Gonca Karakuş

Impulse control disorder comorbidity among patients with bipolar I disorder.

OBJECTIVE Impulsivity is associated with mood instability, behavioral problems, and action without planning in patients with bipolar disorder. Increased impulsivity levels are reported at all types of mood episodes. This association suggests a high comorbidity between impulse control disorders (ICDs) and bipolar disorder. The aim of this study is to compare the prevalence of ICDs and associated clinical and sociodemographic variables in euthymic bipolar I patients. METHOD A total of 124 consecutive bipolar I patients who were recruited from regular attendees from the outpatient clinic of our Bipolar Disorder Unit were included in the study. All patients were symptomatically in remission. Diagnosis of bipolar disorder was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Impulse control disorders were investigated using the modified version of the Minnesota Impulsive Disorders Interview. Impulsivity was measured with the Barratt Impulsiveness Scale Version 11. Furthermore, all patients completed the Zuckerman Sensation-Seeking Scale Form V. RESULTS The prevalence rate of all comorbid ICDs in our sample was 27.4% (n = 34). The most common ICD subtype was pathologic skin picking, followed by compulsive buying, intermittent explosive disorder, and trichotillomania. There were no instances of pyromania or compulsive sexual behavior. There was no statistically significant difference between the sociodemographic characteristics of bipolar patients with and without ICDs with regard to age, sex, education level, or marital status. Comorbidity of alcohol/substance abuse and number of suicide attempts were higher in the ICD(+) group than the ICD(-) group. Length of time between mood episodes was higher in the ICD(-) group than the ICD(+) group. There was a statistically significant difference between the total number of mood episodes between the 2 groups, but the number of depressive episodes was higher in the ICD(+) patients as compared with the ICD(-) patients. There was no statistically significant difference between the age of first episode, seasonality, presence of psychotic features, and chronicity of illness. A statistically significant difference was observed between the ICD(+) and ICD(-) groups in terms of total impulsivity, attention, nonplanning, and motor impulsivity scores as determined by the Barratt Impulsiveness Scale Version 11. CONCLUSION The present study revealed that there is a high comorbidity rate between bipolar disorder and ICDs based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria. Alcohol/substance use disorders, a high number of previous suicide attempts, and depressive episodes should alert the physician to the presence of comorbid ICDs among bipolar patients that could affect the course and treatment of the disorder.

Sociodemographic and Clinical Characteristics of Inpatients with Schizophrenia In Psychiatry Clinics

Objective: The aim of study as to determine the clinical and sociodemographic characteristics of the inpatients with the diagnosis of schizophrenia between the years 2010-2014. Patients were grouped according to the gender and age of onset and these groups were compared. Method: 208 patients who had been diagnosed with schizophrenia according to DSM IV TR between the years 2010-2014. Sociodemographic and clinical data form, Scale for the Assessment of Positive Symptoms(SAPS) and Scale for the Assessment of Negative Symptoms(SANS), Hamilton Depression Rating Scale and Insight Assessment Scale were filled by scanning previous patient files. Results: 107(51,4%) of the patients included in this study were male. Mean age of onset of schizophrenia was 23,82±9,78. There was no significant difference between men and women in terms of age at onset. The rate of patients with one or more delusions was 98,6 % (n:205), the rate of patients with one more halucinations was 59,6 % (n:124). Lifetime smoking, alcohol and substance abuse and legal problem rates were higher in male patients. Lifetime history of suicide and SAPS scores were higher in female patients. Family history of psychiatric disorders was higher in early onset schizophrenia patients(<40 age). Conclusion: The study which determined wider and homogeneous distribution samples in this subject and at same time meeting patients and their families may contribute to identify the clinical features of the disease more detailed.

Assessment of Dyadic Adjustment and Sexual Functions in Patients with Bipolar Disorder

Introduciton There are limited studies investigating the relation between dyadic adjustment, and sexual functions. The aim of this study was to compare patients with bipolar disorder (BD) in euthymic phase with healthy controls, and confirm our hypothesis which we expect to find that dyadic adjustment is negatively affected in bipolar patients with sexual dysfunctions (SDs). Methods A total of 50 euthymic bipolar patients (32 female, 18 male), and 50 healthy individuals as a control group (27 female, 23 male) were included in the study. A data form for socio-demographic features and two other forms for clinical characteristics of bipolar disorder and sexual functions have been filled by clinician. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-4) Axis I was used to determine axis I psychiatric disorders. All patients completed Golombok Rust Inventory of Sexual Satisfaction (GRISS), and Dyadic Adjustment Scale (DAS). Results Twenty-five (50%) of bipolar patients, and 13 (48.8%) of healthy controls were found to have SDs. There was a significant difference between bipolar patients, and healthy controls in regard to the presence of SDs (p=0.013). Dissatisfaction, communication, and anorgasmia subscale scores, and total scores of GRISS was found to be higher in female patients with BD. Intercourse frequency, impotence and premature ejaculation subscale scores and total scores of GRISS were higher in male patient group than healthy controls. When bipolar patients and healthy controls were compared, there was a significant difference between dyadic cohesion and affectional expression scores as measured by DAS. As a result of the univariate and regression analyzes, it was determined that the variable affecting the dyadic adjustment in bipolar patients was affected by sexual dysfunction rather than disease presence. Conclusion The results of this study have shown that the prevalence rate of SDs is higher in bipolar patients than healthy individuals. It was determined that the variable affecting the dyadic adjustment of patients with BB was affected by sexual function rather than disease presence. The presence of SDs in bipolar patients have negative effects on dyadic adjustment.

Sleep and suicide relationship in patients with obsessive-compulsive disorder

Objective: The data about sleep quality and suicide relationship in patients with obsessive-compulsive disorder (OCD) is limited. In this study, we aimed to investigate the hypothesis that there might be a relationship between sleep quality and suicide in the OCD patients with compare the control group. Methods: A total of 50 patients with OCD (31 female, 19 male) and 40 healthy (24 female, 16 male) individuals as a control group were included in the study. A data form for sociodemographic features, one other forms for clinical characteristics of OCD and Yale Brown Obsessive Compulsive Scale (YB-OCS) have been filled by clinician. After the interview, all patients completed Pittsburgh Sleep Quality Index (PSQI) and Suicide Behavior Scale (SBS). Results: Six (12%) of the OCD patients had lifelong suicide attempts and twenty (40%) had lifelong suicide ideation. When OCD patients and healthy controls were compared, PSQI-2, PSQI-3, PSQI-5, PSQI-6, SBS-1, SBS-2, SBS3 and SBS total scores in patients with OCD were higher than healthy controls. In patients group with lifelong suicide ideations, PSQI-1 and PSQI-6 scores were higher. In patients group with lifelong suicide attempts, PSQI-6 scores were higher. In OCD patients, statistically significant correlations were detected between SBS-1 and PSQI-1, PSQI-6; SBS-3 and PSQI-6. This correlations were not observed in the control group. Conclusion: As a result of this study, it has been shown that the subjective sleep quality of the last 1 month in OCD patients and the intake of additional sleeping pills may be related to past suicidal thoughts and attempts. It may be appropriate to monitor OCD patients with subjective sleep quality impairment and use of additional medication more frequently in terms of suicide risk. In this issue, follow-up studies are needed to include more OCD patients.