Ebru Altintas

Factors Associated with Depression in Obsessive-Compulsive Disorder: A Cross-Sectional Study

INTRODUCTION Major depressive disorder (MDD) is the most frequent comorbid psychiatric condition associated with obsessive-compulsive disorder (OCD). This study aimed to evaluate the prevalence of current depression in OCD, differences in socio-demographic and clinical characteristics, and obsessive-compulsive symptoms between OCD patients with and without depression. Additionally, factors associated with comorbid depression were investigated in our study. METHODS In total, 140 OCD patients, of which 63 were OCD patients with MDD (OCD+MDD, n=63) and 77 were OCD patients without depression (OCD-MDD, n=77) were included in the study. All patients were diagnosed with OCD using the Structured Clinical Interview for DSM-IV. The Yale-Brown Obsessive-Compulsive Scale, Beck Anxiety Scale, and Beck Depression Scale were administered to all patients. After the socio-demographic and clinical variables and scales were accomplished, the OCD patients divided into two groups as OCD with or without depression and we compared their mean scores of the variables and scales. Univariate analyses were followed by logistic regression. RESULTS There were no significant differences in age, gender, marital status, period without treatment, profession, medical and family history, and social support between the two groups. Anxiety, depression, and obsession and compulsion scores were significantly higher in the OCD+MDD group. The avoidance, insight, instability, and retardation scores of the OCD+MDD group were also significantly higher than those of the OCD-MDD group. CONCLUSION Our study suggests that many factors are strongly associated with depression in OCD. Positive correlations between poor insight, severity of obsession and compulsion, and stressful life events during the last six months increased the risk of depression in OCD. Our study suggests that high level of avoidance, instability and retardation, history of suicidal attempt, and delayed treatment are other notable factors associated with the development of depression in OCD.

Social Anxiety Level in Adult Patients With Epilepsy and Their First-Degree Cohabiting Relatives

Epilepsy affects not only the patient but also the patients cohabiting relatives, to various degrees. This study investigated state and trait anxiety, depression, and social fear and avoidance levels in 48 adult patients with epilepsy and 48 family members, compared with 43 healthy control subjects, using the Beck Anxiety Inventory, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Liebowitz Social Anxiety Scale. The results suggested that the patients and their first-degree relatives had higher levels of depression, state and trait anxiety, and avoidance compared with healthy subjects. The mothers of patients with epilepsy had the highest level of depression and anxiety.

Migraine and associated comorbidities are three times more frequent in children with ADHD and their mothers

OBJECTIVE Attention deficit and hyperactivity disorder (ADHD) is a neuro-developmental disorder related to internalizing and externalizing disorders as well as somatic complaints and disorders. This study was conducted to evaluate the prevalence of headache subtypes, epilepsy, atopic disorders, motion sickness and recurrent abdominal pain among children and adolescents with ADHD and their parents. METHODS In a multi-center, cross-sectional, familial association study using case-control design, treatment naïve children and adolescents between 6 and 18 years of age diagnosed with ADHD according to the DSM-5 criteria as well as age- and gender-matched healthy controls and their parents were evaluated by a neurologist and analyzed accordingly. RESULTS 117 children and adolescents with ADHD and 111 controls were included. Headache disorder diagnosis was common for both patients and healthy controls (59.0% vs. 37.8%), with a significantly elevated rate in the ADHD group (p = 0.002). Migraine was found in 26.0% of ADHD patients and 9.9% of healthy controls. Tension headache was found in 32.4% of ADHD patients and 27.9% of healthy controls. Headache diagnosis was also found to be significantly more common in mothers of children with ADHD than control group mothers (90.5% vs. 36.6%, p < 0.001). CONCLUSION Headache diagnoses and specifically migraines were significantly more common among children with ADHD and their mothers, while recurrent abdominal pain was elevated in both parents and ADHD patients. Migraine is an important part of ADHD comorbidity, not only for children but also for mothers. Motion sickness may be reduced among families of ADHD probands.

Evaluation of Relationship Between Childhood Maltreatment and Medication Overuse Headache

