Erectile dysfunction is a sexual dysfunction which is commonlycomorbid with major depression. Antidepressant treatment does notalways improve comorbid sexual dysfunctions in major depression. Infact, sexual dysfunction may worsen or get complicated following theintroduction of antidepressants. Modafinil is a drug with stimulanteffect on the central nervous system by binding to norepinephrineand dopamine transporters and consequently increasing synapticnorepinephrine and dopamine levels. Modafinil is primarily used inthe treatment of narcolepsy and chronic fatigue syndrome. In addition,it is known for its effectiveness in attention deficit hyperactivitydisorder and as an add-on option for major depression. In this paper,we report the case of a 39-year-old man with major depression whosecomorbid erectile dysfunction improved after addition of modafinilto antidepressant treatment. Fluoxetine 20 mg/day was initiatedand despite the improvement of most of the depressive symptomsand the sexual desire, his complaints of fatigue, weakness and erectiledysfunction continued. With the addition of modafinil (200 mg /day),improvement was observed not only in psychomotor symptoms but alsoin erectile dysfunction of the patient.
{"title":"[Use of Modafinil in Co-existing Major Depression and ErectileDysfunction: A Case Report].","authors":"H. Karaş, M. Kaser","doi":"10.5080/U23407","DOIUrl":"https://doi.org/10.5080/U23407","url":null,"abstract":"Erectile dysfunction is a sexual dysfunction which is commonlycomorbid with major depression. Antidepressant treatment does notalways improve comorbid sexual dysfunctions in major depression. Infact, sexual dysfunction may worsen or get complicated following theintroduction of antidepressants. Modafinil is a drug with stimulanteffect on the central nervous system by binding to norepinephrineand dopamine transporters and consequently increasing synapticnorepinephrine and dopamine levels. Modafinil is primarily used inthe treatment of narcolepsy and chronic fatigue syndrome. In addition,it is known for its effectiveness in attention deficit hyperactivitydisorder and as an add-on option for major depression. In this paper,we report the case of a 39-year-old man with major depression whosecomorbid erectile dysfunction improved after addition of modafinilto antidepressant treatment. Fluoxetine 20 mg/day was initiatedand despite the improvement of most of the depressive symptomsand the sexual desire, his complaints of fatigue, weakness and erectiledysfunction continued. With the addition of modafinil (200 mg /day),improvement was observed not only in psychomotor symptoms but alsoin erectile dysfunction of the patient.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91498597","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 is to conduct a case management model on a group of individuals with severe mental illness (SMI) and to evaluate the outcomes during a 24-month follow up. METHOD A total of 34 patients diagnosed with schizophrenia or schizoaffective disorder with at least one exacerbation over the last year, poor treatment compliance, who were unemployed and unable to live independently and who gave consent to participate were included to the study. Case management was conducted by a medical professional in the house, schizophrenia association, hospital, and workplace of the patients by interviewing the patients, family members, and the employers of the patients, at intervals arranged according to the need of each patient. Patients were assessed at baseline stage, the sixth, 12th and the 24th month regarding functionality, clinical condition, treatment compliance and family burden. RESULTS The study was completed in 24 months with 30 patients with a mean age was 36, mean education level of 11 years, and a mean illness duration of 13 years. The majority consisted of unmarried males living with their parents. During the follow up, every patient participated in the recommended rehabilitation programs with, improvement in treatment adherence and functionality. A significant decrement was detected in the number of hospitalizations when compared to the history before the start of the study. Family burden decreased. Ten patients got employed and 3 patients left work. CONCLUSION It can be concluded that case management hypothesized to be beneficial for people with SMI with positive outcomes on clinical recovery, improved social and vocational functionality and reduced incidences of hospital stay should be included as a routine psychosocial rehabilitation service.
