V. O. Kotan, F. Yilmaz, S. Neşelioğlu, O. Erel, I. T. Okay, Serkan Kiral, Abdurrahim Bakirhan, E. Göka
Thiol/disulphide homeostasis in men with heroin addiction Objective: Heroin addicts have increased oxidative stress which can disturb thiol/disulfide (SH/SS) homeostasis, causing disulfide formation. No study has determined the serum thiol amount and blood disulfide amount in heroin addicts. The aim of the study was to investigate dynamic SH/SS homeostasis in heroin addicts. Methods: Serum SH/SS statuses of 31 heroin addicts and 31 healthy controls were compared to determine the changes in SH/SS homeostasis in heroin addicts. Blood serum native thiol and total thiol (ToSH) levels were measured and the disulfide bond amount was calculated as the half value of the difference between native thiol and ToSH levels. For comparison t-test was used. Results: SH and ToSH levels were significantly lower (p<0.001 for both) in heroin addicts than in the healthy group whereas disulfide levels were significantly higher (p<0.001). Heroin addicts had significantly higher SS/ToSH and SS/SH ratios and significantly lower SH/ToSH ratios than healthy individuals. Conclusion: The results showed that SH and ToSH levels were decreased in heroin addicts and SH/SS homeostasis was also disturbed with a shift to the disulfide bond formation side. Results of this study could contribute to the knowledge about pathogenesis of heroin addiction and also to its management. We suggest that replacement of the thiol gap and reduction of excess SS might have positive effects in treatment results.
{"title":"Thiol/Disulphide Homeostasis in Men with Heroin Addiction","authors":"V. O. Kotan, F. Yilmaz, S. Neşelioğlu, O. Erel, I. T. Okay, Serkan Kiral, Abdurrahim Bakirhan, E. Göka","doi":"10.5350/DAJPN2017300203","DOIUrl":"https://doi.org/10.5350/DAJPN2017300203","url":null,"abstract":"Thiol/disulphide homeostasis in men with heroin addiction Objective: Heroin addicts have increased oxidative stress which can disturb thiol/disulfide (SH/SS) homeostasis, causing disulfide formation. No study has determined the serum thiol amount and blood disulfide amount in heroin addicts. The aim of the study was to investigate dynamic SH/SS homeostasis in heroin addicts. Methods: Serum SH/SS statuses of 31 heroin addicts and 31 healthy controls were compared to determine the changes in SH/SS homeostasis in heroin addicts. Blood serum native thiol and total thiol (ToSH) levels were measured and the disulfide bond amount was calculated as the half value of the difference between native thiol and ToSH levels. For comparison t-test was used. Results: SH and ToSH levels were significantly lower (p<0.001 for both) in heroin addicts than in the healthy group whereas disulfide levels were significantly higher (p<0.001). Heroin addicts had significantly higher SS/ToSH and SS/SH ratios and significantly lower SH/ToSH ratios than healthy individuals. Conclusion: The results showed that SH and ToSH levels were decreased in heroin addicts and SH/SS homeostasis was also disturbed with a shift to the disulfide bond formation side. Results of this study could contribute to the knowledge about pathogenesis of heroin addiction and also to its management. We suggest that replacement of the thiol gap and reduction of excess SS might have positive effects in treatment results.","PeriodicalId":136580,"journal":{"name":"Düşünen Adam: The Journal of Psychiatry and Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121514275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Associations of psychiatric symptoms and neurocognition with clinical insight in schizophrenia Objective: It is important to understand the etiology of impaired insight in schiophrenia in order to develop effective interventions to improve disorder awareness, treatment adherence, and recovery outcomes. The current study aims to explore the relationship of clinical domains and neurocognitive functions with different dimensions of clinical insight among patients with schizophrenia. Methods: A total of 59 patients who met the diagnostic criteria for schizophrenia according to DSM-5 were recruited in the study. All patients were receiving outpatient treatment and were in fairly stable clinical conditions as defined by the absence of hospitalizations or changes in medication within the last three months. Patients were evaluated by Positive and Negative Symptoms Scale (PANSS), Scale to Assess Unawareness of Mental Disorder (SUMD), The Wisconsin Cart Sorting Test (WCST), Stroop-Test, Auditory Consonant Trigram Test (ACT) and Trail Making Test (TMT). Results: Mean age was 41.1±10.3 years. Of the total 59 patients, 71.2% (n=42) were male and 28.8% (n=17) were female. Mean age of onset for illness was 24.6±7.6 years, mean duration of illness was 16.5±9.4 years and mean number of hospitalizations was 2.6±2.8. According to our findings, PANSS positive and general scores were predictors for SUMD-total score, PANSS general score and duration of illness were predictors for SUMD-awareness of mental illness score, PANSS positive and general scores were predictors for SUMDawareness of the need for treatment score, PANSS general score and age of onset of schizophrenia were predictors for SUMD-awareness of the social consequences of disorder score. Conclusion: This study examined clinical insight, psychopathology and various domains of neurocognitive functioning. Our results suggest that clinical insight is associated with positive and general symptoms but not with negative symptoms and neurocognitive impairment in patients with schizophrenia.
