Ayse Koroglu

Risperidone-induced acromegaly: a case report.

Today, considering their adverse side effects, the first-generation antipsychotics have been replaced by the new-generation antipsychotics (also known as second-generation antipsychotic agents). The superiority of new-generation antipsychotics compared with first-generation antipsychotic agents in terms of side effects, especially movement disorders, are acknowledged by clinicians. But in recent years during the use of second-generation antipsychotic agents, endocrine side effects have been noteworthy. In our study with a diagnosis of paranoid schizophrenia treated with risperidone for 14 years and operated with the diagnosis of pituitary macroadenoma, a 32-year-old female patient is presented in the light of the literature examining the framework of the history of disease.

Oxidative status and prolidase activities in generalized anxiety disorder

OBJECTIVE Prolidase (Pro), an intracellular enzyme necessary for collagen turnover, matrix remodelling and cell growth has been shown to be related to Oxidative Stress (OS). To our knowledge, serum Pro activity in generalized anxiety disorder (GAD) has not been documented yet. In this study, we aimed to evaluate OS and its relation with Pro activity in patients diagnosed with GAD. METHOD Thirty untreated GAD patients and 30 healthy controls were included in the study. Blood samples were collected from all subjects to quantify total oxidant status (TOS), total antioxidant status (TAS) and Pro activity. Oxidative stress index (OSI), the ratio of TOS to TAS, is calculated to evaluate the balance between antioxidants and oxidants. Hamilton Anxiety Rating Scale (HARS) was used to determine the anxiety levels of all subjects. RESULTS GAD group demonstrated statistically significantly higher TOS, OSI and Pro levels, when compared with the control group (t=2.947, p=0.005; t=2.874, p=0.006; and t=9.396, p<0.001 respectively). HARS scores were found to be positively correlated with TOS, OSI and Pro levels (p=0.008, r=0.338; p=0.008, r=0.339; and p<0.001, r=0.751 respectively). CONCLUSION The degree of severity of OS is correlated with the levels of Pro. Thus, Pro might be the target enzyme, promising to be a marker for the follow-up of GAD patients. To the best of our knowledge, this study is the first to report a significant relation between Pro activity and GAD.

The role of obsessive beliefs in patients with major depressive disorder.

Abstract Aim. The aim of this study is to evaluate the differences in obsessional beliefs between patients with major depressive disorder (MDD) and matched healthy controls using the obsessive-beliefs questionnaire (OBQ). Methods. The study sample included 74 outpatients with MDD and 74 healthy subjects. The two groups were matched for age, gender, and education level. The diagnoses were based on the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV). The severity of depression was measured with the Hamilton Depression Rating Scale (HAM-D). All participants filled out the 44-item OBQ. Results. The total and subscale OBQ scores [Responsibility/Threat Estimation (RT), Perfectionism/Certainly (PC), and Importance/Control of Thoughts (ICT)], were significantly higher in patients with MDD than those of the control group. There was a positive correlation between HAM-D scores and the OBQ subscale scores (RT, PC, and ICT) in the patients. Conclusion. Obsessional beliefs appear to be related to MDD.

The evaluation of headache in patients with schizophrenia: a case-control study

Objective: The aim of this study is to explore the frequency and the types of headache in patients with schizophrenia and to compare it with the healthy control group. Method: A hundred and one patients and eighty nine healthy subjects were included in this case-control study. Socio-demographic data form, structured clinical interview for DSM disorders type 1 (SCID-1), Scale for the Assessment of the Negative Symptoms (SANS) and of the Positive Symptoms (SAPS) were applied. The subjects with headache were consulted to the neurology clinic. Results: The prevalence of headache in the patient group was 38.6% whereas the prevalence of headache in the control group was 37.1%. Tension type headache (TTH) was the most prominent type in both group (31.7% of patients, 18.0% of controls) and the presence of TTH in patients with schizophrenia was found statistically significant. Migraine type headache was detected in 2.0% of patients and 11.2% of controls. The ratio of headache was lesser in patients than in the controls. Conclusion: Schizophrenic patients have headache as much as the healthy subjects but they complain less about their headache than the controls do. Further studies with larger samples in patients with schizophrenia would present the importance of the issue and improve the quality of life in patients with schizophrenia contributing the analgesia.

