Çiçek Hocaoğlu

Sexual dysfunction in outpatients with schizophrenia in Turkey: a cross-sectional study

Background Sexual dysfunction is one of several factors related to medication compliance in patients taking antipsychotic medication but the magnitude of this problem is unknown. Aim Compare the self-reported sexual functioning of clinically stable patients with schizophrenia taking antipsychotic medication to that of healthy controls using the Turkish version of the 5-item Arizona Sexual Experience Scale (ASEX). This scale, which has previously been validated in Turkey, assesses 5 components of sexual function: sex drive, sexual arousal, vaginal lubrication/penile erection, ability to achieve orgasm, and satisfaction with orgasm. Methods The Scale for the Assessment of Positive Symptoms, the Scale for Assessment of Negative Symptoms, and ASEX were administered to 101 clinically stable outpatients with schizophrenia (38 females and 63 males). The ASEX was also administered to 89 control subjects (41 females and 48 males) without a history of mental illness. Respondents were classified as having sexual dysfunction if ASEX total score (range 5-30) >18, if any ASEX item score (range 1-6) ≥ 5, or if 3 or more ASEX items ≥4. Results Male patients with schizophrenia have significantly more self-reported sexual dysfunction than healthy controls (46% vs. 8%). The prevalence of sexual dysfunction is higher in female patients than in male patients (68% vs. 46%), but it was also very high in healthy female controls (68%), so the sexual dysfunction of female patients cannot be attributed to their illness or to the medications they are taking. Within the patient group, there was no significant relationship between the severity of positive or negative symptoms and the severity of sexual dysfunction, and the severity of sexual function was not different between patients taking first-generation or second-generation antipsychotic medications. Conclusions The very different findings by gender in Turkey highlights the importance of assessing location-specific and gender-specific sexual norms when trying to assess the role of mental illness and medications on sexual functioning. Prospective studies are needed to distinguish the relative importance of cultural norms, the schizophrenic illness, and the use of antipsychotic medication in the etiology and course of sexual dysfunction among individuals with schizophrenia.

Complementary and alternative medicine use in patients with mental disorders in Turkey

PURPOSE The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use and the associated socio-demographic factors among patients with mental disorders in the Turkish community. METHODS One thousand and twenty-seven patients with a diagnosis of mental disorders who were attending psychiatric outpatient clinics in five Turkish cities were interviewed. A survey questionnaire, which included questions on socio-demographic characteristics and CAM use, was administered face-to-face by psychiatrists. RESULTS 22.2% of patients with mental disorders were using some form of CAM in the Turkish community. CAM and medication concurrent users had a higher level of education and income compared to CAM users only or medicine users only (p < 0.001). The most common type of CAM used was herbal therapy (n = 146, 64%). CONCLUSION Use of CAM by patients with mental disorders should be investigated and taken into account by psychiatrists.

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.

Disability, psychiatric symptoms, and quality of life in infertile women: a cross-sectional study in Turkey.

Background Infertility is a major life crisis which can lead to the development of psychiatric symptoms and negative effects on the quality of life of affected couples, but the magnitude of the effects may vary depending on cultural expectations. Aim We compare the level of psychiatric symptoms, disability, and quality of life in fertile and infertile women in urban Turkey. Methods This cross-sectional study enrolled 100 married women being treated for infertility at the outpatient department of the Obstetrics and Gynecology Department of the Rize Education and Research Hospital and a control group of 100 fertile married women. All study participants were evaluated with a socio-demographic data screening form, the Hospital Anxiety and Depression Scale (HADS), the Brief Disability Questionnaire (BDQ), and the Short Form Health Survey (SF-36). Results The mean anxiety subscale score and depression subscale score of HADS were slightly higher in the infertile group than in controls, but the differences were not statistically significant. The proportion of subjects with clinically significant anxiety (i.e., anxiety subscale score of HADS ≥11) was significantly higher in infertile women than in fertile women (31% v. 17%, χ2=5.37, p=0.020), but the proportion with clinically significant depressive symptoms (i.e., depression subscale score of HADS >8) was not significantly different (43% v. 33%, χ2=2.12, p=0.145). Self-reported disability over the prior month was significantly worse in the infertile group than in the controls, and 4 of the 8 subscales of the SF-36 - general health, vitality, social functioning, and mental health - were significantly worse in the infertile group. Compared to infertile women who were currently working, infertile women who were not currently working reported less severe depression and anxiety and better general health, vitality, and mental health. Conclusions Married women from urban Turkey seeking treatment for infertility do not have significantly more severe depressive symptoms than fertile married controls, but they do report greater physical and psychological disability and a poorer quality of life. The negative effects of infertility were more severe in infertile women who were employed than in those who were not employed. Larger follow-up studies are needed to assess the reasons for the differences between these results and those reported in western countries which usually report a higher prevalence of depression and anxiety in infertile patients.

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.

A little known topic misophonia: two case reports

A little known topic misophonia: two case reports Misophonia is defined as hate of sound. It is characterized with intense emotional reactions like anger, anxiety, or disgust to and avoidance behavior from special sounds such as mouth sounds while eating or chewing gum, nasal sounds like breathing, smelling or blowing or some other sounds done with fingers like playing with a pen, writing or drumming on the table, especially, made by other people. Misophonia has never been present in any of the psychiatric classification systems. Some authors suggest that misophonia should be regarded as a new mental disorder. There is limited information about misophonia. Only few cases of misophonia have been reported. The causes of misophonia, risk factors, the relationship between mental disorders and treatment of misophonia are not fully known. Misophonia is a recently described, poorly understood and neglected condition. Future studies will focus on investigating the epidemiology, phenomenology, neurophysiology, and treatment of the misophonia. Two cases of women who had complaints of misophonia are presented in this study. Principles of diagnosis and treatment in this kind of patients are discussed in our case report.

Living with bulimia nervosa: a case report -

Eating disorders are characterized by the deterioration of eating behavior in various ways due to biological, psychological, familial, and socio-cultural factors. The prevalence of eating disorders is reported around 1% for anorexia nervosa (AN), 2-4% for bulimia nervosa (BN), and 3-4% for binge eating disorder (BED) in Western societies. The increasing of frequency in eating disorders is thought to be associated with cultural changes, increasing assimilation of Western culture and industrialization, weakening of family relations, and diminishing of social support. This increase in prevalence appeals more academic interest to this topic. BN is a life-threatening disorder that is characterized by recurrent binge eating episodes followed by self-induced vomiting or other compensatory methods (e.g., abuse of laxatives, diuretics, or excessive exercise) to prevent weight gain. The disorder is more common in women and average age of onset of BN in women is reported to be earlier than men (15-18 years). In this case report, we discuss a 46-year-old woman with the recurrent binge eating episodes followed by self- induced vomiting for 27 years, in the framework of her background and medical history, and dynamic theories of psychiatry.

Bulimia Nervosa in Males: A Case Report

Bulimia nervosa in males: a case report Bulimia nervosa (BN) is a severe, life-threatening eating disorder characterized by recurrent episodes of binge eating followed by self-induced vomiting or other purging methods (e.g., laxatives, diuretics, excessive exercise) to prevent weight gain. BN is rare in men compared to women. Etiology, treatment and information on the clinical appearance are limited in males patients with BN. A 23-year-old man with BN is discussed under the influence of his psychiatric illness and his childhood history in the light of the literature examining. In this study, general characteristics and treatment of BN in males are presented, emphasizing different features between genders.