Fikret Çökmüş

Quality of Life and Associated Risk Factors in Caregivers of Patients with Obsessive Compulsive Disorder

ABSTRACT INTRODUCTION: Obsessive compulsive disorder (OCD) is a chronic disease that affects social relationships, and occupational and academic performance of patients and their relatives due to cognitive, emotional, and behavioural aspects of the disease. Quality of life (QoL) in relatives of patients with OCD has previously been reported and compared with caregivers of patients with other psychiatric conditions. However, there are few studies available in the literature regarding the causality of QoL in caregivers of patients with OCD. OBJECTIVE: The aim of this study was to evaluate QoL of caregivers of patients with OCD and predictors of QoL of the family caregivers. METHODS: The study population comprised of 68 patients with OCD and their caregivers. The dependent variable of this study is “QoL of caregivers” as assessed by the short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF-TR). The Structured Clinical Interview for DSM-IV/Clinical Version (SCID-I/CV), Yale-Brown obsessive-compulsive scale (Y-BOCS), Y-BOCS symptom checklist, Hamilton Depression Rating Scale (HAM-D), and WHOQOL-BREF-TR were completed by the patients, whereas the SCID-I/CV, WHOQOL-BREF-TR, and Burden Assessment Scale (BAS) were completed by the caregivers. Student’s t-test, MWU, ANOVA, Kruskal–Wallis ANOVA, and Spearman’s correlations were used in univariate analyses, and multiple linear regression tests were run in multivariate analyses. Critical VIF values were taken as 5.0 for detecting collinearity among independent variables in the regression analyses. Type 1 error was taken as 0.05 in the analyses. RESULTS: Linear regression analysis showed that caregivers’ sex, education level, occupational status, disease burden, and patients’ sex, physical QoL, and disease severity were predictors of caregivers’ QoL. Moreover, disease burden was the only common predictor that affected all four dimensions (physical, psychological, social relations, environmental) of the caregiver’s QoL, and as the perceived disease burden increased, the caregiver’s QoL deteriorated.

Quickly diagnosed and treated prepubertal Type 1 narcolepsy case

ABSTRACT Excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucination are the classic tetrad of narcolepsy. It has been shown that narcolepsy, a chronic and disabling disease, starts in childhood and adolescence rather than adulthood. The International Classification of Sleep Disorder (ICSD-3) classifies narcolepsy into Type 1 (narcolepsy with cataplexy) and Type 2 (narcolepsy without cataplexy). There is low awareness and knowledge of narcolepsy among the general public, primary care physicians, and sleep specialists. It has been shown that the lack of recognition of disease symptoms delayed the diagnosis of narcolepsy from 8.7 to 22.1 years. In this case report, we will discuss the case of Type 1 narcolepsy, which started in the prepubertal period and was diagnosed and treated in a short period of time.

Evaluation of serum MicroRNA expression profiles in patients with panic disorder

ABSTRACT BACKGROUND: Studies on the role of microRNAs (miRNA) in anxiety disorders are limited. We aimed to determine the availability of miRNAs as biomarkers in serum and to demonstrate the changes of miRNAs expression in patients with panic disorder (PD). METHODS: Thirty-five patients with PD and 35 healthy controls (HC) were evaluated with Structured Clinical Interview for DSM Disorders-I (SCID-I) and Panic Disorder Severity Scale (PDSS). In each group miRNA expression analysis was performed in venous blood by the Real-time Polymerase Chain Reaction (RT–PCR) method for genetic evaluation. RESULTS: Compared with the HC group, eight miRNA expression levels were found different in the PD group. Five of them were upregulated and three of them were downregulated. There was no correlation between the levels of miRNA expression with PDSS total score and PDSS sub-items. However, miR-1297 and miR-4465 expression levels were significantly different between the two groups. LIMITATIONS: There are some limitations in this research. Firstly the number of samples is small. Another limitation of our study is that the presence of medical illness and continuous drug use were not excluded when PD and HC groups were selected. CONCLUSIONS: Our research is the first miRNA expression study in patients with PD which excluded psychotropic use and additional psychiatric disorders. In the PD group, miR-1297 and miR-4465 expression was upregulated than compared to the HC group. miR-1297 and miR-4465 regulate the GABAA gene regions that affect GABAA receptor subtypes that thought to play a role in the aetiology of PD.