Şizofrenide Aripiprazol Kullanımı ile İlişkili Mani : Bir Olgu Sunumu

Mania associated with aripiprazole treatment in schizophrenia: a case report Aripiprazole is a novel antipsychotic medication that is used to treat a number of psychiatric conditions, including schizophrenia, bipolar disorder, and major depressive disorder. Clinical trials have established its efficacy and favorable tolerability profile. Nevertheless, infrequent undesirable adverse events are often encountered during wide-scale everyday clinical use. There are a few mania/hypomania cases associated with second-generation antipsychotic treatment. Induction of mania, described for almost all secondgeneration antipsychotic, may be one of the rare adverse events of aripiprazole therapy. In this study, a female patient with chronic schizophrenia who had never presented history of mood episodes, in which manic symptoms developed after increasing aripiprazole dosage to 30mg/day and disappeared after cessation of the treatment was presented. During the second-generation antipsychotic use, clinicians should be cautious to patients’s mania/hypomania symptoms.

Childhood Age Epilepsy and Family

Epilepsy is a common neurological disorder in childhood. It is the most widely seen chronic neurological disease in the terms of childhood and affects both the child himself and the family because of its psychological and social results. Parents of children with epilepsy, like parents of children with many other chronic conditions, are faced with a constant feeling of uncertainty about their childs condition. Although the negative effect of epilepsy on patients psychosocial well-being has been increasingly documented in the last decade, the influence of the condition on the family has attracted much less interest. Studies indicate that epilepsy may cause high levels of psychosocial difficulties for all family members, including stigmatization, stress, psychiatric morbidity, marital problems, poor self esteem and restriction of social activities. For this reason, in case any one of the family members undergoes epilepsy, it should not be focused on just patient’s problems considering the other family members can affect this situation, preventive strategies that might protect all family members’ psychology should be developed. In this part, reviews the present state of family research, examining the influence of childhood epilepsy on the psychological and social well-being of family members.

Temporal lobe epilepsy and bipolar disorder: a case report -

Temporal lobe epilepsy is a neuropsychiatric condition that can present with many psychiatric symptoms. Patients suffering from temporal lobe epilepsy may experience many cognitive, emotional, and behavioral problems between episodes leading to a need for specificialized treatment. Psychiatric symptoms were seen in temporal lobe epileptic seizures more than other types of seizures. However, there are very limited data in the literature about manic stage symptoms in patients with temporal lobe epilepsy. In this report, we present a case with temporal lobe epilepsy and review of literature on the topic. The patient has been receieving treatment for 35 years and suffering from manic episodes that occurs after epileptic seizures forlast 10 years.

An evaluation of cases with delirium in a training hospital / Bir eğitim hastanesinde deliryumlu olguların değerlendirilmesi

An evaluation of cases with delirium in a training hospital Objective: Clinical practices have shown that delirium generally confers more risk in patients who receive treatment in internal medicine and surgery clinics, and particularly in the elderly with central nervous system insufficiency. We, therefore, intended to investigate the frequency of delirium patients and treatment approaches among patients who requested psychiatric consultation in our hospital. Method: This study was conducted through a retrospective assessment of database and consultation forms of psychiatric consultations performed. Consultation forms prepared by the Department of Psychiatry included questions about socio-demographic characteristics of the patients, their current medical diagnosis and treatment, objective of the consultation request, psychiatric history, mental examination findings, and diagnosis and treatment follow-up plan. All patients were evaluated for the development and persistence of delirium on a daily basis by psychiatry specialist with expertise in delirium assessment, using the Diagnostic Statistical Manual IV (DSM-IV) criteria of the American Psychiatric Association, the reference standard for delirium ratings. Results: During the study period (1 July 2009 to 30 June 2010), a total of 29410 patients were hospitalized in the Rize Training and Research Hospital. Within the same period, a psychiatric consultation was requested for 405 patients, among them, 106 diagnosed with delirium. Patients with delirium for whom psychiatric consultation was requested made only 0.36% of all hospitalized patients. Conclusions: 0.36% is a very low rate for delirium diagnosis, which is reportedly observed in 11 to 41% of the general hospital populations, and it may be said that psychiatric consultation requests for delirium are very limited. Our findings necessitate that consultation-liaison psychiatry should be made effective and a multidisciplinary treatment approach should be adopted in general hospitals as soon as possible.