Behice Han Almis

The neuropsychological and neurophysiological profile of women with pseudoseizure

OBJECTIVE Our aim in this study was to compare the assessments of neuropsychological tests and the p50 neurophysiological test of patients with seizure diagnosed as conversion disorder and healthy control subjects, and to investigate the neurological status in conversion disorder with pseudoseizure. METHODS A total of 22 female conversion disorder patients with convulsions diagnosed according to SCID-I/CV and 22 healthy women were included in the assessment. The participants were administered WMS-R, the cancellation test, and the Stroop test as neuropsychological tests and p50 was assessed as a neurophysiological test. RESULTS The patients results for the neuropsychological tests were found to be significantly low compared to the control group. The p50 sensory gating ratios of the patient group were statistically significantly lower than the controls. There was no significant correlation between the neuropsychological test scores and gating ratios of the patient and control groups. CONCLUSIONS This study is the first to check sensory gating in conversion disorder patients with pseudoseizure and its most important result is finding reduced p50 sensory gating in patients. Our results suggest that these patients have a neurological tendency to this disease due to functional neurophysiological features.

Mean platelet volume level in patients with generalized anxiety disorder

ABSTRACT OBJECTIVE: Generalized anxiety disorder (GAD) is characterized by persistent and chronic anxiety state. Stressful life events and anxiety usually cause an increase in platelet volume and activity through various mechanisms. Mean platelet volume (MPV), which is indicative of platelet size, is accepted as an indication of platelet activity. METHOD: In this first retrospective cohort study about MPV among GAD patients, we compared complete blood count especially in terms of platelet count (PLT), platelet distribution width (PDW), plateletcrit (PCT) and MPV values of 60 GAD patients with 60 healthy controls. RESULTS: MPV was found to be significantly higher (p = .008) and platelet count was found to be significantly lower in the GAD group (p = .001). The area under the ROC curve (AUC) of MPV levels for GAD was 0.655 (95% CI: 0.557–0.754, p < .001). DISCUSSION: Increased MPV levels in GAD patients in our study supports the hypothesis of increased platelet activation due to sympathetic system activation. Also platelet levels were found to be significantly lower in GAD patients in our study. This finding is consistent with the non-linear inverse relation between platelet volume and platelet count. According to ROC curve analysis for differentiation of GAD from those in the control group, MPV would be considered to be a “poor” biochemical marker. We believe that further controlled prospective studies about this issue will be valuable.

Psychiatric disorders, developmental, and academic difficulties among children and adolescents at-risk for schizophrenia: a controlled study

ABSTRACT OBJECTIVE: The aim of this study was to determine whether there are differences in the presence of developmental delays, academic difficulties, and current mental disorders between offspring of parents with schizophrenia (High risk: HR) and offspring of parents with no mental illness (control group) up to the age of 16 years. The relationship of existing differences with psychosocial difficulties of having a parent with schizophrenia was evaluated. METHOD: The sample of the study consisted of 35 HR and 30 control offspring aged 7–16 years. All parents were assessed using the SCID-I by a psychiatrist and offspring using the K-SADS-PL by a child psychiatrist. Information about the early developmental stages and academic difficulties of children were obtained through interviews with healthy parents. Emotional and behavioural problem levels of children were determined by the Strengths and Difficulties Questionnaire (SDQ), Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV), the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Child Depression Inventory (CDI). All assessments were adjusted for socio-demographic variables. RESULTS: The rates of generalized anxiety disorders, delayed walking, delayed speech and reading difficulties, the levels of conduct problems (CP), depression, and school phobia were significantly higher in HR offspring than in control. When adjusted for socio-demographic variables, the presence of delayed speech and reading difficulties and only CP levels continued to be significantly higher in HR group (p < .05). These differences were not associated with gender of ill parent, duration of parental illness, and hospitalization in affected group (p > .05). CONCLUSION: Internalizing problems such as anxiety and depression are considered as a psychosocial result of having a schizophrenic parent. The higher rates of speech delay, reading difficulties, and CP level might be genetically associated with schizophrenia.

Hypertensive crisis after using zuclopenthixol decanoate: importance of starting oral formulations before starting depot antipsychotics

Zuclopenthixol decanoate depot is an effective and safe antipsychotic which is treatment choice particularly in non-compliant patients with schizophrenia. In this article, a case developing hypertensive crisis after zuclopenthixol decanoate depot is reported first time in the literature. As in other antipsychotics, risk of life threatening adverse effects does exist also after zuclopenthixol decanoate injection and since elimination of depot antipsychotics from the body may take weeks or months, clinicians should be aware of risk imposed by starting therapy directly by a depot antipsychotic.

Ketiyapin ile Birlikte Duloksetin Kullanan Hastada, Ketiyapin Doz Artırımı Sonrasında Gelişen Rabbit Sendromu

Fifty-ix years old, female patient who was being followed and treated for resistant depression, had been using duloxetine 60 mg/day and quetiapine 300mg/day for 3 months. After 2 weeks the quetiapine dose was increased to 600mg/day because of resistant depression concominant with insomnia. A movement disorder was observed, appearing as a rhythmic tremor in the perioral muscles which was defined by the patient as involuntary. This involuntary rhythmic perioral tremor was diagnosed as rabbit syndrome and for this reason quetiapine, the only antipsychotic used by the patient , was gradually decrease in dose and eventually stopped. Four weeks after stopping the quetiapine, the patient’s involuntary perioral rhythmic movements decreased from four to zero points, according to the lips and perioral subgroup of the Abnormal Involuntary Movements Scale (AIMS).