Hülya Ertekin

Evaluation of affective temperament and anxiety-depression levels of patients with polycystic ovary syndrome.

BACKGROUND Women with polycystic ovary syndrome (PCOS) are reported to experience depressive episodes at a higher rate than healthy controls (HC). Affective temperament features are psychiatric markers that may help to predict and identify vulnerability to depression in women with PCOS. Our aim was to evaluate the affective temperaments of women with PCOS and to investigate the association with depression and anxiety levels and laboratory variables in comparison with HC. METHODS The study included 71 women with PCOS and 50 HC. Hormonal evaluations were performed for women with PCOS. Physical examination, clinical history, Hospital Anxiety and Depression Scale (HADS) and TEMPS-A were performed for all subjects. Differences between groups were evaluated using Students t-tests and Mann-Whitney U tests. Correlations and logistic regression tests were performed. RESULTS All temperament subtype scores, except hyperthymic, and HADS anxiety, depression, and total scores were significantly higher in patients with PCOS compared to HC. A statistically significant positive correlation was found between BMI and irritable temperament, and insulin and HADS depression scores in patients with PCOS. Additionally, hirsutism score and menstrual irregularity were correlated with HADS depression, anxiety and total scores in PCOS patients. In logistic regression analysis, depression was not affected by PCOS, hirsutism score or menstrual irregularity. However, HADS anxiety score was associated with hirsutism score. CONCLUSIONS Our study is the first to evaluate the affective temperament features of women with PCOS. Consequently, establishing affective temperament properties for women with PCOS may help clinicians predict those patients with PCOS who are at risk for depressive and anxiety disorders.

Psychiatric Comorbidity in Patients with Conversion Disorder and Prevalence of Dissociative Symptoms

The 1st objective of the current study was to investigate the frequency and types of dissociative symptoms in patients with conversion disorder (CD). The 2nd objective of the current study was to determine psychiatric comorbidity in patients with and without dissociative symptoms. A total of 54 consecutive consenting patients primarily diagnosed with CD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria who were admitted to the psychiatric emergency outpatient clinic of Sisli Etfal Research and Teaching Hospital (Istanbul, Turkey) were included in the study. The Structured Clinical Interview for DSM–IV Axis I Disorders, Structured Interview for DSM–IV Dissociative Disorders, and Dissociative Experiences Scale were administered. Study groups consisted of 20 patients with a dissociative disorder and 34 patients without a diagnosis of any dissociative disorder. A total of 37% of patients with CD had any dissociative diagnosis. The prevalence of dissociative disorders was as follows: 18.5% dissociative disorder not otherwise specified, 14.8% dissociative amnesia, and 3.7% depersonalization disorder. Significant differences were found between the study groups with respect to comorbidity of bipolar disorder, past hypomania, and current and past posttraumatic stress disorder (ps = .001, .028, .015, and .028, respectively). Overall comorbidity of bipolar disorder was 27.8%. Psychiatric comorbidity was higher and age at onset was earlier among dissociative patients compared to patients without dissociative symptoms. The increased psychiatric comorbidity and early onset of conversion disorder found in patients with dissociative symptoms suggest that these patients may have had a more severe form of conversion disorder.

Bakımevinde kalan şizofreni hastalarında yaşam kalitesi ve depresyon

Quality of life and depression in schizophrenia patients living in a nursing home Objective: Nursing homes are seen as alternative housing for patients with schizophrenia. However, it has not yet been established how suitable this accommodation is for schizophrenia patients. First aim of this study is to assess the quality of life and depression level in schizophrenic patients and compare this data with that of patients living with their families. Second aim is to assess factors related to the quality of living and depression state in all participants of this study. Method: This is a cross-sectional study conducted with patients presenting to the Psychotic Disorders Policlinic of the Beyhekim Psychiatric Clinic of Konya Training and Research Hospital consecutively between December 2012 and May 2013 who had received a diagnosis of schizophrenia according to DSM IV-TR. All participants were administered a sociodemographic data form, Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Quality of Life Scale for Schizophrenia Patients (QLSSP). Results: CDSS scores were found to be significantly increased in schizophrenic patients living in nursing homes. Their QLSSP scores, including interpersonal relations, occupational role, mental symptoms, personal belongings/activity scores, and total scores were statistically significantly low. A significant negative correlation was observed between negative symptom levels and occupational area, mental findings, and the personal belongings/activity areas of quality of life. Between positive symptom levels and quality of life, only scores in the occupational area showed a significant negative correlation. A significant negative correlation between CSDS and QLS was observed in all areas. Conclusion: Quality of life and depression need to be evaluated in all schizophrenia patients, as they are conditions that significantly affect treatment and prognosis.