{"title":"Case Management for Individuals with Severe Mental Illness: Outcomes of a 24-Month Practice.","authors":"Aysel İncedere, M. Yıldız","doi":"10.5080/u23532","DOIUrl":"https://doi.org/10.5080/u23532","url":null,"abstract":"OBJECTIVE The aim of this study is to conduct a case management model on a group of individuals with severe mental illness (SMI) and to evaluate the outcomes during a 24-month follow up. METHOD A total of 34 patients diagnosed with schizophrenia or schizoaffective disorder with at least one exacerbation over the last year, poor treatment compliance, who were unemployed and unable to live independently and who gave consent to participate were included to the study. Case management was conducted by a medical professional in the house, schizophrenia association, hospital, and workplace of the patients by interviewing the patients, family members, and the employers of the patients, at intervals arranged according to the need of each patient. Patients were assessed at baseline stage, the sixth, 12th and the 24th month regarding functionality, clinical condition, treatment compliance and family burden. RESULTS The study was completed in 24 months with 30 patients with a mean age was 36, mean education level of 11 years, and a mean illness duration of 13 years. The majority consisted of unmarried males living with their parents. During the follow up, every patient participated in the recommended rehabilitation programs with, improvement in treatment adherence and functionality. A significant decrement was detected in the number of hospitalizations when compared to the history before the start of the study. Family burden decreased. Ten patients got employed and 3 patients left work. CONCLUSION It can be concluded that case management hypothesized to be beneficial for people with SMI with positive outcomes on clinical recovery, improved social and vocational functionality and reduced incidences of hospital stay should be included as a routine psychosocial rehabilitation service.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90306026","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 Despite its importance as a psychological construct, narcissism have been inconsistently defined and measured across studies. Overly narrow construct definition of pathological narcissism and insufficient measurement lead Pincus et al. (2009) to develop Pathological Narcissism Inventory (PNI). Which is a multidimensional measure of pathological narcissism that assesses both overt and covert expressions of narcissistic vulnerability. The aim of this study was to adapt PNI into Turkish language and investigate the validity and reliability indicators. METHOD The Turkish version of Pathological Narcissism Inventory was applied to 518 (205 male) university students. Cronbach alpha and test-retest reliability coefficients were calculated. Confirmatory and exploratory factor analyzes have been carried out to determine the factors. The Narcissistic Personality Inventory (NPI) and the Bell Object Relations and Reality Assessment Scale (BORRTI) object relational form were used for evaluation of validity. RESULTS The Cronbach alpha is .93 for the total score, and test-retest reliability is r= .91. The principal components analysis revealed 6 factors explaining 50.24% of the variance. According to the structural equality model, fit indices indicate valid and reliable models. Analyses revealed significant correlation coefficients with NPI and BORRTI. CONCLUSION The validity and reliability indicators of PNE Turkish form were within an acceptable range and PNE can be used for further studies.
{"title":"[The Standardization of the Pathological Narcissism Inventory inthe Turkish Language and Testing Its Validity and Reliability].","authors":"Gamze Şen, E. Barişkin","doi":"10.5080/U23274","DOIUrl":"https://doi.org/10.5080/U23274","url":null,"abstract":"OBJECTIVE Despite its importance as a psychological construct, narcissism have been inconsistently defined and measured across studies. Overly narrow construct definition of pathological narcissism and insufficient measurement lead Pincus et al. (2009) to develop Pathological Narcissism Inventory (PNI). Which is a multidimensional measure of pathological narcissism that assesses both overt and covert expressions of narcissistic vulnerability. The aim of this study was to adapt PNI into Turkish language and investigate the validity and reliability indicators. METHOD The Turkish version of Pathological Narcissism Inventory was applied to 518 (205 male) university students. Cronbach alpha and test-retest reliability coefficients were calculated. Confirmatory and exploratory factor analyzes have been carried out to determine the factors. The Narcissistic Personality Inventory (NPI) and the Bell Object Relations and Reality Assessment Scale (BORRTI) object relational form were used for evaluation of validity. RESULTS The Cronbach alpha is .93 for the total score, and test-retest reliability is r= .91. The principal components analysis revealed 6 factors explaining 50.24% of the variance. According to the structural equality model, fit indices indicate valid and reliable models. Analyses revealed significant correlation coefficients with NPI and BORRTI. CONCLUSION The validity and reliability indicators of PNE Turkish form were within an acceptable range and PNE can be used for further studies.