Murat Semiz

Serum cortisol and dehydroepiandrosterone‐sulfate levels in schizophrenic patients and their first‐degree relatives

Aims:  Alterations in cortisol and dehydroepiandrosterone sulfate (DHEA‐S) levels are thought to play a role in the pathophysiology of neuropsychiatric disorders, including schizophrenia. The aim of this study was to investigate the role of serum cortisol and DHEA‐S in the pathophysiology of schizophrenia.

Perspectives on reasons of medication nonadherence in psychiatric patients

Purpose This study was carried out to evaluate factors resulting in medication nonadherence within 6 months before admission to the psychiatric service of our hospital for bipolar disorder, schizophrenia/schizoaffective disorder, depression, and other psychiatric diseases. Patients and methods Two hundred and three patients admitted to the Psychiatry Service of the Medical Faculty were included in this study. Sociodemographic parameters and clinical findings within 6 months before admission and patients’ views on reasons of medication nonadherence were examined. Results Patients were classified into four groups according to their diagnosis: bipolar disorder (n=68, 33.5%), schizophrenia/schizoaffective disorder (n=59, 29.1%), depression (n=39, 19.2%), and others (n=37, 18.2%). The ratio of medication nonadherence was higher in the bipolar disorder group when compared to the groups with schizophrenia/schizoaffective disorder, depression, and other disorders (12.1%, 18.2%, and 24.2% vs 45.5%); however, the ratio of medication nonadherence was similar in schizophrenia/schizoaffective disorder, depression, and the others group. In logistic regression analysis, irregular follow-up (odds ratio [OR]: 5.7; 95% confidence interval [CI]: 2.92–11.31) and diagnosis (OR: 1.5; 95% CI: 1.07–1.95) were determined to be important risk factors for medication nonadherence. The leading factors for medication nonadherence were: “not willing to use medication”, “not accepting the disease”, and “being disturbed by side effects” in the bipolar disorder group, “not accepting the disease” in the schizophrenia/schizoaffective disorder group, “feeling well” in the depression group, and “being disturbed by side effects” in the other diseases group. Conclusion Medication nonadherence is an important problem in psychiatric patients and should be dealt with by taking into account the diagnosis, attendance to follow-up appointments, and the patient’s attitude. Ensuring regular attendance to follow-up appointments, adjusting the management plan according to the diagnosis, and improving their thoughts about resistance to medication can be beneficial in terms of medication adherence.

Prevalence of migraine and co-morbid psychiatric disorders among students of Cumhuriyet University

BackroundThe aim of this study was to investigate the prevalence of migraine and associated psychiatric disorders among university students at Cumhuriyet University of Sivas in Turkey.MethodsA total of 1601 university students participated in this study and answered the questionnaires. The study was conducted in three stages: the self-questionnaire, the neurological evaluation, and the psychiatric evaluation. In the first stage, the subjects completed a questionnaire to assess migraine symptoms. In the second stage, the subjects who reported having migraines underwent a detailed neurological evaluation conducted by a neurologist to confirm the diagnosis. In the final stage, the subjects with migraines completed a psychiatric examination using the structured clinical interview for DSM IV-R Axis I.ResultsThe self-reported migraine prevalence rate was 13.7%, and the actual prevalence rate of migraine among the university students was calculated to be 10.6% (n = 169). When the results obtained with the SCID-I were examined, a current SCID-I psychiatric diagnosis was found in 39 (23.1%) of the 169 subjects with migraines. A total of 73 (43.2%) students with migraines had a lifetime SCID-I psychiatric diagnosis.ConclusionsThe results of this study indicate that migraines were highly prevalent among university students in Turkey with comorbid psychiatric disorders. Treatment strategies must be developed to manage these comorbidities.

Test Anxiety Prevalance and Related Variables in The Students Who are Going to Take The University Entrance Examination

Objective: Test anxiety is common among students and has adverse effects on their exam performance. This study firstly focused on finding the prevalence of test anxiety. The second aim was to identify the predictors of test anxiety and its related variables among students who are going to take the university entrance exam. Method: Totally 436 students (girls=220, boys=216) who were randomly recruited from four different schools to represent all the students who will take the University Entrance Examination in Sivas city centre participated in the study. The students filled in the Socio-demographic Data Form sociodemographic form, Test Anxiety Inventory (TAI), Beck’s Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Liebowitz Social Anxiety Scale (LSAS), Wender Utah Rating Scale (WURS) and Adult ADHD Self-Report Scale (ASRS). Results: Test anxiety was detected in the 48.0% of students (n=208). Additionally, exam anxiety was found in 40.3% of the males (n=87) and in 55.8% of the girls (n=121) and the difference between them was statistically significant (p

Prevalence of attention-deficit/hyperactivity disorder and co-morbid disorders among students of Cumhuriyet University