Metabolic syndrome and vaspin in patients with bipolar disorder

Metabolic disorders and abnormal levels of circulating adipokines have been reported in patients with bipolar disorder (BD). The aim of this study was to investigate the differences in the correlations of vaspin plasma levels and metabolic parameters between two groups: patients with BD and mentally healthy persons. We measured plasma levels of vaspin, metabolic parameters, and metabolic syndrome (MS) in 101 patients with BD and 90 healthy control (HC) subjects. Patients with BD were evaluated with the Young Mania Rating Scale (YMRS) to assess manic symptoms and the Hamilton Depression Scale (HDS) to assess depressive symptoms. The Global Assessment of Functioning (GAF) was used to evaluate the general functions of the patients. Body mass index (BMI), weight, waist circumference (WC), fasting glucose, and triglyceride levels of the study group were statistically higher than those of the healthy controls (p = 0.001, p < 0.001, p < 0.001, p = 0.027, and p = 0.001 respectively). Plasma levels of vaspin were 0.978 ng/ml in patients with BD and 0.292 in the HC group (p < 0.001). Our study revealed associations between metabolic parameters/metabolic syndrome and vaspin plasma concentrations in patients with BD. Vaspin can play a specific role in the pathogenesis of metabolic disorders in these subjects and can be a specific indicator substance in BD.

Şizofreni hastalarında antipsikotiklerin depresyon düzeyine etkisi: klozapine karşı diğer atipik antipsikotikler

Introduction: Depressive symptoms may occur in all stages of schizophrenia disorder. Clozapine is the only antipsychotic that has been demonstrated superior efficacy in schizophrenia and suicidal ideation. The aim of this study is to evaluate depressive symptoms in patients with schizophrenia treated with clozapine and to compare with treated with other atypical antipsychotics. Methods: A cross-sectional descriptive study was carried out on patients with schizophrenia according to DSM-IV-TR between December 2012 and May 2013. All participants were evaluated for demographic characteristics and points of Brief Psychiatric Rating Scale, Positive, Negative Syndrome Scale, and Calgary Depression Scale for Schizophrenia. Results: A total 23.6% (n = 13) patients treated with clozapine, while 76.4% (n = 42) patients were treated with other antipsychotic drugs. 23.1% (n = 3) of patients taking clozapine were women, 76.9% (n = 10) were male. The mean age of patients treated with clozapine was 43.0 ± 11.2. The level of depression of patients treated with clozapine was 15.4% (n = 2). No statistically significant difference was found between patients between treated with clozapine and other antipsychotics regarding age, sex, marital status, education years, work history, age at onset of disease, depression and history of suicide attempt Conclusion: As a result of this study it is found that clozapine did not effect on the level of depression in patients with schizophrenia, and depression level of patients with schizophrenia treated with clozapine had no difference from patients treated with other antipsychotics.

Yatarak tedavi gören bipolar bozukluk hastalarında dissosiyatif bozukluk eştanısı olan ve olmayan hasta gruplarının karşılaştırılması

Giris: Bu calismada dissosiyatif bozukluk (DB) estanisi olan ve olmayan bipolar bozukluk (BB) hastalarinin sosyodemografik karakteristiklerinin karsilastirilmasi ve estani varliginin tedaviye etkisinin degerlendirilmesi amaclanmistir. Yontem: BB tanisi ile Şisli Etfal Hastanesi Psikiyatri Klinigi’nde 2010-2011 yillari arasinda yatisi yapilan ardisik 149 hasta calismaya alinmistir. Hastalara SCID-D uygulanarak DB tanisi, SCID-I ile BB tanisi konmus, sosyodemografik karakteristikleri, YMDO, HAM-D, KPDO, DYO puanlari ve hastanede yatis sure ve sayilari incelenmistir. Bulgular: 23 hastada (%15,4) baska turlu adlandirilamayan dissosiyatif bozukluk, 4 hastada (% 2,6) dissosiyatif kimlik bozuklugu, 1 hastada (%0,6) dissosiyatif amnezi tespit edildi. DB estanisi olan BB hastalarinin daha genc ve daha fazla oranda kadin oldugu belirlendi (sirasiyla p=0,002, p=0,015). DB estanili BB hastalarinin DYO toplam puaninin BB hastalarin daha yuksek oldugu tespit edildi (p<0,001). Tum orneklemde DYO toplam puani ile hastanede kalis suresi arasinda korelasyon bulunmustur (p=0,001, Spearman r=0.336). Basvuru sirasinda toplam HDO puani estanili grupta anlamli olarak daha yuksek (p=0,027), intihar maddesi hem basvuru hem taburculukta anlamli olarak yuksek bulunmustur (p<0,001 ve p=0,035). Basvuru esnasinda KPDO puanlarindan, halusinatuar davranis maddesi estanili grupta yuksek bulunmustur (p=0,019). YMDO puanlarindan konusma hiz ve miktari hem basvuru hem taburculukta (sirasiyla p=0,027, p=0,006), icgoru maddesi ise basvuru esnasinda estaninin olmadigi bipolar hasta grubunda yuksek bulunmustur (p=0,018). Sonuc: BB hastalarinda DB estanisi sorgulanmalidir. DB estanili hastalarin daha cok kadin cinsiyette ve daha genc yasta oldugu, daha fazla depresyon puanlarina sahip oldugu; daha uzun sureli hastanede kalis suresine sahip oldugu bulunmustur. Dissosiyasyon estanisi varliginda, intihar girisim sayisi ve halusinatuar davranislarda artis gorulebilir.