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87530226","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 Psychiatric differential diagnosis is often ignored in young patients with memory complaints, even if no neurological or physical illnesses were evident. In this study, we aimed to determine the relationship between subjective memory complaints and objective memory impairment, depression and anxiety levels in young patients with memory complaints. METHOD: The study was carried out with 56 patients under the age of 55 who applied to the psychiatry, neurology and internal medicine outpatient clinics with memory complaints and 55 healthy volunteers. All participants completed the Subjective Memory Complaints Questionnaire (SMCQ), the Montreal Cognitive Assessment (MoCA), the Auditory Verbal Learning Test (AVLT), the Benton Visual Memory Test (BVMT), the Digit Span Test (DST), the Verbal Fluency Test (VFT), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). RESULTS: Significant differences were observed in the scores of SMCQ, MoCA, AVLT, BVMT, DST, VFT, BDI and BAI in individuals with memory complaints compared to the controls, which could not be ascribed to any neurological or physical disease. Depression and anxiety levels were significantly higher than those of the control group. CONCLUSION: Differential diagnosis of memory complaints has to be made in young patients. Subjective memory complaints may be indicative of depression and anxiety disorders. It is necessary to evaluate the cognitive impairment that may develop over time in young patients with subjective memory disturbances via longitudinal studies.
{"title":"[The Relationship Between Subjective Memory Complaints and Objective Memory Performance, Depression and Anxiety Levels in Patients Under 55 Years of Age].","authors":"Lütfiye Söğütlü, N. Alaca","doi":"10.5080/U23084","DOIUrl":"https://doi.org/10.5080/U23084","url":null,"abstract":"OBJECTIVE Psychiatric differential diagnosis is often ignored in young patients with memory complaints, even if no neurological or physical illnesses were evident. In this study, we aimed to determine the relationship between subjective memory complaints and objective memory impairment, depression and anxiety levels in young patients with memory complaints. METHOD: The study was carried out with 56 patients under the age of 55 who applied to the psychiatry, neurology and internal medicine outpatient clinics with memory complaints and 55 healthy volunteers. All participants completed the Subjective Memory Complaints Questionnaire (SMCQ), the Montreal Cognitive Assessment (MoCA), the Auditory Verbal Learning Test (AVLT), the Benton Visual Memory Test (BVMT), the Digit Span Test (DST), the Verbal Fluency Test (VFT), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). RESULTS: Significant differences were observed in the scores of SMCQ, MoCA, AVLT, BVMT, DST, VFT, BDI and BAI in individuals with memory complaints compared to the controls, which could not be ascribed to any neurological or physical disease. Depression and anxiety levels were significantly higher than those of the control group. CONCLUSION: Differential diagnosis of memory complaints has to be made in young patients. Subjective memory complaints may be indicative of depression and anxiety disorders. It is necessary to evaluate the cognitive impairment that may develop over time in young patients with subjective memory disturbances via longitudinal studies.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75211332","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 In this cross-sectional study, childhood traumas, attachment security and alexithymia in adolescents with psychogenic nonepileptic seizures (PNES) were compared with those of adolescents without any psychiatric disorder using both semi-structured clinical interviews and self-report scales. METHOD This study included 42 adolescents with PNES aged between 12-18 and 38 healthy adolescents who were matched with the study group in respect to socio-demographic variables. All adolescents and their parents were interviewed using Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version in order to evaluate psychiatric disorders. Clinician- Administered Posttraumatic Stress Disorder (PTSD) Scale for Children and Adolescents was used to examine the presence of PTSD symptoms. All adolescents completed the Childhood Trauma Questionnaire-28, Short Form of Inventory of Parent and Peer Attachment, Toronto Alexithymia Scale and Rosenberg Self Esteem Scale. RESULTS Adolescents with PNES had more emotional and sexual traumatic experiences and PTSD symptoms compared to the control group. PNES group perceived higher "communication" but lower "trust" in attachment relationships with their mothers and fathers. Higher alexithymia and lower self-esteem were determined in the PNES group. Childhood traumas, lifetime PTSD symptoms and alexithymia were found to be significant risk factors for PNES in adolescents. CONCLUSION Results indicate that comorbid psychiatric disorders, traumatic experiences, attachment problems and alexithymia need to be evaluated and treated in adolescents with PNES.
