Hayrettin Kara

The Efficacy of Fluoxetine in the Treatment of Premature Ejaculation: A Double-Blind Placebo Controlled Study

PURPOSE The efficacy of the selective serotonin re-uptake inhibitor fluoxetine in the treatment of premature ejaculation was examined. MATERIALS AND METHODS The study comprised 17 patients with premature ejaculation who presented to the urology clinic of our medical school. In this double-blind study the patients were randomized into treatment groups receiving 20 mg. fluoxetine daily for 1 week and 40 mg. daily afterward (group 1) or 1 capsule placebo daily for 1 week and 2 capsules daily afterward (group 2). The groups were evaluated according to the latent period of intravaginal ejaculation. RESULTS The latent period of intravaginal ejaculation in group 1 was significantly longer than that in group 2. Nausea, headache and insomnia were reported side effects. CONCLUSIONS Fluoxetine may be regarded as a safe and effective alternative in the treatment of premature ejaculation.

Subjective sleep quality and suicidality in patients with major depression.

The purpose of this study was to examine the association between sleep quality and suicidality in major depressive disorder. We evaluated 41 patients with major depression by using the Pittsburgh Sleep Quality Index (PSQI) and the Schedule for Affective Disorders and Schizophrenia (SADS) suicide subscale. We found that suicidal depressive patients had significantly higher scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency and PSQI global scores than nonsuicidal patients. We also found significant correlations between the SADS suicide subscale scores and most measures of the PSQI. These data suggest that there is an association between poor subjective sleep quality and suicidal behavior in patients with major depressive disorder.

Nightmares and dissociative experiences: The key role of childhood traumatic events

Abstract In order to examine the co‐occurrence of nightmares with dissociative experiences in the adolescent population and to demonstrate the impact of childhood traumatic events in this association, 292 undergraduate students were interviewed for childhood traumatic events. The Van Dream Anxiety Scale (VDAS) and Dissociative Experiences Scale (DES) were also administered to the subjects. For nightmares a 7.5% prevalence of ‘often’ and a 58.2% prevalence of ‘sometimes’ was found for college students. Nightmare prevalence was higher in women than in men. The rate of childhood traumatic experiences was higher in nightmare sufferers than in those who did not have nightmares. The subjects who had undergone physical and sexual abuse had higher VDAS global scores and item scores. When the DES scores of the subjects with nightmares were compared with that of those who had never reported nightmares, the subjects with nightmares had significantly higher scores on DES. The DES scores were also negatively correlated with duration of nightmares in subjects who had childhood traumatic experiences. These findings suggest that the subjects with childhood traumatic events failed to psychologically integrate their traumatic experiences and used dissociation as a coping strategy.

Clinical importance of nightmare disorder in patients with dissociative disorders

Abstract  In the present study the prevalence of nightmare disorder (ND) was examined in patients with dissociative disorders (DD), and comparison was made between those with ND and those without nightmares in terms of clinical characteristics. The 30 patients with DD (5 male and 25 female) were recruited over 12 months in the Yüzüncü Yil University Research Hospital Department of Psychiatry. The subjects were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (4th edn) criteria for ND. The Dissociative Experiences Scale, Beck Depression Inventory, and a semistructured interview schedule for childhood traumatic events were administered to the subjects. A 57% prevalence of ND was found among patients with DD. Among patients with DD, those with ND had a higher rate of self‐mutilative behavior, a history of suicide attempt in the last year, and comorbidity with borderline personality disorder than those without ND. Nightmares or dreams should be considered in the therapy of DD patients.

Recurrent sleep panic, insomnia, and suicidal behavior in patients with panic disorder

The purpose of this study was to examine the association between recurrent sleep, panic, and suicidal behavior in panic disorder. We compared the recurrent sleep panickers (N = 33) with other panickers (N = 34). The Schedule for Affective Disorders and Schizophrenia (SADS) suicide subscale was used to rate the severity of active suicidality. We found that recurrent sleep panickers also had a higher percentage of insomnia and comorbid major depression than the others. A multivariate analysis demonstrated an association between recurrent sleep panic and suicidal tendencies in patients with panic disorder. Although recurrent sleep panic alone is not an independent risk factor for suicidal behavior, it may modify the severity of illness in patients with panic disorder.