{"title":"Associations of psychiatric symptoms and neurocognition with clinical insight in schizophrenia","authors":"P. Zorlu, O. Bilgic, Tuba Sahin, N. Zorlu","doi":"10.5350/DAJPN2017300201","DOIUrl":"https://doi.org/10.5350/DAJPN2017300201","url":null,"abstract":"Associations of psychiatric symptoms and neurocognition with clinical insight in schizophrenia Objective: It is important to understand the etiology of impaired insight in schiophrenia in order to develop effective interventions to improve disorder awareness, treatment adherence, and recovery outcomes. The current study aims to explore the relationship of clinical domains and neurocognitive functions with different dimensions of clinical insight among patients with schizophrenia. Methods: A total of 59 patients who met the diagnostic criteria for schizophrenia according to DSM-5 were recruited in the study. All patients were receiving outpatient treatment and were in fairly stable clinical conditions as defined by the absence of hospitalizations or changes in medication within the last three months. Patients were evaluated by Positive and Negative Symptoms Scale (PANSS), Scale to Assess Unawareness of Mental Disorder (SUMD), The Wisconsin Cart Sorting Test (WCST), Stroop-Test, Auditory Consonant Trigram Test (ACT) and Trail Making Test (TMT). Results: Mean age was 41.1±10.3 years. Of the total 59 patients, 71.2% (n=42) were male and 28.8% (n=17) were female. Mean age of onset for illness was 24.6±7.6 years, mean duration of illness was 16.5±9.4 years and mean number of hospitalizations was 2.6±2.8. According to our findings, PANSS positive and general scores were predictors for SUMD-total score, PANSS general score and duration of illness were predictors for SUMD-awareness of mental illness score, PANSS positive and general scores were predictors for SUMDawareness of the need for treatment score, PANSS general score and age of onset of schizophrenia were predictors for SUMD-awareness of the social consequences of disorder score. Conclusion: This study examined clinical insight, psychopathology and various domains of neurocognitive functioning. Our results suggest that clinical insight is associated with positive and general symptoms but not with negative symptoms and neurocognitive impairment in patients with schizophrenia.","PeriodicalId":136580,"journal":{"name":"Düşünen Adam: The Journal of Psychiatry and Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114984562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Burnout syndrome among physicians: the role of socio-demographic characteristics","authors":"Guler Ozkula, E. Durukan","doi":"10.5350/DAJPN2017300207","DOIUrl":"https://doi.org/10.5350/DAJPN2017300207","url":null,"abstract":"","PeriodicalId":136580,"journal":{"name":"Düşünen Adam: The Journal of Psychiatry and Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128484299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Selma Tural Hesapçoğlu, M. Ceylan, B. Erdogan, Gözde Kandemir, Esra Cop
Which psychiatric symptoms of the mother are related with preschool child’s emotional and behavioral problems? Objective: In this study, it is aimed to explore mother’s which psychiatric symptoms are related to child’s internalizing and externalizing problems. Method: The study group consisted of the mothers of 4-6 years old children, who were referred to Yildirim Beyazit University, Yenimahalle Training and Research Hospital, Child and Adolescent Outpatient Clinic. The control group consisted of 4-6 years old children who have never referred to a child and adolescent psychiatry clinic and their mothers. The mothers filled in the Child Behavior Check List 4-18 (CBCL/4-18), and Symptom Check List-90-R (SCL-90-R). The data were compared with the control group. Results: The study sample consisted of 61 children in the case group, age-matched 55 control children and their mothers. The most common referral complaint was delayed speech (34.4%). There were clinically significant internalizing disorders in 29 (49.2%) children from the study group and 5 (9.4%) from the control group and significant externalizing disorders in 18 (30.5%) children from the study group and 3 (5.7%) from the control group. The correlation analysis revealed that all emotional and behavioral problems of the children were significantly related to the psychiatric symptoms of the mothers. Psychiatric symptom scores of the mothers of children with internalizing and externalizing problems were found significantly higher than the scores of the mothers of children without problems. Conclusion: Mother’s psychiatric symptoms are seen to be related to internalizing and externalizing problems of the child, independent of Psychiatric diagnosis. The fact that any psychiatric symptom of the mother would have an emotional or behavioral reciprocation on the child has to be taken into account by the clinician.
