Emrah Songur

Duration of the depressive episode is correlated with ganglion cell inner plexifrom layer and nasal retinal fiber layer thicknesses: Optical coherence tomography findings in major depression

Optical coherence tomography (OCT) is a relatively new, noninvasive imaging technique that has been used increasingly to diagnose and manage a variety of retinal diseases. Since the axons in retinal nerve fiber layer (RNFL) are nonmyelinated within the retina, OCT has been used in various neurodegenerative diseases to visualize the process of neurodegeneration. Decreases in RNFL and ganglion cell inner plexiform layer (GCIPL) thicknesses were observed in patients with schizophrenia. To date, there is no clinical research investigating OCT parameters in patients with MD. We compared the RNFL thickness, GCIPL thickness in 58 MD patients and 57 healthy controls, and investigated their correlation with clinical variables of depression. Depressed patients were not different from the healthy controls with regard to OCT parameters. GCIPL and nasal RNFL were correlated with the duration of the latest depressive episode. Some measures of OCT were negatively associated with clinical variables like a family history of psychiatric diagnosis and the duration of the latest episode. Larger studies including depressed patients of different severity, including structured interviews and controlling for the effect of antidepressant treatment will provide better results.

Simple markers for subclinical inflammation in the different phases of bipolar affective disorder

Recently, a growing number of publications have suggested that the immune-inflammatory system may be involved in the etiology of bipolar disorder (BD). Objective: The aim of this study was to investigate neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red cell distribution width (RDW) in the three different phases of BD patients compared to each other and controls. Methods: One hundred eighty-seven bipolar patients (78 euthymic, 53 manic/hypomanic and 56 depressed), and 62 age and sex matched controls were enrolled. Sociodemographic variables and complete blood count parameters of the patients and the control group were recorded. Results: The groups did not differ from each other on the hematological parameters, except for NLR and RDW. Post-hoc analyses revealed that NLR values were significantly higher in the euthymic and manic/hypomanic bipolar groups compared to control group. In addition, post-hoc analyses revealed that RDW values were significantly higher in the manic/hypomanic bipolar group relative to the control group. Discussion: Longitudinal studies evaluating the levels of inflammatory markers in the early phases of the disorder, and their relationship with the development of different episodes and medical comorbidities may be useful to understand the role of inflammation in BD

Analysis of the psychiatric consultations for inpatients and from the emergency room in a university hospital: A comparison with studies from Turkey (tur)

Burcu Eser1, Sedat Batmaz2, Emrah Songur3, Mesut Yýldýz4, Esma Akpýnar Aslan5 1Dr., 2Doç.Dr., 5Dr. Öðr. Üyesi, Gaziosmanpaþa Üniversitesi, Týp Fakültesi, Ruh Saðlýðý ve Hastalýklarý Anabilim Dalý, Tokat, Türkiye 3Uzm.Dr., Saðlýk Bilimleri Üniversitesi, Keçiören Eðitim ve Araþtýrma Hastanesi, Psikiyatri Kliniði, Ankara, Türkiye 4Dr. Öðr. Üyesi,Marmara Üniversitesi, Týp Fakültesi, Ruh Saðlýðý ve Hastalýklarý Anabilim Dalý, Ýstanbul, Türkiye

Psychopharmacological treatment differences in autogenous and reactive obsessions: A retrospective chart review

Background: Identification of homogeneous subgroups of obsessive compulsive disorder (OCD) patients may have important implications for improving effective treatment options. It has been proposed that obsessive thoughts can be classified into two subtypes, i.e. autogenous and reactive obsessions. Although it has been shown that patients with autogenous obsessions may display a worse response to treatment, no studies have yet addressed whether there is a different need for the psychopharmacological treatment options in the subtypes of OCD patients. Aim: To investigate the clinical characteristics and treatment differences between autogenous (A-OCD) and reactive (R-OCD) subtypes of OCD patients. Methods: Both OCD subgroups (n = 50 for A-OCD, n = 130 for R-OCD) were compared with each other in terms of their demographic and clinical parameters. Odds ratio values for gender, treatment options, co-morbidity, severity of OCD, and response to treatment were computed. Multivariate hierarchical regression analyses were performed to identify any predictors for treatment options, severity of OCD, and response to treatment. Results: Our results indicated that the A-OCD and R-OCD groups differed from each other on some demographic and clinical variables in addition to their psychopharmacological treatment needs. Patients in the A-OCD group were found to be prescribed an atypical antipsychotic 2.3 times more likely than the R-OCD group. The odds for a combination treatment, or the improvement of OCD symptoms from baseline levels did not differ between the two subtypes of obsession groups. Conclusions: Autogenous and reactive subtypes of obsessions may need to be offered different psychopharmacological treatment options.

