Volkan Topçuoğlu

Adult strabismus and social phobia: a case-controlled study.

PURPOSE To determine the social phobia rate, social anxiety level, severity of depressive symptoms, and disease-related disability in adult strabismus patients. METHODS Forty-nine strabismus patients and 46 control subjects from 15 to 65 years of age were evaluated. A psychiatric interview focusing on social phobia and the Liebowitz Social Anxiety Scale (LSAS) were administered to each participant. All participants completed the Hospital Anxiety and Depression Scale (HADS), a psychiatric symptom checklist (Symptom Checklist 90-Revised; SCL-90R), and the Sheehan Disability Scale. RESULTS Social phobia was diagnosed in 26 of the 49 strabismus patients and in 8 of the 46 control subjects (p < 0.001). Strabismus patients demonstrated significantly greater scores in all of the subscores and the total scores of LSAS. They were more disabled in social life, family life, and at work. They also showed greater interpersonal sensitivity scores compared with the control group. Compared with strabismus patients without social phobia, the strabismus patients with social phobia demonstrated significantly greater depression scores in HADS and also scored in all dimensions of LSAS. Their social life and family life scores in disability scale and all scores in SCL-90-R except somatization were better than strabismus patients without social phobia. CONCLUSIONS In adult strabismus patients, social phobia is a frequent psychiatric comorbidity. Adult patients with strabismus need to be carefully evaluated for social phobia for an appropriate referral and treatment.

Citalopram-induced SIADH in a hypertensive patient on salt restricted diet

Hyponatraemia is a very rare but potentially fatal complication of SSRIs and citalopram therapy, especially during the first weeks of treatment and for those who concomitantly use medications known to cause hyponatraemia. We present a 54-year-old hypertensive female patient who was admitted to the hospital with drowsiness, paresthesia, fatigue, nausea, vomiting and visual hallucinations and who was diagnosed to have syndrome of inappropriate secretion of antidiuretic hormone (SIADH) due to citalopram. All her presenting symptoms disappeared after discontinuation of citalopram therapy, fluid restriction and a careful hypertonic saline infusion. This case suggests that SIADH may develop among hypertensive patients, especially when they use diuretics or follow a salt restricted diet.

Geriatric psychiatry consultations in a Turkish university hospital

OBJECTIVE The size of the elderly population is growing rapidly in Turkey. We aimed to characterize geriatric psychiatry consultations to obtain the characteristic pattern of these patients for further interventions. METHOD A retrospective chart review was undertaken for each patient. RESULTS One hundred and sixty-six patients with a mean age (+/- S.D.) of 75.5 +/- 6.6 years were included in this study. Most referrals came from the Department of Internal Medicine (42.2%), with sleep problems (42.1%), depression (29.5%) and anxiety (28.3%) being the most common reasons for referral. Hypertension was the most frequent medical diagnosis (53.6%). The mean number +/- S.D.) of medications used by each patient was 4.4 +/- 2.0. The leading psychiatric diagnosis at the end of the assessment was adjustment disorder (31.3%). CONCLUSION Turkish geriatric psychiatry consultation patients display similar characteristics to elderly patients from other western countries. The main difference comes from diagnosis of adjustment disorder, which may be related to hospital conditions and strong family ties in developing countries.

RIGHT BASAL GANGLION HYPOPERFUSION IN OBSESSIVE COMPULSIVE DISORDER PATIENTS DEMONSTRATED BY Tc-99m-HMPAO BRAIN PERFUSION SPECT: A CONTROLLED STUDY

The aim of this study is to demonstrate the regional cerebral blood flows (rCBF) of obsessive-compulsive disorder (OCD) patients compared to controls by using Tc-99m-HMPAO SPECT. Sixteen OCD and seven control subjects were admitted into the study. Yale-Brown Obsessive Compulsive Rating Scale (Y-BOCS), Hamilton Depression Rating Scale (HDRS), and Hamilton Anxiety Rating Scale (HARS) were applied to the patients. The rCBF was found to be decreased in right basal ganglion in OCD patients. The right basal ganglion rCBF was negatively correlated with Y-BOCS total and compulsion scores. The left thalamus rCBF was negatively correlated with Y-BOCS obsession score. Right and left cingulate rCBF were negatively correlated with HDRS score. The results indicating hypoperfusion in right basal ganglion in OCD patients support previous findings about dysfunction of frontal-subcortical circuits in this disorder.

