Erhan Kurt

Ghrelin and leptin levels in patients with obsessive–compulsive disorder

To examine the importance of ghrelin and leptin in the pathogenesis of obsessive-compulsive disorder (OCD), we measured serum ghrelin and leptin levels, lipid profile and body mass index (BMI) in 43 patients with OCD and 20 healthy controls. The patients were divided into two subgroups according to whether DSM-IV OCD was accompanied with major depressive disorder (MDD) (OCD+MDD) or not (OCD-MDD). There was no statistically significant difference in ghrelin and leptin levels between groups. The OCD+MDD group had a trend of higher ghrelin levels and lower leptin levels than the OCD-MDD and control groups. There was a negative correlation between change in serum ghrelin and leptin levels only in the OCD+MDD group. Neither ghrelin nor leptin showed any correlation with severity of MDD and OCD. In conclusion, our results suggest that OCD is not associated with leptin or ghrelin levels. More comprehensive and detailed studies are needed to decipher the exact role of ghrelin and leptin in OCD.

Phenomenology of Delusions and Hallucinations in Patients with Schizophrenia

ABSTRACTBackground: The aim of this study is to investigate the influence of living in different geographic regions of the same country on the phenomenology of schizophrenic delusions and hallucinations in two groups of schizophrenic patients.Methods: A total of 373 schizophrenic patients hospitalized in three different psychiatric hospitals in Turkey were recruited, and their delusions were classified by using the classification system developed by Huber and Gross. Patients were categorized with respect to regions in which they lived. Group 1 represented the Western region of Turkey, and group 2 represented the Central region of Turkey.Results: Delusions of persecution and reference were detected frequently in both genders and groups. Delusions of poisoning and erotomania were more prevalent in females than in males. The most frequent auditory hallucinations included hearing voices conversing and voices commenting. Seeing goblins was the most prevalent theme in visual hallucinations.Conclusions: The resu...

Report on 3 years' experience in electroconvulsive therapy in bakirkoy research and training hospital for psychiatric and neurological diseases: 2008-2010.

Objective We present our 3 years’ experience with electroconvulsive therapy (ECT) practice in Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases (BAKIRKOY) ECT Center after modification of ECT regulations in Turkey. Also included in this article is a brief overview and discussion on ECT applications. Methods Bakirkoy medical records in electronic database were examined retrospectively (between January 2008 and December 2010), focusing on several aspects of short-term use of ECT: patient’s age, sex, and diagnosis; mean number of treatments per patient; duration of stay in hospital; percentage of ECT use in hospitalized patients; and frequency and types of adverse events. Results A total of 3490 patients hospitalized for acute conditions (2138 men and 1352 women) were treated with ECT in a period of 3 years, with a total of 27,660 ECT treatments performed. The total number of psychiatric patients hospitalized for acute conditions was 24,310 (14,132 men and 10,178 women) during the same period. The ratio of ECT use among acute care hospitalizations was 1:6.97 (14.36%). The mean ± SD age of patients treated with ECT was 35.02 ± 11.29. The mean ± SD number of ECT sessions was 7.89 ± 2.86. Affective disorders (46.99%) and psychotic disorders (52.12%) were among the leading diagnoses. No deaths occurred during ECT sessions, and no severe adverse events were observed. Conclusion The percentage of patients treated with ECT in BAKIRKOY is similar to rates reported in most Asian countries, which is higher than those reported in Western psychiatric centers. Absence of any life-threatening adverse effect or death, and presence of relatively few adverse effects, may be considered as an indication of conformity to current guidelines.

Affective temperaments in patients with rheumatoid arthritis

The issue whether patients with rheumatoid arthritis (RA) have certain personality characteristics has been discussed. The temperament and personality characteristics of the patient may influence success in competing with stress. The aims of the study were to determine the most common dominant affective temperaments in patients with RA and whether temperament affects the disability.

Electrocardiography changes in bipolar patients during long-term lithium monotherapy

OBJECTIVE Cardiovascular side effects of lithium have been reported to occur mainly at higher-than-therapeutic serum levels. We aimed to investigate the impact of the long-term lithium use on electrocardiogram (ECG) parameters in association with the serum levels in patients with bipolar disorder (BD) and in healthy controls (HCs) serving as the reference group. METHODS The study sample consisted of 53 euthymic BD type I patients on lithium monotherapy at therapeutic serum levels (M = 0.76, S.D. = 0.14, range = 0.41-1.09 mmol/l) for at least 12 months and 45 HCs. A 12-lead surface ECG was obtained from all participants at resting state for at least half an hour for 5-min recording. Heart-rate, Pmax, Pmin, QRS interval, QT dispersion, QT dispersion ratio (QTdR) and Tpeak-to-end interval (TpTe) were measured. RESULTS Regression analyses revealed that QTdR (B = 14.17, P = .001), TpTe (B = 18.38, P < .001), Pmax (B = 17.84, P<.001) and Pmin (B = 25.10, P < .001) were increased in BD patients who were on chronic lithium treatment than in HCs after controlling for age, sex and strict Bonferroni correction for multiple testing. There were no associations between serum lithium levels and ECG parameters. CONCLUSION Our findings suggest that the use of lithium is associated with both atrial and ventricular electrical instability, even when lithium levels are in the therapeutic range.

