Ferhan Dereboy

Serum lipid concentrations in patients with comorbid generalized anxiety disorder and major depressive disorder.

Objective: To ex am ine the lipid lev els in a sam ple of pa tients with comorbid gen er al ized anx i ety dis or der (GAD) and ma jor d epres sive dis or der (MDD). Methods: Se rum lipid con cen tra tions were ex am ined in 40 pa tients with both GAD and MDD, in 27 pa tients with MDD only, in 26 pa tients with GAD only, and in 24 healthy con trol sub jects. Results: All mean se rum cho les terol con cen tra tions are pre sented in Ta ble 1. The mean se rum to tal cho les terol con cen tra tion in pa tients with both GAD and MDD was sig nif i cantly higher than in MDD-only pa tients, GAD-only pa tients, and con trol sub jects. The triglyceride con cen tra tion was also sig nif i cantly higher in pa tients with both GAD and M DD than in MDD-only pa tients, GAD-only pa tients, and con trol sub jects. Pa tients with both GAD and MDD had a lower mean high-density li po pro tein cho lesterol (HDL-C) con cen tra tion than did pa tients with GAD only and con trol sub jects. The se rumcon cen tra tion of low-density li p opro tein cho les terol (LDL-C) was higher in pa tients with both GAD and MDD than in pa tients with MDD only and GAD only and healthy con trol sub jects. Conclusions: Our find ings in di cate that the pa tients with both GAD and MDD have in creased se rum cho les t erol, triglyceride, and LDL-C and re duced HDL-C lev els. These pa tients may have a greater risk of mor tal ity from cor o nary ar tery dis ease (CAD) than do pa tients with ei ther de pres sion or anx i ety dis or der.

Personality disorders in a community sample in Turkey: Prevalence, associated risk factors, temperament and character dimensions

Background: Data from Turkey on prevalence of personality disorders (PD) in the normal population are sparse. Aims: The present study conducted in a community sample aimed to investigate personality disorders in terms of prevalence, associated risk factors and personality dimensions. Methods: A stratified sampling procedure allowed us to compose a sample consisting of 774 participants residing in Aydin, Turkey. The DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) and the Temperament and Character Inventory (TCI) were used to assess PDs and personality dimensions, respectively. Results: Roughly 20% of the participants received a PD diagnosis. Among the individual PD categories, schizotypal and obsessive-compulsive PDs were the most prevalent diagnoses. Participants with PD were more likely to have higher self-directedness and cooperativeness scores. These risk factors and personality dimensions were most strongly associated with the cluster B disorders. Conclusion: New versions of the diagnostic systems should include schizotypal, obsessive-compulsive and cluster B PDs as separate diagnostic categories, and impaired self-directedness as well as cooperativeness as a general diagnostic criterion for the sake of backward and forward compatibility of the research in this field.

Persistent Depression as a Novel Diagnostic Category: Results from the Menderes Depression Study

INTRODUCTION Persistent depressive disorder (PDD) introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 as a novel diagnostic category represents a consolidation of two separate DSM-IV categories, chronic major depressive disorder (MDD) and dysthymic disorder. The present study aims to investigate the frequency and clinical as well as socio-demographic correlates of PDD in comparison with those of episodic MDD among patients seeking treatment for depressive symptoms. METHODS Participants were 140 depressive out-and in-patients under treatment at the psychiatry clinic of the Adnan Menderes University Research Hospital. Each patient was assessed by means of a structured clinical interview (SCID-I) and relevant psychometric instruments including the Hamilton Depression Inventory and Eskin Suicidal Behavior Inventory. RESULTS Among the depressive patients, 61% fulfilled the criteria for PDD and 39% for episodic MDD. As compared with patients with episodic MDD, the PDD patients were older (d=.54), lower in educational attainment (d=.55), more likely to have comorbid generalized anxiety disorder (OR=3.7), and more prone to report symptoms of anxiety, hopelessness, pessimism, and somatic complaints. Nevertheless, the PDD patients displayed heterogeneous characteristics with respect to clinical severity and suicidal behavior. CONCLUSION Our findings suggest that majority of depressive patients, including those fulfilling the criteria for MDD, have been suffering from a persistent ailment rather than an episodic disorder. Clinicians with a cross-sectional perspective are more likely to diagnose MDD, whereas those with a longitudinal perspective are more likely to identify PDD in the majority of depressive patients. The incorporation of both of these perspectives into DSM-5 in a complementary manner will possibly enhance our insight into depressive disorders and improve our treatment results.

Androgenetic alopecia: Does its presence change our perceptions?

Background  The aim of this study was to evaluate the effects of androgenetic alopecia on males with and without hair loss and to delineate the level of stress gained by this type of alopecia.

Validation of the DSM–5 Alternative Model Personality Disorder Diagnoses in Turkey, Part 1: LEAD Validity and Reliability of the Personality Functioning Ratings

ABSTRACT This study addresses longitudinal, expert, all data (LEAD) validity and reliability of the personality functioning ratings in Turkey, which are essential in assessing Criterion A for the entire DSM–5 alternative model for personality disorders (AMPD) diagnoses. A total of 120 consenting patients recruited at a university psychiatry clinic were rated by individual clinicians with respect to DSM–III–R and AMPD criteria. Subsequently, a LEAD panel consisting of 3 senior clinicians convened to reach a consensus personality disorder diagnosis for each participant. Blind personality functioning ratings of a subgroup of 20 participants by the same set of 4 clinicians were obtained for test–retest reliability investigation. Concordance between the LEAD and AMPD diagnoses was as good as that between the LEAD and DSM–III–R diagnoses (kappas = .68). The personality functioning scores correlated strongly (r > .50) with the sum of specific DSM–III–R diagnoses. Reliability estimates pertaining to the personality functioning scores and resultant AMPD Criterion A decisions were mostly in the good range. In conclusion, DSM–5 alternative model-oriented personality functioning ratings yield total or composite scores that are evidently valid and reliable tools to diagnose general personality disorder and to estimate its global severity.

Validation and Reliability of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in Turkish Psychiatry Patients and Healthy Controls

OBJECTIVE: The present study aimed to investigate psychometric properties of a series of disability scores obtained from Turkish version of the WHODAS 2.0 interviewer-, self- and proxy-administered forms consisting of either 36 items or 12 items. METHODS: Following the translation, 35 patients with a psychiatric diagnosis and 35 healthy controls between 18 and 65 years of age selfrated their functional impairment on the WHODAS. In addition, each participant was rated by a relative and by one or two clinicians on the pertinent WHODAS forms. In order to collect evidence for validity and reliability of WHODAS general disability and domain scores, we employed a series of Students t-tests, ROC analyses, logistic regression analyses, intraclass and Pearsons correlation analyses, Cronbachs alpha and item-total statistics. RESULTS: Regarding general disability scores, in both clinical sample and healthy controls, all three types of 36-item WHODAS displayed satisfactory or higher validity and reliability coefficients. On the other hand, for 12-item version, only the interviewer-rated form demonstrated satisfactory results only in the clinical sample. Domain disability scores yielded by the 36-item forms were generally associated with adequate or acceptable coefficients in the clinical sample, while the coefficients were unacceptable in the control group. CONCLUSION: The 36-item WHODAS interviewer-, proxy- and self-rated forms are suitable to assess general disability in Turkish mental health consumers and in healthy subjects. Among the 12-item WHODAS forms, the interviewer-rated form emerges as the sole instrument with comparable validity and reliability for measuring general disability in psychiatric patients. The domain disability scores derived from the long form and general disability scores derived from the short form is suitable for evaluating clinical subjects, but not healthy subjects.