Attentional Bias and Training in Social Anxiety Disorder

Cognitive behavioral therapy (CBT) is one of the most effective treatment modalities for social anxiety disorder (SAD), showing a high level of clinical evidence supporting its effectiveness. On the other hand, lack of the desired benefit from this treatment in some patients causes continuation of the search for new techniques. Recent research studies have focused on attentional bias and attention training in SAD. Attention processes in SAD have been a major target of interest and investigation since the introduction of the first cognitive models explaining SAD. In the first model, it was highlighted that attention was self-focused. The relationship between threatening stimuli and attention was considered in the subsequent models. Attentional bias towards threat may take place in several ways, such as facilitated processing of threat, difficulty in disengaging attention from the threat and avoidance of attention from the threat. After these descriptions regarding the phenomenology of the disorder, treatments to modify attention, processes were developed. In spite of conflicting results, investigations on attentional training are promising. Attention processes, attentional bias and attentional training in SAD are discussed in this review.

Living in difficult conditions: an analysis of the factors associated with resilience in youth of a disadvantaged city

ABSTRACT OBJECTIVE: Children and adolescents facing difficult life circumstances due to social, economic and cultural adversity, form a disadvantaged group in terms of social functioning and healthy psycho-social development. The goal of this study was to evaluate the psychological resilience of high school students in Muş City – which was ranked last in the general life index among 81 provinces according to 2015 data from the Turkish Statistical Institute – and to examine different dimensions of psychological resilience in relation to a variety of variables including adverse life events and demographic characteristics. METHOD: The study sample consisted of 1025 students from the 10th and 11th grades of five different high schools operating in the city centre of Muş. Participants were asked to fill in a socio-demographic questionnaire, the List of Adverse Life Events and the 59-item Resilience and Youth Development Module (RYDM). A series of correlational and descriptive analyses were then performed. RESULTS: Correlational analyses revealed that among the demographic factors, low economic status, a criminal record and poor academic performance were associated with poor psychological resilience, while among adverse life events, the deterioration of parental economic status, frequent arguments between parents as well as a history of mental illness and alcohol/substance abuse in the family were also linked to low levels of psychological resilience. It was also determined that girls had higher scores on internal assets of RYDM (empathy, problem solving, self efficacy, communication and cooperation, goals, self awareness and educational aspirations), while exposure to a larger number of adverse life events negatively affected internal resilience assets. Finally, trauma exposure, just as the low RYDM scores, seems to be associated with frequent arguments between parents, alcohol/substance abuse in the family, male gender and a criminal record. However, there was no significant relationship between psychological resilience and trauma alone. CONCLUSION: Interventions to improve psychological resilience, which is a dynamic process, need to be comprehensive and multi-dimensional. In this context, it is crucial to elucidate the factors associated with the psychological resilience of children and adolescents exposed to a specific risk factor, such as adverse living conditions. In order to improve our understanding of psychological resilience and youth development in Turkey and to determine specific needs for interventions, future studies on various risk groups in different pilot cities – as in the example of Muş – are needed.

Anoreksiya Nervoza’da Psikososyal Tedaviler

Yuksek morbidite ve mortalitesine karsin anoreksiya nervozanin psikolojik tedavilerine yonelik arastirmalar sinirli sayidadir. Bu yazida, anoreksiya nervozaya yonelik cesitli psikososyal tedavi yontemlerinin genel hatlariyla tanitilmasi ve bu yontemlerin etkinliklerine dair randomize kontrollu calismalarin guncel bir derlemesinin yapilmasi amaclanmistir. Derlenen arastirmalar, ergenler uzerinde yurutulen calismalar ve ergenlerle eriskinlerin birlikte oldugu calismalar olmak uzere iki ana baslik altinda incelenmis; diger degiskenlerle ilgili hususlar ayrica ele alinmistir.

EPA-1534 - Attention deficit hyperactivity symptoms in patients with social phobia and its affect on disability and quality of life

Abstract Aims Aim of this study is to determine the prevalence of attention deficit and hyperactivity symptoms, and to compare social phobia patients with high and low level symptoms in terms of disability and quality of life. Methods The study included 16 (44.4%) female and 20 (55.6%) male patients with social phobia (SP). The control group consisted of 36 volunteers who did not have any psychiatric disorder. Study and control group were evaluated using Wender-Utah Rating Scale (WURS-25), Turgay Adult Attention-Deficit /Hyperactivity Disorder (ADD/ADHD) DSM-IV-Based Diagnostic Screening and Rating Scale, Becks Depression Inventory (BDI), The Sheehan Disability Scale (SDS), and The Short Form 36 Quality of Life Instrument (SF-36). Results No statistically significant difference was found between the social phobia and control groups, based on gender, education level and mean age. Medium and high levels of ADHD symptoms were determined in 50.0% (n=18) of the SP group. Mean scores of WURS-25 scale, total and sub-scales of the Turgay ADHD scale in the SP group were higher than those of the control group. In the group with high levels of ADHD symptoms, the mental health sub-scale scores of SF-36 scale was statistically significantly lower than the group with low levels of ADHD symptoms. Conclusions Our results showed that ADHD symptom levels in social phobia patients were higher than controls and this situation can be associated with the deterioration of their mental health.