Relationship of levetiracetam and obsessive-compulsive disorder: a case report

ABSTRACT Levetiracetam has gained wide acceptance in the treatment of epilepsy due to its broad-spectrum efficacy, the lack of significant drug–drug interactions, and a relatively benign side effect profile. However, in recent years, the treatment of epilepsy using levetiracetam has been associated with psychiatric side effects such as anxiety, irritability, hostility, depression, hallucinations, and, in some rare cases, obsessive-compulsive disorder. In this case report, we present and discuss onset of obsessive-compulsive disorder symptoms in a 55-year-old epileptic female patient, who did not have any previous psychiatric disorder, including obsessive-compulsive disorder, and who received levetiracetam treatment.

Reliability and validity of Turkish Form of Severity of Acute Stress Symptoms Scale

Objective: This study demonstrates the reliability and validity of the Turkish Form of Acute Stress Symptoms Scale which was developed according to DSM-5 criteria to measure the severity of acute stress disorder. Methods: This research was carried out with the patients who fulfilled the criteria of any stress related disorders according to DSM-5 criterion in inpatient and outpatient psychiatric clinics of Celal Bayar University, School of Medicine. Except for acute or post-traumatic stress disorders, patients with any other mental or physical disease were excluded. Fifty patients were included in the study. As the control group, 150 volunteers without any mental or physical diseases were invited. Beside Acute Stress Symptoms Scale, Peritraumatic Dissociative Experiences Questionnaire (PDEQ) which is the most commonly used self-rated instrument to rate the experience of recent trauma is utilized for concur-rent validity. In reliability analyses, internal consistency coefficient and item-total correlation coefficients were calcu-lated. In validity analyses, factor analysis and correlation analysis with PDEQ were performed. Results: The mean age of the study group was 32.1±12.0 years, and 57.7% of the sample group (n=116) were female. 31.3% of the group were college graduates, 36.3% primary school graduates, 29.9% is high school graduates. Disease duration in acute stress disorder group was 4.08±4.57 years. For the internal consistency of Acute Stress Symptoms Severity Scale, Cronbach’s alpha coefficient was found to be 0.95. Item-total score correlation coefficients were between 0.76 and 0.88 and all were statistically significant. For the exploratory factor analysis, sample adequacy was tested, Kaiser-Meier-Olkin (KMO) coefficients was 0.91 and Bartlett coefficient was 1388. Single-factor solution was obtained and the eigenvalue was 5.40, representing 77.8% of the total variance. Factor loadings of the items were between 0.82-0.92. The coefficient of correlation analysis with PDEQ was calculated as r=0.88. Area under the curve is found 0.99 as the result of ROC analysis. Conclusion: With these findings, it is shown that the severity of Acute Stress Symptoms Scale is reliable and valid for Turkish.

The comparison of executive functions, social cognition and plasma oxytocin level between mothers of schizophrenia patients and healthy control: Searching for a new endophenotype

Objective: Previous studies documented that there were a variety of endophenotypes that helped to diagnose as well as to predict functionality and treatment response. There is little, if any research that focused on investigating biochemical endophenotypes. Besides, the studies that include executive functions and social cognition, which were accepted as endophenotypes, have different results. In studies involving schizophrenia patients, the deficiency of oxytocin was found to be the most important hormone that would affect the treatment process. However, there have been no endophenotype studies that investigated the role of oxytocin hormone in the treatment process of schizophrenia patients. The purpose of the present study was twofold: (a) to detect new endophenotypes, and (b) to test endophenotypes that were previously found by focusing on the schizophrenia patients’ mothers. Methods: The participants were the healthy mothers of schizophrenia patients and healthy control group. They took the Reading the Mind in the Eyes Test, Wisconsin Card Sorting Test, and Wechsler Adult Intelligence Scale vocabulary subtest, respectively. In addition, participants’ blood samples were collected to include the level of plasma oxytocin as a biochemical in the data analyses. Results: Results revealed that there was a significant difference in plasma oxytocin levels for the healthy mothers of schizophrenia patients and the healthy control group. Low level of plasma oxytocin level was found to be the only significant factor that differentiates the patients’ mothers and the healthy control group. When the results of the Reading the Mind in the Eyes Test that measures executive functions, and the Wisconsin Card Sorting Test that measures social cognition were analyzed, no significant differences were found between the groups. Discussion: Our findings showed that oxytocin hormone could be a new endophenotype for schizophrenia. However, there is still a need for studies that focus on the investigation of detecting new endophenotypes.