Fatmagul Helvaci Celik

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.

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.

Şizofrenide Aripiprazol Kullanımı ile İlişkili Mani : Bir Olgu Sunumu

Mania associated with aripiprazole treatment in schizophrenia: a case report Aripiprazole is a novel antipsychotic medication that is used to treat a number of psychiatric conditions, including schizophrenia, bipolar disorder, and major depressive disorder. Clinical trials have established its efficacy and favorable tolerability profile. Nevertheless, infrequent undesirable adverse events are often encountered during wide-scale everyday clinical use. There are a few mania/hypomania cases associated with second-generation antipsychotic treatment. Induction of mania, described for almost all secondgeneration antipsychotic, may be one of the rare adverse events of aripiprazole therapy. In this study, a female patient with chronic schizophrenia who had never presented history of mood episodes, in which manic symptoms developed after increasing aripiprazole dosage to 30mg/day and disappeared after cessation of the treatment was presented. During the second-generation antipsychotic use, clinicians should be cautious to patients’s mania/hypomania symptoms.

An evaluation of cases with delirium in a training hospital / Bir eğitim hastanesinde deliryumlu olguların değerlendirilmesi

An evaluation of cases with delirium in a training hospital Objective: Clinical practices have shown that delirium generally confers more risk in patients who receive treatment in internal medicine and surgery clinics, and particularly in the elderly with central nervous system insufficiency. We, therefore, intended to investigate the frequency of delirium patients and treatment approaches among patients who requested psychiatric consultation in our hospital. Method: This study was conducted through a retrospective assessment of database and consultation forms of psychiatric consultations performed. Consultation forms prepared by the Department of Psychiatry included questions about socio-demographic characteristics of the patients, their current medical diagnosis and treatment, objective of the consultation request, psychiatric history, mental examination findings, and diagnosis and treatment follow-up plan. All patients were evaluated for the development and persistence of delirium on a daily basis by psychiatry specialist with expertise in delirium assessment, using the Diagnostic Statistical Manual IV (DSM-IV) criteria of the American Psychiatric Association, the reference standard for delirium ratings. Results: During the study period (1 July 2009 to 30 June 2010), a total of 29410 patients were hospitalized in the Rize Training and Research Hospital. Within the same period, a psychiatric consultation was requested for 405 patients, among them, 106 diagnosed with delirium. Patients with delirium for whom psychiatric consultation was requested made only 0.36% of all hospitalized patients. Conclusions: 0.36% is a very low rate for delirium diagnosis, which is reportedly observed in 11 to 41% of the general hospital populations, and it may be said that psychiatric consultation requests for delirium are very limited. Our findings necessitate that consultation-liaison psychiatry should be made effective and a multidisciplinary treatment approach should be adopted in general hospitals as soon as possible.