Psychiatric disorders and demographic characteristics among geriatric outpatients in Canakkale State Hospital

Psychiatric disorders and demographic characteristics among geriatric outpatients in Canakkale State Hospital Objective: The elderly population in Turkey and in the world is progressively increasing and the increase is expected to be more prominent in the future. As the elderly population grows, there will be an increasing demand on health services, resulting in rapidly rising medical, psychiatric, and social healthcare problems. The aim of the present study is to determine the distribution of psychiatric illness, including gender-based differences, demographic characteristics and prevalence within all elderly age groups, among patients visiting the general psychiatry outpatient clinic. Method: This was a retrospective study using data from the patient registry system for elderly patients who visited the general psychiatry outpatient clinic between September 2013 and February 2014. Patients were ≥65 years of age. Patients’ demographic characteristics and their Axis I diagnoses according to DSM-IV-TR were recorded. Results: Of the 1044 patients who visited the general psychiatry outpatient clinic during the 6-month period, 15% (n=158) were aged ≥65 years; 62% of the 158 patients included in the study were female and 38% were male. Depression was present in 41% of patients; 21% had generalized anxiety disorder (GAD); 8% had adjustment disorder (AD), and 7% had schizophrenia. GAD was statistically significantly higher in females and AD was statistically significantly higher in males. Conclusion: Assessing demographic data including common diagnoses and diagnostic differences between genders in elderly patients is important to improve new diagnosis and treatment strategies.

Can obsessive compulsive disorder be detected in adolescent population with three-point scanning?

Obsesif Kompulsif Bozukluk (OKB) ergen toplulugunda yaygin olarak gorulmektedir. OKBsi olan ergenler genellikle islevselligi onemli olcude bozuldugunda tibbi yardim aramaktadir. Bu sebeple ergen toplulugunda OKB taranmasi onemlilik arz etmektedir. Bu calismada kolay, hizli ve ozbildirime dayali uygulanabilen uc maddelik taramanin duyarlilik, ozgulluk ve tahmin edebilme guclerini degerlendirmeyi amacladik. Bu calismanin alan orneklemini 14-17 yaslari arasindaki toplam 177 lise birinci sinif ogrencisi olusturmaktadir. DSM-IV Eksen I Bozukluklari Icin Yapilandirilmis Klinik Gorusme Arastirma Formu OKB modulu sonuclari ile ozbildirime dayali Cocuk Ergen Davranislarini Degerlendirme Olceginden gelistirilen uc maddelik Obsesif Kompulsif Olceginin (CEDDO-OKO) tahmini sonuclari karsilastirilmistir. OKB sikligi (simdiki) yapilandirilmis gorusmeye gore %2.8 olarak saptanmistir. Obsesif Kompulsif Olcegi taramasina gore olasi OKB %46 olarak saptanmistir. Uc maddelik CEDDO-OKO olceginin duyarliligi %60, ozgullugu %54, pozitif prediktif degeri %4 ve negatif prediktif degeri %97 olarak bulunmustur. Sonuc olarak; uc soruluk tarama ile OKB saptama yonteminin duyarliligi ve ozgullugu orta duzeydedir. OKB olmayan ergenleri ayirmasi iyi duzeydedir. Buna karsin pozitif tahmin etme gucunun dusuklugu sebebiyle bu yontemin yeniden gelistirilmesi gereklidir.