母亲的哪些精神症状与学龄前儿童的情绪和行为问题有关?目的:本研究旨在探讨母亲的哪些精神症状与儿童的内化和外化问题有关。方法:研究组由4-6岁儿童的母亲组成，她们转诊至耶尔德勒姆贝亚兹特大学、叶尼马哈勒培训和研究医院、儿童和青少年门诊。对照组由从未去过儿童和青少年精神病学诊所的4-6岁儿童和他们的母亲组成。母亲填写儿童行为检查表4-18 (CBCL/4-18)和症状检查表90- r (SCL-90-R)。将数据与对照组进行比较。结果:研究样本包括病例组的61名儿童，年龄匹配的55名对照儿童及其母亲。最常见的转诊投诉为言语迟缓(34.4%)。研究组29例(49.2%)、对照组5例(9.4%)存在临床显著的内化障碍;研究组18例(30.5%)、对照组3例(5.7%)存在显著的外化障碍。相关分析显示，儿童的情绪和行为问题与母亲的精神症状显著相关。有内化和外化问题儿童母亲的精神症状得分显著高于无问题儿童母亲的精神症状得分。结论:母亲的精神症状与儿童的内化和外化问题有关，独立于精神病学诊断。临床医生必须考虑到母亲的任何精神症状都会对孩子产生情感或行为上的反应。
{"title":"Mother’s which psychiatric symptoms are related to preschool child’s emotional and behavioral problems?","authors":"Selma Tural Hesapçoğlu, M. Ceylan, B. Erdogan, Gözde Kandemir, Esra Cop","doi":"10.5350/DAJPN2017300101","DOIUrl":"https://doi.org/10.5350/DAJPN2017300101","url":null,"abstract":"Which psychiatric symptoms of the mother are related with preschool child’s emotional and behavioral problems? Objective: In this study, it is aimed to explore mother’s which psychiatric symptoms are related to child’s internalizing and externalizing problems. Method: The study group consisted of the mothers of 4-6 years old children, who were referred to Yildirim Beyazit University, Yenimahalle Training and Research Hospital, Child and Adolescent Outpatient Clinic. The control group consisted of 4-6 years old children who have never referred to a child and adolescent psychiatry clinic and their mothers. The mothers filled in the Child Behavior Check List 4-18 (CBCL/4-18), and Symptom Check List-90-R (SCL-90-R). The data were compared with the control group. Results: The study sample consisted of 61 children in the case group, age-matched 55 control children and their mothers. The most common referral complaint was delayed speech (34.4%). There were clinically significant internalizing disorders in 29 (49.2%) children from the study group and 5 (9.4%) from the control group and significant externalizing disorders in 18 (30.5%) children from the study group and 3 (5.7%) from the control group. The correlation analysis revealed that all emotional and behavioral problems of the children were significantly related to the psychiatric symptoms of the mothers. Psychiatric symptom scores of the mothers of children with internalizing and externalizing problems were found significantly higher than the scores of the mothers of children without problems. Conclusion: Mother’s psychiatric symptoms are seen to be related to internalizing and externalizing problems of the child, independent of Psychiatric diagnosis. The fact that any psychiatric symptom of the mother would have an emotional or behavioral reciprocation on the child has to be taken into account by the clinician.","PeriodicalId":136580,"journal":{"name":"Düşünen Adam: The Journal of Psychiatry and Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125532668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Co-occurrence of autism spectrum disorder and very early onset schizophrenia: a case report Very early onset schizophrenia (VEOS) is a chronic and debilitating psychiatric disorder and has received too little attention in the medical literature. Previous studies have suggested that VEOS had a tendency of a worse prognosis and outcome than adult onset schizophrenia. Autism spectrum disorder (ASD) is a life-long impairing heterogeneous disorder, characterized by severe and pervasive impairments in multiple areas of psychological development. Co-occurrence of ASD and VEOS is reported very rarely in the literature. This paper reports on a case diagnosed as ASD with a VEOS comorbidity. With this case report, it is aimed to review the differential diagnosis, common and different clinical features, neuroimaging findings and genetic and environmental etiologies of these two psychopathologies in the light of the literature.
