Nilgün Taşkıntuna

Predictors of psychological distress in survivors of the 1999 earthquakes in Turkey: effects of relocation after the disaster.

Objective:  Relocations after disasters are known to cause added distress in survivors. This study examined the effects of migration and other factors on psychological status of survivors 4 years after the two severe earthquakes in Turkey.

Black cohosh and fluoxetine in the treatment of postmenopausal symptoms : A prospective, randomized trial

The objective of this study was to evaluate the efficacy of fluoxetine and black cohosh in the treatment of women with postmenopausal symptoms. A total of 120 healthy women with menopausal symptoms were recruited to this prospective study with a follow-up period of 6 mo. They were randomly assigned to 1 of 2 groups and were treated with fluoxetine or black cohosh. After entry into the study, patients were examined at the first, second, third, and sixth months of the treatment period. The women kept diaries in which they reported the daily number and intensity of hot flushes and night sweats. In addition, at the beginning and end of the third month, they completed questionnaires consisting of a modified Kupperman Index, Beck’s Depression Scale, and a RAND-36 Quality-of-Life Questionnaire. Statistically significant differences were noted in the Kupperman Index and Beck’s Depression Scale at the end of the third month in both groups compared with baseline values. In the black cohosh group, the Kupperman Index decreased significantly compared with that in the fluoxetine group by the end of the third month. On the other hand, in the fluoxetine group, Beck’s Depression Scale decreased significantly compared with that in the black cohosh group. Monthly scores for hot flushes and night sweats decreased significantly in both groups; however, black cohosh reduced monthly scores for hot flushes and night sweats to a greater extent than did fluoxetine. At the end of the sixth month of treatment, black cohosh reduced the hot flush score by 85%, compared with a 62% result for fluoxetine. By the sixth month of the study, 40 women had discontinued the study—20 (33%) in the fluoxetine group and 20 (33%) in the black cohosh group. Compared with fluoxetine, black cohosh is more effective for treating hot flushes and night sweats. On the other hand, fluoxetine is more effective in improvements shown on Beck’s Depression Scale.

Atypical Antipsychotic Drugs in the Treatment of Delusional Parasitosis

Introduction: Delusional parasitosis (DP) is a rare delusional disorder in which patients believe that they are infected with parasites, worms, insects, or bacteria. Antipsychotics are the preferred treatment in these patients. Method: Case series in which we summarize six patients with DP treated with atypical antipsychotic medications including amisulpride, olanzapine, and risperidone. Results: One patient had a myocardial infarction after being given amisulpride, and several patients did not adjust well. Parenterally administered antipsychotics, particularly risperidone, were the most effective treatment in this series of patients with DP. Conclusion: Patients with DP can be difficult to treat; however, parenterally administered antipsychotics appear to produce better results in these patients.

Psychosocial aspects of living-related donor renal transplantation: Quality of life and mood in recipients, donors and controls.

Due to the high frequency of living-related donor renal transplantation (LRDRT) in our country, we were concerned both about the recipient and the donor quality of life and psychological well-being. We investigated HRQL and mood in LRDRT recipients, donors, and controls using the Beck Depression Inventory, Beck Anxiety Inventory, and 36-item Short Form Health Survey. The recipient group consisted of 69 individuals who underwent renal transplantation between August 2002 and June 2004. The donor group consisted of 35 and the control group 45 healthy individuals. Multivariate analysis of variance and the post hoc (Tukey) test were used to assess and to analyze differences among and between the three groups. The depression scores of the recipients were higher than donors (P < 0.05) but were similar to controls. The recipient scores indicated poorer physical functioning (P < 0.001), greater physical limitation on roles (P < 0.001), and lower levels of general health (P < 0.01) compared to controls. The donor scores indicated higher vitality (P < 0.01), better social functioning (P < 0.05) and greater mental health (P < 0.01) than controls. Poorer health and mood status among the recipient group might reflect the various negative impacts of chronic debilitating disease. It is therefore recommended to screen recipients regularly for clinically relevant HRQL impairments after transplantation.