Low cholesterol level in patients with panic disorder: the association with major depression

BACKGROUND The purpose of this study was to examine whether an association exists between low cholesterol level and major depression in patients with panic disorder. METHODS The subjects of the study were 16 patients panic disorder only, 16 panic disorder patients had also current major depressive episode, and 16 normal control subjects. An automated enzymatic colorimetric method was used for cholesterol determination. RESULTS Panic disorder patients had higher serum cholesterol than panic disorder patients with major depression and normal controls. CONCLUSION There is an association between low cholesterol level and the presence of major depression in patients with panic disorder. LIMITATION Future studies with large sample are needed to confirm this finding. CLINICAL RELEVANCE A low serum cholesterol level might serve as biological marker of major depression in patients panic disorder.

Serum Lipid Concentrations in Obsessive-Compulsive Disorder Patients With and Without Panic Attacks

Objective: To examine serum lipid levels in patients with obsessive–compulsive disorder (OCD) and to test whether panic symptoms affect lipid concentrations in OCD patients. Methods: We assessed 33 OCD patients and 33 healthy control subjects matched for sex and age. Results: OCD patients had higher low-density lipoprotein, very-low-density lipoprotein, and tryglyceride levels, but lower high-density lipoprotein levels, than normal control subjects. We also found that only OCD patients with panic attacks had higher serum lipid concentrations, compared with normal control subjects. Serum lipid levels of pure OCD patients did not differ from control values. Conclusion: These findings suggest that high serum lipid concentrations are related to panic anxiety rather than other symptoms of the illness.

Hypnotizability, pain threshold, and dissociative experiences

BACKGROUND There may be an association between pain threshold, hypnotizability, and dissociative experiences. The purpose of the present study was to examine this association. METHODS Forty-one healthy subjects were included in the study. Pain thresholds were determined using a manual algometer. The Dissociative Experiences Scale was administered to all subjects. Hypnotizability of the subjects was assessed by the eye roll sign of the Hypnotic Induction Profile. There were 14, 15, and 12 subjects in the Grade 1, 2, and 3 groups, respectively. RESULTS Highly hypnotizable subjects had lower pain thresholds and were more likely to report dissociative experiences than the less hypnotizable subjects. CONCLUSIONS There is an association between pain threshold, hypnotizability, and dissociative experiences. It may be suggested that dissociative and somatic symptoms may be integrally linked and related to hypnotic suggestibility.

Sleep‐related violence and low serum cholesterol: A preliminary study

Abstract To examine whether there is a relationship between serum cholesterol level and sleep‐related violence, we evaluated 15 patients with violent behavior during sleep (VBS) and 15 normal control subjects. The patient and control groups were matched for sex, age, and weight. There were 13 women and two men in each group. The patients with VBS had lower serum total cholesterol, triglyceride, and low‐density lipoprotein levels than the healthy subjects. Low cholesterol may effect serotonergic neuronal activity and some types of 5‐HT receptors, then may be related to violent behavior during sleep.

Nightmares and Serum Cholesterol Level: A Preliminary Report

Objective: To examine whether there is a relation between nightmares and serum lipid levels. Methods: Fifteen subjects who met DSM-IV criteria for the diagnosis of nightmare disorder and 15 healthy control subjects participated in the study. We used an enzymatic colorimetric method for cholesterol and triglyceride determination. We measured high-density lipoprotien (HDL) cholesterol using the direct HDL-cholesterol method. Low-density lipoprotein (LDL) was calculated according to the Friedewald formula. Results: Patients with nightmare disorder had lower serum triglyceride, lower total cholesterol, and lower LDL levels than healthy control subjects. Conclusion: These findings suggest that nightmares are associated with low serum lipid levels.