{"title":"Co-occurrence of autism spectrum disorder and very early onset schizophrenia: a case report","authors":"Duygu Kaba, P. Uran, A. Aysev","doi":"10.5350/DAJPN2017300107","DOIUrl":"https://doi.org/10.5350/DAJPN2017300107","url":null,"abstract":"Co-occurrence of autism spectrum disorder and very early onset schizophrenia: a case report Very early onset schizophrenia (VEOS) is a chronic and debilitating psychiatric disorder and has received too little attention in the medical literature. Previous studies have suggested that VEOS had a tendency of a worse prognosis and outcome than adult onset schizophrenia. Autism spectrum disorder (ASD) is a life-long impairing heterogeneous disorder, characterized by severe and pervasive impairments in multiple areas of psychological development. Co-occurrence of ASD and VEOS is reported very rarely in the literature. This paper reports on a case diagnosed as ASD with a VEOS comorbidity. With this case report, it is aimed to review the differential diagnosis, common and different clinical features, neuroimaging findings and genetic and environmental etiologies of these two psychopathologies in the light of the literature.","PeriodicalId":136580,"journal":{"name":"Düşünen Adam: The Journal of Psychiatry and Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122100597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ş. Y. Sapmaz, Handan Özek Erkuran, Dilek Ergin, Nesrin Şen Celasin, Duygu Karaarslan, Masum Öztürk, Ertuğrul Köroğlu, Ö. Aydemir
Validity and Reliability of the Turkish version of DSM-5 “Severity of Acute Stress Symptoms—Child Age 11–17” Form Objective: This study aimed to assess the validity and reliability of the Turkish version of DSM-5 “Severity of Acute Stress Symptoms—Child Age 11–17” Form. Method: The scale was prepared by carrying out the translation and backtranslation of DSM-5 “Severity of Acute Stress Symptoms—Child Age 11–17” Form. Study group consisted of 30 patients that have been treated in a child psychiatry clinic and diagnosed with posttraumatic stress disorder and 40 healthy volunteers that attended middle or high school at the study period. For the assessment, Child Posttraumatic Stress Reaction Index was also used along with DSM-5 “Severity of Acute Stress Symptoms—Child Age 11–17”
{"title":"Validity and Reliability of the Turkish Version of DSM-5 “Severity of Acute Stress Symptoms—Child Age 11–17” Form","authors":"Ş. Y. Sapmaz, Handan Özek Erkuran, Dilek Ergin, Nesrin Şen Celasin, Duygu Karaarslan, Masum Öztürk, Ertuğrul Köroğlu, Ö. Aydemir","doi":"10.5350/DAJPN2017300104","DOIUrl":"https://doi.org/10.5350/DAJPN2017300104","url":null,"abstract":"Validity and Reliability of the Turkish version of DSM-5 “Severity of Acute Stress Symptoms—Child Age 11–17” Form Objective: This study aimed to assess the validity and reliability of the Turkish version of DSM-5 “Severity of Acute Stress Symptoms—Child Age 11–17” Form. Method: The scale was prepared by carrying out the translation and backtranslation of DSM-5 “Severity of Acute Stress Symptoms—Child Age 11–17” Form. Study group consisted of 30 patients that have been treated in a child psychiatry clinic and diagnosed with posttraumatic stress disorder and 40 healthy volunteers that attended middle or high school at the study period. For the assessment, Child Posttraumatic Stress Reaction Index was also used along with DSM-5 “Severity of Acute Stress Symptoms—Child Age 11–17”","PeriodicalId":136580,"journal":{"name":"Düşünen Adam: The Journal of Psychiatry and Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126118459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypomanic episode in CADASIL syndrome","authors":"M. Eroğlu, Ebru Şahan","doi":"10.5350/DAJPN2017300110","DOIUrl":"https://doi.org/10.5350/DAJPN2017300110","url":null,"abstract":"","PeriodicalId":136580,"journal":{"name":"Düşünen Adam: The Journal of Psychiatry and Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126750624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The aim of this study was to investigate the role of hypothalamo-pituitary-adrenal (HPA) axis activity on the pathophysiology of anxiety disorders by examining the HPA axis activity in patients with