression during pregnancy to psychiatric treatment should be provided and is strongly encouraged.

Temperament and character traits in patients with epilepsy: epileptic personality.

Abstract Personality and behavioral changes in epilepsy are well documented. However, neither the quantitative characteristics nor the etiology of these changes is clear yet. Cloninger has developed a psychobiological personality model that provides a way to evaluate personality in a dimensional way. This study examined the relationship between epilepsy and Cloninger’s dimensional psychobiological personality model. A total of 73 epilepsy outpatients and 79 healthy controls were examined using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I Disorders, the Turkish version of the Temperament and Character Inventory, and an epilepsy questionnaire. Epilepsy patients had higher harm avoidance (HA) and lower persistence, self-directedness (SD), and cooperativeness scores than healthy controls did. In epileptic subjects, there was no correlation between age and duration of epilepsy. Subjects with partial seizures had higher HA scores and lower SD scores than generalized ones. Comorbid depression was represented with lower SD scores. In multiple linear regression models, only major depressive disorder predicted lower scores of SD. This study confirms specific personality changes among epileptics according to Cloninger’s dimensional personality model and indicates a relationship between the characteristics of epilepsy and psychiatric comorbidity.

The Relationship between Temperament and Character Traits and Burnout among Nurses

Aim: A repeatedly asked question is why, under the same working conditions, one individual burns out, whereas another shows no symptoms at all. We sought to address this among nurses, who are considered to be particularly susceptible to the danger of burnout due to the nature of their work. Methods: This study was carried out with 108 randomly selected nurses working at Derince Training and Research Hospital. The Maslach burnout inventory and temperament character inventory were applied. Results: Novelty seeking (NS) and harm avoidance (HA) scores showed a positive correlation with high burnout level; a negative correlation was shown with persistence (P), self-directedness (SD), and cooperation (C). According to the regression analysis performed in order to assess whether personality characteristics are predictive of burnout levels, Novelty Seeking and HA were positive predictors, while C was a negative predictor of total burnout levels. Conclusion: This study showed that there is a relationship between the temperament and character traits and burnout. While analyzing the structure of healthcare provider systems, individual specific evaluations and development of personality traits that are protective against individual burnout should be put on the agenda.

Temperament and Character Traits of Parents of Children With ADHD.

Objective: This study investigates the relationship between ADHD and the personalities of parents of children with ADHD. Method: Personality traits of parents of children with ADHD (study group; n = 135) and parents of children without ADHD (control group; n = 122) were compared. Psychiatric comorbidities were excluded with Structured Clinical Interview for DSM-IV Axis I Disorders, Clinical Version [SCID-I-CV]. Personality is assessed with Temperament and Character Inventory, and inattention (IA) and hyperactivity (HI) are assessed with Turgay Scale. Results: Harm avoidance and persistence scores were higher, and self-directedness (SD) scores were lower in the study group than the control group. Being in ADHD group predicted lower SD scores. Positive correlations were found between harm avoidance and IA and HI, and between persistence and HI. Negative correlations were found between SD and both IA and HI. Conclusion: Our data suggest that there is relationship between ADHD in children’s and parents’ personalities. Common etiologic properties and personalized psychoeducation and treatment options for families should be discussed.

Smoking, alcohol, and substance use and rates of quitting during pregnancy: is it hard to quit?

Background Alcohol and substance use is a major health challenge in Turkey, as it is worldwide. Recently, there has been a rapid increase in the number of females using substances and although usage tends to reduce during pregnancy, it is of critical importance to determine its exact level as substance use negatively impacts on the health of both the mother and infant. Aim The aim of the present study was to investigate the frequency of smoking, alcohol, and substance use, and quitting rates during pregnancy. Method This study was conducted on pregnant females in Sakarya, Turkey. A total of 1,082 consecutively presenting females who agreed to participate in the study were evaluated. The study team prepared a sociodemographic data form and adapted the “Introduction” section, derived from the Addiction Profile Index, to cover substance use during pregnancy. Results The substances most frequently used by pregnant females in their previous pregnancies and current pregnancies were cigarettes/tobacco products (11% and 11.8%, respectively), alcohol (0.6% and 0.4%, respectively), and rarely, synthetic cannabinoids (0.3% and 0.2%, respectively). Daily tobacco smokers continued to smoke during pregnancy, with a rate of 42.5%. Based on research into predictors of smoking (cigarettes) in pregnancy, a correlation was found between lifetime smoking and smoking during a previous pregnancy. A similar link was found with respect to alcohol. Conclusion Cigarettes are the most frequently used substance in pregnancy, and to a lesser extent, alcohol and synthetic cannabinoids, also considered to be risky substances. A high incidence of smoking regularly during pregnancy was found in daily smokers. It is recommended that physicians should sensitively ask pregnant females presenting at clinics about all forms of substance use, including alcohol and synthetic cannabinoids, and to include such questions in their routine enquiries.

Addiction profile in probation practices in Turkey: 5-year data analysis.

