Önder Kavakcı

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

Hiperemesis Gravidarum Tedavisi İçin Göz Hareketleri ile Duyarsızlaştırma ve Yeniden İşleme (EMDR) Tedavisi : Olgu Serisi

Hiperemesis gravidarum (HG) is a serious condition during pregnancy that effects 0.3-2% of the pregnancies. It is among the most frequent reasons for the hospitalization of pregnant women during prenatal period. There are many factors that cause the development of HG, including psychiatric factors. A lot of women with HG need a psychiatric evaluation and support. It is a challenging disorder for psychiatrists because it does not have a standard clinical diagnostic criteria and a determined psychiatric treatment. Eye Movement Desensitization and Reprocessing (EMDR) is a new psychotherapy method different from the usual psychotherapy approach that has shown to be effective in the treatment of posttraumatic stress disorder (PTSD). The curative effect of EMDR on PTSD is explained with adaptive information processing. EMDR practice in PTSD provides the desensitization of the triggers of traumatic stimuli. In this study, the hypothesis suggesting that EMDR has desensitization effects on nausea and vomiting and on their triggers in HG cases were investigated. Five patients with HG were enrolled in the present study. Triggers that cause nausea and vomiting were treated with EMDR. While four of the five cases rapidly responded to EMDR therapy, one case had recurrent HG symptoms whose further clinical evaluations revealed gall bladder disease. EMDR approach may be an effective adjunctive treatment option for HG symptoms.

Effects of the preoperative anxiety and depression on the postoperative pain in ear, nose and throat surgery

Background: Anxiety and depressive disorders can be widespread among patients who are being treated in surgical clinics and they can affect operation outcomes. Objective: The aim of this study was to investigate the relationship between the level of their anxiety and depression in the preoperative period and the pain level in the postoperative period, analgesic requirement, development of complications and the duration of hospital stay in patients followed up in an ENT clinic. Materials and Methods : One hundred and three ( n =103) subjects [male = 56 (%54), female = 47 (%45.6)] filled out the Hospital Anxiety and Depression Scale, sociodemographic data evaluation form before the surgery. Postsurgical pain levels of the subjects were evaluated by the Visual Pain Scale. The analgesic requirements of the subjects were assessed and their duration of hospital stay was noted. Results: While the presence of preoperative anxiety was a predictor of postoperative pain, such a relationship was not found between depression and postoperative pain. On the Visual Pain Scale, it was observed that the anxiety levels were moderately correlated with the Visual Pain Scale assessments on the first day of postoperative period (r = 0.30, P P Conclusion: For elective conditions requiring short-term hospitalization in ENT surgery, presence of preoperative anxiety seems to be a significant predictor of postoperative pain.

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.

Assessing anxiety levels and empathic tendency in blood and platelet donors

In spite of a constantly-increasing requirement for blood transfusion in the world, blood donation does not exhibit an increase at the same rate. In Turkey with a population of 74 million, only 15 per 10,000 people donate blood regularly and rate of voluntary blood donation is very low compared to developed countries. The aim of this study is to determine empathic level of donors and anxiety levels of blood and platelet donors and also to enable comfort and motivation of donors by taking precautions for reducing their anxieties. This prospective and descriptive study was conducted with 100 voluntary donors (50 blood donors, 50 platelet donors) who admitted to Blood Centre of Cumhuriyet University Hospital between 15 March 2012 and 30 April 2012. Average age of these donors was 27 (19-48)years. The mean scores of donors from Empathic Tendency Scale (ETS), State Anxiety Invertory (SAI) and Trait Anxiety Inventory (TAI) were 70 (49-83), 40 (33-45) and 34 (30-44), respectively. ETS score of those donating blood/platelet for the first time was low, >1 is higher in those who donated previously. SAI and TAI scores of blood donors were higher than those of platelet donors (p<0.001) and TAI score was higher in those who donate for the first time (p<0.007) compared to previously donated precipitants. In conclusion, this study underscores that the request of the donor to help others is the most important factor for donation. People frequently donate blood to unfamiliar people and recurring blood donations increase the level of empathy. Donation made during the continuous disclosure is an important factor for being a donor.

Post-traumatic stress disorder and anger in migraine patients -

Post-traumatic stress disorder and anger in migraine patients Objective: In recent studies, a relationship between migraine headaches and post-traumatic stress disorder (PTSD) has been suggested. The clinicians in most of these studies have not diagnosed PTSD; the evaluation has been carried out using screening scales. It has also been asserted that there is a relation between anger and migraine and other chronic painful disorders. This study aimed to search the prevalence of clinically diagnosed post-traumatic stress disorder (PTSD) among migraine patients and the relationship with anger. Method: Sixty consecutive migraine patients directed from neurology clinic and 60 healthy controls having similar features constituted the sample of this study. SCID-I/CV PTSD module and clinician administered posttraumatic stress disorder scale (CAPS) implemented by the clinician were administered to the sample. The sample also filled in the socio-demographic data form and Spielberg’s State-Trait Anger-Anger Expression Scale (STAXI). Results: Seventeen persons (28%) in the migraine group and 5 persons (8.3%) in the control group were diagnosed with PTSD. In the migraine group, PTSD was found at a statistically significantly higher level. The trait anger and anger in subscale scores in the migraine group were found statistically significantly higher compared to the control group. In the migraine group, the anger out subscale mean score was statistically significantly higher in the ones with PSTD than the ones without it. A positive correlation was detected between the scores of trait anger and CAPS and a negative correlation between the scores of anger control and CAPS. Conclusion: In migraine patients, PTSD, trait anger and internal anger are higher compared to the healthy ones. In migraine patients diagnosed with PTSD, the external anger has increased. It may be suggested to seek for the trauma experiences in migraine patients and search the efficiency of trauma and anger directed therapies.

Rapid efficacy of the eye movement desensitization and reprocessing in treatment of persistent complex bereavement disorder:report of two cases

Rapid efficacy of the eye movement desensitization and reprocessing in treatment of persistent complex bereavement disorder: report of two cases Grief occurs following the loss of a beloved one and it is a normal experience. However, prolonged (>6 months) grief can serve as a ground for a pathological situation. According to DSM-5, persistent complex bereavement disorder (PCBD) is diagnosed if the grief period exceeds twelve months. If this grief experience accompanies a traumatic event, DSM-5 Appendix recommends including Traumatic Death Specifier. In the process of PCBD, there can be several symptoms such as decreased functionality, sleep disorders, depressed mood, guilt feelings, somatic disorders and denial of the death. Eye movement desensitization and reprocessing (EMDR) is one of the treatment methods for PCBD. In this study, two cases diagnosed with PCDB and recovered apparently with a time-limited EMDR treatment are presented.