{"title":"[Childhood Traumas, Attachment and Alexithymia in Adolescentswith Psychogenic Nonepileptic Seizure Type of Conversion Disorder].","authors":"Özlem Uzun, D. Akdemir, M. Topçu, B. Özsungur","doi":"10.5080/u18398","DOIUrl":"https://doi.org/10.5080/u18398","url":null,"abstract":"OBJECTIVE In this cross-sectional study, childhood traumas, attachment security and alexithymia in adolescents with psychogenic nonepileptic seizures (PNES) were compared with those of adolescents without any psychiatric disorder using both semi-structured clinical interviews and self-report scales. METHOD This study included 42 adolescents with PNES aged between 12-18 and 38 healthy adolescents who were matched with the study group in respect to socio-demographic variables. All adolescents and their parents were interviewed using Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version in order to evaluate psychiatric disorders. Clinician- Administered Posttraumatic Stress Disorder (PTSD) Scale for Children and Adolescents was used to examine the presence of PTSD symptoms. All adolescents completed the Childhood Trauma Questionnaire-28, Short Form of Inventory of Parent and Peer Attachment, Toronto Alexithymia Scale and Rosenberg Self Esteem Scale. RESULTS Adolescents with PNES had more emotional and sexual traumatic experiences and PTSD symptoms compared to the control group. PNES group perceived higher \"communication\" but lower \"trust\" in attachment relationships with their mothers and fathers. Higher alexithymia and lower self-esteem were determined in the PNES group. Childhood traumas, lifetime PTSD symptoms and alexithymia were found to be significant risk factors for PNES in adolescents. CONCLUSION Results indicate that comorbid psychiatric disorders, traumatic experiences, attachment problems and alexithymia need to be evaluated and treated in adolescents with PNES.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79024760","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}
Hyponatremia can be asymptomatic or have a wide range of clinical presentations such as headaches, muscle cramps, nausea, seizures, coma, cerebral edema and may even result in death. Despite it has been suggested that duloxetine has a relatively less risk of hyponatraemia, the number of case reports are increasing. A 45- year old female patient with complaints of fear, anxiety, sleeplessness and headache was started on duloxetine (30 mg/day). In the first week of the treatment, she was admitted to the emergency service with dizziness, dry mouth, polyuria and polydipsia. She had to be transferred to the intensive care unit because of agitation, loss of consciousness and a generalized tonic-clonic seizure. Blood levels of Sodium (Na+), Potassium (K+) and Chlorine (Cl-) were, respectfully, 121 mmol/L, 2.7 mmol/L and 87 mmol/L. Brain imaging displayed cerebral edema. Electrolyte levels were regulated with saline infusions. Amitriptyline was initiated for the ongoing headache and anxiety. In outpatient visits, hyponatremia did not recur in the following 3 months. Low dose duloxetine was associated with severe hyponatremia signs and symptoms in an individual who was not previously considered as high risk for hyponatraemia. The patient's history did not reveal any complaints related to hyponatremia when she was treated with sertraline two years ago. Based on these, we discussed the risk factors for hyponatremia and risky antidepressant classes.