Introduction While drug addiction is a global problem, it is important for every region to know the general features of its own addicts in order to develop effective treatment programs. This study presents sociodemographic data of the individuals diagnosed with drug addiction. Methods In this study, data of the patients between the years of 2009 and 2014 were retrospectively analyzed. The patients were assessed at psychiatry polyclinics according to probation practices of drug abuse. The study involved 513 patients in whom drug positivity was detected in urine analysis at least once and whose diagnoses were confirmed with a clinical interview. Results According to this study, a majority of the addicts were detected in 2013. Males made up 98.2% of the sample population, their average age was 32.12±10.21 years, and minimum and maximum ages for the first drug use were 7 years and 45 years, respectively. Marijuana use was found in 90.8% of the patients, 90% of them were living with their families, and 59.6% of them held a regular job. Treatment response was related with age of first use of drugs, duration of use drugs, and prior treatment anamnesis of the patients. Conclusion In this study, it was determined that the drug which was most frequently was used marijuana. The risk of drug addiction can affect any individual in society, regardless of their education, occupation, or social support levels. Alternative treatment models, especially for chronic and long-term users, should be researched.

Affective temperaments in pregnancy

Abstract Aim: There are many studies on the mood disorders that occur during pregnancy, but no studies that question how affective temperaments, which are the antecedents of the mood disorders, are influenced by pregnancy. This study aims to examine the affective temperaments in women without any psychiatric diagnoses during the pregnancy period. Method: The study included 100 pregnant women at the third trimester of their pregnancy (pregnant group) and 75 non-pregnant women (control group). Structured Clinical Interview for DSM Axis-I Disorders (SCID-I) was used for the evaluation of psychiatric disorders; Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A) was used for the evaluation of affective temperaments. Results: The cyclothymic, irritable and anxious temperament scores of the pregnant women were significantly lower than that of the non-pregnant women (p < 0.05). Pregnancy predicted lower scores of cyclothymic, irritable and anxious temperaments. Younger age and lower levels of education were predictors of higher cyclothymic, anxious and depressive temperament scores. Younger age also predicted higher irritable temperament scores. Conclusion: The third trimester of pregnancy is associated with significantly lower affective temperament. Future studies may help to understand the biological background of the present findings. Chinese abstract 有许多研究是关于发生在孕期的心境障碍，但没有研究是关于情感气质这个心境障碍的前期因素是如何受妊娠的影响的。本研究的目的是探讨无任何精神疾病的妊娠妇女的情感气质。这项研究包括100例妊娠晚期孕妇（妊娠组）和75例非妊娠妇女（对照组）。DSM轴-I障碍定式临床检查（SCID-I）用于精神疾病的评估；情感气质自评量表（TEMPS-A）用于情感气质的评估。孕妇的循环性、易怒和焦虑的气质评分显著低于非妊娠妇女（P＜0.05）。妊娠预测循环性、易怒和焦虑气质的低评分。年轻和低教育水平是循环性、焦虑和抑郁的较高评分的预测因子。年轻也是较高易怒评分预测因子。孕晚期与显着较低的情感气质相关。将来的研究可能有助于了解目前的研究结果的生物学背景。

Alterations of the hematologic cells in synthetic cannabinoid users

Functions, morphology, distributions, and index of the circulating cells are the most useful parameters that indicate various inflammatory and toxic conditions. The aim of this study was to investigate the clinical significance of these parameters in patients diagnosed with (synthetic) cannabis use disorder.

Use of movies for group therapy of psychiatric inpatients: theory and practice.

Abstract This paper reports on the use of cinema therapy at a psychiatry clinic for inpatients. The program, “Watching Cinema Group Therapy,” was used with over 500 inpatients over the course of one year. We found that using movies for group psychotherapy sessions encouraged the patients to talk about their beliefs, thoughts, and feelings while discussing the characters and stories. We also used the movies as a reward for patients who had developed a therapeutic alliance. It motivated the patients to be active instead of simply remaining in their rooms. As a follow-up to full-length films, it was more useful to show short scenes to patients who had been administered high doses of drugs. Movies can be an important, positive, and productive means of treatment and teaching.

Comparing ECT data of two different inpatient clinics: propofol or thiopental?

Abstract Objective. This study compares the data of (modified) electroconvulsive theraphy (ECT) applications from two different inpatient clinics in Turkey: Kocaeli Derince Training and Research Hospital (Clinic-I) and Kocaeli University (Clinic-II). Methods. Recorded files of patients from the two clinics were compared in terms of ECT indications, number and duration of seizures, and anesthetic agents used (propofol vs. thiopental). ECT applications occurring between January 2011 and January 2013 were included in the study. Results. A total of 86 patients (9.5% of the inpatients) received ECT in Clinic-I and 103 patients (21.1% of the inpatients) in Clinic-II during the period studied. The yearly ECT rate (treated person rate per 10,000 per year) was 0.59/10,000 for Kocaeli (Turkey) as a whole. The overall number of ECT applications was 539 in Clinic-I and 999 in Clinic-II, and the average number of ECT sessions for each patient was 6.4 ± 2.33 in Clinic-I and 9.69 ± 4.66 in Clinic-II. The majority of indications were depressive disorders and insufficient response to medicine. Patients in the clinic which utilized thiopental as the anesthetic agent experienced more cardiovascular and respiratory side effects than the one which used propofol. The number of ECT sessions required was greater for patients with schizoaffective disorder than for others. Conclusions. The administration of ECT was considered to be a reliable method of treatment in these clinics. With respect to specific anesthetic agents, propofol was found to have less hemodynamic side effects and shorter seizure durations than thiopental.