INTRODUCTION We aimed to evaluate the prevalence and relationship between childhood maltreatment (CMT) among patients with medication overuse headache (MOH) and to investigate whether CMT is associated with medication overuse in patients having headaches or with headaches that become chronic. Epidemiological studies report a relationship between childhood abuse and headache. There is growing knowledge about the evidence that childhood maltreatment leads to neurobiological sequel. Medication overuse is the most important problem for migraine to become chronic. But in the literature, there was no information about the role of childhood abuse in MOH and for migraine to become chronic. METHODS A total of 116 patients with headache, aged from 15 to 65 years, were included in the study. Patients having chronic migraine (CM), MOH and episodic migraine (EM) were selected out of patients presented to the headache outpatient clinic. Types of headache were determined according to the revised International Headache Society (IHS) criteria published in 2004. The Childhood Trauma Questionnaire, Beck Depression Inventory and Beck Anxiety Inventory were performed. Presence of psychiatric co-morbidities was evaluated by a clinician using Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, the Fourth Edition. RESULTS A total of 116 patients with headache were included in the study. Of patients, 64 had MOH, 25 had CM and 27 had EM. The prevalence of CMT, particularly emotional neglect (62%), physical neglect (44%) and emotional abuse (36.2%), was determined higher in all headache groups. There was no statistically significant difference in prevalence of childhood maltreatment between MOH, CM and EM groups. No statistically significant difference was detected between educational status, psychiatric co-morbidities and childhood trauma, except for physical neglect. CONCLUSION Childhood maltreatment was observed in MOH as in other forms of migraine and headache. However, no significant difference was observed between the three groups of patients with headache.

Developmental delays and psychiatric diagnoses are elevated in offspring staying in prisons with their mothers

The aim of the study was to describe the sociodemographic and clinical features of the mothers and their offspring staying with them in prison. The study was planned as a cross-sectional, single-center study of mothers residing in Tarsus Closed Women’s Prison of Turkish Ministry of Justice along with their 0 to 6 years old offspring. Mothers were evaluated via Structured Clinical Interview for DSM-IV Axis I Disorders. A psychologist blind to maternal evaluations applied the Denver Developmental Screening Test II (DII-DST). Children/mothers were also evaluated by a child and adolescent psychiatrist via K-SADS-PL. Twenty-four mothers with a mean age of 29.3 years were included. Most common diagnoses in mothers were nicotine abuse (n = 17, 70.8%), specific phobia (n = 8, 33.3%), alcohol abuse (n = 7, 29.2%) and substance abuse (n = 5, 20.8%). Twenty-six children (53.9% female) were living with their mothers in prison, and the mean age of those was 26.3 months. Results of the D-II-DST were abnormal in 33.3% of the children. Most common diagnoses in children were adjustment disorder (n = 7, 26.9%) separation anxiety disorder (n = 3, 11.5%) and conduct disorder (n = 2, 7.7%). A multi-center study is necessary to reach that neglected/under-served population and address the inter-generational transmission of abuse, neglect, and psychopathology.

Munchausen Hemoptizi: Nadir Görülen Bir Yapay Bozukluk Çeşidi

Munchausen Hemoptysis: A Rare Type of Factitious Disorder Munchausen Syndrome defined by Asher in 1951 is named after fictitious Baron Karl FriedrichVon Munchausen.This syndrome is characterized by constituting diseases, pathological lying, and visiting healt care units many times with many hospitalizations. These patients seek attention of healthworkers pretending to be sick when in fact they are not. They try to obtain the care and intimacy from health professionals, which they don’t feel they have in daily life They can have the support of physicians because they generally have medical information to a degree to define symptoms. Their medical history is generally full of hard to believe tales. The presented case was a 27-year-old female with three children. She attended the outpatient clinic with complaint of hemoptysis but investigations proved that she created the condition herself by traumatizing her oral mucosa. The etiology of this syndrome which is not fully understood, as well as strategies for differential dignosis is discussed and highlights for management of such patients are underlined in the article Keywords: Factitiousdisorder, Munchausen, hemoptysis Munchausen Hemoptizi: Nadir Gorulen Bir Yapay Bozukluk Cesidi Munchausen Sendromu, adini Baron Karl Friedrich Von Munchausen’dan alan ve Asher tarafindan 1951 yilinda tanimlanan bir bozukluktur. Bu sendrom, hastalik olusturma, patolojik yalan soyleme, saglik kuruluslarina cok kez ziyarette bulunma ve sik hastaneye yatma oykusu ile karakterize bir durumdur. Bu kisiler hasta olmadiklari halde, hasta taklidi yaparak gunluk hayatta goremediklerine inandiklari ilgiyi, doktor, hemsire ve diger gorevlilerde bulmaya calisirlar. Kismen tip bilgileri de oldugu icin, saglik calisanlarini inandiracak kadar belirti tarif edip amaclarina ulasabilirler. Hastalarin tibbi ozgecmisleri cogunlukla inanilmasi cok guc oykuler ile doludur. Sunulan vaka, 27 yasinda evli ve 3 cocuklu bir kadindi. Agizdan kan gelmesi yakinmasi ile basvurmus, ancak yapilan incelemeler sonucu bu durumu hastanin kendisinin agiz mukozasini travmatize ederek yarattigi belirlenmisti. Makalede, bu sendromun tam olarak bilinmeyen etiyolojisinin tartisilmasinin yani sira, ayirici tanida akla gelmesi gereken durumlar gozden gecirilmis ve bu hastalarin takibinde onemli oldugu dusunulen noktalarin alti cizilmistir. Anahtar Kelimeler: Yapay Bozukluk, Munchausen, hemoptizi