{"title":"Duloxetine Induced Hyponatremia.","authors":"Ebru Şahan, Fatma Büşra Parlakkaya Yıldız","doi":"10.5080/u23394","DOIUrl":"https://doi.org/10.5080/u23394","url":null,"abstract":"Hyponatremia can be asymptomatic or have a wide range of clinical presentations such as headaches, muscle cramps, nausea, seizures, coma, cerebral edema and may even result in death. Despite it has been suggested that duloxetine has a relatively less risk of hyponatraemia, the number of case reports are increasing. A 45- year old female patient with complaints of fear, anxiety, sleeplessness and headache was started on duloxetine (30 mg/day). In the first week of the treatment, she was admitted to the emergency service with dizziness, dry mouth, polyuria and polydipsia. She had to be transferred to the intensive care unit because of agitation, loss of consciousness and a generalized tonic-clonic seizure. Blood levels of Sodium (Na+), Potassium (K+) and Chlorine (Cl-) were, respectfully, 121 mmol/L, 2.7 mmol/L and 87 mmol/L. Brain imaging displayed cerebral edema. Electrolyte levels were regulated with saline infusions. Amitriptyline was initiated for the ongoing headache and anxiety. In outpatient visits, hyponatremia did not recur in the following 3 months. Low dose duloxetine was associated with severe hyponatremia signs and symptoms in an individual who was not previously considered as high risk for hyponatraemia. The patient's history did not reveal any complaints related to hyponatremia when she was treated with sertraline two years ago. Based on these, we discussed the risk factors for hyponatremia and risky antidepressant classes.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75183716","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 explore the needs of patients with schizophrenia and to determine the sociodemographic and clinical variables associated with these needs. METHOD The study was carried out with 94 patients diagnosed with schizophrenia and their primary caregivers. The diagnoses were established based on DSM-IV-TR (American Psychiatric Association 1994) criteria. The patients' needs were evaluated with the Camberwell Assessment of Needs Scale (CAN), which reflects both the patient and the caregiver views on needs and problems. In addition, the Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, the Personal and Social Performance Scale, the Quality of Life Scale for Schizophrenia and the Perceived Family Burden Scale were used as data collection tools. RESULTS 'Psychotic symptoms' stood out as the most prevalent need to be met. 'Money' and 'intimate relations' were determined as the needs that the patients suffered most from. Being female, being married, living with families, having high school or higher education were found less associated with the needs. The variables explained 45.1% of the variance in predicting needs and 23.4% in predicting unmet needs. The Calgary Depression Scale for Schizophrenia and Perceived Family Burden Scale were significant predictors for patients and the PANSSPositive Symptoms Scale for caregivers. CONCLUSION Any treatment targeting solely the symptoms proves to be insufficient for patients with schizophrenia. Treatment planning should focus on the needs of patients and the needs identified by patients should be at the center of the treatment. A 'needs assessment' will make an important contribution not only to the planning of individual treatments but also to the planning of a community mental health services scheme and increasing its effectiveness.
{"title":"[Needs of Patients with Schizophrenia and Their Predictors].","authors":"Abdullah Burak Uygur, Ayşen Esen Danacı","doi":"10.5080/u23283","DOIUrl":"https://doi.org/10.5080/u23283","url":null,"abstract":"OBJECTIVE The aim of this study was to explore the needs of patients with schizophrenia and to determine the sociodemographic and clinical variables associated with these needs. METHOD The study was carried out with 94 patients diagnosed with schizophrenia and their primary caregivers. The diagnoses were established based on DSM-IV-TR (American Psychiatric Association 1994) criteria. The patients' needs were evaluated with the Camberwell Assessment of Needs Scale (CAN), which reflects both the patient and the caregiver views on needs and problems. In addition, the Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, the Personal and Social Performance Scale, the Quality of Life Scale for Schizophrenia and the Perceived Family Burden Scale were used as data collection tools. RESULTS 'Psychotic symptoms' stood out as the most prevalent need to be met. 'Money' and 'intimate relations' were determined as the needs that the patients suffered most from. Being female, being married, living with families, having high school or higher education were found less associated with the needs. The variables explained 45.1% of the variance in predicting needs and 23.4% in predicting unmet needs. The Calgary Depression Scale for Schizophrenia and Perceived Family Burden Scale were significant predictors for patients and the PANSSPositive Symptoms Scale for caregivers. CONCLUSION Any treatment targeting solely the symptoms proves to be insufficient for patients with schizophrenia. Treatment planning should focus on the needs of patients and the needs identified by patients should be at the center of the treatment. A 'needs assessment' will make an important contribution not only to the planning of individual treatments but also to the planning of a community mental health services scheme and increasing its effectiveness.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87770450","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}