The prevalence and recognition rate of delirium in hospitalized elderly patients in Turkey

Abstract Objective. Delirium is frequently observed, but generally under recognized in elderly hospitalized patients. The aims of this study were to determine the prevalence of delirium in elderly patients hospitalized at a university hospital, and to determine the recognition rate by hospital staff during hospitalization. Methods. The study included 108 consecutive patients aged ≥ 65 years that were hospitalized in the medical and surgical inpatient departments at Başkent University Hospital, Ankara, Turkey. All the patients were evaluated using the Mini Mental State Examination (MMSE) upon admission and Confusion Assessment Method (CAM) on a daily basis during hospitalization. Written documents and consultation requests from psychiatry and/or neurology departments were reviewed for recognition of delirium by hospital staff. Results. Among the 108 patients in the study, delirium was noted in 18 (16.7%) during their hospital stay. Consultation from psychiatry or neurology departments was requested for 5 of the 18 patients, only 1 with a delirium diagnosis, indicating that 17 of the cases (94.4%) were not recognized by their primary physicians. Conclusions. The delirium non-recognition rate in elderly hospitalized patients was very high. We think that hospital staff must be trained to recognize the symptoms of delirium and identify high-risk patients.

Anxiety, depression, and anger in functional gastrointestinal disorders: A Cross-sectional observational study

Previous studies have identified a link between anger and somatization. However, little is known about the associations between anger and the development and progression of Functional Gastrointestinal Disorders (FGID). The study aim was to determine the associations between FGID and anger, anxiety, and depression. Participants in this cross-sectional observational study were 109 consecutive patients aged 18-64 years with FGID at Gastroenterology Clinic of Başkent University Hospital. A control group comprised of 96 individuals with no chronic gastrointestinal disorders recruited via snowball sampling. Sociodemographic and clinical information were obtained and participants completed the Hospital Anxiety and Depression Scale and the State-Trait Anger Expression Inventory-2. FGID participants scored higher than controls on depression, anxiety, state anger, and anger expression-in. When the FGID group was divided into upper and lower gastrointestinal symptom groups, the lower symptom group showed higher anger expression-out scores than the upper symptom group. Anger may contribute to the etiology and development of FGID. This is the first study to demonstrate a significant psychological difference between individuals with lower and upper FGID. Interdisciplinary collaboration with gastroenterologists and psychiatrists could strengthen FGID evaluation and may improve treatment compliance.

Association of body mass index with depression and alexithymia

OBJECTIVE: Association between body mass index (BMI) and mental disorders had long been investigated. Recent researches declare a relation between obesity and depressed mood as well as clinical depression. On the other hand mental disorders such as alexithymia are also found to be correlated with an increased risk of obesity. Therefore we aimed to evaluate depression and alexithymia together among normal, overweight and obese adults in order to assess what kind of an association is there between BMI, depression and alexithymia. Additionally we investigated whether there was a relationship between psychosomatic disorders and alexithymia. METHOD: We enrolled 100 adults, aged between 18 to 67 from Department of Endocrinology out-patient clinic whom had normal levels of TSH, fT3 and fT4 thyroid hormones and formed 3 groups according to their Body Mass Index (BMI). Individuals who had had BMI between 18.5-24.99 formed the normal, BMI between 25-29.99 formed the overweight and BMI 30 and above formed the obese groups. All three groups were evaluated by Composite International Diagnostic Interview (CIDI) for clinical diagnosis and also given Toronto Alexithymia Scale 26 item (TAS-26) as well as Beck Depression Inventory (BDI). RESULTS: There was a positive relation between BMI and current depressive episode and this finding was stronger in women. There was no such relation with lifelong depression. TAS-26 total and subscale scores revealed no difference between three groups. As BDI total scores got higher TAS-26 scores were higher. Hence there was a strong positive relation between depression and alexithymia. CONCLUSION: Our findings indicate that higher BMI increases current depressive episode. No association is found between BMI and lifelong depression. Depression and depression severity are strongly associated with alexithymia. Contradictive with literature, alexithymia and its severity are not found to be related with BMI. Following overweight and obese indviduals is important to offset the adverse outcomes of depression.