Affective temperament in stroke patients

Objective: The aims of this study were to determine the dominant affective temperament changes in stroke survivors and whether temperament affects the disability. Methods: A total of 63 stroke patients were included in this study. Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire was used to determine the dominant affective temperament (depressive, hyperthymic, cyclothymic, irritable or anxious). The disability level was measured with the Barthel index (BI). Results: Depressive temperament (17.5%) and anxious temperament (12.7%) were the most common dominant affective temperaments. The frequencies of irritable, cyclothymic and hyperthymic temperaments were 4.8, 3.2 and 0%, respectively. The mean BI score was 78.1 ± 18.3 in patients with depressive temperament and 67.4 ± 28.4 in patients without depressive temperament (p = 0.403). The mean BI score was 78.1 ± 15.3 in patients with anxious temperament and 68.0 ± 28.3 in patients without anxious temperament (p = 0.541). Multiple linear regression analysis indicated that BI score was not associated with affective temperament changes. Conclusion: The results of the current study suggest that depressive and anxious temperaments are the most common affective temperaments and that there appears to be no association between disability level and dominant affective temperament in stroke survivors.

Detection of subclinical atherosclerosis and diastolic dysfunction in patients with schizophrenia.

Background Patients with schizophrenia have a higher risk for cardiovascular diseases, which is associated with early mortality compared with the nonschizophrenic population. Early diagnosis of cardiovascular diseases in asymptomatic periods in patients with schizophrenia would enhance their quality of life and reduce mortality. Echocardiography, carotid ultrasonography, and ankle brachial index (ABI) measurement are known to be beneficial methods of detecting subclinical cardiovascular diseases and of risk stratification. The present study investigated carotid intima media thickness (CIMT) and ABI and echocardiographic parameters measured via conventional and tissue Doppler echocardiography in patients with schizophrenia in comparison with a control group. Methods The present case-control study included 116 patients with schizophrenia and 88 healthy patients. Participants with any current comorbid psychiatric disorder, current or lifetime neurological and medical problems, current coronary artery disease, diabetes, hypertension, hypothyroidism, or hyperthyroidism or who were using antihypertensives, antidiabetic agents, or antiobesity drugs were excluded. High-resolution B-mode ultrasound images were used to measure CIMT. Conventional and tissue Doppler measurements were performed according to the recommendations of the American Society of Echocardiography. Results Low ABI, mitral ratio of the early (E) to late (A) ventricular filling velocities, septal E′, septal S′, lateral E′, lateral S′, septal E′/septal A′, lateral E′/lateral A′, and high septal A′, mitral E/septal E′, mitral E/lateral E′, and CIMT values were observed in the schizophrenia group compared with the control group. Conclusion Doppler parameters supported the hypothesis that patients with schizophrenia are at high risk for cardiovascular diseases.

Illness perception of dropout patients followed up at bipolar outpatient clinic, Turkey

Dropout is a common problem in the treatment of psychiatric illnesses including bipolar disorders (BD). The aim of the present study is to investigate illness perceptions of dropout patients with BD. A cross sectional study was done on the participants who attended the Mood Disorder Outpatient Clinic at least 3 times from January 2003 through June 2008, and then failed to attend clinic till to the last one year, 2009, determined as dropout. Thirty-nine dropout patients and 39 attendent patients with BD were recruited for this study. A sociodemographic form and brief illness perception questionnaire were used to capture data. The main reasons of patients with BD for dropout were difficulties of transport (31%), to visit another doctor (26%), giving up drugs (13%) and low education level (59%) is significant for dropout patients. The dropout patients reported that their illness did not critically influence their lives, their treatment had failed to control their illnesses, they had no symptoms, and that their illness did not emotionally affect them. In conclusion, the nonattendance of patients with serious mental illness can result in non-compliance of therapeutic drug regimens, and a recurrence of the appearance symptoms. The perception of illness in dropout patients with BD may be important for understanding and preventing nonattendance.

Experiential avoidance, empathy, and anger-related attitudesin antisocial personality disorder

BACKGROUND/AIM In prevailing opinion, a strong relation exists between lack of empathy and antisocial personality disorder (ASPD). However, recent data fail to wholly clarify this relation, especially in consideration of empathy dimensions. In this study our aim was to address ASPD and social functionality from a contextual behavioral science viewpoint. MATERIALS AND METHODS The present study was conducted with a sample of 34 individuals with ASPD and 32 healthy individuals as the control group. The participants were assessed with a sociodemographic form, Structured Clinical Interviews for DSM I and II (SCID-I and SCID-II), Social Functioning Scale (SFS), Acceptance and Action Questionnaire-II for measuring experiential avoidance, Interpersonal Reactivity Index for measuring empathy dimensions, and the State-Trait Anger Scale for anger-related attitudes. RESULTS Experiential avoidance, dysfunctional anger regulation patterns, and lack of perspective-taking levels were higher in the ASPD group than in the control group. Experiential avoidance and perspective-taking processes were related with social functioning in ASPD. CONCLUSION These findings may provide initial data for understanding ASPD clinical features and related social interaction problems. Further relations between scales and social functionality also analyzed and discussed.

Palate size and shape in schizophrenia

The palate is considered typical of the structures in which schizophrenia-related minor physical anomalies may occur. In this study, we aimed to compare the dimensions and form of palate in patients with schizophrenia with nonpsychiatric controls in a blinded manner. Dental stone casts of 127 patients with schizophrenia and 127 controls were prepared from impressions of the maxillary dental arch. Palate dimensions were measured on the stone casts using a digital caliper and palatometer. Palate length did not differ significantly between the groups, but there was a significant difference in palate width and depth, which were significantly higher in the schizophrenia group. As a result of using multivariate analysis for assessing independent risk factors affecting patients with schizophrenia, furrowed palate shape, palate width, and ellipsoid maxillary dental arch shape were found to be significant. This study also revealed that patients with schizophrenia demonstrate certain gender-related predilections in the differences of palate parameters compared to same-sex controls. As the palate develops in conjunction with both the face and brain, our study findings can significantly contribute to the assumption that there might be structural abnormalities of the palate that could represent specific markers of embryological dysmorphogenesis underlying schizophrenia.