Human microbiota are colonies of microorganisms located in different parts of the human body with diverse functions. Healthy gut microbiota comprises differing ratios of microoganisms wholly contributing to metabolic and other molecular reactions in a healthy, functioning body. After the demonstration of the bidirectional interaction between the central nervous system and gut microbiota through neuroendocrine, neuroimmune, and autonomic nervous mechanisms, investigations have been started on the microbiota-gut-brain axis in psychiatric disorders. Autism spectrum disorder (ASD), which is a neurodevelopmental disorder of early childhood, is one of these disorders. Most of such studies were cross-sectional and mainly investigated the bacterial species. Changes in gut microbiota composition and the leaky gut syndrome are some of the hypotheses proposed to explain the core symptoms and gastrointestinal (GI) symptoms of ASD. Probiotics, prebiotics, fecal microbiota transplantation, diet have been proposed as treatment options. However, the role of microbiota in diagnosis, followup, and treatment is not yet clear. The bidirectional interaction between central nervous system and intestinal microbiota makes it difficult to establish the cause-effect relationship. The current data on microbiota may be useful to plan patient-specific treatment in autistic children with GI symptoms. This article aims to review the results of the studies on microbiota in animal models and children and discuss the emerging clinical relationship of ASD and gut microbiota.
{"title":"[The Role of Gut Microbiota in Autism Spectrum Disorder].","authors":"Burcu Ersöz Alan, Fulya Gülerman","doi":"10.5080/U23560","DOIUrl":"https://doi.org/10.5080/U23560","url":null,"abstract":"Human microbiota are colonies of microorganisms located in different parts of the human body with diverse functions. Healthy gut microbiota comprises differing ratios of microoganisms wholly contributing to metabolic and other molecular reactions in a healthy, functioning body. After the demonstration of the bidirectional interaction between the central nervous system and gut microbiota through neuroendocrine, neuroimmune, and autonomic nervous mechanisms, investigations have been started on the microbiota-gut-brain axis in psychiatric disorders. Autism spectrum disorder (ASD), which is a neurodevelopmental disorder of early childhood, is one of these disorders. Most of such studies were cross-sectional and mainly investigated the bacterial species. Changes in gut microbiota composition and the leaky gut syndrome are some of the hypotheses proposed to explain the core symptoms and gastrointestinal (GI) symptoms of ASD. Probiotics, prebiotics, fecal microbiota transplantation, diet have been proposed as treatment options. However, the role of microbiota in diagnosis, followup, and treatment is not yet clear. The bidirectional interaction between central nervous system and intestinal microbiota makes it difficult to establish the cause-effect relationship. The current data on microbiota may be useful to plan patient-specific treatment in autistic children with GI symptoms. This article aims to review the results of the studies on microbiota in animal models and children and discuss the emerging clinical relationship of ASD and gut microbiota.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86327274","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 Gender dysphoria refers to the experienced discomfort related to the incongruence between gender identity and the sex assigned at birth. Current treatment approach for this clinical condition is gender affirmation procedures. International guidelines about gender affirmation do not recommend routine genetic evaluation. In Turkey, provision of health insurance for medical expenses incurred by these procedures requires genetic consultation which frequently involves chromosome analysis (karyotyping). However, the contribution of routine chromosome analysis to the assessment and management of gender dysphoria is not established. This study aims to assess the results of chromosome analysis and its effect on the management of gender dysphoria. METHOD The completed chromosome analysis results and observational records of 217 individuals among a total of 281 evaluated for gender affirmation in the psychiatry polyclinic were investigated retrospectively. RESULTS The chromosome analysis results of 213 (98.2 %) of the 217 individuals investigated were congruent with the sex assigned at birth. Variations were found in the karyotypes of 4 individuals with female sex assigned at birth, only 1 of whom had been diagnosed with a disorder of sex development. In the other cases, however, chromosome analysis did not affect the diagnosis or the clinical intervention. CONCLUSION Finding that routine chromosome analysis during the assessment for gender affirmation process rarely affected the clinical diagnosis and the treatment was consistent with the reports of previous studies and supported the recommendation that chromosome analysis should be carried out only in cases where history, physical examination and the required imaging investigations suggested a disorder sex development.