panic disorder (PD) and generalized anxiety disorder (GAD). Method: Baseline and post dexamethasone suppression test (DST) serum concentrations of cortisol and dehydroepiandrosterone-sulfate (DHEA-S) were measured in patients with PD (n=24), GAD (n=21) and in healthy controls (n=20). Results: The baseline cortisol levels in GAD group were found lower than those of the patients with PD and healthy controls. Cortisol suppression by dexamethasone in GAD group was found to be lower than PD patients and healthy controls. Baseline and post-DST DHEA-S levels in the patients with PD and GAD were similar to those of the healthy controls. Conclusion: Lower cortisol levels and inadequate cortisol suppression with DST in GAD patients may suggest a downregulation in both corticotropin releasing hormone and glucocorticoid receptors in the central nervous system.
{"title":"Evaluation of hypothalamo-pituitary-adrenal axis activity by using dexamethasone suppression test in patients with panic disorder and generalized anxiety disorder -","authors":"Y. Hacımusalar, E. Eşel","doi":"10.5350/DAJPN2017300102","DOIUrl":"https://doi.org/10.5350/DAJPN2017300102","url":null,"abstract":"Objective: The aim of this study was to investigate the role of hypothalamo-pituitary-adrenal (HPA) axis activity on the pathophysiology of anxiety disorders by examining the HPA axis activity in patients with panic disorder (PD) and generalized anxiety disorder (GAD). \u0000Method: Baseline and post dexamethasone suppression test (DST) serum concentrations of cortisol and dehydroepiandrosterone-sulfate (DHEA-S) were measured in patients with PD (n=24), GAD (n=21) and in healthy controls (n=20). \u0000Results: The baseline cortisol levels in GAD group were found lower than those of the patients with PD and healthy controls. Cortisol suppression by dexamethasone in GAD group was found to be lower than PD patients and healthy controls. Baseline and post-DST DHEA-S levels in the patients with PD and GAD were similar to those of the healthy controls. \u0000Conclusion: Lower cortisol levels and inadequate cortisol suppression with DST in GAD patients may suggest a downregulation in both corticotropin releasing hormone and glucocorticoid receptors in the central nervous system.","PeriodicalId":136580,"journal":{"name":"Düşünen Adam: The Journal of Psychiatry and Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122562337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-27DOI: 10.5350/DAJPN20173001001
A. Serretti
Antidepressant drugs are, according to some estimates, the most widely prescribed class of drugs in the population with 253.6 million prescriptions in 2010 in the United States of America (1). This capacity is due to a number of factors including a wide range of indications and an overall good tolerability. Therefore antidepressants are currently prescribed very frequently by physicians, also recommended by non psychiatrists. The success of antidepressants led to the development of many new compounds over the last decades and we are now able to use more than 40 licensed compounds licensed in the treatment of depression. The availability of so many compounds is positive on one hand, because of the possibility to choose within a wide range of different compounds; but on the other hand it causes confusion for the clinician, who may not be aware of the differences across so many apparently similar drugs. As a result, in the clinical practice many psychiatrists usually prescribe only a small number of compounds which they are familiar with and never or seldom take into consideration other compounds. It is not exceptional to encounter colleagues who prescribe just 2 or 3 different antidepressants, therefore neglecting a wide range of other compounds which could be better suited for their patients. Therefore, the big challenge, which is the main aim of this editorial, is to solicit the awareness within psychiatrist of the whole range of therapeutic possibilities that we have. In fact, on the contrary to what is currently believed, antidepressants are very different one from another and the selection should be performed with great care taking into consideration a wide range of evidence based factors.
