Senol Turan

Case Report: Clozapine use in two women with schizophrenia during pregnancy:

Stabilized patients who receive clozapine may wish to have children; but studies on pregnant women receiving clozapine treatment are limited. In this study, we report on clozapine use during pregnancy in two women. The first woman (Case 1) had two deliveries while she was receiving clozapine treatment for schizophrenia. Both her deliveries were term, uncomplicated vaginal deliveries, and the clozapine dose was reduced throughout pregnancy. The second woman (Case 2) developed schizophrenia after her first child was born. She became pregnant after clozapine initiation. She delivered twins by term, uncomplicated vaginal delivery. In our cases, no specific risks for the mothers and their children can be attributed to the use of clozapine. Physicians must be aware of the changes in fertility induced by prolactin-sparing drugs. Mothers who receive clozapine treatment should not be advised to breastfeed their children.

Effectiveness of olanzapine in neurosyphilis related organic psychosis: a case report.

The clinicians usually do not consider syphilis in the differential diagnosis for patients with acute and chronic psychiatric symptoms. To familiarize clinicians particularly with neurosyphilis (NS) and to discuss the atypical antipsychotic alternatives, we wish to present a case with agitated, resistant psychotic symptoms related to neurosyphilis. The case was a 55-year-old male who has had anxiety, irritability, auditory hallucinations, ataxia, dysarthric speech, paranoid and persecutory delusions and agitated behaviour. Parenteral ziprasidone 20 mg/bid was initialized at the first day of admission to reduce agitation. Then it was switched to olanzapine velotab 10 mg/bid because of inefficacy. Parenteral cephtriaxon 1 g/daily was administered because of seropositive VDRl and TPHA and positive cerebrospinal fluid VDRl. Olanzapine velotab may be a good alternative antipsychotic and should be considered in reducing agitation and psychotic symptoms in NS.

Psychodermatology: Knowledge, Awareness, Practicing Patterns, and Attitudes of Dermatologists in Turkey.

OBJECTIVE Approximately, 1 in 3 patients in dermatology settings has psychiatric comorbidity. Thus, we conducted a survey in Turkey to explore the awareness, knowledge, practicing patterns, and attitudes of dermatologists toward psychocutaneous disorders. METHOD The questionnaire-based study was performed from March 1, 2013, to May 20, 2013. Study participants included 115 dermatologists. The questionnaire consisted of 9 multiple-choice questions and 2 open-ended questions. RESULTS Of the 115 dermatologists in the study, 38 were men and 77 were women. More than 85% of dermatologists indicated that they examine > 30 patients per week in their practice, while only 2% saw < 10 patients per week. The most frequent dermatologic condition associated with psychiatric involvement seen by dermatologists was acne (49.1%). The top 3 diagnoses referred by dermatologists to psychiatrists were psoriasis (42.6%), alopecia areata (38.2%), and pruritus (27.8%). CONCLUSIONS A need for collaboration between primary care, psychiatry, and dermatology disciplines in handling patients with psychocutaneous conditions is widely accepted. Investigating the knowledge, attitudes, and awareness of dermatologists about psychocutaneous disorders might contribute to the development of new educational strategies and elicit qualified biopsychosocial approaches.

Sexual dysfunctions in patients with obsessive compulsive disorder

ABSTRACT Objective: Obsessive compulsive disorder (OCD) is known to have a negative impact on sexual functioning. The aim of the present study was to compare patients with OCD and healthy subjects in terms of the sexual dysfunctions. Method: Seventy eight patients, between 18-52 years of age, sexually active who were admitted to the outpatient unit of a university psychiatry department, and who were diagnosed with OCD according to the DSM-IV diagnostic criteria were enrolled in the study. The control group encompassed 60 healthy subjects. The severity of OCD was rated by using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and all participants were evaluated with the Arizona Sexual Experiences Scale (ASEX) for sexual dysfunction. Results: The rate of sexual dysfunction (SD) was determined in 65.4% of OCD patients and 28.3% of the control group. While anorgasmia was the most reported complaint in females with OCD (51.2 %), hypoactive sexual desire was the most reported in males with OCD (18.2 %). ASEX scores of sexual desire, excitement, vaginal lubrication, orgasm and orgasmic satisfaction were found to be significantly higher in females with OCD compared to healthy subjects.While erectile dysfunction was found significantly higher in healthy males compared to OCD patients, no significant difference was found between the two groups for other sexual functions. Conclusion: In this study, all phases of sexual function were impaired in females with OCD. Though orgasmic dysfunction was identified as the most common sexual dysfunction in females with OCD, this issue is controversial. We did not detect a significant sexual dysfunction in males with OCD, and these findings may suggest that antidepressant drugs might have a positive effect on sexual dysfunction in males or at least did not cause a significant negative effect on sexual functions in male patients.