{"title":"[Chromosome Analysis in the Assessment for Gender Affirmation Process: A Retrospective Study].","authors":"A. Bağcaz, O. Boduroglu, K. Başar","doi":"10.5080/u23572","DOIUrl":"https://doi.org/10.5080/u23572","url":null,"abstract":"OBJECTIVE Gender dysphoria refers to the experienced discomfort related to the incongruence between gender identity and the sex assigned at birth. Current treatment approach for this clinical condition is gender affirmation procedures. International guidelines about gender affirmation do not recommend routine genetic evaluation. In Turkey, provision of health insurance for medical expenses incurred by these procedures requires genetic consultation which frequently involves chromosome analysis (karyotyping). However, the contribution of routine chromosome analysis to the assessment and management of gender dysphoria is not established. This study aims to assess the results of chromosome analysis and its effect on the management of gender dysphoria. METHOD The completed chromosome analysis results and observational records of 217 individuals among a total of 281 evaluated for gender affirmation in the psychiatry polyclinic were investigated retrospectively. RESULTS The chromosome analysis results of 213 (98.2 %) of the 217 individuals investigated were congruent with the sex assigned at birth. Variations were found in the karyotypes of 4 individuals with female sex assigned at birth, only 1 of whom had been diagnosed with a disorder of sex development. In the other cases, however, chromosome analysis did not affect the diagnosis or the clinical intervention. CONCLUSION Finding that routine chromosome analysis during the assessment for gender affirmation process rarely affected the clinical diagnosis and the treatment was consistent with the reports of previous studies and supported the recommendation that chromosome analysis should be carried out only in cases where history, physical examination and the required imaging investigations suggested a disorder sex development.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88864953","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}
Bupropion is a selective norepinephrine and dopamine reuptakeinhibitor. It is used in the treatment of depression and nicotineaddiction. When compared to the other antidepressants, bupropion hasa relatively lower risk of triggering shift to hypomania or mania in bipolardepression treatment. Here we report two cases of bipolar depressionpatients with manic shift when bupropion was used as an adjunct tomood stabilizer treatment. The first was a 43-year old female patient.Manic symptoms occurred after bupropion was added to lithium andquetiapine treatment for bipolar disorder (BD) depressive episode.Her manic symptoms regressed rapidly after discontinuing bupropiontreatment. The second patient was a 26-year old male on lithium andvalproate therapy with a BD diagnosis. After bupropion was added tohis treatment for depressive symptoms, psychotic mania ensued and hehad to be admitted to the hospital. Significant improvement was notedshortly after bupropion was discontinued and antipsychotic treatmentwas initiated.
{"title":"[Manic Shift Due to the Use of Bupropion in Bipolar Depression:Two Case Reports].","authors":"Evnur Kahyacı Kılıç, Yasemin Görgülü, Rugül Köse Çınar, Mehmet Bülent Sönmez","doi":"10.5080/u23391","DOIUrl":"https://doi.org/10.5080/u23391","url":null,"abstract":"Bupropion is a selective norepinephrine and dopamine reuptakeinhibitor. It is used in the treatment of depression and nicotineaddiction. When compared to the other antidepressants, bupropion hasa relatively lower risk of triggering shift to hypomania or mania in bipolardepression treatment. Here we report two cases of bipolar depressionpatients with manic shift when bupropion was used as an adjunct tomood stabilizer treatment. The first was a 43-year old female patient.Manic symptoms occurred after bupropion was added to lithium andquetiapine treatment for bipolar disorder (BD) depressive episode.Her manic symptoms regressed rapidly after discontinuing bupropiontreatment. The second patient was a 26-year old male on lithium andvalproate therapy with a BD diagnosis. After bupropion was added tohis treatment for depressive symptoms, psychotic mania ensued and hehad to be admitted to the hospital. Significant improvement was notedshortly after bupropion was discontinued and antipsychotic treatmentwas initiated.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85348464","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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