Background and Objectives: Most of the previous studies investigated prevalence of attention-deficit/hyperactivity disorder (ADHD) among university students with self report measures. Present study investigated actual prevalence of ADHD and comorbid disorders among university students in Cumhuriyet University of Sivas in Turkey. Methods: In the first stage, 980 university students filled in the Adult ADHD Self-Report Scale and socio-demographic form, 79 of whom were above the cut-off score of Adult ADHD Self-Report Scale, considered as possible ADHD. They were evaluated in the second stage via structured interview SCID I, SCID II, Adult ADHD Module of MINI Plus. In addition, subjects filled in the self report Adult ADD/ADHD DSM IV-Based Diagnostic Screening and Rating Scale. Results: The self report ADHD prevalence rate was 10.1% and the actual prevalence rate of ADHD among the university students was calculated 6.1%. The prevalence of ADHD was greater among male than female (7.0% vs. 5.5%). Among the male students inattentive subtype was 1.6%, hyperactive-impulsive 0.24%, combined 5.1%. Female students were found to be inattentive by 1.45%, hyperactive-impulsive by 0.56% and combined type by 3.48%. Most of the students with ADHD had Axis I (especially depressive disorders) and Axis II disorders (especially cluster B personality disorders). ADHD diagnosis was associated with more cigarette and alcohol use, academic failure, legal problems, somatic complaints and suicide attempts. Students with ADHD were spending more time on the Internet than students without ADHD. Only one student diagnosed with ADHD reported to have had previous ADHD diagnosis. Conclusions: ADHD is common among university students. Having a diagnosis of ADHD in early adulthood seems to be associated with psychological, social, and academic problems. Received: 10 March 2011 Revised: 30 August 2011 Accepted: 18 November 2011 108 ONDER KAVAKCI ET AL.

Case of organic mania associated with stroke and open heart surgery.

ORGANIC MANIA HAS been reported to have multiple causes. Although post-stroke depression is well recognized, post-stroke mania has rarely been reported. There have been few cases in the literature reporting mania secondary to cerebrovascular lesions, one of which followed a lesion in the non-dominant hemisphere. A 27-year-old, right-handed woman presented with symptoms of elevated mood, grandiosity, sleeplessness, and disinhibition with a history of stroke 1 year previously. She had undergone surgery because of mitral valve stenosis 6 months previously. She had no other disease and no family history of psychiatric disorders. At admission, neurological examination was normal except for a mild weakness on the left side. Poststroke magnetic resonance imaging findings of the patient after 6 months were as follows. The lesion was seen on the right insular and frontal cortex. The patient scored 52 out of 60 on the Young Mania Rating Scale. We started treatment with olanzapine (30 mg/day) and valproate (1000 mg/day). Her symptoms significantly improved after three months. The patient provided informed consent to publish this paper. Krauthammer and Klerman described and gave a list of organic causes of mania, such as drugs, infection, epilepsy, cerebral neoplasm and metabolic disturbances. However, mania is a rare complication of stroke with an incidence of <1%. Robinson and colleagues conducted a series of studies with 27 patients with organic mania due to stroke, traumatic injury, or brain tumors. The authors emphasized that mania following brain injury (especially stroke) is associated with a positive family history of mood disorders and lesions involving the right limbic area or subcortical atrophy by increased ventricle-to-brain-size ratio. There have been some cases of mania after heart surgery that may be related to valve replacements or factors complicating surgery, such as macroembolism, microembolism and cerebral hypoperfusion. Although organic mania is generally reported in the elderly, it is also possible in younger patients, like this case.

Antipsychotic-Like Effect of Agomelatine in a Rodent Model

Antipsychotic-like effect of agomelatine in a rodent model Objective: Agomelatine is a naphthalene bioisostere of melatonin. Melatonin is involved in several neurophysiological systems; nevertheless, data about the relationship between melatonin and psychosis such as schizophrenia are limited and contradictory. In this study, we examined the antipsychotic-like effects of agomelatine in a rodent model. Method: In this study, we evaluated the effect of agomelatine on novelty-induced rearing behavior and apomorphine-induced stereotypical behavior in male rats. Agomelatine (20 and 40mg/kg, i.p.), chlorpromazine (1mg/kg, i.p.), or isotonic NaCl (1mL/kg, i.p.) were administered to four groups of rats (n=6), respectively. An hour later, apomorphine (2mg/kg, s.c.) was administered to each rat. Results: Our results showed that either dose of agomelatine decreased rearing behavior in rats significantly, in a dose dependent manner. Agomelatine also decreased the stereotypical behaviour scores like chlorpromazine did. Conclusion: We conclude that agomelatine has beneficial effects on rearing and stereotypical behaviour, which were accepted to be indicators of antipsychotic effect.

The Relationship between Mean Pulmonary Artery Pressure and Quality of Life in Patients with Mitral Stenosis

Objectives: We aimed to evaluate echocardiography-guided hemodynamic determinants of quality of life (QoL) via the Medical Outcomes Study Short Form (SF-36) questionnaire in patients with mild to moderate mitral stenosis (MS). Methods: Eighty consecutive patients with rheumatic MS, who were admitted to the outpatient department, were enrolled into the study upon obtaining informed consent. Forty age-sex-matched healthy individuals were enrolled as a control group. Results: All subscale scores and total SF-36 scores were significantly lower in the patient group representing a worse QoL. In multivariable logistic regression analysis, only mean pulmonary artery pressure (OR 1.138, 95% CI 1.049–1.234, p = 0.002) was found to be an independent predictor of poor QoL in patients with mild to moderate MS. Conclusion: During follow-up of MS patients before intervention, physicians should consider that mean pulmonary artery pressure is the main factor which influences the patients’ QoL. In patients with MS, it seems that referral to intervention should consider components and derivatives of QoL.