Expressed emotion in panic disorder: Relationship with demographic and clinical variables and quality of life

Objective: Expressed emotion (EE) predicts the outcome of treatment in patients with anxiety disorders. We aimed to investigate the relationship between EE and demographic and clinical characteristics of patients with panic disorder (PD), to determine whether there is a difference between PD, major depressive disorder (MDD) patients and healthy controls (HC) in terms of EE and to investigate the effect of EE on quality of life (QOL) in patients with PD. Methods: Our study involved a total of 150 participants (50 patients in each group). All participants were given the Level of Expressed Emotion (LEE) scale and the short-form health survey (SF)-36 . Furthermore, the EE scale was completed by the participant’s key relatives. Results: EE was associated with some sociodemographic and clinical variables in patients with PD. There was no significant difference between PD and MDD and between PD and HC in terms of the LEE and the EE and their subscale scores. It was also demonstrated that EE had no effect on the QOL in patients with PD. Conclusion: EE was not different in PD compared to MDD and HC. Additionally, EE was not related to QOL in PD.

Gastrointestinal symptoms in psychiatry: comparison of direct applications and referrals

Objective: Clinical experience and observations suggest that there are some discrepancies between patients who directly apply to psychiatry clinic, and who are referred from gastroenterology clinic to psychiatry clinic. Thus, we aimed to investigate differences related to the demographic and clinical characteristics of these patients. Method: The study included 115 consecutive patients aged between 18-65 years. Sixty-one of the patients applied directly to the psychiatry clinic, and 54 patients were referred for consultation to the psychiatry clinic. Primary gastrointestinal complaints, psychiatric diagnoses and personality features were recorded on the scoiodemographic data form, and the severity of psychiatric disorders were assessed by the Clinical Global Impression Scale - Severity Subscale. Results: Patients who directly applied to psychiatry clinic were more likely to be female, older, and married. They attributed their gastrointestinal symptoms also more likely to be of psychogenic origin. Patients who directly applied to psychiatry clinic suffered more likely from a sense of fullness/abdominal tension, while patients who were referred to psychiatry clinic more frequently complained of bloating, abdominal pain, and constipation. Patients who directly applied to psychiatry clinic were more frequently diagnosed with depressive disorders, trauma related disorders, and personality disorders, whereas referrals were more frequently diagnosed with psychotic disorders. Directly admitted patients were also more likely to exhibit impulsivity as a personality feature. Conclusion: Patients with gastrointestinal symptoms who directly presented to psychiatry differed from those who were referred from gastroenterology clinics on some of their demographic aspects, primary psychiatric diagnoses and personality traits.

Depression, Anxiety Levels and Quality of Life in Patients with Seborrheic Dermatitis

Objective: In this study, we aimed to determine the risk of depression and anxiety levels of seborrheic dermatitis (SD) and effect of illness on quality of life. Methods: We conduct this study among patients referred to dermatology outpatient clinic in our hospital. Patients diagnosed with SD according to medical history and dermatological examination were included in the study. After recording sociodemographic information such as age, gender, education level and their clinical features of SD, Hospital anxiety and depression scale (HAD) and Short form-36 (SF-36) were administered to patients. Results: We enrolled 50 patients in the study (27 females and 23 males). It was determined that 32% of patients were at risk for anxiety while 34% were at risk for depression. Deterioration in all fields, foremost emotional role functioning and social functioning, were determined in SD patients. Conclusion: It was evaluated that depression and anxiety levels of SD patients were high and quality of life is impaired in patients with SD.