{"title":"Evidence Based Criteria for the Antidepressant Choice","authors":"A. Serretti","doi":"10.5350/DAJPN20173001001","DOIUrl":"https://doi.org/10.5350/DAJPN20173001001","url":null,"abstract":"Antidepressant drugs are, according to some estimates, the most widely prescribed class of drugs in the population with 253.6 million prescriptions in 2010 in the United States of America (1). This capacity is due to a number of factors including a wide range of indications and an overall good tolerability. Therefore antidepressants are currently prescribed very frequently by physicians, also recommended by non psychiatrists. The success of antidepressants led to the development of many new compounds over the last decades and we are now able to use more than 40 licensed compounds licensed in the treatment of depression. The availability of so many compounds is positive on one hand, because of the possibility to choose within a wide range of different compounds; but on the other hand it causes confusion for the clinician, who may not be aware of the differences across so many apparently similar drugs. As a result, in the clinical practice many psychiatrists usually prescribe only a small number of compounds which they are familiar with and never or seldom take into consideration other compounds. It is not exceptional to encounter colleagues who prescribe just 2 or 3 different antidepressants, therefore neglecting a wide range of other compounds which could be better suited for their patients. Therefore, the big challenge, which is the main aim of this editorial, is to solicit the awareness within psychiatrist of the whole range of therapeutic possibilities that we have. In fact, on the contrary to what is currently believed, antidepressants are very different one from another and the selection should be performed with great care taking into consideration a wide range of evidence based factors.","PeriodicalId":136580,"journal":{"name":"Düşünen Adam: The Journal of Psychiatry and Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132288529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Memduha Aydin, B. Ilhan, Abdulbaki Akyildiz, I. Eren
Medroxyprogesterone acetate (MPA) is a steroidal progestin which is used as a contraceptive, in hormone replacement therapy, dysmenorrhea and amenorrhea. A 19-year-old female with bipolar affective disorder who was started on MPA for the treatment of secondary amenorrhea developed manic episodes while taking MPA pills. She was in remission for three years when MPA was commenced. As manic symptoms emerged following the onset of MPA treatment, risperidone and valproic acid was administered, which was then switched to aripiprazole and lithium treatment because of side effects. The manic episode resolved three weeks after hospital admission. This case report highlights the risk of commencing hormone pills in patients with personal history of affective disorders because of the possibility of MPA-induced manic episode.
{"title":"Medroxyprogesterone acetate-induced mania in a patient with bipolar affective disorder -","authors":"Memduha Aydin, B. Ilhan, Abdulbaki Akyildiz, I. Eren","doi":"10.5350/DAJPN2017300109","DOIUrl":"https://doi.org/10.5350/DAJPN2017300109","url":null,"abstract":"Medroxyprogesterone acetate (MPA) is a steroidal progestin which is used as a contraceptive, in hormone replacement therapy, dysmenorrhea and amenorrhea. A 19-year-old female with bipolar affective disorder who was started on MPA for the treatment of secondary amenorrhea developed manic episodes while taking MPA pills. She was in remission for three years when MPA was commenced. As manic symptoms emerged following the onset of MPA treatment, risperidone and valproic acid was administered, which was then switched to aripiprazole and lithium treatment because of side effects. The manic episode resolved three weeks after hospital admission. This case report highlights the risk of commencing hormone pills in patients with personal history of affective disorders because of the possibility of MPA-induced manic episode.","PeriodicalId":136580,"journal":{"name":"Düşünen Adam: The Journal of Psychiatry and Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129704612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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